COMPLEX SYSTEM OF REHABILITATION OF DEPRESSIVE DISORDERS

Abstract

According to modern views on depression, rehabilitation should be considered a prevention of relapse, achievement and maintenance of the most possible level of social functioning for a particular patient, which implies, after remission, the continuation of therapy, including taking into account residual symptoms.

The aim of the study – to develop a complex differentiated system of rehabilitation of depressive disorders, taking into account clinical and psychopathological and pathopsychological features of their course and standards of therapy.

Materials and Methods. The research used clinical-psychopathological, psychometric (Hamilton scale (HDRS), depression scale of the Center for epidemiological research (CES-D)), psychodiagnostic (E. Heim's method for determining the leading coping strategies, the method "Semantic time differential", "Test self-actualization") methods.

Results and Discussion. The system of rehabilitative measures included a medical-psychiatric, psychotherapeutic and social component and covered the stabilizing and preventive stages of therapy. The medical and psychiatric component of rehabilitation included psychopharmacotherapy, aimed at stabilizing the patients' condition, stopping the expressed behavioral disorders, the appointment of a long-term treatment drug. The main tasks of the psychotherapeutic component of rehabilitation were the prevention of disability, the breakdown of the family, the breakdown of social connections, the preservation of the social functioning of the patient, help in overcoming the feeling of guilt, hopelessness, hostility. The psychosocial component of rehabilitation was aimed at improving the patient's social skills, expanding the range of perception and interpersonal communication (developing adequate forms of behavior, training communication and increasing self-confidence). The most effective methods for this category of patients were group cognitive-behavioral psychotherapy, a group of mutual assistance and art therapy. When choosing a technique of cognitive-behavioral therapy a differentiated approach based on the allocation of the targets of psychotherapeutic effect was used separately for depressive episodes, recurrent depressive disorders and dysthymia, depending on the severity and combination of disturbances in specific problem areas.

Conclusions. The use of a complex differentiated system of rehabilitation measures in the work with patients with depressive disorders, which are based on taking into account the peculiarities of current depressive disorders and based on the standards of therapy, makes it possible to increase the effectiveness of providing assistance to this category of patients.