Background. Itch is a key dermatological symptom with variety of clinical characteristics, provoking and etiological factors, as well as consequences, including its impact on psychological parameters. Previously, we have proposed an integrative psychodermatological typology of itch based on the assessment of its duration and impact on quality of life. Aim: Based on a comparative clinical and psychometric assessment, to rank by severity the types of itch previously identified according to the chronicity criteria and impact on quality of life, taking into account their associations with psychosomatic characteristics (anxiety, depression, dysmorphophobia, perceived stress, and stigmatization), and to determine the predictors of a patient getting into the groups with severe types of itch. Methods: This was a multicenter, cross-sectional observational study conducted in three outpatient dermatology clinics from November 2021 to December 2024. During the initial study step, 203 patients with itch were selected for subsequent analysis from those with atopic dermatitis (n = 106), psoriasis (n = 101), acne (n = 104), melanocytic nevi (n = 105), melanoma (n = 88), and skin toxic reactions to anti-tumor treatments (n = 93). Based on a two-step cluster analysis of seven quantitative characteristics of itch (intensity, numerical rating scale), frequency, impact on everyday life, communication with others, sleep, life satisfaction and mood (5PLQ), as well as one categorical variable qualifying itch as acute / chronic (less / more than 6 weeks), we have identified four itch clusters (types): 1) chronic itch with a little impact on quality of life; 2) acute itch with a little impact on quality of life; 3) acute itch with a strong impact on quality of life; 4) chronic itch with a strong impact on quality of life. In this study (step 2), the types of itch identified were compared depending to the severity of associated psychosomatic disorders according to psychometric evaluation for anxiety (GAD-2), depression (PHQ-2, both parts of PHQ-4 anxiety and depression screening scale), for perceived stress (PSS-10), stigmatization (PSQ), and dysmorphophobia (DCQ). We also looked for predictors of severe itch types. Results: The study included 203 patients with itch and various dermatoses and skin neoplasms, as well as skin toxic reactions to antitumor therapy (71.9% women, median age 45 years, 95% confidence interval [CI]: 30–60 years). The patients with the identified four types of itch did not differ in terms of education (p = 0.07), marital status (p = 0.653), employment (p = 0.124), and body mass index (p = 0.192). There were significant differences between the patients with different types of itch on all the scales used and the parameters evaluated, with an increase in parameters from cluster 1 to cluster 4, respectively, as follows: the median total score of anxiety and depression (PHQ-4: 3,00; 3,00; 5,00; 8,00; p 0,001), anxiety score (GAD-2: 2; 2; 3; 4; p 0.001), depression (PHQ-2: 1; 1; 3; 3; p 0.001), dysmorphophobia score (DCQ: 5; 5; 5; 11; p 0.001), stigmatization level (PSQ: 11; 16; 17; 26.5; p 0.001), the proportion of patients with depression (17.7; 17.8; 51.4; 65.9%; p 0.001), anxiety (15.2; 28.9; 51.4; 65.9%; p 0.001) and dysmorphophobia (6.3; 4.4; 17.1; 34.1; p 0.001) above diagnostic thresholds, the level of perceived stress on the PSS-10 scale (p 0.001). Dysmorphophobia parameters and the perceived stigmatization level were the predictors of more severe types of itch: an increase in these indices was associated with an increase in the odds ratio (OR) of getting into itch clusters 3 and 4 (OR 1.77, 95% CI: 1.33–2.36 and OR 1.66, 95% CI: 1.25–2.19, respectively). Conclusion: The validity of the previously proposed by us typology is confirmed by identification of statistically significant differences found in this study with the psychometric assessment of associated psychosomatic characteristics. The increments in the parameters from the 1st to the 4th cluster allow us to rank the previously selected types of itch according to severity: 1) chronic itch, which has little effect on quality of life, as mild; 2) acute itch with little effect on quality of life as mild-to-moderate; 3) acute itch severely affecting quality of life, as moderate-to severe; 4) chronic itch with strong effects on quality of life, as severe one. Differentiation of the types of itch by severity is of practical importance, since it allows us to reasonably identify groups of patients most severely affected by and potentially being in need of comprehensive interdisciplinary management.

The structural MRI of the cortex, subcortical structures, hippocampal subfields, and brainstem regions in patients with persecutory delusions in schizophrenia (ICD-10 code: F20) and delusional disorder (ICD-10 code: F22.0) were analyzed. Patients demonstrated multiple regions of decreased cortical gray matter thickness, reduced volumes of the left thalamus and some hippocampal sub-fields compared to mentally healthy subjects. No alterations in brainstem structures were found. The results were analyzed within the framework of the transnosological model of delusions.

Minisatellites are widespread tandem DNA repeats in the genome with a monomer length of 10 to 100 bp. The high variability of minisatellite loci makes them attractive for the development of molecular markers. Minisatellites are used as markers according to three strategies: marking of digested genomic DNA with minisatellite-based probes; amplification with primers based on the sequences of the minisatellites themselves; amplification with primers designed for borders upstream and downstream of the minisatellite locus. In this study, a microsatellite dataset was obtained from the analysis of the Citrus limon (L.) Osbeck genome using Tandem Repeat Finder (TRF) and GMATA software. The minisatellite loci found were used to develop molecular markers that were tested in GMATA using electronic PCR (e-PCR). The obtained dataset includes sequences of extracted minisatellites and their characteristics (start and end nucleotide positions on the chromosome, length of monomer, number of repetitions and length of array), as well as sequences of developed primers, expected lengths of amplicons, and e-PCR results. The presented dataset can be used for the marking of lemon samples according to any of the three strategies. It provides a useful basis for lemon variety certification, identification of samples, verification of collections, lemon genome mapping, saturation of already created maps, studying of the lemon genome architecture etc.

Plants of the Citrus L. genus are genetically closely related and crossbreed easily, forming interspecific hybrids. The pedigree of many cultivars (or groups of cultivars) can be difficult to trace, so molecular markers that detect polymorphism between Citrus plants are valuable tools for studying them. DNA markers developed using minisatellite loci are often effective in detecting polymorphism even between closely related genomes. The OrV890 minisatellite DNA marker recently developed in the Orange ‘Valencia’ genome was tested on 7 orange cultivars by electronic-PCR (e-PCR). In this study, the OrV890 marker was tested with 48 genotypes of Citrus genus using PCR and fragment analysis. These experiments showed the presence of PCR products for 21 samples and no amplification found for 27 samples. Eight alleles of the studied locus were detected. The fragments of 736 and 750 bp in length were found more frequently than others, while the 771 (in Myrtle-leaved bitter orange), 867 (Lime ‘Kaffir’ and Orange ‘Canaliculata’), 756 (Orangelo ‘Chironja’), 760 (Lime ‘Palestinian sweet’), and 768 bp (Tangor ‘Honey Artounik’) alleles found rare. The 769 bp allele was observed in pomelo variety and their hybrids only. The absence of amplification was observed in lemon, kumquat, and some lime varieties, as well as in a whole group of orange varieties (American varieties), most mandarin varieties, and one grapefruit variety (‘Star Ruby’). Thus, the experimental results showed that the OrV890 marker can be useful for analysis of hybrids, establishing the origin of Citrus plant varieties, as well as for creating breeding programs and accelerating the breeding process.

OBJECTIVE:To develop a systematics of chronic delusional psychoses in schizophrenia and pathology of the schizophrenic spectrum that takes into account psychopathological structure (the mechanism of delusional formation) and the trajectories of the disease course (the ratio of negative/positive dimensions). MATERIAL AND METHODS:The study sample was recruited from the large Moscow psychiatric hospital in 2019-2024 and included 126 patients (94 male, 32 female, mean age 36.5±12.1 years) hospitalized with ICD-10 diagnosis of paranoid schizophrenia (F20.00) or delusional disorder (F22). A clinical-psychopathological method was used. RESULTS:The study identifies three variants of paranoid domains, the typology of which takes into account both the psychopathological structure and the trajectories of their development, which determine the dominance of predominantly negative or positive symptoms throughout the disease: 1) psychosis with delusional interpretations and predominant orientation of symptoms towards the negative pole of the schizophrenia psychopathology (n=37, 29.4%); 2) psychosis with hallucinatory delusions and predominant direction of symptoms towards the positive pole of the schizophrenia psychopathology (n=50, 39.7%); and 3) «combined» hallucinatory-delusional psychosis with a simultaneous orientation of symptoms to the negative/positive poles of the schizophrenia psychopathology (n=39, 30.9%). Detailed phenomenological characteristics of each of the three presented variants are given. CONCLUSION:The developed three-component taxonomy confirms, on the model of chronic delusional psychoses appearing in schizophrenia and the pathology of the schizophrenia spectrum, the concept of simultaneous representation of two relatively independent domains determined by neurobiological processes in the schizophrenia psychopathology positive and negative disorders.

Introduction According to the two-factor theory of delusional belief (Coltheart. Ann N Y Acad Sci 2010; 1191 16-26), explaining the presence of a delusion requires a combination of two neuropsychological impairments. The first deficit initially prompts the delusional belief and defines its content, whereas the second deficit – aberrant belief evaluation – interrupts the rejection of a delusional belief and is common for different types of delusions. The second deficit is associated with compromised functioning of the right ventral frontal/anterior insular cortex (r-VF/AI; Darby et al. Brain 2017; 140 497-507). However, neural correlates of the first deficit in different types of delusions remain obscure. Objectives The aim of the study was to search for regions whose functional connectivity with r-VF/AI is different between patients with somatic delusions (SD) and persecutory delusions (PD) and to further clarify the results by comparing clinical groups with healthy controls. We hypothesized that each clinical group is characterized by aberrant functional connectivity between a region, associated with poor belief evaluation (r-VF/AI), and a region, presumably associated with a neuropsychological impairment specific to the corresponding type of delusions. Methods Patients with delusional disorder or paranoid schizophrenia (n = 23) and healthy controls (n = 9; 5 females; mean age 36.2 ± 1.3) underwent resting-state fMRI (Philips Ingenia 3T). Nine patients had SD (5 females; mean age 40.3 ± 7.9) and fourteen patients had PD (3 females; mean age 35.6 ± 10.2). The clinical groups were compared in terms of whole-brain functional connectivity of r-VF/AI (ROI-to-voxel analysis in CONN; RRID:SCR_009550; www.nitrc.org/projects/conn). Statistical thresholds were p < .005 voxelwise, p[FDR] < .05 clusterwise. Each clinical group was compared with controls in terms of functional connectivity between r-VF/AI and previously identified regions with between-group differences in connectivity (ROI-to-ROI analysis). Age was a covariate of no interest in all analyses. Results Patients with SD compared to patients with PD and healthy individuals had higher functional connectivity between the r-VF/AI and a cluster in the right precentral and postcentral gyri extending to supramarginal and superior frontal gyri (Figure 1). Image: Conclusions The regions whose functional connectivity with r-VF/AI was aberrant in patients with SD are involved in the processing of tactile, proprioceptive, and visceral information. Our results coincide with a suggestion that the evaluation of beliefs related to bodily sensations is disturbed in patients with SD. Research was supported by RFBR grant project 21-515-12007. Disclosure of Interest None Declared

BackgroundItch as the most common symptom in dermatology has been shown to be related to psychological factors such as stress, anxiety and depression. Moreover, associations were found between perceived stigmatization and itch. However, studies investigating the differences between patients with dermatoses with and without itch regarding perceived stress, stigmatization, anxiety and depression are missing. Therefore, one of the aims of the second study of the European Society for Dermatology and Psychiatry (ESDaP study II) was to investigate these relationships in a large cohort of patients with different itchy dermatoses.Results3399 patients with 14 different itchy dermatoses were recruited at 22 centres in 17 European countries. They filled in questionnaires to assess perceived stigmatization, stress, signs of clinically relevant anxiety or depression, itch-related quality of life, the overall health status, itch duration, frequency and intensity. The most significant association between the severity of itching and the perception of stress was observed among individuals with rosacea (correlation coefficient r = 0.314). Similarly, the strongest links between itch intensity and experiences of stigmatization, anxiety, and depression were found in patients with seborrheic dermatitis (correlation coefficients r = 0.317, r = 0.356, and r = 0.400, respectively). Utilizing a stepwise linear regression analysis, it was determined that within the entire patient cohort, 9.3% of the variation in itch intensity could be accounted for by factors including gender, levels of anxiety, depression, and perceived stigmatization. Females and individuals with elevated anxiety, depression, and perceived stigmatization scores reported more pronounced itch intensities compared to those with contrary attributes.ConclusionThis study underscores the connection between experiencing itch and its intensity and the psychological strain it places on individuals. Consequently, psychological interventions should encompass both addressing the itch itself and the interconnected psychological factors. In specific cases, it becomes imperative for dermatologists to direct individuals towards suitable healthcare resources to undergo further psychological assessment.

Introduction There is strong evidence that delusions are associated with cortical and subcortical structural alterations. However, whether these abnormalities differ in different types of delusions within schizophrenia spectrum disorders remains unclear. Objectives We aimed at exploring structural neural patterns underlying influence/persecutory delusions across diagnostic categories within the schizophrenia-spectrum disorders. Methods Twenty six right-handed patients with delusional disorder (n=7) and schizophrenia (n=19), presenting with delusions were divided in two clinical subgroups. The first one was presented with persecutory delusions (n=12, 20.2-55.4 years, mean age 36.0±11.6, 2 females) and the second with delusions of influence (n=14, 21.2-47.6 years, mean age 36.7±8.4, 2 females). The control group consist of 26 matched healthy controls (20.2-53.6 years, mean age 36.3±9.9, 4 females). All participants underwent structural MRI at 3T scanner. MRI images were processed via FreeSurfer 6.0 to quantify cortical thickness (CTh) and volumes for subcortical and brainstem (midbrain, pons, superior cerebellar peduncle and medulla) structures. Results Compared to healthy controls, patients with delusions of influence showed decreased gray matter thickness in 17 cortical regions (Figure, A), and decreased volumes of thalamus bilaterally (left: F(1,35)=9.0, p=0.005; Cohen’s d=−0.8; right: F(1,35)=8.0, p=0.008; Cohen’s d=−0.8), left hippocampus (F(1,35)=8.8, p=0.005; Cohen’s d=−0.8), midbrain (F(1,35)=11.0, p=0.002; Cohen’s d=−0.9) and pons (F(1,35)=8.2, p=0.007; Cohen’s d=−0.8). Conversely, patients with delusions of persecution showed decreased thickness only in 4 cortical regions of the right hemisphere (figure, B) and no alterations in subcortical volumes compared to healthy controls. No differences in cortical or subcortical measures between two clinical subgroups survived corrections for multiple comparisons. No correlations between structural alterations and total PANSS or BABS scores were found in either clinical groups. Figure. Clusters of decreased cortical thickness according to atlas of Desikan et al. (2006) in delusions of influence (A) and delusions of persecution (B) subgroups compared to healthy controls. Image: Conclusions The findings suggest that patients with delusions of influence have more pronounced cortical, subcortical and brainstem structural deficit as compared to patients with delusions of persecution. However, the limited sample size and the lack of correlations with clinical scores do not allow to conclude definitely whether the revealed structural abnormalities underlies delusions of influence, which should be elucidated via further research. This study was supported by RFBR grant 21-515-12007 Disclosure of Interest None Declared

INTRODUCTION:Hidradenitis suppurativa (HS) can severely affect the quality of life (QoL) and is linked to psychological distress, including anxiety, depression, and reduced self-esteem. Stigmatization due to physical appearance may significantly contribute to the psychological burden and impact on QoL for HS patients. This study investigates the association between stigmatization, depression, anxiety, and health- and disease-related variables among HS patients in Europe. PATIENTS AND METHODS:This observational cross-sectional multicenter study was conducted across 22 dermatological outpatient clinics in 17 European countries. Data collected included sociodemographic variables, general health variables, disease-related variables, perceived stigmatization (PSQ), and mental health (PHQ-2, GAD-2). RESULTS:Of the 5487 dermatological patients, 142 (2.6%) were diagnosed with HS, and data from 135 patients (70.1% women, mean age 38.2 years) who completed the PSQ questionnaire were analyzed. Scores on the stigmatization measure indicated that significant stigmatization levels were present in the sample. Linear regression models revealed a significant relationship between stigmatization and both the duration of HS and the presence of itch. Similar findings were noted for the PSQ "confused/staring behavior" scale with depression. The PSQ "absence of friendly behavior" scale was inversely associated with general health status, whereas the "hostile behavior" scale was positively linked to depression. CONCLUSION:HS patients experience significant stigmatization linked to disease duration, itch, and depression. Comprehensive management, including screening for psychosocial co-morbidity, is essential, as is providing access to psychological interventions that support patients to both manage internal distress and the potential reactions of others.

BackgroundDysmorphic concern is an overconcern with an imagined or slight defect in physical appearance that can be a symptom of body dysmorphic disorder (BDD). Appearance-related concerns are frequently reported by people with dermatological conditions. However, relatively little remains known about the relationship between dysmorphic concern and other variables within persons with different skin conditions.ObjectivesThe aim of this multicentre, cross-sectional study was to investigate gender differences regarding dysmorphic concern and the prevalence of BDD in a large sample of patients with skin conditions, in relation to sociodemographic, clinical and psychological variables.MethodsParticipants aged >= 18 years with skin conditions were consecutively enrolled in dermatological clinics of 22 European centres. Dysmorphic concern and the possible presence of BDD were measured using the Dysmorphic Concern Questionnaire (DCQ) and compared between men and women in relation to sociodemographic, clinical and psychological variables, and separately for each skin condition.ResultsThe DCQ questionnaire was completed by 5290 dermatological patients. In all categories, mean scores were significantly higher in women than in men. Mean DCQ scores were also higher in women for most skin conditions, with the highest effect size in vitiligo. The percentage of patients who screened positive for BDD on the DCQ was 10.5%, 7.7% of men and 12.7% of women. The prevalence of BDD positive was 6.9% in patients with mild clinical severity, 11.1% for moderate and 19.1% for severe condition. In the multivariate model in patients with mild skin condition, the presence of BDD was positively associated with stress and stigma both in men and in women.ConclusionsDysmorphic concern and BDD were more frequent in women than in men with skin conditions. Both received and actual stigmatization might have an impact on body-related concerns, in particular in women, who may be more at risk for sociocultural reasons. image

Among functional neurological disorders functional dystonia (FD) is the most difficult to diagnose. We present an observation of a 44-year-old patient, who was observed for a long time with a diagnosis of cervical dystonia (CD) and received disability for this disease. The patient did not have typical manifestations of CD — repetitive stereotypical movements or postures of the head/neck, sensory trick, tonic tension of the neck muscles. For a long time, the patient experienced pain of various localizations and other manifestations of FNR. The psychiatrist regarded the condition as symptoms of a schizotypal disorder. An educational program, therapeutic exercises, and botulinum toxin management led to a decrease in the manifestations of FD. The issues of pathogenesis, diagnosis, differential diagnosis and treatment of FD are discussed.

OBJECTIVE:To compare socio-demographic, clinical and psychological characteristics and comorbid mental disorders in patients with chronic migraine (CM) and episodic migraine (EM).MATERIAL AND METHODS:Eighty patients with migraine (40 with CM (16 men and 24 women, mean age 33.5±6.1 years) and 40 with EM (9 men and 31 women, mean age 31.4±5.7 years) were examined. All patients were interviewed and tested with psychometric methods. Socio-demographic and clinical-psychological characteristics were determined in all patients. The psychiatrist assessed the mental status of patients and diagnosed comorbid mental disorders according to the ICD-10 criteria.RESULTS:Symptoms of depression, high levels of trait and state anxiety, and a tendency to emotional inadequacy of response were more common in CM patients than in EM patients (p<0.05). Mental disorders, predominantly of the anxiety-depressive spectrum, were more common in CM patients than EM patients (OR (95% CI)=2.54 (2.03 to 2.98, p<0.001). Seventy-five percent of CM patients had more than one psychiatric diagnosis, almost a quarter of CM patients had schizotypal disorder, which is significantly higher than in EM patients (OR (95% CI)=1.99; 1.03 to 2.42, p<0.001). There were more unmarried, single (without constant partner), unemployed, high-education patients in the CM group than in the EM group. The negative impact of headache on the daily activity of patients was significantly higher in the CM group than in the EM group (p<0.05).CONCLUSION:Mental disorders and psychological features (anxiety, depression symptoms, a tendency to emotional inadequacy of response) are more common in CM patients than in EM patients. The presence of these factors may contribute to the chronification of migraine.

Perceived stigmatization places a large psychosocial burden on patients with some skin conditions. Little is known about the experience of stigmatization across a wide range of skin diseases. This observational cross-sectional study aimed to quantify perceived stigmatization and identify its predictors among patients with a broad spectrum of skin diseases across 17 European countries. Self-report questionnaires assessing perceived stigmatization and its potential predictors were completed by 5,487 dermatology outpatients and 2,808 skin-healthy controls. Dermatological diagnosis, severity, and comorbidity were clinician-assessed. Patients experienced higher levels of perceived stigmatization than controls (p < 0.001, d = 0.26); patients with psoriasis, atopic dermatitis, alopecia, and bullous disorders were particularly affected. Multivariate regression analyses showed that perceived stigmatization was related to sociodemographic (lower age, male sex, being single), general health-related (higher body mass index, lower overall health), disease-related (higher clinician-assessed disease severity, presence of itch, longer disease duration), and psychological (greater distress, presence of suicidal ideation, greater body dysmorphic concerns, lower appearance satisfaction) variables. To conclude, perceived stigmatization is common in patients with skin diseases. Factors have been identified that will help clinicians and policymakers to target vulnerable patient groups, offer adequate patient management, and to ultimately develop evidence-based interventions.

OBJECTIVE:To establish clinico-pathogenetic ratios of delusional psychoses constituting the psychopathological space of paranoid schizophrenia and to determine clinical and pathogenetic validity of concepts of a single delusional psychosis (a model of chronic delusion with a staged course) and two endogenous delusional psychoses.MATERIAL AND METHODS:A sample consisted of 56 patients (19 women, 37 men; the average age 39.7±9.3 years; average duration of the disease 10.6±9.1 years) with a diagnosis of paranoid schizophrenia, continuous type of course (F20.00), developed at the age above 18 years. At the time of examination, the condition of the patients was determined by persistent delusional or hallucinatory delusional disorders. Clinical, pathopsychological, psychometric (SANS, SAPS, PANSS), immunological and statistical methods were used.RESULTS:The study substantiates a bimodal model of a single delusional psychosis with a polar arrangement of interpretive delusions and delusions of influence based on the phenomena of mental automatism, both in terms of the vector of development (toward the poles of negative/positive disorders) and in terms of the rate of progression. Psychopathological manifestations of interpretive delusions correlate with the slow evolving development of psychosis, the dimensional structure of the paranoid is limited to the limits of the delusional register; functional activity is represented by affiliation to negative changes, integration with personality anomalies ends with the transformation of positive disorders into pathocharacterological ones, corresponding to the post-processual development of the personality. Manifestation of delusional impact (syndrome of mental automatism) is manifested by the complication and maximum expansion of the spectrum of positive disorders; the dimensional structure is represented by a wide range of psychopathological disorders and is formed with the participation of processes of mental dissociation, reaching the level of delusional depersonalization; functional activity is high, which creates conditions for the formation of a «new» subpsychotic structure, a «psychotic character», which is an attenuated duplicate of delusional psychosis. In both groups of patients, a significant increase in the activity of inflammatory markers of leukocyte elastase (249.2 ((231.1-270.0); 272.2 (236.0-292.6) nmol/min∙ml) and alpha - 1 proteinase inhibitor (48.8 (46.0-55.0); 50.4 (42.1-54.8) IU/ml) was shown compared with controls (205.0 (199.8-217.3) nmol/min∙mL and 33.0 (31.0-36.0) IU/mL, p<0.01, respectively). In the group of patients with delusions of influence, an increased level of antibodies to S-100B was also observed (0.88 (0.67-1.0) opt.density units) compared with the control values (0.7 (0.65-0.77) opt.density units, p<0.05).CONCLUSION:The concept of the model is supported by the results of the immunological study, according to which interpretive delusions and delusion based on the mental automatism, indicates the different level of immunity tension, and a qualitative changes in immune reactivity (also due to different genetic burden).

OBJECTIVE:To unite within the framework of a single clinical entity (based on the model of hypochondriacal paranoia) phenomena of the somatopsychotic and hypochondriacal range, which, in accordance with modern systematics, are classified as various categories of psychosomatic, affective disorders and personality disorders.MATERIAL AND METHODS:The sample for analysis consisted of 29 patients (with the diagnosis of delusional disorder (ICD-10; F22.0 in ICD-10), 10 men (34.5%) and 19 women (64.5%), the average age was 42.9±19.9 years; men - 10 nab. (34.5%), women - 19 nab. (64.5%). The average duration of the disease iswas 9.4±8.5 years. The psychopathological method was used as the main one.RESULTS:The article forms an alternative concept of somatic paranoia based on the model of hypochondriacal paranoia. The fundamental difference between the construct of somatic paranoia is an obligate connection between somatopsychic and ideational disorders. Somatopsychic (coenesthesiopathic) symptoms do not exist as an independent (equivalent to the structure of somatic clinical syndromes) dimensions and are formed exclusively with the participation of ideational phenomena.CONCLUSION:In accordance with the presented concept, coenesthesiopathic symptoms within the framework of somatic paranoia act as a somatic equivalent of delusional disorders.

Background: the problem of diseases of the thyroid gland (TG) remains relevant. The clinical picture and prevalence of diseases, as a rule, is analysed depending on the nosological form and severity of endocrinopathy. However, the estimated cases of morbidity syndrome on the basis of modern systemic diseases, the alleged reasonable appointment of endocrinopathies with places — the outcome of the syndromic/functional situation of thyroid disease, are divided into suspected either hypo- or hyperthyroidism.Objective: analysis of publications on the birth of diseases in hypo- and hyperthyroidism with the earliest possible search depth (publications since 1835), aimed at identifying current problems and relevant characteristics.Material and method: according to the key features “hypothyroidism”, “hyperthyroidism”, “mental disorders”, “depression”, “anxiety”, “psychosis”, literary sources in the MEDLINE/PubMed Scopus, Google Scientist databases were significant and studied.Conclusion: as a result of the analysis of the literature, it was revealed that the number of studies of the prevalence of diseases among the population in thyroid diseases compared to other somatic diseases is small, and many questions about the relationship between mantal diseases and diseases of thyroid glands that are currently unresolved. The thyroid gland is limited to affective and anxiety symptoms/syndromes, and genetic belonging to certain categories (nosogenic, somatogenic, endoform) is not qualified. At the same time, a number of significant aspects of the problem are discussed: “common symptoms” of mental affiliation and thyroidopathy, duplicating/ imitating each other; psychopathological prodromes and “masks” of thyroid diseases; stress induction, such as in Graves’ disease; psychopathological disorders, such as non-psychotic and psychotic registries, with analysis of the characteristics of limb features for the use of the thyroid gland.

Uremic pruritus is a common symptom in chronic kidney disease and end-stage renal failure. In addition to physical discomfort uremic pruritus disrupts sleep, negatively affects the psycho-emotional state and quality of life. In this group of patients, the association of uremic pruritus with an increase in mortality due to any causes was demonstrated. At the same time, there are no standardized approaches to the treatment of uremic itching. There is also a special category of patients receiving antitumor therapy and developing dermatological adverse events, also potentially accompanied by itching. This article presents a case of uremic pruritus in a patient with papulo-pustular cutaneous reaction (grade II on a Scale Common Terminology Criteria for Adverse Events, CTCAE v 5.0) to the epidermal growth factor (EGFR) inhibitor cetuximab in combination with leucovorin and 5-fluorouracil for rectal cancer. Treatment of uremic pruritus with small doses of gebapentin (300 mg/day) led to complete regression of pruritus. Papulo-pustular rashes completely regressed after recommended systemic and topical therapy according to the severity of rush (doxycycline 100 mg 2 times a day for 5 days, cream with neomycin, natamycin and hydrocortisone 3 times a day for 7 days). Pruritus was absent during the next 6 months of follow-up. Antitumor therapy was not interrupted due to acneiform rush, and following supportive topical therapy allowed to control severity of exacerbations which did not exceed III grade according to CTCAE v 5.0 and did not require the addition of systemic therapy. Thus, therapy of uremic pruritus with gabapentin has shown was effective also in a patient with severe comorbid pathology. Supportive topical therapy consistent with the severity of papulo-pustular rash reduced the severity of exacerbations during following EGFR inhibitor therapy.

Introduction There is growing evidence to suggest that delusions in schizophrenia-spectrum disorders are associated with altered brain connectivity. Disruptions in long association fibers, such as the superior longitudinal fasciculus, are among the most consistent findings in psychosis. However, functional connectivity (FC) correlates of such structural alterations and their implications in delusional symptoms remains unclear. Objectives The study used a hypothesis-driven approach and aimed at exploring structural connectivity (SC) disruptions of the left superior longitudinal fasciculus (part with parietal terminations, SLFP) and their FC correlates in a group of psychotic patients with persistent delusions across diagnostic categories within the schizophrenia-spectrum. Methods Sixteen right-handed patients (23.1-53.8 years, mean age 39.6±8.5, 44% females) with delusional disorder (DD, n=10) and schizophrenia (SCZ, n=6), presenting with persistent delusions, and 16 matched healthy controls (23.0-56.4 years, mean age 38.9±11.1, 44%females) underwent diffusion-weighted 3T MRI (DW-MRI), while patients additionally underwent resting-state 3T fMRI (rsfMRI). DW-MRI data were processed via FreeSurfer6.0 and TRACULA to derive axial (AD), radial (RD) diffusivities and fractional anisotropy (FA) for left SLFP. rsfMRI data were processed with SPM12 and Conn v19c to calculate ROI-to-ROI FC between lateral prefrontal and inferior parietal components of the frontoparietal network (FPCN) according to Yeo atlas (Yeo et al. J Neurophysiol. 2011; 106(3) 1125-65), which is sought to represent cortical projections of the SLFP (Image). Partial rank-based correlation analysis (with age and sex as covariates, ppcor v1.1, R v4.2.1) was used to explore the associations between SC and FC measures involving the SLFP, PANSS and BABS scores. Results Compared to healthy controls, patients showed decreased AD in left SLFP [F(1, 28)=14.9, p=0.0006; Cohen’s d = −1.3, 95% CI: −2.1 to −0.5]. No RD or FA alterations were found. We revealed a correlation between AD in left SLFP and fronto-parietal FC within the FPN (r = 0.58, p = 0.031) in patients. Correlation between FC and PANSS total score (r = −0.54, p = 0.045) did not survived correction for multiple comparisons. No other correlations between SC or FC, chlorpromazine equivalents and clinical scores were revealed. Image: Conclusions The findings suggest that the structural connectivity disruptions of the SLFP may mediate FC strength within the FPN in patients with persistent delusions. However the limited sample size and the lack of correlations between connectivity measures and clinical scores do not allow to conclude definitely whether the revealed structural-functional connectivity pattern underlies delusional symptoms, which should be elucidated via further research. This study was supported by RFBR grant 21-515-12007 Disclosure of Interest None Declared

The purpose of this review is to correlate current data on the molecular mechanisms of action of the drug Nimodipine with its clinical effects and applicability in mental disorders belonging to the spectrum of affective pathology. The article discusses the prospects for using the calcium channel blocker nimodipine as a method of both mono and combination therapy for bipolar disorders with various types of course. Nimodipine is a selective blocker of voltage-dependent calcium channels, a dihydropyridine derivative. By blocking L type calcium channels, it prevents the entry of calcium ions into the cell. Due to its pronounced ability to penetrate the blood-brain barrier, it has a selective effect on brain neurons and has a vasodilating, antihypertensive and normotimic effect. Nimodipine blocks LTCC channels in brain neurons, thereby influencing synaptic plasticity, transmitter release and excitation-transcription coupling, which makes it possible to influence various clinical conditions with pathology in the area of affect, including bipolar disorders with ultra-rapid cycling, and also, in cases with high resistance and intolerance to other mood stabilizers.