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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">10.31363/2313-7053-2022-56-1-16-24</article-id><article-id custom-type="elpub" pub-id-type="custom">bekhterev-647</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 состояния в структуре постковидного синдрома: особенности и терапия</article-title><trans-title-group xml:lang="en"><trans-title>Depressive states in the structure of postcovid syndrome: features and therapy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4096-6208</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Петрова</surname><given-names>Н. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Petrova</surname><given-names>N N</given-names></name></name-alternatives><bio xml:lang="ru"><p>Петрова Наталия Николаевна — д.м.н., профессор, заведующий кафедрой психиатрии и наркологии, старший научный сотрудник, Почетный работник высшего профессионального образования Российской Федерации, Лауреат премии Правительства РФ в области образования</p><p>г. Санкт-Петербург</p></bio><bio xml:lang="en"><p>Nataliia N. Petrova</p></bio><email xlink:type="simple">petrova_nn@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кудряшов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kudryashov</surname><given-names>A V</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кудряшов Александр Викторович</p><p>г. Москва</p></bio><email xlink:type="simple">lidermed.cprin@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Матвиевская</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Matvievskaya</surname><given-names>O V</given-names></name></name-alternatives><bio xml:lang="ru"><p>Матвиевская Ольга Владимировна</p><p>г. Москва</p></bio><email xlink:type="simple">Matvievskaya_Olga_V@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мухин</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Mukhin</surname><given-names>A A</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мухин Андрей Алексеевич</p><p>г. Москва</p></bio><email xlink:type="simple">aam@lundbeck.com</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лаврова</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Lavrova</surname><given-names>V A</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лаврова Виктория Анатольевна</p><p>г. Санкт-Петербург</p></bio><email xlink:type="simple">valavrova@bk.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/0000-0002-0429-8460</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чумаков</surname><given-names>Е. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Chumakov</surname><given-names>E M</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чумаков Егор Максимович</p><p>г. Санкт-Петербург</p></bio><email xlink:type="simple">chumakovegor@gmail.com</email><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7834-0775</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яльцева</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Yaltseva</surname><given-names>N V</given-names></name></name-alternatives><bio xml:lang="ru"><p>Яльцева Наталья Викторовна</p><p>г. Ярославль</p></bio><email xlink:type="simple">yaltzewa@yandex.ru</email><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7330-1213</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кузьмина</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuzmina</surname><given-names>S V</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кузьмина Светлана Валерьевна</p><p>г. Казань</p></bio><email xlink:type="simple">skouzmina21@list.ru</email><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Костина</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kostina</surname><given-names>N V</given-names></name></name-alternatives><bio xml:lang="ru"><p>Костина Наталья Викторовна</p><p>г. Самара</p></bio><email xlink:type="simple">nvkostina@yandex.ru</email><xref ref-type="aff" rid="aff-9"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7354-467X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Акимова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Akimova</surname><given-names>E V</given-names></name></name-alternatives><bio xml:lang="ru"><p>Акимова Елена Владимировна</p><p>г. Нижний Новгород</p></bio><email xlink:type="simple">akelena76@yandex.ru</email><xref ref-type="aff" rid="aff-10"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Садовничий</surname><given-names>К. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Sadovnichiy</surname><given-names>K S</given-names></name></name-alternatives><bio xml:lang="ru"><p>Садовничий Константин Станиславович</p><p>г. Ставрополь</p></bio><email xlink:type="simple">ksad@inbox.ru</email><xref ref-type="aff" rid="aff-11"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Анцыборов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Antsyborov</surname><given-names>A V</given-names></name></name-alternatives><bio xml:lang="ru"><p>Анцыборов Андрей Викторович</p><p>г. Ростов-на-Дону</p></bio><email xlink:type="simple">andrei.v.ancyborov@gmail.com</email><xref ref-type="aff" rid="aff-12"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дубовец</surname><given-names>М. Э.</given-names></name><name name-style="western" xml:lang="en"><surname>Dubovets</surname><given-names>M E</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дубовец Максим Эдуардович</p><p>г. Омск</p></bio><email xlink:type="simple">maxim-dubovec@yandex.ru</email><xref ref-type="aff" rid="aff-13"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Деменева</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Demeneva</surname><given-names>A A</given-names></name></name-alternatives><bio xml:lang="ru"><p>Деменева Анна Андреевна</p><p>г. Екатеринбург</p></bio><email xlink:type="simple">artemyevaa@gmail.com</email><xref ref-type="aff" rid="aff-14"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2937-7621</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кудрявцева</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Kudryavtseva</surname><given-names>A M</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кудрявцева Анна Михайловна</p><p>г. Екатеринбург</p></bio><email xlink:type="simple">anna.kudryavtseva210298@gmail.com</email><xref ref-type="aff" rid="aff-15"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Акулов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Akulov</surname><given-names>A V</given-names></name></name-alternatives><bio xml:lang="ru"><p>Акулов Александр Владимирович</p><p>г. Новосибирск</p></bio><email xlink:type="simple">docakulov@mail.ru</email><xref ref-type="aff" rid="aff-16"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Виноградова</surname><given-names>Т. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Vinogradova</surname><given-names>T A</given-names></name></name-alternatives><bio xml:lang="ru"><p>Виноградова Татьяна Алексеевна</p><p>г. Смоленск</p></bio><email xlink:type="simple">vinogradova.taty@mail.ru</email><xref ref-type="aff" rid="aff-17"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Саморукова</surname><given-names>Е. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Samorukova</surname><given-names>E M</given-names></name></name-alternatives><bio xml:lang="ru"><p>Саморукова Екатерина Михайловна</p><p>г. Санкт-Петербург</p></bio><email xlink:type="simple">doctorsamorukova@yandex.ru</email><xref ref-type="aff" rid="aff-18"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шадрина</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Shadrina</surname><given-names>E N</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шадрина Елена Николаевна</p><p>г. Краснодар</p></bio><email xlink:type="simple">shadrinaen@rambler.ru</email><xref ref-type="aff" rid="aff-19"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мороз</surname><given-names>Д. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Moroz</surname><given-names>D I</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мороз Денис Игоревич</p><p>г. Омск</p></bio><email xlink:type="simple">danismoroz@mail.ru</email><xref ref-type="aff" rid="aff-20"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мордвинцева</surname><given-names>Е. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Mordvintseva</surname><given-names>E R</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мордвинцева Елена Робертовна</p></bio><email xlink:type="simple">morlen@ngs.ru</email><xref ref-type="aff" rid="aff-21"/></contrib></contrib-group><aff xml:lang="ru" id="aff-1"><institution>Санкт-Петербургский государственный университет</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-2"><institution>Центр Патологии Речи и Нейрореабилитации ДЗМ</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-3"><institution>РООИ «Здоровье человека»</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-4"><institution>Отдел медицины российского подразделения компании Х. Лундбек</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-5"><institution>Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-6"><institution>Психиатрическая больница №1 им. П.П. Кащенко</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-7"><institution>Ярославский государственный медицинский университет</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-8"><institution>Казанский государственный медицинский университет</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-9"><institution>Центр Современного Психоанализа</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-10"><institution>Приволжский исследовательский медицинский университет</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-11"><institution>Клиника пограничных состояний Ставропольского государственного медицинского университета</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-12"><institution>Клиника ментального здоровья «Психея»</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-13"><institution>Медицинский центр “EzraMed Clinic”</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-14"><institution>«Клиника ментального здоровья доктора Александрова»</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-15"><institution>Свердловская областная клиническая психиатрическая больница</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-16"><institution>Городская Клиническая поликлиника 2</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-17"><institution>Смоленский государственный медицинский университет</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-18"><institution>Клиника лечения боли «Медика»</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-19"><institution>Клиника нейрореабилитации «BONUM»</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-20"><institution>Омский государственный медицинский университет</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-21"><institution>Частное учреждение здравоохранения «Клиническая больница «РЖД-Медицина» им. Н.А. Семашко»</institution><country>Russian Federation</country></aff><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>30</day><month>03</month><year>2022</year></pub-date><volume>56</volume><issue>1</issue><fpage>16</fpage><lpage>24</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Петрова Н.Н., Кудряшов А.В., Матвиевская О.В., Мухин А.А., Лаврова В.А., Чумаков Е.М., Яльцева Н.В., Кузьмина С.В., Костина Н.В., Акимова Е.В., Садовничий К.С., Анцыборов А.В., Дубовец М.Э., Деменева А.А., Кудрявцева А.М., Акулов А.В., Виноградова Т.А., Саморукова Е.М., Шадрина Е.Н., Мороз Д.И., Мордвинцева Е.Р., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Петрова Н.Н., Кудряшов А.В., Матвиевская О.В., Мухин А.А., Лаврова В.А., Чумаков Е.М., Яльцева Н.В., Кузьмина С.В., Костина Н.В., Акимова Е.В., Садовничий К.С., Анцыборов А.В., Дубовец М.Э., Деменева А.А., Кудрявцева А.М., Акулов А.В., Виноградова Т.А., Саморукова Е.М., Шадрина Е.Н., Мороз Д.И., Мордвинцева Е.Р.</copyright-holder><copyright-holder xml:lang="en">Petrova N.N., Kudryashov A.V., Matvievskaya O.V., Mukhin A.A., Lavrova V.A., Chumakov E.M., Yaltseva N.V., Kuzmina S.V., Kostina N.V., Akimova E.V., Sadovnichiy K.S., Antsyborov A.V., Dubovets M.E., Demeneva A.A., Kudryavtseva A.M., Akulov A.V., Vinogradova T.A., Samorukova E.M., Shadrina E.N., Moroz D.I., Mordvintseva E.R.</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/647">https://www.bekhterevreview.com/jour/article/view/647</self-uri><abstract><p>В статье приводится обзор научной литературы, посвященный постковидным состояниям. Раскрывается понятие постковидного синдрома, его структура, эпидемиология. Статья содержит результаты 2 совещаний экспертов (психиатров, психотерапевтов, неврологов) из разных регионов России, имевших опыт оказания помощи лицам с постковидым синдромом. Особое внимание уделено постковидной депрессии, ее клиническим характеристикам, опыту терапии. Отмечено, что выраженность постковидного синдрома не зависела от тяжести перенесенного инфекционного заболевания. Ведущими вариантами депрессивных синдромов, наблюдавшихся у реконвалесцентов SARS-CoV-2, явились: астено-депрессивный, апато-депрессивный и тревожно-депрессивный синдромы. В структуре постковидных психических нарушений значительное место занимали ангедония, тревога, когнитивные нарушения, инсомния, ипохондрия. Подчеркивается, что лица с постковидным синдромом, как правило, первоначально оказывались в поле зрения врачей-интернистов, следовательно, актуальна их подготовка по вопросам диагностики постковидных психических нарушений. Клинический опыт продемонстрировал целесообразность терапии постковидной депрессии антидепрессантами, высокую эффективность и безопасность, в том числе, с учетом риска возникновения лекарственных интеракций, применения вортиоксетина, включая назначение препарата пожилым и соматически отягощенным. Статья иллюстрирована клиническими примерами.</p></abstract><trans-abstract xml:lang="en"><p>The article provides a review of the scientific literature devoted to postcoid conditions. The concept of postcovid syndrome, its structure, and epidemiology are disclosed. The article contains the results of 2 meetings of experts (psychiatrists, psychotherapists, neurologists) from different regions of Russia who had experience in providing care to persons with postkovid syndrome. Particular attention is paid to postcovid depression, its clinical characteristics, and the experience of therapy. It was noted that the severity of the post-coV syndrome did not depend on the severity of the infectious disease suffered. The leading variants of depressive syndromes observed in SARS-CoV-2 patients were: astheno-depressive, apato-depressive and anxious-depressive syndromes. Anhedonia, anxiety, cognitive disorders, insomnia, and hypochondria occupied a significant place in the structure of postcovid mental disorders. It is emphasized that persons with postcovid syndrome, as a rule, initially found themselves in the field of vision of internists, therefore, their training in the diagnosis of postcovid mental disorders is relevant. Clinical experience has demonstrated the feasibility of antidepressant therapy for postcovid depression and the high efficacy and safety, including the risk of drug interactions, of using vortioxetine, including prescribing the drug to the elderly and the somatically impaired. The article is illustrated with clinical examples.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>постковидный синдром</kwd><kwd>постковидная депрессия</kwd><kwd>опыт антидепрессивной терапии</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Post-covid-19 syndrome</kwd><kwd>postcovid depression</kwd><kwd>antidepressant therapy</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">Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека. «20 вопросов о «постковидном синдроме». [https://www.rospotrebnadzor.ru/]. Rospotrebnadzor; 2022. Доступно: https://www.rospotrebnadzor.ru/about/info/news/news_details.php?ELEMENT_ID=20293</mixed-citation><mixed-citation xml:lang="en">Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека. «20 вопросов о «постковидном синдроме». [https://www.rospotrebnadzor.ru/]. 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