Consortium psychiatricum最新文献

Background: During the COVID-19 pandemic, Tunisia implemented a national lockdown between March and May 2020. This disrupted daily life and limited access to essential services. The restrictions significantly reduced social interactions and outdoor activities for children and adolescents, raising concerns about the psychological impact on this population.

Aim: To assess the psychological impact of the COVID-19 lockdown on children and adolescents in Tunisia.

Methods: A cross-sectional study using a telephone survey was conducted among 514 Tunisian households in August 2020. We included parents of children aged five to 15 years. The collected data included sociodemographic characteristics, general information, and details on the establishment of routines and adaptive containment measures. A 26-item questionnaire was developed to assess anxiety and emotional and behavioral symptoms. Data were analyzed using descriptive statistics and chi-square tests.

Results: Parents reported depressive symptoms, anxiety symptoms and behavioral manifestations in 38.7%, 69.8% and 61.9% of their children, respectively. Among children, female sex was associated with significantly greater levels of depressive symptoms, sleep disturbances, and eating disturbances (p=0.002, p=0.034 and p=0.011, respectively). Children who had somatic chronic illnesses or whose parents had such conditions reported significantly greater levels of somatic complaints (p=0.037). Those whose fathers continued to work during the lockdown had a more positive attitude toward the COVID-19 pandemic (p=0.027). Children with anxiety symptoms had more positive attitudes towards the COVID-19 pandemic (p=0.002); however, those with depressive symptoms did not (p=0.19).

Conclusion: The COVID-19 lockdown had a substantial psycho-logical impact on children and adolescents in Tunisia, as indicated by high rates of anxiety, depression, and behavioural disturbances. These findings may contribute to the formulation of evidence-based recommendations aimed at safeguarding the mental health of children and adolescents in future pandemic scenarios, thereby minimizing adverse psychological outcomes.

Background: This case series presents a unique manifestation of shared psychotic disorder "folie à trois" transmitted entirely through digital interactions. It is among the first documented clinical accounts demonstrating that immersive online alliances - without physical proximity - can serve as fertile ground for psychotic contagion. The report contributes to evolving psychiatric frameworks by highlighting the role of "virtual cohabitation" in shaping shared delusional systems.

Case series presentation: Three young adult males from different cities in West Bengal developed a shared persecutory delusional system over three years of daily interaction within an online gaming guild. The inducer (Case A) presented with severe paranoia, digital surveillance delusions, and insomnia. Recipients (Cases B and C) displayed alignment with these beliefs, marked social withdrawal, and psychological dependency on the inducer. All patients were diagnosed with shared psychotic disorder. Interventions included second-generation antipsychotics (risperidone, olanzapine, aripiprazole), structured cognitive-behavioral therapy, digital hygiene protocols, and psychoeducation. Separation of digital communication among the triad facilitated therapeutic gains. All three demonstrated symptomatic improvement over 2-3 months, with partial restoration of social functioning.

Conclusion: This case underscores that psychological proximity fostered through immersive digital platforms may suffice for the transmission of delusional beliefs. Clinicians must routinely explore virtual relationships and digital group identities as potential vectors of psycho-pathology. Early detection, digital boundary setting, and integrative therapy approaches are essential in managing such emerging presentations.

Background: Visual perception plays a crucial role in cognitive and behavioral development. Individuals with autism spectrum disorder (ASD) and mild intellectual disability (ID) exhibit distinct patterns of visual processing that influence their learning and interaction with the environment.

Aim: This study aims to compare the visual perception abilities of children with ASD and those with mild ID.

Methods: This study employed an experimental comparative design. The Bender Visual-Motor Gestalt Test was administered to assess visual-motor integration, perceptual organization, and spatial processing abilities. It was scored based on standard qualitative and quantitative criteria. Group comparisons were conducted using descriptive statistics and cross-group performance patterns.

Results: A total of 15 children (8 with ASD and 7 with mild ID), aged between 7 to 12 years, participated in the study. Children with ASD demonstrated superior spatial organization and attention to local details, whereas children with mild ID demonstrated significant difficulties in perceptual coherence, spatial alignment, and motor coordination.

Conclusion: The study highlights the importance of developing tailored intervention strategies that address the distinct perceptual processing styles associated with ASD and mild ID. However, limitations such as a lack of detailed diagnostic criteria, absence of symptom severity differentiation, and failure to control for developmental age must be considered when interpreting the findings. Future research should aim to overcome these limitations by including standardized diagnostic measures, creating a larger and more diverse sample, and involving additional assessment tools for a more comprehensive analysis.

Background: The "Perceived Ability to Cope with Trauma Scale" (PACT) is designed to assess individuals' perceptions of their ability to use various coping strategies when facing potentially traumatic events. These include focusing on the cognitive processing of the trauma (the "Trauma Focus" subscale) and overcoming the trauma (the "Forward Focus" subscale). The key advantages of the PACT scale include an emphasis on perceived self-competence, the absence of the "flexibility/rigidity" dichotomy, and moderate correlations with distress that confirm discriminative validity.

Aim: To adapt the PACT scale for the Russian population and conduct a psychometric assessment of its Russian-language version.

Methods: The adaptation procedure included direct and reverse translations of the PACT scale and expert assessment of their quality. To validate the adapted version of the PACT questionnaire, a survey was conducted involving adults who had experienced at least one potentially traumatic event (with assessment according to the Life Events Checklist for DSM-5). The sample was made up of civilians and employees of emergency services (firemen, rescue workers, physicians, psychologists). The psychometric assessment included a check of the factor structure, assessment of sex, age, occupation, and post-traumatic status invariance, as well as assessment of internal consistency and test-retest reliability. The International Trauma Questionnaire and Depression Anxiety and Stress Scale-21 were used to test convergent validity.

Results: A psychometric assessment of the adapted version of the PACT scale was conducted with 1,054 respondents (56% male) with a mean age of 37.2 (standard deviation 9.54) years. Confirmatory factor analysis confirmed the two-factor structure of the scale, complete invariance by age and partial invariance by sex, occupation, and post-traumatic status. The reliability coefficients (Cronbach's α and McDonald's ω) showed good values for the "Trauma Focus" subscale (ω=0.810, α=0.806) and the "Forward Focus" subscale (ω=0.896, α=0.893). The test-retest reliability was partially confirmed. The convergent validity of the adapted version of the PACT scale was confirmed: symptoms of distress and post-traumatic stress were negatively correlated with the score on the "Forward Focus" subscale and positively correlated with the "Trauma Focus" score.

Conclusion: The Russian-language version of the PACT scale is valid, reliable, and can be used to assess the perceived ability to cope with trauma for research or counseling purposes.

Background: The international community is acutely facing a global problem of refugees and forcibly displaced persons. The situation is currently escalating into a crisis, creating serious humanitarian, social, and healthcare challenges. The forced displacement of the entire Armenian population of Nagorno-Karabakh in 2023 became an emergency in Armenia and highlighted a number of societal issues, including the mental health of the displaced population. What made this migration stand out was its dual nature: on the one hand, it was a flight across national borders to a neighboring country, and on the other hand, it was a return to the historical homeland with which they share a common history, culture, language, and religion.

Aim: To evaluate the mental state of the persons forcibly displaced from Nagorno-Karabakh to Armenia and the risk factors underlying their developing anxiety and depression disorders.

Methods: We performed statistical data processing using hierarchical regression analysis.

Results: The study was conducted among 733 respondents. The majority of the forcibly displaced persons were women. Most of the refugees were married, relocated with their families, and had mainly secondary education. One in five reported a history of mental trauma. More than half of the respondents showed signs of depression and anxiety that required therapeutic intervention. These individuals exhibited significant impairments in functionality and capacity for work.

Conclusion: The study revealed the severity and prevalence of anxiety and depression disorders in forcibly displaced persons. Forced displacement was the key factor in the development of mental disorders in this population. Demographic characteristics, such as sex, age, and marital status, also have a significant impact.

Background: Cognitive impairment in schizophrenia patients is characterized by decreased functioning, reduced quality of life, and is a predictor of a more severe course of the disease. The rs4680 variant of the COMT gene (Val158Met), which encodes catechol-O-methyltransferase, affects dopamine metabolism in the prefrontal cortex and is a key genetic modifier of cognitive endophenotypes. However, the associations of the rs4680 alleles with the severity of cognitive impairment remain unclear. This review summarizes and critically re-evaluates the evidence on the role of rs4680 in the development of cognitive deficits in schizophrenia.

Aim: To explore the associations of the rs4680 variant of the COMT gene with cognitive functions in schizophrenia.

Methods: A literature search of the PubMed database for the last 10 years (2014-2024) was performed with the search query "rs4680 schizophrenia cognition". The review included 11 studies.

Results: In the majority of studies (9 out of 11), carriers of the Met allele demonstrated better cognitive parameters, such as verbal and visual memory, information processing speed, and regulatory functions (especially in men). Individuals with the Val/Val genotype demonstrated worse attention. Women in the Russian population with Met allele had better conceptualization and inhibitory control results, and men in the Han population with Met allele had a better association with memory and attention.

Conclusion: The results of this review confirm the association between the rs4680 variant of the COMT gene and cognitive function. Although the quality of the studies included in this review was low, the overall results indicate that further investigation of this association is promising. The identification of a stable association between the COMT genotype and the severity of cognitive deficit provides the basis for a personalized approach in the management of patients with schizophrenia. Further studies on the validation of genetic markers in independent cohorts and the development of algorithms for the integration of genetic data with complex neurocognitive assessments and clinical endophenotypes are needed to make the clinical implementation of this approach successful.

Background: Delirious mania (DM) is a severe neuropsychiatric syndrome characterized by the acute onset of delirium, psychosis and increased psychomotor activity. Its classification remains debated, with overlapping features of mania, catatonia, and delirium complicating diagnosis and treatment. The condition poses significant challenges in differential diagnosis, particularly in patients with comorbid medical conditions.

Case presentation: We report the case of a 52-year-old man with bipolar disorder who presented with acute agitation, disorientation, confabulation, incontinence, and severe behavioral disturbances, initially suggestive of DM. Despite targeted psychiatric treatment, his condition remained refractory until a syphilitic infection was identified, with a possible presentation of neurosyphilis, and treated with antibiotic therapy. Resolution of his symptoms followed, with the delirium persisting briefly after the mania had subsided, suggesting an organic contribution to his presentation.

Conclusion: This case highlights the importance of considering organic etiologies, such as neurosyphilis, in presentations of DM. It also supports the view that DM may represent a syndromic entity with both psychiatric and medical underpinnings, rather than merely a subtype of bipolar disorder. Early identification and treatment of DM, along with any underlying medical conditions, are crucial for patient recovery.

Background: Schizotypy (ST) and psychotic-like experiences and negative symptoms (PENS) are commonly used phenotypes in high-risk and early intervention research for schizophrenia and other non-affective psychoses. However, the origin of these phenotypes in the general population is poorly understood and their association with the genetic predisposition to psychoses has not yet been proven.

Aim: The aim of this study is to answer the question of whether data on the relations of ST and PENS with polygenic risk scores for schizophrenia (SZ-PRS) support the hypothesis that these phenotypes are subclinical manifestations of genetic liability for schizophrenia.

Methods: Literature describing these relations in the general population was analyzed. The literature search was performed in the PubMed database using the following keywords in English: (("schizotyp*" OR "psychotic-like experiences" OR "psychosis proneness" OR "psychotic experiences") AND ("polygenic risk" OR "genetic liability" OR "polygenic score")); the search in eLIBRARY.RU was conducted using the Russian words for "schizotypy", "schizotypal features", "psychotic experiences", "psychotic experience", "psychotic symptoms", and "polygenic risk", covering publications from 2009 to 2024.

Results: Of the identified records, 45 publications were found eligible. No expected positive correlations of SZ-PRS with common ST measures have been observed. For PENS, the results are inconsistent. Overall, SZ-PRS correlate more often with the PENS general factor and negative symptoms than with psychotic experiences per se.

Conclusion: The literature does not provide convincing evidence of the association between SZ-PRS and ST/PENS. The search for the substantive psychological meaning of polygenic vulnerability to psychosis captured by SZ-PRS should be expanded to other personality processes and traits.

Background: The advent of neuroleptics and antidepressant therapy marked a significant step forward in clinical psychiatry. Numerous experiments worldwide had been dedicated to a search for the potential neurobiological mechanisms underlying the potency of new psychopharmacological drugs. The first laboratory of psychopharmacology in the USSR was established in 1960 at the Leningrad Psychoneurological Institute. It was headed by Professor Izyaslav Petrovich Lapin. The foundational article by Lapin I.P. and Oksenkrug G.F. (The Lancet, 1969) continues to be cited 55 years after its publication, which determines the interest in the role of this research team in shaping temporal concepts of the pathogenesis of depression and the development of psychopharmacology.

Aim: To analyze the contribution of Lapin I.P. and his research team to the development of experimental approaches for studying the mechanisms of depression.

Methods: We analyzed the articles and monographs authored by Professor Lapin I.P., both individually and in coauthorship, available in PubMed, Google Scholar, eLIBRARY.RU, and in the bibliographic collection of the V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology.

Results: This analysis highlights the significance of Lapin I.P. and his scientific team's work in advancing our understanding of serotonin role in the mechanisms of depression and in the development of animal depression models. The scientific contribution of this team is an important milestone towards future research into the neurobiological mechanisms underlying depression, as well as the development of therapeutic approaches.

Conclusion: Lapin's scientific publications and the work of his team in the field of psychopharmacology have had a significant impact on the development of neuroscience and continue to be of unquestionable importance in advancing scientific practice more than 50 years later.

Background: Anticonvulsants are widely used in treating patients with mental and neurological disorders. Their long-term use increases the risk of a decrease in bone mineral density (BMD) and low-energy fractures. Despite the growing number of studies of drug-induced osteoporosis, the effect of anticonvulsants on bone microarchitecture remains poorly studied.

Aim: To study the effect of treatment duration with different generations of anticonvulsants on bone mineral density and fracture risk.

Methods: We examined 100 adult patients with epilepsy who had been on anticonvulsants for more than 12 months and 58 healthy subjects who had never taken anticonvulsants. All the participants underwent a general clinical and neuropsychological assessment, as well as bone densitometry using quantitative computed tomography in three regions of interest (lumbar vertebrae L1, L2 and femoral neck).

Results: BMD reductions were observed in 47 patients (47%) taking anticonvulsants and 29 (50%) subjects in the control group. The mean duration of anticonvulsant therapy was 8.7 years (SD=8.05) in patients with normal BMD, 10.7 years (SD=7.07) in patients with osteopenia, and 9.5 years (SD=5.24) in patients with osteoporosis. Age was found to significantly affect BMD, while the duration of anticonvulsant therapy affected it to a lesser extent. Patients taking first-generation anticonvulsants had lower BMD (p=0.018). ROC analysis confirmed the existence of a relationship between the duration of anticonvulsant therapy and the risk of fractures (p<0.001). The "duration of anticonvulsant therapy" threshold at the cut-off point corresponding to the highest Youden index value was 10 years.

Conclusion: Long-term treatment with conventional anticonvulsants adversely affects BMD and can lead to pathological bone resorption, increasing the risk of fractures in patients. New-generation anticonvulsants did not show any significant negative impact on BMD. The results of this study indicate the need for further research to better understand the effects of anticonvulsants on bone tissue.