UKRAINS'KYI VISNYK PSYKHONEVROLOHII

The Scientific and Practical Journal of Medicine
ISSN 2079-0325(p)
DOI 10.36927/2079-0325
Home » Archive of numbers » 2022 » Volume 30, issue 3 (112) » CLINICAL-PSYCHOPATHOLOGICAL, GENEALOGICAL AND GENETIC REGULARITIES OF FORMATION OF RECURRENT DEPRESSIVE DISORDERS

CLINICAL-PSYCHOPATHOLOGICAL, GENEALOGICAL AND GENETIC REGULARITIES OF FORMATION OF RECURRENT DEPRESSIVE DISORDERS

Authors

Type of Article

  • Scientific Article

In the Section

  • DIAGNOSIS AND TREATMENT OF NEUROLOGICAL, PSYCHIATRIC AND DRUG-RELATED DISORDERS

Key words

Index UDK:
  • 616.8-008.64:575.191

Abstract

The purpose of the research: analysis of clinical-psychopathological, genealogical and genetic regularities of the formation of recurrent depressive disorders (RDD) for the improvement of diagnosis and therapy

175 patients with RDD were examined (main group), who underwent an inpatient course of treatment in the department of borderline psychiatry of the Department of Borderline Psychiatry of the State Institute of Internal Medicine of the National Academy of Medical Sciences of Ukraine, the comparison group included 46 people without mental disorders. The diagnosis of RDD was established according to the criteria of ICD-10.

As a result of the research, it was established that the mechanisms of RDD formation are determined by the combined influence of clinical and genealogical, social and environmental (factors of mental trauma) and individual and psychological (stress resistance and personal characteristics) factors. Depending on the degree of severity of RDD, the specificity of the leading psychotraumatic factors is determined. Specific features of the syndromal structure of RDD depending on the severity of the course: with a mild depressive episode, anxiety-phobic and somatic-vegetative syndromes probably prevailed; with a moderate depressive episode — asthenic and apathetic syndromes; with a severe depressive episode — hypochondriac syndrome, asthenic and apathetic syndromes.

It was established that a significant family accumulation of mental disorders in the pedigrees of patients with ADHD indicates a high role of hereditary factors in the occurrence of depressive disorders.

According to the results of the study of individual and psychological features that determine the stressprotective qualities of the personality, it was determined that patients with RDD are characterized by: the presence of pronounced anti-vital tendencies (the most pronounced are “helplessness”, “negative image of the present and future”, “loneliness”, anxious ruminations, as well as anti-vital thoughts. Patients with RDD have a low level of vitality (resources to overcome obstacles and compensatory mechanisms).

It was established that the frequency of genotypes associated with increased expression of P-glycoprotein (TT + ST genotypes) among patients is 68 %, and pharmacogenetically significant polymorphisms CYP2D6*4, CYP2C19*2 cause a high percentage of slow metabolizers (30 % and 23 % for markers CYP2D6*4 and CYP2C19*2, respectively), which indicates the importance of genetic testing for these markers before prescribing pharmacotherapy. It was found that the tendency of decreasing the frequency of genotypes associated with slow metabolism of antidepressants (CYP2D6*4, CYP2C19*2) and high expression of P-glycoprotein (MDR1) from severe to mild forms of depression may indicate the influence of these polymorphisms on the expressiveness of symptoms

The obtained data should be used for careful diagnosis of ADD, early detection of the risk of developing recurrent depression, selection of adequate pharmacotherapy taking into account genotyping and psychotherapeutic measures.

Pages

  • 105-114

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UKRAINS'KYI VISNYK PSYKHONEVROLOHII

The Scientific and Practical Journal of Medicine

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