In the context of the COVID-19 pandemic, 50 patients and 30 medical personnel were infected in a psychiatric hospital in Wuhan (Hubei Province, China), which required the Ministry of Health of China to urgently analyze the situation and develop a set of measures aimed at containing the spread of the virus and organizing a full and safe psychiatric care. The reasons for this situation could be the lack of reserve beds for psychiatric patients, low awareness of psychiatrists in diagnosing and treating infectious diseases, the separation of the psychiatric care system between the two departments, and the cramped living conditions of patients in psychiatric hospitals. More than 500 psychiatrists from across the country were sent to Wuhan to fill staff. Psychiatric patients with mild to moderate COVID-19 were transferred to temporary psychiatric hospitals organized in gymnasiums and exhibition centers. Severely ill psychiatric patients COVID-19 were transferred to hospital infectious diseases. A single patient routing system was organized, a shift schedule for doctors was introduced. To reduce the burden on public transport, the outpatient unit of psychiatric care was taken to regional hospitals, which had previously dealt only with forensic psychiatry and the control of patients with addictive disorders. Based on the experience of Wuhan, psychiatric communities from different countries proposed a list of practical recommendations designed to reduce the risks of spreading the infection and optimize the work of psychiatric care. All hospitals should have a reserve bed capacity, which can be used for the rehabilitation and socialization of patients in quiet times. Hospitals must be provided with a sufficient number of tests, drugs, and personal protective equipment. Outpatients need to be fully provided with access to medical and psychotherapeutic therapy using telemedicine technologies to minimize the risk of infection. It is crucial to restructure the appointment of doctors by introducing work on a shift schedule: two weeks in two weeks, which will not only ensure a good rest but also allow doctors to be quarantined after each shift.

IntroductionHepatitis C virus (HCV) infection produces a chronic systemic disease that induces chronic hepatitis, cirrhosis and hepatocellular carcinoma. Patients with chronic HCV infection may present with a range of extrahepatic symptoms including neuropsychiatric disorders.ObjectivesThe aims of this review are to summarize recent literature looking at the associations between psychosocial and neurocognitive factors and HCV, identify the most common neuropsychological disorders and consider the probable mechanisms of mental and cognitive impairment in patients with HCV.MethodsPubMed/Medline was systematically searched for psychosocial and neurocognitive factors associated with hepatitis C and patient wellbeing. In this review 83 valid articles were analyzed from 1994 to 2018.ResultsAccording to the literature review in the group of HCV-positive patients were found a significant decrease in higher cognitive functions: memory impairment, concentration and listening. These manifestations of cognitive dysfunction are supposed to be similar to the early symptoms of Alzheimer’s disease. An increased risk of developing dementia has also been noted. The most frequently diagnosed symptoms were fatigue and sleep disturbances, associated with mood disorders diagnosed in 19,2% of cases. Several mechanisms have been considered to explain the pathogenesis of neuropsychiatric disorders observed in chronic HCV infection: 1) the concept of the direct neuroinvasion of HCV; 2) derangement of metabolic pathways; 3) cerebral or systemic inflammation.ConclusionsTo date, the mechanisms of various mental and neurological disorders in patients with chronic HCV infection have been partially identified, but the long-term effect of these changes requires further study.

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Introduction. In the modern literature, the problem of the influence of multifocal brain damage in vascular dementia on the development of aggressive behavior in patients is only partially covered.The purpose of this work is to study the influence of neurobiological factors (number, localization of lesions) on the development of aggressive behavior in multi-infarct dementia.Materials and methods. The study involved 98 subjects diagnosed in multi-infarct dementia (F 01.1), established according to the ICD-10 criteria (1992), in which 52 were men (53.1 %) and 46 women (46.9 %), aged 60 to 90 years, the average age was 74.5 [67; 81] years. Patients are divided into a main group – with aggressive behavior (n = 49), and a control group − without aggressive behavior (n = 49). The study used clinical-anamnestic, clinical-psychopathological, psychometric and neuroimaging methods.Results. The study showed that patients with aggressive behavior compared to patients without aggressive behavior have a greater number of lesions (p < 0.0001). The localization of which is statistically significantly more often determined in the left frontal lobe, subcortical nuclei on the left and in the left ventricular region (p = 0.0002, 0.0212, 0.0036), and patients without aggressive behavior often do not have frontal lobe lesions.Discussion. Patients who show aggression in general, or in isolation physical, verbal aggression, or irritability, have a statistically significantly greater number of lesions than patients without these symptoms (p < 0,0001). Each additional lesion increases the likelihood of developing aggression and its severity. In patients with irritability, lesions localized in the left frontal lobe and left ventricle.Conclusion The study suggests that the number of lesions from four or more, as well as their predominant localization in the left hemisphere of the brain, leads to the development of various types of aggressive behavior.

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