THE ROLE OF CLINICAL AND PSYCHOPATHOLOGICAL FACTORS IN THE FORECAST OF DEPRESSIVE DISORDERS

Abstract

In today's conditions, the definition of the factors of course and release formation prediction of depressive disorders, which will allow the development of personified approaches to therapy and will contribute not only to the reduction of the number of forms with protracted and chronic course but also to the reduction of socio-economic consequences of these disorders for society, will become important.

The aim of the study – to learn the influence of clinical and psychopathological factors on the prediction of the severity of the course and the outcome of depressive disorders.

Materials and Methods. For the analysis of the obtained data, the methods of descriptive statistics and the method of multiple regression analysis using the step-by-step method were used. Parameters of evaluation of the course of depressive disorders, taking into account clinical and psychopathological factors in the framework of this study included: the severity of depressive disorder (on the scale of CGI-S); the outcome of depressive disorder (on the scale of CGI-I).

Results and Discussion. Clinical and psychopathological factors of the favorable prediction of the severity of depressive disorder are: critical to their condition, social and professional implementation (absence of violations in the field of work and activity), self-esteem (lack of sense of guilt for their own failure), adequate perception of the microsocial environment (no paranoid symptoms in the form distrustful attitude towards others and expectations of censure), subjective preservation of the ability to enjoy life. As factors of the adverse prediction of the severity of depressive disorder are: endogenous initial manifestation of the disease (absence in the history of provoking factors of mental traumatism), inhibition, suicidal intentions, early insomnia, weight loss, feelings of guilt, paranoid symptoms in the form of distrustful attitude to others and expectations of condemnation, reduction of criticality to the state, violation in the sphere of social and professional implementation, subjective feeling of anxiety, ideas of self-deprecation (feeling worse than others).

The favorable prognosis for the outcome of depressive disorder is determined by: reduction of guilt, hypochondria, obsessive – compulsive symptoms in the form of obsessive thoughts about their own insolvency and lack of prospects, inhibition in restoring social and professional functioning and criticality to their own condition. As factors of unfavorable prognosis for the outcome of depressive disorder are: maintaining in the structure of clinical symptoms of hypochondria, anxiety, obsessive–compulsive symptoms in the form of obsessive thoughts about their own insolvency and lack of prospects, feelings of guilt.

Conclusions. The results of the presented study prove that the features of the clinical structure of the disorder, the subjective perception of patients by their condition, the factor of the initial manifestation of the disease affect the formation of the severity of depression, its outcome and can be used as factors of prognosis and specific targets of therapeutic and rehabilitation measures.