The search for new approaches to the mental disordersclassification is one of the priority tasks in modern psychiatry. Current approaches evaluate mental disorders in isolation, ignoring the fact that they are a multisystem pathology that affects not only mental functions, but also a wide range of somatic manifestations. However, there is more and more reason to consider mental disorders as multisystem diseases. This approach is of interest not only for explaining the high comorbidity of somatic and mental disorders, but also in studying the pathophysiological mechanisms that determine the risks and course of multisystem diseases. This strategy can be the basis for the fundamentally new approaches to the systematics of mental disorders with both theoretical and practical significance. To integratesuch an approach, it is necessary to determine the “starting point”, which may be the evaluation of mental disorders andinherited metabolic disorders interaction.

The amount of publications devoted to the endothelial cells, on the one hand, and neurological diseases, on the other hand, has been growing rapidly in recent years. Nevertheless, the relationship between the endothelial monolayer and the cells of the nervous system remains poorly studied. This review presents the available information about endothelial markers, molecular and cellular mechanisms for maintaining the integrity of the endothelial monolayer and the violations in some acute and chronic neuropsychiatric diseases. At the molecular level, the most important pathogenetic link in endothelial dysfunction is an imbalance of Ca²⁺ ions, which is associated with redox imbalance in the cells and increased generation of reactive oxygen species. Genetic and epigenetic factors that cause these disorders and their cause-and-effect relationships are considered. Of the genetic diseases, the most studied are monogenic diseases associated with impaired blood-brain barrier integrity: this is a deficiency of protein molecules that ensure glucose transport, structural and functional integrity of tight junctions and the basement membrane of endothelial cells themselves, as well as mutations in pericytes and smooth muscle cells. Mutations that increase the risk of developing known neurodegenerative diseases, but are also the cause of cerebrovascular pathology, are less studied. The small vessel diseases constitute a whole group of primarily epigenetically caused diseases, the clinical consequence of which is often vascular dementia. Special attention is paid to one of the least studied problems—the pathogenesis of toxicological diseases that occur at different times after acute and chronic organophosphate poisoning. Microangiopathies caused by damage to the endothelium in the central and peripheral nervous systems can be the main cause for the development of delayed effects in organophosphate poisoning. In the absence of effective therapies for neurodegenerative diseases, more and more evidence is emerging about the positive impact of the nutritional structure and healthy lifestyle on the state of blood vessels and the risk of developing these diseases.

This article presents a non-systematic descriptive review of sleep disturbance problems in patients with alcohol dependence. A search was carried out in databases such as Google Scholar, ELibrary.ru, Scopus, PubMed. We considered works published no earlier than January 1, 2015, but no later than January 10, 2020. A search was carried out with the use of search queries of various combinations of the specified words: “alcohol use disorder,” “alcoholism”, “insomnia,” and others. After analyzing a number of publications, it is possible to conclude that the relationship between the described phenomena is synergetic with a mutual reinforcement. In the current review it is demonstrated that the risk of the development of alcoholism against the background of sleep disturbances might be related to the initial use of alcohol as a somnolent with further development of tolerance and alcoholism. At the same time, the severity of sleep disturbances quite often coincides with the severity of alcohol dependence. For those patients who are in a stage of remission sleep disturbances is a risk factor for relapse. This review clearly demonstrates that further research of the relationships between alcohol dependence and sleep disorders are needed.

The review of the native and foreign literature was conducted on modern diagnostic and therapeutic algorithms for persistent postural-perceptual dizziness, a new diagnostic syndrome that combines the key features of all previously identified types of chronic subjective vertigo and related disorders. In this article details there is a detailed description of the use of antidepressants and cognitive behavioral therapy.

Randomized controlled trial (RCT) is a “gold standard” evidence-based approach to the assessment of psychological and psychosocial interventions; the results of RCT provide an opportunity to give a scientifically grounded decision about the effectiveness and the applicability of intervention. The current biopsychosocial approach requires the necessity of having precise, comprehensive, and transparent reports about conducting RCT in medicine, as well as psychological and psychosocial interventions, including psychotherapy. The unified standards for reporting RCT’s results were developed by the CONSORT group (CONsolidated Standards Of Reporting Trials, the latest edition in 2010). They are currently considered a guide for presenting results in leading medical journals in the world. The expansion of CONSORT, which described the standards for presenting the results of psychological and psychosocial intervention CONSORTSPI was developed in 2018. The article presents the history of developing the standards, their scientific and methodological principles, the brief content, and the main instruments used (check-list and block-scheme). It is important to consider the guidelines of CONSORT-SPI 2018 and follow them in order for the scientific community to assess the quality, the applicability of different contexts, as well as replicability of psychological and psychosocial interventions studies.

The fourth edition of the Diagnostic and Statistical Manual on Mental Disorders (DSM-IV) recognizes the existence of a disease as a potential life-threatening stressor capable of causing post-traumatic stress disorder (PTSD). This research is one of the first works dedicated to the study of PTSD in patients diagnosed with «multiple sclerosis» (RS). A total of 724 complete sample patients were screened for outpatient treatment at the «City MS Center» in Saint Petersburg. According to the results of the screening survey and the expert clinical interview for the verification of the diagnosis of PTSD, the clinic—psychopathological signs sufficient for the diagnosis of PTSD have been identified in 61 patients, which is 8.4% of the total number of screened patients. The presence of PTSD is confirmed by high indices of sub-scales «avoidance», «intrusion», «physiological excitability» on the WOVTS scale, as well as higher indicators of dissociation level compared to control group. The lack of correlation between PTSD and the duration of RS, the degree of disability of patients, as well as socio-demographic data was found. Thus, the development of PTSD is more related to the premorbid personality characteristics than to the characteristics of the disease. These findings suggest that RS may have PTSD-type reactions. Further studies of the psychological characteristics of this group of patients are needed to identify the targets for psychotherapy.

The psychological characteristics of patients with akinetic-rigid andtrembling forms of Parkinson’s disease were compared. It was revealed that regardless of the form of the disease, all patients with PD are characterized by a decrease in their perception of their social reputation, attractiveness, popularity, respect for others, as well as the ability to achieve their goals; unsociability, poor self-giving ability, poor imagination, and lack of long-term attachments. Only patients with the akinetic-rigid form arecharacterized by docility, obedience, complaisance, patience, distrust, and detachment from other people. Most of the patients we examined with PD are highly likely to perceive stressful situations as threatening and alarming.

Background: It is well known, that old age dementias steadily grow progressively worse and inevitably lead to fatal outcome. Mortality indices in foreign research largely vary, they are practically absent in domestic scientific studies, and official statistical data on the prevalence of dementia and the cause of death do not reflect the real situation. The Objective of the study was to perform the analysis of completed cases of late age dementias from the materials of observations in Alzheimer’s disease center of the Mental Health Research Center.

Patients and Methods: Observational study, using prospective method of out-patient observation of subjects with dementias, who consulted Alzheimer’s disease center in 2007-2016 for the first time, made it possible to obtain reliable data on 217 patients, who died during this period.

Results: More than one third of such cases (39%) referred to nosologically various dementias with an early onset of the disease. In more than half of the cases (58%) the cause of death was medical pathology. In the rest of the patients severe or terminal stage of the basic disease was noticed toward the end of life under conditions of home care.

Conclusions: Holistic view of the clinical picture of old age dementias (from the onset of the disease till the fatal outcome) is necessary for creation of incidence registers and obtaining of science-based statistical indices of survival, mortality and causes of death. It is necessary to develop measures of assistance to families of patients with the most severe stage of dementias, creation of out-patient and in-patient network of hospices for this contingent of patients.

Metacognitive functioning is the basis of the individual’s ideas about his ability to build relationships with other people and manage own’s social behavior. Deterioration of metacognitive functioning in schizophrenia patients, presumably due to neurocognitive deficiency and other manifestations of the disease, probably contributes to disruptions of social functioning and quality of life. The aim of this study was to assess the metacognitive functioning (MF) of patients with paranoid schizophrenia, operationalized as a cognitive ability to understand their own and other people’s emotions, and to explore the connection between social functioning (SF) and quality of life (QOL), as well as to establish logical relationships between MF with clinical indicators and socio-demographic characteristics of patients. In a sample of 300 patients with paranoid schizophrenia (age from 18 to 50 years, disease duration of at least 5 years, a total PANSS score of less than 120), MF was assessed using the Lyusin emotional intelligence test (EmIn) and the subjective assessment of interpersonal relationships (SOMO) test. Cognitive deficit was verified using a standardized battery of a Brief Assessment of Cognition in Schizophrenia (BACS). The indicators obtained using the quality of life questionnaire for schizophrenia patients (QOL-SM) and the social functioning scale (PSP) were used to create an integrated indicator that comprehensively assesses SF and QOL of schizophrenia patients (Factor B). Reliable associations of this factor with indicators obtained using the Emin method (p<0.05), SOMO (p<0.001), the PSP scale, the QOL-SM questionnaire, the BACS and PANSS scales, and also with a number of clinical-dynamic and socio-demographic characteristics were established. Significant relationships between the parameters of MF, SF and QOL were obtained, and logical relationships between MF, neurocognitive deficiency and other clinical manifestations of schizophrenia were established.

The study was conducted to assess the possibility of using vortioxetine for the treatment of depressive disorders in a hospital setting. Material and methods: 32 patients with depressive disorders of various etiologies were included. Patients were assessed using Clinical Global Impression scale and Hamilton Depression Rating Scale HDRS-17 at the beginning of the study and in dynamics. Mean HDRS-17 value at the beginning was 20.1±6.6. According to the etiology of depressive disorders patients were divided into three groups: endogenous disorders—17, organic depressions—11, reactive states—4. Patients were followed-up for 60 days. Results. Vortioxetine was used both as first line treatment and after previous therapy, 10 to 20 mg a day. In 7 patients (21,9%) therapy was discontinued due to adverse events or worsening of condition. The remaining 25 patients (78,1%) showed positive dynamics. Patients with depression with psychotic features (n = 18) were assessed separately: in 5 patients therapy was discontinued, in the remaining 13 people positive dynamics were noted. Conclusion. The study has demonstrated high efficacy of vortioxetine when prescribed for the treatment of depressive disorders, including psychotic depression, in a hospital setting. The drug was well tolerated in the majority of patients.

The article presents the results of a survey of specialists from the Orenburg region who provide assistance to patients with mental and behavioral disorders, regarding the experience of using telemedicine technologies. The purpose of the study was to assess the level of awareness of specialists about new technologies, the relevance of their application in the field of psychiatry, as well as to identify problems that arise in the process of implementing telemedicine in the practice of a doctor. The data obtained indicate a high interest in new technologies among doctors who previously participated in remote consultations. At the same time, among specialists who did not have experience with the telemedicine system, a low level of awareness about its capabilities and distrust of new technologies was revealed. Using the survey, it was possible to identify the main problems of telemedicine faced by specialists of the Orenburg region.