Vol 3, No 4 (2022)


Comment on “Violence Against Psychiatric Trainees: Findings of a European Survey”

Chumakov E.M., Petrova N.N., Vadivel R., Bhugra D., Ventriglio A.
Consortium Psychiatricum. 2022;3(4):5-7
pages 5-7 views


The Effect of Untreated Illness in Youth Depression: A Cross-Sectional Study

Omelchenko M. ., Migalina V.V., Kaleda V.G.


BACKGROUND: The existing research has mainly focused on exploring how the duration of untreated psychosis eff ects the further course of the disease. By contrast, the duration of an untreated illness (DUI) in youth depression and its impact on the further course of the disease has remained scarcely investigated.
AIM: The current study aims to determine how the duration of untreated illness aff ects the severity of the symptoms during the fi rst depressive episode and the degree to which the symptoms are reduced after treatment.
METHODS: Fifty-two young male patients (15–29 years old) were examined. First, they were hospitalized with a severe without psychotic symptoms (F32.2) and moderate (F32.1) depressive episode. The Hamilton Depression Rating Scale (HDRS), the Scale of Prodromal Symptoms (SOPS), and the Scale for Assessment of Negative Symptoms (SANS) were used to achieve the research goals. The examination was conducted twice at the time of patient admission to the hospital and before discharge. Our statistical analysis was carried out with the Statistica 12 software. The Mann–Whitney U test was used to compare the diff erences between two independent groups. The Spearman’s rank correlation coeffi cient was used to uncover any correlation between how long the illness has remained untreated and the severity of its clinical symptoms.
RESULTS: All patients were hospitalized at the fi rst depressive episode. The average duration of an untreated illness was 35.8±17.0 months. The patients were divided into two groups: the fi rst group (59.6%, n=31), with a duration of the untreated illness of more than 36 months, and the second group (40.4%, n=21), with a duration of the untreated illness of less than 36 months. A cross-group comparison between the participants showed that the reduction of HDRS scores was signifi cantly higher in the second group (p=0.019) at the time of discharge, with no diff erences in the severity of depressive symptoms (p=0.544) at the time of admission. Comorbidity was detected in 83.9% of the patients in the fi rst group and in 42.9% of the patients in the second group. A greater therapy eff ectiveness was found to exist in the second group, as the depressive symptoms score on the HDRS scale (p=0.016; U=196.0) and prodromal symptoms score on the SOPS disorganization subscale (p=0.046; U=218.0) were found to have been reduced signifi cantly.
CONCLUSION: The study showed that DUI has an impact on the reduction of depressive, negative symptoms and symptoms of disorganization in youth patients at the fi rst depressive episode. A high level of comorbidity has been uncovered, confi rming that a variety of non-psychotic and psychotic disorders in youth manifest themselves in depression at a prodromal stage, causing diffi culties in establishing diagnoses and requiring subsequent verifi cation. Future research might need to focus on exploring depressive symptoms as predictors of mental disorders in youth patients.
Consortium Psychiatricum. 2022;3(4):8-17
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Epidemiological Study on the Early Detection of Mental Disorders in Young Children in Russia

Ivanov M.V., Boksha I.S., Balakireva E.E., Klyushnik T.P.


BACKGROUND: Assessing the risk of children developing mental, behavioral, and developmental disorders (MBDDs), including autism spectrum disorders (ASDs), as well as achieving early detection of such disorders, has become one of the most important undertakings for public mental health professionals worldwide.

AIM: This study aims to evaluate the risk of developing MBDDs and the prevalence of MBDDs among young children (18–48 months old) in Russia.

METHODS: A two-level epidemiological screening approach was developed and adopted for the purposes of this study. At the first level, the parents of all children between 18 and 48 months old were questioned using Russian national validated Screening Checklist for Parents for Identification of the Risk of Mental, Behavioral, and Developmental Disorders in Early Childhood in nine regions of Russia (Volgograd, Kirov, Moscow, Novosibirsk, Orenburg, Tver, Chelyabinsk, Yaroslavl, and Stavropol). At the second level, children identified at the first level of screening as being at risk of developing MBDDs were assessed by a child psychiatrist on a voluntary basis and diagnosed according to the International Classification of Diseases, Tenth Revision criteria.

RESULTS: The present study revealed that the risk of developing MBDDs stands at 13.07% or 1,307 cases per 10,000 child population aged 18–48 months, whereas the prevalence of confirmed MBDDs is 1.51% or 151 cases per 10,000 among a Russian child population aged 18–48 months.

CONCLUSION: Screening for the risk of developing MBDDs, including ASDs, in Russia among very young children is a promising area of preventive medicine. This initiative allows us to develop optimal algorithms for specialized care measures that could help prevent the development and aggravation of children mental health issues.

Consortium Psychiatricum. 2022;3(4):18-26
pages 18-26 views

The Prevalence of Autism Spectrum Disorders in the Russian Federation: A Retrospective Study

Ustinova N.V., Namazova-Baranova L.S., Basova A.Y., Soloshenko M.A., Vishneva E.A., Suleymanova Z.Y., Lapshin M.S.


BACKGROUND: There has been an increase in the prevalence of autism spectrum disorders (ASD) worldwide over the past decades. Studies have shown that the number of confirmed diagnoses correlates with the awareness of the disorder among the general public and the professional community, in particular, as well as the availability of formalized screening procedures and modern medical and educational tools for families raising children with ASD in regional population centers. Thus, comparing autism prevalence rates in regions of the same country helps identify regions with limited access to diagnostic services and adequate medical care.

AIM: To estimate the overall number of individuals meeting the diagnostic criteria for ASD in Russia and determine the differences in the number of registered individuals with established diagnosis in the constituent territories of the Russian Federation.

METHODS: We conducted a retrospective, observational study and analyzed data from official statistical reports (form 12 “Information on the Number of Diseases Registered in Patients Residing in the Service Area of a Healthcare Institution” for 2020–2021).

RESULTS: A steady upward trend in the number of individuals with autism has been observed since 2014 in the Russian Federation as a whole and in the federal districts, although the prevalence rates differ from the global median prevalence of ASD (all-Russian figure by almost 40 times). In addition, regional differences (by 104.5 times) in the frequency of the diagnosis have been revealed: from a minimum of 1.7 to a maximum of 177.7 per 100,000 population. The percentile distribution of the number of individuals with ASD that are followed-up at healthcare facilities in the constituent territories of the Russian Federation was in the interquartile range (25–75th percentile), below the 25th percentile, and above the 75th percentile in 38, 26 and 21 regions, respectively.

CONCLUSION: The study has shown significant differences in the ASD diagnosis rates by regions in the country against a backdrop of a low (compared to international data) number of registered cases of autism. The presented data suggest that, due to the lack of proper diagnosis, a significant number of individuals with ASD do not receive adequate medical care, nor do they receive social, psychological, or pedagogical support. Possible reasons for this probably include low awareness of new diagnostic approaches among psychiatrists; low level of involvement of pediatrics professionals in screening activities; and fear of stigmatization because of a psychiatric diagnosis in the absence of a developed medical care infrastructure that encompasses a social, psychological, and pedagogical support system for people with ASD.

Consortium Psychiatricum. 2022;3(4):28-37
pages 28-37 views

Predictors of Self-Harm Types in Members of Online Communities: Age As a Moderating Variable

Razvaliaeva A.Y., Polskaya N.A.


BACKGROUND: Deliberate self-harm includes direct and indirect behaviors that cause harm to the body. Various manifestations of such behavior (e.g., non-suicidal self-injuries) are prevalent in adolescent and youth populations, and they often serve as precursors of subsequent suicidal behavior. The interpersonal dynamics that lead to self-harm behavior remain understudied. Interpersonal sensitivity, defined as an anticipation of criticism and fear of rejection in one’s relationships with other people, may become one such factor.

AIM: The present study was conducted to investigate the relationship between interpersonal sensitivity, psychopathological symptoms, and types of self-harm.

METHODS: The sample (n=804, 17–35 years, M=23.3±4.6 years) was recruited in online communities. A survey developed by the authors was used to measure the types of self-harm. Other measures included the Interpersonal Sensitivity Measure and Symptom Checklist-90-R.

RESULTS: It was discovered that superficial self-injuries could be related to more severe types of self-harm, destructive for the body on the whole (e.g., risk-taking, deprivation, fasting, substance abuse). Fear of rejection and psychopathological symptoms emerged as predictors of both superficial self-injuries and self-destructive behavior. Although younger respondents (17–19 years old) were more likely to inflict on themselves superficial self-injuries, those who scored high on fear of rejection were more likely to report more severe self-destructive behavior. Acute psychological distress elevated this risk for both younger and older participants (27–35 years old).

CONCLUSIONS: The results of the study point at the important role the dynamics of interpersonal relationships plays in perpetuating self-harm.

Consortium Psychiatricum. 2022;3(4):38-51
pages 38-51 views


Community Mental Health Care in Aotearoa New Zealand: Past, Present, and the Road Ahead

Ramalho R., Groot S., Adams P.J.


The healthcare system in Aotearoa New Zealand is currently undergoing a far-reaching overhaul. When it comes to mental health reforms, it is helpful to look at the road ahead, while paying attention to the road behind. Policies and services concerning the mental health and addiction sectors have undergone various reforms; first, during the transition from a hospital-centered to the current community-based system, and second, in the successive attempts to improve this system. In this article, we provide an overview of the current mental health and addiction health care system. We also discuss the impact of colonization on community mental health, the emergence of community-based mental health and addiction policy and services in Aotearoa New Zealand, and the challenges along the way. Finally, we identify five key areas requiring special attention during the current period of reform. Over all, we believe there is broad support for reducing the emphasis on individualized approaches to mental wellbeing and moving all systems and structures towards models inclusive of social context, including approaches that incorporate service users’ perspectives, family, communities, and culture. We look forward to policy and services with a much stronger orientation to the diverse needs of our population.

Consortium Psychiatricum. 2022;3(4):53-62
pages 53-62 views

Recent Developments in Community-Based Mental Health Care in Japan: A Narrative Review

Iwatani J., Ito J., Taguchi Y., Akiyama T.


BACKGROUND: Since the 1950s, mental health care in Japan has been hospital-centered. A set of legislative initiatives were undertaken in 1995, emphasizing the importance of community-based mental health care. However, despite these attempts to develop a community-based mental health care system, the rate of inpatient-based treatment has remained high and the shift from hospital-centered care to community-based has still not fully materialized.

AIM: This study aims to conduct a review of the available literature on the development of community-based mental health care in Japan between 2010 and 2020.

METHODS: We conducted a standardized literature search in the electronic database Igaku Chuo Zasshi, aiming to identify original studies published between 2010 and 2020 that explored community mental health care in Japan. The included studies’ outcomes were categorized as performance surveys, service user reports, service provider reports, and educational activities. A descriptive-analytical method was implemented in the current review.

RESULTS: A total of 25 studies were examined. Six studies reported surveys assessing the performance of community-based mental health care on the assertive community treatment (ACT), compulsory treatment, home-visit nursing care, physical complications, and a welfare medicine collaboration on a remote islands. Four studies investigated the perspectives of service users or their families on home-visit nursing care, social participation, community program, and legislative revision. Ten studies focused on social withdrawal, service providers perspectives on local population needs, supporting skills, care programs, and the professional growth of psychiatric social workers. Five studies focused on educational approaches for future healthcare professionals and efforts to improve mental health literacy among adolescents.

CONCLUSION: This paper provided the first comprehensive review of Japan’s community-based mental health care. Between 2010 and 2020, community mental health care in Japan evolved in many directions, with the understanding that various needs should be met. Home-visit nursing care and ACT can be considered as the most thoroughly investigated and better developed. Research that adopt rigorous methodologies such as randomized controlled trials is required if the goal is to achieve solid conclusions.

Consortium Psychiatricum. 2022;3(4):63-74
pages 63-74 views


DC:0–5™ Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Promotion in Russia

Skoblo G.V., Trushkina S.V.


The purpose of the report is to inform the community of Russian pediatric mental health professionals about the international DC:0–5™ Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: its purpose, target age, structure and content of diagnostic axes, as well as about the steps already taken domestically to promote the Classification in Russia. We show that the diagnostic Classification is the brainchild of leading foreign experts in the mental health of children and that it is based on an analysis and extrapolation of a large body of clinical data from around the world and covers a wide range of mental disorders experienced by children during their first five years of life. The interdisciplinary focus of DC:0–5™ is emphasized, as well as the presence in it of a crosswalk to the DSM-5 and ICD-10 systems, and the possibility to supplement these classifications taking into account the age specificity of disorders. It was made note that this diagnostic classification is almost unknown among Russian specialists. The report briefly touches on the results of the research activities of the interdisciplinary research group of the Scientific Center for Mental Health (Moscow) carried out in the period between 2002 and 2017 and aimed at analyzing the diagnostic approaches proposed in the Classification and testing them on Russian sample populations. The release of the Russian version of DC:0–5™ in 2022 by the non-profit organization Caritas Social School (St. Petersburg), with the official consent of the DC:0–5™ developer and in cooperation with the Faculty of Psychology of St. Petersburg State University, and an accompanying DC:0–5™ introduction course developed by this team for Russian child mental health professionals were announced.

Consortium Psychiatricum. 2022;3(4):76-79
pages 76-79 views


The Experience of the Crisis Clinic at the Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. Sukhareva

Bezmenov P.V., Basova A.Y., Deych R.V., Severina Y.V.


BACKGROUND: Suicidal behavior by children and adolescents has been and remains one of the most intractable of our social ills. Despite the general downward trend in suicide rates, children and adolescents remain one of the most at-risk groups. Suicidal behavior in all its manifestations is a biopsychosocial problem in which the superiority of one approach or the other cannot be unambiguously justified. It flows from this that strategies that aim to prevent suicide should weave together not just the medical and psychological aspects of the issue, but the social, legal, pedagogical, and other dimensions as well.

AIM: To develop an integrated approach that could provide primary, secondary, and tertiary prevention of suicidal behavior in children, provide the routing of patients, and coordinate actions both between the outpatient link and inpatient specialized care and between different departments, primarily between the Moscow Department of Healthcare and the Department of Education.

METHODS: We analyzed the dynamics of the number of admissions to the Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. Sukhareva of Moscow Health Department (Sukhareva Center) with suicidal manifestations in 2019–2022. Organization of the Crisis Care Clinic (Crisis Clinic), which specializes in helping children and adolescents aged 11 to 17 who find themselves in a situation of psychological crisis, have suicidal tendencies, display self-injurious behavior, experience grief, violence, or have suffered abuse.

RESULTS: A comprehensive multi-disciplinary approach is identified as the most efficient way to treat and prevent suicidal behavior in children and adolescents. Psychopharmacotherapy is used to influence severe depressive symptomatology, reduce anxiety, moderate sedation, correct behavioral disorders, etc. In addition to medication, comprehensive psychotherapeutic assistance is recommended. The leading therapeutic approaches are cognitive-behavioral, including DBT, and family therapy, with the efforts of therapists concentrated on alleviating post-traumatic stress, depression, and behavioral problems, as well as resolving intrafamily conflicts.

CONCLUSION: The need to remedy severe crisis conditions and their associated psychopathological repercussions (including suicidal and self-harming behavior) calls for coordinated efforts on the part of specialists from different fields of knowledge related to childhood and adolescence. Our analysis of the experience of working with children and adolescents in the Crisis Clinic at the Sukhareva Center shows that there is high demand for such highly specialized institutions and that the basic principles laid down at its creation, urgency, stage, and continuity of care, poly-professionalism with a focus on non-drug treatment methods, orientation towards the patient’s family are relevant.

Consortium Psychiatricum. 2022;3(4):80-88
pages 80-88 views

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