Personality, Defense Mechanisms and Psychological Distress in Women with Fibromyalgia

Background: Previous studies have shown that many personality traits are associated with fibromyalgia (FM), worsening both the quality of life and psychological distress of patients. Despite the high comorbidity of psychopathological disorders in this syndrome and their association with immature defense styles, few studies have examined the defense mechanisms used by FM patients. The main aim of our study was to investigate personality traits and defense mechanisms in FM patients compared to in a healthy control group (HC). Moreover, we investigated the effect of personality traits and defense mechanisms on psychological distress in both FM and HC groups. Methods: A total of 54 women with FM and 54 healthy women completed the (1) Temperament and Character Inventory—Revised; (2) the Toronto Alexithymia Scale; (3) the Defense Style Questionnaire; and (4) the Hospital Anxiety and Depression Scale. Results: The results indicated that FM patients display higher alexithymia, higher harm avoidance, lower self-directedness, lower persistence, and the higher use of a maladaptive defense style compared to HC. We found that alexithymia, harm avoidance, and maladaptive defense style are significant predictors of patients’ psychological distress. Moreover, harm avoidance and adaptive defense style significantly predicted psychological distress in the HC group. Conclusion: The present study is the first to explore the contribution of both defense mechanisms and personality characteristics on the psychological distress of FM patients. Our findings have important clinical implications and may help diagnose and treat FM patients more in depth.

Non-Suicidal Self-Injury in the Decompensation of Personality Disorder in Adolescents During the COVID-19 Pandemic in 2020–2021

The aim of the study was to determine the clinical and psychopathological characteristics of non-suicidal self-injury (NSSI) in personality disorder (PD) in the comparative age-related aspect during the coronavirus infection (COVID-19) pandemic. Patients and methods: a total of 230 patients (177 males and 53 females) aged 16–25, diagnosed with PD and NSSI behavior manifestations, were studied retrospectively in mental hospital and outpatintly by using clinical-psychopathological method. All patients were divided into two equal groups of 115 people each. Group I was examined in 2017–2019, Group II — in 2020–2021 during the coronavirus infection (COVID-19) pandemic. Results: common features established in both groups were as follows: affective instability, alexithymia, conflict relations with significant others, and current traumatic experience. For a comparative assessment of NSSI in patients of both groups, we used the NSSI typology in adolescent PD, previously developed by the authors. Impulsive, demonstrative, addictive, depersonalizing and self-destructive types of NSSI were recognized as significant for the diagnostic assessment. In the second group of patients, that is, during the period of the COVID-19 pandemic, a change in the selected variants of NSSI was found, that is, in borderline and narcissistic PD the impulsive type was replaced by a demonstrative type, and in schizoid and anxious PD it turned into an addictive one. For a comparative assessment of NSSI in patients of both groups, we used the NSSI typology in PD in adolescence, previously developed by the authors. When assessing suicidality in group II, it was revealed that in most types of PD, with a decrease in the number of suicidal attempts, there was a noticeable increase in the incidence of NSSI with demonstrative suicidality, which correlated with the trajectories of the identified variants of NSSI. Conclusions: the study underlined the role of personality pathology in in adolescence in the development of psychopathological disorders with NSSI and their high association with suicidal activity. The modification of various NSSI variants in the context of a coronavirus infection (COVID-19) pandemic may be due to the unique characteristics of the psychotraumatic factor. With the same strength of impact, the multidirectional influence on various personality types and comorbid psychopathological disorders in adolescence should be taken into account, when creating new models of therapeutic and socio-rehabilitation interventions for the adolescent contingent of patients.

Prevalence of Child Sexual Violence in Brazil in the Period 2010-2018: an Ecological Study

Violence is characterized as a sociocultural phenomenon that can affect the individual physically, psychosocially and cognitively. Child sexual abuse is one of the biggest public health problems, however, its prevalence is still undefined. It is also the cause of several psychopathological disorders and future difficulties in the context of the victim's interpersonal and sexual relationships. To describe the prevalence of child sexual abuse in Brazil in the of period 2010 – 2018. Descriptive ecological study, whose data were obtained by consulting the SINAN database, made available by DATASUS. Where cases of child sexual violence between 0 and 14 years old were selected from 2010 to 2018. A steady progression was evidenced in all regions and in almost every year, in cases of sexual violence. The North and South regions have the highest prevalence. Cases were more frequent in females (82.7%), between 10 and 14 years old (49%), with the main aggressors being parents (13.8%) and stepfathers (12.9%). The prevalence of child sexual violence is higher among children aged 10 to 14 years, female and the cases are more concentrated in the north region. Keywords: Childhood Abuse, Sexual. Epidemiology. Child. Resumo A violência é caracterizada como um fenômeno sociocultural que pode afetar o indivíduo em âmbito físico, psicossocial e cognitivo. O abuso sexual infantil é um dos maiores problemas de saúde pública, porém, sua prevalência ainda é indefinida. Sendo também causador de diversos transtornos psicopatológicos e dificuldades futuras em âmbito de relações interpessoais e sexuais da vítima. Portanto o objetivo do presente estudo é descrever a prevalência do abuso sexual infantil no Brasil no período de 2010 - 2018. Trata-se de um estudo ecológico descritivo, cujos dados foram obtidos por meio de consulta à base de dados SINAN, disponibilizados pelo DATASUS. Onde foram selecionados os casos de violência sexual infantil, de 0 a 14 anos registrada no período de 2010 a 2018. Foi evidenciado uma progressão contínua em todas as regiões e em quase todos os anos, nos casos de violência sexual. As Regiões Norte e Sul apresentam maior prevalência. Os casos eram mais frequentes no sexo feminino (82,7%), entre 10 e 14 anos (49%), sendo os principais agressores pais (13,8%) e padrastos (12,9%). Pode-se concluir que a prevalência de violência sexual infantil é maior entre crianças de 10 a 14 anos, do sexo feminino e os casos estão mais concentrados na região Norte. Palavras-chave: Abuso Sexual na Infância. Epidemiologia. Criança.

Emotional intelligence and anger in adolescents with obsessive-compulsive symptoms

Poor perception, understanding and regulation of emotions often play a key role in the development and maintenance of psychopathological disorders. The aim of this study was to analyze differences in attention, compression, regulation of emotion and anger, taking into account some variables that may influence results (age, anxiety and depression). Participants were 315 adolescents (213 boys and 102 girls) aged between 12 and 18 years old (M= 14.92, SD= 1.98), high (≥ 90th percentile) and low (< percentile 21) ratings in obsessive-compulsive dimension in The Symptom Check List (SCL-90-R; Derogatis, 1975). Statistically significant differences between groups were observed in emotions and anger variables except internal expression of anger and physical expression of anger. Age, anxiety and depression influenced some variables. These findings are relevant for treatment.

THE PROBLEMS OF OLDER PEOPLE AND DIRECTIONS OF MEDICAL, SOCIAL AND PSYCHOLOGICAL SUPPORT DURING THE COVID-19 PANDEMIC

В обзорной статье рассмотрены медицинские, психологические и социальные проблемы людей пожилого возраста в связи с пандемией. Продемонстрировано негативное влияние хронического стресса на формирование психопатологических расстройств (тревога, астения, паника, когнитивная дисфункция). На основании результатов собственного клинического опыта лечения и психологической коррекции этих психопатологических расстройств у людей старшего поколения, переживавших пандемию, а также по итогам аналогичных результатов других исследователей в разных странах, проведён анализ методов психологической поддержки при различных психопатологических расстройствах у пожилых людей. На основании результатов собственных исследований в период пандемии выявлено увеличение частоты астении и психосоматических расстройств у пациентов. Представлены алгоритмы дифференциальной диагностики и лечения астении в рамках постковидного синдрома. Описаны особенности опыта самоизоляции для пожилых людей в разных странах, проанализированы причины психической дезадаптации, формирования аддикций. Продемонстрированы алгоритм и итоги психологической поддержки, оказанной людям старшего поколения в формате работы организации социально-психологической помощи. The review article examines the medical, psychological and social problems that older people face due to the pandemic. The article contains the analysis of the mortality rate in the older age group in different countries. It also demonstrates the negative impact of the pandemic stress on the formation of psychopathological disorders (anxiety, asthenia, panic, cognitive dysfunction). The authors carried out an analysis of psychological support methods for various psychopathological disorders among the elderly, based on both the results of their own clinical experience in the treatment and psychological correction of the disorders of older people experiencing the pandemic, and similar results of other researches in other countries. The results of the presented research during the pandemic suggest that the frequency of asthenia and psychosomatic disorders in patients was increased. The paper presents algorithms for the differential diagnosis and treatment of asthenia as part of the post-covid syndrome. The article contains an objective scientific and practical assessment of the experience of self-isolation for the elderly, as well as the analysis of the reasons for mental maladjustment and the formation of addictions. The algorithm and the results of psychological support, provided to older people by a psychosocial support organization, are demonstrated.

Association of Mental Fatigue due to Long-term Restrictive Measures with Reasoning: A COVID-19 Study

Coronavirus Disease 2019 broke out in China at the end of 2019 and spread rapidly around the world. In response, many countries have adopted social distancing and lockdown measures. But restrictive measures resulted in many unwanted psychological consequences, including mental fatigue. Mental fatigue in turn is very likely to cause psychopathological disorders and cognitive malfunctions. A cognitive ability that is likely to be affected by mental fatigue is reasoning, while high reasoning ability is a prerequisite for compliance with restrictive measures. The present study aims to explore the association between mental fatigue and reasoning under the impact of long-term restrictive measures. The findings indicated that mental fatigue correlates negatively with cognitive reflection, while it has no significant association with general reasoning. The results also showed that mental fatigue correlates positively with the misperception of the preventive measures and negatively with the incomprehension of the restrictive measures. The implications of the results have been discussed.

СУЧАСНІ МОЖЛИВОСТІ ЗАСТОСУВАННЯ ДЕТОКСИКАЦІЙНИХ ЛАЗЕРНИХ ПРОГРАМ ПРИ КУПІРУВАННІ ЗАПІЙНИХ ФОРМ АЛКОГОЛІЗАЦІЇ

In recent years, there has been a significant complication of the clinical picture of somatoneurological and mental status of patients with intoxicated forms of alcohol dependence. The aim of the study was to clinically evaluate the effectiveness of the innovative complex in the complex and the development of a therapeutic algorithm for its use in drug practice. The object of our scientific and practical interests in recent years has been modeling, testing and implementation of a new generation of non-drug and pharmacological methods of treatment of acute and urgent drug pathology, and its consequences, creating a set of innovative laser treatment and rehabilitation programs. The therapeutic efficacy of the laser infusion therapeutic complex was evaluated using pre-treatment rating scales, first, third and fifth days of treatment. In the course of therapy a clinical and laboratory study, general blood and urine tests, biochemical blood test were performed. Based on the data, we can conclude about the high efficiency of laser infusion detoxification as a means of alleviating the drunken form of alcohol dependence. The rate of reduction of somatoneurological and psychopathological disorders was significantly higher in the case of using an innovative treatment module based on laser technology than in the process of therapy with traditional drugs. Clinical interpretation of the obtained results in the main group allowed recording the tendency to a more pronounced positive dynamics, which manifested in a smoother disappearance of post-intoxication symptoms. In our opinion, the main clinical feature of the laser complex is the differences in the intensity of the positive therapeutic effect, indicating the presence of pronounced detoxifying properties. Thus, the therapeutic effects of the proposed laser detoxification program are extremely necessary to alleviate the drunken form of alcohol dependence in drug practice. The obtained results expand the current possibilities of etiopathogenetic therapy and allow recommending the inclusion of the developed method in complex therapeutic and rehabilitation programs for the treatment of drug addicts.

Health of Immigrant Children: The Role of Immigrant Generation, Exogamous Family Setting, and Family Material and Social Resources

Although the children of first-generation immigrants tend to have better health than the native population, the health advantage of the children of immigrant families deteriorates over generations. It is, however, poorly understood where on the generational health assimilation spectrum children with one immigrant and one native parent (i.e., exogamous families) lie, to what extent family resources explain health assimilation, and whether the process of assimilation varies across health conditions. We seek to extend our understanding of the process of health assimilation by analyzing the physical and mental health of immigrant generations, assessing the role of exogamous family arrangements, and testing the contributions of family material and social resources to children's outcomes. We use register-based longitudinal data on all children residing in Finland, born in 1986–2000, and alive in 2000; these data are free of reporting bias and loss to follow-up. We estimate the risk of receiving inpatient and outpatient care for somatic conditions, psychopathological disorders, and injuries by immigrant generation status. Our results show evidence of a negative health assimilation process, with both first- and second-generation immigrant children having a higher prevalence of physical problems and particularly mental health problems than native children that is only partially explained by family resources. We find that the children of exogamous families are at especially high risk of developing psychopathological disorders. These results provide strong support for the hypothesis that children of exogamous families constitute a specific health risk group and that the impact on children's health of family social and material resources seems to be secondary to other unobserved factors.

Effectiveness of neurotropic therapy in the treatment of non-psychotic mental disorders in patients who have suffered a cerebral stroke

The purpose of the study: to clarify the prevalence of non-psychotic mental disorders in the population of patients suffered a cerebral stroke, and to assess the potential use of neurotropic drugs for the correction of certain types of psychopathological syndromes. Materials and methods: 180 patients were examined in the recovery period of brain stroke (the average duration of stroke was 20.7±6.6 months): 78 men and 102 women aged 39 to 90 years (the average age was 64.8±11.2). All patients underwent neuroimaging, experimental psychological research and a psychiatrist’s examination. Results: as a result of the survey, almost all patients in the recovery period of a brain stroke (90.5%) were found non-psychotic mental disorders with a predominance of psychoasthenic syndrome and mnestic-intellectual disorders that develop because of the predomimamt lesion of the brain frontal lobes. As a result of isolated neurotropic therapy, several therapeutic tasks were solved: treatment of focal neurological deficit, reduction of asthenia and the severity of mnestico-intellectual disorders, reduced drug load on the patient. Conclusion: the majority of patients in the recovery period of stroke have various psychopathological disorders, but due to somatic burden can not always receive psychotropic therapy. In this case, it is important to use new approaches to the correction of psychopathological disorders. The use of isolated neurotropic therapy has shown high efficiency in correcting the psychopathological component of stroke, which allows solving several rehabilitation tasks. Research on various aspects of post-stroke mental disorders can help identify additional opportunities for personalized and safe treatment of patients who have suffered acute stroke.

Clinical case of Guillain-Barré syndrome associated with COVID-19

Background: The coronavirus infection caused by SARS-Cov-2 is characterized by a damage to many organs and systems of the human body. To date, convincing information has been obtained about the involvement of various parts of the nervous system in the pathological process in patients with COVID-19. Among the most frequently described impairments, there are disorders of smell and taste, common disorders of the central nervous system, characterized by general cerebral symptoms, such as headache, asthenization, psychopathological disorders. One of the rare and severe forms of the peripheral nervous system damage in COVID-19 is Guillain-Barre syndrome (GBS), characterized by acute post-infectious inflammatory polyneuropathy with an autoimmune etiology. Clinical case description. We present a clinical case of GBS associated with COVID-19. The disease debuted as a peripheral tetraparesis with a progredient course of up to 21 days. Systemic administration of immunoglobulin stopped the disease progression. The association of GBS with COVID-19 was clarified a month after the disease onset, when bilateral polysegmental pneumonia was diagnosed, and a high level of IgG to the S-protein of SARS-CoV-2 was found, 3 times higher than the level of IgM, which indicated the duration of the disease was not less than three weeks. Conclusion: The GBS development upon infection with SARS-CoV-2 may precede the lung damage. The debut of GBS during the COVID-19 pandemic requires the exclusion of the SARS-CoV-2 etiological role in each case.