GENETICS OF PHOBIC DISORDERS

At present time, on the basis of genome-wide association studies (GWAS), several authors found linkage of phobic disorders with certain regions of chromosomes – 3q26 (agoraphobia), 14q13 (specific phobias), 16q21 (social phobias), 16q22 (social phobias) and 4q31-q34 (phobic disorders). We propose 19 genes that are localized in these regions and are expressed in the brain: PRKCI, CLDN11, EIF5A2, TNIK, CLCN3, CPE, GLRB, GRIA2, NEK1, NPY2R, NPY5R, RAPGEF2, TRIM2, SMAD1, ADGRG1, BEAN1, CDH8, DOK4 and KATNB1. Therefore, these genes may be investigated as candidate genes of phobic disorders. Various sources propose 26 potential candidate genes of phobic disorders. Finnish geneticist J. Donner carries out a meta-analysis to study the 8 most probable among them and corroborates statistical validity only for 4 genes: ALAD, CDH2, EPB41L4A and GAD1. First three genes are involved in the social phobias, and fourth is involved in whole phobic disorders. Phobias are heterogeneous and multifactorial diseases. To understand the biological mechanisms of such disorders, to create effective methods for their prevention and treatment, there are needed further intensive molecular genetic studies of these disorders on sufficiently large samples and corroborating these results by other authors.

Outlook of applying of virtual reality (VR) technologies in the treatment of patients with mental disorders (review of foreign literature)

The purpose of the study was to summarize data from foreign studies about the use of virtual reality (VR) technology in the treatment of patients with various mental disorders.Materials and methods: we selected and analyzed articles from MEDLINE / PubMed databases during the period from 2000 till 2020, as well as relevant references in the bibliography of the analyzed articles. 45 articles were included in further analysis from 575 English-language articles.Results: The use of VR technologies in the treatment of mental disorders appears to be one of the promising directions in psychiatry. The successfulness of these methods in patients with eating disorders, anxiety-phobic disorders, and obsessive-compulsive disorder is supported to be evidentiary information. There is evidence of the effectiveness of such methods in patients with schizophrenia, particularly, one of the most significant results is an increase in social functioning. The absence of side effects data makes it possible to consider t VR therapy as a safe method. It is needed to make further study the areas of application of VR therapy and conduct research to identify possible side effects of this method.Conclusion: The obtained results are important for drawing attention to the prospect of using VR technologies in Russian psychiatry and demonstrate the need for further study of this method.

The COVID-19 pandemic: risks to psychological well-being and mental health

The problematic article is devoted to the issues of psychological well-being and mental health in the context of the COVID-19 pandemic. The sociopsychological effects of pandemics that potentiate mental health disorders have been analyzed. The effect of the influence of the media and social networks on the mental state is considered. Quarantine, social distance and social exclusion have a negative impact on mental health and physical well-being. The growth of deviant forms of behavior, stigmatization, excessive mental stress on medical workers who are in the focus of a pandemic, and the non-standard state of medical institutions have been noted among the main factors that worsen mental health. The peculiarities of anxious and phobic disorders in the context of the COVID-19 pandemic have been described and analyzed in detail. It has been established that organic anxiety predominates in patients with COVID-19, having a number of clinical peculiarities (the predominance of somatic anxiety with an asthenic radical, high comorbidity with depression and hypochondria, cognitive deficit and the severity of vegetative manifestations). Pharmacogenic anxious and depressive effects have been described with the use of antiviral agents. The peculiarities of the treatment of patients with anxious and phobic disorders in the situation of the COVID-19 pandemic are the use of Internet technologies (psychoeducation, psychotherapy) and the discussion of specific problems and fears at psychotherapy sessions. Timely diagnosis, therapy and prevention of mental and behavioral disorders that occur during an outbreak of infectious diseases is a priority for successfully overcoming both the immediate and longterm effects of the COVID-19 pandemic and the mental health of all segments of the population. Keywords: COVID-19, pandemic, risk, psychological well-being, mental health, anxiety, phobias

Problems of depression and auto-aggressive manifestations in cancer patients

Purpose. To study the clinical features of non-psychotic depression and autoaggressive manifestations (AM) in cancer patients and to identify ways of improving the quality of medical support indicated patients. Materials and methods. Clinical and paraclinical methods xamined 30 women with tumors of the female reproductive system ІІ-ІІІ stages: cervical cancer (C52) cancer of the vagina (C53) at age of 42 to 65 years (mean 47±0,5), who asked to diagnostic and treatment in the Department of radiotherapy of the National cancer Institute in a month or more after the establishing of cancer diagnosis, and outpatients treated with depressive complaints and the AM, to the Department of psychiatry and narcology of Bogomolets National Medical University. These patients are examined by oncologists, gynecologists, internists, neurologists, psychiatrists, endocrinologists, using clinical-psychopathological, clinical-dynamic, catamnestic, paraclinical methods, followed by radiation therapy, chemoradio therapy, psychopharmacotherapiy and psychotherapy. Catamnestic observation lasted from one to two years. Results and discussion. AM was diagnosed in 30 of the women surveyed in the cancer (C52; C53) with depression underneurotic and stress-related disorders (ICD -10; F4). Highlighted anxious (n = 12; 40%), astheno-subdepressivee (n = 7; 23,3%), phobic (n = 6; 20%), dysphoric (n = 5; 16.7%) syndromes. About half of the 12 (40%) patients had accentuation of character, disharmony of personality and psychopathic traits. Thus, patients with the cancer dominated by anxious-depressive, subdepressive and phobic disorders, rarely dysphoric disorder, which was confirmed by the aggregation (p <0.05; p <0,05-0,01). Conclusion. In cancer patients with cancer (C52, C53) with depression and isdominated by AM, anxiety-depressive, astheno-subdepressive and phobic disorders, rarely dysphoric disorder (ICD-10; F4) that worsen the medical condition, prognosis and treatment of the underlying disease, reduce the quality of life of patients, increase the risk of suicide. The solution of this problem requires integration of efforts oncological, psychological, psychiatric and other institutions in the unifiedstate strategy.

Mechanisms of changes in dynamical complexity of physiological signal patterns

The monograph is a continuation of the development of the concept of reducing the dynamic complexity of physiological rhythms in the event of a pathological condition. The results presented in the monograph represent new evidence of the change in this complexity in various disorders of the functional state of the central nervous system, and give an understanding that only a complex application of a combination of nonlinear dynamics and wavelet analysis methods to the analysis of physiological signals allows, firstly, to identify statistical significant differences in the structure of the patterns of the studied signals for a healthy person and a person with functional disorders, and, secondly, to determine the biophysical mechanisms of changes in the dynamic complexity of these patterns when the functional state changes. The biophysical mechanisms underlying the change in the dynamic complexity of patterns of electrical activity of the brain and involuntary hand oscillations in the event of pathological conditions associated with anxiety-phobic disorders, vascular disorders, epileptic injuries, motor dysfunctions, and neuropathic pain are considered. It is shown that in the case of multifractal signals, these mechanisms are associated with a change in the degree of correlation of patterns due to the occurrence of fluctuations in sequential signal values, and in the case of non-fractal signals, with the occurrence of bifurcations leading to a change in oscillation modes. The possibility of using wavelet, multifractal and recurrent characteristics of EEG patterns and involuntary hand oscillations is demonstrated to assess the effectiveness of psychotherapeutic treatment in pain syndrome in patients with anxiety-phobic disorders, to find the degree of deviation of a person’s motor function from the norm and to reliably distinguish between parkinsonian and essential tremors. The mechanisms of structural rearrangements in the patterns of tremor arising during the performance of a motor task are revealed, and an explanation is obtained for the decrease in this complexity with an increase in the degree of deviation of a person’s motor function from the norm. The molecular mechanism underlying the change in the dynamic complexity of the patterns of impulse activity of sensory neurons in the event of an antinociceptive response has been identified. The monograph is addressed to both biophysicists, neurophysiologists, and clinical practitioners, since the research results presented in it allow assessing the degree of disorders of the functional state of the nervous system and represent new approaches to the diagnosis of these conditions. The monograph includes a detailed description of modern methods for analyzing the dynamics of non-stationary physiological signals and can be used by graduate students and researchers specializing in the study of the structure of dynamic changes in complex signals generated by physical, chemical, biological or economic systems.

Chapter 3. Mechanisms of changes in dynamic complexity of EEG patterns underlying correction of psychogenic pain in anxiety-phobic states

The third chapter explains the mechanisms for correcting anxiety-phobic states. For this, the changes occurring in the EEG patterns during the presentation of a painful stimulus and in the process of eliminating the pain sensation using the psychorelaxation technique in healthy individuals are considered; and these changes are compared with changes in EEG patterns during patients’ feelings of psychogenic pain and during its removal using psycho-relaxation techniques. It has been shown that the mechanisms underlying the correction of psychogenic pain in anxiety-phobic states are associated with changes in the dynamics of successive EEG values and the degree of their multifractality. With successful correction in the process of psychorelaxation in persons with anxiety-phobic disorders, there is a transition to the values of multifractal parameters characteristic for healthy people.

Panic and Phobic Disorders

Panic and phobic disorders are among the most common psychiatric syndromes. Panic disorder is a chronic illness characterized by recurrent, acute panic attacks, which are discrete episodes of anxiety or fearfulness with definite onset, rapid increase, and spontaneous termination. Phobic disorder is a chronic condition dominated by one or more phobias. Different types of phobias include specific phobias (e.g., fear of animals), social phobias (e.g., fear of public speaking), and agoraphobia (fear of being in places where help might not be available in the event of an anxiety attack). Panic disorder and agoraphobia are currently diagnosed independently of one another, but previously these diagnoses were linked diagnostically (panic disorder with or without agoraphobia and agoraphobia without panic disorder).