Hyperkinetic disorder (HD) refers to chronic non-processual diseases, including among the main symptoms impaired attention, impulsivity and hyperactivity, and corresponds to a mixed version of attention deficit hyperactivity disorder (ADHD).Currently, the etiology of HD is considered as a polyetiological concept, since the formation of any chronic disorder involves, first of all, biological factors, including hereditary mechanisms, nonspecific “trigger” factors and factors of early brain damage that “support” the course of the diseaseand ensuring the uniqueness of each clinical case.The cause of HD is a genetically determined pathogenetic mechanism realized by the dysfunction of monoamine systems, in most cases complicated by minimal residual organic lesions of the central nervous system. In this case, a close connection is established between the clinical manifestations of the disorder in question and the biochemical imbalance of monoamine systems, creating a picture of the clinical and biochemical heterogeneity of the main symptoms of a hyperkinetic disorder. Hyperkinetic disorder is characterized by both clinical and biochemical heterogeneity and is determined by a number of etiological factors that create a variety of manifestations not only of the disease itself, but also of its comorbid conditions, which largely determines the direction of rehabilitation measures. Under these conditions, the specific weight of each factor at different stages of the disease depends on a number of exogenous situations.It is logical in this light, according to the current prevailing view, that GH symptoms are viewed as multidimensional traits due to the concerted action of many common and rare genetic variants in interaction with multiple environmental factors.

Depressive and anxiety disorders’ comorbidity is the most common combination of psychiatric disorders, which is associated with a higher risk of suicidal behavior, medical, social and professional problems. The clinical features of comorbid disorders are characterized by the difficulty of verification and is complicated by the possibility of developing secondary disorders, such as alcohol and psychoactive substance abuse. Etiopathogenetic mechanisms include a complex interaction between biological and psychological processes. In this regard, the need for further development of diagnostic algorithms, study of complex therapy to achieve stable remission in patients with comorbid depressive and anxiety disorders is emphasized.

Introduction: The paper examines the features of the phenomenon of déjà vu in focal epilepsy. The article presents the main anatomical, clinical and psychopathological features of this phenomenon. Material and methods: the analysis of Russian and English-language articles in scientific databases from 1905 to 2022 was carried out. The selection of scientific primary sources for analysis was carried out in the Russian eLibrary, the English PubMed, as well as in open sources. The following search queries were generated for the search: «deja vu phenomenon», «deja vu in epilepsy», «phenomenon of what has already been seen». To search in the English-language database, the queries are formed: «deja vu experience», «deja vu in epilepsy», «deja vu in neurology». A total of 112 sources were studied, in the final analysis remained 39 sources (34%). Results:various brain formations take part in the development of déjà vu in epilepsy, among which the medial sections of the right temporal region, the structures of the limbic system. The connection of the phenomenon of «already seen» with affective disorders is emphasized. The data on the characteristic signs of «already seen» in focal epilepsy are presented, namely, their paroxysmal nature, the presence of a focus of epileptiform activity on the EEG, its localization, lateralization. Conclusion: to date, déjà vu in epilepsy is not sufficiently covered in Russian and foreign sources. Research is mainly devoted to the anatomical, pathophysiological features of this phenomenon. There are no basic psychopathological characteristics of déjà vu in epilepsy, data on prognostic significance.

The literature review presents the main modern data on the epidemiology and socio-economic significance of bipolar affective disorder (BD), discusses the difficulties of early diagnosis of bipolar spectrum disorders, predictors of the bipolar course of affective disorders and a probabilistic approach to the diagnosis of BD, discusses controversial issues in the diagnosis of mixed affective states, the use of potential biomarkers both for the diagnosis of bipolar disorder and for the differential diagnosis of unipolar and bipolar depression, as well as possible therapeutic approaches for the probabilistic diagnosis of bipolar disorder.

The purpose of this study is to develop a predictive model of the relationship between the duration of “psychiatrist-avoidant behavior” and clinical and psychological parameters in patients with somatization disorders. The objectives were to designate the clinical characteristics of somatization disorders, study the level of alexithymia, personal anxiety and self-stigmatization in patients with somatization disorders with different durations of the period before contacting a psychiatrist, and develop a predictive equation that allows, based on the relationship of the studied parameters, to predict the duration of “psychiatrist-avoidant behavior.” Materials and methods. In 2019-2022, on the basis of the Kursk Clinical Psychiatric Hospital named after. Holy Great Martyr and Healer Panteleimon» (day psychiatric hospital of the dispensary department), 274 patients with somatization disorders (F 45.0) who applied for psychiatric help for the first time were examined. The main research group included 176 patients with somatization disorders who had not consulted a psychiatrist for a long time (from 2 to 6 years). The control group consisted of 108 patients with somatization disorders who came for an appointment in a relatively short period (within 1 year). Methods: clinicalpsychopathological, clinical-dynamic, psychological (D. Taylor’s personal anxiety questionnaire, alexithymia scale, I.O. Mikhailova’s method for studying self-stigma), statistical method (Fisher’s angular transformation test, Mann-Whitney U test, Pearson’s χ2 test, multiple linear regression, Forward Stepwise method). As a result of the discovered relationships, taking into account the level of personal anxiety, alexithymia and selfstigmatization, as well as the clinical variety and type of somatization disorder, a prognostic equation was developed to determine the duration of non-core visits to psychiatric help. Conclusion. The introduction of this forecasting method in primary health care institutions will contribute to early diagnosis and timely routing of patients with somatization disorders.

Craving is one of the central symptoms of alcohol use disorder. Currently, there is no single accepted definition, model, or standardized approach to assessing craving for alcohol use, but the phenomenon is extensively studied in the field of addiction research. The Obsessive-Compulsive Drinking Scale was developed based on the hypothesis that both obsessive-compulsive disorder and alcohol use disorder have similar symptoms. The purpose of this study was to examine the factor structure as well as the convergent, discriminant, and criterion validity of the Obsessive-Compulsive Drinking Scale. 222 patients with Alcohol Use Disorder undergoing inpatient treatment (163 men (73,42%), average age 42,67±10,06 years old, average age of the onset of alcohol use disorder 32,19±8,57 years old) were recruited for the study. The following methods were used: clinical interview, Obsessive-Compulsive Drinking Scale, Penn Alcohol Craving Scale, Motivation for Alcohol Consumption, and Barratt Impulsiveness Scale. The results of the study confirmed two-factor structure of the scale; however, the goodness-of-fit indices slightly differed from acceptable cut-off values. The scale had acceptable internal consistency and convergent validity. Discriminant validity was moderate. The analysis of criterion validity revealed a negative correlation between the factor “Compulsions” and age of the first alcohol drink, start of the regular alcohol use, and age of the first inpatient treatment for alcohol use disorder. Participants with daily use had significantly higher scores on both factors compared to the participants with heavy drinking episodes.

According to the lack of sufficient scientific data on the ratio, severity, and clinical pathomorphism of positive and negative symptoms in schizophrenia, a more detailed research of this issue is required. The ratio of positive and negative disorders in the structure of schizophrenia spectrum disorders is different in each specific case.
It is known that problems associated with the formation of stable remission in schizophrenia significantly affect the functional well-being, quality and life expectancy of patients. To ensure comprehensive, effective and safe treatment of patients with schizophrenia antipsychotic drugs with a broad spectrum of action are needed. Cariprazine is one of the more effective antipsychotics, both in relation to positive symptoms and in relation to negative and cognitive symptoms.
This paper presents a number of clinical observations that demonstrate the efficacy of the third-generation neuroleptic cariprazine as a potent antipsychotic drug with a favorable safety profile, providing high adherence to therapy and successfully used both in patients with the first psychotic episode and in patients with a disorder duration of more than five years. Also, the complex therapy schemes with psychosocial rehabilitation measures in the inpatient and outpatient departments of the Psychosocial Rehabilitation Center, located on the basis of the Regional Clinical Psychiatric Hospital, are described in detail.

Adverse childhood experiences (ACEs) are a significant risk factor for the development of mental disorders in adulthood, and their accurate assessment using the ACE-IQ questionnaire in psychiatric practice requires consideration of several methodological specifics. Objective: To analyze the application of the Adverse Childhood Experiences International Questionnaire (ACE-IQ) for assessing ACEs in patients with mental disorders, and to examine potential limitations and methodological aspects of working with this instrument. Material and Methods: A literature review was conducted on the topic of ACEs and their association with mental disorders in adulthood. The structure of the ACE-IQ questionnaire and the specifics of its application in psychiatric practice were examined. Results: The Adverse Childhood Experiences International Questionnaire (ACE-IQ) is a convenient and informative instrument for the systematic assessment of adverse childhood experiences (ACEs). Patients with psychiatric disorders represent a complex and heterogeneous population, for whom many of the topics in the questionnaire may be challenging and potentially traumatic to answer. Moreover, there is a high likelihood of distortion of facts and appraisals by the patient regarding their ACEs within the context of their current mental disorder and its phase. To obtain accurate results when utilizing the ACE-IQ with psychiatric patients, establishing a trusting therapeutic alliance is essential. The clinician should be prepared to monitor changes in the patient’s mental state throughout the questionnaire administration, and the involvement of a clinical psychologist is advisable. Detailed clarification of individual questions and terminology in the questionnaire is crucial, taking into account the patient’s sociocultural background. Interpretation of the ACE-IQ results warrants caution due to the potential distortion of facts by the patient within the framework of their present psychiatric condition. Conclusion: The ACE-IQ questionnaire is a valuable tool for assessing adverse childhood experiences; however, its application in psychiatric practice requires consideration of several methodological specifics. The correct use of the questionnaire will allow obtaining reliable data on the relationship between ACEs and mental disorders, which is important for understanding the role of social factors in the etiology of mental illnesses and the development of preventive programs.

The aim of the study is to adapt and validate the Russian version of the Clinical Assessment Interview for Negative Symptoms (CAINS).
Material and methods. From 2018 to 2024, 89 people were examined: 42 men (47.2%) and 47 women (52.8%), average age 37±9.8 years. Among them, 82 patients (92.1%) were diagnosed with F20.0 according to ICD-10, 5 patients (5.6%) with F21, and 2 patients (2.3%) with F23.1. The mean duration of the mental disorder was 18 [1-42] years, with an average number of hospitalizations of 12 [1-28] times. The CAINS manual and questionnaire text, translated into Russian by a group of young psychiatrists from the RSP YPC, were utilized for assessment.
Results: The Cronbach’s alpha for the total score of the questionnaire was 0.91. Convergent validity was demonstrated by a significant positive correlation between CAINS scores and the Marder PANSS factor. Confirmatory factor analysis indicated the preservation of the questionnaire’s two-factor model, explaining 55.8% of the total variance. Discriminant validity was evidenced by the more frequent absence of correlations between CAINS scores and positive and general psychopathological PANSS ratings. Inter-rater reliability was established by a sufficient level of agreement, with Cohen’s kappa coefficient, among independent raters for the majority (91%) of clinical assessments using the CAINS questionnaire.
Conclusion: The obtained results demonstrate that the Russian adaptation of the Clinical Assessment Interview for Negative Symptoms (CAINS) is a valid and effective psychometric clinical interview. It can be utilized for both clinical research and everyday clinical practice when working with patients suffering from psychotic disorders within the schizophrenia spectrum.

Chronic progressive cerebrovascular pathology is a powerful disabling factor in modern society. Chronic cerebral ischemia is based on microcirculation and neuroinflammation problems, which are mutually potentiating pathogenetic aspects. As a search for modern pathogenetically oriented targeted therapy, great attention is paid to cerebral capillary disease, oxidative stress in brain tissue and the issues of suppressing neuroinflammation. The article presents the materials of experimental and clinical studies of Ginkgo biloba extract and choline, as well as their combination — Choline Strong®