In this review, we have collected the latest data on Kotar syndrome. The question of its nosological affiliation is considered, etiological theories and epidemiological indicators are presented. The options for the development of the clinical picture are described, data on the results of neuroimaging diagnostic studies are presented.

The treatment of patients with hematological malignancies is often complicated by a number of negative side effects, which include mental disorders, among which cognitive impairment occupies a special place. Psychopathological, psychological, neuropsychological, neurophysiological and neurovisual methods were used to examine 46 patients with various hematological malignancies during periods prior to allo-HSCT, 1-3 months after allo-HSCT, and 6 months after transplantation. When statistical analysis of data was performed correlation and multivariate analyzes. Patients at each stage of the study identified cognitive impairment caused by a combination of risk factors — the presence of a hematological malignancy, the encephalotropic activity of chemotherapy drugs, and mental, neurological disorders. The characteristic and stable dynamics of CN in the post-transplantation period is traced — a sharp decline in cognitive functions in almost all indicators at once in the early post-transplant period with their gradual recovery by 6 months after allo-HSCT. The attitude of patients to cognitive deficiency also changes during the period of treatment: from anozognosic and hyponozognosic at the pre-transplantation stage to hypernosognostic at long-term periods after allo-HSCT.

The article presents the results of screening data from a simultaneous study of 443 outpatient cards of patients with schizophrenic spectrum disorders who were under dynamic outpatient monitoring in two areas of the psycho-neurological dispensary No. 2 in Moscow in order to assess the incidence of type 2 diabetes mellitus (T2DM), and also metabolic disorders (MD) in patients with prolonged anti-relapse antipsychotic therapy. The incidence of these disorders as a whole was 24.6%. Differences in the prevalence of diabetes mellitus 2 and MN were considered depending on the gender of the patient and the antipsychotic used. The obtained data on the high frequency of occurrence of the above metabolic disorders indicate the need to develop standards for antipsychotic therapy of patients with schizophrenic spectrum disorders when combined with T2DM and MD.

The investigation studies the relationship between narcissistic self-regulation with the features and expression of self-stigmatization in patients with endogenous mental disorders. The study involved 131 people, including patients with schizophrenia — 66.8% and individuals with affective disorders — 33.2%. The survey was conducted by using the following methods: «Index of Self-system functioning» and questionnaire of self-stigmatization by Mikhailova-Yastrebov. Data on correlation of strength personality reducing with selfstigmatization, the specifics of Self-regulation structure in various inner stigma forms, and the absence of IFSS significant differences in patient’s groups with different nosological forms of mental disorders, disease’s duration and number of hospitalizations — were obtained. The specific personal characteristics underlying premorbid changes in the Self-regulation system that determine the vulnerability of patients to the formation of stigma are discussed.

In article the detailed analysis of modern researches in the field of studying of emotional and personal characteristics of mentally retarded children is given. During the carried-out work features of the emotional and personal sphere of the children of younger school age with easy degree of intellectual backwardness who are brought up in families and being in boarding school conditions which are shown that mentally retarded children from families to a thicket are guided by motives of behavior as self-approving and social approved elections and have the increased uneasiness level are revealed; mentally retarded children from families are more disturbing. Authors focus attention on importance of carrying out psychoeducational programs as one of the most important components of system of rehabilitation of the families which are bringing up the mentally retarded child.

The study examined interactions between parenting and child effortful control in the prediction of problem behavior in Russian preschoolers in parent reports of 28-year-old children (N = 652). Effortful Control and its components, inhibitory control, attentional control, low-intensity pleasure, and perceptual sensitivity, were measured by the Very Short Form of the Children’s Behavior Questionnaire (CBQ-VS). Positive parenting, punishment, and inconsistent discipline were measured by the Alabama Parenting QuestionnairePreschool Revision (APQ-R). Externalizing problems, internalizing problems, total difficulties, and impact of problems on the child’s life were measured by the Strengths and Difficulties Questionnaire (SDQ). The results indicated that effortful control and perceptual sensitivity interacted with parental punishment to predict externalizing problems and total difficulties such that temperament was more strongly related to problem behavior when parents used more punishment. In a similar way, inhibitory control was more strongly related to externalizing problems and their impact on the child’s life when parents used more punishment. The majority of moderating effects were consistent with the diathesis-stress or dual risk model. That is, temperament was more strongly related to externalizing and internalizing problems and their impact on the child’s life when parents used more punishment and were inconsistent in their use of discipline.

Summary. With symptomatic remission and functional recovery as the overarching therapeutic objectives of antidepressant therapy, composite endpoint measures that conjointly consider both aspects of treatment are needed. This analysis evaluated the combined effect of vortioxetine on depressive symptoms and functional capacity in adults with MDD.

Methods: NCT01564862, a multinational, double-blind, placebo-controlled, duloxetine-referenced study, con-ducted between April 2012 and February 2014, in 602 adult outpatients (18–65 years) with moderate-tosevere MDD (Montgomery-Asberg Depression Rating Scale (MADRS) ≥ 26), a major depressive episode of ≥ 3 months’ duration, and self-reported cognitive symptoms were randomized to once-daily vortioxetine (10 or 20 mg), duloxetine (60 mg), or placebo for 8 weeks. Assessments included the University of California San Diego Performance-based Skills Assessment (UPSA) and the MADRS. Two versions of UPSA were utilized; UPSA ‒Validation of Intermediate Measures and UPSA Brief form. An aligned UPSA-B (communication and finance items) was examined for sensitivity analysis. Efficacy was analyzed versus placebo according to the dualresponse (change from baseline in UPSA ≥ 7 and ≥ 9 and reduction in MADRS total score from baseline ≥ 50%).

Results: Significantly more vortioxetine-treated patients were classified as dual responders for change in MADRS total score and UPSA score of ≥ 7 (clinically important difference [CID]) (27.4% vs 14.5%; P = 0.004), and change above CID (≥ 9) (23.4% vs 13.9%; P = 0.025). Duloxetine did not differ significantly from placebo for these dual response criteria. Sensitivity analysis using the aligned UPSA-B confirmed these results for vortiox-etine.  

This discussion article describes the legislative contradictions of the legitimacy of hospitalization of the mentally ill patients in psychiatric hospitals. We give a specific recommendations to eliminate errors of practicing psychiatrists, as well as proposals to improve the legislation in the field of mental health care.

In order to identify the comparative regional features of the syndrome of professional burnout in anesthesiologists, 50 doctors of the Komi Republic and the Arkhangelsk Region were examined. Used methods of research: survey, questionnaire «Attitude to work and professional burn-out» V.Vinokur, the scale of organizational stress, Mak-Lin, the Freiburg personality inventory, spielberger test H in the modification Y.Hanin, coping test of R.Lazarus and S.Volkmann, methods of evaluation of psychological atmosphere in the team A.Fiedler. It was found that 63.6% of anesthesiologists-resuscitators of the Komi Republic and 53.9% of doctors of the Arkhangelsk Region showed signs of professional burnout, characterized by emotional exhaustion and stress in the work, deterioration of health and social adaptation. Anesthesiologists-resuscitators of both groups are characterized by type A behavior, which is manifested by high subjective value of professional activity, high readiness for energy costs, low resistance to frustration and stress. Recommendations for the prevention of professional burnout in anesthesiologists-resuscitators are proposed, depending on factors contributing to the development of burnout syndrome.

The article presents a supporting medico-psychological program for multiple sclerosis patients that can be used in the framework of center specialized in MS treatment. It encompasses the definition of medico-psychological support of MS and presents the content of psycho-social interventions depending not only on the MS stage but also on the interrelationship of the MS period and patients mental and physical capacities. The supporting program consists of four consequent stages: information-diagnostic, psycho-correction, psychotherapy, psycho-rehabilitation. Implementation of each stage has its specific tasks, interventions and specialists team. The defined stages of the supporting program allow the specialists to provide personalized intensity and specific of psycho-social interventions and also elaborate a long-term treatment plan for each patient.

To assess the dynamics of doctors ‘ opinions on continuing medical education (CME) in 2016 and 2018 was conducted an anonymous online survey, which was attended by 52 psychiatrists (in 2016 year, from 14 regions of Russia) and 203 psychiatrists (in 2018 year, from 46 regions of Russia). There is the growth of skeptical views on the feasibility of introducing a new system (in 2016 it was supported by 55,8% of respondents, in 2018 — only by 38,3%). Also in the 2-year term increased the number of difficulties in accessing to attend conferences, increased availability of online modules and has not changed significantly the availability of training in the departments in universities. The most difficult for doctors is to find attending conferences (average score in assessing difficulties 3,6), which requires the search for funds for travel expenses and separation from work, the most convenient — online training (average score in assessing difficulties 3,0). The effectiveness of all three types of educational activities of CME (conferences, online modules and courses in the departments) is estimated at a relative average level (about 3 points on a 5-point scale). The impact of CME on the solution of actual organizational and methodological problems of health care is also rather skeptical.