Pub Date : 2024-03-01DOI: 10.30629/2618-6667-2024-22-1-47-57
I. A. Zrazhevskaya, K. V. Bykov, E. Topka, R. N. Isaev, A. M. Orlov
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.
{"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":null,"pages":null},"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}
Pub Date : 2024-03-01DOI: 10.30629/2618-6667-2024-22-1-90-98
A. V. Abramov, E. Makushkin
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.
背景：谷氨酸受体功能障碍在精神障碍、神经系统、自身免疫和肿瘤病理学中的作用在过去十年中得到了深入研究。本研究的目的是描述与遗传引起的谷氨酸能受体结构改变有关的神经发育障碍（根据国际疾病分类第 11 版，L1-6A0）的现代概念。材料与方法：在 MEDLINE/Gene 数据库、MEDLINE/PubMed 科学图书馆、Online Mendelian Inheritance in Man (OMIM)、UniProt、ClinGen 和 eLibrary 中搜索了与离子型和代谢型谷氨酸受体亚基遗传缺陷相关的神经精神发育受损病例。大多数已知的离子型谷氨酸受体（GluA、GluN、GluK、GluD）和一些代谢型谷氨酸受体（mGluR1、5、7）的遗传诱导结构异常与神经精神障碍的严重变异有关，这些变异表现在婴儿期和幼儿期。结论：这些病例的临床表现差异很大，需要儿科、儿童精神病学、神经病学、遗传学以及医疗和社会康复等方面的专家合作，采用跨病种的方法对患者进行诊断和管理。
{"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":null,"pages":null},"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}
Pub Date : 2024-03-01DOI: 10.30629/2618-6667-2024-22-1-36-46
A. Pichikov, D. I. Tikhomirov, M. Sorokin, L. V. Lukina, R. Grebenshchikova
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.
{"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":null,"pages":null},"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}
Pub Date : 2024-03-01DOI: 10.30629/2618-6667-2024-22-1-58-67
A. Kosikova, I. Shoshina, S. Lyapunov, Z. Guseinova, I. Lyapunov, A. A. Radivilko, M. V. Ivanov
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.
{"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":null,"pages":null},"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}
Pub Date : 2024-02-29DOI: 10.30629/2618-6667-2024-22-1-6-14
L. V. Androsova, A. Simonov, O. V. Senko, N. M. Mikhaylova, A. V. Kuznetsova, T. Klyushnik
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.
背景：作为最常见的痴呆症，阿尔茨海默病（AD）的特点是认知能力退化，通常以丧失对近期事件的记忆开始。目的：根据白细胞弹性蛋白酶（LE）的酶活性和α1-蛋白酶抑制剂（α1-PI）的功能活性等炎症标志物开发机器学习算法，用于诊断和评估阿尔茨海默病的严重程度。患者和方法：研究对象包括128名年龄在55至94岁（73.7 ± 7.9岁）的患者，其中91名患者被诊断为阿尔茨海默病，37名患者为表面健康者（对照组）。血浆中的 LE 和 α1-PI 指标被用作建立模型的分类特征。建立机器学习模型时使用了以下算法：最佳有效分区（OVP）、逻辑回归（LR）、支持向量机（SVM）、随机森林（RF）、梯度提升（GB）和统计加权综合征（WSWS）。结果表明：所开发的机器学习算法可以在 LE 和 α1-PI 坐标的二维图表中将一般受试者群体（患者 + 条件健康者）以及不同 AD 严重程度的患者可靠地划分为 4 个象限，并显示出接近和相当高的预测效率。结论：事实证明，所开发的机器学习算法在根据炎症标志物（LE 的酶活性和 α1-PI 的功能活性）评估注意力缺失症严重程度方面具有接近和足够高的预后效力，可能有助于疾病的早期诊断和及时治疗。
{"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":null,"pages":null},"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}
Pub Date : 2024-02-29DOI: 10.30629/2618-6667-2024-22-1-15-25
A. Dudina, D. Tikhonov, O. Y. Vershinina, V. Kaleda, I. S. Lebedeva
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.
{"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":null,"pages":null},"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}
Pub Date : 2024-01-31DOI: 10.30629/2618-6667-2023-21-7-46-64
N. Kolomeets
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.
背景：精神分裂症被认为是一种连接障碍性疾病，神经影像学研究显示，白质和灰质的髓鞘化发生了改变。髓鞘化改变提示少突胶质细胞（OL）家族病变。少突胶质细胞祖细胞（OP）在成熟大脑分化的最后阶段髓鞘化轴突，因此特别值得关注。综述的目的是总结有关精神分裂症 OL 家族细胞周期改变的现代研究数据及其合理原因。材料与方法：使用关键词 "精神分裂症、OL、OP"、"OP 与精神分裂症风险基因"、"OP 与神经损伤"、"OP 与抗精神病药物"、"OP、多巴胺、5-羟色胺"，在 MedLine/PubMed、Google Scholar、eLibrary 数据库中选择了 164 项有关上述因素对 OP 分化影响的研究进行分析。 结论：死后研究表明，OL 家族细胞基本缺失，这些细胞数量之间的相关模式发生了改变，这表明 OP 分化发生了改变。一些导致精神分裂症风险较高的 OL 和髓鞘相关基因变异在 OP 分化过程中起着关键作用。神经炎症是精神分裂症大脑病理学的重要组成部分，而促炎细胞因子和活化的小胶质细胞对 OP 的增殖和分化有很大影响。非典型抗精神病药物能够纠正 OP 的成熟，并具有抗炎作用。OL和OP以及小胶质细胞和外周免疫细胞表达多巴胺和5-羟色胺受体，这是这些药物的主要治疗靶点。OP病理学是精神分裂症发病机制的重要组成部分，与其他异常密切相关，被认为是未来治疗策略的有希望的靶点。
{"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":null,"pages":null},"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}
Pub Date : 2024-01-31DOI: 10.30629/2618-6667-2023-21-7-65-75
O. S. Zaitsev, N. P. Ilyaev, O. A. Maksakova
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.
{"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":null,"pages":null},"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}
Pub Date : 2024-01-31DOI: 10.30629/2618-6667-2023-21-7-76-96
Y. Fedorova
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.
{"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":null,"pages":null},"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}
Pub Date : 2024-01-31DOI: 10.30629/2618-6667-2023-21-7-31-45
M. Kuzminova, T. Solokhina
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.
{"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":null,"pages":null},"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}
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