Aldona Šiurkutė 1, 2, Marius Karnickas 2, Jūratė Lengvenienė 2, Valentinas Mačiulis 1, 2
¹ Vilnius University Medical Faculty Psychiatric Clinic, Vilnius, Lithuania
² Republican Vilnius Psychiatric Hospital, Vilnius, Lithuania
Objective of the study: 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 inpatients with the diagnosis of recurrent depressive disorder (out of the annual total of 409 treated at the university clinical department in August 2014 – July 2015) – 92 females and 32 males, aged from 19 to 82 (average ± SD 55.37 ± 13.11).
Methods. Mainly psychopathological clinical and clinical-catamnestic ones, in addition rating scales MADRS and CGI, psychological examination.
Results: 6 types of depression singled out: anxious (52.42%), anesthetic (4.03%), melancholic (13.71%), hypochondriac (22.58%), apathetic-adynamic (4.84%), 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. 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 the diagnostic and prognostic significance of the established typology was discussed. The worst prognosis was found in anesthetic depression. Alcohol and benzodiazepines abuse was another negative factor.
Conclusions: Classic forms of depression were rare. In the most of cases complex polymorphic symptoms prevailed (senestopathic, hypochondriac symptoms, depersonalization, obsessions, phobias, various overvalued ideas). Long duration and severe course were characteristic. Our study showed the increasing complexity of endogenous depressions, frequent relapses and deteriorations, poor prognosis and growing resistance to antidepressants.