Wilson's (Wilson–Konovalov) disease (WD) is a chronic progressive disease resulting from impaired body copper metabolism with damages to target organs (liver, brain, and kidneys). The paper describes a clinical case of organic delusional (schizophrenia-like) disorder in a patient with WD. The characteristic feature of its psychiatric onset in the patient is schizophrenia-like disorders in the absence of neurological and gastroenterological symptoms. Because of this onset of WD, patients have not received specific treatment for a long time (frequently before the appearance of the Kayser–Fleischer rings or the occurrence of cirrhosis). Thus, the diagnostic search should include WD in young patients with a primary psychotic episode. The search for early effective methods for WD verification is of interest for further investigations.

Мета роботи – аналіз методів та засобів навчання, направлених на оптимізацію викладання дисципліни “Психіатрія. Наркологія” на кафедрі психіатрії, загальної та медичної психології Державного закладу “Дніпропетровська медична академія Міністерства охорони здоров’я України”. Основна частина. Враховуючи розповсюдженість психічних розладів в Україні та світі, постала необхідність змінити ставлення у студентів медичних вузів до проблем, якими десятиліттями займалися лише лікарі-психіатри. Для підвищення якості освіти, інтересу до предмета, а також задля розвитку у студентів нестандартного, творчого мислення на кафедрі психіатрії, загальної та медичної психології ДЗ “ДМА” широко застосовуються такі завдання, як кросворди, кейси, в тому числі і відео­кейси, рольові ігри. Для оцінки ефективності запропонованих форм оцінки знань студентів було розроблено уніфікований опитувальник. Для виключення суб’єктивності при оцінці цих знань, а також для оптимізації і стандартизації роботи викладачів, введена багаторівнева система навчання і оцінювання, яка заснована на так званих “рівнях навчання” за В. П. Беспальком. Висновок. Постійне вдосконалення процесу викладання дозволяє поглиблювати знання майбутніх лікарів з дисципліни “Психіатрія. Наркологія”.

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Background. The presence of chronic pain in the structure of hip avascular necrosis hurts the patient's mental state, causes chronic postoperative pain, and reduces the quality of life. Treatment of nonpsychotic mental disorders may be a therapeutic strategy to reduce risk factors for health-related quality of life and satisfaction with treatment outcomes. Successful rehabilitation of patients with hip avascular necrosis consists of restoring the functions of the affected joints and providing the necessary psychological assistance, through the available nonpsychotic mental disorders and gender-age features. The study aimed to determine the gender age and socio-demographic characteristics of patients with aseptic necrosis of the femoral head, which may act as predictors of the risk of developing non-psychotic mental disorders. Methods. 137 persons with aseptic necrosis of the femoral head were examined: 92 (67.2%) men and 45 (32.8%) women, the average age was 52.01 ± 11.29 years. In addition to the clinical-psychopathological and socio-demographic examination were used the Beck depression inventory, the Beck anxiety inventory and Teilor's Manifest Anxiety Scale, the Beck hopelessness scale, and the Toronto alexithymia scale (TAS-20) were. Results. It was found that 25.8% (17/66) of people with higher education were engaged mainly in manual labour, but at the time of the survey, only 7.6% (5/66) were working. It was found that there is no difference in the levels of depression prevalence depending on gender and age. Anxiety levels at a young age are higher in females, but gender and age differences in the prevalence of anxiety levels have not been identified. Among the examined patients, a high level of alexithymia was found in all age and gender groups. There is a tendency for a higher level of hopelessness in young females compared to males.

Aseptic necrosis of the femoral head (ANFH) is a severe chronic poliaethiologic disease of the hip joint which is prevalent mainly in young people with a loss of professional and social skills. It is known that the non-psychotic mental disorders appearance in patients with ANFH can lead to the increasing disability, the decreasing in the quality of life, and difficulties in organizing the rehabilitation period. Current researches prove that the preoperative mental state assessment in patients can lead to the statistically significant decrease of the pain intensity in the postoperative period, an improvement in the quality of life related to health, a decrease in anxiety, depression and behavioural problems in the postoperative period. The aim of this research was to study the syndromic features of non-psychotic mental disorders, alexithymia and anxiety levels in patients with ANFH at the preoperative stage. The study involved 137 people aged 25 to 75 years, who were diagnosed with ANFH and identified non-psychotic mental disorders. Clinical-psychopathological and psychodiagnostic methods of examination were used (AUDIT test, Toronto alexithymia scale-20, Taylor manifest anxiety scale). The patients were divided into two groups depending on the ANFH duration. The results of the study revealed the main leading syndromes: asthenic-depressive – in 35.8%, depressive-hypochondriac – in 18.2%, anxious-phobic – in 16.1%, anxious-depressive - in 15.3% and astheno-apathetic – in 14.6% of cases. The average anxiety score was 26 (19; 37), which indicates the presence of a medium-high level of anxiety in the examined, while 52.5 percent of patients had high and very high levels of anxiety. A multivariate logistic regression analysis was performed and as a result, the duration of the disease (OR: 2.23; 95% [CI]: 1.11-4.47; p<0.05), estimates of alexithymia (OR: 2.52; 95% [CI]: 1.00-6.36; p<0.05) and female sex (OR: 2.16; 95% [CI]: 1.03-4.50; p<0.05) were found to be independent risk factors associated with the level of anxiety in persons with ANFH at the preoperative stage.

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The article presents the results of a study of the quality of mental life in patients with avascular necrosis of the femoral head and non-psychotic mental disorders. The aim of the work was to study the mental component of the quality of life in patients with avascular necrosis of the femoral head and non-psychotic mental disorders and to determine the predictors that influence its formation. A study of 137 people was conducted, of which 96 reached the end of the study. The Short Form Health Survey (SF-12) quality of life questionnaire was used to assess the mental component of quality of life. The SCL-90-R scale, Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI) and Taylor Manifest Anxiety Scale (TMAS), Beck Hopelessness Scale (BHS), and Toronto Alexithymia Scale (TAS-20) were also used. The determined psychopathological and psychometric factors that influenced the quality of life of patients with avascular necrosis of the femoral head and non-psychotic mental disorders made it possible to develop a logistic model for predicting the achievement of an average level of the mental component of the quality of life in the postoperative period. The mental component of qua lity of life at the preoperative stage, the general index of severity of psychopathological symptoms according to the SCL-90-R method, the presence of anxiety-depressive or apathy-abulic syndromes and alexithymia according to the TAS-20 method acted as predictors. The resulting lo- gistic model has an outstanding predictive ability: AUC = 0.849 (95 % CI 0.761—0.914), p < 0.0001, sensitivity — 77.78 % (CI 60.8—89.9) and specificity — 78.33 % (CI 65.8—87.9).

The purpose of this review was to study the mechanisms of development, clinical features and treatment of psychotic disorders during the disease caused by the SARS-CoV-2 virus. In the first part of the review, especial attention was paid to the available literature data on the mechanisms of development of mental disorders in COVID-19. Among the main pathogenetic mechanisms of the onset of psychotic disorders in coronavirus infections, there are direct effects of a viral infection (including a brain infection), cerebrovascular diseases, hypoxia, an immunological response, the consequences of medical interventions, social isolation, the psychological impact of a severe and potentially fatal illness, fears of infecting another’s and stigmatization. The second part of the publication is devoted to a review of clinical studies and syndromokinesis in infectious and coronavirus psychoses. Particular attention is paid to delirious syndrome, including pharmacogenic delirium and antibiotic-associated encephalopathy. The article describes the features of therapy for psychotic disorders in COVID-19, taking into account drug‑drug interactions and the effect on the cardiovascular and respiratory systems. The analyzed literature allows us to make a reasonable conclusion that the management of coronavirus psychoses should be aimed at treating the underlying disease while eliminating psychotic symptoms with antipsychotics while ensuring maximum safety of psychopharmacotherapy.