This analytical review highlights the issue of interdisciplinary collaboration between neurologists and psychiatrists in the context of the high prevalence of comorbid depressive and anxiety disorders among neurological patients. Evidence indicates that up to 64.6% of individuals seen in outpatient neurological settings have diagnosable psychiatric conditions. Particular attention is given to neuroinflammation as a transdiagnostic mechanism linking the pathogenesis of depressive disorders with neurological diseases, especially post-stroke conditions. The therapeutic potential of antidepressants with anti-inflammatory properties is examined, emphasizing their pleiotropic effects, which extend beyond conventional antidepressant action and contribute to neuroplasticity and functional recovery. The review underscores the need to integrate validated psychometric instruments and structured diagnostic interviewing into neurological practice to enable timely screening and risk stratification. As a strategic measure, the establishment of large interdisciplinary congresses is proposed to facilitate the development of consensus clinical algorithms, modernization of educational programs, and harmonization of regulatory frameworks, ultimately helping to overcome existing barriers and improve care for patients with comorbid conditions.

The article overviews the results of the studies of different formulations of opioid antagonist naltrexone (oral, injectable and implantable) for stabilization of remission and relapse prevention in patients with opioid dependence conducted by authors during the last twenty five years. Based on the results of these studies, long-acting sustained release formulations of naltrexone (injectable and implantable) are more effective than oral formulation and may solve the problem of poor adherence to oral naltrexone. Naltrexone implant is more effective that oral formulation for both relapse prevention and improving adherence to antiretroviral therapy in patients with opioid dependence. Depot formulations of naltrexone are effective, well tolerated and open a new perspective for the treatment of opioid dependence.

The article is a narrative review of the literature that comprehensively examines the problem of suicidal behavior in patients with schizophrenia. This article describes the risk factors, methods of prevention and treatment of suicidal behavior in patients with schizophrenia. Suicide is one of the leading causes of premature death among patients with schizophrenia, significantly reducing the average life expectancy in this category of patients. The risk of suicide in schizophrenia is significantly higher than in the general population. The highest risk of suicidal behavior occurs in the first years after the onset of the disease, but it persists throughout life. The key factors of suicide risk are male gender, young age, depression, substance abuse, somatic comorbid pathology and social isolation, etc.

Adequate assessment of suicide risk requires careful verification of risk factors. Modern approaches to this problem are focused on a comprehensive assessment of risk factors, using a personalized approach that takes into account subjectively significant aspects for the patient. The main goals of therapy include identifying patients at risk, reducing modifiable factors, and preventing events that increase suicidality with active use of protective factors. The high prevalence of suicidal behavior among this group of patients makes the problem relevant for clinical practice and the health care system. Psychosocial interventions play an important role, including measures to increase adherence to therapy, psychoeducational programs for patients, staff, and relatives of patients, as well as family therapy. For effective treatment and prevention of this group of patients, a comprehensive approach is needed, including psychosocial interventions and the use of modern drug methods.

Objective. The aim of this analytical review was to search, analyze, and summarize data on associations of inflammatory candidate genes and their effect on the pathogenesis and clinical manifestations of schizophrenia. Materials and Methods. A comprehensive search was conducted for original research articles, systematic reviews, and meta-analyses in the databases Google Scholar, PubMed, and eLIBRARY.ru. The inclusion criteria encompassed publications from January 1, 2017, to December 31, 2024, without language restrictions, focusing on the genetic aspects of inflammation in the context of schizophrenia. Results. The review confirmed the significant role of inflammatory genetic associations in the pathogenesis of schizophrenia. Polymorphisms in genes encoding pro- and anti-inflammatory molecules (IL6, IL10, IL1B, IL28B, TNF-α, HLA, VEGF-A, NF-κB) were found to be associated with disease risk, clinical symptoms, and brain structure alterations. Additionally, genetic regulation of inflammatory processes appears to contribute to impaired neuroplasticity, blood–brain barrier permeability, and oxidative stress in schizophrenia. Conclusion. Our review highlights the critical role of genetic associations related to inflammatory mechanisms in the pathogenesis of schizophrenia. A hereditary predisposition to immune response imbalance may influence the development, severity, and course of the disorder.

The article is another attempt to return to the best achievements of European psychiatry, which, unfortunately, have been forgotten due to the influence of the world unification processes. The authors analyze the causes and consequences of the growing confusion surrounding psychomotor psychosis concepts, using this example to demonstrate the prospects of a phenomenological approach to diagnosis. In the first part of the article, the evolution of scientific ideas about psychomotor psychoses is examined, along with the differences in the interpretations of clinical phenomena that arose at the turn of the 19th and 20th centuries. The prognostic reliability, etiopathogenetic and constructive validity of the classification of psychomotor psychoses, developed by the Wernicke-Kleist-Leonhard school, are demonstrated. Phenomenological descriptions of typical forms are provided. Cycloid motility psychosis manifests as akinetic and/or hyperkinetic episodes, with complete recovery in between.

This disorder is associated with developmental abnormalities of brainstem structures. This state features acute onset, stupor or disinhibition of reactive and expressive movements, dream-like consciousness, hypermetamorphosis of attention, altered affect, and metabolic, thermoregulatory, and autonomic dysfunction. A hyperkinetic episode can be complicated by the development of life-threatening febrile status. Fronto-striatal system damage produces qualitative distortions in automatic motor skills, appearing as catatonic symptoms (parakinesias). Periodic (remitting) catatonia episodes present with polymorphic symptoms, combining parakinesias, hyperkinesias, and akinesia in different body parts. Even with frequent relapses, the defect pattern is limited to flattening of affect. Persistent (systemic, lucid) catatonia follows a monotonous course, quickly leading to personality decay and intellectual decrease. Autochthonous transitions from one form of idiopathic psychomotor psychosis to another are not observed in clinical practice. Different pathophysiological mechanisms suggest the need to develop differentiated treatment methods for various forms of psychoses.

High-quality diagnostics of anxiety and depression is essential for adequate planning and implementation of interventions, prevention of relapse at the stages of remission formation in alcohol dependence. The aim of the study: to study the correspondence / inconsistency of self-assessment and clinical assessment of anxiety and depression in patients, and to analyze possible causes of discrepancies in assessments. Study material: 56 male patients with a diagnosis of F10.2; subgroups of "consistency of assessments", "predominance of self-assessment score", and "predominance of clinical assessment score" were identified, separately for anxiety and depression. A comparative intergroup analysis of characterological features and coping style of patients with different ratios of assessments was carried out. The results of the study reveal a high prevalence of discrepancies in assessments, more often in the direction of predominance of clinical assessment over self-assessment. A comparatively lower clinical assessment of symptoms is revealed in relation to patients with an exacerbation of characterological traits: individualism, pessimism, rigidity, as well as maladaptive coping (despair reactions and pessimistic forecasting in stressful situations). A comparatively higher clinical assessment was revealed in relation to patients with low values of these indicators and a more adaptive stress-coping.

Conclusion: when assessing emotional disorders in patients with alcohol dependence, which are involved in the formation, maintenance and recurrence of this disorder, it is advisable to use the "dual diagnostics" system (self-assessment scales and clinical assessment by a doctor). It is necessary to compare and analyze the results and reasons for the discrepancy in assessments. This will increase the level of the intervention’s personalization by more accurately identifying the leading symptoms in the patient's condition at the stages of remission.

Non-suicidal self-injury (NSSI) in adolescents is an important issue in child and adolescent psychiatry. The inclusion of NSSI in DSM-5 as a “research diagnosis” emphasizes its clinical significance. Despite its widespread prevalence among young people, this phenomenon has not been sufficiently studied in the Russian context, especially with respect to its family and clinical-anamnestic characteristics. The aim of the work: to identify and study the family and clinical-anamnestic characteristics of adolescent girls who committed non-suicidal self-harm in order to describe the key factors associated with this behavior. Patients and Methods: in a cross-sectional observational study, medical and social data of 186 female patients (12-17 years of age) hospitalized in a specialized neuropsychiatric hospital in 2022–2024 were analyzed. Family and clinical-anamnestic characteristics of the participants were assessed based on medical records, a specially developed statistical card, and anamnestic information. Results: the average age of the included patients was 14.9 ± 1.5 years. Emotional and behavioral disorders (F90–F98) were diagnosed in 67.2% of patients, neurotic disorders (F40–F48) in 7.5%, and affective disorders (F30–F39) in 5.9%. Important factors associated with NSSI were dysfunctional family relationships (single-parent family – 35.5%, conflictual relationships between parents – 11.8%), as well as a family history of mental disorders and alcoholism in parents. Perinatal pathologies and traumatic brain injuries were among the clinical and anamnestic factors. Conclusion: the identified clinical, family, and clinical-anamnestic characteristics associated with NSSI indicate the potential importance of a comprehensive approach to the diagnosis and prevention of this behavior in adolescents. The data obtained emphasize the importance of taking into account family and anamnestic factors when developing targeted preventive and therapeutic measures for this group.

The Somatoform Dissociation Questionnaire-5 (SDQ-5) is a well-known instrument for assessing the sensorimotor traumatic experiences. Objective. The aim of this study was a psychometric analysis of the Russian version of the SDQ-5 on a sample from the general population and a sample of patients with eating disorders. Material and Methods. The data were collected in a sample from the general population (n = 587) and a sample of patients with eating disorders (n = 185). The main part of the questionnaire included measures for assessing somatoform dissociation, anxiety (Generalized Anxiety Disorder-7, GAD-7), depression (Patient Health Questionnaire-9, PHQ-9), somatization (Somatic Symptom Scale-8, SSS-8), and psychoform dissociation (Brief Dissociative Experiences Scale, DES-B). The variable part of the questionnaire contained measures for assessing adverse childhood experiences (Adverse Childhood Experiences Questionnaire, ACE) in a sample from the general population and dysmorphophobia (Body Dysmorphic Disorder-Dimensional Scale, BDD-D) in a sample of patients with eating disorders.

Results. The factor validity and internal reliability of the adapted questionnaire were confirmed by the identification of one common factor of somatoform dissociation, which has adequate values of internal consistency. The convergent validity of the Russian version of the SDQ-5 has been proven by strong correlations of somatoform dissociation with anxiety, depression, somatization, and psychoform dissociation. The criterion validity of the adapted questionnaire was confirmed, on the one hand, by higher rates of somatoform dissociation in the sample of patients with eating disorders, on the other hand, by the relationships of somatoform dissociation with dysmorphophobia and adverse childhood experiences.

Conclusion. The Russian version of the SDQ-5 is a psychometrically based questionnaire for the diagnosis of somatoform dissociation, which can be recommended for solving research tasks and for use in psychotherapy and psychological counseling for people with eating disorders.  

SARS-CoV-2 infection is associated with the development of motivational-hedonistic disorders in post-COVID syndrome. It is known that anhedonia is associated with a high risk of suicidal ideation, which emphasizes the importance of its study. The aim of the study was to determine probable clinical, therapeutic and socio-demographic predictors of severe anhedonia, as well as to establish the ratio of its physical and social aspects in psychiatric inpatients who had COVID-19. Materials and methods. Secondary analysis of retrospective data from 48 people treated in a psychiatric hospital. Sociodemographic status, neuropsychiatric symptoms, information on the diagnosis and nature of the course of COVID-19 were recorded. To assess the structure of hedonistic disorders, the Russian-language versions of the Revised Physical Anhedonia Scale (RPAS) and the Social Anhedonia Assessment Questionnaire (RSAS) were used. Information on drug therapy administered during the 2 weeks prior to hospitalization and during current inpatient treatment was collected from primary medical records. Erythrocyte sedimentation rate (ESR) as an indicator of systemic inflammation and body mass index (BMI) as a marker of metabolic syndrome were also extracted. An objective assessment of physiological functions was performed based on blood pressure variability.

Results. The hypothesis that anhedonia is a component of post-COVID syndrome was partially confirmed. Among therapeutic strategies for relieving delayed neuropsychiatric symptoms, an increase in the doses of antidepressants prescribed in the hospital was observed after a longer period of time. Significant associations with the severity of social anhedonia, gender, use of antipsychotic drugs, type and dose of antidepressants, and blood pressure variability were established as predictors of the development of physical anhedonia. Conclusion. The potential for correcting anhedonia in the post-infection period of COVID-19 was demonstrated by choosing a rational therapeutic strategy, in particular modern antidepressants, as well as reducing the phenomena of vascular dysregulation.

Mental disorders are represented in the population mainly in the form of dynamic manifestations of various degrees of severity of remission conditions. The meaningful concept of remission in schizophrenia is a widely discussed topic in modern psychiatry, and is considered in the form of two approaches, categorical (clinical) and dimensional (standardized). The advantages of a categorical approach to classifying remissions in patients with schizophrenia, taking into account the qualitative signs of residual positive, negative (deficit) and personality symptoms, is a holistic view of the psychopathological characteristics of patients, indicating the general nature of supportive therapy, and to a certain extent the prognosis of further development of the disease. The categorical approach in the assessment of remission optimizes the development of rehabilitation measures for patients with various forms of schizophrenia, however, has a number of disadvantages in practical use.

The aim of the study was to study the characteristics of the categorical characteristics of remission in patients with undifferentiated and paranoid schizophrenia. Materials and methods: On the basis of the Bekhterev National Research Medical Center of the Ministry of Health of the Russian Federation, patients from a clinical sample (n=106) were examined, including 61 men (57.5%) and 45 women (42.5%), aged 19-59 years, who had no relapses within 12 months after hospital discharge. The majority of patients (n=76, 71.7%) were diagnosed with "paranoid schizophrenia" (F20.0) according to ICD-10, and "undifferentiated schizophrenia" (F20.3) was diagnosed with a lower frequency (n=30, 28.3%). Two groups of patients were formed from the general clinical sample: group 1 who received atypical antipsychotics (aripiprazole, olanzapine, quetiapine, risperidone) (n=85, 80.2%), group 2 who received typical antipsychotics (haloperidol)‒ (n=21, 19,8%). Clinical-psychopathological, clinical-anamnestic, clinical-catamnestic research methods, and a coding list were used. Results: in 106 patients with paranoid and undifferentiated syndrome, remissions are formed more often (71;67%) than symptomatic (35;33%). Patients with paranoid schizophrenia were more likely to have a paranoid variant of symptomatic remission: 14 (56%) versus 0 (0%), p=0.008, and patients with undifferentiated schizophrenia had an obsessive one: 7 (70%) versus 1 (4%), p<0.001; the distribution of syndromic remission variants was similar. Patients receiving typical antipsychotics were more likely to develop an apathetic variant of syndromic remission: 13 (86.7%) versus 3 (5.4%), p <0.001, and patients receiving atypical ones were more likely to develop a psychasthenic variant of syndromic remission:16 (28.6%) versus 0 (0%) in patients receiving typical antipsychotics, p=0.016; the frequency of formation of symptomatic remission variants was similar.

There were no significant differences in the frequency of the types of syndromic and symptomatic remissions and their variants depending on the atypical antipsychotic used. The advantages of the categorical approach in optimizing preventive, diagnostic, and therapeutic tactics are analyzed, and the disadvantages of the categorical approach to assessing remission for developing a personalized rehabilitation program for patients with schizophrenia are identified. It is concluded that for a clearer definition of the target symptoms, additional consideration of the dynamic characteristics of the remission state is possible: individual dimensional (affective, negative, positive), as well as social and psychological characteristics.

Relevance: Comorbidity of alcohol dependence (AUD) and mental disorders is a widespread phenomenon. Depressive disorders, sleep disorders, and anhedonia significantly increase the risk of relapse in patients with various addictions. Research Objective: To assess the relationship between anhedonia, sleep quality, and pathological alcohol craving in patients with AUD and comorbid depression who did not respond to placebo therapy at the randomization stage of a clinical trial. Research Design: A cross-sectional study was conducted involving 100 patients diagnosed with alcohol dependence (F10.2). The study evaluated several parameters, including the level of alcohol craving, sleep disturbances, social functioning levels, depression, anxiety, and clinical and anamnestic data. Results: The study revealed several significant correlations. The level of depression, as measured by the Montgomery-Asberg scale, showed an inverse correlation with the social functioning scale (Spearman’s ρ = -0.416; p = 0.000). The sleep quality index demonstrated a direct correlation with the level of alcohol craving (Spearman’s ρ = 0.371; 0.366; 0.356; p = 0.000). Dysfunctional beliefs about sleep showed a direct correlation with the “enjoyment of life” subscale of the Ferguson anhedonia scale (ρ-Spearman = 0.366; p = 0.000). The level of alcohol craving also showed a direct correlation with the severity of anhedonia on both subscales of the Ferguson anhedonia scale. Specifically: for PSVA: Spearman’s ρ = 0.287, p = 0.004 (ILF); ρ = 0.368, p = 0.000 (ELF), for OCSVA: Spearman’s ρ = 0.276, p = 0.006 (ILF); ρ = 0.254, p = 0.011 (ELF), for VASVA: Spearman’s ρ = 0.266, p = 0.023 (ILF); ρ = 0.227, p = 0.023 (ELF).

Conclusions: The findings indicate that in patients with alcohol dependence, sleep disorders were directly associated with alcohol craving, which in turn correlated with the level of anhedonia. Considering the significant impact of anhedonia levels on the relapse of addictive pathology, these results emphasize the critical need for timely pharmacological intervention to prevent relapse and maintain dependence remission.