Psikhiatriya最新文献

{"title":"The Relationship between Emotional Burnout and the Quality of Life of Psychiatrists","authors":"I. A. Zrazhevskaya, K. V. Bykov, E. Topka, R. N. Isaev, A. M. Orlov","doi":"10.30629/2618-6667-2024-22-1-47-57","DOIUrl":"https://doi.org/10.30629/2618-6667-2024-22-1-47-57","url":null,"abstract":"Background: effective and safe provision of medical care depends on the well-being of medical workers – problems related to health and quality of life do not allow the clinician to realize his potential fully. A high level of work stress undermines the well-being of medical personnel. One of its most characteristic manifestations is burnout.The aim was to study the relationship between burnout and quality of life with the construction of a mathematical model for prediction of the quality of life based on information about the degree of psychiatrists’ burnout.The main hypothesis of this study was that burnout significantly and negatively affects the quality of life.Participants and methods: 82 psychiatrists, working in Moscow psychiatric clinics, independently filled out the Maslach Burnout Inventory and an abbreviated version of the WHO questionnaire «Quality of Life» (WHOQOL-BREF). The multiple linear regression was used to assess the impact of burnout on the quality of life of physicians. The values of the Maslach Burnout Inventory, the age, and gender of the respondents were used as predictors; the response variables were the values of WHOQOL-BREF.Results: the value of the domain «emotional exhaustion» is negatively associated with the four dimensions of the WHOQOL-BREF such as «physical health», «psychological health», «social relationships», «environment». The domain «personal accomplishment» positively correlated with respondents’ physical and psychological health. Age affected these indicators negatively but did not affect social relationships and health in the «environment» subscale. The gender of psychiatrists did not have a significant impact on their quality of life. The adjusted coefficient of determination of the models was in the range from 0.1907 to 0.511.Conclusions: еmotional burnout negatively affects the quality of life of practicing psychiatrists. Prospective, longitudinal studies are still needed to establish causal connections between these constructs.","PeriodicalId":516298,"journal":{"name":"Psikhiatriya","volume":"113 49","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140090736","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":"Neurodevelopmental Disorders Caused by Genetic Defects in Structure of Glutamatergic Receptors","authors":"A. V. Abramov, E. Makushkin","doi":"10.30629/2618-6667-2024-22-1-90-98","DOIUrl":"https://doi.org/10.30629/2618-6667-2024-22-1-90-98","url":null,"abstract":"Background: the role of glutamate receptor dysfunction in mental disorders, neurological, autoimmune, and oncological pathology has been intensively investigated in the past decade. The development of drugs that target glutamatergic receptors has also been a focus of research.The aim was to describe modern concepts of neurodevelopmental disorders (according to the International Classification of Diseases 11th revision, L1-6A0) that are associated with genetically induced alterations of the structure of glutamatergic receptors.Material and method: a search for descriptions of cases with impaired neuropsychiatric development associated with genetic defects of ionotropic and metabotropic glutamate receptor subunits was performed in the MEDLINE/Gene database, MEDLINE/PubMed scientific library, Online Mendelian Inheritance in Man (OMIM), UniProt, ClinGen and eLibrary. Genetically induced structural abnormalities of most known ionotropic (GluA, GluN, GluK, GluD) and a number of metabotropic glutamate receptors (mGluR1, 5, 7) are associated with severe variants of neuropsychiatric disorders that manifest in infancy and early childhood.Conclusion: the considerable variation in the clinical presentation of these cases demands a transnosological approach to diagnosis and management of patients, under cooperation of specialists in pediatrics, child psychiatry, neurology, genetics, and medical and social rehabilitation.","PeriodicalId":516298,"journal":{"name":"Psikhiatriya","volume":"55 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140085597","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":"Psychosis Due to Osmotic (Pontine) Myelinolysis in Non-Hodgkin’s Lymphoma: Case Report","authors":"A. Pichikov, D. I. Tikhomirov, M. Sorokin, L. V. Lukina, R. Grebenshchikova","doi":"10.30629/2618-6667-2024-22-1-36-46","DOIUrl":"https://doi.org/10.30629/2618-6667-2024-22-1-36-46","url":null,"abstract":"Introduction: central pontine myelinolysis (CPM) is rare neurological condition. The severe symptoms of neurologic and psychiatric disorders accompanying this condition are not sufficiently disclosed in the literature. Most often CPM develops on infusion therapy and forced correction of hyponatremia. The complexity of diagnosis and the lack of certain algorithms for the management of this category of patients cause a high frequency of disability, persistent neurological and psychiatric symptoms, and lethal outcomes.The aim was to present and analyze clinical picture of psychosis in CPM on the example of non-Hodgkin’s lymphoma case report. Patient and method: clinical analysis of disorders in 14-years old patient with diagnosis of non-Hodgkin’s lymphoma.Results: clinical polymorphism of psychotic features, catatonic disorders, neurological symptoms at the end stage and development of psychosis associated with CPM during cytotoxic treatment. A year and a half follow-up of the first generation antipsychotics administration is presented.Conclusion: CPM may occur on cytotoxic infusion therapy in patients with non-Hodgkin’s lymphoma and be accompanied by severe psychotic disorders. Thus, practitioners should be aware of the risks of this condition, its diagnostic and therapeutic options when working with these patients.","PeriodicalId":516298,"journal":{"name":"Psikhiatriya","volume":"11 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270031","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":"Characteristics of Visual Contrast Sensitivity and Ocular Microtremor in Schizophrenia","authors":"A. Kosikova, I. Shoshina, S. Lyapunov, Z. Guseinova, I. Lyapunov, A. A. Radivilko, M. V. Ivanov","doi":"10.30629/2618-6667-2024-22-1-58-67","DOIUrl":"https://doi.org/10.30629/2618-6667-2024-22-1-58-67","url":null,"abstract":"Background: schizophrenia is a severe mental illness characterized not only by cognitive but also sensory impairments, including the visual system. Research suggests impairments in contrast processing in schizophrenia, but evidence regarding the nature of these impairments is inconsistent. The theory of tremor modulation signal connects contrast sensitivity with the parameters of ocular microtremor – high-frequency and low-amplitude micromovements that are controlled by neurons of the nuclei of the brain stem. The parameters of ocular microtremor in psychopathology, in particular in schizophrenia, have not been described in the scientific literature.The aim of the study was to study the characteristics of contrast sensitivity and microtremor of the eyes of patients with schizophrenia.Patients and methods: to register contrast sensitivity, the method of computer visocontrastometry was used. Gabor elements were presented with spatial frequencies of 0.4, 1.0, 3.0, and 10 cycles/deg. Eye microtremor was recorded using a non-contact high-speed video recording method using an original optical system. The study involved 30 patients diagnosed as paranoid schizophrenia and 30 people without psychopathology and neurological diseases.Results: the contrast sensitivity of patients was reduced in the region of medium and high spatial frequencies compared with conditionally healthy controls, which may be associated with the chronic course of the disease. Ocular microtremor in the patient group was characterized by a lower frequency and a higher amplitude compared to the control group.Conclusions: contrast sensitivity and ocular microtremor are considered as potential markers for determining the functional state in schizophrenia, which requires further research and accumulation of experimental data.","PeriodicalId":516298,"journal":{"name":"Psikhiatriya","volume":"34 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140082520","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":"Diagnostics and Assessment of the Severity of Alzheimer’s Disease: Machine Learning Algorithms Based on Markers of Inflammation","authors":"L. V. Androsova, A. Simonov, O. V. Senko, N. M. Mikhaylova, A. V. Kuznetsova, T. Klyushnik","doi":"10.30629/2618-6667-2024-22-1-6-14","DOIUrl":"https://doi.org/10.30629/2618-6667-2024-22-1-6-14","url":null,"abstract":"Background: as the most common form of dementia, Alzheimer’s disease (AD) is characterized by cognitive deterioration and usually begins with loss of memory of recent events. It is important to search for biological, sensitive and affordable methods that could be used for early diagnostics of AD and determine the severity of the disease.Objective: to develop machine learning algorithms based on such inflammatory markers as the enzymatic activity of leukocyte elastase (LE) and the functional activity of the α1-proteinase inhibitor (α1-PI) for diagnosing and assessing the severity of AD.Patients and methods: the study included128 people aged 55 to 94 years (73.7 ± 7.9 years), of which 91 patients were diagnosed with Alzheimer’s disease and 37 apparently healthy people (control). The indicators of LE and α1-PI in blood plasma were used as classifying features for building models. The following algorithms were used to build a machine learning model: Optimal Valid Partition (OVP), logistic regression (LR), support vector machine (SVM), random forest (RF), gradient boosting (GB) and statistically weighted syndromes (WSWS). The predictive performance of the constructed classiers was evaluated by the overall accuracy (accuracy), sensitivity (sensitivity), specificity (specificity), F-measure and ROC-analysis.Results: the developed machine learning algorithms made it possible to reliably divide the general group of subjects (patients + conditionally healthy), as well as patients with different AD severity, into 4 quadrants of a two-dimensional diagram in the LE and α1-PI coordinates and showed close and fairly high predictive efficiency.Conclusion: the developed machine learning algorithms have proven close and sufficiently high prognostic efficacy for assessing the severity of AD based on inflammatory markers (enzymatic activity of LE and functional activity of α1-PI) and, probably, can be useful for early diagnostics of the disease and timely administration of therapy.","PeriodicalId":516298,"journal":{"name":"Psikhiatriya","volume":"2000 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140416790","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":"Structural MRI of the Brain in Treatment-Resistant Schizophrenia","authors":"A. Dudina, D. Tikhonov, O. Y. Vershinina, V. Kaleda, I. S. Lebedeva","doi":"10.30629/2618-6667-2024-22-1-15-25","DOIUrl":"https://doi.org/10.30629/2618-6667-2024-22-1-15-25","url":null,"abstract":"Background: despite a significant progress of psychopharmacology, treatment-resistant schizophrenia (TRS) remains a challenge for clinicians. The etiology and pathogenesis of TRS probably differ from schizophrenia susceptible to therapy, which underlies the non-respondence to most antipsychotics.Objective: to establish morphometric gray matter brain structural features in TRS as well as to analyze the association of these parameters with the clinical characteristics of patients.Patients and methods: 21 right-handed male patients diagnosed with paranoid schizophrenia and meeting criteria for treatment resistance and 21 matched healthy controls underwent MRI and clinical examination. T1-weighted images were processed via FreeSurfer 7.1.1. For each subject average values for the cortex thickness and area, volumes of subcortical structures, brain stem structures, and separately volumes of the amygdala nuclei and hippocampal subregions were obtained. Intergroup comparisons and correlations with clinical scales (PANSS, CDSS) and antipsychotic dosage in chlorpromazine equivalent were calculated. Results: TRS patients showed decreased gray matter thickness in frontal, temporal, parietal, occipital, cingulate and insular regions, volumes of the amygdala, hippocampus and nucleus accumbens, as well as a number of amygdala nuclei and hippocampal subregions bilaterally. The volume of the right globus pallidus, on the contrary, was increased.Conclusion: the widespread gray matter thinning in TRS confirmed the other researchs, which described resistance as a more severe form of schizophrenia that affects brain structures worse. The increase of globus pallidus volume is a surprising result, which is not yet clearly explained.","PeriodicalId":516298,"journal":{"name":"Psikhiatriya","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415282","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":"Oligodendrocyte Progenitors in Schizophrenia: The Role in Pathogenesis and Potential Treatment Target","authors":"N. Kolomeets","doi":"10.30629/2618-6667-2023-21-7-46-64","DOIUrl":"https://doi.org/10.30629/2618-6667-2023-21-7-46-64","url":null,"abstract":"Background:  schizophrenia is considered as a dysconnectivity disorder supported by neuroimaging studies have revealed altered myelination of white and grey matter. Altered myelination suggests oligodendrocyte (OL) family pathology. Oligodendrocyte progenitors (OP) are of special interest since they myelinate axons in mature brain at the last stage of the differentiation. The aim of review  —  to summarize modern research data concerning altered cell cycle of OL family in schizophrenia and their plausible reason. Material and methods: using the keywords “schizophrenia, OL, OP”, “OP and schizophrenia risk genes”, “OP and neuroinflamation”, “OP and antipsychotic drugs”, “OP, dopamine, serotonin” 164 studies concerning the influence of listed above factors on OP differentiation were selected the MedLine/PubMed, Google Scholar, eLibrary databases for analysis.  Conclusion: postmortem studies demonstrated essential deficit of OL family cells as well as altered correlation pattern between the number of these cells suggested altered OP differentiation. Some of OL and myelin-related gene variants caused higher schizophrenia risk play a critical role in OP differentiation. While neuroinflammation is important component of schizophrenia brain pathology proinflammatory cytokines and activated microglia exert substantial influence on OP proliferation and differentiation. Atypical antipsychotics are able to correct OP maturation and have anti-inflammatory effects. OL and OP as well as microglia and peripheral immune cells express dopamine and serotonin receptors, main  therapeutic targets of these drugs. OP pathology as important component of schizophrenia  pathogenesis, tightly linked with another abnormalities, and considers as promising target for future therapeutic strategy.","PeriodicalId":516298,"journal":{"name":"Psikhiatriya","volume":"451 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140478319","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":"Postoperative Psychoses in Patients with Brain Gliomas","authors":"O. S. Zaitsev, N. P. Ilyaev, O. A. Maksakova","doi":"10.30629/2618-6667-2023-21-7-65-75","DOIUrl":"https://doi.org/10.30629/2618-6667-2023-21-7-65-75","url":null,"abstract":"Background: despite the widespread opinion that psychoses are common after surgery in neurosurgical patients, they remain practically unexplored to date.  Objective: based on the analysis of scientific literature to get an idea of the state and prospects of studying the problem of psychoses arising after operations for brain gliomas.  Materials and methods: the work is a scoping review; the main method used was the search for publications by the keywords “postoperative psychosis”, “postoperative delirium ”, “brain gliomas”, “neurosurgery”, “craniotomy” conducted in the Medline/PubMed, Scopus, Web of Science, RISC and other sources over the past 20 years.  Conclusion: studies of postoperative psychoses in patients with brain gliomas and comparison of results in neurosurgery and general surgical practice are hindered by terminological dissonance and shortcomings of various types of verification of postoperative psychotic disorders. This manifests itself both at the epidemiological data (the probability of occurrence ranges from 4 to 29%), and in determining the risk factors necessary and sufficient to predict the onset of psychosis: according to literature data. About 80 indicators claim this role (gender, age, premorbid diseases, preoperative mental state,  tumor malignancy, options for neurosurgical interventions, etc.) while the list does not contain conceptually important features, such as the profile of individual brain asymmetr y, tumor lateralization, etc. These problems lead to controversy in approaches to treatment and prevention of postoperative psychotic disorders. Before evaluating the effectiveness of the main drugs (dexmedetomidine, GABA-ergics, antipsychotics, etc.) and non-drugs influences, one must understand the phenomenon clearly with all the individual characteristics and variants of disease manifestations.","PeriodicalId":516298,"journal":{"name":"Psikhiatriya","volume":"76 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140471546","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":"Evolution of Concepts of Differential Diagnostics in Frontotemporal Dementia","authors":"Y. Fedorova","doi":"10.30629/2618-6667-2023-21-7-76-96","DOIUrl":"https://doi.org/10.30629/2618-6667-2023-21-7-76-96","url":null,"abstract":"Background:  frontotemporal dementia (FTD) is a group of neurodegenerative diseases, with onset usually in presenile age, the clinical picture is manifested by behavioral disorders and relatively intact cognitive features in the initial disease. In  the early stages of FTD, it is difficult to differentiate this type from other dementias or other mental diseases. The  aim was to analyse recent scientific publications on the problem of differential diagnostics of frontotemporal dementia.  Material and methods:  using the keywords “frontotemporal dementia”, “frontotemporal lobar degeneration”, “differential diagnosis of frontotemporal dementia”, “behavioral variant of frontotemporal dementia”, selected and analyze publications for the last two decades. Results: the behavioral variant of FTD (bv-FTD) is the most common form of FTD, accounting for 50% of all cases of FTD, and especially in cases with early onset. Predominantly, this variant of FTD presents diagnostic difficulties, due to the limited accuracy of neuroimaging examinations and the lack of specific biomarkers. The clinical symptoms of bv-FTD are characterized by considerable overlap with symptoms of neurodegenerative diseases and mental diseases, such as schizophrenia, bipolar affective disorder, obsessive-compulsive disorder, and personality disorders. Conclusion: the diagnosis of FTD at the initial stage of the disease is problematic and difficult, the sensitivity and specificity of almost all diagnostic methods increase as the disease progresses. This literature review highlights some of the diagnostic methods that can be used in suspected cases of FTD and informs about the differential diagnostics recommendations that have been developed to improve the accuracy of FTD diagnosis.","PeriodicalId":516298,"journal":{"name":"Psikhiatriya","volume":"268 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140471896","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 Social Factors in the Genesis of Mental Disorders: Development of Research in the 21st Century","authors":"M. Kuzminova, T. Solokhina","doi":"10.30629/2618-6667-2023-21-7-31-45","DOIUrl":"https://doi.org/10.30629/2618-6667-2023-21-7-31-45","url":null,"abstract":"Background: the important role of social factors in the development of mental disorders has long been known, but recently, due to the growth of mental disorders, including against the background of various global social crises, it seems necessary to summarize already existing knowledge in this field, as well as to consider new trends in the influence of social factors on the occurrence, course and prognosis of mental disorders.  The aim of review  was to analyse domestic and foreign studies on the influence of various social aspects of mental disorders in order to rationally solve clinical, diagnostic, therapeutic, rehabilitation and organizational problems. Material and methods:  the authors used the key words “social factors and mental disorders”, “risk factors for mental disorders”, “family factors in severe mental disorders”, “impact of disasters (man-made and natural) on mental health”, “network theory of mental disorders”. The authors selected available publications in MEDLINE/PubMed, Scopus, eLibrary,  RSCI, Google Scholar, as well as relevant articles in the source lists of the reviewed papers.  Conclusion: the role of childhood and adolescent mental trauma in the etiopathogenesis of mental illness in adulthood is an object of many studies. The increase of social disasters cases (both natural and man-made) is reflected in the detection of PTSD. Family factors are considered of enormous importance and could have both favourable and negative effects. The gender-specific influence of social factors is more attributable to cultural differences, as well as to marital status, including the lower self-esteem of single women. Biopsychosocial model despite its widespread proclamation is underused in practice, which reduces the effectiveness of comprehensive therapy. First proposed in 2008, the network theory of mental disorders is rapidly evolving and is now a full-fledged  field of psychiatric research.","PeriodicalId":516298,"journal":{"name":"Psikhiatriya","volume":"9 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140474860","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}