BACKGROUND: In addition to the neurological complications affecting people infected with COVID-19, cognitive impairment symptoms and symptoms of anxiety and depression remain a frequent cause of complaints. The specificity of cognitive impairment in patients with COVID-19 is still poorly understood. AIM: An exploratory study of factors that may be associated with cognitive decline during the COVID-19 pandemic. METHODS: The cross-sectional multicentre observational study was conducted in a polyclinic unit in Saint Petersburg and in the regions of the North-Western Federal Region. During the study, socio-demographic parameters and information about the somatic condition of patients who applied for primary health care was collected. Emotional and cognitive state were investigated using the Hospital Anxiety and Depression Scale (HADS) and Montreal Cognitive Assessment (MoCA). Mathematical and statistical data processing was carried out using SPSS and RStudio statistical programs. RESULTS: The study included 515 participants, 60% (n=310) of which were women. The sample was divided into those who did (28.5%, n=147) and did not (71.4%, n=368) complain of cognitive decline. Patients with complaints of cognitive decline were significantly older, had lower levels of education and higher levels of depression and anxiety according to HADS (p 0.05). Patients with complaints of cognitive decline underwent the MoCA test (24.3%, n=125). The median MoCA test scores were within the normal range (Median=27, Q1=25, Q3=28), and cognitive decline (MoCA less than 26 points) was detected in 40% (n=50) of patients with complaints of cognitive decline. No significant correlations were found between the MoCA scores and the levels of anxiety and depression according to the HADS (p 0.05). Patients with mild severity of the COVID-19 course were more successful with MoCA subtests than patients with moderate and severe courses. CONCLUSION: We found no linear association between objective cognitive deficit and the affective state of respondents. Patients subjective complaints about cognitive dysfunction were mostly caused by their emotional state than an objective decrease of their cognitive functions. Therefore, in case of subjective complaints on cognitive decline, it is necessary to assess not only the cognitive but also the affective state of the patient. The severity of the COVID-19 course affects the functions of the cognitive sphere, including attention, regulatory functions and speech fluency. Mild and moderate severity of the COVID-19 correlates with clinically determined depression. The absence of this relationship with the severe course of the disease is probably explained by the significant somatic decompensation of patients.

Background: increasing interest in visual disturbances in schizophrenia is connected with the fact that they are a potential biomarker for objectification of a mental condition. The nature of the relationship between visual disturbances and higher-level cognitive functions in schizophrenia remains understudied.The aim of the study was to investigate differences in visual information processing between individuals with paranoid schizophrenia and healthy individuals, and to analyze the relationship between visual system characteristics with clinical and cognitive factors.Patients and methods: thirty-three patients with the paranoid form of schizophrenia and 19 healthy subjects were included in the cross-sectional study. Cognitive impairment was assessed using a battery of BACS tests, and the severity of the mental state was assessed using the PANSS scale. Contrast sensitivity characteristics were measured by computer visocontrastometry.Results: the study found that the visual system of persons with schizophrenia is characterized by hypersensitivity in the high and midrange, but decreased sensitivity in the low-frequency range. Decreased sensitivity in the low-frequency range was associated with better cognitive functioning and less pronounced productive symptoms. Medium frequencies at the trend level correlated with the digit sequencing tests, assessing working memory, and verbal fluency, reflecting speed of information processing.Conclusions: our findings expand information on the character of the relationship between contrast sensitivity and cognitive function. The results of study will provide the basis for further research on the development of more effective non-medicinal methods to improve cognitive functioning.

To investigate whether visual processing abnormalities are the result of visual dysfunction involving cognitive impairment or independent abnormalities and to identify the relationship of visual impairments with cognitive functions and severity of psychopathological symptoms. We compared results of visual size perception and actions on objects (motor assessment) in patients with schizophrenia (n=37), including patients with non-resistant schizophrenia (n=19) and healthy individuals (n=20). Cognitive impairments were assessed with BACS. Severity of schizophrenia symptoms was assessed with PANSS. The error in the visual size perception test was smaller in healthy controls compared with non-resistant patients (p<0.03). There are no significant differences between non-resistant patients and other groups. Also, there are no significant differences in motor assessment between healthy controls and patients with schizophrenia. In the visual size perception test, the amount of error correlates with cognitive impairments (r= -0.84, p<0.001), and the severity of psychotic symptoms on PANSS (r=0.55, p<0.05). Changes in visual threshold in patients with schizophrenia are correlated with cognitive dysfunction and reflect dysfunction in the parvocellular system.

ЦЕЛЬ Обзора — представить информацию о наиболее эффективных современных нелекарственных методах, применяющихся в практике лечения депрессий. Был проведен анализ публикаций в базах данных PubMed and PsycINFO and Cochrane Library за последние 10 лет. Нелекарственные методы биологической терапии демонстрируют высокую эффективность в редукции депрессивной симптоматики у пациентов с рекуррентной депрессией. Применение нелекарственной терапии не исключает продолжения приема психофармакологических средств. Для выбора оптимального метода лечения необходимо учитывать психофизическое состояние пациента, тяжесть депрессивной симптоматики, ответ на медикаментозную терапию и возможность ее назначения, а также руководствоваться принципами доказательной медицины.

ЦЕЛЬ ИССЛЕДОВАНИЯ Выявление связей между психотропной лекарственной терапией (антипсихотические и антихолинергические препараты) и когнитивными функциями у больных шизофренией. МАТЕРИАЛ И МЕТОДЫ Обсервационное проспективное исследование проводилось на базе отделения биологической терапии психически больных НМИЦ ПН им. В.М. Бехтерева. В исследовании принял участие 41 пациент (22 мужчины и 19 женщин, средний возраст 30,12±8,24 года) с параноидной формой шизофрении (F20 соответственно критериям МКБ-10) на стабильной антипсихотической монотерапии или в комбинации с антихолинергическим препаратом (тригексифенидил). Оценка когнитивных функций проводилась с помощью шкалы краткой оценки когнитивных функций у пациентов с шизофренией (BACS), тяжесть психического состояния и выраженность экстрапирамидных нарушений измерялись с помощью шкалы оценки позитивных и негативных синдромов (PANSS) и шкалы Симпсона—Ангуса для оценки экстрапирамидных побочных эффектов (SAS). Все процедуры обследования проводились дважды на 2-й и 8-й неделях терапии. Пациенты были разделены на две группы по характеру получаемой антипсихотической терапии. Двенадцать пациентов (1-я группа) получали антипсихотики первого поколения (АПП), 29 (2-я группа) — антипсихотики второго поколения (АВП). РЕЗУЛЬТАТЫ У пациентов, получавших АВП, значимо снизился общий балл по шкале SAS на 8-й неделе терапии по сравнению с данными на 2-й неделе (V=192, p=0,033) и наблюдалось улучшение когнитивных функций (V=46, p=0,0003), в отличие от пациентов, получавших АПП. Изменения по отдельным тестам BACS также были только у пациентов 2-й группы по таким тестам, как «Порядок чисел» (V=51,5, p=0,007), «Двигательный тест» (V=75,5, p=0,007) и «Башня Лондона» (V=52, p=0,027). ЗАКЛЮЧЕНИЕ К 8-й неделе приема АВП улучшилась переносимость препарата, а также когнитивные показатели. Исследование подтверждает необходимость придерживаться принципа минимальной эффективной дозы антипсихотических препаратов для лечения шизофрении, профилактики когнитивных нарушений, а также отдавать предпочтение в выборе терапии АВП.