Пандемия новой коронавирусной инфекции продолжается уже два года. Вирус мутирует, появляются новые штаммы, что приводит к рецидивам эпидемии и колебаниям показателей заболеваемости и смертности. Несмотря на появление вакцин, увеличение мощностей стационаров и подготовку системы здравоохранения к новым волнам заболевания, коронавирусная инфекция SARS-CoV-2 остается одной из главных причин временной утраты трудоспособности и ухудшения соматического здоровья населения. Кроме того, инфекция наносит существенный вред психи-ческому состоянию людей [1]. Социальное и экономическое влияние COVID-19 больше, чем предыдущих глобальных пандемий, что не может не сказываться на психическом благополучии населения [2]. При этом нельзя не отметить неблагоприятное влияние самой инфекции на центральную нервную систему и, как следствие, на психическое состояние [3].За два года опубликовано большое количество исследований, посвященных проблеме психических нарушений в период пандемии. Однако в начале эпидемии в связи О Б З О Р Ы 75
Atypical depression (AtD) is contrasted with classical endogenous melancholic depression and is characterized by the presence of its uncharacteristic abnormalities, but the list of the latter varies from individual symptoms (increased appetite, weight gain, drowsiness, weakness, and anxiety) and their concurrence to syndromes accompanying depression (anxiety-phobic, obsessive-compulsive, panic attacks, derealization-depersonalization, hypochondriacal syndrome). In accordance with the DSM-5 diagnostic criteria, AtD is a symptom complex that includes mood reactivity and at least two of the following symptoms: hyperphagia, hypersomnia, lead-palsy, and personality sensitivity. AtD has been described within a variety of disorders: recurrent depressive disorder, bipolar affective disorder, dysthymia, cyclothymia, and psychogenic depression. The paper describes a clinical case of atypical depressive syndrome within the framework of type 2 bipolar disorder in a 51-year-old patient. AtD was concurrent with dermatitis herpetiformis (Dühring's disease) in some depressive episodes; it was accompanied by various somatic complaints in other cases. The latest episode of AtD occurred during the COVID-19 pandemic and included obvious reactive anxiety-phobic disorders. A detailed clinical and psychopathological analysis of history data, mental state, and ongoing therapy was carried out, which clearly reflects difficulties in the differential diagnosis of AtD and the use of adequate treatment.
Objective: to compare depression treatment efficacy with and without antidepressants (ADs) in men and women with bipolar affective disorder (BAD).Patients and methods. We enrolled 100 patients with BAD (F31.3–F31.5 according to ICD-10), including 50 women aged 33.0 [23.0; 50.2] years and 50 men aged 37.5 [29.5; 47.2] years using prospective and retrospective methods. Various antidepressants, normothymics, antipsychotics combinations were used to treat depression. We performed a comparative analysis of treatment efficacy with and without antidepressants in men and women subgroups. Clinical assessment at the baseline and the end of 1, 2, 4, 6-th week of therapy (or at discharge) included a specially developed clinical examination chart and the following psychometric scales: Montgomery-Asberg Depression Rating Scale (MADRS), Clinical Global Impression – Severity of illness (CGI-S), Clinical Global Impression – Improvement (CGI-I).Results and discussion. Women tended to have a slower improvement in the condition compared to men. Maximum reduction in MADRS score and a CGI-I, CGI-S higher frequency of clinical improvement and remission was observed in men and women who did not receive antidepressants than patients who did not receive antidepressants. When BAD type was included in the analysis, in patients treated with antidepressants, transient symptoms of the opposite pole occurred in 24.7% of patients of both sexes with bipolar affective I disorder (BAD I) and in 16.8% with bipolar affective II disorder (BAD II). There were no significant gender differences in patients with BAD I, while women predominated in BAD II group (22.5% compared to 7.8% men). No significant treatment-emergent affective switch was observed with tricyclic antidepressants and selective serotonin and norepinephrine reuptake inhibitors in both groups (21; 16.7; 16.7% in men and 28; 21.8; 12.5% in women, respectively). The assessment of intermission revealed that women were significantly more likely to have shorter periods between phases (42% compared to 22% in men). In addition, women were significantly more likely to have shorter periods between phases (42% compared to 22% in men) when the intermission duration was included in the analysis. In some patients with severe depression and infective first-line therapy (anticonvulsants and atypical antipsychotics), antidepressants prescription can increase treatment effectiveness. However, several factors should be considered, such as BAD type and variant, depression severity, treatment-emergent affective switch in history, and gender.Conclusion. A decision about antidepressants' dosage and treatment duration requires a dynamic follow-up of the patient in order to discontinue the antidepressants as fast as possible and decrease the risk of treatment-emergent affective switch and shortening of remission period.
A study of the attempt to publish regional Soviet encyclopedias of the 1920s-1930s has revealed that a majority remained unfinished, in part because of the suppression of the local history movement all over the country. Referencing archival documents, the author studies the history of preparation and publication for the Ural Soviet Encyclopedia, which was cancelled after publication of the first volume. The author scrutinizes the destructive role of censorship in regional publishing, demonstrating how local history proved incompatible with the ideology of the ruling party. Finally, the article provides information on the authors of the Encyclopedia.
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