Mental Health. 2025; Volume 20. Issue 5

The procedure of examining patients using the Protocol of structured professional psychological judgment, developed to assess the psychological factors influencing the formation of socially dangerous behavior in people with severe mental disorders, is described. The features and procedure of its application in psychiatric service units are described as an addition to the SOROP methodology and clinical assessment. The protocol allows taking into account individual personal characteristics of patients, structuring professional judgments of specialists and increasing the accuracy of forecasting potential public danger. It is shown that its application contributes to the objectification and evidence-based decision-making, as well as the integration of an integrated multidisciplinary approach into the risk assessment procedure.

Keywords: persons with mental disorders, illegal behavior, socially dangerous actions, prevention, risk assessment, psychological risk factors, protective factors, protocol of structured professional psychological judgment

Introduction. The aim of the research was to study the subjective attitude of students towards psychiatry, psychiatrists and mental disorders, in dynamics from junior to senior years, with an assessment of the impact of psychiatric supervision on the issues under consideration.

Methods. А survey of RostSMU students was completed in 2025. The author’s anonymous questionnaire was used, the results were analyzed using nonparametric statistical methods. 593 people participated in the study: students in the first (176 people; 29.7%), third (311; 52.5%) and fifth (106; 17.9%) courses of the Faculty of Medicine and Prevention; the fifth course was of particular interest because it provides supervision of psychiatry.

Results. A generally positive assessment of psychiatry by students has been established: the overwhelming majority of respondents consider it an «equal part of the family of medical sciences» (this opinion increases statistically significantly from the first to the fifth year). At the same time, every 20th senior year student does not consider psychiatry to be a part of medicine. The rating of psychiatry as a specialty among medical university students both at the beginning of their studies and at senior courses is significantly (p < 0.05) inferior to therapy, surgery and neurology. It does not undergo significant changes throughout the course of study – the supervision of psychiatry in the fifth year, in its modern form, does not contribute to improving the rating of the specialty in the understanding of students. Students adhere to the popular myth that psychiatry is engaged in providing assistance almost exclusively to patients with psychotic forms. Having come to the first year relatively optimistic about the potential curability of mental disorders (60.8%), students paradoxically by the fifth year are more likely to speak in favor of the theory of the incurable psychopathology (56.6%). A significant part of the respondents (from 68% to 81%) considers a psychiatrist not just a doctor, but a doctor with additional competencies (in particular, knowledge of psychology). At the same time, this assessment significantly «melts» from the first year to the fifth, and in its place, the frequency of the belief that «a psychiatrist has significant problems increases significantly, and this is what leads him to the specialty.» By the senior years, 64.2% of students remain carriers of the myth of the danger of the mentally ill. This persistent reflection of the stigmatization of the mentally ill cannot be corrected over the years of higher medical education. As they master medicine, the number of students who believe that working in psychiatry increases the risk of developing a mental disorder increases significantly. On the other hand, even more significantly (p=0.02), the number of students who have come to the conclusion that the probability of acquiring a mental disorder while working as a doctor is high, regardless of the chosen specialty. When analyzing the relationships between the studied parameters and academic performance, it was revealed that students with low academic performance tend to perceive a psychiatrist more often as a person with special needs, who chose a profession because of this. At the same time, higher academic performance is associated with a higher probability of assessing a mental disorder as incurable.

Conclusions. Based on the results of the study, the authors conclude that there is an urgent need to modernize the modern system of pre-graduate education in psychiatry.

Keywords: psychiatry, pre-graduate education, stigma, students

Introduction. Providing assistance through telemedicine consultations has now become of leading importance in the daily medical practice of medical organizations, in this regard, it is necessary to analyze the main errors in the formation of requests for telemedicine consultations and search for ways to eliminate them. To date, the literature has not covered the issue of difficulties in the organization of telemedicine consultations, in particular, the mistakes made, which makes this study relevant. This article discusses the problems and mistakes made in the formation of requests for telemedicine consultations, which affects the quality of care in clinical practice.

Aim: to study and evaluate the main errors in the formation of requests for telemedicine consultations for the subsequent correct organization of this process.

Methods. An analysis of 4519 requests for telemedicine consultations (TMС) sent to the Serbsky National Medical Research Center for Psychiatry was carried out. To process the received requests in accordance with the order of the Ministry of Health of Russia dated 30.11.2017 No 965n, the digital platform «Telemedicine system of remote consultations at the federal and regional levels» was used. TMС’s requests came from the Central, Ural, Siberian and Far Eastern Federal Districts, the «new territories», as well as from other federal districts (Volga, Southern, North Caucasian). TMС’s request was received and processed by the operator of the telemedicine center (TMC), the compliance of the submitted documents on the telemedicine request with the requirements of the current legislation was checked (Federal Law of 21.11.2011 No 323-FZ «On the Fundamentals of Public Health Protection in the Russian Federation»; Federal Law of 27.07.2006 No 152-FZ «On Personal Data»; Law of the Russian Federation of 02.07.1992 No 3185-1 «On Psychiatric Care and Guarantees of the Rights of Citizens in the Provision of Psychiatric Care») and provisions Based on the results of processing the request, a decision was made either to accept TMС’s request for execution, or to reject the request, informing the medical organization that initiated TMС’s request about the reasons for the rejection.

Results. The analysis revealed the remaining problems in the formation of requests and the execution of the medical documentation provided. The vast majority of TMС’s requests in the period from January 1, 2020 to December 31, 2024 - 3087 (68.31%) were made without significant errors, while 1432 requests were rejected due to gross violations and errors in the execution of the request. It is advisable to structure and divide the identified errors into the following groups: errors in the execution of consents to the processing of personal data and the conduct of TMС; errors in the registration of the patient’s personal information; errors in specifying the consultation profile; errors in the information about the medical organization that initiated the request for TMС and the attending physician; errors in registration or lack of medical documentation; errors in the use of ICD-10 codes; errors in the choice of TMС form; mistakes in choosing the purpose of the consultation. The reasons for errors are: poor knowledge of regulatory documents governing the processing of TMС requests; registration of requests for TMC by specialists who do not have medical education; lack of a sequence of preparation and execution of documentation for TMС’s request, fixed in the regulatory documents of medical organizations initiating TMС requests.

Conclusion. Telemedicine consultations in psychiatry have become an important tool for increasing the availability of care, especially in under-resourced and crisis settings. However, mistakes at the stage of preparation for such consultations can significantly reduce their effectiveness and even harm patients. Key challenges include the lack of clear communication protocols, underestimation of the importance of pre-assessment of the patient’s condition, as well as poor awareness of clinicians and patients about the specifics of the remote format. Eliminating these errors requires a comprehensive approach: the introduction of standardized training algorithms, training digital literacy specialists, adapting diagnostic tools to the online format, and actively involving patients in the communication process.

Keywords: telepsychiatry, telemedicine, teleconsultation, teleconsultation with videoconferencing

In order to assess the features of stress-coping behavior of police officers and determine the degree of influence of perfectionism on its character, 85police officers were examined, who, in accordance with the ICD-10 criteria, were diagnosed with hypertensive disease (I. 11.0). The study revealed that the style of protective behavior reflects the individual response profile in stressful situations. Relationships of perfectionism scales with co-behavior strategies and psychological protection mechanisms have been investigated. The role of perfectionism is identified as a factor involved in the development of hypertension through the tendency to set difficult goals and targets, as well as excessive requirements for oneself. Proposals are given on realization of obtained results in psychoprophylactic work with internal affairs officers, which will serve to increase their professional reliability.

Keywords: hypertensive disease, coping behavior strategies, style of adaptive response, psychoprophylaxis

Introduction. Tick-borne borreliosis, also known as Lyme disease, is a naturally occurring disease caused by bacteria of the genus Borrelia. With the increasing number of cases of tick-borne borreliosis, especially in areas with high concentrations of ticks, it is important to remember the consequences that have significant harm to human mental health. In recent years, this topic has become particularly relevant, thereby attracting the attention of the medical community.

Methods. A search and critical analysis of Russian-language and English-language articles was conducted in the following databases: Cyberleninka, RMJ, Pubmed, Scopus, WoS. The articles were searched using the following keywords: tick-borne borreliosis, neuroborreliosis, Lyme disease, nervous system damage, diagnostics. Inclusion criteria: full-text articles in Russian and English; original research, publication dates – from 1959 to 2025. Exclusion criteria: abstracts; textbooks; A total of 6553 publications were found. 654 publications met the inclusion criteria. 27 publications were included in the article.

Results. Neuroborreliosis is a serious medical problem that affects a significant proportion of patients, especially in endemic regions of Russia. At the same time, the greatest damage to the nervous system is observed in the North-West and in the Central part of the country. Despite the fact that chronic forms of the disease have a low official frequency, the actual level of diseases can be significantly higher, especially after undergoing an aerithematous form. The clinical course of neuroborreliosis varies, and symptoms of damage to the nervous system can manifest as meningoradiculitis or other neurological disorders.

Conclusion. It should be emphasized that specific cognitive impairments in the late stages of the disease remain insufficiently studied, although they have a significant impact on the quality of life of patients. Early diagnosis based on clinical manifestations and epidemiological data, as well as serological tests for antibodies to borrelia, can significantly increase the chances of successful treatment. Timely administration of adequate antibacterial therapy can significantly improve the condition of patients and prevent the progression of symptoms. The study of neuropsychological changes in patients in the late period of the disease is important for the development of effective strategies for the management and prevention of cognitive impairment.

Keywords: Tick-borne borreliosis, neuroborreliosis, Lyme disease, nervous system damage, diagnosis

The article is devoted to a comprehensive analysis of the possibilities and risks of using neurotechnology in penitentiary psychiatry. Based on an interdisciplinary review of modern research, the article considers the methods of virtual reality, artificial intelligence, transcranial magnetic stimulation and deep brain stimulation in the context of rehabilitation and resocialization of prisoners. It was found that virtual reality simulations simulating the consequences of crimes reduce aggression in 78% of participants, artificial intelligence algorithms increase the accuracy of predicting recidivism to 88%, and transcranial magnetic stimulation demonstrates effectiveness in correcting impulsive behavior. However, the implementation of these technologies is associated with ethical and legal challenges: the risks of algorithmic discrimination, forced neuromodulation and threats to personal autonomy. Using international experience as an example, the need to develop legal standards that guarantee the voluntariness of interventions and the transparency of algorithms is shown. A model of a balanced approach is proposed that combines innovation with the protection of fundamental human rights.

Keywords: neurotechnology, penitentiary psychiatry, virtual reality, artificial intelligence, bioethics, recidivism

The article is devoted to the scientific legacy of the outstanding Soviet psychiatrist and gerontopsychiatrist Nikolai Feofanovich Shakhmatov (1923–1996). The paper highlights the key stages of N.F. Shakhmatov’s scientific activity, examines his views on the treatment of mental disorders in late life, analyzes the contribution of cognitive impairments to the concept of «painful aging», its significance for modern views on the processes of involution, and compares his ideas with modern therapeutic strategies.

Keywords: gerontopsychiatry, N.F. Shakhmatov, mental aging, dementia, cognitive impairment, late-life psychosis, history of psychiatry