Aim. To compare the speed of onset, magnitude, and duration of the analgesic effect of two doses of ketoprofen lysine salt – 40 mg and 80 mg – for the acute treatment of tension-type headache in adults.

Materials and methods. Thirty patients with episodic tension-type headache were enrolled in an open-label, prospective study and allocated to two groups of 15: KAP (ketoprofen lysine salt 80 mg) and KA (40 mg). Pain intensity (visual analogue scale, VAS) was assessed at baseline and 5, 10, 15, 30, 60, 120, and 240 minutes after intake; pain-reduction slope was also calculated. Quantitative data are presented as median and interquartile range (Me [Q1; Q3]); non-parametric methods were used. Differences were considered significant at p < 0.05.

Results. Groups were comparable at baseline (VAS 8.0 [6.5; 8.5] and 7.0 [6.5; 8.0]). A significant reduction from baseline occurred by 10–15 minutes in both groups; a plateau was reached by 120 minutes, with median VAS approaching zero. Between-group differences in pain intensity and in the magnitude of reduction were not significant at any time point (p>0.20).

Conclusion. Both doses provided fast (significant by 10–15 minutes) and sustained analgesia with good tolerability. No significant differences between the 40 mg and 80 mg doses were found in onset, magnitude, or duration. Given the comparable efficacy and the NSAID analgesic ceiling, either studied dose may be used; dose choice should be guided by clinical objectives and constraints (tolerability, comorbidities, adverse-event risk).

Rationale. Vitiligo is associated with a high psychosocial burden and comorbid anxiety and depressive adjustment disorders, which reduce treatment adherence and quality of life in patients. Basic therapy does not always provide reduction of nosogenic reactions, which justifies the need for a comprehensive approach including psychopharmacotherapy.

Objective. To conduct a comparative analysis of the effectiveness of basic and combination therapy (including alimemazine or maritupirdine) in patients with non-segmental vitiligo and concomitant anxiety and anxiety-depressive adjustment disorders, and to evaluate the clinical significance of repigmentation at the stage of prolonged dermatological treatment.

Materials and methods. A single-center, randomized, prospective study included 80 patients (39 men, 41 women; mean age 38.2±13.0 years) with nonsegmental vitiligo (VIDA ≥ +1) and clinically significant manifestations of anxiety and/or depression according to the Hospital Anxiety and Depression Scale (HADS-A and/or HADS-D ≥11). Adjustment disorder (F43.2) was verified during the initial consultation. Patients were randomized into three groups: group 1 – basic therapy (UVB-311 nm and external agents), group 2 – basic therapy and alimemazine (10–20 mg/day), group 3 – basic therapy and maritupirdine (20–40 mg/day). Basic treatment was carried out in two courses of 20 sessions with a 30-day interval; Psychopharmacotherapy – during the first 8 weeks. The condition was assessed at baseline, 8, and 20 weeks using the HADS, DIQI, VASI, and VES scales.

Results. After 20 weeks, the median relative reduction in VASI in group 1 was 32.1 % (27.4–41.7), in group 2–36.4 % (28.8–45.0), and in group 3–39.6 % (30.2–47.8) (p=0.192). According to VES, by week 20, the dynamics were 36.5 % (21.7–49.4) in group 1, 44.2 % (27.7–56.1), and in group 3–45.1 % (40.9–52.5) (p=0.137). Normalization of anxiety (HADS-A <8) after 20 weeks was noted in the first group in 13/26 (50.0 %), in the second – 25/27 (92.6 %) and in the third – 4/26 (15.4 %), 2nd – 17/27 (63.0 %) and 3rd – 20/27 (74.1 %) (p<0.001).

Conclusion. Stress-associated nosogenic adjustment disorders with anxiety and anxiety-depressive symptoms, developing against the background of  dermatosis, clinically aggravate the course of non-segmental vitiligo and reduce the quality of life of patients receiving basic therapy. The inclusion of alimemazine or maritupirdine in the combination treatment regimen is associated with a significantly more pronounced reduction in anxiety and depression according to the HADS and an increase in clinically significant improvements in the DIQL. Positive dynamics are noted in all groups for the VASI/ VES dermatological indices, however, early and sustained clinically significant repigmentation is more often achieved in the combination therapy groups.

Objective – to assess the diagnostic value of objective saccadic eye-movement parameters for early detection of neurocognitive deficit in patients with chronic cerebral ischemia (vascular encephalopathy, stages I–II).

Materials and methods. Fifty participants were examined: 22 patients with vascular encephalopathy (MMSE 26.3±2.4) and 28 conditionally healthy volunteers (MMSE 28.8±1.1). Eye movements were recorded using the Pupil Invisible video-oculography system. The protocol included the Gap, Overlap, and Prediction tasks. Latency, gain, coefficient of variation (CV), and error rate were analyzed.

Results. In the Gap task, mean latency and gain did not differ, whereas CV was more than twofold higher in patients (35.9±13.2 % vs 16.1±4.5 %; p=0.012). In the Overlap task, a trend toward longer latency was observed (p=0.07) with no difference in the gap effect (p=0.41). The most pronounced differences were found in the Prediction task: increased latency (p=0.041) and a higher error rate (p=0.038).

Conclusion. In vascular encephalopathy stages I–II, measures of response stability and performance quality in cognitively demanding tasks are the most informative.

HIV-associated ALS-like syndrome represents a rare clinical phenotype of motor neuron disease that differs from classical amyotrophic lateral sclerosis in terms of disease onset and clinical course. Modern diagnostic approaches enable timely diagnosis, while antiretroviral therapy may modify disease progression and contribute to clinical stabilization.

This work demonstrates the potential of using valproic acid in psychiatric patients to relieve psychomotor agitation that develops outside nosological boundaries. Considering psychomotor agitation as a transnosological condition caused by weakness of inhibitory processes in the brain, valproic acid, by potentiating the non-selective action of the inhibitory neurotransmitter, does not produce dissociative effects on brain function. Based on 18 clinical cases (patients with various psychiatric diagnoses) in which intravenous administration of valproic acid led to relief of psychomotor agitation symptoms, it was shown that the drug can be used as a nonspecific/universal agent for managing psychomotor

agitation without causing pathomorphosis of the clinical picture of the disease.

The purpose of the study. To study the frequency, structure and severity of anxiety-depressive and asthenic disorders in patients with encephalopathy on the background of end-stage chronic renal failure (CRF), corrected by programmed hemodialysis.

Materials and methods. 124 patients (71 men and 53 women) aged 40–70 years with end-stage CRF encephalopathy corrected by programmed hemodialysis were examined. Depending on the dialysis experience, they were divided into 2 groups: 67 people with 1–5 years of dialysis experience, 57 people with more than 5 years of dialysis experience. Anxiety (personal and reactive) was recorded using the C. D. Spielberger–Khanin scale, depression was recorded using the T. Beck scale. The structure and severity of asthenia were studied using the MFI-20 questionnaire.

Results. Patients with encephalopathy on the background of chronic kidney disease corrected by programmed hemodialysis were characterized by a high frequency and severity of anxiety-depressive and asthenic disorders, a high polymorbidity index.

Background. Primary care patients present with physical complaints without an appropriate organic or somatic explanation in 20–30 % of cases. Functional somatic symptoms pose significant challenges in diagnosis, treatment, and therapy, associated with significant unnecessary costs and a reduced quality of life for socially active general practitioners.

The aim of the study was to comprehensively examine the clinical characteristics of somatized mental disorders in general medical patients, aimed at developing a typology and optimizing treatment.

Materials and methods. A two-center, cross-sectional, observational study was conducted among 80 patients (27 men, 53 women, mean age 37.3±12.4 years) who presented to Sechenov University clinics with functional somatic symptoms. Diagnoses were verified according to ICD-10 criteria. A psychopathological examination, the Hospital Anxiety and Depression Scale (HADS), the Somatic Symptom Questionnaire (PHQ-15), the Quality-of Life-Questionnaire (SF-36), and the Structured Clinical Interview for the Diagnosis of Personality Disorders (SCID-II) were used. Statistical analysis was performed using IBM SPSS Statistics 26.

Results. Based on the clinical and psychopathological analysis, two groups were distinguished: patients with depressive disorders with somatic symptoms such as depressive hyperesthesia in the somatopsychic sphere (n=40) and patients with somatoform disorders, where somatic symptoms appeared in the structure of body-oriented anxiety-hypochondriacal syndrome (n=40). In the group with depressive disorders, depressive affect prevailed (17.0±4.2 points on the HADS scale) with a high level of concomitant anxiety (13.5±2.8 points), diffuse polymorphic somatic symptoms were recorded (15.2±3.1 points on the PHQ-15 scale) with daily fluctuations and morning deterioration, as well as a global decrease in the quality of life according to the affective-dependent scales of the SF-36 (general health, vitality, emotional state). In the group with somatoform disorders, anxiety symptoms dominated (16.0±3.4 points) with moderate depression (10.2±2.5 points), focused intense somatic symptoms were noted (12,4±2,7 points on the PHQ-15 scale).

Conclusion. The developed typology confirms the pathogenetic heterogeneity of the somatization phenomenon and creates the basis for a differential approach to the diagnosis and treatment of this category of patients in general medical practice.