Introduction Over last decades convincing evident data was accumulated about the positive correlation of religious involvement and better mental health in depression, substance abuse, suicide, stress-related disorders and dementia. The studies of the impact of religion on patients with schizophrenia and schizoaffective disorders are still insufficient and controversial. Objectives To investigate the impact of the religious coping strategies in patients with schizophrenia and shizoaffective disorder with focus on resolution and quality of remission in schizophrenia and schizoaffective disorder. Methods The pilot 1 year study covers 68 orthodox (group 1) and 55 unbeliever (group 2) outpatients with schizophrenia and schizoaffective disorder in remission on the maintenance therapy in FSBSI MHRC. The groups matched in age (18-60 y.o.), gender, treatment. The orthodox group received religious coping therapy. Number of relapses, remission quality (PANSS), quality of life (QLS), compliance (MARS) were measured 3 times (baseline visit, 6, 12 months). Statistical analysis (regression and correlation) was applied. Results Religious coping strategies proposed by Paragment K. (2013) were applied considering the peculiarities of value-semantic structures and selected religious values of the patients as important rehabilitation resource (Kopeyko et al, 2016). Group 1 demonstrated statistically significant better remission at 12-months point – better subjective well-being, social/functional outcomes, higher adherence to medication, less relapses, less psychotic symptoms. Conclusions Religion contributes to acquire adaptive functions as the meaning of life, sense of hope, spiritual comfort, supports the overcome the disease burden. Religious coping is an important tool for rehabilitation and preventing the relapses in patients with schizophrenic disorders. Disclosure No significant relationships.

Introduction Despite existing observations of religious delusions in epilepsy in classical psychiatric literature, such clinical cases are rare in current practice. Objectives To reveal features of disease progression, interference of combined mental pathology, treatment specifics, markers of possible harmful behavior. Methods Psychopathological, Multichannel eyes closed resting EEG in interictal period. Results Patient N, 39 years old, manifested her illness at age 13 with affective bipolar disorder; phases lasted several months each. From age 19, rare recurrent generalized convulsive paroxysms preceded by an aura; non-convulsive paroxysms were observed. The patient was uncritical of paroxysms and discontinued anticonvulsive therapy. At age 29 and 30 she suffered two psychotic attacks (lasting several weeks) with sensory delusions of meaning, staging, persecution, megalomaniacal ideas of apocalyptic content (ideas that she was responsible for possible outbreak of nuclear war, coming of the Apocalypse, her son was the antichrist). Delusional behavior (tried to take the naked infant out into the cold, throwing him out of the window). Anticonvulsive therapy accompanied by antipsychotic medications. Schizoaffective disorder and epilepsy diagnosed. From age 35, acute psychotic attacks with apocalyptic delirium preceded by the same aura lasted maximum one day, followed by partial amnesia. Epileptiform polyspikes (up to 150 μV) registered in the right temporal-central EEG leads. Conclusions Presence of religious delusion in combined schizoaffective disorder and epilepsy, requires special approach: combination of anticonvulsants and antipsychotics. Religiosity of patient should be taken into account as well. Disclosure No significant relationships.

Introduction Diagnostics of End-World delusion with religious content (EWDRC) is relevant due to its insufficient exploration, difficulty in differential diagnostics and social danger of the delusional behavior. Objectives To develop a typology based on psychopathological and phenomenological features. Methods Sixty patients with EWDRC were examined. Psychopathological and statistical methods were applied. Results Study of EWDRC found heterogeneity of clinical appearances. Two different types were identified: apocalyptic and eschatological. The apocalyptic type (51 patients, 85%) was characterized by prevalence of End-World ideas in an acute sensual delusion. Due to heterogeneity of delusion’s dynamics two subtypes were identified: - Subtype 1 (31 patients, 61%) was characterized with long period of development (changes in the stages) of different delusion’s types: delusion of perception, importance, staging, and the antagonistic one. Psychotic symptoms were quickly reduced with antipsychotic therapy. - Subtype 2 (20 patients, 39%) was characterized with rapid development of delusion’s stages up to oneiro-catatonic states which were hardly jugulated. Eschatological type (9 patients, 15%) was characterized by the systematized interpretive delusion with individual interpretation of apocalyptic signs. These states evolved within mixed forms of schizophrenia. Conclusions The analysis of EWDRC revealed the apocalyptic type’s acute course. Patients with the apocalyptic type have a premonition of upcoming End-World, and feel themselves engaged in it. The eschatological type is based on the systematized interpretive End-World delusion with “confirmations” found in everyday life. The results showed the high risk of the delusional behavior in patients with EWDRC which requires careful approach to the diagnostics and treatment of these conditions. Disclosure No significant relationships.

Introduction Kandinsky–Clérambault syndrome with religious delusion of possession (KSRDP) in schizophrenia is insufficiently explored phenomenon. The syndrome characterized by significant severity of clinical state, high social risks and resistance to psychopharmacotherapy and requires the close attention. Objectives To analyze psychopathological specifics of KSRDP and to identify the prognosis, dynamics of schizophrenia with KSRDP. Methods Thirty four patients (18 women; 16 men; the average age 28 ± 9,5 years) with schizophrenia (F20.0, F20.01, F20.02 according to ICD-10) were examined by psychopathological, psychometrical and statistical methods Results The specifics of the syndrome is delusional belief in possession by demonic or divine ‘spiritual being’, invaded within the body. This possession is interpreted by patients as the totality of mind, body and soul control; and in several cases – as the appearance of a new identity. According to the “classical” Kandinsky–Clérambault syndrome, KSRDP accompanied by extensive psychic automatisms (ideational, cenestopathic, kinaesthetic), haptic and olfactory pseudo-hallucinations. Furthermore the specific hallucinations for KSRDP (Hallucinationen der Gemeingefühlsempfindun by von Krafft-Ebing, R.) are observed, which based on sensory-spatial imaginary sensations, with a clear localization in the field of a visceral sensitivity (as a material object with a certain shape, consistency, size, and weight). Conclusions In contrast with “classical” paranoid syndrome of Kandinsky–Clérambault when negative effect is usually perceived by patients as external influence, KSRDP is characterized by delusional idea of ‘spiritual being’s invasion inside the body, mind and soul to control the whole human’s existence. Patients with KSRDP require specific treatment and management due to the religious content of delusion. Disclosure No significant relationships.

Introduction Despite a significant number of studies devoted to the relationship between depression and religiosity, the diagnosis of depression in religious patients is complicated due to the insufficiently studied psychopathology and the peculiarities of the patient’s experiences. Objectives To determine the specific features of psychopathology and phenomenology of depression, masked by a “religious facade”, for timely diagnostics and prevention of suicidal behavior. Methods One hundred and fifteen religious (orthodox) inpatients (41 male, 74 female) with depression (F31.3, F31.4, F 32.1., F 32.2, F 33.1, F 33.2 according to ICD-10) were examined. Psychopathological method, HAM-D, SIDAS and statistical analysis were applied. Results Five types of depression were specified, which differed in psychopathological structure and content of the religious experiences. Overvalued ideas of guilt and sinfulness were predominant in melancholic depressions, ideas of God-forsakenness and the loss of “living” faith - in apathetic. Depressions with overvalued doubts whether the right faith and confession has been chosen accompanied with anxiety, melancholy and apathy. It should be specially mentioned apathetic and melancholic depressions characterized by “spiritual hypochondria” with specific cenesto-hypochondrical symptomatology. Melancholic depressions characterized by high suicidal risk prevailed (65%) over the other depressions. Conclusions Depressions masked by a “religious facade” often are not recognized due to specifical content, which results in lack of timely diagnostics and creates a high risk of suicidal behavior. Disclosure No significant relationships.