Prof. Florence Thibaut, France

Paris Descartes University, University Hospital Cochin Paris, Paris, France

Pharmacological treatments for compulsive sexual behaviors among offending individuals: focusing on neurobiology and neuropharmacology of behavior decline

Abstract:
Even if the prevalence of hypersexuality in paraphiliacs or paraphilic disorders is close to the prevalence reported in the general population, it remains a risk factor for sexual offense. In current lecture we review common risk factors between hypersexuality and paraphilic disorders as well as the comorbidity between both disorders, especially in sexual offenders. Although the neurobiology and neuropharmacology of sexual behavior remain unclear, there has been significant research that aims to highlight the neuronal circuits and neurotransmitters involved in sexual disorders such as paraphilic disorders and hypersexuality. Pharmacological treatment of sex offenders with paraphilic disorders should follow the principles of the risk-needs responsivity model, meaning that the higher the risk, the more intensive the proposed therapeutic approach. The criminogenic needs addressed by pharmacological treatments are paraphilias/paraphilic disorders (mostly pedophilic and sadistic disorders) and hypersexuality. Pharmacological treatment of sex offenders with paraphilic disorders should be part of a more comprehensive treatment plan including psychotherapy (mostly behavior therapy). The treatment guidelines for patients with comorbid paraphilic disorders and hypersexuality are proposed in the talk, as far as the ultimate goal of clinicians is to prevent sexual offenses in these patients.

Timur Syunyakov, MD, PhD, Uzbekistan

Chief advisor on R&D, Republican Specialized Scientific and Practical Medical Center of Narcology, Tashkent, Uzbekistan
Leading expert (Coordinator on Statistical Data Analysis), International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
Senior researcher, Learning Center, SBFH «Clinical Psychiatric Hospital №1 named after Alekseev»

Depression in the chronic course of schizophrenia

Abstract:
Depressive disorders occur in 80% of patients with schizophrenia at some stage of its course, and its occurrence poses a serious risk for suicidal behavior and negative treatment outcomes. At the same time, depression can be difficult to differentiate from a number of other manifestations of schizophrenia: negative symptoms and side effects of antipsychotic therapy. The lecture discusses the reasons for the frequent coexistence of schizophrenia and depression, and reviews the approaches to its diagnosis and therapy.

A/Prof. Daria Smirnova, MD, PhD, Russia

International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, Samara, Russia

Language in mild (stress-related) depression

Abstract:
Deviations from typical word use have been previously reported in clinical depression, but language patterns of mild depression (MD), as distinct from normal sadness (NS) and euthymic state, are unknown. In the study which we report here, we aimed to apply the linguistic approach as an additional diagnostic key for understanding clinical variability along the continuum of affective states. We studied 201 written reports from 124 Russian-speaking patients and 77 healthy controls (HC), including 35 cases of NS, using hand-coding procedures. In MD, as compared with healthy individuals, written responses were longer, demonstrated descriptive rather than analytic style, showed signs of spoken and figurative language, single-clause sentences domination over multi-clause, atypical word order, increased use of personal and indefinite pronouns, and verb use in continuous/imperfective and past tenses. In NS, as compared with HC, we found greater use of lexical repetitions, omission of words, and verbs in continuous and present tenses. MD was significantly differentiated from NS and euthymic state by linguistic variables [98.6%; Wilks’ λ(40) = 0.009; p < 0.001; r = 0.992]. The highest predictors in discrimination between MD, NS, and euthymic state groups were the variables of word order (typical/atypical) (r = −0.405), ellipses (omission of words) (r = 0.583), colloquialisms (informal words/phrases) (r = 0.534), verb tense (past/present/future) (r = −0.460), verbs form (continuous/perfect) (r = 0.345), amount of reflexive (e.g., myself)/personal (r = 0.344), and negative (e.g., nobody)/indefinite (r = 0.451) pronouns. Family and existential semantic categories were exaggerated over cognitive and altruistic during the state of depression. The most significant between-group differences were observed in MD as compared with both NS and euthymic state.MD is characterized by patterns of atypical language use distinguishing depression from NS and euthymic state, which points to a potential role of linguistic indicators in diagnosing affective states and its important use as the evidence-based targets for the intensive language-action treatments.

A/Prof. Daria Smirnova, MD, PhD, Russia

International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, Samara, Russia

Schizophrenia with predominant negative symptoms

Abstract:
Lecture discovers the topic of schizophrenia with predominant negative symptoms and its treatments, focusing on the dialogue between scientific data and routine clinical practice. Negative symptoms are described from the historical point of view and terms of clinical psychopathology, via the discussion on psychometric scales used for their assessments, revealed domains, dimensions and factors, as well as the typology (e.g., primary, secondary, persistent, prominent, predominant), which address us to the target-focused treatment approaches regarding specific manifestations of negative symptoms. Current findings on neurobiology, pathophysiology and clinical representation of negative symptoms have been reviewed in detail. The importance of (i) following modern clinical guidelines, (ii) evidence-based algorithms, (iii) augmentation strategies of combined antipsychotic pharmacotherapy, (iv) patients’ needs in psychosocial intervention, cognitive remediation, paying appropriate attention to all the issues of biopsychosocial context , in general, and, finally, (v) switching from the stratified, personalized, precise medicine approach to the individualized therapy of each single patient with schizophrenia, have been reported.