Госпитальная шкала тревоги и депрессии (Hospital Anxiety and Depression Scale, HADS) — широко применяемый инструмент для скрининга тревоги и депрессии, в том числе в практике врачей соматического профиля. Однако полноценная адаптация и валидация русскоязычной версии HADS для общей российской популяции до настоящего времени не проведена. ЦЕЛЬ ИССЛЕДОВАНИЯ Выполнить разработку, валидацию и оценку психометрических свойств адаптированной для российской популяции версии HADS. МАТЕРИАЛ И МЕТОДЫ Оценка психометрических свойств HADS проведена в выборке, включавшей 283 участника (77,4% женщин, средний возраст — 31,49 (9,066) лет), наличие психических расстройств выявлялось в ходе клинического интервью с использованием критериев МКБ-10. РЕЗУЛЬТАТЫ И ОБСУЖДЕНИЕ Факторный анализ подтвердил выраженную двухфакторную структуру HADS. Высокие значения альфы Кронбаха для всех вопросов HADS (α=0,90), а также для подшкал тревоги (α=0,86) и депрессии (α=0,84) свидетельствуют о хорошей внутренней согласованности опросника. На основании построения предиктивных моделей и проведения ROC-анализа предложены следующие оптимальные пороговые значения для выявления депрессии, тревоги и психических расстройств в целом: 9 баллов по подшкале депрессии, 10 баллов по подшкале тревоги и 18 баллов по общей шкале соответственно. ЗАКЛЮЧЕНИЕ Полученные результаты свидетельствуют о валидности и надежности русскоязычной версии HADS и позволяют рекомендовать ее для скрининга симптомов тревоги и депрессии в общей популяции, в том числе в рутинной практике врачей соматического профиля.

The serotoninergic system as a target for add-on treatment seems to be a promising approach in patients with schizophrenia.Objective: To clarify if selective 5HT-6 antagonist AVN-211 (CD-008-0173) adds clinical and cognitive effects to stable antipsychotic treatment.Methods: A randomized, double-blind, placebo-controlled, add-on, 4r-week trial in 47 schizophrenia patients (21 patients receiving study drug and 26 receiving placebo) who were stabilized on antipsychotic medication was performed. Seventeen patients from the study drug group and 25 patients from the placebo group completed the trial. Treatment effects were measured using clinical rating scales and attention tests.Results: With no differences at baseline, there was a significant difference between the groups in Positive and Negative Syndrome Scale (PANSS) positive subscale score (p = 0.058) in favor of patients in the treatment group at the endpoint. The PANSS positive subscore (p = 0.0068) and Clinical Global Impression–Severity (CGI-S) (p = 0.048) score significantly changed only in the treatment group. Only in the placebo group were significant changes in Calgary Depression Rating Scale (CDRS) total score registered. The indices of attention tests at endpoint did not show differences between the groups, with the exception of the scope of change in the results of the subtest VIII of the Wechsler Adult Intelligence Scale (WAIS), which showed difference between the groups (p = 0.02) and was significantly larger in the treatment group. Only inside the study drug group, significant changes in selectivity and continuous attention were observed regarding total correct responses (p = 0.0038) and reaction time (p = 0.058) in the Continuous Attention Task (CAT) test.Conclusion: Selective 5HT6 antagonist AVN-211 (CD-008-0173) added antipsychotic and some procognitive (attention) effects to antipsychotic medication.

BACKGROUND: Patients in general hospitals often display concomitant signs of mental maladjustment: low mood, anxiety, apathy, asthenia, all of which can have a negative impact on the course of the underlying disease and the recovery process. One of the non-pharmacological approaches that has gained wider acceptance in medical practice in recent years is the use of procedures based on virtual reality. AIM: Assess the efficacy of the new domestic, virtual reality application Flow as relates to symptoms of anxiety and asthenia in patients undergoing inpatient treatment. METHODS: The study was open-label and had a comparison group; the patients were assigned to the experimental or control group using a randomization table. The patients were assessed using the Spielberger State Anxiety Inventory; the Fatigue Symptom Rating Scale; the Well-being, Activity, Mood questionnaire; the Depression Anxiety Stress Scale; and the Clinical Global Impression Scale. Physical parameters were measured before and after each virtual reality session. The obtained data were statistically processed. RESULTS: The study involved 60 patients. In 40 patients, the treatment program included a course of five daily relaxation sessions in virtual reality; the control group consisted of 20 patients, who were treated in accordance with the usual practice of the institution. The addition of virtual reality sessions to the standard treatment course yielded significant advantage in terms of affective symptoms reduction in patients both after a single session and as a result of undergoing the full course, and several days after its completion. The patients in the experimental group also showed a significant decrease in blood pressure after the sessions, and this was most pronounced in individuals who initially had elevated and high blood pressure. CONCLUSION: The use of relaxation program courses in the virtual reality application Flow is an effective and promising means of non-pharmacological care for non-psychiatric inpatients showing symptoms of anxiety, apathy, depressive mood, as well as hypertension.

До настоящего времени для психофармакотерапии шизофрении применяются только блокаторы допаминовых рецепторов, несмотря на активный поиск альтернативных фармакологических агентов и множество проведенных исследований. Большинство этих исследований касались молекул, так или иначе влияющих на различные рецепторы нейромедиаторов.Также достаточно активно изучались различные противовоспалительные препараты. В то же время попыткам коррекции оксидативного стресса уделяется существенно меньше внимания, хотя возникновению последнего способствуют совершенно различные патофизиологические процессы и факторы внешней среды, связанные с развитием шизофрении. Так, блокада NMDA-рецепторов, дефицит витамина D, социальная изоляция, хронический стресс в подростковом возрасте, воспаление, перинатальная инфекция и др. — все это в конечном счете может приводить к возникновению оксидативного стресса. При этом существует значительная разница в выраженности этого процесса в зависимости от стадии течения шизофрении, что, вероятно, частично объясняет гетерогенность результатов исследований биомаркеров оксидативного стресса при этом расстройстве. С целью преодоления данных методологических проблем представляется перспективным проведение двойных слепых исследований эффективности антиоксидантов при шизофрении с отбором гомогенных групп пациентов, учитывая стадию течения расстройства и показатели уровня определенных биомаркеров оксидативного стресса (F2-isoprostanes, 8-oxodG, 8-oxoGuo). Оптимальными фармакологическими агентами для подобных исследований представляются N-ацетилцистеин в связи с позитивными результатами предыдущих исследований и мелатонин как антиоксидант с уникальным профилем активности.

BACKGROUND: The “Inventory of Statements About Self-Injury” (ISAS) is one of the most widely used and reliable psychometric tools for assessing non-suicidal self-injury (NSSI) and its motivations. The Russian adaptation of the ISAS, involving patients with nonpsychotic psychiatric disorders, demonstrated high internal consistency and a two-factor structure similar to the original. However, the reliability and suitability of ISAS in a non-clinical population remain unclear. AIM: To adapt the ISAS in Russian, evaluate its psychometric properties, and analyze its factor structure in a sample of Russian university students. METHODS: The psychometric properties and factor structure of the adapted ISAS version were evaluated through an anonymous online survey of Russian university students. Respondents had reported lifetime NSSI and scored above 4 on the ISAS-Functions subscale. Exploratory and confirmatory factor analysis (EFA/CFA) were performed on two randomly formed subgroups to evaluate the factor structure of ISAS. Additionally, the associations between the identified ISAS factors and the presence of suicidal thoughts and attempts over a lifetime and in the week before their participation in the study, as well as seeking psychiatric and/or psychotherapeutic care over a lifetime, were analyzed. RESULTS: The survey included 3,919 participants, of whom 1,149 (29.3%; 88.0% female) reported NSSI, with a median age of 20 (18; 22) years. The Russian ISAS demonstrated high internal consistency (Cronbach’s alpha = 0.851). EFA results supported the original two-factor structure. CFA results suggested an alternative three-factor structure of the ISAS, including “Signal”, “Regulation”, and “Influence” factors. Suicidal attempts were associated with the factors “Regulation” and “Influence”, suicidal thoughts with “Regulation” and female gender, and the seeking of psychiatric and/or psychotherapeutic care with “Regulation” and age. CONCLUSION: The adapted ISAS in Russian is a reliable tool with high internal consistency. The study proposed a three-factor structure, indicating a greater heterogeneity of the NSSI phenomenon compared to earlier understandings. The study demonstrated the association between two of the three identified factors with suicidal behavior and thoughts, and the seeking of psychiatric care.