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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">psychiatry</journal-id><journal-title-group><journal-title xml:lang="ru">ПСИХИАТРИЯ</journal-title><trans-title-group xml:lang="en"><trans-title>Psychiatry (Moscow) (Psikhiatriya)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1683-8319</issn><issn pub-type="epub">2618-6667</issn><publisher><publisher-name>FSBSI “The Mental Health Research Centre”;   LLC «Publisher «MIA»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30629/2618-6667-2019-81-6-19</article-id><article-id custom-type="elpub" pub-id-type="custom">psychiatry-385</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ВОПРОСЫ ПСИХОПАТОЛОГИИ, КЛИНИЧЕСКОЙ И БИОЛОГИЧЕСКОЙ ПСИХИАТРИИ</subject></subj-group></article-categories><title-group><article-title>Невротическая  депрессия:  проблема  нозологической  квалификации</article-title><trans-title-group xml:lang="en"><trans-title>Neurotic  depression:  the  problem  of  nosological  qualification</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сорокина</surname><given-names>О. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Sorokina</surname><given-names>O. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сорокина Ольга Юрьевна, аспирант </p></bio><bio xml:lang="en"><p>Yu. Sorokina, graduate student</p></bio><email xlink:type="simple">msolgasorokina@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Волель</surname><given-names>Б. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Volel</surname><given-names>B. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Волель Беатриса Альбертовна, доктор медицинских наук, профессор, старший научный сотрудник</p><p>заведующая психотерапевтическим отделением УКБNo3</p></bio><bio xml:lang="en"><p>Beatrisa A. Volel, Dr. of Sci. (Med.), professor, senior researcher</p><p>chief of psychotherapeutic unit</p></bio><email xlink:type="simple">beatrice.volel@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ  «Научный  центр  психического  здоровья»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>FSBSI  «Mental  Health  Research  Centre»</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБНУ  «Научный  центр  психического  здоровья»; &#13;
ФГАОУ  ВО  Первый  МГМУ  им.  И.М.  Сеченова  Минздрава  России  (Сеченовский  Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>FSBSI  «Mental  Health  Research  Centre»; &#13;
FSAEI  HE  I.M.  Sechenov  First  MSMU  MOH  Russia  (Sechenovskiy  University)</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>30</day><month>10</month><year>2019</year></pub-date><volume>0</volume><issue>81</issue><fpage>6</fpage><lpage>19</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Сорокина О.Ю., Волель Б.А., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Сорокина О.Ю., Волель Б.А.</copyright-holder><copyright-holder xml:lang="en">Sorokina O.Y., Volel B.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.journalpsychiatry.com/jour/article/view/385">https://www.journalpsychiatry.com/jour/article/view/385</self-uri><abstract><sec><title>Цель работы</title><p>Цель работы: исследование клинических  характеристик,  динамики  нозологической  квалификации  и  факторов,  соуча-ствующих в формировании невротической депрессии.</p></sec><sec><title>Материал и методы</title><p>Материал и методы: обследованы 60  пациентов  (женщин  —  55,  мужчин  —  5),  средний  возраст  которых  составлял  36,9 ± 10,8 года, средняя длительность депрессивных фаз — 18,1 ± 10,8 мес. Исследование проводилось с использованием клинического, катамнестического, патопсихологического, статистического методов. Применялись психометрические методики (HAM-D, MFI-20, SANS, PANSS) и опросники (ОЧХ-В, SPQ-А, SCL-90, опросник Холмса–Рея).</p></sec><sec><title>Результаты</title><p>Результаты: объединяемые термином «невротическая депрессия» состояния клинически неоднородны (депрессии с явлениями виктимизации со страхом сепарации и депрессии с  привязанностью,  формирующейся  при  явлениях  эротомании),  в  первую  очередь  по  содержанию  кататимного  комплекса  (тревожно-фобический  и  сверхценный  кататимный  комплекс).  Различия в структуре денотата соотносились с гетерогенностью клинических проявлений и динамики депрессий.  Клиническая картина невротических депрессий у пациентов первой группы подвергалась  трансформации:  происходила  смена  первоначально доминировавшей тревоги явлениями негативной аффективности (апатия, ангедония), а также приобретение эндоформных  черт  (тоска,  патологический  суточный  ритм).  Помимо выявляемой у 38,2% аффективной патологии, у 61,8%  пациентов  данной  группы  установлен  диагноз  из  круга  расстройств  шизофренического  спектра.  При этом невротические депрессии с явлениями эротомании со сверхценной привязанностью в большинстве своем  (76,9%)  не  выходили  за  рамки  аффективных фаз невротического регистра, реализующихся на траектории расстройств личности. Установлено, что основ-ной для всех пациентов личностной дименсией, соучаствующей в формировании невротической депрессии, являлся феномен виктимизации, характеризующий способность пациентов оказываться и  длительно  пребывать  в  психотравмирующей  (фрустрирующей) обстановке. Помимо этого, выявлено, что наряду с характерологическими особенностями кластеров В и С (DSM-5), у 83,3% пациентов определяются преморбидные черты, присущие кластеру А.</p></sec><sec><title>Выводы</title><p>Выводы: неоднородность денотата  невротической  депрессии  определяла  различия  в  клинической  картине,  динамике  (с  разным  социальным  и  трудовым  прогнозом).  Установлена нозологическая  гетерогенность  состояний,  объединяемых  термином «невротическая депрессия»: наравне с аффективной патологией выявлялся диагноз расстройства личности и за-болеваний шизофренического спектра. Структура кататимного комплекса также взаимосвязана с разной личностной предиспозицией с чувствительностью к определенным стрессорным триггерам.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Objective</title><p>Objective:  to  study  the  clinical  characteristics,  dynamics,  nosological  qualifications  and  factors  involved  in  the  formation  of neurotic depression.</p></sec><sec><title>Material  and  methods</title><p>Material  and  methods:  60  patients  (women  —  55,  men  —  5)  with  an  average  age  36,9  ±  10,8  years  were  examined,  the  average  duration  of  depressive  phases  was  18,1  ±  10,8  months.  The  study  was  conducted  with  using  clinical,  catamnestic,  pathopsychological, statistical methods. Psychometric scales (HAM-D, MFI-20, SANS, PANSS) and questionnaires (Questionnaire of personality traits of an adult, SPQ-A, SCL-90, Holmes–Ray Stress Inventory) were used.</p></sec><sec><title>Results</title><p>Results: the states combined by the term «neurotic depression» are clinically heterogeneous (depressions with victimization phenomena  with  the  separation  anxiety  and  depressions  with  love  addiction  —  erotomania),  primarily  in  the  content  of  the  catathymic complexes (anxiety-phobic and overvalued catathymic complexes). The differences in the structure of the denotation correlated  with  the  heterogeneity  of  clinical  manifestations  and  the  dynamics  of  depression.  The  clinical  picture  of  neurotic  depressions  in  patients  of  the  first  group  transformed:  the  initially  dominant  anxiety  was  replaced  by  negative  affectivity  (apathy, anhedonia), and there was an acquisition of endoform traits. In addition to affective pathology, which was detected in 38,2%, 61,8% of patients in this group had diagnosis of schizophrenic spectrum disorders. At the same time, most of the neurotic depressions with erotomania with overvalued attachment (76,9%) did not go beyond the affective phases of the neurotic register,which  are  realized  on  the  trajectory  of  personality  disorders.  It  has  been  established  that  the  main  personality  dimension  for  all  patients  participating  in  the  formation  of  neurotic  depression  was  the  phenomenon  of  victimization,  which  characterizes  the ability of patients to get into and stay in a psycho-traumatic (frustrating) environment for a long time. In addition, it was found that 83,3% of patients had premorbid traits of cluster A (DSM-5), along with the characteristic features of clusters B and C.</p></sec><sec><title>Conclusions</title><p>Conclusions: the heterogeneity of denotation of neurotic depression determined the differences in the clinical picture, dynamics  (with  different  social  and  labor  prognosis).  The  nosological  heterogeneity  of  the  conditions  combined  by  the  term  «neurotic depression» was established: along with affective pathology, the diagnosis of personality disorder and diseases of the schizophrenic spectrum was detected. The structure of the catathymic complexes is also interconnected with different personal predispositions with sensitivity to certain stressful triggers.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>невротическая  депрессия</kwd><kwd>виктимизация</kwd><kwd>фрустрация</kwd><kwd>нозологическая  гетерогенность</kwd><kwd>кататимный комплекс</kwd></kwd-group><kwd-group xml:lang="en"><kwd>neurotic depression</kwd><kwd>victimization</kwd><kwd>frustration</kwd><kwd>nosological heterogeneity</kwd><kwd>catathymic complexes</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Bartolomucci A., Leopardi R. Stress and depression: preclinical research and clinical implications. PLoS One. 2009;4(1):e4265. January 30, 2009. 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