Vol LVI, No 4 (2024)

The article analyzes the problem of psychological and psychiatric affiliation of identity diffusion as illustrated by the clinical case of 17-year-old Samiha, a girl with an Arabic name who decided to change it to the Korean unisex name Ha-neul. The patient considered herself to be a non-binary person, but sought help at a psychiatric care facility due to suicidal thoughts/tendencies and self-harming behavior rather than gender dysphoria. The article presents a differential diagnosis between the identity diffusion included in the diagnostic criteria for borderline personality disorder, and autopsychic and somatopsychic depersonalization. It is concluded that identity diffusion may be both a psychological phenomenon and a psychopathological symptom. This requires a deeper understanding and inclusion of the new symptom in the psychospathology catalogue. The article suggests that it is important for modern psychopathology theory to keep track of social postmodernist changes as they led to emergence of a new subdiscipline, Neo-Psychopathology, in psychiatry.

BACKGROUND: Since publications on the differences of gaming addiction (GA) cohorts are scarce and primarily discuss the factors of only one type (gambling or gaming), it appears relevant to study personal, psychological, morphofunctional, genetic and other traits of patients by comparing different GA types to develop targeted prevention programs. A thorough approach to studying the specific traits of patients with the developed GA or at risk of GA contributes to the development of effective social and psychological, and psychological and educational preventive programs, and improvement of psychotherapeutic approaches to such patients.

AIM: This study develops an algorithm for differentiated assessment of the Internet addiction disorder risk.

MATERIALS AND METHODS: The study of clinical psychopathology, clinical dynamics, psychology, psychometrics, and risk factors of Internet addiction disorder included an open study of 69 gaming addiction (GA) patients, including 39 Pure GA patients and 30 Gambling GA patients. The control group (CG) consisted of 40 healthy volunteers. Basic study included clinical, psychological and psychometric techniques, and the genetic method as an additional tool. Statistics were processed using the Shapiro–Wilk test, Kolmogorov–Smirnov test, Student’s t-test, Welch’s t-test, and Mann–Whitney U-test.

RESULTS: For the first time, two key gaming addiction (GA) types (Pure GA and Gambling GA) were compared by analyzing the personality traits, morphofunctional and gender attributes of GA patients. The identified traits and attributes were considered in terms of the addiction risk (both in general and differentially) in relation to various Internet addiction types. The data analysis allowed to develop mathematical models to assess the Internet addiction risk in general and its specific types, identify risk groups and refine preventive actions.

CONCLUSION: The algorithm for differentiated assessment of the Internet addiction disorder risk was developed.

BACKGROUND: Damage of the central nervous system in COVID-19 patients includes cognitive impairment, depression, and fatigue. Clinical features of cognitive impairment after the acute phase of COVID-19 and the contribution of various factors to the development of memory deficit have not been fully studied.

AIM: This study assesses the clinical features of cognitive impairment in COVID-19 patients complicated by depression after the acute phase and analyzes how health and demographic factors contribute to the development of cognitive impairment.

MATERIALS AND METHODS: The observational cross-sectional study includes 33 patients aged 18–80 (mean age: 53.5; women: 60.6%) who meet the eligibility criteria. All subjects had a clinical semi-structured interview, a general clinical examination, MoCA, HDRS-17, and MFI-20 neuropsychological tests.

RESULTS: The average MoCA-total score was 23.8±2.2. Cognitive impairments primarily affected memory (average MoCA memory score: 10.5±2.0), executive functions (average MoCA executive functioning score: 9.5±1.1), and attention (average MoCA attention score: 14.8±1.9). There is a strong negative correlation of HDRS-17 and MoCA-total values ( r=−0.72; p<0.05), executive functioning index ( r=−0.82; p<0.05), and memory index ( r=−0.85; p<0.05). Age (β=−0.028; p=0.03), number of cardiovascular risk factors (β=−0.53; p=0.001), severity of COVID-19 in the acute phase (β=−0.97; p=0.001) and depression (β=−0.065; p=0.02) are the main contributors to cognitive impairment.

CONCLUSION: Multi-domain cognitive impairment with predominant deterioration of executive functions, memory and attention was detected in patients who had COVID-19 complicated by depression after the acute phase. The key factors of, or main contributors to, cognitive impairment were identified, which can help select the best targeted therapy for this category of patients.

BACKGROUND: Mental disorders are one of the leading causes of primary disability in children, a concern for both public healthcare and clinical psychiatry. The issue is further complicated by the lack of objective diagnostic measures of mental disorders, regional differences in the interpretation of diagnostic criteria, and significant social influences.

AIM: The aim of the study was to identify the main clinical and epidemiological characteristics of childhood primary disability due to mental disorders in the Republic of Tatarstan in 2021–2023.

MATERIALS AND METHODS: The main statistical data provided by the Information and Analytical Center of the Ministry of Health and the Bureau of Medical and Social Expertise of the Ministry of Social Protection of the Republic of Tatarstan were used as study materials, including relative primary and overall incidence and primary disability due to mental disorders in children under the age of 18. The main correlation trends were described. Statistical significance was determined using the nonparametric t-test, and the correlation coefficient (r) was calculated using the Pearson correlation coefficient.

RESULTS: A positive trend in primary mental disability in children is reported. The most common cause was organic non-psychotic mental disorders (F06 — Other mental disorders due to brain damage and dysfunction and to physical disease) at a rate of 4.02 per 100,000 of the relevant population. A significant decline in autism spectrum disorder (ASD) cases contributing to primary disability was observed between 2022 and 2023. This was associated with in-depth diagnosis as part of a comprehensive ASD care project (3.04 and 1.28 per 100,000 of the relevant population in 2022 and 2023, respectively, marking a 58% decrease).

CONCLUSION: Major trends in causes of primary disability in children include an increase in the incidence of organic nonpsychotic disorders and a decrease in the incidence of autism spectrum disorders. The incidence of schizophrenia and mental retardation as causes was unchanged.

Breast cancer is the second most common cancer overall, the most common cancer in women, and a leading cause of death in women. The incidence of brain metastases has increased due to longer patient survival. Thus, chemotherapy for breast cancer has significantly increased promising a positive outcome. However, long-term and repeated chemotherapy leads to involvement of the peripheral nervous system by creating clinical issues dominated by peripheral neuropathy and cognitive changes.

This literature review assesses the negative neurological effects of chemotherapy in breast cancer patients.

The review discusses neuropathic pain mechanisms, primarily neuroimmune and inflammatory changes, ion-channel remodeling, mitochondrial dysfunction, and genetic predisposition. The review gives advice on the prevention of peripheral neuropathy and neuropathic pain in breast cancer patients. It shows the relationship of chemotherapy and deteriorated quality of life, where special attention should be paid to early detection and treatment of chemotherapy-induced peripheral polyneuropathy to improve the quality of life of breast cancer patients.

With advances in pharmacology, the introduction of targeted therapy and its combinations, especially those involving epidermal growth factor receptor 2, the survival potential of breast cancer patients increases, but there are risks of more frequent neurological complications, primarily peripheral neuropathy and cognitive changes.

The review presents a psychopathological phenomenon new for the Russian psychiatry. It combines various cognitive and psychopathological entities (hallucinations, delusions, consciousness disorders) occurring in cancer patients as a result of chemotherapy. In foreign literature, such entities are generalized under such common terms as chemo brain, chemo fog, and post-chemotherapy cognitive impairment (PCCI). Chemo Brain is a symptom complex developing after treatment with various groups of chemotherapeutic drugs and caused by certain functional and structural brain changes. This article collates the data on etiology, pathogenesis, clinical features and interventions in case of disorders generally known as Chemo Brain. In addition, it discusses chemotherapeutic drugs most often inducing the Chemo Fog phenomenon (Cisplatin, Doxorubicin, Methotrexate, 5-fluorouracil), and a clinical Chemo Brain case with severe cognitive impairment and a confusion episode. A 74-year-old female patient undergoing chemotherapy for sigmoid colon carcinoma and metastases experienced a sharp deterioration of memory, self-care, and mobility after a routine chemotherapy round. The patient had been treated with a cocktail of chemotherapy drugs for 3 years and had several surgeries. With acute memory impairment, she consulted the internal medicine department. The doctors were puzzled with her symptoms. Having received advice of various medical specialists and the corresponding treatment, the patient showed improvement of both cognitive and motor functions. The review emphasizes the need for further clinical research of Chemo Brain drug treatment.