The novel coronavirus 2019 (COVID-19) pandemic has affected not only the somatic health of people but also their mental health and the organization of mental health care. Self-isolation, quarantine, extensive media coverage of the situation, a large amount of inaccurate information, and conflicting recommendations – all this has led to an increase in admission of patients who have not previously had mental illness to psychiatrists. As a confirmation of the influence of the above factors on the population's mental health, we present a case report of a 25-year-old patient who first came to a psychiatric clinic due to the obsessive-compulsive disorder that developed due to the pandemic.
Approaches to treating cognitive-amnestic disorders of various origins, including Korsakoff's syndrome (KS), are currently being actively elaborated. KS is manifested by severe memory impairment, leading to disability. It is quite common in alcohol abusers. There is still no proven effective treatment for KS. In view of the fact that studies on the treatment of KS have been very few, there are no clear recommendations for its most effective treatment. There has been evidence that in addition to thiamine deficiency, the toxic effect of glutamate that is actively released through binding to NMDA receptors during the ethanol withdrawal period is the basis for KS development. Memantine, a noncompetitive NMDA receptor antagonist, has recently been used successfully to treat KS. The paper describes a clinical case of a 55-year-old patient with KS treated with akatinol memantine, in which the latter has demonstrated its high efficacy and good tolerance. Analysis of the data available in the literature and the presented clinical case suggest that it is advisable to prescribe memantine for patients with alcohol-related memory impairment.
Objective: to study the clinical features of mental disorders during the COVID-19 epidemic in those who turned to psychiatrist for the first time, as well as in patients with already diagnosed mental illness.Material and methods. We examined 100 patients who turned to psychiatrist due to deterioration of their mental state on the background of a pandemic. Of these, 50 were new cases (1st group; 23 women and 27 men, mean age 34 years) and 50 were cases with previously diagnosed mental disorders (2nd group; 25 women and 25 men, mean age 37 years). 80% of patients of the 1st group, 54% of patients of the 2nd group had coronavirus infection. Anxiety and depressive disorders prevailed in the 1st group, endogenous diseases prevailed in the 2nd group: bipolar affective disorder, recurrent depressive disorder, schizophrenia. The study was conducted by the clinical method using a specially designed map; the severity of depression was assessed using the Montgomery-Asberg Depression Rating Scale, and the severity of anxiety was assessed using the Hamilton Anxiety Rating Scale.Results. The clinical picture of primary and recurrent depressive episodes after infection was characterized by the presence of motor and associative retardation, severe apathy, hypersomnia and lack of sleep, fatigue, increased appetite, and complaints of impaired attention and memory. Depression in SARS-CoV-2 survivors was characterized by anxiety, anhedonia, irritability, somatic complaints, and hypochondriacal inclusions. Anxiety symptoms in those who were not ill included severe anxiety, reaching agitation, disturbed sleep with frequent awakenings, irritability, somatic complaints, and hypochondriacal fixation on one’s condition. In recovering patients, anxiety was accompanied by control of somatic functions, cognitive impairments, and fear of retention or even intensification.Conclusion. The results obtained indicate the existing differences between the mental disorders that first appeared and worsened during the pandemic, as well as the differences in the structure of the depressive and anxiety syndrome depending on the presence or absence of coronavirus infection.
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
Цель исследования -изучение причин и предикторов психических нарушений в период эпидемии COVID-19 у впервые обратившихся к психиатру, а также у пациентов с уже диагностированными психическими заболеваниями. Пациенты и методы. Обследовано 100 пациентов, обратившихся к психиатру в связи с ухудшением психического состояния на фоне пандемии, из них 50 -впервые заболевших (1-я группа) и 50 -с ранее диагностированными психическими расстройствами (2-я группа). Исследование проводилось клиническим методом с помощью специально разработанной карты с последующей статистической обработкой полученных данных.
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