[The problem of multiple somatic and/or psychiatric pathology basic concepts and prevalence]

[The impact of depression symptoms on postmorbid adaptation of patients who have undergone SARS-CoV-2 infection (assessment from the position of the multimorbidity model)]

OBJECTIVE

To evaluate the impact of psychosomatic and anxiety symptoms of depression on the formation of postmorbid adaptation in patients who have undergone SARS-CoV-2 infection.

MATERIAL AND METHODS

The data of 54 patients, aged 18-55 years, with a current depressive episode who had outpatient SARS-CoV-2 infection were analyzed. The Hamilton depression rating scale (HDRS) was used and somatic condition was assessed using a general assessment of the patient's function limitation at the stage of reconvalescence. A linear regression analysis was performed to assess the association of psychosomatic and anxiety symptoms with somatic condition in SARS-CoV-2 infection, regardless of other factors.

RESULTS

The multimorbidity model took into account, in addition to SARS-CoV-2 caused by organic somatic disorders, psychosomatic manifestations (B=-1.9, p=0.004) and anxiety (B=-3.7, p=0.04) symptoms of depression. Somatic anxiety was significantly correlated with a pronounced impairment of postmorbid readaptation (p<0.05), while mental anxiety did not demonstrate such a relationship (p=0.46). The observed trend seems to be due to the overlap of manifestations of somatic anxiety with the construct of residual somatic symptoms, even though there is no multicollinearity between them.

CONCLUSION

Identification of clusters of symptoms associated with reduced opportunities for full recovery in the SARS-CoV-2-postmorbid period can significantly help in providing a high-quality and targeted psychopharmacological care.

[Combined mental diseases in children and adolescents]

OBJECTIVE

To establish the prevalence, clinical patterns and dynamics as well as social adaptation of combined mental disorders in juvenile patients traced to a young adult age.

MATERIAL AND METHODS

An outpatient cohort included 1203 children and adolescents born in 1990-1992. A group of patients from this cohort was followed up till the age 23-25 years.

RESULTS AND CONCLUSION

A combined mental illness was identified in 17,5% of all children and adolescents. The most common types of disorders associated with the underlying mental illness were organic mental disorders and early onset addictions. Clinical dynamics of children-adolescent combined mental diseases was characterized by the prolonged presence of symptoms of two or more diseases during the follow-up. Social adaptation of patients with co-morbidities was worse than those with one disease.