Сомparative analysis of clinical and psychopathological symptomatology of depressions resistant and non-resistant to the therapy
DOI:
https://doi.org/10.15587/2313-8416.2015.50597Keywords:
depression, resistance, clinical and psychopathological features, recurrent depressed disorder, bipolar affective disorderAbstract
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
References
Baybarak, N. A. (2012). Clinical and typological variants of recurrent depressive disorder with long flow course. Ukrains’kyi Visnyk Psykhonevrolohii, 20 (1), 34–39.
Bykov, Yu. V. (2009). Treatment resistant depressions.Stavropol, 77.
Mazo, G. E., Gorbachev, S. E., Petrova, N. N. (2008). Treatment resistant depression: Modern approaches for Diagnosis and Treatment. Vestnik Sankt-Peterburgskogo universiteta. 2, 87–95. Available at: http://www.med.spbu.ru/archiv/vest/8_2/2_10.pdf
Goldenko, O. N. (2010). Socially-psychological adaptation of patients with recurrent depressive disorders. Arkhiv psikhiatrii, 16 (1), 33–36.
Vovin, R. Ya. Aksenova, I. O., Kyune, G. E.; Vovin, R. Ja., Kjune, G. E. (Eds.) (1989). Problems of psychosis chronization and ways for overcoming treatment resistance (in model of depressive states). Moscow: Meditsina, 182.
Al-harbi, К. S. (2012). Treatment-resistant depression: therapeutic trends, challenges, and future directions. Patient Prefer Adherence, 2012:6, 369–388. doi: 10.2147/ppa.s29716
Bacherikov, A. M., Denysenko, M. M. (2010). Clinical-psychopathological, pathopsychological peculiarities and principles for prevention of a suicidal behavior in patients with еndogenous and exogenous depressions. Ukrains’kyi Visnyk Psykhonevrolohii, 18 (4), 56–60.
Maruta, N. O., Bacherikov, A. M., Tkachenko, T. V. et. al (2011). Diagnostics of hidden suicidal intentin patients with mental disorders: method. recommendations. Ministry of Health, 17.
Prishlyak, V. І., Fіlts, O. O. (2008). Some peculiarities of the clinic of chronic depressions in the contex of basic psychopathologic mechanism of their formation. Zhurnal psikhiatrii i meditsitsinskoy psikhologii. 1 (18), 55–61.
Keller, M. B. (2005). Issues in treatment-resistant depression. J. Clin. Psychiatry, 66, 5–12.
Podkorytov, V. S., Chayka, Yu. Yu. (2002). Depression and resistance. Zhurnal psikhiatrii i meditsitsinskoy psikhologii, 1 (9), 118–124.
Moroz, S. M. (2004). Some parameter of depression resistance development. Arkhіv psikhіatrії, 10 (1), 105–108.
Fava, M. (2003). Diagnosis and definition of treatment-resistant depression. Biological Psychiatry, 53 (8), 649–659. doi: 10.1016/s0006-3223(03)00231-2
Pidkorytov, V. S. (2008). Modern approaches in treatment of depressions resistant to pharmacotherapy. Ukrains’kyi Visnyk Psykhonevrolohii, 16 (2), 55–58.
Souery, D., Papakostas, G. I., Trivedi, M. H. (2006). Treatment-resistant depression. J. Clin. Psychiatry, 67, 16–22.
Dikaya, T. I. (2011). Clinical and psychopathological features and dynamic aspects of protracted and chronic endogenous depression. Vesnik Rossiyskoy AMN, 4, 19–25.
Vertogradova, O. P., Petuhov, V. V. (2005). Protracted depression: regularitiese of formation, prognosis and therapy. Sotsial'naya i klinicheskaya psikhiatriya, 15 (4), 18–22. Available at: http://psychiatr.ru/files/magazines/2005_12_scp_803.pdf
Aksenova, I. O. (1980). Clinic and therapy of chronic treatment resistant and endogenous depressions. Leningrad, 22.
Smulevich, A. B. (2002). Treatment of resistant prolong edendogenous depression Psikhiatriya i psikhofarmakologiya, 4, 128–132.
Nemeroff, C. B. (2007). Prevalence and management of treatment-resistant depression. J. Clin. Psychiatry, 68, 17–25.
Downloads
Published
Issue
Section
License
Copyright (c) 2015 Маріанна Владиславівна Маркова, Людмила Володимирівна Рахман
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
