Background: Modern medicine has provided considerable knowledge of the pathophysiology of mental disorders at the body, systemic, organ and neurochemical levels of the biological organization of the body. Modern clinical diagnostics of depression have some problems, that is why psychiatric society makes use of diagnostics and taxonomy of different types of depression by implemention of modern molecular biomarkers in diagnostic procedures. But up to now, there are no reliable biomarkers of major depressive disorder (MDD) and other types of depression. Objective: The purpose of this review is to find fundamentals in pathological mechanisms of depression, which could be a basis for development of molecular and genetic biomarkers, being the most feasible for clinical use. Method: This review summarizes the published data using PubMed, Science Direct, Google Scholar and Scopus. Results: In this review, we summarized and discussed findings in molecular biology, genetics, neuroplasticity, neurotransmitters, and neuroimaging that could increase our understanding of the biological foundations of depression and show new directions for the development of reliable biomarkers. We did not find any molecular and genetic biomarker approved for the clinic. But the Genome-Wide Association Study method promises some progress in the development of biomarkers based on SNP in the future. Epigenetic factors also are a promising target for biomarkers. We have found some differences in the etiology of different types of atypical and melancholic depression. This knowledge could be the basis for development of biomarkers for clinical practice in diagnosis, prognosis and selection of treatment. Conclusion: Depression is not a monoetiological disease. Many pathological mechanisms are involved in depression, thus up to now, there is no approved and reliable biomarker for diagnosis, prognosis and correction of treatment of depression. The structural and functional complexity of the brain, the lack of invasive technology, poor correlations between genetic and clinical manifestation of depression, imperfect psychiatric classification and taxonomy of subtypes of disease are the main causes of this situation. One of the possible ways to come over this situation can be to pay attention to the trigger mechanism of disease and its subtypes. Researchers and clinicians should focus their efforts on searching the trigger mechanism of depression and different types of it . HPA axis can be a candidate for such trigger in depression caused by stress, because it influences the main branches of disease: neuroinflammation, activity of biogenic amines, oxidative and nitrosative stress, epigenetic factors, metabolomics, etc. But before we shall find any trigger mechanism, we need to create complex biomarkers reflecting genetic, epigenetic, metabolomics and other pathological changes in different types of depression. Recently the most encouraging results have been obtained from genetics and neuroimaging. Continuing research in these areas should be forced by using computational, statistical and systems biology approaches, which can allow to obtain more knowledge about the neurobiology of depression. In order to obtain clinically useful tests, search for biomarkers should use appropriate research methodologies with increasing samples and identifying more homogeneous groups of depressed patients.

The high prevalence, burden and social impact of mental disorders, the lack of mental health care professionals and services around the world, the improvement and dissemination of digital technologies are the factors that have provided increased attention to the process of digital transformation in mental health care recently. The COVID-19 pandemic has increased the importance of remote interaction between different participants in the therapeutic process. Digital technologies in mental health care can bring significant advances in both clinical and scientific psychiatry. The article presents the most promising digital solutions for the diagnosis, therapeutic interventions and prevention of mental disorders. The technologies by which they are implemented are described, including computer programs, virtual and augmented reality, internet resources. The advantages and disadvantages of digital technologies usage in psychiatric practice are analyzed. The article described the main barriers that stand in the way of digital transformation in mental health, including insufficient scientific and practical support of the developed digital products, the lack of methodological foundations, the regulatory framework, and legislation.

Prevalence of anxiety disorders has increased in last decades, specifically in COVID-19 pandemic. Despite the frequency and burden of post-COVID anxiety disorders, there are still no recommendations for the treatment of these conditions. The article presents the interim results of a post-registration multicenter observational study of the efficacy and safety of a new original drug Aviandr in the treatment of anxiety developing after COVID-19. The study included 170 patients over 18 years of age treated by Aviandr for 6 weeks at a dose of 20 mg 2 times a day. All patients completed 6 weeks of treatment and 2 weeks of follow-up. The decrease in the average total score of the Hamilton Rating Scale for Anxiety (SIGH-A) was 77.13 % of the baseline values. Most patients experienced clinical improvement; 72.35 % patients have reached remission by week 6 of therapy. The drug was equally effective in different age groups (≤/> 65 years). It is important to note that Aviandr was effective in relieving both mental and somatic anxiety, measured with SIGH-A scale — the reduction in average scores was 75.13 % and 79.12 %, respectively. The study drug showed a good safety profile. Adverse events were observed in 5.88 % of patients; 85.7 % of AEs were mild, only 14.3 % were moderate. Thus, Aviandr showed good efficacy in the treatment of anxiety disorders after COVID-19. The absence of withdrawal syndrome, drug dependence, a high safety profile, including in elderly patients, make Aviandr a good choice for use in clinical practice.

Medical article медицинская статья

To identify main clinical/psychopathological characteristics of aged psychiatric inpatients who regularly used anxiolytic and hypnotic benzodiazepines without control from the physician.