Prognostic value of the diagnostic parameters of endogenous diseases with delusional depressions

The aim of the study: was to analyze the prognostic value of psychopathological and clinical indices of delusional depressions, taking into consideration the specificities of delusion formation of depressive ideas and evaluation of diagnostic parameters of the disease.

Material and methods: a total 91 females (average age was 31,3 yrs.) were examined by using the clinical-psychopathological and clinical and follow up methods. In the dynamics of the endogenous diseases delusional depressions were diagnosed in them, with ideas of self-humiliation, of little value, self-accusation and guilt constituting the content of depressive delusion. According to  ICD-10  mental  status  of  the  patients  corresponded  to  F31.5;  F32.3  and  F33.3  items.  In  all  194  delusional  depressions  were  analyzed in the clinical pictures of first manifest and repeat episodes. Some patients were examined directly during the period of the delusional depression (48% of patients), others were examined retrospectively (51,6%) with the following personal author’s follow-up, in 40,7% the duration of follow up observation was from 5 to 10 and more years.

Results: during comparison of diagnostic parameters at various stages of the disease clinical indices were established, which at the level of statistic reliability correlated with nosological evaluation of the disease, its course, and the degree of its progression,  and  are  prognostically  the  most  significant.  In  manifest  period  at  the  l00%-level  of  concurrence  the  index  of  the  typology  of  delusional  depressions  was  in  the  lead,  which  was  developed  taking  into  consideration  their  psychopathological  structure and mechanisms of delusion formation of depressive ideas. The index of share holding of affect (manic and depressive)is prognostically significant in the formation of structure of delusional component of affective-delusional states, its maximumpresentation (from 100 to 85%) is conjugated with non-progressive, or relatively favorable course within the framework of affective  psychosis,  recurrent  and  cyclothymia  schizophrenia.  The  level  of  negative  personality  changes,  reflecting  the  degree  of the disease progression being detected before the development of delusional depression, is directly embodied in the indices of negative shift in the clinical picture of the subsequent remission and determines the prognosis of its quality. At pre-manifest stage the reliable signs of the prognosis have clinical specificities and the frequency of affective disorders (in the form of reactive, or autochthonous affective lability), as well as the depth of impairment of schizoid personality disposition up to the degree of accentuation, psychopathy, pseudopsycopathy.

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