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Systematic use of LSD, mephedron and amanita muscaria without signs mental and addictive pathology. The case of Daria D. 有系统地使用LSD,麻黄碱和毒蝇,没有精神和成瘾病理的迹象。达利娅·D。
Pub Date : 2023-01-24 DOI: 10.17816/nb119537
The article describes the case of Daria D., 23 years old, who has been using various drugs (LSD, marijuana, mephedrone) for a number of years and independently abandoned using drags with the transition to the use of microdoses of red fly agaric (Amanita Muskaria). Her mental and addictive status is analyzed. It is concluded that, despite the systematic use of drugs, there are no grounds for making Darya D. a psychiatric or addiction diagnosis.
这篇文章描述了23岁的Daria D.的案例,她多年来一直使用各种药物(LSD,大麻,甲氧麻黄酮),并独立放弃使用药物,过渡到使用微量的红蝇木耳(Amanita Muskaria)。分析了她的精神和成瘾状态。结论是,尽管有系统地使用药物,但没有理由将Darya d诊断为精神病或成瘾。
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引用次数: 0
Magical thinking in normal and pathological conditions: literature review 正常与病理状态下的神奇思维:文献综述
Pub Date : 2023-01-24 DOI: 10.17816/nb108946
The scientific literature analysis on a magical thinking problem was conducted. A review of studies in a historical perspective on this problem was given (English anthropological and French sociological schools, psychoanalysis views), various descriptions of magical thinking structure and possible causes of its development were discussed. A brief review of experimental studies of magical thinking of people without mental pathology is described as well as a specificity of magical thinking in childrens mind. The study of magical thinking in various mental pathologies is considered as one of the forms of psychosis-like experiences, as well as the phenomenon of thought action fusion.
对一个神奇思维问题进行了科学文献分析。从历史的角度对这一问题的研究进行了回顾(英国人类学和法国社会学学派,精神分析学派),讨论了对魔法思维结构的各种描述及其发展的可能原因。简要回顾了对无精神病理的人的神奇思维的实验研究,并描述了儿童心灵中神奇思维的特殊性。对各种精神病理中神奇思维的研究被认为是一种类似精神病的体验形式,也是一种思维-行动融合的现象。
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引用次数: 0
Cognitive functioning in patients with Chiari malformation type I and relationship with neurological manifestations I型Chiari畸形患者的认知功能及其与神经学表现的关系
Pub Date : 2023-01-24 DOI: 10.17816/nb115003
BACKGROUND. The symptom complex of Chiari malformation type I (CMI) is traditionally characterized by the set of cerebrospinal fluid disorders, coordination disorders, brainstem and myelopathic manifestations. Cognitive impairments, as manifestations of CMI, are little-known area. Study of the characteristics of cognitive status in patients with CMI and analysis of relationship between cognitive phenotype and severity of neurological manifestations can become basis for the formation of a more detailed understanding of this pathology. AIM. The aim was to characterize complex of the neuro-neuropsychological spectrum symptoms and their relationship in patients with CMI. MATERIALS AND METHODS. The main group included 105 adult patients with CMI 74 (70.5%) men and 31 (29.5%) women aged 25.616.89 years. The control group included 50 patients without signs of CMI, other organic brain pathology and cognitive disorders of known etiology 31 (62%) men and 19 (38%) women aged 26.365.00 years. The neuroimaging verification of CMI was performed by magnetic resonance imaging of the brain. Clinical assessment consisted of the collecting complaints, anamnestic information and detailed neurological examination. Comprehensive neuropsychological testing was performed by using MMSE, MoCA and TMT (A and B). RESULTS. Dissociation was noted between prevalence of the typical subjective symptoms and frequency of the objective neurological manifestations in patients with CMI. Among the most frequent subjective symptoms in CMI were headaches and neck pain, asthenia, disorders of the coordination sphere, as well as subjective signs of cognitive dysfunction. Objective neurological deficits were mainly represented by cerebellar disorders. Signs of cognitive dysfunction in the form of memory and attention disorders described by patients with CMI in 20% cases were confirmed by the results of complex neuropsychological testing in comparison with a group of healthy respondents. The relationship of the cognitive deficits with presence and severity of the objective neurological, mainly cerebellar, manifestations in patients with CMI was revealed. CONCLUSIONS. The relationship of cognitive dysfunction with the presence and severity of objective neurological, mainly cerebellar, disorders indicate the complexity of neurological and neuropsychological manifestations in CMI. These data suggest an important role of the disturbed anatomy of the cerebellum and its connections with the cerebral cortex in the pathophysiology of a wide range of major clinical manifestations of CMI.
背景。I型Chiari畸形(CMI)的复杂症状传统上以脑脊液紊乱、协调障碍、脑干和脊髓病表现为特征。认知障碍作为慢性脑损伤的表现,是一个鲜为人知的领域。研究CMI患者的认知状态特征,分析认知表型与神经系统表现严重程度的关系,可以成为对CMI病理形成更详细认识的基础。的目标。目的是表征复杂的神经-神经心理谱症状及其在CMI患者的关系。材料和方法。主要组为年龄25.616.89岁,男性74例105例(70.5%),女性31例(29.5%)。对照组包括50例无CMI体征、其他器质性脑病理和病因已知的认知障碍患者,男性31例(62%),女性19例(38%),年龄26.365.00岁。通过脑磁共振成像对CMI的神经影像学进行验证。临床评估包括收集主诉、记忆信息和详细的神经学检查。采用MMSE、MoCA、TMT (A、B)进行综合神经心理测试。在CMI患者中,典型主观症状的患病率与客观神经学表现的频率之间存在分离。在CMI中最常见的主观症状是头痛和颈部疼痛、虚弱、协调领域障碍以及认知功能障碍的主观体征。目的神经功能障碍主要表现为小脑功能障碍。与一组健康应答者相比,20%的CMI患者以记忆和注意力障碍的形式描述的认知功能障碍的迹象通过复杂的神经心理测试结果得到证实。揭示CMI患者认知障碍与客观神经系统(主要是小脑)表现的存在及严重程度的关系。结论。认知功能障碍与客观神经系统(主要是小脑)障碍的存在及其严重程度的关系表明CMI的神经和神经心理表现的复杂性。这些数据表明,小脑的解剖紊乱及其与大脑皮层的连接在CMI的各种主要临床表现的病理生理中起着重要作用。
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引用次数: 0
The anticipatory concept of neurosis and cognitive behavioral model: prospects for integration 神经症的预期概念与认知行为模型:整合前景
Pub Date : 2022-11-04 DOI: 10.17816/nb108865
The article deals with the theoretical intersections of V.D. Mendelevichs anticipatory concept of neurosis and models developed within the framework of the cognitive behavioral direction of psychotherapy. The fundamental similarity of approaches is shown, which allows integrating both theoretical and practical aspects of these concepts. Using examples of clinical cases, the possibility of joint integrative conceptualization is demonstrated, taking into account the ideas inherent in both approaches. This work can serve as a basis for further research on the development of psychocorrective and psychotherapeutic interventions.
本文讨论了门德列维奇的神经症预期概念和心理治疗认知行为方向框架内发展的模型的理论交叉点。方法的基本相似性显示,这允许整合这些概念的理论和实践方面。使用临床病例的例子,联合综合概念化的可能性被证明,考虑到这两种方法固有的想法。本研究可为进一步开展心理矫正和心理治疗干预的研究奠定基础。
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引用次数: 0
ICD-11 (psychiatric section): who diagnoses better treats better? ICD-11(精神科):谁诊断得好治疗得好?
Pub Date : 2022-11-04 DOI: 10.17816/nb108994
The article analyzes the reasons for the opposition of a significant number of Russian psychiatrists to the introduction of a new international classification of mental and behavioral disorders (ICD-11). An opinion is expressed that the increase in the effectiveness of therapy from ICD-9 to ICD-10 in world psychiatry is associated not so much with the transition to syndromic (anosological) assessment of clinical phenomena, but because of the widespread use of modern psychopharmacological drugs and the introduction of evidence-based medicine principles, which in domestic psychiatry are also criticized. It is argued that two important aspects of psychiatry diagnosis and therapy are practically independent of each other, and the entire dispute about rejection or acceptance of the new classification (ICD-11) has nothing to do with the effectiveness of therapy.
本文分析了大量俄罗斯精神病学家反对引入新的国际精神和行为障碍分类(ICD-11)的原因。有一种观点认为,世界精神病学从ICD-9到ICD-10治疗效果的提高与临床现象向综合征(精神病学)评估的过渡没有太大关系,而是因为现代精神药理学药物的广泛使用和循证医学原则的引入,这在国内精神病学中也受到批评。有人认为,精神病学诊断和治疗的两个重要方面实际上是相互独立的,关于拒绝或接受新分类(ICD-11)的整个争议与治疗的有效性无关。
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引用次数: 0
Structural and bioenergetic changes in muscle tissue in idiopathic muscular dystonia 特发性肌张力障碍中肌肉组织的结构和生物能量变化
Pub Date : 2022-11-04 DOI: 10.17816/nb111190
BACKGROUND. Muscular dystonia is a syndrome with localization of the pathological process in the central nervous system and the formation of local muscle hypertonicity. It is relevant to study changes in the muscles involved in hyperkinesis in dystonia as one of the possible symptoms of the disease. AIM. To identify structural and bioenergetic changes in muscles in patients with idiopathic muscular dystonia. MATERIAL AND METHODS. 10 patients were examined with a diagnosis of idiopathic segmental and generalized dystonia, including cervical dystonia syndrome. The control group included 5 conditionally healthy individuals. All patients received injections of botulinum toxin type A with a TWSTRS and Tsui efficacy score before injection and 3 weeks after injection. Structural changes in the muscles were assessed by magnetic resonance imaging (MRI) (1.5 Tl). To assess bioenergetic changes, the parameters of mitochondrial respiration were studied, including basal respiration during oxidation of substrates (pyruvate and pyruvate-malate), respiration during oxidative phosphorylation with various participation of respiratory chain complexes, electron transport chain capacity (ETC), ATP-associated respiration in a trapezius muscle biopsy. RESULTS. Bioenergetic changes in muscle tissue were revealed in the form of a decrease in the indices of initial respiration, basal respiration with the participation of the I complex (KI) ETC in the process of oxidation of pyruvate and pyruvate-malate substrates, oxidative phosphorylation with the participation of KI. Structural changes of muscle tissue in the form of asymmetric hypertrophy and partial fat replacement of the involved muscles are demonstrated. The presence of fat replacement reduced the difference on the TWSTRS scale before botulinum therapy and 3 weeks after injection. CONCLUSIONS. Patients with dystonia have bioenergetic changes in muscle tissue in the form of a defect in the work of the KI respiratory chain, but these changes do not affect the effectiveness of botulinum therapy. Structural changes in the form of partial fat replacement of muscle tissue reduce the effectiveness of botulinum therapy.
背景。肌张力障碍是一种中枢神经系统的局部病理过程和局部肌肉高张力形成的综合征。研究肌张力障碍中参与运动亢进的肌肉变化作为该疾病的可能症状之一是有意义的。的目标。确定特发性肌张力障碍患者肌肉结构和生物能量的变化。材料和方法。10例患者被诊断为特发性节段性和全身性肌张力障碍,包括宫颈肌张力障碍综合征。对照组为条件健康个体5例。所有患者均接受A型肉毒毒素注射,注射前和注射后3周分别进行TWSTRS和Tsui疗效评分。采用磁共振成像(MRI) (1.5 Tl)评估肌肉结构变化。为了评估生物能量变化,研究了线粒体呼吸参数,包括底物(丙酮酸酯和丙酮酸酯-苹果酸酯)氧化过程中的基础呼吸、呼吸链复合物氧化磷酸化过程中的呼吸、电子传递链容量(ETC)、斜方肌活检中atp相关呼吸。结果。肌肉组织的生物能量变化表现为初始呼吸指数的降低,丙酮酸和丙酮酸-苹果酸底物氧化过程中I复合物(KI) ETC参与的基础呼吸指数的降低,KI参与的氧化磷酸化。肌肉组织的结构改变以不对称肥大和部分脂肪替代受累肌肉的形式被证明。脂肪替代的存在减少了肉毒杆菌治疗前和注射后3周TWSTRS量表的差异。结论。肌张力障碍患者在肌肉组织中以KI呼吸链工作缺陷的形式发生生物能量变化,但这些变化不影响肉毒杆菌治疗的有效性。部分脂肪替代肌肉组织的结构改变会降低肉毒杆菌治疗的有效性。
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引用次数: 0
ICD-11: Routine diagnostic tool without the splendor of classical psychopathology of the past ICD-11:常规诊断工具,没有过去经典精神病理学的辉煌
Pub Date : 2022-11-04 DOI: 10.17816/nb109313
The psychiatric section of ICD-11 is the subject of criticism both in the world and in the Russian psychiatric community. Russian psychiatrists find such shortcomings in the ICD-11 as excessive simplicity of presentation, lack of in-depth psychopathology, unjustified removal of gender dysphoria from the list of mental, behavioral and neurodevelopmental disorders. The authors of this article tend to consider the noted features of the new version of the ICD as advantages rather than disadvantages, and regard it far from ideal and in many ways inferior to the DSM-5, but quite suitable for the psychiatric practice diagnostic tool.
ICD-11的精神病学部分是世界和俄罗斯精神病学社区批评的主题。俄罗斯的精神科医生发现ICD-11的缺点是表现过于简单,缺乏深入的精神病理学,不合理地将性别焦虑症从精神、行为和神经发育障碍的列表中删除。本文的作者倾向于认为新版ICD的显著特点是优点而不是缺点,并认为它远非理想,在许多方面不如DSM-5,但非常适合精神病学实践诊断工具。
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引用次数: 0
Some theoretical models of addictive disorder are used for behavioral transformation 成瘾障碍的一些理论模型被用于行为转化
Pub Date : 2022-11-04 DOI: 10.17816/nb109102
Existential, neurobiological and cognitive models of addictive behavior are considered as a theoretical basis for transformational therapy of addictive disorders. The NMDA receptor antagonist ketamine, which has neurotrophic, modulatory and psychedelic effects, demonstrates the universal properties of a transforming agent for any of the presented concepts of addictive behavior. Since persistent mental and behavioral changes essentially are psychobiological changes, the substrate that determines the effectiveness of the intervention is synaptic plasticity and neural network remodeling.
成瘾行为的存在主义、神经生物学和认知模型被认为是成瘾障碍转化治疗的理论基础。NMDA受体拮抗剂氯胺酮具有神经营养、调节和迷幻作用,证明了任何成瘾行为概念的转化剂的普遍特性。由于持续的心理和行为变化本质上是心理生物学变化,因此决定干预有效性的基础是突触可塑性和神经网络重塑。
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引用次数: 0
Social intelligence in the context of the development of subjective cognitive impairment 社会智力在主观认知障碍发展的背景下
Pub Date : 2022-11-04 DOI: 10.17816/nb106918
BACKGROUND. The presented literature review reveals the topic of subjective cognitive impairment in the context of social intelligence disorders as one of the most important components of cognitive functions. AIM. Analysis of existing literature data on subjective cognitive impairments and assessment of social intelligence. MATERIAL AND METHODS. Various sources were considered during conducting a literature review on the selected topic. The search depth was more than 15 years. Russian and foreign sources were studied on Internet platforms such as Web of science, UpToDate, PubMed, Medscape, eLIBRARY for selection of literature. RESULTS. The paper compares the types of cognitive disorders and the main differences between the group of subjective disorders and other pronounced forms of cognitive disorders. The key differences include the impossibility of making a diagnosis based on the results of neuropsychological testing, the absence of a clinically pronounced syndrome and difficulties in performing everyday tasks. The connection of social intelligence with factors adversely affecting the state of health is considered, and a generalizing characteristic of social intelligence as a separate cognitive function is presented. CONCLUSION. The low detectability of subjective cognitive impairments is associated with ignorance of their severity on the part of both the doctor and the patient. There is a problem of adequate methods for assessing subjective cognitive impairment using neuropsychological testing, including determining the level of social intelligence. The most accurate method of assessing social intelligence is the Guilford test.
背景。本文对社会智力障碍背景下的主观认知障碍作为认知功能的重要组成部分进行了综述。的目标。主观认知障碍与社会智力评估的现有文献资料分析。材料和方法。在对所选主题进行文献综述时,考虑了各种来源。搜寻深度超过15年。在Web of science, UpToDate, PubMed, Medscape, library等互联网平台上研究俄罗斯和国外来源,以选择文献。结果。本文比较了认知障碍的类型和主观性障碍组与其他显著形式的认知障碍的主要区别。关键的区别包括无法根据神经心理学测试的结果做出诊断,没有临床明显的综合症,以及在执行日常任务时遇到困难。社会智力与影响健康状况的因素之间的联系被认为是不利的,并提出了社会智力作为一种单独的认知功能的概括特征。结论。主观认知障碍的低可检测性与医生和患者对其严重程度的无知有关。目前存在一个问题,即使用神经心理学测试来评估主观认知障碍,包括确定社会智力水平。评估社会智力最准确的方法是吉尔福德测验。
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引用次数: 0
On some aspects of psychiatric diagnosis 关于精神病诊断的一些方面
Pub Date : 2022-11-04 DOI: 10.17816/nb109667
At present, the concepts of psychical disease and disorder are compared. The concept of disease is preferred. Psychiatric diagnosis and its aspects are considered for the position of the biopsychosocial (trichotomy) model, the second term is preferred, the concept of a soul is concretized. The medical aspect is pathological experiences, the social one is the demetaphorization of the disease, the destigmatization of the patient, the psychological one is the impact on the healthy among the sick, the philosophical one is divine madness is teleological.
目前,对精神疾病和精神障碍的概念进行了比较。优先考虑疾病的概念。精神病学诊断及其方面被考虑为生物-心理-社会(三分法)模型的位置,首选第二项,灵魂的概念具体化。医学方面是病理经验,社会方面是疾病的去隐喻化,病人的去污名化,心理方面是病人对健康的影响,哲学方面是神性疯狂是目的性的。
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引用次数: 0
期刊
Neurology Bulletin
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