psychiatryПСИХИАТРИЯPsychiatry (Moscow) (Psikhiatriya)1683-83192618-6667FSBSI “The Mental Health Research Centre”; LLC «Publisher «MIA»10.30629/2618-6667-2015-67-32-41psychiatry-44Research ArticleВОПРОСЫ КЛИНИЧЕСКОЙ И БИОЛОГИЧЕСКОЙ ПСИХИАТРИИДифференцированная психофармакотерапия рекуррентного депрессивного расстройства на этапе ремиссииDifferential psychopharmacotherapy in remission of recurrent depressive disorderЗахароваНаталья ВячеславовнаZakharovaNataliyanataliza80@gmail.comФГБНУ «Научный центр психического здоровья»РоссияFSBSI «Mental Health Research Center»Russian Federation201528092015033241Copyright © Захарова Н.В., 20152015Захарова Н.В.Zakharova N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journalpsychiatry.com/jour/article/view/44

Актуальность разработки дифференцированных терапевтических стратегий при рекуррентном депрессивном расстройстве на этапе ремиссии обусловлена недостаточной изученностью проблемы. Если терапии собственно аффективных фаз посвящены многочисленные исследования, то рекомендации относительно лечения в период ремиссии, как правило, ограничиваются указаниями относительно необходимости осуществления стабилизирующего и поддерживающего (противорецидивного) лечения. Цель исследования. Изучить виды и методы дифференцированной терапии ремиссий при рекуррентной депрессии в зависимости от их клинической типологии (симптоматические/синдромальные) и клинического генеза резидуальных симптомов. Материал и методы. Исследование обсервационное. Выборку составили 186 пациентов (130 женщин, 56 мужчин; средний возраст 45,8 ± 15,3 года), перенесшие не менее трех эпизодов рекуррентной депрессии, разделенных ремиссиями длительностью не менее 6 месяцев. Анализу подвергнуты данные о лекарственной терапии, проводимой во время ремиссий с учетом стратегий психофармакотерапии (включая комбинированное лечение), анализируемых за период максимально возможнойпродолжительности.Результаты и выводы. На основании данных ретро- и проспективного исследования определены основные стратегии поддерживающего лечения в рутинной клинической практике, предложены дифференцированные подходы к психофармакотерапии в зависимости от типологической дифференциации ремиссий, основанной на их психопатологических характеристиках.

Background. The relevance of developing differentiated therapeutic strategies in remission of recurrent depressive disorder is based on an underestimation of the problem. Since there is alot of studies devoted to depressive episodes treatment, treatment modalities in remission are underinvestigated and limited by general recommendations about stabilizing and anti-recurrence treatment.The objective of the study was a naturalistic analysis of the methods of differential therapy of remissions in recurrent depression, depending on their clinical typology (symptomatic/partial or syndromal/ complete ) and residual symptoms genesis including psychopharmacological strategies investigation (i.a. combination therapy) during a period of maximum possible duration.Material and Methods. The sample included 186 patients (130 women, 56 men; mean age 45,8 ± 15,3 years) who have had at least three episodes of recurrent depression, separated by remissionslasting atleast 6 months.Results. The basic strategies of maintenance treatment in routine clinical practice, differentiated strategies offered drug treatment depending on the typology of remission and psychopathological characteristics of residual symptoms have been established on the basis of retro- and prospective study data.

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The authors declare that there are no conflicts of interest present.