Mental Health. 2025; Volume 20. Issue 11

An analysis of state statistical data for the period from 2022 to 2024 is presented. During the reporting period, the total number of psychiatric institutions in the country decreased, mainly due to their consolidation. At the same time, there was an expansion of the network of outpatient departments. The number of institutions with psychiatric offices, as well as other medical units – including inpatient rehabilitation departments, first-episode psychosis clinics, and therapeutic workshops – increased. A significant growth was observed in the number of medical organisations with psychotherapy departments and offices. Positive trends in the organisation of psychiatric care include an increase in the number of psychiatrists, child psychiatrists, psychotherapists, and medical psychologists. The reorganisation of the psychiatric care network was accompanied by the development and strengthening of outpatient services and the introduction of a team-based approach to the treatment and rehabilitation of patients, including the formation of independent living skills. On average across the country, the incidence and prevalence of mental disorders did not change significantly during the reporting period. The decline in suicide mortality among patients under dispensary observation, which began in previous years, continued. The use of hospital-substituting technologies remains an important element of treatment and rehabilitation work, contributing to the preservation and development of the principle of patient comfort and non-restrictiveness. It is necessary to further disseminate them in the system of providing psychiatric care to the population of the Russian Federation.

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

Since January 1, 2024, Federal Law No. 10 FZ «On Probation» has been in force in the Russian Federation, which establishes three types of probation (executive, penitentiary and post-penitentiary) and an interdepartmental support model. This has created a new circuit of interaction between the penal enforcement system, employment, social protection and health services, which is critically important for people with mental disorders. The article summarizes the legal, organizational, and clinical and social features of probation for people with mental disorders and suggests a practical model of an interdepartmental route consistent with current Russian regulations and international recommendations. Regulatory and literary review: analysis of 10 Federal laws, by-laws (on probation centers and the Unified Register), legislation on psychiatric care and health protection; consideration of European probation rules and the recent Council of Europe recommendation on the mental health of convicts; review of international guidelines and scientific reviews on the needs and continuity of care. The key features of working with the target group in the context of three types of probation are highlighted; the «patient’s probation route» is proposed with stages T–90/T–30 before release and T+7/T+30/T+90 after, with a list of control points for screening, transfer of medical information on a legitimate basis (consent/other grounds), the appointment of visits to PHE/day care facilities, the continuity of pharmacotherapy and social support. The legal requirements for informed voluntary consent, medical secrecy and the work of the Unified Registry are noted, and the effectiveness metrics are determined: the proportion of visits to the HDP is less than 7/30 days, the continuity of drug therapy is 30/90 days, the proportion of employed is less than 90 days, repeat hospitalizations and outcomes. The implementation of probation in the Russian Federation creates conditions for the systemic continuity of psychiatric care while respecting the rights of patients. For the sustainability of the results, unified regional agreements between probation and healthcare entities, specialized training, and monitoring of clinical and social indicators in accordance with international standards are needed.

Keywords: probation, mental disorders, resocialization, continuity of care, dispensary supervision, convicts

Introduction. Normal aging is accompanied by changes in cognitive functions and the functional organization of the brain. The brain’s default mode network (DMN) is a key resting-state network, and its alterations may serve as an early marker of aging, independent of cognitive reserve.

Aim. To identify the specifics of the activity and functional connectivity of brain structures within the default mode network in elderly and very old women compared to a young control group using a novel EEG localization method («virtually embedded electrode»).

Methods. A cross-sectional study was conducted. Resting-state EEG was recorded in 284 women from three age groups: young (18–44 years, n=37), elderly (60-75 years, n=133), and very old (75-90 years, n=114). The elderly groups were further stratified into subgroups with normal cognitive status (MoCA/MMSE=29-30) and with cognitive impairment (MoCA/MMSE<29). The activity of 53 cerebral structures was reconstructed using a spatial filtering method («virtually embedded electrode», Russian patent No. 2785268). The amplitude of activity and functional connectivity (correlation coefficients) between structures were assessed. Statistical analysis was performed using Student’s t-test with correction for multiple comparisons (α<0.01).

Results. No statistically significant differences in DMN functional connectivity were found between elderly groups with preserved cognitive status and those with cognitive impairment. When all elderly and very old subjects were combined and compared to the young group, significant differences in the functional connectivity system were revealed. Strengthening of hypothalamus connectivity with subcortical structures (globus pallidus, putamen, thalamus), amygdala, and frontal cortex was found, as well as weakening of its connections with the brainstem and midbrain. Changes in the activity strength of individual structures were significant only in the very old group with cognitive impairment.

Conclusion. The data obtained demonstrate that age-related changes in the functional organization of the brain’s default mode network, particularly the reorganization of hypothalamus connections, are a universal marker of aging that does not depend on the severity of cognitive decline. The proposed EEG localization method allows for a quantitative assessment of these changes and can be used for the objective diagnosis of age-related brain changes.

Keywords: aging, default mode network, functional connectivity, electroencephalography, hypothalamus, cognitive reserve, virtually embedded electrode

Introduction. Persistent psychovegetative disorders in the clinic of anxiety disorders in patients who have been infected with SARS-CoV-2 are a serious obstacle to recovery, leading to chronization and causing the resistance of anxiety symptoms to therapy. In this study, the authors planned to study the relationship between the clinical and psychopathological characteristics of anxiety and immunobiological parameters within the framework of the immunoinflammation model in order to predict the effectiveness of therapy.

Methods. The study was conducted on the basis of descriptive clinical-psychopathological and clinical-dynamic methods, as well as using the following tools: «Research scheme for detecting signs of autonomic disorders» to assess the severity of psychovegetative symptoms; «C.D. Spielberger anxiety scale adapted by Yu.L. Khanin» – to analyze the intensity of anxiety symptoms; «General health questionnaire MOS SF-36» – assessment of the quality of life. The concentrations of cortisol, C-reactive protein, and interleukin-6 in blood serum were analyzed as immunobiological markers. The statistical analysis was performed using the licensed software StatSoft Statistica version 10.0.

Results. The study involved 40 patients who met the inclusion criteria and were treated at the Mental Health Research Institute clinics of the Russian Academy of Sciences, of whom n=32 (80%) women and n=8 (20%) men. The clinical group was divided into two subgroups based on the results of a clinical dynamic assessment of mental state during therapy based on a cluster analysis using the k-means method: the first subgroup (n=24) with a slight improvement or no effect; the second subgroup (n=16) with a significant and significant improvement in mental state. It was found that the mental state of patients in both subgroups was classified as polymorphic, with leading anxiety symptoms combining end-to-end and persistent depressive (subdepressive, dysthymic), hypochondriac, asthenic and dyssomnic manifestations. Patients of the first subgroup were characterized by a greater severity of psychovegetative disorders, without significant dynamics in terms of reactive, personal anxiety and quality of life. Patients of the second subgroup were characterized by a lower intensity of psychovegetative symptoms, a decrease in the value of reactive anxiety and an improvement in the quality of life characteristics according to the «mental component of health» parameter during therapy. Immunobiological parameters in patients of the first subgroup before the start of therapy were characterized by higher values of cortisol levels (p=0,0003), concentrations of C-reactive protein (p=0,0002) and interleukin-6 (p=0,0002). There were no differences in the dynamics of immunobiological parameters after three weeks of therapy for each of the subgroups.

Discussion. The difference in clinical and therapeutic dynamics may be due to the influence of chronic smoldering inflammation, which continues in the post-covid period, and the synthesis of pro-inflammatory cytokines with the development of a cascade of inflammatory reactions. In this regard, increased levels of cortisol, C-reactive protein and interleukin-6 are considered as markers of a persistent inflammatory process associated with psychovegetative dysregulation and maintenance of relevant anxiety symptoms in patients during the post-covid period.

Conclusion. The obtained clinical, psychopathological, psychological and immunobiological data can be used in the diagnosis and prognostic assessment of the effectiveness of therapy for psychovegetative disorders in the structure of anxiety disorders in patients in the post-covid period.

Keywords: psychovegetative disorders, anxiety, post-covid syndrome, immune inflammation

Introduction. This publication is devoted to the study of the age-related dynamics of neurocognitive deficit in schizotypal disorder (SD) using a comprehensive express method for assessing neurocognitive profiles.

Methods. Fifteen adolescent and 11 adult patients with a verified diagnosis of SD, who were undergoing inpatient treatment at the Federal State Budgetary Scientific Institution Scientific Center for Mental Health, were examined.

Results. The average neurocognitive profile of both adults and adolescents with SD reveals deviations from the norm in all parameters, while more severe violations in most parameters of neurocognitive functioning are observed in the sample of adult subjects. At the same time, the indicators of cognitive control, phonemic and general verbal fluency are more stationary – almost similar in both groups.

Conclusion. In the neurocognitive profile of the studied groups, both relatively stationary and dynamic indicators can be identified. The indicators primarily related to regulatory (frontal) functions (planning, control, phonetic verbal fluency) are relatively stationary – they demonstrate significant differences from the norm already in adolescence. The indicators related to right-hemispheric and subcortical functions (visual-spatial, visual memory) are subject to dynamics, which may indicate their increasing deficit with the course of SD.

Keywords: schizotypal disorder, neurocognitive deficit, age-related changes, cognitive control, phonemic verbal fluency, visual-spatial functions, visual memory, frontal lobe functions, subcortical functions

In order to identify the structural and dynamic characteristics of the protective and coping response and the nature of the effects of asthenia, depression and anxiety, 150 police officers were examined, who were diagnosed with somatoform autonomic dysfunction of the cardiovascular system in accordance with the ICD-10 criteria (F. 45.3).The study revealed and showed that the differences are both purely individual in nature and cross-cutting, reflecting a pronounced intrapersonal conflict. This indicates the weakness of the protection system for police officers suffering from somatoform autonomic dysfunction, regardless of gender, emphasizing their low adaptive capabilities, making it difficult to understand the problems. Constant internal tension associated with conflictogenic attitudes contributes to the formation of a stable stereotype of behavior and the style of adaptive response in conditions of stress-coping behavior. The features of the course of somatoform pathology, the qualitative uniqueness of its interrelationships with personal characteristics are the key to understanding the prognostic value of the formed compensatory and adaptive mechanisms, which significantly increases the effectiveness of medical support programs for police officers suffering from borderline mental pathology and timely provision of qualified medical and preventive care. The results of the study are proposed to be used in psychohygienic work with employees who are prone to somatoform reactions in conditions of duty, which will contribute to their professional success.

Keywords: somatoform vegetative dysfunctions, coping behavior strategies, mechanisms of protective response, police officers

The presented literature review complements the previously presented results of the analysis of foreign works with specific aspects that deserve the attention of specialists. The data on the effectiveness of non-pharmacological treatment methods in improving or maintaining cognitive functions, mood, work capacity, self-confidence, and quality of life is presented. The need for further differentiation of specialized assistance to the population and the development of specific segments is shown. This includes penitentiary psychiatry, given the significant prevalence of mental disorders among individuals in places of detention. Separate nosological forms of mental diseases also deserve significant attention, as they require personalized rehabilitation approaches based on the latest scientific developments due to their social significance and clinical characteristics.

Keywords: non-pharmacological treatment methods, development of mental health services, transcranial magnetic stimulation, neuromodulation, and penitentiary psychiatry

The review article reveals the main psychopathological disorders of religious content, including delusional ideas and hallucinations. Demographic, socio-psychological and epidemiological characteristics of patients with this pathology are given. The main clinical manifestations and types of delusions and hallucinations of religious content are analyzed with examples of mental disorders in the structure of which this symptom complex is most common. The issues of differential diagnostics of delusional and overvalued ideas are considered, and methods of treating patients with religious psychoproductive symptoms are touched upon. In conclusion, several cases of the described disorders are demonstrated, accompanied by aggression directed by patients at themselves and at those around them.

Keywords: psychopathology (delusional ideas, hallucinations), religious themes, socially dangerous actions of the mentally ill

Introduction. Anxiety and depression rank among the most prevalent mental disorders worldwide. The pathogenesis of these conditions involves multiple physiological systems, and alongside well-established mechanisms, emerging evidence points to the involvement of the immune system. Certain controversial findings also suggest a potential influence of AB(0) blood group antigens. An infectious component should not be ruled out either. Current scientific data highlighting the multifactorial origin of anxiety and depression have brought closure to several longstanding academic debates while simultaneously raising new questions about innovative therapeutic approaches for mental health disorders.

Methods. This non-systematic review was conducted through a comprehensive analysis of scientific publications selected for their relevance to the research theses. The investigation utilized both international (including PubMed database) and Russian scientific resources (particularly the eLibrary platform), enabling the development of a multidimensional evidence base. The study encompassed a thirty-year period (1993-2023), ensuring representative analysis of evolving scientific perspectives on the subject.

Results. The analytical results revealed several common pathogenetic mechanisms underlying anxiety-depressive disorders and immuno-metabolic disturbances. Furthermore, we examined data suggesting the potential involvement of viral persistence in the development of anxiety and depression. Additionally, the review discussed studies investigating the role of AB(0) blood group antigens, though the conclusions remain equivocal and warrant further investigation.

Conclusion. The obtained findings underscore the necessity for further investigation into the relationships between the immune-metabolic system, viral persistence, and mental health status. Furthermore, the existing knowledge gaps regarding the role of AB(0) blood group genetic markers are of particular interest from the perspective of developing novel therapeutic and preventive approaches for anxiety-depressive disorders.

Keywords: anxiety, depression, herpes virus. Cytomegalovirus. Epstein-Barr virus, blood groups

Introduction. This publication is a review of the literature on the manifestation of impulsivity in emotionally unstable personality disorders (F60.31, F60.30). Difficulties in defining the phenomenon, different views on the place of impulsivity in the psychopathological structure of personality disorders are discussed.

Objective. To present a review of the literature on the problem of impulsivity in personality disorders of the emotionally unstable circle.

Methods. By searching the scientific databases «PubMed» and «Google Scholar» by combinations of keywords «personality disorder», «impulsivity» were selectively selected publications corresponding to the aim of the study.

Results. Despite the fact that impulsivity is one of the main criteria for diagnosing personality disorders of this emotionally unstable circle, its independence can be called into question by the data of experimental studies.

Conclusion. One of the main findings is the difference between «cold» and «hot» cognitions in this cohort of patients – disturbances in the form of impulsivity are detected only when interacting with emotionally charged situations and stimuli, whereas in the case of neutral ones the results are generally no different from the control groups.

Keywords: impulsivity, personality disorders, BPD, neurocognitive impairment