Mental Health. 2025; Volume 20. Issue 1

The analysis of the data of the state statistical observation for the period from 2019 to 2023 is presented. It has been established that with a general reduction in the number of psychiatric organizations, the network of medical units of this profile has been preserved. There has been a redistribution of the number of positions occupied by psychiatrists, psychotherapists and medical psychologists in favor of the outpatient sector. In the course of a structural and dynamic statistical study conducted nationwide, dynamic trends in intensive indicators of primary and general morbidity of mental disorders and dispensary follow-up have been established. The data obtained can be used for further in-depth comparative evaluation of data in diagnostic, age and organizational aspects at the regional and interregional levels.

Keywords: organization of psychiatric care, psychiatric service, mental disorders and behavioral disorders, contingents of patients registered with the psychiatric service, dispensary supervision, monitoring of activities

Introduction. Difficulties in achieving remission of rheumatoid arthritis (RA) may be associated not only with the pathogenetic features of the disease, but also with the psychological features of the patient, in particular, with alexithymia. A number of researchers have noted a higher level of alexithymia in rheumatological patients, and the relationship of alexithymia with pain perception in patients with RA has been shown. The aim of the present study was to assess alexithymia in patients with RA and its relationship with the peculiarities of the course of the disease.

Methods. A total of 72 patients (62 of them women) diagnosed with RA were included in an open, uncontrolled, non-randomised, single-stage study. Alexithymia was investigated by questionnaire using the Russian-language version of the Toronto Alexithymic Scale.

Results. Alexithymia was detected in every second (55.6%) patient with RA. RA patients with «alexithymic» personality type were older (p=0.029), had a later onset of the disease (p=0.049) with no significant difference in its duration (p=0.095). On objective examination, they had more swollen joints (p=0.008), higher levels of COE (p=0.004) and CRP (p=0.045), and high disease activity according to the DAS28 index (p=0.024); arthritis of peripheral joints was more often erosive (p=0,044), radiological changes in joints were more pronounced (p=0,013), complications of the main disease were registered 2 times more often (p=0,036). Correlation analysis demonstrated a positive correlation between the severity of alexithymia and the main indicators characterising the severity of RA course. The case history of a patient with a high alexithymia score, whose underlying disease was characterised by a relatively unfavourable course according to the totality of clinical data and «response» to pharmacotherapy, is presented.

Discussion. The absence of a significant effect of RA duration on the level of alexithymia suggests that alexithymic characteristics were not a consequence of the impact of rheumatic disease on the patient’s personality; on the contrary, alexithymia can be considered as one of the risk factors for the development of RA.

Conclusion. «Alexithymic» type of personality is associated with a later onset of RA, clinically pronounced arthritis, elevated acute-phase proteins, higher indices of disease activity, significant radiological changes in peripheral joints, more frequent development of complications of the underlying disease and additional difficulties in the selection of pathogenetic therapy.

Keywords: alexithymia, Toronto Alexithymic Scale, rheumatoid arthritis, clinical characteristics

Introduction. The study is devoted to the analysis of the phenomena of awareness in psychotherapy and the role of the formation of mindfulness skills in the client as the basis and conditions for the success of therapy in various psychotherapeutic areas. The process of forming the client’s awareness can serve as a universal principle of psychotherapy of any direction and a unifying link in the implementation of integrative psychotherapy. In the practice of modern psychotherapy, a psychotherapist increasingly goes beyond any one psychotherapeutic system, forming a «technical eclecticism» – combining techniques from different directions during one session. Despite the fact that psychotherapists belong to different schools, they use standard methods of forming a psychotherapeutic alliance: establishing rapport, empathy, questioning, listening, etc. However, it seems that the integration of approaches takes place not only at the formal and technical level common to all forms of therapy, but also at a deeper, meaningful level and also common to different approaches – on the phenomenon of the client’s awareness of his own ineffective strategies, states of «here and now», etc.

Aim: analysis of the place of mindfulness formation practices in the client of psychotherapy in a number of the most popular psychotherapeutic areas.

Method. An observational study of psychotherapeutic practices to find common approaches to the development of mindfulness.

Results. Awareness is the ability of consciousness to introspect its own activities. The phenomenon of mindfulness is paradoxical: most of the time, a person does not reflect on their own states and behavior, but acts in accordance with stereotypes and automatisms that «turn off» consciousness. The skill of mindfulness is not easy for a person: consciousness, directing the beam of attention to its own states, encounters resistance. The development of mindfulness skills becomes the subject of psychotherapeutic study, the purpose of which is for the client to learn how to master the skill of reflexive thinking.

The analysis of the array of techniques for developing mindfulness allows us to reduce all their diversity to three main factors: the training of inner contemplation in order to detect and fix internal states, identify them and search for the causes that caused them. Three techniques are based on these factors, which are taught in three stages.

The first stage: Reflection training. The client learns introspection, as well as perception of sensory signals. The second stage is the identification of sensations, experiences, and thoughts. The main difficulty is that most people cannot answer the question of what emotion, experience, or feeling they are experiencing, so at this stage the client learns the semantics of emotions and experiences. The third stage: Learning to identify the sources and causes of experience and sources of thought.

Observations show that in a number of simple cases, the awareness skill formed during one or two sessions is sufficient for the client to cope with his own feelings, obsessive thoughts, anxiety and regret. The skill of mindfulness is therapeutic in itself, has the effect of «mini-cognitive behavioral self-therapy» and serves as the basis for the successful promotion of therapy at all stages, making it more effective and reducing its duration.

Conclusion. The «gold standard» of techniques used in every area of psychotherapy (rapport, empathy, listening, etc.) can be supplemented by developing mindfulness skills in the client. Developed awareness is the initial condition for effective progress in therapy. If the client is competent in matters of his own state of mind and emotions, understands at every moment what is happening to him, then this helps to shorten the duration of therapy, effectively cope with his unproductive emotions, cognitions and behavioral impulses.

Keywords: mindfulness, awareness, integrative psychotherapy, success of psychotherapy

Introduction. In the situation of increasing frequency of diagnosis of chronic somatic diseases in minors, the ability to self-regulation becomes particularly important as a factor of complaensis. The aim of this study was to identify the characteristics of self-regulation in adolescents suffering from chronic somatic diseases.

Methods. The experimental study was conducted using techniques: «Style of self-regulation of behavior» V.I. Morosanova, «Questionnaire of voluntary self-control» A.V. Zverkova, E.V. Eydman, «Self-regulation» A.K. Osnitsky. Sample: 60 adolescents aged 14–17, including 40 adolescents with the diagnosis «bronchial asthma» and «type 1 diabetes» and 20 adolescents without chronic somatic diseases. The non-parametric U-critterion of Mann-Witney was used to process the obtained data.

Results and discussion. There are reliably significant differences in the self-regulation of adolescents of experimental subgroups and control group on the following structural components: «programming», «persistence», «voluntary self-regulation». The nozological specificity of structural features of self-regulation was identified in a comparative analysis of experimental subgroups of adolescents with bronchial asthma, type 1 diabetes mellitus and adolescents without chronic diseases: Type 1 diabetes adolescents are reliably different from the control group on indicators «modelling», «programming», «flexibility» and «general level of self-regulation», adolescents with bronchial asthma are reliably different from the control group on indicator «flexibility» and have a higher «flexibility» score.

Conclusion. The specificity of the self-regulation features of adolescents with the diagnosis «bronchial asthma» and «type 1 diabetes» is confirmed by its presence in adult patients in previous studies. The information gathered can be used to determine optimal treatment commitment and to establish prevention programmes for developing anxiety disorders in adolescents.

Keywords: self-regulation, adolescents, chronic somatic disease, bronchial asthma, diabetes mellitus

Objective: assessing quality of life in police officers suffering from somatoform vegetative dysfunction of the gastrointestinal tract. The sample was made by 108 police officers for whom according to criteria of ICD-10 the somatoform vegetative dysfunction of the gastrointestinal tract was diagnosed (F.45.32). The study identified the role of perfectionism as a factor that affects the formation of a system of moral and value qualities due to overestimated claims to others and self-requirements, orientation on the selection of information about their own failures and errors. The identified correlation relationships of the scale «overestimated claims and self-requirements» and «selection of information about their own failures and errors», which was reflected in the nature of the presentation of moral qualities in the system and showed their mutual influence in the conditions of somatoform vegetative dysfunction of the gastrointestinal tract. One should understand the inability of the patient in the early stages of treatment to abandon the «pursuit of the ideal,» since this refusal leads to remorse, self-humiliation and painful forms of self-punishment. The constant internal tension associated with conductionist aspirations and attitudes contributes to the formation of a stable stereotype of behavior and the style of adaptive response in condition stress-coping behavior. The peculiarities of the somatoform pathology course, the qualitative peculiarity of its relationships with personal characteristics is the key to understanding the prognostic value of the formed compensatory-adaptive mechanisms, which significantly increases the effectiveness of medical support programs for internal affairs officers suffering from borderline mental pathology and timely provision of qualified therapeutic and preventive care to them.

Keywords: somatoform disorders, perfectionism, moral and ethical qualities, police officers

The description and isolation of epileptiform manifestations without genetic and metabolic substantiation of their origin in the form of syndromes (in particular, Ohtahara syndrome, West syndrome, Lennox-Gastaut syndrome, Dravet syndrome) occurred in the early period of clinical and empirical accumulation of information about epilepsy, the study of the features of EEG, the empirical search for more effective antiepileptic drugs (AEDs). As a result, a dramatic situation has developed: the genesis of these syndromes is based, in fact, on the same molecular-metabolic-genetic causes, reflecting the heterogeneity of epileptogenesis and the need for personalized pathogenetic therapy, but instead attempts are made empirically by the method of «trial and error» to identify the most effective drug (or 2-4 at once) for each or every syndrome. As a result, average recommendations are formulated, leading, in most cases, only to the palliative effect, the accumulation of de novo mutations, poisoning of the central nervous system and internal organs, the so-called AEDs (which, according to the mechanisms of action, are neurotoxic poisons), the additional inclusion of genetic and metabolic defects and, as a result, to the transformation of clinical manifestations into a more severe syndrome.

Keywords: Ohtahara syndrome, West syndrome, Lennox-Gastaut syndrome, Dravet syndrome, epilepsy, antiepileptic drugs

This literature review is dedicated to the problem of shperrung — a well-known yet ambiguous phenomenon of impaired spontaneity of thought. The presented literary material is based on a search for Russian and English articles in the following databases: ELibrary.ru, Web of Science, Scopus, Clinical Case, PubMed, Cochrane Database of Systematic Reviews. The search for articles was conducted using the keywords: schperrung; spontaneity of thought; automatism; basis symptoms of schizophrenia. Inclusion criteria: full-text articles in Russian and English; original studies; Cochrane reviews; clinical observations; publication date – from 1900 to 2024. Exclusion criteria: abstracts, theses, educational materials; publication date – before 1900. A total of 126 publications were found. 39 publications met the inclusion/exclusion criteria. It discusses the phenomenological descriptions of this phenomenon across different historical periods, from the classics of psychiatry to the present day, as well as related states, possible typologies of shperrung, its relationship with catatonia and schizophrenia, and its position in contemporary diagnostic classifications. Attention is given to the modern interpretation of shperrung as a basis symptom of schizophrenia. The authors of the review conclude that there is a considerable list of unresolved questions related to shperrung, believing that clarifying these issues could be beneficial for improving the quality of modern diagnosis and therapy of mental disorders.

Keywords: shperrung, spontaneity of thought, automatism, basis symptoms of schizophrenia