Structural analysis of interrelations of pathoharacterological features of persons prone to criminal impulsive aggression

Psychometric testing of persons undergoing a complex forensic psychological and psychiatric examination in cases related to criminal impulsive aggression was carried out: mentally healthy persons, persons with personality disorders, persons with organic mental disorders who have committed crimes against life and health. Psychometric testing included diagnostics of predisposition to certain types of aggressive actions (Bass-Darka hostility questionnaire in the adaptation of S. N. Enikolopov) and the severity of certain personality structures associated with impulsive aggression - anxiety (Spielberger-Khanin anxiety scale), locus of control (a variant of J. Rotter - assessment of the level of subjective control (LSC)), the desire to seek new sensations and experiences. One of the main methods was also the questionnaire of the structure of temperament by V.M. Rusalov, allowing to explore the properties of temperament in the subject and in the social spheres. The results were processed using correlation analysis, the obtained correlation coefficients were visualized using the method of constructing correlation pleiades. It is shown that the structure of interrelationships of indicators of psychometric testing is specific in the studied groups, the features of the relationship of personality structures with aggressive tendencies are described both in mental health and in mental disorders that do not exclude sanity.

Analysis of disability due to organic mental disorders for 2019 in the Republic of Mordovia

Background. The trend of recent years is a steady increase in mental illness among the population. according to the statistics of the ministry of health of the russian federation, mental disorders were classified as socially significant diseases in russia in 2018. Thus, the absolute number of patients with a first-time diagnosis of a mental disorder who applied for counseling and treatment in the Russian Federation in 2018 was 379818, which is 3.4% more than in 2017. [20,21,22,23,24] the number of patients with a first-time diagnosis of " mental disorder (except for diseases related to the use of psychoactive substances)" taken under dispensary observation in the republic of mordovia in the same year was 35.5 per 100,000 population. In addition, mental illnesses are in third place among disabling diseases, second only to malignant neoplasms and diseases of the circulatory system. In the structure of repeated disability by class of diseases, this group of diseases is 9%, and the lion's share falls on people of working age. Thus, there is a steady increase in mental illnesses, as well as disability due to them [1], [3]. The question arises of the need to study the patterns of disability formation in order to further develop theories and concepts of ways to protect human health, prevent disability, assess the rehabilitation potential and prognosis, develop rehabilitation measures that improve social adaptation and integration of patients in the family and society. The aim- study of the patterns of disability formation due to organic mental disorders in the Republic of Mordovia, taking into account age characteristics and severity of disability, which is important for the development of comprehensive measures for the prevention of morbidity, early diagnosis and rehabilitation of this group of people. Materials and methods. The analysis included information from the statistical collections of Rosstat and approved forms of state statistics No. 7-sobes for 2019. The data of all first-time persons recognized as disabled due to mental disorders in the Republic of Mordovia for 2014-2019 on the basis of the ITU information base for the Republic of Mordovia are analyzed using a continuous method. Results. Having analyzed the data of all first-time persons recognized as disabled due to mental disorders in the Republic of Mordovia for 2014-2019 on the basis of the ITU information base for the Republic of Mordovia, it was concluded that a significant place in the structure of disability is occupied by organic mental disorders. The percentage of people with organic mental disorders among those first recognized as disabled 18 years and older over the past five years is significant and stable, ranging from 20.1 (in 2017) to 25.1 (in 2014). In the structure of patients who were diagnosed with disability with this diagnosis, there is a predominance of repeated patients over primary ones (by 23.6 %), and it should be noted that this pathology is more common in men (71% of the total number of persons (or in the population) with the above diagnosis). Patients with both primary and re-recognized disabilities with a diagnosis of "Organic mental disorder" were more often assigned to the third group of disability (62% of cases among primary, 57.4% among repeated). Also, the third group of disability prevails regardless of the patient's gender. The study of age-related features of disability due to organic mental disorders in the Republic of Mordovia in 2019 showed that organic mental disorders are most often found in the working-age population. In addition, the proportion of young people (from 18 years to 44 years) is high, it is 59.2% for men, 50% for women. Conclusions. Given the steady increase in mental illness and disability as a result of it, it is necessary to study the theories and concepts of medical and social expertise and rehabilitation of patients suffering from mental disorders. The role of fundamental and applied research in the field of medical and social expertise and medical and social rehabilitation is significant in order to create ways to protect human health, prevent disability, and develop factors that improve social adaptation and integration of patients in the family and society. in order to develop such concepts, it is necessary to study the structure of disability, the patterns of formation, and the peculiarities of the influence of age and gender factors.

Association of alcohol dependence syndrome with clinical and psychological characteristics of suicidal behavior in individuals with organic mental disorders and aggressive behavior (moral and ethical features)

Purpose of the study: to study the association of alcohol dependence syndrome with the clinical and psychological characteristics of patients with organic mental disorders, aggressive behavior, and suicidal attempts. Materials and methods: we examined 842 patients with organic mental disorders, addictive disorders and aggressive behavior who made a suicide attempt from 1991 to 2018 in the Tyumen region, which were divided into two groups: 1) 421 patients who were diagnosed with an organic mental disorder (in categories F06.6, F06.7, F06. 8, F07.8): 201 men and 220 women; 2) 421 people with organic mental disorders of the above categories and alcohol dependence (F10.242, F10.252, F10.262): 208 men and 213 women. Results and discussion. According to the data of the clinical conversation, the structure of subjective indicators characterizing various disorders of the neuropsychiatric state was described in individuals with high and low levels of factors contributing to the development of suicidal behavior. When assessing the relative risk of factors contributing to the development of suicidal activity, when comparing the indicators of the clinical and mental status of men and women of the studied groups, a 95% confidence interval was determined: mood instability (1.34), psychosomatic complaints (1.03), sleep disorders (1.09), interpersonal interaction problems (1.02), psychopathic (1.48), depressive (1.11) reactions and self-esteem inadequacy (1.05). Conclusions: when comparing the indicators of the neuropsychiatric status in persons with organic mental disorders, aggressive behavior and addictive disorders who have committed suicide attempts, more than half (75.6%) of the examined persons revealed a high level of factors for the development of suicidal activity: 38.0% of women and 37.6% of men. Clinical and psychological parameters were significantly (p < 0.001) characterized by: mood instability (12.4%), difficulties in interpersonal interaction (11.6%), prenosological neurotic (8.5%), psychopathic (8.9%) and depressive (6.2%) reactions. The results obtained can be used to develop effective prevention and rehabilitation measures using digital resources.

The comparative analysis of clinical and social characteristics of patients with schizophrenia and organic mental disorders receiving care in partial inpatient units

The article presents the results of a comparative analysis of the clinical and social characteristics of patients with schizophrenic spectrum disorders (SSD) and organic mental disorders (OMD) who received care in day hospitals and intensive psychiatric care units (Moscow). During the study, a random sample of 487 discharge epicrises was studied, of which 392 (80,49%) were patients with SSD and OMD, who were subjected to further analysis. The study revealed gender differences and low rates of labor and family adaptation in both nosological groups of patients. The highest percentage of patients observed on a long-term basis in neuropsychiatric dispensaries and the rate of hospitalization in a round-the-clock inpatient unit were among the patients with diagnoses of schizophrenic spectrum disorders who were treated in intensive psychiatric care units. There were significant differences in the routing of patients depending on the pathology: district psychiatrists more often refer patients with a diagnosis of schizophrenia to the intensive psychiatric care unit in order to prevent hospitalization and patients with organic mental disorders - to day hospitals for therapy selection and medical and social rehabilitation, while doctors of the round-theclock hospital – vice versa (in order to continue treatment or follow up in out-of-hospital conditions). There was also a circulation of patients between the intensive psychiatric care unit and the day hospitals. Isolated episodes of compliance violations were noted. Indicative indicators such as hospitalization in a round-the-clock psychiatric inpatient unit within a year after the discharge from partial inpatient units was low and was usually due to severe continuous forms of the disease and the formation of therapy resistance in patients. Day hospitals and departments (offices) of intensive psychiatric care in general effectively perform the functions of inpatient unit substitution.

Major aspects of working-age population disability caused by mental disorders

The scientific review reveals the relevance of the problem of persistent disability in patients with mental disorders as one of the most important indicators of public health. It has been shown that organic pathology plays an important role in increasing of incidence of disability due to mental disorders in people of working age. In addition, the clinical and epidemiological data of recent years, confirming the large scatter of disability rates across regions and the poorly understood clinical factors that determine disability in organic mental disorders, are presented. The need for further study of predictors of health deterioration as well as risk factors for persistent disability in order to solve the problems of preventing disability and to develop personalized programs of medical and social rehabilitation is discussed.

Case Report: Organic Hallucinosis in Viral Encephalitis

Introduction : Organic mental disorders are diseases we need to put more attentionon because they are related to systemic disorders or disorders of the brain and cancause high mortality. Organic mental disorders often manifest in the form ofpsychiatric symptoms so that they can be treated too late because the physician isnot able to recognize the symptoms which can be fatal. Sequelae can be found inorganic mental disorders and may affect the patient’s quality of life, so a fast andproper management is needed to get a better outcome. Case presentation: A caseof organic hallucinosis in viral encephalitis had been reported in a 18 year-old malewith a history of sudden changes in behaviour. The symptoms appeared after thepatient had problems during OSPEK and was threatened by someone. The patientwas the only child in the family and often spoiled by his parents. Laboratory andimaging studies showed that there was a cerebritis in the CT scan result, a decreasein CD4 count, and an increase in anti-Rubella IgG titers in which the patient wasfinally diagnosed with viral encephalitis. Conclusion: The diagnosis of organicmental disorders can easily be overlooked in daily clinical practice so that patientsdo not receive proper management

Clinical and Social Characteristics of Patients with Schizophrenia and Organic Mental Conditions Who Committed a Repeated Socially Dangerous Act

Study Objective: To compare clinical and social characteristics of patients with schizophrenia and organic mental conditions who committed a repeated socially dangerous acts (SDAs), not only in order to compare, but also to identify specific SDA risk factors. Study Design: comparative study. Materials and Methods. The study included 86 schizophrenia patients (study group) and 45 patients with organic mental conditions who committed SDAs, were found insane and were forced to undergo various court-appointed therapies for 2 and more times. In this study, we used the clinical psychopathologic method with due account to psychopathology and clinical statistic method as the main methods. Study Results. Hereditary load study demonstrated that in the study group (А) 35 (40.7%) out of 86 patients had hereditary exogenous conditions (pi < 0.05), while in controls (B) 9 (20%) out of 45 patients had such conditions (pi < 0.01). The number of patients without hereditary load was comparable in both groups: 45 (52.3%) vs. 24 (53.3%), respectively. In schizophrenia patients, only 6 (7%) patients had confirmed hereditary endogenous conditions, while in comparison group (B) this value was 9 (20%). Combined hereditary load was recorded only in controls: 3 (6.6%) patients. Almost all patients in comparison group (B) did not have a place work (44 (97.8%); pi < 0.01), while in the study group (A) the unemployed made 44 (51.1%). During the study, 45 (52.3%) patients in group (A) had associated bad habits (alcohol and drug abuse); 14 (16.3%) patients had both alcohol and drug abuse. 23 comparison group (B) patients had various bad habits; combined abuses were recorded in 8 (17.8%) cases. Alcohol and drug abuse were not diagnosed in 20 (23.2%) patients in study group and in 4 (8.9%) patients in controls. Conclusion. Data analysis demonstrates the clinical-social factors are noted in study groups and affect criminal behaviour and a probability of repeated SDAs in the future (with identification of factors specific for each nosological factor group). We have also identified differences in risk factors of a repeated SDA between patients with organic mental disorders and schizophrenia. Keywords: schizophrenia, organic mental disorders, repeated socially dangerous acts.

Pathomorphism of HIV-associated mental disorders

The article considers HIV-associated mental disorders, biopsychosocial factors affecting their development and course. Positive intradynamic pathomorphism of organic mental disorders is revealed. It manifests itself in easier clinical dynamics of psychoorganic syndrome, slower deterioration and dominance of the asthenic version of psychoorganic syndrome.