In order to study the point of view of doctors supervising patients with dementia regarding the methods and tactics of treating diseases that occur with severe cognitive impairment, their experience ...in the use of drugs and criteria for choosing a drug for long-term treatment of dementia, an online survey of 197 specialists was conducted.
The majority of Russian physicians surveyed prefer basic therapy for dementia, while the main criteria for choosing a drug for long-term therapy are effectiveness and safety of the drug. Despite the absence of drugs capable of complete curing of dementia, Russian doctors have certain expectations and goals when prescribing therapy, in particular, the hope for the longest possible preservation of the quality of life and capacity of patients, as well as slowing down the progression of the disease. 90% of respondents consider it necessary to continue (and even start) therapy even at a severe stage, despite the depletion of the effect. Memantine has become the main drug of choice in different regions of Russia as a drug with a wide range of registered indications, the fewest side effects and a low percentage of patient refusals.
The article notes that the Western model of civilization based on the cult of individual legal freedom, including a clear and optimistic picture of the future developing according to the laws of ...liberal progress based on this cult, has been significantly shaken in recent years due to the post-informational stage of development of society, and especially with the advent of the Internet. These factors contributed to the strengthening of distressing influences in society, leading to anxious expectations of the population as a reaction to the redundancy of the uncontrolled flow of information and, as a consequence, to the growth in the 21st century of the massive demand for global security. During the SARS-CoV-2 pandemic, biopolitical projects of total security have entered into the sphere of practical politics, with Western society failing to consider the issue of public security vs. human rights in an analytically impartial and critically free capacity as scientists, including specialists in the field of public health, did 10-15 years ago. The situation that has arisen reinforces the negative socio-psychological tendencies noted above. This circumstance makes it necessary to consider the situation of a pandemic from the point of view of the special role of its network information support and the nature of organizational and methodological measures aimed at combating disease.The article examines the socially destructive and socio-psychopathological aspects of the network era, fraught with the threat of the development of mass psychosis, which was most clearly manifested in the situation of a pandemic, regardless of the specific ideological attitudes of a particular social group. The network factor and organizational and methodological measures aimed at combating the coronavirus are analyzed in detail. It is concluded that it is necessary to correct the non-optimal trends that were revealed at the height of the network era both in public sentiment and in the actions of the authorities, in terms of a more effective fight against the SARS-CoV-2 pandemic. To this end, it is proposed to take into account the laws of the network era and be actively present in the Internet space, creating from within an informational counterbalance to the observed negative trends. Specific directions in the implementation of this work are listed.
•Negative coping is the main drinking motive among Russian women with HIV/HCV co-infection.•Social drinking is key drinking motive among Russian women with HIV/HCV co-infection.•Health effects of ...alcohol use was salient motive for drinking abstinence.•Clinicians were not consistently recommending drinking abstinence.
Alcohol use is prevalent among Russian women with HIV and hepatitis C Virus (HCV) co-infection despite alcohol's known harmful health effects for this population. Identifying factors that facilitate continued unhealthy alcohol use is critical to developing effective alcohol reduction interventions. This study assessed situational and motivational factors associated with unhealthy alcohol use among HIV/HCV co-infected women in clinical care in St. Petersburg, Russia.
Guided by the motivational model for alcohol use, we conducted 30 semi-structured interviews with women living with HIV/HCV co-infection to identify situational and motivational factors associated with unhealthy drinking and barriers and facilitators to abstaining. Interviews were recorded and analyzed using a thematic analysis approach.
Despite awareness of the health risks associated with alcohol use, many women reported heavy episodic drinking, particularly in social situations. A key motive for drinking was coping with negative emotions triggered by stressful situations, such as work- and family-related conflicts. Key situational factors included drinking with family and friends and in social situations. Women who endorsed negative drinking coping motives were the most motivated to stop drinking. Health concerns were also cited as reasons to stop drinking; however, few women reported that their doctors recommended that they abstain.
Several situational and motivational facilitators of alcohol use and barriers to alcohol reduction were identified, as well as some opportunities for prevention, among women in care for HIV in Russia. Awareness-raising and training regarding the adverse consequences of alcohol use among persons with HIV/HCV co-infection should include clinicians, patients and relatives.
The report is dedicated to the landmark work by V.A. Karlov “Epilepsy in children and adult women and men”, 2nd edition, released in 2019. Here, there are discussed crucial aspects underlying a ...theory and application for epilepsy treatment reflected in the monograph that underline a great importance for complete all-encompassing analysis of experience and advances in domestic and foreign epileptology described in the book.
The purpose of the study:
to give a comprehensive characteristic (clinical-immunological, psychosocial, psychopathological) of women with HIV / viral hepatitis C (HCV) co-infection, to determine ...the presence of structural and functional changes in the brain using neuroradiological research methods.
Material:
The main study group consisted of 200 women with HIV / HCV co-infection and 200 women diagnosed with HIV infection without HCV.
The criteria for inclusion in the study were: age from 18 to 45 years; the presence of a confirmed HIV / HCV co-infection or HCV monoinfection; the absence of the use of psychoactive substances (except alcohol) during 6 months prior to the study; non-pregnant.
Methods:
clinical; socio-demographic; laboratory; instrumental. In the future 36 women were selected from the main and comparison groups by the method of paired comparisons, identical to each other in age, at the initial stages of HIV infection, with a CD4 lymphocyte count of over 350 cells/µl; taking antiretroviral therapy for no more than 12 months; not receiving HCV antiviral therapy; without concomitant diseases; not using any substances during 6 months before the study. The studies of the structure and metabolism of the central nervous system were performedthem: magnetic resonance imaging (MRI) and positron emission tomography / computed tomography (PET / CT) with fluorodeoxyglucose (FDG).
Results:
Women with HIV / HCV, unlike women with HIV monoinfection, are more predisposed to the development of psychopathological conditions with a significant frequency of asthenic and anxiety disorders against the background of mild and moderate cognitive impairment, which is probably due to both the presence of concomitant HCV and the use of substances in the past. Patients with HIV / HCV revealed neuroradiological features in the form of vascular and HIV-encephalopathic changes, a high incidence of glucose hypometabolism. The relationship between the localization of signs of glucose hypometabolism and the identified anxiety, cognitive and insomniac disorders has been determined. The algorithm of examination and management of patients with HIV infection and HCV is proposed.
The COVID-19 pandemic imposed not only serious threats to the physical health of the population, but also provoked a wide range of psychological problems. The study was aimed to define the structure ...of anxiety in the population during the epidemic period, as well as to identify the most vulnerable social groups (including individuals with affective disorders) which were most in need of psychological and/or psychiatric help. The online survey of 1957 Russian-speaking respondents aged over 18 was carried out from March 30 to April 5, 2020. The anxiety distress level was verified using the Psychological Stress Measure (PSM-25), the stigmatization of individuals experiencing respiratory symptoms was assessed using the modified Perceived Devaluation-Discrimination Questionnaire (PDD; Cronbach's α = 0.707). In 99.8% of respondents, the combination of various concerns associated with COVID-19 was observed, the mean psychological stress score was increased to moderate level (score 104.9 ± 34.4), and the stigmatization score exceeded the whole sample median value (19.5±3.4; Me = 17). About 35% of respondents had concerns associated with anxiety distress (Cohen’s d = 0.16–0.39): these were the "risk of social isolation" and the "possible lack of medication for daily use". The following groups of respondents were the most susceptible to the stress: people with affective disorders, young people (aged ≤20), unemployed persons, single persons, people with no formal education, and women. Thus, the broad sectors of the population need correction of anxiety distress associated with the COVID-19 pandemic. Therefore, the measures’ implementation should be targeted, and in terms of coverage and content oriented to the identified vulnerable social groups.
Summary
. The aim of the study was to identify nosologically nonspecific signs of hospitalism in patients of a gerontopsychiatric hospital and to develop, on their basis, a method for screening ...diagnostics of hospitalism.
Materials and methods
. We examined 194 inpatients aged 55 to 91 years, hospitalism was detected in 102 people, 92 people made up the comparison group. The survey was carried out at the stage of preparation for discharge in the form of a semi-structured interview, supplemented by the collection of anamnestic and follow-up data.
Results
. The most common signs of hospitalism in this sample were the deterioration of the mental and somatic state before discharge (78% of the examined patients of the main group, a confidence interval (CI) of 68–85%), a long duration of the current hospitalization (73%, CI 64–82%), violations of compliance (73%, CI 63-81%), long duration of inpatient treatment in anamnesis (71%, CI 61-80%), deterioration soon after discharge (67%, CI 52-80%), a large number of hospitalizations during the entire period of illness (67%, CI 57-76%), lack of discharge intention (62%, CI 51-72%), tendency to increase the duration of hospitalizations (54%, CI 43-64%), high level of anxiety before discharge (50% , CI 34-66%), reduction in the intervals between hospitalizations (49%, CI 38-59%), p <0.05.
Conclusion
. The proposed methodology is intended for screening assessment of the presence of hospitalism and identification of the circle of persons for whom an in-depth assessment of social and psychological adaptation is advisable in order to prevent the adverse effects of hospitalization.
Many words, little scientific N. G. Neznanov; A. P. Kotsubinsky; D. A. Kotsubinsky
Obozrenie psikhiatrii i medit︠s︡inskoĭ psikhologii imeni V.M. Bekhtereva,
04/2021, Letnik:
55, Številka:
1
Journal Article
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