Depression makes a major contribution to the overall global burden of disease, including the increased risk of a wide range of concomitant somatic pathology. А high percentage of mortality in psychiatric patients is attributed to physical diseases, mainly cardiovascular (CVD). Metabolic syndrome (MetS) is one of the risk factors for both the CVD and a frequent comorbid depression. The purpose of this review is to systematize data on the relationship between MetS and depression, in particular, on the shared pathogenetic mechanisms as systemic inflammation. The manuscript evaluates the issue of the use of hematological indices of systemic inflammation (HISIs) in the diagnosis of both MetS and affective pathology, and also provides data on new combined indicators, including the cellular link and lipidogram parameters. The latter include the ratios of lymphocytes and high-density lipoproteins (HDL) (Lymphocyte To High-Density Lipoprotein Ratio, LHR), neutrophils/HDL (Neutrophil To High-Density Lipoprotein Ratio, NHR), platelets/HDL (Platelet To High-Density Lipoprotein Ratio, PHR) and monocytes/HDL (Monocyte To High Density Lipoprotein Ratio, MHR). Understanding the relationship between hematological indices and metabolic syndrome in patients with depression can help identify individuals at high risk and identify timely preventive measures. Various clinical trials and studies indicate a link between hematological parameters and metabolic syndrome, but the question of choosing the most effective coefficients remains open. Further study of the problem can help identify potential risks of comorbid disorders and perform adequate preventive strategies.

The article addresses the problem of Alzheimer’s disease (AD) from the perspective of the interaction between two important pathological processes: oxidative stress and metabolic disorders. Although histopathological changes in early and senile dementia are similar, and both variants are attributed to AD, individuals with early-onset AD (EOAD) demonstrate a more aggressive course of the disease with rapid cognitive decline and fewer concomitant morphological changes. The development of late-onset AD (LOAD) depends on multiple environmental factors, lifestyle, and, among other things, the functioning of general adaptation mechanisms, including redox, immunological, and hormonal systems.

The article pays special attention to the role of metabolic syndrome (MS) as an important risk factor not only for cardiovascular and cerebrovascular diseases but also for AD. The presence of MS in individuals over 60 years of age increases the risk of developing dementia by 13% under the age of 60 and by 8% between the ages of 60 and 70. The article emphasizes the importance of oxidative stress (OS), which causes oxidation of biomolecules and tissue damage, in the pathogenesis of metabolic disorders and the development of MS. Possible mechanisms of the relationship between oxidative stress processes and metabolic disorders are described. Understanding the mechanisms of AD and MS development, as well as their interrelation, is key to developing effective methods for preventing and treating these diseases.

The deleterious impact of depression on the course and outcome of somatic illness is well understood, but the subject of how somatic diseases affect the clinical picture, course, and prognosis of depression has received little attention. There is a lack of awareness on the actual level of comorbidity of somatic diseases in patients with depression, as well as the relationship of comorbidity with clinical features of the disease, patient age, sex, and diagnostic variants of depression. Metabolic syndrome (MS), cardiovascular diseases (CVDs), and type II diabetes (T2D) are the most common comorbidities, causing significant impairment and contributing to mortality rates. All these diseases are closely related to depression through shared pathophysiologic mechanisms of neuro-immuno-metabolic and cardio-metabolic nature. Inflammatory processes and genetic risk factors play a crucial role in realization of these mechanisms. Objective: The aim of this study is to analyze the existent knowledge on prevalence of MS, CVDs, and T2D in patients with major depressive disorder (MDD) and bipolar disorder (BD) in comparative aspect, taking into account possible effects of sex and age. Additionally, we strive to highlight the specific clinical features of comorbid patients. Methods: We conducted a literature review on the topic of comorbidity of MDD and BD with MS, CVDs, and T2D. We mostly selected meta-analyses and prospective studies with large samples. Results: According to current research, MS affects an average of 30-35% of individuals with both BD and MDD, with a minor predominance of male patients. CVDs are detected in an average of 18-20% of patients with BD and 25-45% of patients with MDD, also with a slight predominance of male patients. T2D affects an average of 8-10% of people with both BD and MDD, with no gender differences. There are no consistent and identifiable clinical signs that distinguish comorbid patients from non-comorbid patients for either BD or MDD. Conclusion: More research into the comorbidity of depression and chronic somatic diseases is required, particularly given the scarcity of scientific data for the Russian population.

The problem of frequent comorbidity between depression and metabolic syndrome has been known to medicine for a long time. However, there is more and more data on the joint course of these states. The narrative review presents current scientific data on the relationship between metabolic syndrome and depression, as well as the results of studies on the effect of antidepressants on the development of metabolic disorders. The review is based on an analysis of 75 publications published in the bibliographic databases of the RSCI and Medline. Despite numerous research results proving the comorbidity of depression and metabolic syndrome, the question of their causal relationship remains open. The presented materials complement the understanding of the associations of metabolic syndrome and depression, and also allow us to take into account the mechanisms of comorbidity of these conditions when choosing antidepressants.

Over the past decades the prevalence of metabolic syndrome (MS) among adolescents has increased significantly. Psychiatric disorders and treatment with psychopharmacological drugs are among the risk factors for the development of MS. The risks of drug-induced metabolic disturbances in adolescents are higher than in adults. Conversely, potential reversibility of MS at its initial stages emphasizes the importance of early detection and treatment. The aim of this narrative review is to summarize the available data on the diagnostics, prevention and treatment of MS in adolescents with mental disorders. Medline and RSCI electronic databases were searched to identify relevant sources of information. Synthesis of information based on 157 publications demonstrates the lack of universally accepted criteria for the diagnosis of MS in adolescents and the limited data on effective preventive or therapeutic interventions. In this review the diagnostics of the components of MS and associated disturbances in adolescents are overviewed, pharmacological and nonpharmacological approaches to MS prophylaxis and treatment are discussed. The results of the reviewed studies reveal a number of factors contributing to the development and progression of MS (both unmodifiable and modifiable): genetic, systemic immune-inflammatory, environmental, pharmacological. Further exploration of these factors in adolescents with mental disorders, as well as the development of preventive and therapeutic strategies based on these factors, are important directions for future research.

The wide representation among the Russian population of depressive and anxiety disorders, manifested both in the form of independent nosological forms and in the form of comorbid conditions, determines the importance of studying the factors that determine their etiopathogenesis. The patient’ microsocial environment is traditionally considered as a significant predictor, largely determining the course of depressive and anxiety disorders. At the same time, there is a lack of studies revealing the ratio of the psychological content of relatives’ experiences with the severity of symptoms and clinical dynamics of the patient’s condition.

The aim of the study was to determine the value of the psychological characteristics of the microsocial environment of patients with depressive and anxiety disorders for predicting the clinical dynamics of their condition during inpatient treatment and in catamnesis (six months after discharge). Based on the investigation of 50 patients (17 men, 33 women, average age 27.81 [SD = 9.96] years) and 50 relatives (16 men, 34 women, average age 48.04 [SD = 11.45] years), it was shown that the nature of the relationship to the disease of a loved one and the perception of family situation by relative are interrelated with indicators reflecting the dynamics of patients’ remission. In particular, emotional support from a loved one contributes to the of the patient’s is improvement at the inpatient treatment phase. And the presence of understandable family rules, orderliness, hierarchical relationships, as well as attention to moral aspects in the family contributes to the stabilizatioin of remission in a delayed perspective.

The data obtained indicate the importance of a systematic approach in the psychotherapy of depressive and anxiety disorders, taking into account both the individual psychological characteristics of patients and the characteristics of their microsocial environment.

Objective: to evaluate the efficacy and safety of Ranquilon® (INN amide N-(6-phenylhexanoyl) glycyl-L-tryptophan)) tablets 1 mg2 at a dose of 6 mg per day (JSC “Valenta Pharm”, Russia) compared with placebo in the treatment of patients with anxiety in neurasthenia and adjustment disorder. Materialand methods. The clinical trial (CT) included a total of 220 patients with anxiety due to neurasthenia or adjustment disorder (adaptive reaction disorder) and a score on the Hamilton Anxiety Rating Scale (HARS) from 18 to 24 inclusive, the severity of asthenia on the self-assessment scale of asthenia (Multidimensional Fatigue Inventory, MFI-20) is more than 50 points, as well as at least 4 points on the severity subscale of the clinical global impression scale (Clinical Global Impression—Severity, CGI-S), who were randomly assigned to two groups and received double-blind treatment. Patients of group 1 (n=110) received Ranquilon® , 1 mg tablets, at a dose of 6 mg/day (2 tablets 3 times) for 28 days. Patients of group 2 (n=110) received PL in the same dosage regimen. The primary outcome measure for the clinical trial was the assessment of patient response rate (proportion of responders) as a ≥50% reduction in the mean total Hamilton Anxiety Rating Scale (HARS) score at Visit 3 (Day 29±1) compared to baseline at Visit 0 (days from -7 to -1). Secondary efficacy criteria included assessment of various parameters over time at visits 2 and 3 compared to the baseline (visit 0), in particular: on the HARS scale—the proportion of patients with a decrease in anxiety level (in the mean total score) by ≥50% and the proportion with ≤17 points, average anxiety score; for the CGI-I subscale—the proportion of patients with significant and pronounced improvement, on the CGI-S subscale—the proportion of patients with a score of 1 or 2 points, the mean total score of the change in the severity of the condition; on the MFI-20 scale—change in mean total score, the proportion of patients with a decrease in mean total score by 25%, by 50% and to ≤30 points, the mean total score for all subscale items; on the Spielberger-Hanin scale—change in the mean total score of personal anxiety and situational anxiety. To assess safety monitoring of adverse events (AEs), serious adverse events (SAEs), clinically significant deviations in vital signs, laboratory parameters, ECG parameters, etc. was analyzed. Results. The proportion of responders with a ≥50% reduction in HARS mean total score at Visit 3 (Day 29±1) compared to baseline (Visit 0) was statistically significantly higher (p<0.0001) in in group 1 (Ranquilon® ) compared with group 2 (PL), respectively, was 70.0% (n=77) and 24.5% (n=27) (difference—45.5% (n =50)). Evaluation of all secondary efficacy criteria also showed a statistically significant benefit of therapy in Group 1 compared to Group 2 (p><0.05). A total of 64 AEs were recorded in 44 (20.0%) patients: 43 AEs in 28 patients (25.5%) in Group 1 and 21 AEs in 16 (14.6%) patients in Group 2. There was no significant difference between treatment groups in the number of patients with AEs (p=0.063). In both groups, mild AEs were recorded; there were no patients with serious AEs (SAEs), SAEs with fatal outcome, or AEs that led to discontinuation of study therapy. No clinically significant abnormalities observed in vital signs, laboratory parameters, or ECG parameters. Conclusion. The superiority of Ranquilon® tablets 1 mg at a dose of 6 mg per day therapy over placebo in reducing anxiety in patients with conditions due to neurasthenia and adaptation disorder was confirmed. The drug demonstrated a favorable safety profile similar to that established for PL.><0.0001) in in group 1 (Ranquilon® ) compared with group 2 (PL), respectively, was 70.0% (n=77) and 24.5% (n=27) (difference—45.5% (n =50)). Evaluation of all secondary efficacy criteria also showed a statistically significant benefit of therapy in Group 1 compared to Group 2 (p<0.05).

A total of 64 AEs were recorded in 44 (20.0%) patients: 43 AEs in 28 patients (25.5%) in Group 1 and 21 AEs in 16 (14.6%) patients in Group 2. There was no significant difference between treatment groups in the number of patients with AEs (p=0.063). In both groups, mild AEs were recorded; there were no patients with serious AEs (SAEs), SAEs with fatal outcome, or AEs that led to discontinuation of study therapy. No clinically significant abnormalities observed in vital signs, laboratory parameters, or ECG parameters. Conclusion. The superiority of Ranquilon® tablets 1 mg at a dose of 6 mg per day therapy over placebo in reducing anxiety in patients with conditions due to neurasthenia and adaptation disorder was confirmed. The drug demonstrated a favorable safety profile similar to that established for PL.

COVID-19 caused not only acute but also delayed neuropsychiatric disorders. A highly probable manifestation of the latter may be physical anhedonia, since this transnosological psychopathological phenomenon is associated with a violation of metabolic and neuroinflammatory processes. The goal. To identify the prevalence of physical anhedonia in the clinic of post-COVID syndrome and to assess the association of this transnosological psychopathological symptom with concomitant somatic burden, the severity of the SARS-CoV-2 infection and the time elapsed since the disease. Materials and Methods. The prevalence of acute and delayed neuropsychiatric symptoms was assessed in 48 psychiatric inpatients with severe mental disorders depending on the history of COVID-19. Quantitative and qualitative assessment was carried out by self-reporting on the number of simultaneously present groups of chronic diseases, and the severity of obesity was objectively assessed - by body mass index, dysregulation of vascular tone-by blood pressure variability, systemic inflammation - by sed rate and platelet-lymphocyte ratio (PLR). Physical anhedonia was detected using the Russian-language version of the Revised physical anhedonia scale (RPAS). Results. The association between the severity of COVID-19 and the severity of anhedonia, as a probable component of post-COVID syndrome, was confirmed. The total general therapeutic burden was the most important predictor of acute and delayed neuropsychiatric symptoms against the background of COVID-19. The probable role of metabolic syndrome, systemic inflammation and vascular tone was shown in the development of late disorders after coronavirus infection. Conclusion. The role of general therapeutic burden (including obesity, vascular dysregulation and systemic inflammation) in the development of anhedonia in patients with mental disorders who have had COVID-19 has been demonstrated.

The mechanisms of anticonvulsant effects on bone metabolism are not studied sufficiently. This determines the relevance of research on factors that influence the development of osteoporosis in patients taking long-term anticonvulsants. The aim of the study to evaluate the effect of modifiable and non-modifiable osteoporosis risk factors on changes in bone mineral density during long-term therapy with anticonvulsants. Materials and methods. The study included 100 adult patients receiving anticonvulsants for moren12 months and 58 healthy volunteers. All participants underwent a clinical screening with assessment of factors affecting bone metabolism and a densitometric study using quantitative computed tomography at three points (L1, L2 and femoral neck). Results. CT-densitometry results showed decrease bone mineral density in the most part of the participants in both study groups. According to the data of the analysis of the influence of osteoporosis risk factors on bone mineral density values, it was found that the presence of fractures in the anamnesis and low level of motor activity increased the risk of osteoporosis development in patients taking long-term anticonvulsants (p (χ2) < 0.001). Conclusion. The results of the study confirm the importance of continuing research on factors affecting bone metabolism and developing a set of preventive measures to prevent the development of osteoporosis.

In order to study the clinical and psychopathological characteristics of affective disorders in childhood and adolescence and their relationship to neurophysiological and neuroimaging studies, clinical and psychopathological (using scales of comprehensive assessment of mental state and the Kovach M child depression questionnaire) and instrumental methods (MRI, VEM) examined 134 children and adolescents aged 6 to 18 years, diagnosed with epilepsy. Differences in the frequency of affective symptoms according to the SWAPS data were revealed, depending on the gender of patients and the form of epilepsy, as well as neurophysiological and neuromorphological changes that increase the likelihood of developing comorbid epilepsy affective disorders in childhood and adolescence.