Psychopathy like depressions with hysterical disorders (part 1)

The aim of the study was to investigate the clinical-pathological specifcities of psychopathy like depressions with hysterical disorders, to develop their typology, to study regularities of their dynamics, to reveal special features of their clinical picture in a case of various endogenous diseases, and to develop optimal therapeutic approaches. Patients. A total of 55 patients (45 females and 10 males) aged 18–55 were included in the study. Inclusion criterion was the presence of depressive state with a predominance of hysterical psychopathy like symptomatology. Methods: clinical-psychopathological; clinical and follow-up methods. Results and conclusion: the analysis of psychopathological structure of endogenous depressions with hysteroform psychopathy like disorders detected their clinical polymorphism. Different symptoms of conversion-dissociative symptomocomplex vary from simple sensory, motor, and sensible conversions in the structure of hystero-hypichondriac depression to pathogenetically integral conversion and mental (dissociative) impairments in hystero-psychotic depressions. The predominance of anxiety and apathetic hypothymic radical allows classifying of psychopathy like hysteroform depressions as anxiety-apathetic ones. The following three phenomenologically different anxiety variants were singled out: cothymia (combination of endogenous, predominantly paroxysmal, and neurotic anxiety) in a case of hystero-hypochondriac depressions; 2) endogenous anxiety in combination with motor agitation within the framework of affective-mixed state in hystero-behavioral depressions; 3) endogenous anxiety with projection to external stimuli in hystero-psychotic depressions.

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