Elena Rudol'FOvna Isaeva

The psychological consequences of COVID-19 represent a widespread, heterogeneous, and polymorphic phenomenon. These disorders significantly impair the quality of life, productivity, and social rehabilitation of COVID-19 survivors. However, global healthcare lacks a systemic approach to the medical rehabilitation of post-COVID patients, partly due to the wide variety of disorders affecting the nervous, bronchopulmonary, cardiovascular, and other systems, including psycho-emotional manifestations. Based on empirical data, this study aims to identify rehabilitation targets for patients experiencing the psychiatric and psychological consequences of COVID-19, as well as to provide a theoretical rationale for differentiated approaches to comprehensive psychological intervention and neurorehabilitation for post-COVID syndrome (PCS). This regional clinical and epidemiological study of the population in the Northwestern Federal District included a questionnaire survey (n = 3,500) and an in-depth assessment of the psychoneurological status of PCS patients (n = 300) conducted between 2023 and 2025. The high-risk profile for PCS development was characterized by elevated stress levels and a history of psychoneurological disorders. Functional neurological assessment and neuropsychological examination were used to profile the patients’ quality of life and attitudes towards the disease. The research revealed seven main factors (PCS subphenotypes): anxiety, depression, asthenia, cognitive dysfunction, neuromuscular disorders, autonomic dysfunctions, and sensory disorders. Finally, the article describes rehabilitation targets for PCS patients and proposes theoretical recommendations for mitigating the impact of COVID-19 for each key subphenotype, incorporating principles of psychological correction and neurorehabilitation into recovery programs.

Background. Social cognition impairments are one of the key components of schizophrenia spectrum disorders and have a significant impact on patients' social adaptation. Aim. To test the author's projective technique 'Closecards', aimed at identifying impairments of social cognition in individuals with schizophrenia spectrum disorders. Methods. In the pilot stage of the study, 64 people aged 18 to 45 years participated: 32 patients diagnosed with F20–F25 (ICD-10) and 32 conditionally healthy respondents. The projective technique 'Close-cards' was used, including 15 photo cards with partially covered images of social situations. Responses were assessed according to three components: attributional style, emotion understanding, and probabilistic forecasting. Methods of descriptive statistics, Mann–Whitney test, and Pearson's χ² test were applied. Results. Patients with schizophrenia spectrum disorders demonstrated statistically significant differences in all studied indicators compared with the control group (p <0.001). The most pronounced impairments were found in the sphere of probabilistic forecasting. Cards with the most complex plot and the absence of clear emotional markers proved to be the most diagnostically significant. Conclusion. The projective technique 'Close-cards' has the potential to serve as a diagnostic tool for social cognition impairments in schizophrenia spectrum disorders and may be used in clinical psychological practice.

The relevance of the study is justified by the high prevalence of suicidal behavior among patients with depressive disorder. Despite the fact that the suicide rate in Russia decreased from 2011 to 2021, the high mortality rate among suicides remains an urgent medical, social and ethical problem. The aim of the study was to determine the possibility of using the Psychache scale to determine the level of suicide risk in patients with depressive spectrum disorders (F30F34 according to ICD-10). It was assumed that this scale may have the same diagnostic sensitivity as the Columbia Suicide Risk Scale used in the healthcare system. The results of the study showed a high correlation between the level of psychache and the risk of a suicide attempt in patients of the studied nosological group. With an increase in the intensity of psychache experienced by patients, the intensity of suicidal ideas increases, the degree of their controllability decreases, and the influence of factors restraining from suicide decreases.

The aim of the study was to investigate the characteristics of treatment adherence, the unmet needs in the socio-economic domain, and to determine the presence of an association between these factors during the intensive phase of chemotherapy in patients with tuberculosis exhibiting preserved drug sensitivity of the pathogen. Materials and methods . The study involved patients aged 26 to 67 years (N=130, M _age =42.9 years, SD=9.6) with a newly established diagnosis of drug-sensitive respiratory tuberculosis at the start of the intensive phase of treatment. Psychodiagnostic methods included the «Compliance Level» technique by R. V. Kadyrov, O. B. Asriyan, and S. A. Kovalchuk; the «Level of Social Frustration» scales (USF-1, USF-2). Data analysis comprised descriptive statistics (frequency analysis) and correlational analysis (methods of paired and partial correlations). Data processing — IBM SPSS Statistics version 27. Results and discussion . A diffuse type, oriented towards mechanistic adherence to the physician’s prescriptions, characterizes patients’ attitudes toward the illness. It was established that treatment adherence in patients with drug-sensitive respiratory tuberculosis during the intensive phase of chemotherapy is closely associated with the level of dissatisfaction in the socio-economic domain of life. Conclusions . The complex of frustrations and barriers identified during the study exerts a direct negative impact on patients’ adherence to treatment, which in turn underscores the necessity for social and clinical-psychological support for patients from the very first day of anti-tuberculosis chemotherapy. Which, in turn, will make the tuberculosis treatment process less psychologically traumatic for the patient, reduce the level of dissatisfaction, and strengthen treatment adherence.

The aim of this studyto determined bythe prevalence of and high mortality from cardiovascular pathology throughout the world, which makes this nosological unit one of the most important problems of the world healthcare. Of all cardiovascular diseases (CVD), the highest mortality is observed in coronary heart disease (CHD). To this end, more than 70% of deaths in patients with CHD occur outside medical organizations, are sudden for the patients themselves, which prevents them from timely seeking medical help. Coronary heart disease is associated with elderly com, which also explains the relevance of studying this particular age group. The empirical study involved 60 patients with an established diagnosis of 'coronary heart disease, acute/recurrent myocardial infarction' (ICD-10: I21 and I22), with the mean age 70.9±9.5 years. The study was conducted in the hospital of the cardiology department of the V.A. Almazov National Medical Research Center, and all patients were undergoing the second stage of rehabilitation after myocardial infarction. The following methods were used: Geriatric Depression Scale (GDS-30), questionnaire of gerotranscendental changes by O.Yu. Strizhitskaya (QGC); the Semantic Time Differential by L.I. Wasserman (SDT); Russian universal questionnaire of quantitative assessment of adherence to treatment. The compliance of patients with coronary heart disease is positively influenced by younger age, first infarction, positive perception of the past and future, realistic assessment of the present, psychological well-being and understanding of the limitations associated with the future. The main targets in the work of a psychologist with this group of patients were determined: normalization of the assessment of their current state, harmonization of the assessment of the future time (understanding the necessary limitations and maintaining a positive idea of their future) and correction of depressive symptoms.

Introduction. Smoking is a leading risk factor for the development of chronic bronchitis, chronic obstructive pulmonary disease (COPD), cardiovascular pathology, cancer, diabetes mellitus. The main role in helping smoking patients and identifying their respiratory pathology in outpatient practice belongs to the primary care physicians The paper analyzes the problems of managing smoking patients with a pulmonological profile in real outpatient practice, shows the need for psychological support for patients during the period of quitting smoking.Purpose. To identify signs of bronchoobstructive syndrome in smokers, assessment of smoking status, formation of tobacco cessation groups, analysis of routing of patients with respiratory complaints in real outpatient practice.Material and methods. In state institutions of the Kalinsky district of St. Petersburg, screening examinations were conducted for smoking women and men of working age with an average socio-economic status. The examination was completed by 140 smoking patients aged 20 to 60 years, including 41 men (average age 43.5-+) and 67 women (45.9+1.1 years). In addition to the questionnaire, all subjects underwent spirometry and determination of CO (ppm) in exhaled air.Results. Women started smoking later than men. The number of cigarettes smoked per day, the smoking index, and the degree of nicotine dependence in women were significantly lower, which was naturally accompanied by a significantly lower content of CO in the exhaled air. Bronchoobstructive syndrome was detected in 56% of men and 40% of women; the degree of nicotine dependence and respiratory symptoms were interrelated only in women (r = 0.50, p < 0.01). With almost identical levels of motivation to quit smoking and the number of attempts to get rid of tobacco dependence, the duration of abstinence from smoking in women turned out to be more significantConclusion. The identified problems of managing smoking patients with a pulmonological profile in real outpatient practice dictate the need for clear routing of these patients with mandatory psychological support during the period of smoking cessation.

В настоящее время данных о клинико-психологических особенностях пациентов с впервые выявленным лекарственно-чувствительным туберкулезом органов дыхания в контексте поло-ролевого (гендерного) поведения недостаточно для формирования комплексного медико-психологического сопровождения. Целью данного исследования является изучение клинико-психологических аспектов отношения к болезни и здоровью мужчин и женщин с впервые выявленным лекарственно-чувствительным туберкулезом органов дыхания на старте химиотерапии. Исследование предоставляет научное обоснование для составления программы психологического сопровождения и, в дальнейшем, может быть учтено при дополнении клинических рекомендаций по лечению туберкулеза разделом, посвященным оказанию психологической помощи. Материалы и методы. Анализ медицинских карт и анамнестических данных; психодиагностические методы: методика «Тип отношения к болезни (ТОБОЛ)»; «Уровень комплаентности»; «Методика исследования самоотношения (МИС)»; методика «Диагностика реальной структуры ценностных ориентаций личности»; Методы математической обработки данных – частотный, сравнительный анализы. В исследовании приняли участие 130 пациентов в возрасте от 26 лет до 67 лет, из них 70 мужчин (Mвозраст = 43,03; SD = 8,62) – группа 1; 60 женщин (Mвозраст = 42,75; SD = 10,75) – группа 2, давшие добровольное информированное согласие на участие в психологическом исследовании. У всех больных был верифицирован диагноз лекарственно-чувствительного (ЛЧ) туберкулеза органов дыхания (МКБ-10: А15–А16). Результаты. Полученные данные позволяют говорить о том, что имеются гендерные различия в отношении к заболеванию с преобладанием сенситивного компонента у мужчин, и эргопатического компонента у женщин. Также различны и ценностные ориентации: у мужчин преобладают ценности, связанные с получением удовольствия, в то время как у женщин ценности определяются просоциальной активностью. Кроме того, установлено, что здоровье не является доминирующей ценностью в обеих группах. Выводы. При формировании индивидуализированной программы психологического сопровождения пациентов с лекарственно-чувствительным туберкулезом органов дыхания на старте химиотерапии необходимо учитывать поло-ролевые особенности пациентов. Для повышения приверженности лечению пациента-мужчины врачу-фтизиатру и медицинскому психологу необходимо консолидировать усилия для десенсибилизации стигматизации. В то же время для пациентов-женщин целесообразнее акцентировать внимание на эмоциональном комфорте лечебного процесса. Также вне зависимости от пола необходимо включать в программу сопровождения психологические тренинги по формированию ценности здоровья и здорового образа жизни.

Introduction. Long-term consequences associated with COVID-19 have a significant impact on people’s health. The most common symptoms observed in the post-COVID period include disorders of the nervous system (21.7 %). However, data on the mental structure of the consequences induced by SARS-CoV-2 is still lacking. The purpose of this study was therefore to assess the structure and nature of health complaints as well as neuropsychological and pathopsychological disorders in people in the post-COVID period. Materials and Methods. This article presents the results of an extensive survey involving 1,200 respondents, which aimed to identify the main general somatic, mental and neurological consequences that developed from four weeks to twelve months after COVID-19 infection. Another part of the described results comes from an experimental psychological examination of 47 respondents randomly selected from the main study group (n = 1,200), which included an assessment of the overall state of cognitive functions, memory, attention, gnosis, praxis and the severity of psychopathological symptoms. Results. A total of seven subphenotypes of disorders were identified in the post-COVID period, among them anxiety and related phenomena (1), neuromuscular disorders associated with pain syndrome (2), disorders of respiratory, cardiovascular and autonomic systems (3), asthenic phenomena (4), disorders of cognitive functions (5), depressive phenomena (6) and disorders of sensory organs (7). The experimental psychological examination revealed the following mental disorders: a decline in logical and mechanical long-term memory, a decrease in mental stability, difficulties in spatial gnostic and praxic orientations, the severity of anxious and depressive tendencies and a proclivity for obsessive phenomena. Conclusions. Rehabilitation of persons with a history of COVID-19 infection requires a comprehensive neuropsychological correction program rooted in a multidisciplinary approach. The identified subphenotypes and mental disorders of the post-COVID period can be used as corrective targets in rehabilitation. Введение. Отсроченные последствия, ассоциированные с COVID-19, оказывают значимое влияние на состояние здоровья населения. Лидирующие позиции среди симптомов постковидного периода занимают нарушения со стороны нервной системы (21,7 %). При этом данных о психической структуре последствий SARS-CoV-2 на сегодняшний день недостаточно. В связи с этим целью исследования была оценка структуры и характера жалоб на состояние здоровья, а также нейропсихологических и патопсихологических нарушений у людей в постковидный период. Материалы и методы. В статье приводятся результаты расширенного анкетирования 1200 респондентов, которое было направленно на выявление основных общесоматических, психических и неврологических последствий, развившихся в период от 4 недель до 12 месяцев после перенесенного COVID-19. Другая часть описываемых результатов относится к экспериментально-психологическому обследованию 47 респондентов, случайным образом отобранных из основной группы исследования (n = 1200), включавшему оценку общего состояния когнитивных функций, памяти, внимания, гнозиса, праксиса, а также выраженности психопатологической симптоматики. Результаты исследования. С повышением возраста увеличивалась тяжесть протекания как острой фазы, так и отсроченных последствий перенесенной новой коронавирусной инфекции. Было выявлено семь субфенотипов нарушений в постковидном периоде, включающих в себя тревожные и сопряженные подобные явления (1), нервно-мышечные нарушения, сопряженные с болевым синдромом (2), нарушения дыхательной, сердечно-сосудистой и вегетативной систем (3), астенические явления (4), нарушения со стороны когнитивных функций (5), депрессивные явления (6), нарушения со стороны органов чувств (7). В рамках экспериментально-психологического обследования были выявлены следующие психические нарушения: снижение логической и механической долговременной памяти, снижение психической устойчивости, трудности пространственных гностических и праксических ориентировок, выраженность тревожных и депрессивных тенденций, склонность к навязчивым явлениям и выраженному дискомфорту от наличных соматических...

Currently, translation into clinical practice of scientific knowledge on pathological reorganization of brain mechanisms in psychiatric disorders, as suggested by functional neuroimaging data, remains limited. This situation calls for the exploration of new approaches, which were recently proposed for the combined use of the simultaneous application of psychodiagnostic testing and fMRI scanning. Consequently, a self‐rated psychodiagnostic scale was used as an experimental task during fMRI scanning for patients with major depressive disorder. Given the promising neuroimaging results obtained in these studies, in current research, our objective was to replicate these results and conduct an fMRI study using statements from the von Zerssen depression as experimental conditions. Eighteen patients with recurrent depressive disorder and healthy volunteers participated in the study to replicate the group size of previous research. The results obtained showed that patients with recurrent depressive disorder exhibited greater activity in the right precuneus and bilateral supramarginal gyrus than healthy controls while responding to diagnostically specific (DS) statements compared to diagnostically neutral (DN) ones. These findings replicate the main results of the original study and emphasize the potential of this approach in the field of translational psychiatry. In addition, they contribute to understanding the pathophysiological mechanisms of depression through the use of this unique fMRI paradigm.

Language disorders are criteria of psychopathology diagnostics listed both in the 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the Diagnostic and Statistic Manual of Mental Disorders (DSM). However, structure and grammar remain understudied in this aspect, which makes structural analysis a relevant research topic. A structural analysis of written narrative may objectivize particular language disorders, thus facilitating psychodiagnostics of different mental disorders. The research objective was to describe the structural features of written narratives obtained from 127 patients with schizophrenic, bipolar, and personality disorders. The narratives were subjected to structural and statistical analyses. Schizophrenic narratives demonstrated a poor vocabulary, a low volume, and a high degree of formality with a passive narrator. Bipolar texts tended to be long, detailed, egocentric, and active, with multiple participles. Patients with personality disorders emotionally relived their memories, producing reflective written narratives with a lot of actors. The final list of written speech indicators to be used to distinguish between schizophrenic, bipolar, and personality disorders included such variables as text volume, verb tense, non-finite verb forms, first-person singular pronoun, number of actors, passive / active narrator, and laconic / detailed narration.