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The high prevalence of primary affective disorders in patients with epilepsy is beyond doubt. However, patients in this group are often identified as suffering from mood disorders that do not fulfil the criteria for primary mood disorders, such as recurrent depressive disorder and bipolar affective disorder. The aim of this paper is to analyze the classification and clinical picture of affective disorders in patients with epilepsy and differential diagnostic approaches to identify primary affective disorders and secondary affective disorders in epilepsy. A set of diagnostic signs for the differential assessment of affective disorders in patients with epilepsy is presented. Research of affective pathology in patients with epilepsy and the development of strategies for its successful treatment are still needed.

Cerebral microangiopathy (CMA) is one of the significant causes of depression in the elderly. Close associations of the risk of developing depression with white matter hyperintensity, the presence of lacunar infarcts, and other markers of vascular disease are shown. The available data suggest that various vascular mechanisms, in particular, involvement of small vessels of the brain, generalized microvascular and endothelial dysfunction, metabolic risk factors, – are risk factors for the development of depression. Pathogenetic mechanisms include cerebral hypoperfusion and immune dysregulation. Depression is also a common complication of coronavirus infection, occurring both in the acute and postCOVID periods. The same mechanisms as in vascular depression are involved in the pathogenesis of the development of post-COVID depressive disorders. Given the complexity of the mechanisms of development of depressive disorders in patients with CMA, the presence of severe comorbid vascular pathology, antidepressants with an optimal ratio of efficacy and safety should be preferred. Agomelatine (Valdoxan) is one of such drugs.

Background: Parkinson's disease (PD) is an age-related neurodegenerative disease in developed countries. The prevalence of PD ranges from 41 per 100,000 in the fourth decade of life to more than 1,900 per 100,000 in people over 80 years of age. Neurodegeneration associated with Parkinson's disease probably occurs several decades before the onset of motor symptoms. Affective and cognitive impairments are one of the most frequent non-motor manifestations of PD, which can lead to a number of adverse outcomes. Aim: to evaluate affective and cognitive impairments in patients at the early stages of PD. Methods: 61 patients with PD participated in the study. All the participants were divided into two groups depending on the presence or absence of a diagnosis of depression verified by psychiatrists: Group 1 was the main group (n=48), group 2 was the control group (n=13). The control group included patients without depression. The average age of the participants was 62.29.6 years. The analysis of the PD stages was carried out in both groups. In the main group, stage II PD was diagnosed in 75%, in the control group in 31% of patients. The average duration of the disease was 2.51.6 years. A clinical examination was carried out using the Beck depression questionnaire, apathy scale, Spielberger anxiety questionnaire and anxiety assessment scale in PD (to assess emotional disorders), cognitive function assessment scale in PD (SHOBP-Cog, Scopa-Cog), digital symbol replacement test (symbols-numbers test), Montreal assessment Scale cognitive functions (MoCA test), a test for connecting numbers and letters, and a Stroop test (for evaluating cognitive functions). Results: It was revealed that in the early stages of PD, the prevalence of depression, clinically significant apathy, personal and reactive anxiety was high. Significantly higher rates of depression severity, depression level, apathy level and personal anxiety were noted among the patients with stage II PD compared to the patients with stage I PD. There was a marked tendency to a decrease in cognitive functions at stage I of PD, aggravated at stage II of the disease, which was confirmed by the results of the tests: a low level of cognitive functions on the Montreal scale was detected in 52%; 70% of patients, regardless of the PD stage, showed a low rate of completion of the 1st and 2nd parts of the Stroop test for their age; the results of the digital character replacement test were below normal in 75% of cases. Conclusion: The most common affective disorders in the early stages of PD are depression and anxiety. Apathy and depression have a negative impact on the cognitive functions of patients, which worsen with the progression of the disease.

Alcohol dependence (AD) and mood disorders are not only a serious medical and socio-economic problem for modern society, but also the cause of social adaptation disorders that form even in the early stages of each of these disorders, as well as in case of their comorbidity.Objective: to determine the relationship between the level of subjective assessment of social adaptation and the main clinical, dynamic and psychological characteristics in patients with affective disorders (AFD) with comorbid AD.Patients and methods. The study included 126 patients treated for AFD in the departments of affective or addictive conditions of the clinic of the Research Institute of Mental Health of the Tomsk National Research Medical Center (F31 – F34.1 according to ICD-10; n=83) or AFD comorbid with AD (F10. 2; n=43). The study used clinical-dynamic, psychometric, pathopsychological and statistical methods.Results and discussion. Patients with AFD without comorbidity at admission were characterized by a greater severity of subjective impairment of social adaptation and anhedonia; hypochondriacal, depressive, psychasthenic and schizoid traits predominated in the structure of their personality. At the same time, the condition of patients with AFD and AD comorbidity was objectively assessed as more severe. An inverse correlation was found between the level of subjective assessment of social adaptation and anhedonia in the group of patients with «pure» AFD, and in the group with AFD and AD comorbidity, with the severity of depressive symptoms (due to typical depressive symptoms), as well as with depressive and anxious personality traits of patients.Conclusion. Self-assessment of social adaptation of patients with “pure” AFD depends on the intensity of anhedonia manifestations, and in patients with AFD and AD comorbidity, on depressive symptoms (due to typical depressive symptoms) and on the severity of such psychological characteristics as depression and psychasthenia.

Background. Depression is one of the most maladaptive manifestations of Parkinson's disease (PD). The relationship between depression and motor, cognitive, and other affective disorders in the early stages of PD remains debatable. Aim. To assess the frequency and severity of depression, to clarify the features of motor, affective disorders, and cognitive functions in patients with depression in the early stages of PD. Materials and methods. We observed 61 patients diagnosed with PD at stages III according to the HoehnYahr scale. The average age was 62.29.6 years, the average duration of PD was 2.51.6 years. Data were analyzed using the Unified PD Scale, the Beck Depression Inventory, the Apathy Scale, the Spielberger Anxiety Inventory, the PD Cognitive Assessment Scale (SCOPA-COG), the digital character substitution test (the symbolsnumbers test), the Montreal the Cognitive Function Assessment Scale (MoCA), the number-to-letter combination test, the Stroop test. Results. Symptoms of depression were detected in 48 (79%) patients with PD; 20 (33%) patients had subdepression, 24 (39%) had moderate and severe depression, and 4 (7%) had severe depression. In patients at stage I PD according to HoehnYahr, the frequency of moderate depression was 28%, at stage II (moderate and severe) 45%, and severe 10%. Patients with depression were characterized by a greater severity of motor symptoms, disturbances in daily activities, anxiety, apathy, as well as a decrease in executive cognitive functions. An inverse correlation was noted between the duration of depressive symptoms and deterioration in performance on tests to assess attention and control cognitive functions. Conclusion. Depression is a characteristic feature of the early stages of PD. Its frequency and severity increase from stage I to stage II of PD. Depression can be considered as an indicator of a more severe course of the disease, the progression of impairments in controlling cognitive functions. The possibility of assessing the prognosis of the course of the disease additionally substantiates the need to diagnose depression in patients with PD in the early stages of the disease.

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]

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]

Alcohol dependence (AD) and affective disorders (ADs) are serious medical and socio-economic problems of modern society. It is hypothesized that both disorders share a common neurobiological basis. Phosphatidylinositol-4-phosphate-5-kinase type 2 alpha (PIP5K2A) plays an essential role in neuronal phosphoinositide signaling pathways. Nonsynonymous rs10828317 mutation of the PIP5K2A gene leads to conformational changes of the PIP5K2A protein and a decrease in the functional activity of this enzyme. In this study, we assessed the possibility of using the rs10828317 polymorphic variant of the PIP5K2A gene as a marker of AD and ADs.Objective: to study the associations of the PIP5K2A (rs10828317) polymorphism with AD and ADs clinical course.Patients and methods. We enrolled 255 patients with AD and 325 patients with ADs. 126 patients with AD and 71 patients with ADs underwent a comprehensive clinical, clinical-dynamic, psychodiagnostic assessment using a set of clinical scales and tests, including Structured Interview Guide For The Hamilton Depression Rating Scale, Seasonal Affective Disorders Version (SIGH-SAD), Alcohol Use Disorders Identification Test (AUDIT), The Obsessive-Compulsive Drinking Scale for craving in alcohol (OCDS).Results and discussion. PIP5K2A (rs10828317) polymorphism in patients with AD was associated with the OCDS mean score after the inpatient treatment; in patients with ADs - with the severity of atypical depression symptoms assessed by SIGH-SAD at the time of admission.Conclusion. The results of our pilot study indicate the involvement of PIP5K2A (rs10828317) polymorphism in the AD and ADs pathophysiology.

The aim is to study the features of brain activity in patients with affective disorders, depending on the response to therapy. Material and methods. The study included 84 patients with affective disorder. All patients received syndrome-induced psychopharmacotherapy, which included antidepressants and normotimic drugs. The severity of affective disorder was assessed using the Hamilton depression scale. The criterion for the effectiveness of therapy (sensitivity) was an improvement in clinical symptoms by 50% or more, estimated using the Hamilton scale. The study was performed in two stages (points): at the first point, patients were examined upon admission to the Department before taking medications (electroencephalogram recording and filling in the Hamilton scale were performed), the second point was performed after a 4-week course of treatment of patients in the hospital (filling in the Hamilton scale). Registration and analysis of bioelectric activity of the brain was carried out using a 16-channel encephalograph. The signals were processed using fastFourier transform, and the values of absolute spectral power (mV2) for θ — (4 — 7 Hz), α — (8 — 13 Hz) and β — (14 — 30 Hz) rhythms were analyzed.Results. Analysis of the spectral power of electroencephalographic rhythms at rest with closed eyes showed statistically significantly higher values of alpha-rhythm in the frontal(p=0.044) and parietal (0.049) cortex, beta-rhythm in the frontal cortex (p=0.048) and theta-rhythm in the frontal (p=0.0004), Central (p=0.009), parietal (p=0.003) and occipital (p=0.001) cortex in patients who were not sensitive to therapy for compared to respondents.Conclusion. Our study revealed significant differences in quantitative electroencephalogram parameters between patients with affective disorders, depending on the sensitivity to the therapy. The results show that there are aspects of quantitative electroencephalogram thatare related to the response to pharmacological treatment of affective disorders.

Несмотря на то что по результатам множества исследований становятся все более очевидными различия в психопатологии у пациентов с разными типами фенотипической асимметрии, ее влияние на эффективность и побочные эффекты терапии остается крайне малоизученным. Материалы и методы: Обследовано 100 пациентов с эндогенными аффективными расстройствами. Для каждого пациента определялся индивидуальный профиль функциональной асимметрии и оценивалась эффективность проводимой фармакотерапии. Результаты: Пациенты со смешанным профилем асимметрии более других склонны к обострениям состояния на фоне лечения, чаще нуждаются в аугментации антидепрессантов нейролептиками, имеют большее количество рецидивов в год и тенденцию к более длительным госпитализациям. У левшей значительно чаще, чем у остальных пациентов, отмечаются побочные эффекты терапии. Выводы: Необходим дифференцированный подход к лечению эндогенных аффективных расстройств с учетом различий в фенотипической функциональной асимметрии.

В обзорной статье выполнен анализ данных научных публикаций, касающихся психоэндокринологических и метаболических проблем терапии современным антипсихотиком третьего поколения – карипразином – у больных шизофренией и биполярным расстройством. В сравнительном аспекте приведены данные о частоте встречаемости и степени выраженности отдельных антропометрических и биохимических показателей нейроэндокринных дисфункций. Представлены данные сравнительных исследований по влиянию отдельных антипсихотиков в сравнении с карипразином, а также различных доз препарата на уровни пролактина, липопротеидов высокой и низкой плотности, глюкозы, триглицеридов, а также на изменения массы тела больных с психическими расстройствами, в частности, с учетом возрастного фактора. Показаны преимущества карипразина по профилю безопасности и переносимости в отношении гиперпролактинемии и метаболических нарушений.

The relationship between cognitive impairment (CI) and depression is complicated: h\the latter can be one of the symptoms of Alzheimer’s disease or may precede the onset of CI. Depression also has cognitive symptoms that alter the clinical presentation of the disease. Patients with depressive pseudodementia experience difficulties concentrating, confusion concurrent with impaired memory and thinking, whereas the patient’s answers to certain questions often resemble the vague pseudoamnestic pattern of the impairment. Mnestic disorders occur in at least 40% of patients with depression, and if the latter is diagnosed in the patient who already has dementia, the rate of cognitive decline may be faster. The mechanisms underlying the development of CI can also affect the development of depression. When assessing the risk of dementia in depression, it is necessary to take into account the time from the onset of a major depressive episode until moderate CI appears, to carry out a detailed analysis of neuropsychological testing for Alzheimer’s disease and to use the current lifetime markers for amyloidosis and neurodegeneration. Serotonergic antidepressants and non-pharmacological cognitive behavioral and psychotherapeutic procedures play the most important role in the treatment of depression and dementia.

A clinical case of a rare genetic oculo-auriculo-vertebral syndrome (Goldenhar syndrome) is presented in a young man of 18 years old, who was first sent for examination and treatment to the psychiatric ward. A retrospective analysis of anamnestic information indicates the emergence of psychopathological disorders in childhood in the form of a delay in psychoverbal development, emotional immaturity, and delays in the development of social behavior. Subsequently, persistent encephalasthenic and neurosis-like disorders were complicated by the addition of affective disorders of the depressive-dysphoric type and psychotic disorders. The lack of a timely integrated therapeutic approach with the addition of psychopharmacotherapy, psychotherapy and social therapy led to the formation of specific personality changes in organic etiology with significant disorders in the emotional sphere (lability of emotions, irritability, outbursts of anger, constant resentment and dissatisfaction with others), a decrease in the level of cognitive activity and a tendency to chronic course of neurosis-like and affective disorders. A statement of persistent pronounced violations of mental functions during follow-up observation caused severe restrictions in the main areas of life (communication, behavior control, education, work) and social maladaptation of the patient, which was the basis for referral to medical and social examination with the establishment of a disability group.

Introduction. Patients with type 2 diabetes are more likely to have concomitant depression. In addition, there are some studies that have alluded to a direct relationship between overweight and diabetes and daytime drowsiness.The aim of this study was to study the relationship of metabolic disorders, anthropometric data with daytime sleepiness and depression in patients with type 2 diabetes.Material and methods. A general clinical study consisted in interviewing the patient (complaints, medical history), obtaining physical data (anthropometry) – height (cm), weight (kg), neck circumference (cm), waist circumference (cm), hip circumference (cm). The object of the study was the whole blood and blood plasma of patients in order to determine the level of fasting plasma glucose, glycosylated hemoglobin and other blood biochemical parameters. To verify violations in the emotional-volitional sphere, the Beck Depression Inventory and the Epworth Sleepiness Scale were used.Results. All patients had visceral obesity, the waist circumference is significantly higher than normal, both in men and women. In accordance with the Epworth drowsiness scale, on average, borderline insomnia was recorded in the examined patients with type 2 diabetes. Drowsiness rate correlated with waist circumference (r = 0,65) and hips (0,67), age (0.34) only in male patients. The level of depression correlated with age in female patients (r = 0.37, p < 0,05) and male (r = 0,6, p < 0,05) and did not correlate with drowsiness in both groups. The level of depression was 16, which corresponds to mild to moderate depression. However, the rate of depression is negligible, but higher among female patients (14.00 [6.00; 18.00] versus 19.00 [10.50; 20.00], p = 0,047).Conclusions. Increased daytime sleepiness and depression accompany patients with type 2 diabetes, regardless of gender. The dependence between the severity of decreased daily activity and increased anthropometric indicators and age can be seen in male patients, which may illustrative of increasing androgen deficiency in men and its contribution to the development of metabolic disorders, including obesity. Depressive states have deeper manifestations in female patients with type 2 diabetes compared to male patients, which may indicate both emotional instability of female patients and a more pronouncedeffect of the disease itself on the psychoemotional background in women.

Over the last century frequency of diagnosed catatonic states continuously decreased. This phenomenon can be explained through hypothesis of pathomorphosis of psychiatric diseases. Pathomorphosis is an important aspect of mental diseases, including catatonic states, especially therapeutic pathomorphosis. Changes in clinical presentation of psychosis led to under-recognition of catatonic signs, that cause incorrect diagnostic and treatment tactics. The aim of this study is to investigate clinical and psychopathological features of psychosis with catatonic features and actual differences in clinical presentation compared to traditional descriptions and earlier clinical cases. Two groups of patients was explored. First is patients, which admitted to psychiatric hospital due to psychosis with catatonic features. Second group contains archival clinical cases of patients, which were treated since 1969 to 1972, before introduction of atypical antipsychotics to clinical practice.

The literature review describes history of views on catatonia from Kahlbaum to present time. Descripted as a discrete disease by Karl Kahlbaum, since Kraepelin’s and Bleuler’s works catatonia was associated with schizophrenia for many years. At the present time catatonia is classified as a nonspecific syndrome, which can be observed in many mental diseases. Despite of common view on catatonia as a rare disease, a lot of studies show that this state is very frequent. Catatonia remains an underdiagnosed syndrome. Prompt recognition of catatonia is important since this state is life-threatening and catatonic patients need correct treatment. This article describes some diagnostic scales, used to recognize catatonia in psychiatric patients.

В настоящеи статье рассмотрены доказательные исследования, посвященные проблеме диагностики, патофизиологии и терапии кататонии. Кататоническии синдром (Кс) представлен широким спектром двигательных, речевых и поведенческих нарушении и на текущии момент рассма- тривается как полиэтиологичное состояние, имеющее в основе формирования как психиатрические, так и непсихиатрические причины. новые исследования показывают, что среди психических расстроиств Кс наиболее часто встречается при биполярном расстроистве, в то время как при шизофрении он наблюдается существенно реже. Рассмотрены различные терапевтические подходы к Кс, среди которых методами первого выбора являются бензодиазепины и электросудорожная терапия.

The article presents the results of the theoretical analysis of the Russian and international studies devoted to the phenomenon of the time perspective of the personality. The time perspective is an extremely relevant research topic, and at the same time, a littlestudied area of psychological and psychiatric science. The history of the term is briefly described, the main approaches to the definition of the concept are considered, the important properties and characteristics of the time perspective of the individual are determined. In this article, the features of the time perspective of a personality are considered with regard to anxiety and depression, important manifestations of affective disorders; the properties of the temporal perspective are considered in the context of manifestations of anxiety and depression in patients with affective disorders. The connection of the depressive episodes and the subjective attitude to the past, present, and future is marked, the role of dysfunctional time perspective in the context of depressive and anxious experiences is emphasized. The influence of subjective perception of time, especially future, on the increasing anxiety is reflected. Some foreign and domestic studies of the time perspective in patients with affective disorders are considered and analyzed. We found some differences in subjective perception of time and time perspective in patients with anxious and depressive manifestations: the speed of time in depressed patients is slowed down, in anxious patients it is accelerated; as for the attitude to the past, present, and future, in patients with severe depressive manifestations there is a pessimistic attitude to the events of the future and fixation on the events of the past.

Differential diagnosis of endogenous psychoses with episodic course is an extremely relevant issue of modern psychiatry due to the pathomorphosis of mental illnesses and subclinical persistence of clinical markers after the first episodes of the disease. Correct and timely diagnosis of these conditions determines the adequacy of therapeutic and socio-rehabilitation influences not only during disease exacerbations, but also in the period between bouts of psychosis in order to preserve the social adaptation of patients. The purpose of this study was to perform a comparative analysis of the clinical-catamnestic and medico-social characteristics of remission in patients with schizophrenia, schizoaffective disorder (SAD) and affective disorders (AD). Contingents and methods. A total of 221 patients were examined on the basis of the Regional Clinical Psychiatric Hospital (Zaporizhzhіa), 49 of whom were with AD (31 patients with a diagnosis of “bipolar affective disorder” and 18 with a diagnosis of “recurrent depressive disorder”), 76 patients were diagnosed with “schizoaffective disorder” and 96 patients were diagnosed with “paranoid schizophrenia, episodic course” having a pronounced affective component in the structure of psychotic episodes. An obligatory criterion for inclusion was the state of clinical remission with psychotic symptoms reduction. The main methods of the study were clinical-catamnestic and clinical-psychopathological as well as medical statistical analysis. Results. In patients with episodic course of endogenous psychosis, there is a persistent decline in the social adaptation level of varying degrees, the severity and manifestations of which differ depending on nosological form. Schizophrenia and SAD are characterized by a more pronounced negative impact on the level of labor adaptation than AR. This is confirmed by a large percentage of unemployed individuals (P < 0.01), a lower percentage of persons working in positions related to skilled and mental work (P < 0.01). SAD patients more often (P < 0.01) receive treatment courses in a hospital than patients with other periodic endogenous psychoses. Social factors are more likely (P < 0.01) cause repeated hospitalizations in SAD than in AD and episodic schizophrenia (26.7 %, 5.8 % and 12.5 %, respectively). Conclusions. A high level of rehospitalization for social reasons in SAD demonstrates persistent pathopersonological transformations and the lack of efficacy of therapeutic and rehabilitation measures used in SAD during a remission period. Persistent pathopersonological transformations, occurring in endogenous psychoses, require a comprehensive study and a system of congruent therapeutic and rehabilitation measures in order to prevent social disadaptation.

The review of literature data addresses the problem of diagnosis, classification, comorbidity, basic neurobiological mechanisms, as well as therapy of pathological manifestations of anger (“anger disorders”, anger attacks), considering into account the results of current epidemiological and clinical-biological studies.

The article presents a study of gelotophobia (the fear of being laughed at) for depression. 32 patients with depressive syndrome and 33 mentally healthy people were examined with a complex of methods: clinical interview, the Liebowitz Social Anxiety Scale, the Fear of Negative Evaluation Scale, gelotophobia, gelotophilia and katagelasticism questionnaire the PhoPhiKat, the Guilt and Shame Proneness scale (GASP), the Beck Depression Inventory, and the Buss-Perry Aggression Questionnaire. The results showed higher gelotophobia (the fear of being laughed at) in patients with depressive syndrome in comparison with the control group, and, on the other hand, lower gelotophilia (the joy of being a target of laughter) and katagelasticism (the joy of laughing at others). No differences on gelotophobia were found in the subgroups of patients with depression within schizophrenia and affective disorders. Gelotophobia under depression was closely connected with social anxiety and the fear of negative evaluation, but was not associated with aggression. Although depression includes experiencing both guilt and shame, gelotophobia characterized only those patients who tended to experience shame. The results of the study allow to reveal specifics of the fear of being laughed at under depression, which may be used in clinical diagnostics and psycho-rehabilitation of these patients.

Abstract Differential diagnosis of endogenous episodic psychoses is an extremely important task of modern psychiatric theory and practice in view of the existing pathomorphosis of mental illness and tendency of the recent years to steady expansion and transformation of ideas about taxonomy and typology. To make the correct diagnosis at the onset of endogenous illness is a significant factor for adequate and successful further therapeutic and social rehabilitation measures, which determine the medical and social prognosis and the quality of patients’ life. The aim of this study was a comparative analysis of the clinical and psychopathological characteristics of remission states in patients suffering from schizophrenia, schizoaffective disorder (SAD) and affective disorders (AD).Contingents and methods. 49 patients suffering from AD (31 patients were diagnosed with bipolar affective disorder and 18 - with recurrent depressive disorder), 76 patients with diagnosis of schizoaffective disorder and 96 patients – paranoid schizophrenia, episodic type of course were examined on the basis of the Regional Clinical Psychiatric Hospital (Zaporizhzhia). The structure of the disease episodes was characterized by a pronounced affective component in all studied patients. The mandatory inclusion criterion for both groups was the state of clinical remission with psychotic symptoms reduction. The main methods of examination were clinical-catamnestic and clinical-psychopathological as well as medical-statistical analysis.Results. The obtained results allowed to reveal the presence of negative, general and productive disorders in patients with periodic endogenous psychoses in the state of remission, which are related to pathopersonological transformations. Nosologically specific increase in pathopersonological transformations severity was recorded in the AD-SAD-schizophrenia direction. There was a discrepancy between the aforementioned tendency (the increase in psychopathological symptoms severity in the AD-SAD-schizophrenia direction) and some indicators of positive disorders subscale (P4 (Excitement) and P5 (Grandiosity)). The profile of pathopersonological transformations in SAD had the most complex structure in the group of periodic endogenous psychoses.Conclusions. The study of stable pathopersonological transformations of these contingents would help to increase the accuracy of differential diagnosis in the group of periodic endogenous psychoses, leading to enhanced efficiency of the treatment and rehabilitation measures undertaken.

The article deals with coping and self-regulation of behavior in patients with schizophrenia and affective disorders. The study revealed that the highest level of self-regulation of behavior in patients from both groups noted selection, mainly, adaptive coping, and the ways of coping do not depend on subjective perceived psychopathology. Patients with schizophrenia different tendency to seek social support and optimistic outlook for the future. Patients with mood disorders tend to ignore problems and emotional discharge.

Cognitive and affective disorders and quality of life were studied in patients with acute ischemic stroke. Registered: minimal cognitive deficit in more than 50% cases. Cognitive impairment was associated with patients’ physical functioning decrease. Depressive and anxiety disorders were registered in 42.8% and 47% cases, respectively, and were associated with the severity of neurological dysfunction and less cognitive dysfunction. Pronounced reduce of quality of life was obtained. The possibility of quality of life level’s quantification in acute stroke patients using visual-analouge scale and EQ-5D-5L questionnaire was demonstrated.

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.

The paper proposes a typology of affective disorders in epilepsy, including preictal, ictal, interictal and postictal states. It also discusses various variants of affective states (depressive, dysphoric, manic) in epilepsy. Mild, moderate and severe depression has been identified in patients with epilepsy depending on the degree of severity of depressive symptoms. The paper describes the clinical impressions of patients with epilepsy which showed the efficacy of anticonvulsants in affective disorders.

This article presents results of one of the parts of the empirical study carried out in 2017 by the research group. It is concentrated on the attitudes of citizens of the Belarusian capital towards antidepressant use and other forms of depressive disorder treatments. The author explores how people in Minsk tackle emotional and psychological problems. The research objectives are (1) to identify which opinions about depression are widespread among Minskers; (2) to detect the main trends in their attitudes towards the use of antidepressants; (3) to determine generational differences in perceptions of depression and its treatment. In this research, the mixed-methods approach was employed. In August and September of 2017, three FGIs on ideas about depression and ways of dealing with it were conducted in three different age groups. In the article, it is suggested that the acceptance of self-care practices among Minskers is a sign of transitional society. In particular, it deals with perspectives on antidepressants use and counselling as practices that contradict the Soviet legacy of dismissing emotional problems and mood disorders. [ABSTRACT FROM AUTHOR]

The study objective is to investigate characteristics of mixed anxiety-depressive disorders (MADD) and the level of subjective self-control in relation to health (SSCh), as well as the effect of affective disorder severity on clinical course and prognosis of the disease in men and women with acute myocardial infarction (AMI).Materials and methods. The study included 124 patients with AMI aged between 30 and 85 years (mean age 58.6 ± 12.1 years), who were divided into 2 groups: the 1st group contained 88 (71 %) men, the 2nd group – 36 (29 %) women.Results. Per the screening test, MADD was more frequently diagnosed in the female group (91.7 %) compared to the male group (56.8 %), р 0.05) mortality, respectively. Conclusion. Psychometric tests have shown higher rate and severity of MADD in the female group compared to the male group. In the female group, left ventricular ejection fraction was significantly lower than in the male group, and overall and hospital mortality was higher.

The aim: to identify changes in mental status due to receive HAART and comprehensive assessment of the biological, behavioral and social factors in adherence to treatment in HIV-infected patients with endogenous mental disorders. Material: The study involved 53 patients with HIV infection and schizophrenia / affective spectrum comorbidity. Results: In the tolerability and adherence to ARV therapy affects not only the neurobiological vulnerability, but also a change in the mental state and condition of the patient social life. After the start of ART mental state of patients with endogenous mental disorders often deteriorates. Depending on their degree of penetration into the central nervous system were observed pronounced effect of ART on the structure of psychopathological symptoms and the course of mental illness in general.

Mental disorders persistent identified in patients with epilepsy as significant personal and affective disorders, especially depressive and anxiety spectrum observed in the interictal period of the disease.Purpose. Study the frequency of nonpsychotic mental disorders in patients with epilepsy; highlight the clinical features of non-psychotic affective disorders and to analyze the relationship of different variants affective disorders with symptoms of pharmacological resistance.Material and methods. The study involved 160 patients with epilepsy: 80 patients with drug-resistant epilepsy (DRE), 80 patients with controlled epilepsy using a battery of psychometric scales.Results. The variety of depressive and anxious psychiatric condition detected in 59.4% of patients with epilepsy, in 86.3% of patients with DRE, in 32.5% – with controlled epilepsy. Clinical and psychopathological analysis of non-psychotic mental disorders showed that in patients with DRE have statistically more frequent affective disorders, also a great “brutality”, “structural complexity” and the depth of depressive and anxiety disorders than in patients controlled epilepsy. We established that patients with affective symptoms have earlier onset and a longer course of disease.Conclusion. The therapeutic resistance of patients with epilepsy accompanied by the presence of various non-psychotic affective mental disorders represented, mainly, depressive and anxiety psychopathological conditions. In terms of clinical and psychopathological a characteristics they are close to an endogenous affective mental disorders and, essentially, represent their “organic model.”

Objective: to study of the emotional features in patients with myasthenia.Patients and methods. 52 myasthenic patients (11 men and 41 women; mean age, 50.5±13.8 years) were examined. The investigators determined the level of situational and personal anxiety (SA and PA) by the Spielberger-Hanin questionnaire and that of depression by the Zung scale. They clarified the association of these indicators with gender, age, myasthenia duration and severity by the Myasthenia Gravis Foundation of America (MGFA) scale, and with the presence of crises.Results and discussion. The patients with myasthenia showed a higher level of SA than those with depression. There was an increase in the indicators depending on age and disease duration and severity according to the MGFA scale, and on the group of disability. A number of patients who were critically ill and had high MGFA scores were noted to have low PA levels, which may contribute to the decreased level of protective psychological mechanisms.Conclusion. Most myasthenic patients have high levels of anxiety. In these patients, the absence of depression or the presence of its mild form and the prevalence of anxiety determine the choice of therapy with a preference being given to psychotherapy.

Objective: To determine the clinical and psychopathological features of affective disorders in women in the perimenopausal and early postmenopausal periods., Material and Methods: The study included 90 female patients receiving inpatient psychiatric care for affective disorders, among them 41 patients were perimenopausal (group 1) and 49 were early postmenopausal (group 2). Clinical and psychopathological, psychometric (the Hospital Anxiety and Depression Scale - HADS, the Hamilton Depression and Anxiety Scales - HAM-D and HAM-A, the Hypomania Checklist-32 - HCL-32, the Bipolarity Index (BI), the Insomnia Severity Index - ISI, the Pittsburgh Sleep Quality Index - PSQI) and statistical methods were used., Results: Symptoms of atypical (63.4%) and anxious (87.8%) depression predominated among perimenopausal patients, and melancholic depression (59.2%) prevailed in early postmenopause. Patients in group 1 had higher anxiety scores on HADS and HAM-A compared to group 2 ( p =0.003 and p =0.01). At the same time, early postmenopausal women had higher depression scores on the HADS and HAM-D ( p =0.001). ISI and PSQI scores in postmenopause were significantly higher than in perimenopause ( p =0.001 and p =0.009)., Conclusion: The clinical features of affective disorders as well as severity and nature of the accompanying sleep disturbances vary depending on the stage of menopause, which must be considered when prescribing additional methods for examination and treatment of these disorders.

The purpose of the investigation was to clarify the importance of gender factor in the clinical picture of recurrent (RD) and bipolar depression (BD) with somatization. Total of 99 patients had taken part in the testing including 70 (70.7 %) women and 39 (39.3 %) men. The general trend identified was intensive anxious and somatized signs in clinical structure of depression. In comparison with the men the female patients with RD had predominantly "psychic" and "physical" signs of anxiety, and men had more "typical" traits (depressive somatization). In the clinical picture of BD gender differentiation had shown the signs of anxiety again. In other words, the women with BD had mostly the signs of "mental" anxiety and neurosal (phobic anxiety and hysterical conversion) somatized signs, while male patients with BD more often had vegetal equivalents of anxiety (anxiety disorder) making hypochondriac ideational abnormalities (ideational somatization) in combination with physical signs of depression. In both testing groups women had the common traits - frequent complaints about paracenesthesia over extended periods (SSI); it can show some inclination to formation of a morbid personality, exacerbating a patient's condition. The findings indicate that gender differentiation expresses mainly in bipolar course of an affective disease in the clinical picture of somatized depression. The study outcome suggests the improvement of diagnostics and somatized depression treatment.

Objective: to evaluate the efficiency and safety of different therapy regimens for depression in relation to the clinical type of bipolar affective disorders (BAD) and to choose optimal treatment regimens for depression in BAD type I (BADI) and BAD type II (BADII).Patients and methods. A total of 65 depressive patients, including 25 with BADI and 37 with BADII, were examined. 212 depressive episodes were analyzed in BAD patients, of them there were 74 with BADI and 138 with BADII. The patients with BADI took a combination of an antidepressant (AD) and a normothymic (NT), NT and a neuroleptic (NL), AD, NT and NL. Those with BADII received monotherapy with AD or NL, a combination of AD + NT, AD + NL. The patients' status was clinically evaluated using a specially designed questionnaire and the MADRS and CGI psychometric scales at baseline and then at the end of 1, 2, 4, and 8 weeks of therapy.Results. The AD-containing regimens used to treat patients with BADI proved to be more effective; this therapy led to a more marked reduction in depressive symptoms (55.73% in the AD + NT-treated patients; 54.07% in the AD + NT + NL group versus 33.64% in the NT + NL-treated patients), a higher response to therapy, and a larger number of remissions by the end of the investigation (80.0, 72.7, and 33.3%, respectively). Moreover, the incidence of transient hypomanic symptoms did not significantly differ in these groups (20.0, 27.3, and 8.3%, respectively). The depressive patients with BADII generally responded better to different therapy regimens (the reduction in depressive symptoms was 52.08, 58.82, 58.40, and 53.98% in the AD, NL, AD + NT, and AD + NL groups; the remission index by the end of the investigation was 60.6, 92.9, 77.8, and 69.2%, respectively); these patients were seen to have less frequently symptoms of an antipole during their treatment (18.2, 7.1, 0.0, and 15.4%, respectively).Conclusion. The incorporation of AD into a therapy regimen in BAD patients accelerates emergence from any depression severity and considerably enhances the efficiency of treatment. According to the clinical picture of depression, both AD monotherapy (BADII) and a combination of AD + NT and/or NL (BADI, BADII) may be used. The incorporation of AD into a therapy regimen does not significantly increase a risk for developing an inverse phase.

Objective. To assess the quality of life and mood disorders of patients with myasthenia gravis.Materials and methods. A comprehensive clinical and neuropsychological testing of 34 patients, accounting for 43.6 % of all patients with myasthenia living in the Leningrad region. To assess the severity of the international rating scale used by the severity of myasthenia gravis (MGFA). For the diagnosis of affective disorders, anxiety scale and Spielberger–Khanin depression scale, CES-D were used, quality of life was assessed by the SF-36 scale. The study included patients with stable clinical picture at least for the last 2 months. Comparison was made in population as well as within the studied group, divided into several groups depending on the severity and duration of the disease.Results. The quality of life of patients with myasthenia gravis in terms of physical health significantly lower (p = 0.04) than in the general population and directly depends on the severity of the disease. Depressive disorders are typical for patients with a long (more than 3 years) history of the disease, including the level of depression scale CES-D averaged 28.1 balls, which was significantly (p = 0.03) higher than for the patients in the early stages of the disease. In assessing affective disorders with anxiety scale Spielberger–Khanin was expressed by the average value on the scale of situational anxiety – 31.8 ± 8.3 points, and on the scale of personal anxiety 31.5 ± 8.1 points, indicating moderate anxiety disorder. We have not found a statistically significant relationship of affective disorders with disease severity and bulbar syndrome.Conclusion. The quality of life of patients with myasthenia generally reduced in comparison with the general population, and depending on the severity and depressive disorders typical for patients with a long history of the disease.

Aim. To assess influence of combined antihypertensive (captopril or metoprolol) and antidepressant (thianeptin or sertralin) therapy on clinical status, blood pressure (BP) and myocardial function in patients with arterial hypertension (HT) and affective disorders (AD).Material and methods. 106 patients with HT were involved in the study. 64 patients (60,4%) had concomitant AD. All patients were divided into 3 groups. 46 patients with HT and AD were included in the 1-st group. They received metoprolol or captopril in combination with tianeptine or sertaline. The 2-nd group included 18 patients with HT and AD who received only antihypertensive therapy. The 3-rd group consisted of 42 patients with HT without AD. They also received only antihypertensive therapy.Results. After 6 month therapy patients of the 1-st and the 3-rd groups had more significant clinical improvement and BP reduction (according to 24- hour BP monitoring) as well as more farourable structural and functional changes of left ventricular in comparison with patients of the 2-nd group.Conclusion. In patients with HT and concomitant AD combined antihypertensive and antidepressant therapy result in favourable clinical changes, effectively reduce BP, improve left ventricular structure and function.

Sexual behavior is one of the biologically highly relevant types of behavior. Sexual arousal, or an initial stage of sexual behavior, is of particular interest since it triggers all the following events but still remains the least known element of this behavior. Sexual dysfunctions are caused by aging, stress, or side effects of psychotropic drugs; they are symptoms of a variety of neurological and psychiatric disorders. Therefore, the study of sexual behavior appears to be an important step in modeling various animal pathologies and the effects of psychotropic drugs. We have performed phenotyping of animals with hereditary predisposition to catalepsy using our previous development, a model of male sexual arousal, and examined the relationship between catalepsy and sexual arousal. The main gene for a high predisposition to catalepsy was shown to be associated with the expression of sexual motivation, but not with the hormonal component of sexual arousal (increase in plasma testosterone levels following exposure to a receptive female). ASC (Antidepressant Sensitive Catalepsy) mice, proposed as a model of depression, had a decreased manifestation of sexual motivation, while male GC (Genetic Catalepsy) strain rats had enhanced sexual motivation. Noteworthy, highly excitable GC strain animals corresponding to the manic pole of bipolar disorders prevail at the current stage of breeding. Our results are in a good agreement with clinical data that indicate reduced libido in depressed patients and hypersexuality in people with bipolar disorder.

The authors propose a fundamental review, devoted to the factors, wich increase the risk of suicidal behavior (suicidal ideation and suicide attempts) in patients with epilepsy. It is known, that suicidal risk is increased 5 times more in patients with epilepsy, and 25 times more in patients with temporal lobe epilepsy and complex focal seizures, than in general population. The main factors, increasing suicidal risk in epilepsy, are comorbid affective disorders (depression), and psychosis. The authors also describe the role of antiepileptic drugs.

The research was conducted among 625 patients aged from 25 to 70years with abdominal obesity (51,2 % women and 48,8 % men). Affective disorders (depressed mood) were revealed in 42,9 % of patients with various metabolic syndrome (MS) components. Affective disorders caused appearance and further advance of MS components, having negative influence on its course. At the increase of duration of existence of separate MS components the depressions were diagnosed more often.

In outpatient practice, neurologists often face patients diagnosed with dyscirculatory encephalopathy (DEP). Sleep disorders, headaches, rapid and unexplained fatigability, and irritability are predominating, which poses a number of complex medical issues. A case report of a 69 year-old patient, who was being followed up for a long time because of DEP diagnosis is reported. However, examination of the neu-ropsychic status revealed the depressive disorder with somatoform complaints, which was verified by a psychiatrist. Psychotherapy and antidepressant therapy led to significant improvement. The differential diagnosis and treatment of depressive disorders in outpatient practice are discussed.

The data of the study by continuous total disability due to affective disorders of the adult population in the Irkutsk region referral to the bureau of medical-social expertise in 2007—2011 years were presented. Intensive index was calculated per 1000 population (level). The percentage of primary disability for 5 years was 18,5 %, whereas redisability (81,5 %) prevailed. The level of total disability due to affective disorders has decreased from 0,16 in 2007, 0,18 in 2008 to 0,14 in the years of the period. People of working age were 82,5 % disabled due to affective disorders, while the retirement age - only 17,5 %. The mean total disability in working age (16,5) exceeded the rate of retirement age (11,5 per 1000). Women predominated, among the disabled. The level of total disability in men was more than two times lower.

The author analyzes researches on the study of affective disorders in arterial hypertension (AH). It is noted that AH at the present stage is considered as one of the factors of cognitive dysfunction. The article emphasizes that the analysis of comorbid relations of depression and hypertension is hardly possible without the study of affective and cardiovascular disorders at the clinical level, taking into account their dynamic characteristics and key features of the course of depressive states in general. The author considers the features of the current: post-stroke depressions, nosogenic depressions of anxious and anxious-hypochondriacally types, anxiety-phobic disorders, comorbid panic disorders, protracted depression with traits of endoreactive dysthymia, hypochondriacal disorders, panic attacks, and the like in patients with arterial hypertension. Some features of affective disorders are revealed in patients with cardiovascular disorders. It is emphasized that the increase in the effectiveness of treatment of mental disorders in patients with hypertensive encephalopathy can be solved by improving the methods of early diagnosis, developing additional screening and monitoring diagnostic tools using it in an interdisciplinary approach.

The goal of the research was the comparative analysis of affective and cognitive disorders headache at women and men with dyscirculatory encephalopathy (DE), identify the connection of these disorders with the cerebral hemodynam-ics, neuroimaging of cinerea changes and BDNF in patients’ blood serum. 72 women (middle age 64,3±1,0) and 48 comparable in age and education men (middle age 65,0±1,2) with initiatory stages of dyscirculatory encephalopathy (DE) have been studied using comparative analysis of neuropsychological, sonographic and neuroimaging characteristics. The research revealed the predomination of cognitive impairment among men with (DE), especially attention, verbal coding and praxis disorders. Affective and insomnia disorders prevailed with women-patients. The results have shown possible links between low levels of brain-derived neurotrophic factor (BDNF) in blood plasma and the severity of depression and cognitive impairment at patients with (DE), especially at men. The received results may be important for individualization of therapeutic intervention.

The impact of antiepileptic drugs (AEDs) on affective disorders was analyzed in women with epilepsy. One hundred and one reproductive-aged epileptic patients with depressive and emotionally labile disorders were examined. Thirty-two (31.7%) and 64 (63.4%) took one and two AEDs, respectively; 5 (4.9%) patients did not take. New-generation AEDs were shown to have a more favorable profile of psychotropic effects than traditional ones. The positive psychotropic effects of lamotrigine in treating epilepsy in women with affective disorders are described.

The data of the CIRCADIAN-I trial suggest that depressions are unsatisfactorily diagnosed in psychiatric practice. Thus, some of the ICD-10 diagnoses used to denote depressive states (dysthymia, cyclothymia) are made extremely rarely. Only comparatively short-term and reversible vital depressions are considered to be preferred for the categories of affective disorders (F.30-F.33). Any clinical deviations from this clinical presentation (sensitive, anxiety symptoms, a prolonged course, and no well-defined seasonal and circadian rhythms of mood worsening) are regarded as a guide for ruling out the diagnosis of affective disorder. At the same time depressive states are classified as schizophrenia, adjustment disorders, etc.

The article describes a psychoanalytically-informed study of the defense organization of the personality of patients with affective disorders during a psychoanalytic interview. The authors propose their definition of the defensive organization and a typology of mental dispositions which helps to conduct a clinical and empirical investigation of the dynamic of the defensive organization of patients with psychotic and affective disorders. Using the method of configuration analysis and the proposed typology of mental dispositions the authors offer a detailed analysis of the dynamic of the defensive organization of a patient with bipolar affective disorder in the course of two psychodynamic interviews.

Alcohol is considered to be the most common exogenous toxins, causing encephalopathy. The defeat of almost all parts of the nervous system should be assigned to the special features of ethanol. Neurophysiological mechanisms of development of substance dependence are based in the stem and limbic structures of the brain that are involved in ensuring the regulation of emotional state, mood, motivation sphere, psychophysical tone of human behavior in general and its adaptation to the environment. Stress or disruption of the normal functioning of these structures can lead to the formation of abstinence syndrome, affective disorders in remission and craving for alcohol. Dopaminergic and opioid (endorphin) system play an important role in the genesis of various mental and motor disorders. In some way alcohol dependence can be regarded as an endorfinodefitsitnoe disease with a pathogenetic point of view. Activating of opioidereal system by trans-cranial electrical stimulation promotes the restoration of disturbed emotional, cognitive and autonomic functions, reduces craving for alcohol and in that way increases the effectiveness of rehabilitation treatment

Aim: to study the prevalence, pattern of and trends in affective disorders (AD) in patients with acute myocardial infarction (AMI) and to assess whether they might be corrected with the antidepressant tianeptin. Subjects and methods. The study enrolled 108 patients with AMI. To detect and evaluate affective spectrum disorders, all the enrolled patients were interviewed on days 2-3 of AMI, by using the screening questionnaire developed at the Moscow Research Institute of Psychiatry (MRIP), Russian Agency for Health Care, and 4-5 days and 2 and 6 months after the onset of AMI they underwent an in-depth psychopathological examination by a psychiatrist who applied the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). To correct affective symptomatology in some patients with verified depression, the antidepressant tianeptin was added to the conventional therapy for AMI on its days 5-7. Results. The screening questionnaire study revealed depressive spectrum disorders in 45.4% of the patients with AMI. The in-depth psychopathological examination confirmed the presence of AD in 40.7%. Mild and moderate depressive episodes were observed in 26.9% of the patients and adjustment disorders were seen in 13.8%. The sensitivity and specificity of the MRIP screening questionnaire for the diagnosis of depressive spectrum disorders in patients with AIM was 86.2 and 69.6%, respectively. The concomitant symptoms of anxiety were detected in 27.8% of the patients with AMI. The duration of a course of antidepressant therapy with tianeptin averaged 3.9±1.1 months. Six moths after AMI, the tianeptin group a showed significant reduction in HDRS scores by 50% (p = 0.0013) and in HARS scores by 52.7% (p = 0.0004) versus the baseline values. During a follow-up, there was no significant decrease in HDRS and HARS scores in a group of patients who refused antidepressant therapy. Conclusion. Affective spectrum disorders are most common in myocardial infarction (MI). The use of the MRIP screening questionnaire favors a more adequate diagnosis of depressive spectrum disorders in patients with AMI. Tianeptin therapy for AD concurrent with MI causes an evident reduction in psychopathological symptomatology and a statistically significant decrease in HDRS and HARS scores.