INTRASYNDROMIC PHENOMENOLOGY OF ENDOGENOUS DEPRESSIVE DISORDERS IN ASPECT OF CLINICAL PATHOMORPHOSIS
DOI:
https://doi.org/10.11603/2415-8798.2018.4.9792Keywords:
endogenous depressive disorders, pathomorphosis, clinical phenomenologyAbstract
Problem of phenomenological pathomorphosis of depressive disorders is one of the actual problems in modern clinical psychiatry.
The aim of the study – to investigate features of clinical pathomorphosis of endogenous depression in comparative aspect.
Materials and Methods. We studied medical records of 236 patients with endogenous depressive disorders, who applied for medical aid in 1971–1995; 189 patients with endogenous depression who applied for medical aid in 2015–2018 were examined clinically.
Results and Discussion. It is revealed that clinical pathomorphosis of depressive disorders at modern stage is characterized by an increase in prevalence of asthenic symptomatology (79.9 % vs. 67.4 %, p<0.01), inability to concentrate and make decisions (71.4 % vs. 61.0 %, p<0.05), anxiety symptoms (81.0 % vs. 73.7 %, p<0.05), pessimism (80.4 % vs. 79.2 %, p<0.05), suicidal thoughts (70.4 % vs. 60.2 %, p<0.05), gastrointestinal symptoms (60.3 % vs. 51.7 %, p<0.05), insomnia manifestations (93.1 % vs. 81.8 %, p<0.01), and decrease in manifestations of anhedonia (76.2 % vs. 84.3 %, p<0.05) and low self-esteem (80.5 % vs. 73.0 %, p<0.05). It was revealed that intrasyndromological structure of depressive disorders at modern stage is characterized by decrease in prevalence of vital depression (from 56.8 % to 42.9 %, p <0.05) and anesthetic depression (from 25.8 % to 18.0 %, p < 0.05) with an increase in prevalence of apathic depression (24.3 % vs. 17.4 %, p <0.05), presence of anxiety-phobic and hypochondriac inclusions (56.1 % vs. 47.5 %, p <0.05), insomnic disorders in form of presomnic, intrasomnic, postsomnic manifestations with predominance of the latter (93.1 % vs. 81.8 %, p<0.01), vegetative-somatic disorders and somatization manifestations in the form of polymorphic cenestopathy (77.8 % vs. 68.2 %, p<0.05), cenesto-algetic syndrome (11.6 % vs. 6.4 %, p<0.05) and asthenic depression (79.9 % versus 66.9 %, p<0.01), agitated depression (38.6 % vs. 30.1 %, p<0.05) and depression with flight of ideas (28.0 % vs. 20.8 %, p<0.05).
Conclusions. Change in the intrasyndromic structure of depressive disorders due to prevalence of apathic and anxiety depression with reducing of vital and anesthetic forms is the basis of modern clinical pathomorphosis of depressive disorders. Study of total constellation of symptoms of dyssomnical register demonstrates predominance of postsomnic manifestations with domination of obsessive-phobic reflections and inferiority ideas. Revealed patterns of pathomorphosis should be taken into consideration while developing differentiated therapeutic, rehabilitation and preventive measures.
References
Cleare, А., Pariante, C.M., & Young, A.H. (2015). Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2008 British Association for Psychopharmacology guidelines. Journal of Psychopharmacology, 29 (5), 459-525.
Fekadu, N., Shibeshi, W., & Engidawork, E. (2017). Major depressive disorder: pathophysiology and clinical management. Journal of Depression and Anxiety, 6 (1), 255-257.
Maruta, N.A., & Semykina, E.E. (2007). Novye vozmozhnosti terapii depressivnykh rasstroistv [New treatment options for depressive disorders]. Ukrainskii visnyk psychonevrolohii – Ukrainian Bulettin of Psychoneurology, 26, 3 (52), 89-94 [in Ukrainian].
Al-Harbi, K.S. (2012). Treatment-resistant depression: therapeutic trends, challenges, and future directions. Patient Preference and Adherence, 6, 369-388.
Pototska, I.S., & Gryshina, O.V. (2018). Suitsydalna nalashtovanist yak proiav samoruinivnoi povedinky u robitnyts komerciinoho seksu [Suicidal attitude as a manifestation of self-destructive behavior in workers of commercial sex]. Psychological Journal, 4 (14), 138-148 [in Ukrainian].
Pshuk, N.G., Stukan, L.V., & Kaminska, A.O. (2018). Introducing system of psychotherapeutic intervention for family caregivers of patients with endogenous mental disorders. Wiadomosci Lekarskie, 71 (5), 980-985.
Pshuk, N.G., & Kaminska, A.O. (2017). Koncepty kommunikatyvnoho resursu u khvorykh na recurentnyi depresyvnyi rozlad ta ikh referentnykh rodychiv [Concepts of communicative resource in patients with recurrent depressive disorder and their reference relatives]. Visnyk socialnoi hihieny ta orhanizacii okhorony zdorovia Ukrainy – Bulletin of Social Hygiene and Health Protection Organization of Ukraine, 2 (72), 33-38 [in Ukrainian]. DOI: https://doi.org/10.11603/1681-2786.2017.2.8105
Skrypnikov, A.M., Gerasimenko, L.O., & Gryn, K.V. (2016). Vikovyi patomorfoz recurrentnych depressivnych rozladiv [Age pathomorphosis recurrent depressive disorders]. Svit mediciny ta biologii [The World of Medicine and Biology], 4 (58), 64-66 [in Ukrainian].
Pidkoritov, V.C., & Serikova, O.I. (2008). Suchasna kliniko-typolohichna struktura depresyvnykh epizodiv bipoliarnoho afektyvnoho rozladu [Current of clinical-typological structure of depressive episodes of bipolar affective disorder]. Zhurnal psikhiatrii i meditsinskoy psihologii – Journal of Psychiatry and Medical Psychology, 3 (20), 5-9 [in Ukrainian].
Korostelev, V.I. (2016). Osobennosti patogeneza, kliniki i techeniya involycionnoi i endogennoi depressii [Features of pathogenesis, clinic and course of involutional and endogenous depression]. Vestnik Baltiiskogo universiteta im. Canta – Bulletin of Baltic Kant University, 2, 33-39 [in Russian].
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