bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2025-4-2-1202bekhterev-1243Research ArticleИССЛЕДОВАНИЯINVESTIGATIONSФакторы гедонистического баланса в постифекционном периоде COVID-19 пациентов психиатрического стационараFactors of hedonistic balance in the post-infection period of COVID-19 in psychiatric inpatientshttps://orcid.org/0009-0000-2343-4643КатынкинИ. Р.KatynkinI. R.

Катынкин Илья Романович — врач-психиатр

300045, Тульская область, г. Тула, ул. Оборонная, д. 114а

Ilya R. Katynkin

Tula

ilya_111198@mail.ruhttps://orcid.org/0000-0003-2502-6365СорокинМ. Ю.SorokinM. Yu.

Сорокин Михаил Юрьевич – к.м.н., ведущий научный сотрудник отделения интегративной фармако-психотерапии психических расстройств, учёный секретарь

192019, г. Санкт-Петербург, ул. Бехтерева, 3

Mikhail Yu. Sorokin

St. Petersburg

m.sorokin@list.ruhttps://orcid.org/0000-0002-9481-7411ЛутоваН. Б.LutovaN. B.

Лутова Наталия Борисовна — д.м.н., главный научный сотрудник отделения интегративной фармако-психотерапии психических расстройств, руководителя Института клинической психиатрии

192019, г. Санкт-Петербург, ул. Бехтерева, 3

Natalia B. Lutova 

St. Petersburg

lutova@mail.ruhttps://orcid.org/0009-0001-5872-7195ШабельникА. В.ShabelnikA. V.

Шабельник Антон Вадимович - аспирант отделения интегративной фармако-психотерапии психических расстройств

192019, г. Санкт-Петербург, ул. Бехтерева, 3

Anton V. Shabelnik

St. Petersburg

dr.shabelnik.psy@mail.ruТерриториальный центр медицины катастроф, скорой и неотложной медицинской помощиРоссияTerritorial center of disaster medicine, emergency and urgent medical careRussian FederationНациональный медицинский исследовательский центр психиатрии и неврологии имени В.М. БехтереваРоссияV.M. Bekhterev National Medical Research Centre for Psychiatry and NeurologyRussian Federation202510012026594-28799Copyright © Катынкин И.Р., Сорокин М.Ю., Лутова Н.Б., Шабельник А.В., 20262026Катынкин И.Р., Сорокин М.Ю., Лутова Н.Б., Шабельник А.В.Katynkin I.R., Sorokin M.Y., Lutova N.B., Shabelnik A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/1243

Инфекция SARS-CoV-2 сопряжена с развитием мотивационно-гедонистических нарушений при постковидном синдроме. Известно, что ангедония связана с высоким риском развития суицидальной идеации, что подчеркивает важность её изучения. Цель исследования - определить вероятные клинико-терапевтические и социо-демографические предикторы выраженной ангедонии, а также установить соотношение ее физических и социальных аспектов у пациентов психиатрического стационара, перенесших COVID-19. Материалы и методы. Вторичный анализ ретроспективных данных 48 человек, проходивших лечение в психиатрическом стационаре. Зафиксированы социо-демографический статус, нейропсихиатрические симптомы, сведения о диагностике и характере течения COVID-19. Для оценки структуры гедонистических нарушений использованы русскоязычные версии пересмотренной шкалы физической ангедонии (RPAS) и опросника выявления социальной ангеднии (RSAS). Сведения о медикаментозной терапии, проводившейся в течение 2 недель до госпитализации и на протяжении текущего стационарного лечения собраны из первичной медицинской документации. Также извлечены показатели скорости оседания эритроцитов (СОЭ) в качестве показателя системного воспаления и индекс массы тела (ИМТ) - маркер метаболического синдрома. Объективная оценка физиологических функций проведена по вариабельности артериального давления.

Результаты. Частично подтверждена гипотеза, что ангедония является компонентом постковидного синдрома. Среди терапевтических стратегий купирования отсроченных нейропсихиатрических симптомов, по прошествии большего времени наблюдалось увеличение назначаемых в стационаре доз антидепрессантов. В качестве предикторов развития физической ангедонии - установлены значимые ассоциации с выраженностью социальной ангедонии, полом, приемом антипсихотических препаратов, типом и дозой антидепрессантов, вариабельностью артериального давления. Заключение. Продемонстрирован потенциал коррекции ангедонии в рамках постинфекционного периода COVID-19 при выборе рациональной терапевтической стратегии и в частности - современных антидепрессантов, а также при уменьшении явлений сосудистой дисрегуляции.

SARS-CoV-2 infection is associated with the development of motivational-hedonistic disorders in post-COVID syndrome. It is known that anhedonia is associated with a high risk of suicidal ideation, which emphasizes the importance of its study. The aim of the study was to determine probable clinical, therapeutic and socio-demographic predictors of severe anhedonia, as well as to establish the ratio of its physical and social aspects in psychiatric inpatients who had COVID-19. Materials and methods. Secondary analysis of retrospective data from 48 people treated in a psychiatric hospital. Sociodemographic status, neuropsychiatric symptoms, information on the diagnosis and nature of the course of COVID-19 were recorded. To assess the structure of hedonistic disorders, the Russian-language versions of the Revised Physical Anhedonia Scale (RPAS) and the Social Anhedonia Assessment Questionnaire (RSAS) were used. Information on drug therapy administered during the 2 weeks prior to hospitalization and during current inpatient treatment was collected from primary medical records. Erythrocyte sedimentation rate (ESR) as an indicator of systemic inflammation and body mass index (BMI) as a marker of metabolic syndrome were also extracted. An objective assessment of physiological functions was performed based on blood pressure variability.

Results. The hypothesis that anhedonia is a component of post-COVID syndrome was partially confirmed. Among therapeutic strategies for relieving delayed neuropsychiatric symptoms, an increase in the doses of antidepressants prescribed in the hospital was observed after a longer period of time. Significant associations with the severity of social anhedonia, gender, use of antipsychotic drugs, type and dose of antidepressants, and blood pressure variability were established as predictors of the development of physical anhedonia. Conclusion. The potential for correcting anhedonia in the post-infection period of COVID-19 was demonstrated by choosing a rational therapeutic strategy, in particular modern antidepressants, as well as reducing the phenomena of vascular dysregulation.

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The authors declare that there are no conflicts of interest present.