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

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.

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