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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">bekhterev</journal-id><journal-title-group><journal-title xml:lang="ru">Обозрение психиатрии и медицинской психологии имени В.М.Бехтерева</journal-title><trans-title-group xml:lang="en"><trans-title>V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7053</issn><issn pub-type="epub">2713-055X</issn><publisher><publisher-name>V. M. BEKHTEREV  NATIONAL  RESEARCH  MEDICAL  CENTER  FOR  PSYCHIATRY  AND  NEUROLOGY                           OF    THE  RUSSIAN  FEDERATION   MINISTRY  OF  HEALTH</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31363/2313-7053-2025-4-2-1258</article-id><article-id custom-type="elpub" pub-id-type="custom">bekhterev-1262</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НАУЧНЫЕ ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>SCIENTIFIC REVIEW</subject></subj-group></article-categories><title-group><article-title>Депрессивные и тревожные расстройства как междисциплинарная проблема: пути оптимизации диагностики и лечения в практике психиатра и невролога</article-title><trans-title-group xml:lang="en"><trans-title>Depressive and Anxiety Disorders as an Interdisciplinary Problem: Optimizing Diagnosis and Treatment in Psychiatric and Neurological Practice</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4658-2195</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Касьянов</surname><given-names>Е. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Kasyanov</surname><given-names>E. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Касьянов Евгений Дмитриевич — к.м.н., ведущий научный сотрудник отделения социальной нейропсихиатрии</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Kasyanov Evgeny Dmitrievich – PhD in Medicine, Leading Researcher at the Department of Social Neuropsychiatry</p><p>St. Petersburg</p></bio><email xlink:type="simple">i@kasyan.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6437-232X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Амелин</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Amelin</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Амелин Александр Витальевич — д.м.н., профессор кафедры неврологии, руководитель отдела общей неврологии</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Amelin Alexander Vitalievich – MD, PhD in Medicine, Professor, Professor of the Department of Neurology, Head of the General Neurology Department of the Neurology Research Institute</p><p>St. Petersburg</p></bio><email xlink:type="simple">avamelin@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5116-836X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Васильева</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Vasilyeva</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Васильева Анна Владимировна — д.м.н., руководитель международного отдела, главный научный сотрудник отделения лечения пограничных психических расстройств и психотерапии; профессор кафедры психотерапии и сексологии</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Vasilyeva Anna Vladimirovna – MD, PhD in Medicine, Head of the International Department, Chief Researcher of the Department of Treatment of Borderline Mental Disorders and Psychotherapy; Professor of the Department of Psychotherapy and Sexology</p><p>St. Petersburg</p></bio><email xlink:type="simple">annavdoc1@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0608-3831</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дроздова</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Drozdova</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дроздова Екатерина Александровна — к.м.н., заведующая неврологическим отделением для лечения больных</p><p>Нижний Новгород</p></bio><bio xml:lang="en"><p>Drozdova Ekaterina Alexandrovna – PhD in Medicine, Head of the Neurology Department for Stroke Patients of the Regional Vascular Center No. 1, Neuropsychologist-Aphasiologist</p><p>Nizhny Novgorod</p></bio><email xlink:type="simple">hosp13_2nevrol@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2266-9197</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захаров</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharov</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Захаров Денис Валерьевич — д.м.н., главный научный сотрудник, заведующий отделением интегративной терапии больных нейропсихиатрического профиля</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Zakharov Denis Valerievich - MD, PhD in Medicine, Chief Researcher, and Head of the Department of Integrative Therapy for Neuropsychiatric Patients</p><p>St. Petersburg</p></bio><email xlink:type="simple">zaharov_dv@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2214-3187</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иванова</surname><given-names>Г. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Ivanova</surname><given-names>G. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Иванова Галина Евгеньевна — д.м.н., профессор, заведующая кафедрой медицинской реабилитации, руководитель НИЦ медицинской реабилитации ФГУ ФЦМН ФМБА России, председатель Союза реабилитологов России, главный внештатный реабилитолог Минздрава России</p><p>Москва</p></bio><bio xml:lang="en"><p>Ivanova Galina Evgenevna - MD, PhD in Medicine, Professor, Chief Specialist in Medical Rehabilitation of the Ministry of Health of the Russian Federation, Head of the Department of Medical Rehabilitation; Head of the Department of Medical Rehabilitation</p><p>Moscow</p></bio><email xlink:type="simple">reabilivanova@mail.ru</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6318-7536</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лиманкин</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lymankin</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лиманкин Олег Васильевич — д.м.н., главный врач; профессор кафедры психотерапии и сексологии</p><p>Scopus Author ID: 49863908800</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Limankin Oleg Vasilevich - MD, PhD in Medicine, the chief physician; senior researcher, Medical Institute</p><p>Scopus Author ID: 49863908800</p></bio><email xlink:type="simple">limankin@mail.ru</email><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7036-5927</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мазо</surname><given-names>Г. Э.</given-names></name><name name-style="western" xml:lang="en"><surname>Mazo</surname><given-names>G. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мазо Галина Элевна — д.м.н., заместитель директора по инновационному научному развитию</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Mazo Galina Elevena – MD, PhD in Medicine, Deputy Director for Innovative Scientific Development</p><p>St. Petersburg</p></bio><email xlink:type="simple">galina-mazo@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-2937-7639</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мартынихин</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Martynikhin</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мартынихин Иван Андреевич — к.м.н., доцент кафедры психиатрии и наркологии; руководитель</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Martynikhin Ivan Andreevich – PhD in Medicine, Associate Professor of the Department of Psychiatry and Narcology; Head of the "Reshenie" Medical and Psychological Center</p><p>St. Petersburg</p></bio><email xlink:type="simple">ivan.martynikhin@gmail.com</email><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1955-1032</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Скиба</surname><given-names>Я. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Skiba</surname><given-names>Ya. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Скиба Ярослав Богданович — к.м.н., врач-невролог; заведующий лабораторией клинической фармакологии и терапии боли; научный сотрудник научно-клинического центра трансплантации и клеточной терапии при аутоиммунных и нейродегенеративных заболеваниях</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Skiba Yaroslav B. - MD, PhD in Medicine</p><p>St. Petersburg</p></bio><email xlink:type="simple">yaver-99@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2502-6365</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сорокин</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Sorokin</surname><given-names>M. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сорокин Михаил Юрьевич – к.м.н., ведущий научный сотрудник отделения интегративной фармако-психотерапии психических расстройств, учёный секретарь</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Sorokin Mikhail Yurevich - MD, PhD in Medicine, Leading Researcher at the Department of interactive pharmaco-psuchotherapy of mental disorders</p><p>St. Petersburg</p></bio><email xlink:type="simple">m.sorokin@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5618-4206</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Незнанов</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Neznanov</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Незнанов Николай Григорьевич – д.м.н., профессор, Заслуженный деятель науки РФ, директор ФГБУ «НМИЦ ПН им. В.М. Бехтерева» Министерства здравоохранения Российской Федерации, Президент Российского общества психиатров, заведующий кафедрой психиатрии и наркологии ФГБОУ ВПО ПСПбГМУ им. И.П. Павлова Минздрава России, главный внештатный специалист-эксперт по психиатрии Росздравнадзора</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Neznanov Nikolay Grigorievich – MD, PhD in Medicine, Professor, Honored Scientist of the Russian Federation, Director of the V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology of the Ministry of Health of the Russian Federation, President of the Russian Society of Psychiatrists, Head of the Department of Psychiatry and Narcology at the Pavlov First Saint Petersburg State Medical University of the Ministry of Health of Russia, Chief External Expert in Psychiatry of Roszdravnadzor</p><p>St. Petersburg</p></bio><email xlink:type="simple">spbinst@bekhterev.ru</email><xref ref-type="aff" rid="aff-8"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. И.П. Павлова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Министерства здравоохранения Российской Федерации;&#13;
ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И. И. Мечникова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of the Russian Federation; &#13;
I.I. Mechnikov North-Western State Medical University, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ГКБ №13 Автозаводского района</institution><country>Россия</country></aff><aff xml:lang="en"><institution>City Clinical Hospital No. 13 of the Avtozavodsky District</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н. И. Пирогова» Министерства здравоохранения Российской Федерации; ФГБУ «Федеральный центр мозга и нейротехнологий» Федерального медико-биологического агентства России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation&#13;
Moscow; Federal Center for Brain and Neurotechnologies, Federal Medical-Biological Agency of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>СПб  ГБУЗ «Психиатрическая больница №1 имени П.П. Кащенко»; ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И. И. Мечникова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>P.P. Kaschenko Psychiatric Hospital No. 1; I.I. Mechnikov North-Western State Medical University, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. И.П. Павлова» Министерства здравоохранения Российской Федерации; ООО "Медико-психологический центр Решение"</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of the Russian Federation; "Reshenie" Medical and Psychological Center LLC</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Министерства здравоохранения Российской Федерации; ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. И.П. Павлова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health of the Russian Federation; I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>10</day><month>01</month><year>2026</year></pub-date><volume>59</volume><issue>4-2</issue><fpage>8</fpage><lpage>19</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Касьянов Е.Д., Амелин А.В., Васильева А.В., Дроздова Е.А., Захаров Д.В., Иванова Г.Е., Лиманкин О.В., Мазо Г.Э., Мартынихин И.А., Скиба Я.Б., Сорокин М.Ю., Незнанов Н.Г., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Касьянов Е.Д., Амелин А.В., Васильева А.В., Дроздова Е.А., Захаров Д.В., Иванова Г.Е., Лиманкин О.В., Мазо Г.Э., Мартынихин И.А., Скиба Я.Б., Сорокин М.Ю., Незнанов Н.Г.</copyright-holder><copyright-holder xml:lang="en">Kasyanov E.D., Amelin A.V., Vasilyeva A.V., Drozdova E.A., Zakharov D.V., Ivanova G.E., Lymankin O.V., Mazo G.E., Martynikhin I.A., Skiba Y.B., Sorokin M.Y., Neznanov N.G.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.bekhterevreview.com/jour/article/view/1262">https://www.bekhterevreview.com/jour/article/view/1262</self-uri><abstract><p>Аналитический обзор актуализирует проблему междисциплинарного взаимодействия неврологов и психиатров в контексте высокой распространенности коморбидных депрессивных и тревожных расстройств у неврологических пациентов. Установлено, что в амбулаторной неврологической практике до 64.6% пациентов имеют психиатрическую патологию. Особое внимание уделяется нейровоспалению как трансдиагностическому механизму, связывающему патогенез депрессивных расстройств и неврологических заболеваний, в частности, постинсультных состояний. Рассматривается терапевтический потенциал антидепрессантов с противовоспалительной активностью, плейотропные эффекты которых выходят за рамки собственно антидепрессивного действия и способствуют нейропластичности и функциональному восстановлению. Подчеркивается необходимость интеграции валидированных психометрических инструментов и навыков диагностического интервью в неврологическую практику для своевременного скрининга и стратификации риска. В качестве стратегического решения предлагается организация крупных междисциплинарных конгрессов для выработки согласованных клинических алгоритмов, модернизации образовательных программ и гармонизации нормативной базы, что позволит преодолеть существующие барьеры и оптимизировать помощь пациентам с сочетанной патологией.</p></abstract><trans-abstract xml:lang="en"><p>This analytical review highlights the issue of interdisciplinary collaboration between neurologists and psychiatrists in the context of the high prevalence of comorbid depressive and anxiety disorders among neurological patients. Evidence indicates that up to 64.6% of individuals seen in outpatient neurological settings have diagnosable psychiatric conditions. Particular attention is given to neuroinflammation as a transdiagnostic mechanism linking the pathogenesis of depressive disorders with neurological diseases, especially post-stroke conditions. The therapeutic potential of antidepressants with anti-inflammatory properties is examined, emphasizing their pleiotropic effects, which extend beyond conventional antidepressant action and contribute to neuroplasticity and functional recovery. The review underscores the need to integrate validated psychometric instruments and structured diagnostic interviewing into neurological practice to enable timely screening and risk stratification. As a strategic measure, the establishment of large interdisciplinary congresses is proposed to facilitate the development of consensus clinical algorithms, modernization of educational programs, and harmonization of regulatory frameworks, ultimately helping to overcome existing barriers and improve care for patients with comorbid conditions.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>депрессия</kwd><kwd>тревожные  расстройства</kwd><kwd>междисциплинарное взаимодействие</kwd><kwd>нейровоспаление</kwd><kwd>неврологические заболевания</kwd></kwd-group><kwd-group xml:lang="en"><kwd>depression</kwd><kwd>anxiety disorders</kwd><kwd>interdisciplinary collaboration</kwd><kwd>neuroinflammation</kwd><kwd>neurological diseases</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Касьянов Е.Д., Рукавишников Г.В., Кибитов А.О., Мазо Г.Э. 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