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Psychopathology, clinics and therapy of endogenous depressions: clinical and follow-up study

https://doi.org/10.30629/2618-6667-2017-76-11-19

Abstract

The aim of the study was to analyze the psychopathological structure of endogenous depressions, to establish the associations of its structure with the course and prognosis of the disease. Material: 124 in-patients with the diagnosis of recurrent depressive disorder (out of the annual total of 409 treated at the Republican Vilnius Hospital University department in August 2014 — July 2015) — 92 females and 32 males, aged from 19 to 82 (average SD 55,37 ± ± 13,11). Manifestation of disease was between 16 and 59 years (average 37,56 ± SD 12,57). Duration of disease was between 2 and 37 years (average 14,35 ± SD 9,40). Methods: mainly psychopathological clinical and clinical-catamnestic ones, in addition rating scales MADRS and CGI, psychological examination. Results: 6 types of depression were singled out: anxious (52,42%), hypochondriac (22,58%), melancholic (13,71%), apatheticadynamic (4,84%), anesthetic (4,03%) and dysphoric depression (2,42%). All cases of depression were of severe level, with MADRS fluctuating between 30–39 scores (35,6 ± 7,9), and CGI-S — 5,4 ± 0,9. Majority of cases were anxious and hypochondriac depressions. All types had long duration of episodes (from half to 3 years), some cases much longer. The clinical pictures and psychological peculiarities of separate types were analyzed, as well as the diagnostic and prognostic signifcance of the established typology was discussed. Conclusions: сlassic forms of depression were rare. In the most of cases complex polymorphic symptoms prevailed (senestopathic, hypochondriac symptoms, depersonalization, obsessions, phobias, various overvalued ideas), had long duration of episodes. Our study showed the increasing complexity of endogenous depressions, tendency to poor prognosis and growing resistance to antidepressants.

About the Authors

Aldona Siurkute
Vilnius Universiry, Vilnius; Vilnius Psychiatric Hospital, Vilnius
Lithuania
PhD, MD, candidate of medical sciences, assistant professor


Marius Karnitskas
Vilnius Psychiatric Hospital, Vilnius
Lithuania


Yurate Langvenene
Vilnius Psychiatric Hospital, Vilnius
Lithuania


Valentinas Maciulis
Vilnius Universiry, Vilnius; Vilnius Psychiatric Hospital, Vilnius
Lithuania
PhD, MD, professor


References

1. Carvalho A.F., McIntyre R.S. Treatment-resistant mood disorders. Oxford University Press, 2015.

2. Härter M., Klesse C., Bermejo I. , Bschor T. , Gensichen J., Harfst T., Hautzinger M., Kolada C., Kopp I., Kühner C., Lelgemann M., Matzat J., Meyerrose B., Mundt C., Niebling W., Ollenschläger G., Richter R., Schauenburg H., Schulz H., Wein- brenner S., Schneider F., Berger M. Evidenzbasierte Therapie der Depression. Nervenarzt. 2010;81(9):1049–1068. doi: 10.1007/s00115-010-3084-7

3. Lietuvos sveikatos statistikos rodiklių sistema [Sistema pokazatelej statistiki zdravoohraneniya Litvy]. http://sic.hi.lt/webdps/tables/tblC.php

4. Mitihina I.A., Mitihin V.G., Yаstrebov V.S., Limankin O.V. Psihicheskoe zdorov'e naseleniya mira: ehpidemiologicheskij aspekt (zarubezhnye issledovaniya 2000–2010 gg.). Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2011;6:4–13. (In Russ.).

5. Preskorn S.H. Declining differences in response rates with antidepressants versus placebo. J. of Psychiatric Practice. 2013;19(3):227– 233.

6. Preskorn S.H. Therapeutic Drug Monitoring (TDM) in psychiatry (part I): why studies attempting to correlate drug concentration and antidepressant response don‘t work. J. of Psychiatric Practice. 2014;20(2):1331–1337.

7. Thase M.E. Residual symptoms and the risk of relapse in major depression. J. Clin. Psychiatry. 2013;74(11);e22. URL: http://www.medscape.com/medline/abstract/24330907

8. Paykel E.S. Residual symptoms and relapse in depression. Medicographia. 2009;31:157–163.

9. Smulevich A.B., Andryushchenko A.V., Romanov D.V., Zaharo- va N.V. Remissii pri affektivnyh zabolevaniyah: psihopatologiya, klinicheskij social'nyj prognoz, vtorichnaya profilaktika. Zhurn. nevrologii i psihiatrii im. S.S. Korsakova. 2014;3:4–13. (In Russ.).

10. Montgomery S., Wang G. Clinical severity, treatment resistance, and recurrence of depression. Medicographia. 2011;33:132–137.

11. Jäger M., Frasch K., Becker T. Die Krise der operationalen Diagnostik in der Psychiatrie. Nervenarzt 2008;79(3):288–294. doi: 10.1007/s00115-008-2418-1

12. Leongard K. Sistematika ehndogennyh psihozov i ih differen- cirovannaya ehtiologiya (red. A.S. Tiganov). Moskva: Praktich- eskaya medicina, 2010:41–74. (In Russ.).

13. Tiganov A.S. (red.). Psihiatriya: Rukovodstvo dlya vrachej. Moskva. Medicina; 2012;t.1:638–752. (In Russ.).

14. Tiganov A.S. Obshchaya psihopatologiya: kurs lekcij. Moskva. Medicinskoe informacionnoe agentstvo, 2016. (In Russ.).

15. Chitlova V.V. Trevozhnye depressii: aspekty psihopatologii i tera- pii. Psihiatriya i psihofarmakoterapiya. 2012;14(4):27–33. (In Russ.).

16. Bondar' V.V. Klinicheskie osobennosti i tipologicheskoe delenie rezistentnyh k terapii ehndogennyh depressij. Zhurnal nevropatologii i psihiatrii im. S.S. Korsakova. 1992;1:84–88. (In Russ.).

17. Shirshova M.B. Psihopatologiya melanholicheskih depressij pri shizofrenii. Zhurnal nevropatologii i psihiatrii im. S.S. Korsakova. 1997;11:16–18. (In Russ.).

18. Baranov P.A. Endogennye anesteticheskie depressii (psihopatologiya i tipologiya). Vestnik Rossijskoj akademii medicinskih nauk. Moskva: Medicina, 2011;4:10–13. (In Russ.).

19. Ahapkina M.V. Nekotorye aspekty psihopatologii depersonalizacionnyh rasstrojstv pri shizofrenii Zhurnal nevropatologii i psihiatrii im. S.S. Korsakova. 1993; 93(4):46–49. (In Russ.).

20. Bürgy M. Zur Differenzialdiagnostik der Depersonalisationserlebnisse. Nervenarzt. 2012;83(1):40–48.

21. Petrilowitsch N. Zur Psychopathologie und Klinik der ntfremdungsdepression. Arch. Psychiatr. Nervenkr. 1956;194:289–301.

22. Haug K. Depersonalisation und verwandte Erscheinungen. Bumke O. Hanbuch der Geisteskrankheiten. Berlin. 1939;Вd.1:134–204.

23. Oka K. Zur Psychopathologie der Depersonalisation. Nervenarzt. 2006;77(7):823-829. doi: 10.1007/s00115-006-2066-2

24. Burba B.V. Psihopatologija i klinika adinamicheskih depressij v techenii shizofrenii Zhurn. nevropatol. i psihiatr. im. S.S. Korsakova. 1988;88(1):61–65. (In Russ.).

25. Sorokin S.A. Typology and dynamical features of endogenous apathetic depressions. Psychiatry. 2010;5(47):25–31. (In Russ.).

26. Drobizhev M.Yu. Antidepressanty pervyh pokolenij v sovremennoj terapii depressii. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2008;12:32–38. (In Russ.).

27. Schwarzt T.L., Stahl S.M. Treatment strategies for dosing the second generation antipsychotics. CNS Neuroscience & Therapeutics. 2011;17:110–117.

28. Agorastos A., Lederbogen F., Otte C. Behandlung der Depression bei koronaren Herzkrankung. Nervenarzt. 2015;86(3):375–387. doi: 10.1007/s00115-014-4162-z

29. Strakowski S.M. Treating сo-occurring substance. Abuse and Mood Disorders. URL: http://www.medscape.com/viewarticle/849178_print.


Review

For citations:


Siurkute A., Karnitskas M., Langvenene Yu., Maciulis V. Psychopathology, clinics and therapy of endogenous depressions: clinical and follow-up study. Psychiatry (Moscow) (Psikhiatriya). 2017;(76):11-19. (In Russ.) https://doi.org/10.30629/2618-6667-2017-76-11-19

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