SUMMARY
Obesity remains a pressing issue as a multidisciplinary condition with a significant psychoemotional component.
Objective. To assess the clinical and psychoemotional status of female patients with exogenous-constitutional obesity and comorbid affective disorders, as well as to determine the efficacy of incorporating vortioxetine into the comprehensive treatment regimen.
Materials and Methods. The study included 66 women aged 39 to 46 years with obesity (BMI 35–40 kg/m²). The main group (n=34) received vortioxetine 10–20 mg/day alongside standard obesity therapy (diet and physical activity); the comparison group (n=32) declined pharmacological treatment but followed endocrinologist recommendations. Assessment included anthropometric measurements, biochemical and hormonal analyses, and psychometric evaluations using the Hamilton Depression Rating Scale (HDRS‑17) and Hamilton Anxiety Rating Scale (HARS) at baseline, 3 months, and 6 months.
Results. Both groups exhibited a high prevalence of depressive and anxiety disorders ranging from mild episodes to mixed states and dysthymia. By month 6, the main group demonstrated a statistically significant reduction in depression and anxiety levels: average HDRS scores decreased from 19.0 to 9.9, and HARS scores from 16.3 to 7.9. No significant changes in psychoemotional status were observed in the comparison group. Body weight reduction was more pronounced in the vortioxetine group, while the comparison group had a higher rate of treatment refusal (34.4 %).
Conclusion. The use of vortioxetine in women with obesity and affective disorders leads to an improvement in psychoemotional status and may contribute to the correction of metabolic disturbances.

SUMMARY
Relevance. The effectiveness of medical rehabilitation (MR) of stroke patients depends on their emotional status. The prevalence of depression varies from 35% in the acute period to 44.7% in the early recovery period.
Aim. To study the effect of robotic brain-computer interfaces (BCI) and electromyostimulation (EMS) on the emotional state, daily functioning, and quality of life of patients with ischemic stroke (IS).
Matherials and methods. The study included 120 patients with IS. The patients were randomized into one of 4 groups, 30 people each: the main group, MG (basic complex MR, robotic BCI and EMS); comparison group 1 (basic complex and robotic BCI); comparison group 2 (basic complex and EMS); control group (basic complex MR). Over time (1 week, 2 weeks, 3 months), functional independence (Barthel index, BI), quality of life of patients (EQ‑5D questionnaire), and emotional state were assessed on the HADS.
Results. The average age of patients was 56.54±2.53 years, and the duration of IS was 48.7 ± 3.5 days. The average values on the HADS corresponded to subclinically expressed anxiety (9.46±0.50 points) and subclinically expressed depression (8.85±0.58 points), BI to moderate restrictions on daily activity (63.92 ± 0.23 points), the EQ‑5D questionnaire data to the presence of health-related difficulties (43.99±5.45 points). After the MR, significant positive changes were noted in the MG: the total score on the «Anxiety» subscale decreased by 53.9% after 2 weeks, by 55.6% after 3 months, and on the «Depression» subscale by 50.1% and 62.3%, respectively. An increase in the average score of the BI had a significantly greater increase in MG. There was an increase in the quality of life according to EQ‑5D in all groups with significantly better values in the MH (2 weeks – 71.55±5.45 points, 3 months – 84.65±6.10 points).
Conclusions. Against the background of the use of comprehensive rehabilitation programs with the inclusion of robotic BCI and EMS, a regression of emotional disorders, an increase in functional independence and quality of life of patients with IS.

Each year, 35–40 million cases of spinal cord injury (SCI) are registered worldwide. Among these, 80–100% of patients become disabled or die. In 20% of cases, disability results from neurogenic pelvic organ dysfunction (urination and defecation disorders). This study assessed the effectiveness of multilevel magnetic stimulation (MMS), which combines peripheral, spinal, and transcranial rhythmic magnetic stimulation techniques, in patients with SCI and neurogenic pelvic dysfunction. A total of 30 patients with traumatic SCI were examined. The control group (n=15) received standard therapy, while the experimental group (n=15) additionally underwent MMS. The results showed that MMS was most effective in patients with thoracic spinal cord injuries, demonstrating significant improvements in urinary outflow (p=0.024), bladder filling function (p=0.020), and compensation of urination according to the O. A. Perlmuter’s scale (p=0.038). No statistically significant improvement was observed in the control group. These findings suggest that MMS is a promising method for the rehabilitation of neurogenic pelvic dysfunction in patients with SCI.

SUMMARY
Objective. Description of the clinical and genetic characteristics of a patient with pharmacoresistant epilepsy and brain malformations caused by previously undescribed variants of the WDR 62 and STAG1 genes.
Materials and methods. Clinical observation of a 20-year-old patient with pharmacoresistant structural focal epilepsy who underwent surgical treatment of epilepsy and the installation of a vagus nerve stimulator. The analysis of epileptiform activity was evaluated based on the results of video EEG monitoring both during wakefulness and during sleep. To identify malformations of the brain, the results of a specialized protocol of magnetic resonance imaging (MRI) of the brain were analyzed. The identification of the genetic variant was carried out based on clinical exome sequencing (NGS). The identified mutations were verified by direct Sanger DNA sequencing of the patient and her parents. The patient and her parents signed an informed consent to the publication of the results of the examination.
Results. Based on the identified clinical features of the course of the disease, family history, pharmacoresistance and unsuccessful surgical treatment, an assumption was made about the genetic nature of the disease. Previously undescribed variants of the WDR 62 and STAG1 genes have been identified.
Conclusion. Given the difficulties of differential diagnosis of epileptic encephalopathies in adults, new-generation full-exome and full-genome sequencing is a necessary diagnostic method for determining pharmacoresistance, even for structural forms of epilepsy.

The relevance of integrating mobile applications into the psychosocial treatment of the first psychotic episode lies in their potential to personalize treatment, increase commitment, control symptoms in real-time, and overcome stigma. The aim of this study is to conduct a comprehensive analysis of data on the possibilities and limitations of digital technologies in order to assess their clinical effectiveness and barriers to implementation. The methodology is based on a systematic review of scientific literature published between 2013 and 2025, selected from databases such as PubMed, Scopus, Web of Science, PsycINFO, and Cochrane Library. The findings confirm that digital technologies significantly enhance the availability and quality of healthcare, contributing to the psychosocial rehabilitation of patients and their integration into society. Mobile applications are an addition to, rather than a replacement for, complex therapy, and their success relies on overcoming the «digital reductionist» approach – taking into account the clinical, ethical, and technological nuances involved. Further research should focus on developing adaptive algorithms, conducting long-term studies, and fostering interdisciplinary collaboration in order to realize the full potential of digital solutions for transforming care for individuals experiencing their first psychotic episode.

QT prolongation is one of the most significant adverse reactions associated with the use of antipsychotics due to the high risk of life-threatening ventricular arrhythmias.
The aim of the study was to determine the risk of QT prolongation during antipsychotic therapy.
Materials and methods. An analysis of 1000 cases of hospitalization of patients diagnosed with schizophrenia spectrum disorder (F20-F29) who underwent inpatient treatment in the period from 01/01/2022 to 12/31/2024 was conducted. QTc interval prolongation was defined as a difference of ≥30 ms between the QTc interval values of the baseline and repeat electrocardiograms.
Results. QTc interval prolongation was registered in 17.7% of cases of monotherapy and in 25.3% of cases of polytherapy (OR 1.58; 95% CI 1.063–2.348). The AP dose in monotherapy was lower than the AP dose in polytherapy (p<0.001). Polytherapy was used more often in men (84%) than in women (16%). In monotherapy, no difference was found between QTc groups by gender (p=0.691), age (p=0.960), or AP dose (p=0.369). QTc interval prolongation was most frequently observed during clozapine treatment, both in mono(32.8%, including 6.1% ≥60 ms) and polytherapy (30.5%, including 2.8% ≥60 ms). Lurasidone and trifluoperazine had no effect on the QTc interval in monotherapy.
Discussion. The increased risk of prolongation of the QTc interval during polytherapy may be due to an increase in the total dose of AP, the appointment of AP with a high risk of prolongation of the QTc interval as adjuvant therapy, augmentation of clozapine with other antipsychotics. Our results differ from the information in the international CredibleMeds® database, which may be due to genetic differences in the populations of different regions.
Conclusion. It is recommended to conduct a baseline ECG before prescribing an antipsychotic, regular ECG monitoring during therapy, and adjust treatment in case of prolongation of the QTc interval ≥30 ms. Particular attention is required for patients taking clozapine.

Objective. To evaluate the diagnostic accuracy of artificial intelligence (AI) technologies for automated detection of magnetic resonance imaging (MRI) signs of multiple sclerosis (MS) and differentiation from other pathologies using benchmark datasets.
Materials and methods. A retrospective diagnostic study was conducted in accordance with the STARD 2015 methodology. Two AI services integrated into the Unified Radiological Information Service of the Moscow EMIAS were tested. The benchmark dataset (n=100) included results of brain MRI with and without contrast. Diagnostic accuracy metrics were assessed: area under the ROC curve (AUROC), sensitivity, specificity, and accuracy.
Results. AI service 1 demonstrated an accuracy of 0.86 (95% CI 0.79–0.93), sensitivity of 0.73 (95% CI 0.6–0.85), and specificity of 0.98 (95% CI 0.94–1.0). AI service 2 showed superior results: accuracy of 0.99 (95% CI 0.97–1.0), sensitivity of 1.0 (95% CI 1.0–1.0), and specificity of 0.98 (95% CI 0.94–1.0).
Conclusions. AI technologies show high potential for automating MRI analysis in MS diagnosis. However, significant differences in accuracy and reproducibility between AI services highlight the need for further research in real-world clinical settings.

The aim of the study was to analyze sleep disorders among 5th‑6th year students of Saratov Medical University.
Methods. The study employed a survey conducted with 374 fifth- and sixth-year students.
Results. A survey of 374 respondents was conducted using an original questionnaire during both the regular academic period and the examination period. Pre-sleep activities depended on the academic period. Many students exhibited various sleep disorders and a lack of proper sleep hygiene. High-quality sleep was significantly more common during the regular academic period compared to the examination period. Poor sleep negatively affected the respondents' psycho-emotional state both during exams and in the regular academic period. Chronic stress was significantly more prevalent during the examination period than outside of it. Sleep duration and quality depended on students' living conditions. The study identified not only sleep disorders but also other health-related issues, such as excessive body weight, first-degree obesity, and physical inactivity. A significant correlation was found between high self-rated health, an adequate level of physical activity, and good sleep quality.
Conclusion. Commitment to a healthy lifestyle, adherence to sleep hygiene, and a rational daily schedule remain pressing issues for medical university students.

Impulsive aggression is considered an important psychopathological symptom of a number of mental disorders, including borderline and antisocial personality disorders. Serotonin plays a critical role in modulating mood, anxiety, aggression, sleep-wake cycle, motivation, pain perception and neuroendocrine function, including aggression suppression. The correlation of the severity of aggressive behavior with neuroendocrine signs of low serotonin function was revealed. Serotonergic genes play an important role in the regulation of serotonin activity. The article discusses the results of research conducted among those convicted of violent and nonviolent crimes. The association of various genes regulating serotonin activity with aggression has been studied. The characteristics of several serotonergic candidate genes for the risk of developing antisocial behavior, which is based on impulsive aggression, are given. In conclusion, the conclusion is made about the inconsistency of the results of the analyzed studies due to methodological differences, which requires further development of this problem.