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{"title":"Efficiency of the De-stigmatization Program in Somatoform Disorders","authors":"Yuliya V Bogushevskaya, A. V. Pogosov","doi":"10.31550/1727-2378-2022-21-4-79-84","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-4-79-84","url":null,"abstract":"Study Objective: To study the role of the psychoeducational program in coping with self-stigmatization in patients with somatoform disorders. Study Design: Observational emperical comparative clinical trial with two randomized groups with provisional and final examination. Materials and Methods. The study enrolled patients aged 20 to 45 years old who were hospitalised for a somatoform disorder for the first time. The study group comprised 60 patients, who attended a psychoeducational program in addition to psychopharmacological treatment. Controls were 60 patients treated only with medications. Patients’ status was evaluated using clinical, psychological and psychognostic methods. Study Results. After completion of the therapy, the difference in the degree of self-stigmatization and the level of knowledge about the mental disorder in the groups was statistically significant (p < 0.001). When groups were compared on a somatization scale, a statistically significant trend towards differences was noticed (0.05 ≤ p < 0.1). Conclusion. The psychoeducational program facilitates coping with ‘avoiding the psychiatrist’ behaviour, thus reducing the risk of disease chronization and helping prevent irreversible personality changes. Keywords: psychoeducation, de-stigmatization program, somatoform disorders, degree of self-stigmatization, level of knowledge about the mental disorder.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78145605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Anna Karenina”: a Suicidological Study","authors":"K. Chistopolskaya, S. Enikolopov","doi":"10.31550/1727-2378-2022-21-8-82-86","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-8-82-86","url":null,"abstract":"Objective of the Review: to analyze one of the most popular L. Tolstoy’s works “Anna Karenina” by showing that it illustrates classic and contemporary theories of suicide, starting from the sociological study of suicide by E. Durkheim. Key Points. The novel depicts four episodes of suicidal behavior: ego-dystonic thoughts (Lewin), suicide attempt (Vronsky), completed suicide (Anna) and volunteer fighters (Vronsky and other men going to war). The article draws parallels with four types of suicide according to E. Durkheim: anomic, egoistic, fatalistic and altruistic. Besides, the paper points out changes in worldviews of the main characters that happen after their mortality was made salient, which corresponds to Terror Management Theory in social psychology and works of cultural anthropologist E. Becker. In the end, we look at Anna’s presuicidal state from the point of view of Narrative Crisis Model of Suicide by I. Galynker. Conclusion. Thus, the novel “Anna Karenina” can help specialists in studying various theories of suicidal behavior, as L. Tolstoy carefully depicted the phenomenology of suicidal feelings and mechanisms of psychological defense from the fears of death, even before suicidology was established as a science. Keywords: suicide, Durkheim, Terror Management Theory, Narrative Crisis Model of Suicide, Suicide Crisis Syndrome.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89013369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Сorrelations of EEG with Clinical Scores in Depressive Patients with a History of Suicide Attempts","authors":"A. Iznak, E. Iznak, E. Damyanovich, I. Oleichik","doi":"10.31550/1727-2378-2022-21-8-78-81","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-8-78-81","url":null,"abstract":"Study Objective: to clarify the role of neurophysiological mechanisms in the pathogenesis of suicidal behavior in young depressed patients with a history of suicidal attempts. Study Design: open study. Materials and methods. The study included 35 female patients aged 16-25 years. Relationships between pre-treatment quantitative clinical scores (according to the HDRS-17 scale) and values of the absolute spectral power of the background resting EEG in narrow frequency sub- bands were analyzed. Study Results. Significant negative correlations (p < 0.05) between the EEG parameters and the sum of depression cluster scores of the HDRS-17 scale indicate reduced activation of the frontal-anterotemporal cortex areas of both hemispheres (according to the values of the alpha2 EEG sub-band (9–11 Hz) spectral power in F7, F3, F4 and F8 leads), and especially, of the left anterior temporal region (according to the values of the EEG beta2 sub-band (20–30 Hz) spectral power in F7 lead). In addition, these patients are characterized by a somewhat reduced functional state of the central temporal-parietal zones of the right hemisphere in the form of significant positive correlations (p < 0.05–0.01) of the slow-wave delta (2–4 Hz), theta1 (4–6 Hz) and theta2 (6–8 Hz) EEG activity spectral power values in F4, C4, T4 and P4 leads with the sum of anxiety cluster scores of the HDRS-17 scale. Conclusion. The results obtained make it possible to clarify the neurophysiological mechanisms of the pathogenesis of suicidal behavior in young depressive patients. Keywords: depression, young age, suicide attempts, quantitative EEG.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79506281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Clinical and Criminological Features of Patients with Organic Mental","authors":"S. Popov","doi":"10.31550/1727-2378-2022-21-4-67-71","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-4-67-71","url":null,"abstract":"Study Objective: To study the clinical and criminological factors in patients with schizophrenia and organic mental disorders (OMDs) recorded before the first socially dangerous act (SDA), and to analyse various features taking into account follow-up of these patients and repeated SDA prevention. Study Design: Comparative study. Materials and Methods. The study included 86 schizophrenia patients (study group A) and 45 patients with OMDs (study group B) who committed repeated SDAs, were found insane and were forced to undergo various court-appointed therapies for 2 and more times. In this study, we used the clinical psychopathologic method with due account to psychopathology and clinical statistic method as the main methods. Study Results. 49 (57%) and 23 (51.1%) patients in group A and group B, respectively, were not held criminally liable before; thus, 37 (43%) patients in group A and 22 (48.9%) patients in group B had criminal records. In group A, 26 (30.2%) patients were held criminally liable once, whereas in group B — 9 (20%); 11 (12.8%) and 13 (28.9%) patients, respectively, had multiple criminal records. Patients with schizophrenia committed more crimes against life — 13.5% in past medical history to 30.2% in case of a repeated SDA; the number of crimes against property remained relatively stable (from 59.4% in past medical history to 54.7% in case of a repeated SDA). Drug-related crimes became more numerous: an increase from 2.7 to 11.7%. In patients with OMDs, the number of crimes against property dropped from 86.4% in past medical history to 51.1% in case of a repeated SDA, whereas the number of crimes against life rose (from 4.5% in past medical history and up to 35.6% in case of a repeated SDA). At the same time, the incidence of drug-related crimes grew insignificantly (from 9.1% to 11.1%). Conclusion. It was found out that patients in these nosological categories have specific criminal behaviours affecting their illegal activities, features of SDA relapses, and changes in the criminal behaviour structure over the course of disease. The obtained data make it possible to study the characteristics of criminal behaviours of mentally handicapped individuals and will help develop recommendations for prevention and forecast of crimes committed by mentally ill persons. Keywords: psychiatry, organic mental disorders, schizophrenia, socially dangerous acts.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84621023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Rate Variability in Schizophrenia and Shizoaffective Disorder","authors":"O. Antipova, M.K. Reznikov","doi":"10.31550/1727-2378-2022-21-4-72-78","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-4-72-78","url":null,"abstract":"Objective of the Review: To analyze and systematize the results of the studies of heart rate variability in schizophrenia and schizoaffective disorder. Key points. Most studies demonstrate a reduction in total heart rate variability and a decrease in parasympathetic tone and reactivity in patients with schizophrenia and schizoaffective disorder, including in response to a cognitive or stress load. And also the baroreflex sensitivity decrease was revealed. Autonomic cardiac dysregulation detected in unmedicated patients with schizophrenia, as well as in healthy first-line relatives. The extent of these changes correlates with the severity of productive, negative and affective symptoms, as well as with the presence of metabolic syndrome. Autonomic cardiac dysregulation is much more pronounced in psychotic states. Antipsychotics with anticholinergic and/or α1-adrenolytic activity can exacerbate these changes. Reductions in total heart rate variability and vagal activity are detected not only in schizophrenia, but also in other mental and somatic disorders, in the pathogenesis of which distress is involved. Conclusion. The possibility of using heart rate variability indicators as additional criteria for assessing the severity of psychosis, predicting the effectiveness of therapy, as well as for early stratification of cardiovascular risks requires further study in scientific research. Keywords: heart rate variability, autonomic nervous system, schizophrenia, schizoaffective disorder, antipsychotics, biomarkers.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83199159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophilic Gastritis in a Child. How to Suspect? Diagnostic Criteria","authors":"I. Berezhnaya, L. Goncharova, I. D. Maikova, E. R. Radchenko, E. I. Epifanova, E. Skorobogatova, I. Osmanov, I. Zakharova, A. S. Koshurnikova","doi":"10.31550/1727-2378-2022-21-7-45-51","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-7-45-51","url":null,"abstract":"Objective of the Review: To analyze current data on eosinophilic lesions of the stomach in children with the analysis of a clinical case. Key points. Diseases of the gastrointestinal tract associated with primary tissue eosinophilia are a heterogeneous group of changes characterized by inflammation, with predominantly eosinophilic tissue infiltration in the absence of other known causes. Clinical manifestations of allergic inflammatory diseases of the gastrointestinal tract are most often nonspecific. Depending on the level of the lesion, eosinophils are distinguished: gastritis (EoG), enteritis, and colitis. In recent years, more and more attention of experts has been directed to research in this area, but so far there are no general epidemiological data on the prevalence of this pathology in the population, both adults and children. Conclusion. Currently, there are no clear morphological criteria for diagnosing eosinophilic lesions of the stomach, small and large intestine in children, and clinical manifestations, especially in young children, are nonspecific. When making a diagnosis of EoG, it is necessary to take into account a family allergic history, a set of laboratory diagnostic data (eosinophilia in a clinical blood test and a high level of total IgE) and a morphological study of a biopsy of the gastric mucosa. Keywords: children, eosinophilic gastritis, eosinophilia, tissue eosinophilia, food allergy.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88263889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Modern Robot-aided Rehabilitation Technologies for the Improvement of the Upper Extremity Functions","authors":"E.A. Biryukov, I. P. Yastrebtseva","doi":"10.31550/1727-2378-2022-21-8-39-43","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-8-39-43","url":null,"abstract":"Objective of the Review: To discuss the efficiency of using various robot-aided rehabilitation devices in order to improve the upper extremity functions in patients with cerebral pathologies. Key Points. The medical devices market is abundant in various robot-aided devices for patient rehabilitation. Currently, the issue of combining various rehabilitation techniques is still open; scientific researches are ongoing which aim at analysing the problem of gain of motion. Conclusion. The variability of technical solutions and results of the use of rehabilitation techniques requires further deep analysis of factors determining the efficiency of their use, and development of personified approaches to the management. Keywords: stroke, neurorehabilitation, exoskeleton, robot-aided complexes.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89370265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensuring the Effectiveness and Quality of Modern Professional Development Programs for Medical Workers: the Experience of Russian Medical Academy of Continuous Professional Education","authors":"G.H. Romanenko, A.A. Stremoukhov","doi":"10.31550/1727-2378-2022-21-2-10-14","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-2-10-14","url":null,"abstract":"Objective of the Review: to determine the criteria for the effectiveness and quality of modern educational programs, the choice of advanced training programs by medical professionals within the framework of personal and professional growth in the formation of an individual educational trajectory. Key Points. Additional professional training programs ensure the updating of professional standards in the context of changing goals, content, technologies, regulatory support of professional activity in a particular field, and also take into account the qualification requirements specified in the qualification reference books for the relevant positions and specialties. Educational programs must meet strict requirements: be relevant, modern, practice-oriented, methodically and scientifically sound. Conclusion. The formation of the educational trajectory of a medical specialist and the choice of advanced training programs should be based on the quality criteria of both individual educational programs and the educational process as a whole: compliance with the federal state educational standard in the specialty, professional standard in the specialty/position, clinical recommendations and their evidence base. The quality of training of a medical specialist increases many times when the content of the educational program is supported by a specialized interdisciplinary educational event. Training and advanced training of medical workers should be carried out in medical educational organizations with qualified teaching staff, full-fledged logistical and methodological support, as well as their own bases of practical (clinical) training. Keywords: doctor, additional professional education, continuous professional development, professional development program, educational event, Russian Medical Academy of Continuing Professional Education.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73567168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Prevention in Patients with Ischemic Heart Disease after Myocardial Revascularization","authors":"S. Boldueva, D. Evdokimov, V. M. Guzeva","doi":"10.31550/1727-2378-2022-21-6-19-24","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-6-19-24","url":null,"abstract":"Objective of the Review: Help the doctor in a conversation with the patient to additionally motivate him to follow the recommendations for secondary prevention in the period after myocardial revascularization. Key points. The article discusses the main risk factors that contribute to the progression of cardiovascular diseases (overweight and obesity, smoking, physical inactivity, depression and anxiety, dyslipidemia, diabetes mellitus, arterial hypertension), as well as various methods of secondary prevention after myocardial revascularization, based on modern data of evidence-based medicine: weight loss, regular physical training, psychopharmacotherapy, high adherence to drug therapy. Conclusion. Conducting secondary prevention measures is extremely important for patients after myocardial revascularization, since the progression of coronary artery atherosclerosis continues after surgery. Therefore, in the postoperative period, the likelihood of developing cardiovascular events, in particular, early periprocedural myocardial infarction, stent thrombosis, and late restenosis, remains. Optimal drug and non-drug preventive measures improve the quality of life and improve the prognosis in this category of patients. Keywords: ischemic heart disease, cardiovascular disease, secondary prevention, myocardial revascularization, healthy lifestyle.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78247385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamics of Uterine Blood Flow Parameters in Minimally Invasive Surgeries of the Intrauterine Pathology with the Use of Various Energy Types","authors":"O. Safronov, E. Kazachkova, E. Kazachkov, I.V. Safronovа, G.N. Mshak-Manukyan","doi":"10.31550/1727-2378-2022-21-5-75-80","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-5-75-80","url":null,"abstract":"Study Objective: To analyze the nature of changes in the parameters of uterine blood flow in minimally invasive surgical treatment of intrauterine pathology with the use of the diode laser energy operated in pulsed mode or bipolar energy. Study Design: Retrospective comparative study. Materials and Methods. A retrospective analysis of the reports of the Doppler ultrasound examination of the uterine blood flow in 102 patients who underwent surgery in the period from 2016 till 2020 was conducted to study the dynamics of uterine blood flow parameters in minimally invasive surgeries of intrauterine pathology utilizing various types of energy. Treatment of intrauterine pathology with the use of surgical diode laser in pulsed mode was performed in 60 women (1st group), 42 women were treated with bipolar energy (2nd group). Resistance index (RI) and pulsatility index (PI) in the right and left uterine arteries, arterial perfusion index (API), possibility to register the blood flow in sub-endometrial and endometrial blood vessels were evaluated while studying the uterine blood flow. Study Results. After the surgeries performed with the use of diode laser, the IR and PI remained unchanged statistically significantly more frequently than after the surgical treatment with the use of bipolar energy: 75 and 53.34% vs 30.95 and 33.33%. API statistically significantly more frequently increased in the 1st group (53.33%) and decreased in the 2nd group (66.67%). The blood flow in basal and coiled arteries of the uterus in post-surgery period is registered statistically significantly more often if diode laser was used as compared to the surgeries performed with bipolar energy (43.33 and 41.67% vs 21.43 and 19.05%, respectively). Conclusion. The use of bipolar energy in the treatment of intrauterine pathology leads to more severe uterine blood flow disturbances than surgeries with the use of diode laser. That is why it is reasonable to use the energy of a diode laser in pulsed mode in case of minimally invasive surgical treatment of intrauterine pathology. Keywords: intrauterine pathology, office hysteroscopy, diode laser, bipolar electrode, uterine blood flow.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86076573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}