Mental Health. 2026; Volume 21. Issue 6

Electroconvulsive therapy (ECT) is currently a widely used treatment for mental disorders. However, its use in patients with cardiovascular disease is associated with some concerns. This literature review analyzes current data on the safety of ECT in high-risk cardiac patients (myocardial infarction, unstable angina, decompensated congestive heart failure, severe aortic stenosis, uncontrolled atrial fibrillation, uncontrolled hypertension, arrhythmias, abdominal aortic aneurysm, and implanted pacemakers). The pathophysiological mechanisms of the therapy’s effects on the cardiovascular system are examined. Particular attention is paid to strategies for minimizing the risk of mortality.

Keywords: electroconvulsive therapy, cardiovascular disease (high-risk group)

Introduction. This article presents the results of a study of eating disorders and suicide risk in medical students. The aim of the study was to determine the influence of eating disorder symptoms on the severity of suicide risk, as well as to identify sociodemographic and clinical predictors associated with increased suicidal tendencies.

Methods. The study was conducted at four medical universities, with a sample of 137 students. The Beck Suicide Inventory and the Eating Behavior Rating Scale were used.

Results and Discussion. According to the results, 54.7% of respondents had scores above the cutoff on the suicidal ideation scale. Regression analysis revealed that eating disorder symptoms explained 19.1% of the variance in suicidal ideation; however, when demographic variables were included, their contribution was reduced, and the model explained 40.4% of the variance.

Conclusions. Female gender and having a partner emerged as significant protective factors. The authors conclude that suicidal ideation in individuals at risk for eating disorders is most closely related to psychological and interpersonal aspects rather than specific eating symptoms.

Keywords: medical students, eating disorders, risk factors, suicide

Introduction. Post-traumatic stress disorder (PTSD) significantly impairs schoolchildren’s academic performance, social functioning, and emotional regulation, necessitating tailored educational interventions.

Aim: to analyze existing foreign research on school-based psychoeducational support of schoolchildren with PTSD and to identify ways to increase its effectiveness.

Methods. This study followed PRISMA guidelines to identify relevant scientific papers for systematic reviews and meta-analysis. The search was conducted in international scientific publication databases (PubMed, etc.). The sample included peer-reviewed studies (2000–2026) on school-aged (5-18 years) PTSD psychoeducational interventions. The final sample consisted of 45 publications.

Results. Trauma-focused cognitive behavioral therapy and cognitive behavioral intervention for trauma in schools reduce PTSD symptoms by 68-86 % post-treatment, with sustained effects at 6–12 months. Trauma-informed school approaches improve behavior and attendance but show smaller effects on symptoms.

Conclusion. School-delivered cognitive behavioral therapies are efficient for accessible, stigma-reducing psychoeducational support of PTSD schoolchildren. We recommend teacher training, parental involvement, and further randomized controlled trials to address gaps in chronic trauma and comorbidities in schoolchildren.

Keywords: PTSD schoolchildren, Trauma-Focused Cognitive Behavioral Therapy, Cognitive Behavioral Intervention for Trauma in Schools, traumatic experience, psychoeducational support, psychotherapy

The present literature review addresses both general and specific issues in contemporary forensic psychiatry, including the pathogenesis of mental disorders, legal frameworks, prison psychiatry, forensic psychiatric assessment, and compulsory treatment in both inpatient and outpatient settings. It is emphasized that legal epidemiology may serve as a scientific foundation for improving legislative frameworks and ensuring equitable and effective psychiatric care. It is further noted that a hierarchical machine learning model integrating patient history data and longitudinal clinical monitoring substantially improves predictive accuracy for aggressive behavior, while providing clinicians with instruments for timely risk assessment and the implementation of personalized preventive interventions.

Keywords: aggressive behavior, treatment methods, personalized medicine in mental health services

Aim: to study the use of psychotherapeutic methods in treatment for schizotypal disorder and draw conclusions about their potential efficacy.

Methods. Literature analysis from 2000 to 2026. Preference was given to systematic reviews, original studies, descriptions of individual clinical cases, and among them – works available in full-text format.

Results. The main psychotherapeutic methods in cognitive-behavioral, psychodynamic and mixed approaches in treatment for schizotypal disorder are considered. Special attention is paid to the methods of metacognitive therapy (MERIT, ESTS). Conclusions are drawn about the efficacy of psychotherapeutic treatment for schizotypal disorder.

Conclusion. Psychotherapy as a treatment for schizotypal disorder understudied enough. Current psychotherapeutic treatment evidence for schizotypy is limited and heterogeneous. Individual studies have demonstrated the potentially beneficial effect of psychotherapeutic interventions. Larger, high-quality randomized controlled trials are needed to confirm especially the efficacy of metacognitive psychotherapy, which has shown promising results in the treatment of schizotypal disorder.

Keywords: psychotherapy, psychotherapeutic treatment, schizotypal disorder, schizotypal personality disorder, systematic review

Introduction. The institutionalization of probation in the Russian Federation poses a challenge for penitentiary psychiatry to transition from fragmented care to continuous support for individuals with mental disorders involved in the criminal justice system.

Objective: to provide a conceptual justification for the role of probation as a tool for constructing a continuous trajectory (continuum) of psychiatric and addiction care for this category of persons.

Methods. An analytical review of contemporary Russian and international studies (n=18) in the fields of penitentiary psychiatry, epidemiology, criminology, and evidence-based intervention models (Risk-Need-Responsivity model, Good Lives Model), as well as regulatory legal acts of the Russian Federation, was conducted. A conceptual synthesis of philosophical-anthropological, clinical, and organizational approaches was carried out.

Results. A critical gap in care provision during the early post-penitentiary period was identified, associated with high risks of mortality and recidivism. The necessity of integrating departmental efforts based on the principles of «warm handover», procedural justice, and maintaining medical autonomy is substantiated. It is shown that the synthesis of risk management and Good Lives models creates a substantive framework for probation, addressing both clinical and social needs. The prospects for differentiated pathways for special groups (women, young adults, the elderly, persons with cognitive impairments) and the role of digital tools are considered.

Conclusion. Integrating probation and penitentiary psychiatry into a public health framework can transform the system from punitive to restorative. The Russian psychiatric school possesses the necessary resources to implement this model, with the key success factor being the formation of a therapeutic environment and a new quality of interagency interaction.

Keywords: probation, penitentiary psychiatry, continuum of care, rehabilitation, procedural justice, risk management, differentiated pathways

Background. Physical activity (PA) and structured physical exercises (PE) are considered an accessible and safe non-drug approach to maintaining cognitive health in the context of global population aging and the increasing prevalence of cognitive impairment.

Aim: to systematize current data on the mechanisms of the neuroprotective effect of PA, present a comparative analysis of the effectiveness of various types of PE, determine optimal exercise dosing parameters, and develop an algorithm for integrating PA into clinical practice at different stages of cognitive impairment.

Method. A literature review was conducted for 2020–2026 using PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library. Systematic reviews, meta-analyses, longitudinal cohort studies, and randomized controlled trials (45 sources in total) were selected.

Results. Physical activity has a positive effect on brain structure and function: it increases hippocampal volume and cortical thickness, maintains white matter integrity, improves network functional connectivity, and slows the accumulation of tau pathology (accounting for up to 84% of the cognitive effect). According to most studies, the optimal target range for stepping activity is 5,000–7,500 steps/day. Strength training is most effective for global cognition and inhibitory control (SUCRA 82.1%), physical and mental exercises for working memory and task switching (SUCRA 85.1–89.7%), and aerobic exercise for episodic memory (SUCRA 76.8%). Long-term physical activity reduces the risk of dementia by 24–40%, and improves global cognition in patients with mild cognitive impairment (SMD = 0.36–0.80). In patients with dementia, physical activity stabilizes function and reduces the risk of falls by 31%.

Conclusion. Physical activity is an effective, safe, and affordable means of preventing and correcting cognitive impairment. The greatest benefit is achieved by transitioning from a sedentary lifestyle to a moderate level of activity (5,000–7,500 steps/day). Personalized exercise selection based on the priority cognitive domain, genetic profile, and stage of cognitive decline maximizes the clinical effect. We recommend integrating physical activity assessment into routine clinical practice and developing programs to support long-term patient adherence.

Keywords: cognitive rehabilitation, dementia, Alzheimer’s disease, physical activity, prevention of cognitive decline

Introduction. The creation of new classifications of diseases is an undoubted fact of advancing medical science, rethinking approaches to diagnosis and systematization of various types of pathology. However, this process should take place when all the possibilities of the previous classification have been exhausted and the principles on which the new one is based are radically different from the previous one, especially in terms of finding objective criteria for pathological processes. The study aims to show that ICD-10, being an empirical system based on a subjective assessment of clinical data, has found patterns that correlate with neurophysiological changes in the brains of patients with psychopathology and has not yet exhausted its diagnostic capabilities. Its significant disadvantage was the lack of objective neurophysiological criteria, and this mistake should not be repeated in the future.

Methods. A routine EEG examination of patients using the alpha rhythm dispersion analysis method was conducted at the Regional Clinical Neuropsychiatric Dispensary in Tver, who are undergoing treatment and examination in inpatient departments. To conduct the study, a special methodology was developed for creating a database of conclusions based on the results of EEG studies based on licensed MS Excel software and encephalographs from Medical Computer Systems LLC, Zelenograd, Russia.

Results. Over the course of 20 years, 15,836 dispensary patients with various psychopathologies participated in the study, of which 75% were men and 25% were women. The hypothesis was confirmed that the parameters of the alpha rhythm variance, being a marker of the entropy of the neural-glial network of the brain, correlate with the severity of psychopathology: the higher the parameters of the entropy of the brain, the more severe the disease. At the same time, the general trend in the ICD-10 classification, based on the principle of reducing the severity of the disease from F00x to F69x in adults, was a decrease in the severity of entropy according to the parameters of the alpha rhythm variance analysis. In diseases that began in childhood, at F70x-F79x, the severity increased with increasing brain entropy, and then from F80 to F99, it decreased with decreasing entropy.

Discussion. The ICD-10 classification, based on empirical observations of the clinic of psychopathology, reveals a correlation with objective parameters of the entropy of the neural-glial network of the brain, the markers of which are the parameters of the variance of the amplitude-frequency characteristics of the alpha rhythm. This process did not depend on the will of psychiatrists, since the very possibility of such a correlation is rejected by official psychiatry. Thus, ICD-10 has not exhausted its possibilities of systematization of psychopathology. It is possible that an integrated approach may become the basis for a national classification of psychopathology.

Conclusion. The ICD-10 classification of mental illnesses using the parameters of the dispersion analysis of the amplitude-frequency characteristics of the alpha rhythm of the EEG can be a significant step forward in the diagnosis of psychopathology for its prevention, early diagnosis and monitoring of treatment.

Keywords: ICD-10, psychopathology, correlation with alpha rhythm variance