The Role of Personality and Environmental Factors in the Formation of Clinical Variants of Unipolar Depressive Disorders

Background: disclosure of specific environmental and personality factors of depression development was an object of many studies, but without consensus on their importance. The aim was to study the role of personality and environmental factors in the formation of subtypes of depressive disorders. Patients and Methods: the study made up in-patients treated from May 2021 to April 2024. Diagnostic verification and typology of depressive disorders were performed according to the DSM-5 diagnostic criteria (melancholic, anxious, atypical type). The severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale (HDRS). Questionnaire data were used to determine socio-demographic data and features of early development. The SCID-II Personality Disorder Traits Structured Personality Questionnaire (SCID-II-PD) was used to analyse the personality characteristics of the patients. Results: a total of 120 patients (n = 120) were divided into three groups by type of depression: melancholic (n = 40; 33%), anxious (n = 44; 37%), and atypical (n = 36; 30%). In patients with melancholic depression, accentuations of cluster A (schizoid, schizotypal; n = 17; 43%) and C (avoidant, dependent; n = 18; 45%) more often prevailed, with anxious depression — accentuations of cluster C (avoidant; n = 29; 66%), with atypical depression — accentuations of cluster B (histrionic; n = 29; 81%). There was a correlation between type of depression and scores on the Holmes- Rahe Stress Scale (Social Readjustment Rating Scale, SRRS), (χ² = 7.981, p = 0.018), number of marriages (χ² = 7.530, p = 0.023), patient's age when their family became incomplete (χ² = 8.193, p = 0.017), and the number of their own children (χ² = 4.818, p = 0.09). Conclusion: the identified accentuations of personality traits highlight the specifics of patients' emotional and behavioural reactions depending on the subtype identified. Socio-demographic variables such as family structure and number of children, living alone, birth trauma and smoking have also been found to be associated with type of depressive disorder. These factors may serve as indicators for clinicians to develop more effective intervention and personalised support strategies for patients with depressive disorders.

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