DOI: https://doi.org/10.15587/2313-8416.2015.50597

Сомparative analysis of clinical and psychopathological symptomatology of depressions resistant and non-resistant to the therapy

Людмила Володимирівна Рахман, Маріанна Владиславівна Маркова

Abstract


The prevalence of depressive disorders in structure of psychiatric morbidity is rather high. At the same time the modern epidemiological and clinical studies illustrate that more than 50 % of patients with depression do not demonstrate an essential clinical improvement. According to these data the large part (30–50 %) of such disorders are defined as therapeutically resistant depressions (TRD). The solution of the problem of resistance of depressive disorders consists mainly in understanding of biological and psycho-social mechanisms of forming and clinical course of this nosology and also clinical and psychopathological features of TRD compared to non-resistant ones. The data of numerous clinical studies confirm that TRD is characterized with atypicalness and polymorphism of clinical symptomatology, structural heterogeneity of depressive syndrome with heterogenic inclusions, clinical course has the features of blurring, monotony and rigidity, depressive symptomatology is characterized with somatization of psychopathological manifestations. It was proved that the leading psychopathological radical of depressive syndrome is crucial in development of residual symptomatology at TRD. An early detection of reliable clinical parameters of TRD, opportune diagnostics and use of the necessary treatment allow considerably increase its efficiency.

Aim: Comparative analysis of the clinical and psychopathological symptomatology at depressive disorders resistant to treatment and depressions amenable to traditional therapy.

Materials and methods: Following the conditions of ethical and deontological principles of clinical studies 60 patients with depressive disorders were under observation, further they were separated into 2 groups of 30 persons. The first group included patients with TRD, the second one – patients with depressions amenable to traditional therapy.

We used the next methods in our work: clinical and psychopathological, psychometric, psychopathological, statistical.

Results: At studying socio-demographic indicators the gender-specific features were not detected in the groups of comparison. Patients with TRD are mainly city dwellers. On age indicator patients with TRD were at the mean younger by 17,4 %, with manifestation of depressive disorders in the young age (mainly under 39 years). Resistant depressions develop mainly in persons with high education who are engaged in intellectual labor and persons who do not work for a long time. The hereditary inclination to psychic diseases in the group of examined persons with TRD was 53,3 %. On nosologic sample the resistant depressions are mainly attributed to the recurrent depressive disorders and bipolar affective disorders. The group of patients with TRD demonstrated in overwhelming majority the heavy degree of intensity of depressive manifestations. The dominating ones were apathic and adynamic, obsessive and depressive, gloomy (melancholic) syndromes on the background of monotony and rigidity of clinical course with high suicidal risk, gradual somatization of psychopathological manifestations


Keywords


depression; resistance; clinical and psychopathological features; recurrent depressed disorder; bipolar affective disorder

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