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Neuroendocrine tumors (NETs) are a heterogeneous group of slowly progressing tumors from neuroendocrine cells able to secrete biologically active substances. The most striking clinical manifestation of functioning NETs is the carcinoid syndrome, which is caused by serotonin overproduction and is most often associated with hot flashes, diarrhea, and abdominal pain. The prevalence of depressive and anxiety spectrum disorders in NETs patients can amount to 30–50%. The development of depressive and anxiety spectrum disorders in NETs can occur both through a nosogenic mechanism facilitated by a long pre-diagnostic stage, the presence of a serious disease with severe somatic symptoms and resulting significant decrease in quality of life. The mental disorders may be a result of somatogenic factors, which include an imbalance of significant mediators in the central nervous system (in particular, serotonin), as well as chronic inflammation and abnormalities of the body's immune defense. In the treatment of patients with NETs and verified anxiety and depressive disorders, special attention is paid to the safety of prescribing the first-line therapy, the selective serotonin reuptake inhibitors. The side effects of these agents are related to the activity of serotonin receptor agonists in the gut, which results in diarrhea and increased gastrointestinal motility, the symptoms similar to the carcinoid syndrome manifestations. The accumulated evidence allows concluding on the relative safety of serotoninergic antidepressants in NETs patients, but does not exclude some groups of patients with an increased risk of complications related to an additional effect on serotonin metabolism. Current knowledge on the prevalence, pathogenesis and treatment of depressive and anxiety spectrum disorders, comorbid to NETs, are limited and contradictory. Therefore, further studies with a larger patient samples are required to identify key factors of the pathophysiology and manifestation of mental disorders in NETs patients, which would generally facilitate the optimization of their treatment.

Anxiety disorders, except the manifestations of anxiety itself, are characterized by a broad spectrum of cognitive and somatic symptoms significantly reducing the individual’s quality of life and increasing the risk of somatic disorders. The rate of cardiovascular, respiratory, gastrointestinal, and other disorders throughout life is significantly higher in people suffering from anxiety. Furthermore, many symptoms of anxiety and panic/fear mimic manifestations of somatic disorders. Optimal treatment of anxiety disorders includes both pharmacological and psychotherapeutic interventions. At the same time, psychotherapy is not always available for patients, and internists not always decide to prescribe psychotropic medication, for example antidepressants. In such situations, nonbenzodiazepine anxiolytics showing high efficacy and tolerability can be used. Mebix, having an adaptogenic effect on the central nervous system and a stabilizing effect on the autonomic nervous system, that affects almost all neurotransmitters can be considered one of such drugs. The paper reports clinical cases of patients with anxiety disorders, who were treated with Mebix as monotherapy or in combination with antidepressants.

Differentiation of organic and psychogenic disorders is one of the most difficult tasks of neurology and psychiatry, both because of the difficulties in determining the genesis of the condition itself, and because of their frequent comorbidity. A certain commonality of the pathogenetic nature of both disorders allows, when choosing therapeutic tactics, to rely on drugs that affect the central link in the pathophysiology of these processes – an imbalance of mediator systems. The purpose of this study was to study the efficacy and safety of Pantogam Active in patients in the complex therapy of neurological and psychiatric diseases in outpatient settings. The analysis included 120 people divided into 2 groups: group 1 took the main therapy and Pantogam Active on the recommendation of the attending physician at a daily dosage of 600–1200 mg (the average daily dosage is 900 mg), group 2 – only the main therapy. Patients were randomly assigned to groups. The duration of the study was 3 months. The effectiveness and safety were evaluated during a control examination by a specialist and based on the results of evaluation scales. The results of the study demonstrate a positive effect on both subjective feelings (well-being of patients receiving complex therapy) and changes in an objective assessment. The addition of the main therapeutic regimen with Pantogam Active is recommended for patients in order to correct concomitant symptoms that reduce the quality of life and adherence to treatment: asthenic syndrome, anxiety and depressive disorders, cognitive impairment

In most cases, chronic dizziness is persistent postural perceptual dizziness (PPPD), which is often combined with other diseases of the vestibular system and anxiety disorders. In real-life clinical practice, PPPD and comorbid disorders are rarely diagnosed and effective treatments are rarely prescribed, so the development of modern methods for managing patients with PPPD with comorbid diseases is important.Objective: to analyze the typical management practices and evaluate the effectiveness of complex therapy in patients with PPPD and comorbid disorders.Material and methods. We examined 60 patients (mean age – 42.5±13.8 years) with diagnosis of PPPD (according to the diagnostic criteria of the Barany Society) and comorbid diseases. All patients were examined twice: at the beginning and after completion of treatment, which lasted an average of 1 month. Treatment included antidepressants (serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors), anti-anxiety medications, vestibular exercises, an educational program, and cognitive behavioral therapy. Arlevert (a combination of cinnarizine 20 mg + dimenhydrinate 40 mg) was used as a drug therapy for the treatment of vestibular dizziness in 28 patients. A clinical otoneurological evaluation and videonystagmography were performed to assess vestibular disorders; the severity of dizziness was assessed using an otoneurological questionnaire and the Dizziness Handicap Inventory (DHI); the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Spielberger Anxiety Inventory (STAI) were used to assess anxiety and depressive disorders.Results. None of the 60 patients had previously been diagnosed with PPPD. They were observed with a misdiagnosis of cerebrovascular disease and/or cervical spine pathology and received ineffective treatment. Anxiety and depressive disorders were detected in 32 (53.33%) patients, migraine – in 20 (33.33%) and previous peripheral vestibular disorders – in 8 (13.33%) patients. After one month of treatment in patients with PPPD and comorbid conditions, the severity of dizziness according to DHI decreased from 45.59±15.47 to 29.9±12.56 points (p

Purpose. To continue the narrative that we have started in the first part of this article, telling the reader about the history of the use of certain plant pigments in the treatment of several mental and neurological diseases, as well as in histological studies of brain tissue. To present to the reader the modern research data regarding the potential effectiveness and safety of some plant pigments in the treatment of various mental and psychosomatic pathologies, as well as some neurodegenerative diseases. Then, to present the reader a detailed description of a clinical case from the authors’ own practice. In the aforementioned case, the combined use of a low-calorie diet, exercise, metformin, chromium picolinate, thermogenic fat burners (caffeine and synephrine) and several different plant pigments and antioxidants — made it possible to achieve remission, both in terms of the mental state and in terms of endocrine and metabolic status in a young woman with obesity, polycystic ovary syndrome, depression, hyperuricemia, and an initial stage of urate-based urolithiasis, without the use of traditional psychopharmacotherapy. Methodology. For the purpose of second part of this review, we have selected primarily those plant pigments that are widely distributed in a variety of plants, and therefore cannot be attributed to any one plant (for example, the carotenoids lycopene, lutein and zeaxanthin, or anthocyanins, which are present in many berries and in the brightly colored flowers of some plants, such as hibiscus). Secondly, we were interested in the pigments from dyeing plants that some traditional medical systems (for example, traditional Chinese medicine, or Indian Ayurvedic medicine, or traditional medicine of the American Indians) have historically used and/or still continue using for the treatment of mental and neurological diseases. Many of those plants, for example, madder, are relatively little known as medicinal plants to modern European doctors and patients. We then searched for information about the medical use of such plant pigments with the help of search engines and databases such as PubMed, Google Scholar, Science Direct, Web of Science. Then we have summarized the data we had found and collected, and presented the summarized data in this second part of the review. Then we described in detail a clinical case from our own clinical practice. Results. The data we have obtained in the process of compiling this review, in our opinion, indicate a significant therapeutic potential for the use of some plant pigments that we have reviewed there — in the treatment of several mental and neurological disorders. The evidence base for the use of such plant pigments in psychiatry and neurology — varies widely in quality. For some plant pigments (eg, for lycopene from tomatoes, for lutein and zeaxanthin, for anthocyanins from various berries or from hibiscus flowers, for resveratrol from red wine and from dark grape varieties) — there are positive data from small randomized clinical trials, in combination with data from population studies (for example, on the association between the consumption of tomatoes, of lycopene and of carotenoids in general, of resveratrol and of plant antioxidants in general — and the frequency of depressive and anxiety disorders). For some other plant pigments that were historically used and are still used in some traditional medical systems, among other their uses, specifically for the treatment of mental and neurological disorders — for example, madder extract — we so far were able to find only experimental data on animals and on neuronal cell cultures, combined with the empirical experience of such traditional medical systems. Practical implications. The results that we have presented in this review, in our opinion, can provide theoretical and practical grounds for the use of some of the plant pigments that we have reviewed there (for example, lycopene, lutein and zeaxanthin, resveratrol, etc.) in the combination treatment of chronic fatigue syndrome, of mild forms of anxiety and depressive disorders, mild cognitive impairment — especially in patients who refuse standard psychopharmacotherapy, or who do not tolerate it well. Some other plant pigments that were historically used in the treatment of mental and neurological disorders in some traditional medical systems (for example, madder extract) — in our opinion, deserve to be studied in humans in this role, preferably in the format of randomized controlled trials.

The addictive potential of social media is well known. However, data on the impact of social media on mental health are contradictory. Some studies report the benefits of using social media for mental health. In turn, data from other studies have shown that widespread use of social networks has been associated with a number of psychological and mental health problems, such as depression, anxiety, psychological stress, especially in young people. The purpose of the study. To study the association of problematic use of social networks with anxiety indicators on the HADS scale among medical university students Materials and methods. The study included 229 students of both sexes enrolled in the 3rd year of the medical faculty of the Medical University. The analysis of the problematic use of social networks was carried out using the Russian version of the questionnaire «The Social Media Disorder Scale». The identification and assessment of the severity of anxiety disorders was carried out using the Russian version of the hospital scale of anxiety and depression HADS. Results. It was found, that the frequency of problematic use of social networks in the general group of surveyed students studying at a medical university was 9,6%. The presence of signs of anxiety was detected in 34,9% of the surveyed students. The frequency of problematic use of social networks among people with signs of anxiety was 59,1%. Among the examined girls the number of people with signs of anxiety with problematic use of social networks was twice as large as compared to patients without problematic use of social networks. Conclusion. Associations of problematic use of social networks with indicators of anxiety on the HADS scale among students at a medical university were revealed.

Introduction. In Ukraine, on average, 30% of people are obese and 25% are overweight. In parallel with the increase in the number of overweight patients, the percentage of people with migraine is increasing. The prevalence of migraine is high, it affects 12-15% of the population. Both diseases negatively affect not only the function of internal organs, but also the nervous-psychological state of patients, leading to anxiety and depressive disorders. The aim of the study was to analyze the features of the structure of anxiety disorders in obese patients with chronic migraine. Materials and methods: 180 patients (90 women and 90 men) were examined and divided into two clinical groups: 1st group – 60 persons with chronic migraine with an average BMI=23.5.8±1.10 kg/m2; 2nd group – 60 obese patients with chronic migraine, BMI=34.6±1.42 kg/m2. The control group consisted of 60 patients without a headache and with averange BMI=19.5±0.7 kg/m2. The ICHD-3 criteria were used to diagnose migraine. The DSM-5 criteria were used to diagnose anxiety disorders. The patient's level of anxiety was measured using Taylor Manifest Anxiety Scale (TMAS). Statistical processing was performed using dispersion and correlation analysis. Results: Phobic anxiety disorders were in 1.5 times more common in 2nd group patients (c2=9.81, p

Vegetative disorders are characteristic of patients with anxiety disorders, which are becoming more common and negatively affect the quality of life of both the patients themselves and their environment. Almost 20% of the population suffers from anxiety disorders, and women are more prone to these diseases than men. Anxiety disorders include panic disorder, generalized anxiety disorder, and other disorders. In most cases, anxiety disorders are accompanied by vegetative symptoms, such as palpitations, sweating, trembling, changes in appetite and others. Vegetative disorders often mimic somatic and neurological disorders in patients with anxiety disorders, therefore they create problems for diagnosis. In our country, a significant part of patients with anxiety disorders are observed by neurologists with a diagnosis of somatoform dysfunction of the autonomic nervous system or autonomic dystonia. The therapy of the underlying disease, which includes lifestyle optimization, psychotherapy and medications, is of leading importance in reducing vegetative disorders.

Purpose. To provide the reader with a detailed historical overview of the human use of plant pigments for medical purposes, starting from ancient times. To show how modern chemical theory of color and evolutionary biology of plants explain, from their very different points of view — some commonly observed properties of many plant pigments, such as their antioxidant and anti-free radical activity. To present modern data on pharmacological properties and potential therapeutic utility in psychiatry and neurology of some selected plant pigments. Methodology. To get an idea of what originally were the rationales for human use of plant pigments for medical purposes, we turned to books on the history of medicine and on the history of pharmacology. To get an idea of what is the relationship between the absorption spectrum of a molecule and its chemical properties (in particular, properties of a reducing agent, an electron donor, an antioxidant and a free radical scavenger) — we turned to the book on the chemistry of pigments. And to get an idea of the evolutionary role of pigments in plant tissues — to the book on evolutionary biology. We then selected, based on the lists of plant pigments provided in two of the most authoritative manuals for DIY fabric dyeing with natural dyes — some of the plants that looked most interesting for our purposes. We then searched for information about the use of these plants in psychiatry and neurology and about their neuropharmacological properties, with the use of search engines such as PubMed, Google Scholar, Science Direct, Web of Science. The data we have collected were summarized and presented to the reader in this review. Results. The data that we have obtained in the process of compiling this review, in our opinion, do indicate a significant therapeutic potential for the use of certain plant pigments in psychiatry and neurology. The evidence base for the use of various plant pigments in psychiatry and neurology — significantly varies in quality. For some plant pigments (for example, for curcumin from turmeric, or for crocetin and crocin from saffron, or for roburin from common oak bark, epigallocatechin gallate from green tea leaves, chlorogenic acid and caffeic acid from coffee beans), there is positive data from small randomized clinical trials. For others, so far there is only data from population studies (for example, on the correlation between consumption of walnuts and olives with the lowered incidence of depression), combined with some open-label studies on dietary supplements that contain those pigments. Practical implications. Our results, in our opinion, provide theoretical and practical grounds for the use of some plant pigments (curcumin, crocin and crocetin, epigallocatechin gallate, chlorogenic and caffeic acids, roburin, oleuropein, juglone) in the combination treatment of chronic fatigue syndrome, mild forms of anxiety and depressive disorders, mild cognitive impairment, early stages of Alzheimer disease and other neurodegenerative diseases, especially in patients who refuse pharmacotherapy or who do not tolerate it well.

Depressive disorders and anxiety are the most common mental disorders in the perinatal period, occurring in 14–23% of women. Antidepressants from the selective serotonin reuptake inhibitor (SSRI) group are considered the drugs of choice for the treatment of these disorders. Although SSRIs are the best-studied antidepressants used in pregnant women, there are still conflicting opinions about their effect on pregnancy course and outcomes of pregnancy. At the same time, the risks associated with their use in pregnant women are often exaggerated, while the risks of untreated mental disorders are underestimated. SSRI use during pregnancy has been associated with a modestly increased risk of adverse events, including postpartum haemorrhage, miscarriage, preterm birth, cesarean delivery, fetuses small for their gestational age and low birth weight, low Apgar scores, and increased rates of neonatal hospitalization to intensive care units. However, depressive and anxiety disorders in the mothers themselves also contribute to similar outcomes, so it is not always possible to distinguish the contribution of medication and illness. Comparative data on the effects of different SSRI medications on outcome for the mother and fetus during pregnancy are limited, but paroxetine and fluoxetine are reported to pose the greatest risk to the fetus/neonate. Information on the safety of citalopram and escitalopram during pregnancy and lactation is limited. Citalopram has the highest concentrations in amniotic fluid of all SSRIs. According to current data, sertraline has the most favourable safety profile during pregnancy and lactation, which is explained by its low penetration through the placenta. Sertraline concentrations in the fetus are approximately 1/3 of those in maternal plasma. Sertraline has the lowest concentrations in breast milk of all SSRIs and is associated with a low risk of adverse effects in a baby, making it the drug of choice for nursing mothers. In conclusion, sertraline is one of the best studied SSRIs and has a favourable safety profile for both the mother and the fetus/neonate.

Anxiety and anxiety disorders are important modifiable risk factors for cardiovascular and other common chronic non-communicable diseases and complications. Anxiety disorders significantly reduce the motivation and adherence of patients to lifestyle changes and drug therapy, significantly worsen the quality of life, and increase the risk of disability and the costs of the health care system. The issues of diagnosis and therapy of anxiety are relevant for the practice of physicians and cardiologists due to the high incidence of anxiety disorders in patients with cardiovascular diseases, a decrease in the quality of life and an increase in adverse outcomes, and also due to the insufficient awareness of the risks associated with the psycho-emotional state of patients. Therapy of anxiety disorders includes both drug and non-drug methods. The first-line drugs in treating most anxiety disorders are selective serotonin reuptake inhibitors or selective serotonin-norepinephrine reuptake inhibitors. The risk of possible side effects of these agents in patients with cardiovascular diseases should be considered. Sedative and anti-anxiety drugs, including non-benzodiazepine tranquilizers, are more commonly used. The most studied drug from this class in therapeutic and cardiological practice is fabomotizole. The efficacy and safety of fabomotizole, including long-term use, have been studied in numerous studies in patients with cardiovascular diseases and a wide range of anxiety disorders.

Persistent postural perceptual dizziness (PPPD) is the most common cause of vague chronic vertigo and severely limits patients' quality of life.Limited data are available on comorbidities, the typical treatment of patients with PPPD, and the efficacy of combination therapy for PPPD.Objective: to identify comorbid disorders and evaluate the efficacy of complex therapy in patients with PPPD.Material and methods. Sixty patients (mean age 42.5±13.8 years) with PPPD were studied. All patients were prescribed complex treatment that included antidepressants (selective serotonin reuptake inhibitors), vestibular exercises, and an educational program. In 28 patients, Arlevert (combination of cinnarizine 20 mg + dimenhydrinate 40 mg) was used as drug therapy. A clinical otoneurologic examination, videonystagmography, assessments by Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Spielberger State-Trait Anxiety Inventory (STAI), Dizziness Handicap Inventory (DHI) and otoneurologic examination were performed at baseline and at the end of treatment (mean, one month).Results. All patients had previous misdiagnoses, among which vertebrobasilar insufficiency and chronic cerebral ischemia predominated. Thirty two (53.33%) patients with PPPD had anxiety-depressive disorders (ADD) as the main comorbidity, 20 (33.33%) patients had migraine, 8 (13.33%) patients had previously had peripheral vestibular disorders that were not diagnosed. The severity of dizziness according to the otoneurological questionnaire and the DHI decreased after one month of therapy in the group with PPPD and ADD from 44.00±16.80 to 29.6±12.80 points (p

The review presents the results of clinical studies of the efficacy and safety of Tenoten and Tenoten children’s in the treatment of anxiety, neurotic, stress-related and somatoform disorders and adjustment disorders. Technologically processed antibodies to the S100 protein in Tenoten and Tenoten children’s drugs change the conformation of the S100 protein, which is considered as a pathological link in the development of anxiety states, as well as neurodegenerative diseases. Tenoten is a well-studied daytime anxiolytic that combines a favorable safety profile with high anxiolytic activity. The efficacy of Tenoten in the treatment of anxiety disorders is comparable to that of benzodiazepine drugs. Tenoten has no inhibitory and muscle relaxant effects, does not cause drug tolerance, addiction, "withdrawal" syndrome, as well as drug interactions. Tenoten for children has been shown to be effective in the treatment of anxiety in children, including those with somatic manifestations, attention deficit hyperactivity disorder, and learning disabilities.

Introduction and purpose: Anxiety disorders are a heterogeneous cluster of common mental health disorders typically characterized by hyperarousal, excessive fear and worry. Unfortunately, a large portion of the world's population does not have access to traditional mental health care, this is influenced by the paucity of available psychiatric services, particularly in many low- and middle-income countries. This article will discuss how patients suffering from depression or anxiety disorders turn to non-pharmacological and unconventional interventions such as exercise, yoga, meditation, aromatherapy or music therapy. The aim of study: The purpose of this literature review was to assemble and analyse the available data about anxiety disorders. Material and method: Standard criteria were used to review the literature data. The search of articles in Pubmed database was carried out using following keywords: Anxiety disorders; depression; mental illness; alternative treatment methods. Description of the State of Knowledge: Pathologically increased anxiety is found not only in anxiety disorders per se, but also in most other types of mental illness. The first-line methods are pharmacotherapy and cognitive-behavioral therapy. Of particular interest is the use of physical activity and exercise in the treatment of anxiety disorders. This treatment is inexpensive and has few undesired effects. Exercises such as yoga, meditation, tai chi or qi gong are becoming more and more popular. Summary: Anxiety disorders can now be treated effectively. Current research focuses on individualized forms. We hope that even more effective methods of therapy will be developed than those currently available. Keywords: Anxiety disorders; depression; mental illness; alternative treatment methods.

Introduction. Behavioral methods on laboratory animals are recognized as the main approach in studying the activity of potential psychotropic drugs and allow us to evaluate the main effects of new compounds, increase the possibility of predicting a successful outcome of future clinical trials.Text. This review article analyzes the main modern behavioral models in rodents that are widely used for screening and studying the pharmacological activity of potential psychotropic drugs. The advantages and disadvantages of each test are highlighted and complexes of behavioral methods are demonstrated that most conclusively confirm the reproducibility of the results obtained in clinical trials. The description and evaluation of behavioral methods that characterize the state of anxiety, which are used to screen for new compounds with anxiolytic activity (tests «Open field», «Dark-light chamber», «Elevated plus maze», «Sequence of rays»). The range of tests used to study cognitive functions and memory processes is widely presented (various mazes – T-shaped, U-shaped, radial maze, Barnes maze, E-maze; water mazes – Morris, T-maze) with a description of a comparative analysis and necessary conditions that ensure the reliability of information. An important direction in the field of behavioral pharmacology is the modeling of violations of social behavior and the study of approaches for its correction – the main methods necessary for the study of social behavior are presented in the review by the tests «Three-chamber social test», «Open field» extended test, etc.Conclusion. Behavioral pharmacology dictates the need for close interaction between preclinical and clinical stages of research in the framework of the development of translational medicine and the development of approaches that provide evidence for the reproducibility of the results obtained in clinical trials. It is also necessary to improve existing and develop new behavioral models of mental disorders and to search for new ways to study the mechanisms of formation of behavioral disorders.

Background. A lot of scientific articles have been published since the global COVID-19 pandemic was officially announced by WHO. Although different aspects of COVID-19 impact on the mental sphere were studied, some issues regarding the psychological characteristics of those who have had a coronavirus infection are still not fully revealed. It is noted by many authors that even when the main symptoms of the disease are subsided, symptoms of anxiety, depression, cognitive & mood disorders are still persistent even after the treatment. Purpose: to study cognitive and emotional spheres of patients who are recovering from coronavirus infection and currently undergoing rehabilitation procedures. Materials and methods. The study involved 100 patients undergoing medical rehabilitation, 55 of them are recovering from traumatological, neurological and cardiovascular disorders (27 male and 28 female patients, aged 57±10) and 45 patients are recovering from pneumonia caused by coronavirus infection (11 male and 34 female patients, aged 58±12). The study was conducted using the Montreal Cognitive Assessment Scale (MoCA), the Hospital Anxiety & Depression Scale (HADS), and the Health-Activity-Mood Scale (SAN). Statistical analysis of raw data had included calculation of descriptive statistics, Pearson’s correlation coefficient, Student’s t-test for independent groups, Fisher’s φ* transformation and significance of correlation coefficients differences with Fisher’s transformation & Student T-distribution, and was processed with Microsoft Office Excel 2016 build-in data analysis package. Results. Analysis of MoCA results showed that ratio of severe impairments of memory functions and attention span is higher in post-COVID group of patients. This group also had higher rate of anxiety symptoms and sub-clinical depression state. In both groups more than a half of the patients have average level of anxiety and depression, however patients from post-COVID group are more likely to experience more symptoms of anxiety than non-COVID patients. Patients from post-COVID group are significantly more likely to have a higher scores of anxiety compared to patients in the other group and at the same time they are less likely to have average anxiety level. Differences between groups were discovered for “Health” and “Mood” scales of SAN with higher scores among post-COID patients as well as lower scores for “Activity” scale. Conclusion. Statistically significant differences between the groups were found; common and specific correlations were found for both groups. The results may be useful for healthcare professionals working with post-COVID patients, and can also be used by psychologists who deal with the problems of social and psychological rehabilitation of post-COVID patients.

Aim. To evaluate the impact of anxiety disorders on adherence to anticoagulant therapy (ACT) in patients with atrial fibrillation (AF). Materials and methods. 179 outpatients (131 women, 48 men, mean age 69.96.2 years) with AF were examined. The research methods included a physical examination according to the standards of medical care in an outpatient facility, clinical and psychopathological examination using psychometric scales. Results. Based on the assessment of adherence to ACT using the MoriskyGreen test, 2 groups of patients were identified: Group 1 patients with high adherence to ACT, Group 2 patients with partial/low adherence to ACT. In group 1, anxiety disorders were verified in 51.7% of cases, in group 2 54.3%. There were no statistically significant differences in the prevalence and severity of anxiety in the study groups. In accordance with the binary logistic regression model, the probability of high adherence to therapy is determined by higher (compared with the group of patients with partial/low adherence to therapy) scores in terms of mental health (p0.001), vital activity (p=0.02) and the total score of the SF-36 scale (p=0.08), as well as the extraversion parameter (p=0.02) of the NEO-FFI scale. Conclusion. In the present study, no significant association was found between anxiety symptoms and a decrease in adherence to ACT in patients with AF. However, the results obtained suggest a contribution to the adherence to therapy of personality characteristics.

Anxiety disorders are the most common mental disorders. Up to one-third of the population suffers from them during their lifetime. An important problem is also the lack of awareness of patients about their disease. Only half of the anxiety disorders are diagnosed. Only a fifth of people suffering from anxiety disorders sought help from a specialist doctor. Only a third of patients are offered pharmacological treatment. The main symptom of this disease is an increased and intense feeling of anxiety. It is also associated with many other physical symptoms. It is correlative with a reduced quality of life and functioning in society. Diagnosis of anxiety disorders is very difficult due to the lack of specific imaging and laboratory tests that may be helpful in making or suggest a diagnosis. There is also a correlation between these disorders and the occurrence of depressive disorders, which is why the problem is complex and requires increased diagnostic sensitivity. Worldwide, anxiety disorders are underdiagnosed and undertreated, that's why it's so important to be aware of this disease entity. Prompt intervention by a physician is very important due to the increased frequency of suicides. The basic treatment is medication therapy with drugs from the SSRI and SNRI group combined with cognitive-behavioral therapy. Quick diagnosis and implementation of treatment contributes to a significant improvement in the quality of life of patients.

The review article gives a modern definition of the concept of agoraphobia. Different classification approaches in the typing of agoraphobia are presented. Its role as a factor aggravating the course of non-psychotic mental disorders is shown. The features of its manifestation depending on the nosological affiliation are analyzed. It was revealed that agoraphobia is a predictor of an unfavorable outcome in people with panic disorder. In turn, panic disorder often causes the development of agoraphobia. At the same time, gender and age aspects are noted. The comorbidity of agoraphobia and somato-vegetative type of generalized anxiety disorder is shown. Agoraphobia increases the risk of suicidal behavior in depression, has a high correlation with the severity of personality disorders, especially of the avoidant and dependent type. At the same time, some researchers dispute the point of view that these types of personality disorders are predisposing factors for panic disorder and agoraphobia, based on retrospective data on the premorbid personality structure of patients with anxiety disorders. The relationship between PTSD and panic disorder is emphasized in connection with the emergence of a circular model of the development of feelings of fear, which postulates a similar etiology of anxiety disorders. There is a comorbidity of agoraphobia with disorders of the hypochondriac spectrum: from the degree of fixation to obsessive nature. reduces the effectiveness of therapy for schizophrenic spectrum disorders and the quality of life of patients. The picture of the panic disorder itself with agoraphobia becomes heavier if the patient has chronic alcoholism (in particular, the frequency of seizures increases), while the presence of agoraphobic symptoms leads to a relapse of alcoholic illness, which is explained by taking alcohol to relieve symptoms, and also increases the likelihood of developing dependence on tranquilizers.

Due to the processes of globalization and transition to the information society their negative effects started to become apparent, namely virtually unlimited access to an abundance of information. Information overload occurs when the amount of information exceeds the perceptual abilities of accepting human being. It questions the impact of this process on health and sleep. Such phenomena as mind scrolling, communicative overload, distrust of digital security, cyber violence, digital inequality as mediators or consequences of information overload are considered. This article reviews the types of the information overload, ways of disseminating information, mechanisms of influence on the self-rated health and psychological condition and sleep, connections with anxiety and depression. This subject became especially relevant in the context of COVID-19 pandemic, since isolation, restriction of motor activity, and increased time spent behind the screen have become important predictors not only of sleep disorders, but also of other health problems. The article addresses the issue of subjects of studies are usually teenagers and people under 35 (generation Z), as the most active smartphones, messengers, social networks and mass media users. The problem of providing unfair information to users of social networks of different regions of residence, socio-economic levels is raised. Most scientists agree that the ways to solve the described problems are to limit the time behind the screen, the amount of content consumed per day, and compliance with sleep hygiene. Additional studies are required to determine the exact pathophysiological mechanisms of the effect of stress on sleep.

Purpose. In this article, we want to show to the reader (both with the thorough literature review, and with presentation of two clinical cases from our own practice), what might be the objective difficulties in differential diagnosis between primary depersonalization-derealization disorder (DPD, code 6B66 according to ICD-11, F48.1 according to ICD-10) and schizotypal disorder (STD, code 6A22 according to ICD-11, F21 according to ICD-10), what may be the cause of these difficulties, and how can a psychiatrist still distinguish between these disorders in his everyday clinical practice. Methodology. First, we turned to well-known and scientifically respectable DPD monographs, in particular to the Daphne Simeon’s book «Feeling Unreal: Depersonalization Disorder and the Loss of the Self» and to the Maurizio Sierra’s book «Depersonalization: A New Look at a Neglected Syndrome», and to similarly respected monographs on STD, in particular «Schizotypy: New dimensions» by Oliver Mason and Gordon Claridge, and «Schizotypal Personality» by Adrian Reine, as well as to the relevant sources which were cited by these authors in respective chapters of their books. Then we searched for other relevant articles on the topic of interest, with the use of keywords such as «depersonalization disorder», «schizotypal disorder», «differential diagnosis», in the international scientific databases PubMed, Google Scholar, Web of Science, Elsevier ScienceDirect, Elsevier ClinicalKey. The literature data we have found were then analyzed, summarized and presented in this article, together with a thorough description and clinical and psychopathological analysis of two clinical cases from our own practice. Results. The data we have obtained while writing this literature review, as well as our own clinical experience, presented there in the form of a thorough description of two cases from our own practice, in our opinion, convincingly indicate that the differential diagnosis between primary DPD and STD is sometimes difficult. Nevertheless, such differential diagnosis is not only possible, but also necessary. In the field of psychiatry, making the correct diagnosis is also of great practical importance for choosing the correct strategy and tactics of treatment, both psychopharmacological and psychotherapeutic. Our data also convincingly indicate that, unfortunately, in Russia and post-Soviet countries, overdiagnosis of STE is extremely common in cases where the patient actually has primary DPD, or depersonalization-derealization syndrome (DP/DR syndrome) within the clinical picture of some other mental disorder (usually from an anxiety disorders spectrum or from affective disorders spectrum), as well as a misunderstanding of what the DP/DR syndrome is, what are the typical symptoms and phenomenology of it, together with underestimation of its importance in the overall clinical picture of any given mental disease, underestimation of the importance of specific measures to eliminate the DP/DR syndrome in a given patient, and insufficient ability of specialists to diagnose and treat this devastating syndrome. In light of this, we believe that the material presented in this article is of particular relevance and importance for Russian and other post-Soviet countries’ psychiatrists. Practical implications. In our opinion, the results we have presented in this review deserve the widest possible application in psychiatry.

To study the rehabilitation potential of law enforcement officers and the process of its development, a verbalcommunicative diagnostic method was used to collect information about subjects with depressive disorders using "Google Form". The study was conducted on the social network Facebook during 2020-2021. The study involved 452 people from the Central, Southern and Eastern regions of Ukraine aged 20 to 49 years with depressive disorders of the neurotic spectrum and 182 subjects without affective disorders. Socio-demographic features of the subjects with depressive disorders of different genesis are analyzed. It was found that women (54.51%) and subjects aged 30-49 years (70.0%) predominated among the surveyed. The majority of respondents are city dwellers (58.51%), with incomplete higher education (33.33%), mostly working and having family (with neurotic depression (54.95% and 51.65% respectively) and organic depression) (51.16% and 55.81%, respectively) and mostly unemployed and single (with endogenous depression) (59.14% and 58.06%, respectively). It was determined that among the factors of mental trauma in subjects with neurotic depression factors related to family and personal relationships (DC=3.32) dominated, in organic depression – with their own health (DC=2.08), in endogenous depression – factors of socio-psychological nature (DC=2.75). It was found that such factors as young age (20-29 years), higher education, living in the city, having a family, can be favorable factors for the formation of the rehabilitation potential of people with depressive disorders of various genesis. It was also determined that according to many socio-demographic indicators, subjects with neurotic disorders coincided with the respondents of the control group, which may indicate a higher level of rehabilitation potential of people with neurotic depression. [ABSTRACT FROM AUTHOR]

The work focused on the examining the use of virtual reality (VR) technologies in the reduction of depression in Europe. More than 70 issues of the journals “Cyberpsychology, Behavior, and Social Networking”, “European Psychologist” were analyzed. We used the bibliometric analysis, the "keyword method" to analyze the text, which is understood as a search for typical terms, content analysis of the content of articles that used VR and depression. In the journal "European Psychologist" the term VR has not been mentioned for the last 2 years, which indicates the secondary importance of this issue for general psychology. In cyberpsychology, on the contrary, since 2019 in Europe, the interest of researchers in the use of VR technologies in clinical psychology has increased. By the content of the journal articles. "Cyberpsychology, Behavior, and Social Networking" VR technologies are used primarily for the correction of anxiety disorders, and secondly, for the correction of depression. These technologies are used in various ways. The first option is to create VR programs with a direct impact on depression reduction. Here, VR is used as a symptom awareness tool, to create an avatar environment for client dialogue in a non- judgmental environment. Research has shown that such VR programs are rated by users as a useful tool for informing and emotionally responding to depressive states. The second option is an indirect effect on reducing the level of depression through the reduction of fears, phobias; increased activation, tone, euphoria in mental states; the development of a positive mood, cognitive motivation; an increase in indicators of field independence (cognitive style). A study based on the methods of psychosemantics is presented, which has demonstrated the effect of a specially created VR program with an avatar on changing the unconscious attitudes of the personality, reducing phobia of darkness. The effectiveness of using of VR technologies in reducing depression is determined by modeling of mental experiences and actions in VR, creating a virtual ontology, the influence of VR on conscious and unconscious attitudes, the possibility of responding to unconscious experiences through the user's identification with an avatar.

Introduction: Gabapentin is a drug used for monotherapy or adjunctive therapy of simple and complex partial epileptic seizures in adults and children. It is also used to treat neuropathic pain for adults. There are reports in the medical literature of the effective use of gabapentin in the treatment of other conditions. Let's take a closer look at its therapeutic potential. Aim of the study: The overview of current literature knowledge about the usage of gabapentin in various medical conditions within the fields of toxicology, dermatology, gynecology, psychiatry branches' issues, with indicating the potential abuse. Materials and Methods: We reviewed the literature available in the PubMed database, using the keywords. Results: Gabapentin is an anticonvulsant drug structurally similar to gamma-aminobutyric acid (GABA). It is considered to be a centrally acting analog of GABA, nevertheless, it presents a different molecular mechanism comparing to the other drugs that affect GABA-ergic transmission. The registered indications for its use are the treatment of seizures within adults and children and neuropathic pain in adults. The literature reveals that gabapentin is also used in the treatment of alcohol abuse disorders within the patients with alcohol withdrawal symptoms, the treatment of pruritus, hot flashes during menopause and the treatment of anxiety disorder. Summary: Due to the ambiguous effects of gabapentin usage, it can be applied to treat various medical conditions. Nevertheless, the usage of this drug described in the literature requires additional studies on a larger group of patients to confirm the findings.

DiGeorge anomaly is characterized by a wide variety of clinical manifestations and laboratory test results. Various etiological factors leading to deletion in chromosome 22q11 have been indicated. DiGeorge anomaly has a high comorbidity with various mental disorders (psychosis, attention deficit/hyperactivity disorder, anxiety and affective disorders, etc.). The psychological profile of these patients includes disorders in memory, attention, arithmetic skills, language and intellectual deficits, social dysfunction and others. Patients with DiGeorge anomaly require complex interventions and care, in terms of somatic and mental health. The assessment of their mental state requires a multidisciplinary team, including: child psychiatrist/psychiatrist, psychologist, speech therapist, etc. [ABSTRACT FROM AUTHOR]

Low back pain is one of the most common reasons for seeking medical attention. Musculoskeletal (nonspecific) pain is the most common (90%) cause of chronic pain. Depressive and anxiety disorders, sleep disorders, mainly in the form of insomnia, which negatively affect the course of the disease, are often encountered as comorbid disorders in patients with chronic musculoskeletal low back pain (CMLBP). When managing patients, it is effective to use an integrated approach: drug therapy, kinesitherapy and psychological methods. Kinesitherapy uses various types of exercise and walking; it is important that they are performed regularly under the supervision of a specialist, excluding excessive physical and static loads. Cognitive-behavioral therapy is the most effective psychological effect in CMLBP, which should be directed not only to pain, but also to insomnia, depression and anxiety disorders. Non-steroidal anti-inflammatory drugs (NSAIDs) are used as drugs for chronic pain. It is important to take into account the presence of risk factors, concomitant diseases, interactions with other drugs. The use of etoricoxib (Arcoxia) for chronic low back pain is discussed. The author presents his own experience in managing 71 patients (average age 55) with CMLBP using kinesitherapy, psychological methods, and NSAIDs. As a result of treatment after 3 months, a significant decrease in VAS was achieved from 8 (6-8) to 2 (0-4) points (p < 0.0001), the depression decreased from 7 (5-9) to 4 (3-6) points in HADS (p = 0.002), the anxiety from 7 (5-10) to 5 (3-7) points in HADS (p = 0.0003), a decrease in disabilities according to the Oswestry question-naire from 46 (34-57.77) to 11.11 (4.44-26) percent (p < 0.0001), increase in physical activity according to IPAQ-SF from 11 (7-16) to 23 (15-26 ) points (p = 0.0002), decrease insomnia according to ISI from 12 (7-15) to 6 (2-10) points (p < 0.001), improvement in sleep quality according to PSQI from 9 (7-13) points up to 4 (2-9) points (p < 0.001). The widespread introduction of complex treatment of patients with CMLBP is of great medical and social importance.

Aim. To determine the possible impact of anxiety and depression disorders on the adherence of patients with atrial fibrillation (AF) to anticoagulant the rapy.Material and methods. The study included outpatients with AF of any type. After signing the informed consent, patients filled out questionnaires and scales that determined the level of anxiety and personal predisposition (MMAS-8, MMAS-4, SF-36, SHAI, STAI, HADS, NEO-FFI).Results. A total of 117 outpatients treated for AF were included. The mean age of patients was 74±5 years (men, 38%). Based on MMAS-4 and MMAS-8 results, adherent and non-adherent cohorts of patients were formed. Low adherence group had significantly higher situational anxiety according to STAI (45,9±9,9 vs 41,1±10,7, p=0,045) and depression according to HADS (7,9±3,6 vs 5,9±3,5, p=0,018). SF 36 showed that non-adherent patients had a lower general health (41,6±12,9 vs 52,2±20,0, p=0,01). Five-factor model revealed an association between low compliance and low extraversion (21,3±6,6 vs 26,4±7,2, p=0,002). Pharmacokinetic data on blood concentrations of anticoagulants or its metabolites at the second visit were available in 76 (67%) patients. Assessment of pharmacokinetic and compliance data revealed a moderate direct correlation (Matthews correlation coefficient (MCC), 0,345) and a weak direct correlation with the MMAS-8 (MCC, 0,177). The difference in MMAS-4 and MMAS-8 scores between high and low pharmacokinetic adherence groups was significant on both scales (p=0,011 and 0,015, respectively).Conclusion. The rationale for widespread introduction of standardized questionnaires and scales (MMAS 4, MMAS 8, STAI, HADS, SF 36, Big 5) was shown in order to early identify patients with low adherence to treatment. The results highlight the need for further study of the contribution of psychiatric disorders to low compliance to anticoagulant therapy.

Abstract Introduction and purpose: The co-occurrence of mental illness and somatic diseases is a relationship confirmed by researchers in the fields of clinical medicine, health psychology or neuroscience. This article aims to present and discuss the interrelationship between mental and somatic diseases and to present issues related to the process of diagnosis. State of knowledge (brief description): Depression, schizophrenia, eating disorders and anxiety disorders are mental illnesses cited among researchers on the basis of studies as particularly prone to somatic comorbidities. Among somatic diseases, on the other hand, cancer is cited as the most frequently implicated in psychiatric comorbidity. However, this is not a clear-cut problem, as the impact of somatic and mental illnesses on each other can be bidirectional. Diagnosis of these requires a physician to have a great deal of factual knowledge and great vigilance in conducting an interview that may be conducted not only with the patient, but also with his family or environment. Summary: Working with people who are both mentally and somatically ill is a job that requires knowledge that combines both disciplines. Data indicate that 20-35% of patients with chronic somatic disease also have an additional psychiatric diagnosis; somatization of mental problems is a common phenomenon in outpatient treatment.

The work is aimed at examining the use of virtual reality (VR) technologies in clinical psychology in Europe. More than 37 issues of the journal "Cyberpsychology, Behavior, and Social Networking" with impact factor 2.3 were analyzed, and the articles reflect both cyber and clinical and psychological orientation. The "keyword method" was used to analyze the text, which is understood as a search for typical terms that designate a criterion or replace it. Then the keyword "virtual reality" was associated primarily with the types of disorders in clinical psychology of the classification of group F (according to ICD-10). The topics "virtual reality" and "clinical psychology" are the most frequently discussed topics in the field of the problem area "cyberpsychology". According to the study, the possible applications of virtual reality in the field of clinical psychology are essentially limited to three disorders: anxiety disorders, depression, and autism. According to publications of specialists in general psychology, the term "virtual reality" is not mentioned, which shows that this topic is of secondary importance.

Введение: Качество и результаты клинических исследований в современной психиатрии имеют важное значение, поскольку они служат основой для клинических рекомендаций. Однако многие аспекты проведения исследований антидепрессантов и анксиолитиков в последнее время являлись предметом серьезной критики. В данном обзоре рассмотрена литература последних двух десятилетий, посвященная методологическим и методическим проблемам при изучении новых лекарственных препаратов для терапии тревожных и депрессивных расстройств. Результаты: Исследованиям анксиолитиков и антидепрессантов присущи как общие проблемы подходов к проведению клинических исследований, так и собственные особенности. Современные требования и процедура стандартизованных клинических исследований новых лекарственных препаратов решают формальные задачи с целью официальной регистрации препарата и не вполне приемлемы для психиатрии на данном этапе ее развития. Особенности классификации психических расстройств, недостаточность представлений о механизмах их патогенеза, ограничения методов психометрической оценки, недостаточно контролируемый плацебо-эффект и многие другие проблемы, возникающие у организаторов, исполнителей и субъектов клинических исследований, могут приводить к искажению получаемых результатов. Ряд других проблем, включая игнорирование оценки особенностей клинико-фармакологического действия препарата, снижает применимость результатов исследований в реальной клинической практике. Выводы: Появление более эффективных решений этих проблем позволит повысить адекватность разных аспектов исследования, начиная с выбора гипотезы, параметров эффективности (конечных точек) и популяции исследования, и получать данные, ориентированные не только на формализованную оценку результативности терапии в рамках исследований (efficacy), но и на персонифицированный/стратифицированный прогноз эффективности в реальных клинических условиях.

In a situation of rapidly changing environmental conditions and the growth of stress of different strengths and orientations, people are more likely to experience anxiety. The results of epidemiological studies show that up to 33.7% of the population suffers from lifelong anxiety disorders. According to large population-based surveys, comorbidity among people with this pathology is high: three out of four people with anxiety disorder experience at least one other mental disorder during their lifetime. The pathogenetic mechanisms of anxiety and insomnia are closely related, mutually aggravating each other’s influence. The difficulty of sleep generation and regulation makes this process very vulnerable to sleep and circadian rhythms disturbances, which include problems with the quality, time and quantity of sleep. Some researchers suggest that anxiety acts as an endogenous factor that affects the manifestations of the sleep-wake cycle, and the irregularity of this cycle contributes to anxiety. Recent studies display that chronotype may also be an important occurrence marker of chronic primary insomnia and a risk factor for anxiety disorders.The COVID-19 pandemic has become a major challenge for the mental health of people around the world. Numerous scientific publications have covered the prevalence of mental and behavioural disorders, including anxiety and dyssomnia, both in the context of psychosocial stress caused by the COVID-19 pandemic and in patients with long-term consequences after coronavirus disease. The term “Long COVID” covers a number of features that indicate damage to many organs, and lasts for weeks and months after the onset of the disease. An analysis of the literature shows that although physical symptoms are given the most attention, the impact of COVID-19 on mental health is no less important. At present, the long-term COVID-19 syndrome has not been definitively identified, but the leading signs of mental disorders after coronavirus disease, including sleep problems, anxiety, depression, fatigue, and cognitive difficulties, have been described.

The review of data from the available literature cites the results of studies of psychological disorders comorbid to multiple sclerosis and highlights scientific papers detailing domestic and foreign research. The high prevalence of affective and adaptive impairment is linked both to the neurophysiological particularities of this chronic, progressive, neurodegenerative illness and to psychological factors — individual personality traits and the attitude of those afflicted to their illness, to the change in their social functioning and to their prognosis. It is demonstrated that patients with multiple sclerosis have a significantly higher frequency of depressive and anxiety disorders than the general population, which suggests the need for an integrated, personalized approach to people with this illness.

Diagnostic criteria and approaches to the therapy of anxiety syndromes were considered. The basic method of anxiety treatment is psycho-pharmacologic treatment selected depending on the type of prevailing disorder and degree of its severity. The drug selection depends on the degree of anxiety severity and duration of the disease.

The main concept of the World Health Organization, set out in the Global Strategy for Womens, Childrens and Adolescents Health (20162030), is providing up to 2030 for every woman, every child, every adolescent in any city in the world the possibilities for realization of the rights to physical and mental health, social and economic opportunities. Therefore, in recent years, of particular concern is the problem of mental disorders occurrence in childhood, due to their rather high frequency and different complications in the state of somatic and mental health. Today, anxiety disorders are the most frequent among all categories of mental disorders and registered at 3.7-5.1 % of cases; they are characterized by significant polymorphism of clinical manifestations, dynamism and often cause serious difficulties in therapy. Factors that cause anxiety disorders are the following: genetic predisposition to psychosomatic and mental disorders, presence of the personal characteristics of the mother and the accentuated traits of the child, dysfunctional relationships with peers and family members. These factors often lead to the formation of suicidal behavior of the child and decline in the quality of life and, consequently, to the development of psychopathological disorders in adult life. Significant number of pathological conditions associated with structural changes in DNA, are characterized by disorders of the central nervous system development and functioning. Genomic rearrangements, revealed at submicroscopic and microscopic levels, are one of the most frequent causes of nervous and mental diseases. The hypothesis is considered on the role of one of the mechanisms of somatic mosaicism activation of the mobile genetic elements transposition in the pathogenesis of psychiatric disorders. One of the major causes of genome destabilization and changes in the system of maintaining the genome stability is violation in the functioning of the group of RNA-editing proteins AID/APOBEC, which play an important role in maintaining the stability of the genome of nerve cells through inhibition of unlimited expansion of retroelements that can lead to mental diseases, but this hypothesis needs further study. However, determination of the genetic nature of these disorders is not clarified completely. Aim. Study of spontaneous mutagenesis level in peripheral blood lymphocytes (PBL) of patients with various forms of anxiety disorders in vitro. Object and methods. Cytogenetic analysis has been carried out in 53 patients of 7 to 17 years old with various forms of anxiety disorders (31 patients with phobic anxiety disorders (PAD) and 22 patients with anxiodepressive disorders (ADD)). The comparison group consisted of 41 conditionally healthy peers. Results. Mean frequency of spontaneous mutagenesis in PBL of patients with PAD was 4.95 % and in patients with ADD 5.75 % that exceeded the same parameters in healthy peers by more than three times (1.59 %). Chromosome-type aberrations were presented by single and paired acentric fragments, the frequency of which was higher than in lymphocytes of healthy children. Dicentric chromosomes were also more frequently defined in PBL of sick children. The ratio of chromatid type aberrations to chromosome-type aberrations was 3.2 : 1 patients with PAD, 2.1 : 1 in patients with ADD, which corresponds to the spontaneous chromosome mutagenesis in somatic human cells. Increased frequency of chromosome aberrations in blood lymphocytes of patients with PAD and ADD has been revealed as a result of the performed studies. Preventive treatment aimed at genome stabilization in sick children may contribute to their reproductive health in future.

Anxiety disorders are considered as the most common class of mental disorders of adolescence. Anxiety affects all areas of a teenager’s life, significantly worsening his state of health, school performance indicators and relationships in the family and society. The article describes the characteristics of anxiety disorders in the adolescent period from the position of etiopathogenesis, classification, clinical features. The need for an integrated approach to the therapy of anxiety disorders in adolescents is grounded, which includes, in addition to full-fledged pharmacotherapy, a wide range of psychotherapeutic, physiotherapeutic and social rehabilitation activities.

Introduction. The relevance of the subject is primarily due to the high frequency of anxiety disorders in the population. According to various schools of psychology and psychotherapy, the motivation of the patient, their deep-seated attitudes and values play a significant role in the emergence and development of anxiety disorders. But nowadays there is a lack of empirical studies that consider achievement motivation and perfectionism in connection with anxiety disorders. Objective. On the one hand, the study is focused on the relationship between the direction and the achievement motivation in motivational conflicts, and on the other hand, the authors illicit the general level and structural characteristics of perfectionism in people with anxiety disorders. Procedure. The study involved 21 patients with anxiety disorders undergoing inpatient treatment at the Moscow Research Institute of Psychiatry, Moscow, Russia, and 20 healthy subjects. In order to measure achievement motivation, the authors used TAT (Thematic Apperception Test) modified by H. Heckhausen (Heckhausen, 1963, 1967; Magomed-Eminov, 1987). In order to identify the degree of manifestation and features of the structure of perfectionism, the Kholmogorova-Garanyan perfectionism questionnaire (Garanyan, Yudeeva, 2008, 2009) and the Hewitt and Flett Multidimensional scale of perfectionism were used (Hewitt, Flett, 1998; Gracheva, 2006). An intergroup comparison was performed in terms of the severity of the characteristics assessed, and also a correlation study of the perfectionism and motivation indicators was conducted in each group. Results. Compared to healthy individuals, patients with anxiety disorders show a higher level of general perfectionism and socially prescribed perfectionism, as well as reduced achievement motivation. They revealed a greater discrepancy between the motives for achieving success and avoiding failure, which suggests that their activity is directed to the motive of avoidance than to the motive of achievement. The overall level of perfectionism in both groups negatively correlates with the severity of the achievement motive, however, in healthy people, perfectionism is associated with the hope of success, and in patients with anxiety disorders it is associated with the fear of failure. Conclusion. The results can be used in psychotherapeutic practice treating patients with anxiety disorders. The study gives way for further research on patients with anxiety disorders, depressed patients, etc.

The article features the effectiveness of different psychotherapeutic approaches to psychological care in order to determine the most effective type of psychotherapy for depressive and anxiety disorders. The research considers the place of anxiety and depressive disorders in the ICD-10 classification; the article notes a contradiction between the theoretical separation of these disorders in ICD-10 and the frequent comorbidity (50 %) of these disorders in the clinical picture; the authors justify the choice of one form of psychotherapy for disorders of the anxiety-depressive spectrum. The paper contains an overview of the results of meta- analyses for person-centered, psychodynamic, cognitive-behavioral psychotherapy. It describes and analyses the most common approaches to psychotherapy of anxiety-depressive spectrum disorders by applying combined pharmacotherapy and psychotherapy in the cognitive-behavioral and interpersonal approaches. Based on the overview of meta-analyses of evidencebased studies of the effectiveness of these types of psychotherapy, it is concluded that short-term interpersonal and cognitive-behavioral approaches are most preferable in the therapy of anxiety and depressive disorders. There is a tendency towards further integration of approaches on the methodological basis of cognitive-behavioral therapy.

Objective - to evaluate the efficacy and safety of D-, L- hopantenic acid (pantogam active) on cognitive and anxiety disorders in patients with arterial hypertension. Material and methods. Autors selected 80 inpatients of a cardiology department with the verified diagnosis of hypertension and comorbid cognitive and anxiety disorders (50 patients in the main group, 30 patients in the control one). All patients received standard cardiotropic hypotensive treatment. Patients of the main group received in addition pantogam active in the daily dose from 600 to 1200 mg. Psychopathological and psychometric examinations were conducted, the data were compared with the dynamics of physical parameters (ECG, ambulatory blood pressure monitoring, blood chemistry). The duration of treatment with pantogam activ was 28 days. Results. There was a significant reduction in both cognitive and anxiety disorders in the main group compared with the controls and in patients with a history of stroke. The positive dynamics was observed during the treatment period. Conclusions. Authors support the possibility of using D-, L-hopantenic acid (pantogam active) as a drug of choice with bimodal activity (nootropic and tranquilizing) in the treatment of cognitive and anxiety disorders in patients with arterial hypertension. A rapid (in the first week) significant reduction of cognitive and anxiety disorders during the treatment with pantogam activ was noted.

Study of oculomotor response (OMR) in patients with various psychiatric disorders gives us a chance to obtainvaluable information about cortical mechanisms linked with cognitive functioning as well as about the basic stages of motor skills organization in central nervous system. In our research the functioning of saccadic system in patients with affective and anxiety spectrum disorders has been evaluated. With the help of video-oculography 70 subjects were tested (13-with recurrent depression,10-with bipolar affective disorder, 22-with anxiety spectrum disorders, 25-control group). Both in patients with affective disorders and anxiety disorders the increase of latency in reflectoryprosaccades’ programming has been revealed.However, the accuracy of this cognitive task performance has been compromised only in patients with affective disorders. No operational efficiency deficit has been detected in all the studied groups. The mistakes number in antisaccade test and the rate of multisaccades was higher in patients with affective disorders opposite to the normal results of those tests in patients with anxiety spectrum disorders. The possible neurophysiological mechanisms of detected oculomotor disturbances are discussed in the paper.

В экспериментальных исследованиях установлено, что фармакологическое действие селективного анксиолитика фабомотизола, производного бензимидазола, реализуется на различных моделях тревожных состояний в широком диапазоне доз – от 0,5 до 10,0 мг/кг. Цель исследования – cравнительная характеристика особенностей терапевтического действия и эффективности в клинических условиях разных доз фабомотизола у больных с тревожными расстройствами. Материал и методы. Обследованы 120 больных (42 мужчины и 78 женщин), из них 40 – с генерализованным тревожным (ГТР, F41.1 по МКБ

The results of the quality of life (QoL) changes study during fabomotizole treatment in patients with anxiety disorders are presented. The QoL indexes measured with WHOQOL-BREF questionnaire in patients with anxiety disorders are significantly decreased compared to healthy persons. Fabomotizole treatment is associated with both positive changes in QoL and anxiety symptoms reduction. Given the need to treat anxiety disorders in outpatient settings and importance to maintain patient’s optimal social performance and QoL it is reasonable to use fabomotizole as the first line treatment.

The exact cause of the development of anxiety disorders (AD) in present time has not been fully established and is a subject of debate in many countries. Interest in studying the mechanisms of action of proteins of S100 group, in particular, neurospecific protein S100b, is caused by its participation in processes of integrative activity of brain/neuron and development of diseases of nervous system. The functions of S100 proteins determine their influence on synaptic plasticity and participation in the regulation of stress-realizing and stress-limiting systems, the imbalance of which (primarily, the insufficiency of the GABA-ergic system) is the neurobiological basis of the majority of anxiety-depressive pathologies. Preparations regulating the activity of S100 protein have a distinct clinical anti-anxiety effect and additionally contribute to the restoration of neuronal plasticity processes.

Anxiety disorders among general practice patients are the most common. We examined the efficacy and safety of Buspirone in patients with anxiety disorders in outpatient practice. In accordance with lCD-10, the patients were distributed as follows: generalized anxiety disorder - 38.7 %, panic disorder - 29 %, adjustment disorder in the form of mixed depressive and anxiety reaction - 32.3 %. In order to evaluate the impact of therapy the following research methods were used: clinical, clinical-psychopathological, psychometric (Hamilton anxiety scale (HaM-А), Spielberger-Hanin anxiety level self-evaluation scale, Shihan anxiety self-evaluation scale, Clinical Global lmpression-Severity Scale (CGl-S), and Clinical Global Impression of Improvement (CGl-l) Scale. Among patients with anxiety disorders 28 people (90.3 %) have finished the study, three persons (9.7 %) dropped out of the study with regard to the ineffectiveness of Buspirone therapy. Analysis of the values on the HAM-А scale revealed statistically significant reduction in composite score by the end of day 14 (by 23.4 %, p < 0.05) and a statistically significant increase in differences by day 35 of therapy and reduction of scores by 51.5 % (p < 0.01). A statistically significant reduction (by 21.9 %, p < 0.05) of points on the Shihan anxiety scale was revealed by day 21 of therapy. Reduction of the mean values of the total score of reactive and personal anxiety by the Spielberger - Hanin scale was recorded from day 21 of therapy (p < 0.05). CGl-S scale statistically reliable reduction of patients with moderate degree of severity to 26.6 % (p < 0.05) and a statistically significant increase in the number of patients with mild degrees of severity by 20 % (p < 0.05) were revealed on day 14 of therapy. On the CGl-l scale, a marked improvement (26.7 %, p < 0.05) and a slight improvement (33.3 %, p < 0.05) is achieved by day 14 of therapy. Undesirable effects in the form of motor coordination disturbance, drowsiness, dizziness leveled during the therapy and did not require additional prescriptions for their correction. Buspirone can be recommended as an effective anxiolytic drug with safe portability profile for the treatment of anxiety disorders.

Aim. To evaluate the experience of the usage of Pantogam active (PIQ-PHARMA LLC,Russia) under the concept of personalized approach to correction of cognitive and emotional (anxiety and depression) disorders in arterial hypertension (AH) and chronic heart failure (CHF).Material and methods. The analysis has been done, of three recent trials came out with the results showing efficacy of D-,L-Hopanthenic/rac-Hopanthenic acid (Pantogam active compound for non-cardiac pathology (AH and CHF). The endpoints of efficacy control were the grade of cognition reduction, emotional correction (anxiety and depression), life quality improvement. Also, the influence of the drug was evaluated, on the parameters of cardiovascular system. Results. In the 3 studies, totally 232 patients participated, with cardiovascular diseases (CVD), of those 147 were controls. Duration of Pantogam active intake lasted for 4 to 12 weeks. Responders by the parameter of cognitive function were 78-100%, for emotional disorders — to 88%, for life quality improvement — 86%. Tolerance of the therapy was evaluated as good, and minimal side effects were reduced within the first week of treatment.Conclusion. Application of Pantogam active for complex treatment of AH and CHF patients leads to correction of comorbid cognitive and emotional disorders, with the absence of tolerance, hyperstimulation and withdrawal syndrome, improves life quality, contributes to therapy effectiveness of main CVD and improvement of cardiovascular parameters (blood pressure, heart rate variability, exercise tolerance).

Актуальность. Существует недостаток исследований распространенности тревожных расстройств в России, статистические данные свиде тельствуют о редком использовании российскими психиатрами диагнозов главы F4 «Невротические, связанные со стрессом и соматоформные расстройства». Методика. С целью изучения практического опыта диагностики и лечения тревожных расстройств отечественными специалистами, а также для оценки относительной частоты использования диагнозов этой группы расстройств на сайте Российского общества психиатров был проведен онлайн опрос. В опросе приняли участие 1015 психиатров из 75 регионов России. Ответы респондентов о частоте использования диагности ческих рубрик были сопоставлены с ответами участников опроса ВПА–ВОЗ. Результаты. Диагнозы тревожных расстройств регулярно используют в своей повседневной практике (не реже 1 раза в неделю) 11,9 % ре спондентов опроса РОП и 33,6 % участников опроса ВПА–ВОЗ. Наиболее часто диагнозы этой группы расстройств применяют психотерапевты и респонденты, работающие в соматической сети и частной практике. Среди тревожных и связанных со стрессом расстройств чаще всего отечественные психиатры используют диагнозы смешанного тревожного и депрессивного расстройства и расстройства адаптации, которые по своей сути являются предварительными диагнозами и не всегда ведут к назначению адекватной состоянию больных терапии. Диагноз генера лизованного тревожного расстройства в России устанавливается существенно реже, чем в мире, тогда как диагноз панического расстройства, наоборот, чаще. Большинство респондентов (84 %) не выставляют диагнозы тревожных расстройств в качестве вторых диагнозов у больных другими психическими расстройствами. Назначаемая при лечении тревожных расстройств российскими психиатрами терапия во многом соот ветствует международным клиническим рекомендациям, однако врачи широко применяют также препараты с недоказанной эффективностью, не соблюдают разработанные на основе принципов доказательной медицины терапевтические алгоритмы, в том числе в отношении последо вательности назначения препаратов и длительности курсов терапии. Выводы. Диагнозы тревожных расстройств используются российскими психиатрами существенно реже, чем психиатрами других стран мира. Во многом этот факт и другие особенности диагностики этой группы расстройств в России могут быть связаны с пробелами в образовательных программах, что делает необходимым совершенствование программ подготовки психиатров.

Настоящая статья посвящена проблеме диагностики и дифференцированной терапии депрессий в рамках различных нозологических категорий. Обсуждаются сложности диагностики и систематики депрессивных состояний, предлагается алгоритм обследования больного с депрессией. Показаны различия в терапевтических подходах к депрессии при рекуррентном депрессивном расстройстве, биполярном расстройстве и ши зофрении.

Anxiety disorders are a group of phenomenologic close but etiopathogenetically heterogeneous psychopathologic states. Modern recognition and correction of anxiety disorders provide a long-term effect and can be seen as a form of primary prevention of cardiovascular and other somatic and neurological diseases. In case of anxiety disorders patients with somatic illnesses should be treated with adequate primary illness therapy. In light and moderate cases of anxiety disorders, especially in the somatoform manifestations and the undesirability of sedation the use of Tofisopam is preferable.

Aim. To study emotional impairments in patients with migraine and to evaluate the efficiency of Noophen therapy for this pathology. Subjects and methods. 63 patients aged 18 to 45 years with migraine without aura were examined. 56 patients used prophylactic antimigraine therapy: Group 1 (n = 26) received metoprolol and Group 2 took metoprolol in combination with Noophen. Results. The patients with migraine had a significantly higher level of alexithymia than the controls. Concomitant anxiety disorders were found in 47 (74.6%) cases. The study provided evidence that the treatment was highly effective in Group 2 that exhibited a more pronounced decrease in pain intensity, a greater reduction in the levels of anxiety, and more vital activity. Conclusion. The results of this study allow a conclusion that emotional impairments are implicated in the pathogenesis and clinical presentations of migraine and that it is appropriate to use Noophen for the treatment of this pathology.

The review summarizes the successes and difficulties in creating and using biological models of the human brain diseases, which belongs to the important issues of applied Neurobiology. The review mentions and attempts to theoretically comprehend the relative role of genotype, environmental influences and their dynamic interactions (LEARN concept). The article reviews the examples of developed genetic models of human diseases (Alzheimer's, Down syndrome, Autism, etc.). When creating models of anxiety disorders the focus is made on the difficult problem of "norm" and "pathology", as well as the importance of integrating and understanding species specific behavior of animals used as biological models of this kind.

The variants of heterotypic comorbidity of anxiety disorders (AD) with attention deficit hyperactivity disorder, autism spectrum disorders, speech and language development disorders, specific learning disabilities (dyslexia, dysgraphia, dyscalculia), migraine, tension type headache in children and adolescents are discussed. In cases of heterotypic comorbidity the patients with AD referrals to specialists may be primarily associated with their emotional problems. Meanwhile, the comorbidity of AD with these diseases leads to a deterioration of their clinical manifestations and a worsening of the prognosis, and anxiety symptoms often not only persist, but also increase with age. It should be borne in mind that AD in children with neurodevelopmental disorders contribute to a decrease in the quality of life, academic failure, have a negative impact on peer relationships and the family environment, and in young adulthood, patients have an increased risk of depression and substance abuse. Therefore, early intervention and a comprehensive therapeutic approach with a dynamic assessment of the patient's condition are becoming important. When choosing pharmacotherapy, it is advisable to choose medictions that have a complex effect on the pathogenetic mechanisms of the underlying disease and concomitant AD, which include Tenoten for children.