Schizophrenia and schizophrenia spectrum disorders (SSD) are characterized by significant cognitive deficits and impairments in social adaptation, which have a profound impact on patients’ quality of life. The present study focuses on the investigation of cognitive impairments and the level of functioning in patients during the remission phase. The study included 93 patients with a confirmed diagnosis of schizophrenia spectrum disorders who underwent clinical and psychometric assessment using the Positive and Negative Syndrome Scale (PANSS), the Brief Assessment of Cognition in Schizophrenia (BACS), and the UCSD Performance-Based Skills Assessment (UPSA) upon achieving remission. The findings indicate that patients with recurrent psychotic episodes exhibit more pronounced cognitive impairments (particularly in working memory and processing speed) and reduced functional capacity compared to those who experienced a first-episode psychosis. Correlation analysis revealed a strong association between cognitive performance and social functioning. These results highlight the importance of early identification and treatment of cognitive deficits to improve functional outcomes and promote social reintegration. The study’s findings may inform the development of personalized treatment and rehabilitation strategies for individuals with schizophrenia spectrum disorders.

Neuropsychological study of adolescents with varying severity of Internet-addicted behavior showed the highest (92.7 %; n=89) number of coincidences of subjective assessment of IAPS stimuli with reliable change of SS-EEG upon presentation of stimuli of neutral valence (image of chair according to IAPS). Directly opposite structure of coincidence/mismatch was determined during visual affective stimulation with device images (Apple laptop): coincidences accounted for 25.3 %; (n=24), and mismatches — for 74.7 %; (n=71). When presenting stimuli of positive and negative valence, the ratio was approximately the same: 83.3 % (n=80) / 16.7 % (n=16) and 85.4 % (n=82) / 14.6 % (n=14), respectively. The maximum number of significant changes in the SS-EEG was detected when presenting images of devices in the range of 8–13 Hz (α rhythm). The maximum (up to 4.7 ± 2.2 μV) drop in the amplitude of the α wave occurred in Internet-independent (II) adolescents, and the minimum (25.6 ± 7.6 μV) — in Internet addicts (IA). Comparison of these values between the IA and II groups against the background of visual stimulation revealed a significantly (p = 0.006) low alpha activity in Internet-independent adolescents relative to Internet addicts. The amplitude of the background theta rhythm was highest in the group of adolescents without signs of Internet addiction, with IAPS stimulation, as in the case of the α rhythm, a sixfold decrease in the amplitude of θ activity occurred in Internet-independent adolescents, which significantly exceeds its two-fold decrease in the group of Internet addicts. The maximum desynchronization reaction determined in adolescents without signs of Internet addiction indicates good preservation of emotional selection mechanisms. On the contrary, this indicator was the worst in adolescents with Internet addiction, which serves as a sign of tolerance or rigidity, less effective selection of emotionally significant visual stimuli. The combination of psychometric analysis of subjective assessment of emotionally significant IAPS stimuli with registration of event-related EEG serves as an effective neuropsychological tool for studying neuropsychic functions in users of information technologies. The results are discussed both from the standpoint of stress theory and taking into account neurophysiological data on Internet-dependent behavior. The authors believe that the main result of the study is revealing a significant contribution of the visual system to the pathogenesis of Internet addiction.

Introduction. Medical workers, including physicians of therapeutic specialties, are one of the most vulnerable categories among helping professions in terms of the formation of disorders of the psycho-emotional sphere, increased levels of professional stress and anxiety, and a decrease in the quality of life. Purpose of the study. Establishing the characteristics of the state of the psycho-emotional sphere, the development of personal and situational anxiety, assessing the characteristics of the quality of life among physicians of therapeutic specialties (oncologists of the therapeutic profile (outpatient oncologists), pulmonologists, occupational pathologists, who, in addition to medical work, deal with issues of examination of the relationship between a disease and an occupation and examination of professional suitability). Material and methods. The study was performed at the Department of Occupational Diseases and Clinical Pharmacology named after honored scientist of the Russian Federation professor V.V. Kosarev, FSBEI HE Samara State Medical University of the Ministry of Health of the Russian Federation, and the regional center for occupational pathology SBHI SR Samara City Hospital No. 5. The following groups of doctors were examined: group 1 included oncologists of the therapeutic profile (outpatient oncologists) of the outpatient departments of the state budgetary healthcare institutions of the Samara Region (n=30); group 2 consisted of pulmonologists of the clinics of the FSBEI HE Samara State Medical University of the Ministry of Health of the Russian Federation, SBHI SR Samara Regional Clinical Hospital named after V.D. Seredavin, SBHI SR Samara City Hospital No. 5, and outpatient departments of the State Budgetary Healthcare Institutions of the Samara Region (n=30); group 3 included occupational pathologists of the occupational pathology department of the Regional Center for Occupational Pathology of the SBHI SR Samara City Hospital No. 5 and outpatient departments of the state budgetary healthcare institutions of the Samara Region (n=42); group 4 was the control group that included workers in engineering, technical, and economic specialties whose activity is not related to work in medical organizations (n=190). The study used the integrative anxiety test (IAT) to study the formation of psychoemotional disorders in physicians of therapeutic specialties. Quality of life was determined using the SF-36 questionnaire. The processing of the obtained data was carried out by means of the Statistica package from StatSoft (USA). Results. It has been established that the work of physicians of GP specialties is associated with the impact of occupational stress, an increase in the level of anxiety, and a decrease in the quality of life. Limitations of the study. The study has regional (Samara Region) and professional (in terms of detailing working conditions in the studied comparison groups) limitations. Conclusions. The work of physicians of GP profile is associated with an increase in the levels of occupational stress, an increase in the level of anxiety, and a decrease in the quality of life. At the same time, psychological changes are most pronounced in oncologists of the therapeutic profile (outpatient oncologists), as well as occupational pathologists. It is necessary to continue research into the emotional state of medical personnel in order to conduct timely preventive treatment to maintain the health of medical workers.

Hypoxic-ischemic lesions occur in premature and preterm infants and lead to disorders of the central nervous system, with the main cause of this condition being perinatal asphyxia. Modern statistical data indicate that approximately every second newborn with systemic hypoxia in the perinatal period has morphofunctional CNS disorders. Currently, asphyxia is the third most common cause of neonatal mortality, with prematurity and severe infectious diseases ranking first and second. Hypoxic-ischemic encephalopathy occurring in the neonatal period causes abnormalities in the development of the nervous system, which persist throughout life and can negatively affect the ability to learn based on associations. Therefore, children with this pathology need to be monitored by a neurologist and carefully examined throughout childhood, up to adolescence.

Cerebral edema is one of the most severe complications of various central nervous system (CNS) diseases, significantly affecting treatment outcomes. The use of glucocorticoids (GCs) in cerebral edema remains controversial despite their long history of application. We conducted a systematic analysis of 18 clinical guidelines (Russian and international) and 7 studies from PubMed (out of 33 identified). Significant heterogeneity in the evidence base for GCs use in cerebral edema of various etiologies was revealed. In traumatic brain injury, guidelines unanimously advise against GCs administration. For brain abscesses, GCs are recommended in cases of pronounced mass effect, despite contradictory meta-analysis results. In CNS tumors, GCs are indicated for symptomatic management of peritumoral edema, using minimally effective doses. GCs use is not recommended for hemorrhagic and ischemic strokes. The greatest variability in recommendations, with a substantial lack of evidence, is observed in infectious diseases. The efficacy of GCs varies significantly depending on the etiology of cerebral edema. A notable deficiency of high-quality randomized controlled trials (RCTs) with sufficient statistical power was identified, highlighting the need for standardized approaches to evaluate GCs use in different types of cerebral edema, considering individual patient characteristics.

The article discusses new therapeutic options for the treatment of postpartum depression using zuranolone. The authors' independent literature review includes an analysis of the clinical trials "MOUNTAIN-A", "3 CORAL" and "SAGE-217". The generalizations made in the course of the work emphasize the innovative mechanism of action of zuranolone as a positive allosteric modulator of GABAa receptors, its ability to quickly relieve symptoms of depression, and its potential value in the context of personalized therapy. The introduction of zuranolone into the treatment of postpartum depression may be promising, given that it is the first oral drug of this group available for its treatment.

Current clinical guidelines for the treatment of schizophrenia, based on the principles of evidence-based medicine, emphasize the key role of antipsychotic drugs in the long-term support therapy of patients with this disease. While these medications have been shown to be effective, adherence to the treatment regimen is still a significant challenge in clinical practice. Low adherence in schizophrenia patients is associated with reduced therapeutic and rehabilitation potential and, as a consequence, with an increased risk of relapse, rehospitalization, suicidal behavior, and premature death. Additionally, non-adherence negatively affects the prognosis of the disease leading to chronicity of the disease, development of resistance to treatment, and cognitive and social impairment, all of which contribute to a poor quality of life for patients. The aim of this review is to examine the existing research on the impact of therapy adherence (compliance) on the treatment and recovery potential of patients with severe forms of schizophrenia. The focus is on identifying factors that contribute to or hinder adherence to treatment, as well as assessing the consequences of compliance for rehabilitation and the prognosis of the illness. Our findings suggest that high levels of adherence are associated with better clinical outcomes, such as reduced relapse rates, sustained remission, improved cognitive functioning, and enhanced quality of life. Conversely, low adherence can lead to decreased rehabilitation potential, worsened prognosis, increased hospitalization, and social maladjustment.

Asthenic syndrome is a common pathological condition characterized by structural and symptomatic polymorphism. The issue is particularly relevant among medical students who experience intense academic loads. This study assessed the prevalence and severity of asthenia in 296 fourth-year medical students by means of a standardized scale. The results showed that 45.6 % of the respondents had no signs of asthenia, 45.95 % had a mild degree, and 8.45 % had a moderate degree. Statistically significant gender differences were identified: asthenia was more prevalent among female students (58.26 % vs. 43.59 % in males, p = 0.009). Subscale analysis revealed a predominance of mental asthenia (57.1 %) over physical asthenia (46.28 %). Students with chronic diseases were 1.66 times more likely to have asthenia (p = 0.045), confirming the role of somatic pathology in the syndrome development. The findings align with current understanding of asthenia pathophysiology, including neuroinflammation, hypothalamic-pituitary-adrenal axis dysfunction, and neurotransmitter imbalance. Special attention is given to hormonal factors, which may explain gender differences through the modulation of serotonergic and dopaminergic systems by sex hormones.

Neuronal ceroid lipofuscinosis (NCL, neuronal waxy lipofuscinosis, neuronal ceroid lipofuscinosis) is a group of hereditary neurodegenerative diseases, one of the most common causes of neurodegeneration in childhood. Often, the totality of all NCL is also called Batten’s disease, which is associated with discrepancies in terminology, since this concept can also refer to one specific form of NCL (CLN3). In total, approximately 13 forms are described. The article presents a rare form of neuronal ceroid lipofuscinosis with the classic development of symptoms of this disease. Based on this clinical case, it is possible to identify the genetic mechanisms of the disease, the stages of disease progression, and the basis for the symptomatic treatment of lipofuscinosis. The purpose of the study: to review a clinical case of neuronal ceroid lipofuscinosis type 3 in a 14-year-old child. Material and Method: patient’s medical history BUZ UR "Republican Children's Clinical Hospital" of the Ministry of Health of the Udmurt Republic Сonclusions: based on this clinical case, it is possible to see the progression of symptoms of neuronal ceroid lipofuscinosis type 3, identify characteristic syndromes, and understand the tactics of symptomatic treatment of the disease.

The management of severe traumatic brain injury (TBI) with intracerebral hematomas remains a pressing challenge in modern medicine with significant socioeconomic implications. Materials and Methods. The study included 175 patients (2020-2021) divided into three groups: 1. TBI + COVID-19 (treated with a combined protocol: anticoagulants, oxygen therapy, dexamethasone). 2. TBI + COVID-19 (conventional treatment). 3. Isolated TBI (standard therapy). Results: In Group 1 (87% of cases), TBI progression mirrored classical patterns without deterioration. Group 2 exhibited pronounced cerebral symptoms, hypoxia, and prolonged hospitalization (+5 days on average). Clinical outcomes in Groups 1 and 3 were comparable, validating the efficacy of the proposed protocol. Conclusions. The combined therapeutic approach (anticoagulants, oxygen therapy, dexamethasone) improves outcomes in TBI patients with concurrent COVID-19 by reducing complication risks and shortening treatment duration.

Background. The study of stress-coping mechanisms in patients with psychoactive substance use disorder remains highly relevant in modern addiction medicine and psychiatry. Despite extensive research on addictive behaviors, many aspects of the formation and functioning of coping strategies in this patient population require further in-depth investigation. In particular, the characteristics of internal defense mechanisms and their role in stress adaptation among individuals with addiction remain understudied. This gap exists because addictive behavior is often accompanied by impaired emotional regulation, maladaptive coping strategies, and increased stress vulnerability. Clarifying these mechanisms could contribute to the development of more effective psychotherapeutic and rehabilitation interventions aimed at enhancing stress resilience and reducing relapse risk. Objective. To assess the characteristics of stress coping in patients with psychoactive substance use disorder. Materials and Methods. The study involved 79 patients (n = 79), including 41 men (59.9 %) and 38 women (48.1 %), aged 18 to 65 (mean age 38.97±9.7 years), hospitalized for dependence syndrome. The participants were divided into two typological groups: opioid dependence group (n = 36, 45.6 %): 18 men (50 %) and 18 women (50 %), and alcohol dependence group (n = 43, 54.4 %): 23 men (53.5 %) and 20 women (46.5 %). All participants had maintained abstinence from opioids or alcohol for at least 7 days prior to the study. Results. Both groups exhibited a high prevalence of denial (alcohol dependence — 83.7 %; opioid dependence — 88.8 %) and avoidance (90.7 % and 80.5 %, respectively). However, key differences were observed: intellectualization (81.3 % and 61.1 %) and hyperthymia (41.9 % and 27.8 %) were more common in alcohol dependence. Women with alcohol dependence more frequently employed regression (r = 0.511, p = 0.0003) and displayed elevated anxiety (r = 0.448, p = 0.002). The opioid dependence group showed higher rates of projection (48.8 % and 88.8 %) and exaltation (30.2 % and 66.6 %). In addition, opioid-dependent individuals more often sought social support (38.9 % and 11.6 %). Women in this group also demonstrated a correlation with reaction formation (r = 0.427, p = 0.009). Conclusion. Despite similarities in psychological processes across different addiction types, significant differences exist and must be considered when designing rehabilitation programs for this patient profile.

The problem of treating severe traumatic brain injury (TBI) is relevant in modern medicine and has great socio-economic importance. Materials and methods. During the study period April 2020 — June 2021, 50 patients aged 18 to 90 years (median 42.5 years) with SCT-verified compression of the brain (subdural, epidural hematomas) and verified by clinical and laboratory, instrumental data (PCR smear on SARS-COV-2, chest CT data) diagnosis «New coronavirus infection» were examined in St. Petersburg. Results. The administration of anticoagulants in the early postoperative period has no negative effect in the form of hemorrhage in the surgical intervention area, as well as bleeding from the postoperative wound (p<0.05). Early oxygenation of patients with TBI and COVID-19 certainly has a positive effect on the course of TBI. To date, the method can be effectively used in the treatment of patients with TBI and COVID-19. The technique is promising, and requires further randomized research. Conclusion. The concomitant diagnosis of "New coronavirus infection" and community-acquired polysegmental viral pneumonia in patients with severe TBI, with, due to the syndrome of mutual aggravation, negatively affects the outcome of treatment.