The article discusses the use of different doses of psychotropic drugs in the treatment of mental disorders. It is known that the number of responders is about two thirds of all patients, which according to the “three sigma” rule for the normal distribution of cases, fits into the range of one sigma. The hypothetical calculation of the relative proportions of patients responding to treatment in low, mid-range and high doses is given. In accordance with this, the use of a mid-range treatment doses is justified, thereby the number of potential responders increases almost twice as compared with the use of small doses. Within the framework of pharmacodynamics, the probability of the development of dose-dependent effects is assessed, including both desirable and untoward effects of various pharmacological classes of psychotropic drugs in different doses.

Neurosurgical treatment for psychiatric disorders has a controversial history. This branch of neurosurgery called by developer of prefrontal leucotomy and Nobel prize laureate Egaz Moniz “psychosurgery”, was initially based not on scientific researches, but on enthusiasm of individuals and pressing social need. The outcome of psychosurgery regardless of its clinical benefits was the negative attitude of the broad masses and medical community, some countries have banned psychosurgery – the era of psychopharmacology has come. However, some patients suffering from severe course of the psychiatric disorder are resistant to conservative treatment.

Over the last decades, the novel neuroimaging methods and neurobiological researches have considerably improved understanding of the pathogenesis of psychiatric disorders and scientific validity of the surgical intervention into the neural circuits. In this article, the main stages of the history of the psychiatric neurosurgery are briefly reviewed. Furthermore, the clinical and surgical considerations including the anatomic target localization, outcome and possible complications of the major operations which are still in practice are presented. The new neurosurgical techniques such as deep brain stimulation and gamma knife stereotactic radiosurgery were also considered. The part of the article is devoted to ethical, legal and terminological issues of psychiatric neurosurgery.

The scientific review is devoted to the actual problem of personality-psychological features of patients with somatoform disorders (SFD). It is based on the analysis of 91 publications on this topic (42 in Russian and 49 in English) that have been published over the past 10 years. The search for publications was carried out in the RSCI and Medline bibliographic databases. The purpose of the review was to consider the main directions of the studies of personality-psychological factors for the SFD formation which has been developing over the past decade, and to highlight those of these factors that are currently the most generally recognized. The review considers the following directions of research in this area: studies of alexithymia, studies of somatosensory amplification, studies of the patients’ character features, studies of cognitive processes in SFD, studies of psychological defenses and coping strategies, studies in the framework of attachment theory, studies of socio-psychological factors of SFD development, integrative concepts of personality predisposition to SFD. As a result, a high level of alexithymia and personality anxiety, rigidity of cognitive processes, general inferiority of psychological defenses and coping strategies, and a high socio-stress load was highlighted as the most generally recognized personality-psychological factors of the SFD formation. Factors that are sufficiently recognized, but still need further study, are also the somatosensory amplification, the frequent use of reactive formation as a psychological defense and avoidant behavior as a coping strategy, the pattern of insecure attachment. The conclusion notes the need to continue research in this area and proposes possible further directions, in particular, the identification of causal relationships between already established personality-psychological predictors of SFD, as well as the study of their interactions with factors of a different nature (genetic, morphological, psychopathological).

The review article highlights the problem of using hematological coefficients of systemic inflammation in clinical practice, as well as the results of studies aimed at its use in the diagnosis and evaluation of therapeutic response in the treatment of mood disorders. The contribution of each individual link of the immune system to the pathogenesis of an inflammatory reaction is known, but currently of most interest are neutrophil-lymphocytic (NLR), monocyte-lymphocytic (MLR) and platelet-lymphocytic (PLR) ratios, as well as indices of systemic immune-inflammation (SII, platelet count x number of neutrophils / lymphocytes) and system inflammation response (SIRI, number of neutrophils x number of monocytes / lymphocytes). All coefficients are available for calculation based on a routine complete blood count. The analysis of the literature demonstrates the significance of these ratios, but emphasizes the need for further research. A more detailed study of these ratios will allow achieving their prognostic value and a more objective assessment of their validity and specificity for the diagnosis, prediction of risks and variants of the affective disorders course.

Tic disorders (TR) occupies one of the leading places among neurological diseases of childhood. Recently, educators, medical psychologists, social workers and psychiatrists are increasingly faced with the problem of tic disorders in children, defining them as states of nervous development characterized by the presence of tics and related behavioral problems. Modern neurology, psychiatry and medical psychology need to update both the therapeutic and diagnostic aspects of tic disorders. This article presents an overview of the current literature on the problem of tic disorders in children, as well as methods of their correction. The analysis of the literature actualizes the polymodal approach, taking into account possible etiological predicates of the development of the disease.

The purpose of this literature review is to analyze the evidence of the effectiveness of the use of electrotherapy in the treatment of epilepsy. In chronological order, the opinions of various leading scientists and doctors of antiquity, XVIII, XIX centuries, such as Avicenna, J Wesley, W Erb, etc., based on the results of their own work, are presented on the possibilities of using animal, static, galvanic current in the treatment of epilepsy. Particular attention is paid to the transcranial micropolarization method, which has been gaining popularity in recent decades, based on the effect of low-intensity direct current on the projections of selected cortical structures. The data of experimental and clinical studies conducted under the guidance of corresponding member GA Vartanyan, academician NP Bekhtereva, etc., as well as foreign authors, testifying to the effective use of micropolarization in the treatment of epilepsy are presented. Possible prospects for the development of the method for obtaining the greatest therapeutic effect are discussed. The result of such work may be the development of a method of bio-controlled micropolarization.

Purpose of the study: to determine the individual psychological characteristics and features of coping with the disease in patients with the first psychotic episode and post-psychotic depression in order to identify targets for subsequent psychosocial interventions. We examined 1112 patients who underwent the first psychotic episode, of which, after the introduction of inclusion/exclusion criteria, two groups were formed in the final design: 243 patients with postpsychotic depression and 119 patients without depression in partial remission. Clinical and psychopathological method with objectification by PANSS, CDSS scales, clinical and psychological method with diagnostics of coping, psychological defense mechanisms, perfectionism and self-stigmatization by standardized questionnaires were used, regression analysis was carried out using the method of multiple linear regression with stepwise inclusion. From the numerical characteristics of the samples, the arithmetic mean was determined with the calculation of the standard error of the mean, standard deviation. Statistically significant results were accepted at the p<0.05 significance level.

Conclusions: the study found a significant effect on the clinical manifestations of postpsychotic depression in patients who underwent PES of schizophrenia, all studied individual psychological characteristics with the highest coping activity, which indicates the undoubted involvement of reactive mechanisms in the development of this type of pathology. This confirms the importance in the treatment of the studied cohort of patients, not only of differentiated psychopharmacotherapy, but also of active psychotherapeutic support with the study of selected “targets” of coping, individual psychological characteristics.

Summary.  The central place in the system of personality relations is occupied by the attitude towards oneself. Its violations are the main link in the development of neurotic disorders and adaptation disorders. There was proved the connection between the attitude to the time perspective and the emotional-affective status, one of the indicators of which is the attitude towards oneself. In this regard, the purpose of the work was to study the attitude towards onуself and to the personal perspective of the patients of a cosmetological clinic with different levels of mental adaptation.

Materials and methods. Patients of a cosmetological clinic with different level of mental adaptation detected using the «Test of neuropsychic adaptation» (NPA), were compared in terms of self-attitude and self-esteem studied using the author’s structured interview and S.Ya.Rubinstein’s technique (1999); the same groups were compared accordind to the indicators of the technique of «Semantic time differential» (STD) characterizing the attitude of a person to the time perspective [10]. The were used statistical methods of data analysis (Pearson χ² and ANOVA, included in the statistical packages SPSS v. 25.0).

Results. Among patients of the cosmetological clinic 54,1% have a reduced level of mental adaptation; 45,9% of women have no significant adaptation disorders. Groups of women with a reduced and nonreduced level of mental adaptation differ in the general indicator NPA (М= - 1,16+0,15, М=3,20+0,11 p=0,000), practically do not differ in socio-demographic and clinical characteristics, but statistically significantly differ in all studied psychological characteristics: self-esteem, attitude towards oneself as a person, attitude towards one’s psychical «Ego», confidence in one’s external attractiveness, attitude towards the present, pas, and future. It is concluded that a decrease in the level of mental adaptation in a patient of cosmetological clinic is associated not only with a change in the system of significant personality relationships, but also due to violations of the emotional-affective sphere.

Conclusion. Prospects of research related to the study of the dynamics of self-esteem of attitude towards oneself and the perception of a time perspective in the process of cosmetological correction of facial skin defects, as well as the structure of the personality of women seeking cosmetic help.

The COVID-19 pandemic has had an enormous impact on public health and many other social institutions. Although the disease continues evolving, new strains do not exhibit the previous lethality, and coronavirus limitations are being lifted, the problem is still relevant. An important aspect of the study of COVID-19 is the process of patient recovery, including inpatient rehabilitation programs. The aim of this pilot study was to examine the psychosocial characteristics and dynamics of the indicators of emotional state (anxiety, depression) and quality of life in patients undergoing a medical rehabilitation program after COVID-19 (N=36; mean age 63.72±12.78 years; 33.33% male, 66.67% female).

Research methods included a structured interview to collect data on patients’ sociodemographic and psychosocial characteristics, the State-Trait Anxiety Inventory (STAI), the Beck’s Depression Inventory (BDI), and the 36-Item Short Health Survey (SF-36). The patients were found to have an objective perception of their physical condition, with a lack of awareness of both the disease and the rehabilitation; the illness and recovery situation was markedly stressful for the patients. During the in-patient rehabilitation period, there was a positive change in state anxiety, depressive symptoms and quality of life (p<0.001). The dynamics of the specified characteristics almost do not differ in groups of male and female patients, except for indicators of anxiety, in which differences before and after rehabilitation are more expressed among women. The findings can be used to assess the effectiveness of rehabilitation programs and to improve it, and also indicate the primary role of the clinical psychologist in managing this group of patients.

The actual direction of increasing the efficacy of alcohol dependence (AD) treatment is the search for opportunities for individualization of therapy using pharmacogenetic markers to stratify patients in order to select the most optimal therapeutic tactics. Aims. To test an associations of possible pharmacogenetic markers with indicators of the efficacy of disulfiram and cyanamide to stabilize remission in patients with AD. Materials and methods. A pharmacogenetic study was conducted on the basis of a double-blind, randomized, comparative, placebo-controlled clinical study of the efficacy and tolerability of disulfiram and cyanamide in the treatment of alcohol dependence syndrome. The main outcome: the duration of retention of patients in the treatment program (in remission), and withdrawal from the treatment program for any reason was considered a negative outcome. Secondary outcomes: time to relapse to alcohol use and time to recurrence to AD. 150 patients with AD (ICD-10 criteria) (av. age — 40.65±1.09 y.o., 19.3% females) were randomly assigned to one of three treatment groups (50 subjects in each): Disulfiram, Cyanamid and Placebo. All patients had weekly (12 weeks) visits to research clinic for brief counselling session. The genetic panel of the study consisted of 15 polymorphic loci in 9 genes: dopamine receptors 2 (DRD2) and 4 (DRD4) types, transmembrane dopamine transporter (DAT), enzymes dopamine-beta-hydroxylase (DBH) and catechol-ortho -methyl-transferase, as well as a two polymorphisms in the genes of the endogenous opioid system and the aldehyde dehydrogenase enzyme gene cluster.

Results. For disulfiram, the DBH rs1108580 is associated with a longer remission (p=0.053, trend), and DRD4 VNTR 48 bp is associated with a shorter remission (p=0.006). For cyanamide, DAT VNTR 40 bp was associated with shorter remission (p=0.006) and rapid recurrence to AD (p=0.045). DAT rs27072 has an effect simultaneously in two treatment groups, while the direction of the effect is opposite. For cyanamide, the marker is slightly associated with a longer remission (p = 0.082, trend), a longer time to relapse (p = 0.063, trend) and a longer time to recurrence to AD (p = 0.083, trend). For placebo, DAT rs27072, on the contrary, is associated with a shorter time to to recurrence to AD (p = 0.066, trend). For placebo, DRD2 rs1799732 was associated with a shorter remission (p = 0.001), a shorter time to relapse (p = 0.018), and a shorter time to recurrence to AD (p = 0.001). Conclusion. Preliminary pharmacogenetic markers of the efficacy of alcohol dependence treatment have been identified in genes that control dopaminergic neurotransmission. After independent validation, the obtained genetic markers may be used for pharmacogenetic stratification of patients in order to select the optimal treatment options for alcohol dependence.