The association of latent toxoplasmosis with mental disorders in general and with schizophrenia in particular was noticed in the mid-1950s. In subsequent years, the role of Toxoplasma gondii was established based on its ability to survive for long periods of time in the nerve cells of the brain. The acute manifestations of the infection include psychopathic symptoms resembling those of schizophrenia. In the former USSR, and in other parts of the world, a number of studies were performed with respect to the association of latent toxoplasmosis and schizophrenia. However, with the dissolution of the USSR at the beginning of the 1990s, studies on the subject were halted due to financial problems and have resumed only recently. The reasons for the resumption of such studies in contemporary Russia are related to the progressively increasing incidence of schizophrenia over the last 25–30 years in the country. According to official data, approximately 550 000 persons reported suffering from the disease in 2014. There are reasons to believe that this is only a fraction of the real burden of the disease. Economically, it cost the state no less than approximately US $10 billion. The purpose of the study was to identify the level of toxoplasmosis seroprevalence in patients with verified diagnoses of schizophrenia in comparison to healthy people in Moscow City and in the Moscow region. A total of 155 persons constituted the patients group and 152 healthy people were in the control group. An integrated approach to the diagnosis and comparison of data from the entire spectrum of serological markers of infection was used, including the detection of specific IgM and the determination of IgG concentrations. It was found that among persons with neuropsychiatric disorders, the incidence of cases with latent toxoplasmosis was higher than in the control group. The effect of toxoplasmosis was significant and similar for men and women. Further statistical analyses revealed that among patients with a diagnosis of schizophrenia, the incidence of latent toxoplasmosis was significantly higher than in the control group. These data are in agreement with the results of similar studies in other countries.

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.

To study possibilities of using depression scales in elderly patients, evaluate the parameters of their reliability and validity and develop practical recommendations on the use of these scales in clinical practice. The study included 234 patients, aged over 50 years, with anxious depression. The following scales/questionnaires BDI, GDS-15, CES-D-10, CES-D-20, ZDS and HADS-D were used at baseline and 12 weeks after treatment. Data analysis included the calculation of convergent, discriminative and diagnostic validity of depression scales/questionnaires in elderly. All scales are effective for the diagnosis of depression in elderly people. The possibility of using these scales in patients with mild cognitive impairment is shown. An increase of the correlation between the scores on depression and anxiety scales up to the loss of discriminative validity of «double» scales/questionnaires by the alternative set of symptoms for the diagnosis of depression and anxiety was confirmed. Based on the RESULTS: the authors have developed common and specific for each scale recommendations on the optimal use of depression scales/questionnaires in elderly.

To describe the specifics of using self-report anxiety scales in elderly patients, determine the parameters of their reliability and validity and develop recommendations on the use of these scales. The study included 234 patients, aged over 50 years, with non-psychotic anxiety disorders. The following scales/questionnaires BAI, GAI, STAI, ZAS, HADS were used at baseline and 12 weeks after treatment. Conditions of testing, form and content of instructions were similar. Data analysis included the estimation of reliability and validity of these scales. Assessment made by the physician on the Hamilton anxiety scale (HAМ-А) was used as «validity standard». All scales (BAI, GAI, STAI, ZAS, HADS-А) can be used for screening diagnosis of anxiety in elderly people. The diagnostic sensitivity and specificity of the scales for subjective assessment of anxiety slightly decrease in advanced age and is sufficient for screening purposes. Based on the analysis, the authors have developed recommendations (common and specific for each scale) on the optimization of using self-report anxiety scales in advanced age.

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.

ЦЕЛЬ ИССЛЕДОВАНИЯ. А Нализ социодемографических и клинических особенностей первого депрессивного эпизода и рекуррентной депрессии. МАТЕРИАЛ И МЕТОДЫ Обследовали 321 пациента с депрессивными расстройствами , из них 96 больных с впервые развившейся депрессией и 225 больных с рекуррентным течением. Обследование проводили с использованием психопатологического и психометрического методов. РЕЗУЛЬТАТЫ И ЗАКЛЮЧЕНИЕ Установлены клинико-анамнестические различия изучаемых групп при сходстве основных социодемографических показателей и таких факторов риска, как наследственная отягощенность и патология личности. При рекуррентном течении заболевания отмечено увеличение с каждым эпизодом тяжести депрессии, выраженности депрессивных идей и суицидальных тенденций, что влияет на отмеченные особенности, которые требуют дальнейшего исследования, особенно с учетом влияния терапии.