CLINICAL PICTURE OF DEPRESSIVE MANIFESTATIONS AMONG PATIENTS WITH COGNITIVE IMPAIRMENTS IN DEPRESSIVE DISORDERS

Maruta N. O., Yaroslavtsev S. O., Kalensʹka H. Yu.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The problem of depression will remain relevant for many years, due to the extremely widespread prevalence of mental disorders. According to various epidemiological studies, depression affects from 14% to 25% of the population. Timely and adequate treatment of mood disorders is a very important problem around the world, because according to the WHO, it is one of the leading causes of disability among the working population. Depression negatively affects all components of the lives of patients and their relatives, reduces their standard of living and the degree of social functioning. An important aspect of depressive disorders is that they are characterized by a recurrent course, a tendency to form resistant forms and pose a significant threat due to the development of suicide risk in this category of patients. But at the present stage of development of science and practice, the detection and classification of depression in the general medical network are associated with significant difficulties. Therefore, research aimed at studying the clinical and psychopathological features in patients with CP in different types of DR is relevant and will improve the diagnostic criteria and increase the effectiveness of treatment of different types of DR. The aim of the study was to identify specific manifestations of emotional, psychomotor, somato-vegetative and sensory disorders in patients with cognitive impairment in different types of depressive disorders. Object and methods of research. 362 patients with cognitive impairment in depressive disorders (DD) were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 patients with prolonged depressive reaction (PDR). A set of research methods was used: clinicalpsychopathological and statistical. Results. Specific clinical and psychopathological features of depressive manifestations were established in patients with cognitive impairment in various types of DD, which were expressed in the presence of psychomotor, somato-vegetative, emotional and sensory impairments. A sleep and appetite disorders, weight loss, cardiovascular symptoms, hypesthesia, anesthesia, inhibition of movements, hypomimia, hypotension, sensitivity, emotional lability and anxiety were recorded in patients with RDD. A constipation, decreased appetite and weight, sexual dysfunctions, hypoesthesia, senestopathy, body structure disorders, inhibition of movements, hypomimia, muscle adynamia, hypotymia, apathy, emotional coldness and ambivalence of emotions were recorded in patients with BAD. A vegetative-visceral crises, headaches, sexual dysfunctions, gastrointestinal symptoms, hyperesthesia, anxiety, hypotension, a sense of fear, emotional lability and sensitivity were recorded in patients with PDR. Conclusions. Clinical and psychopathological analysis of depressive manifestations in patients with cognitive disorders in depressive disorders allowed identifying specific manifestations of emotional, psychomotor, somatoautonomic and sensory disorders that are characteristic of different types of depression, which will further help improve differential diagnosis and preventive measures.

patients with cognitive impairment, depressive disorders, clinical and psychopathological characteristics, emotional, psychomotor, somato-vegetative and sensory disturbances, recurrent depressive disorder, bipolar depressive disorder, prolonged depressive reaction.

1. Marcus M, Yasamy MT, van Ommeren M, Chisholm D, Saxena S. Depression: a global public health concern. Geneva, Switzerland: World Health Organization; 2012. р. 6-8.
2. Brisa S Fernandes, Leanne M Williams, Johann Steiner, Marion Leboyer, André F Carvalho, Michael Berk. The new field of ‘precision psychiatry’. BMC Medicine. 2017;15:80.
3. Meeten F, Davey GCL. Mood-as-input hypothesis and perseverative psychopathologies. Clin. Psychol. Rev. 2011;31(8):1259-75. DOI: 10.1016/j.cpr.2011.08.002
4. Patricia A Arean, Kevin A Hallgren, Joshua T Jordan, Adam Gazzaley, David C Atkins, Patrick J Heagerty, Joaquin A Anguera. The Use and Effectiveness of Mobile Apps for Depression: Results From a Fully Remote Clinical Trial. Journal of Medical Internet Research. 2016 Dec 20;18(12):e330. DOI: 10.2196/jmir.6482
5. Kompleksnyy plan deystviy v oblasti psikhicheskogo zdorov’ya na 2013-2020 gg. [Internet]. Zheneva: VOZ; 2013. s. 2-37. Dostupno: http:// apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R8-ru.pdf?ua=1 [in Russian].
6. Kessler RC. The costs of depression. Psychiatr. Clin. North Am. 2012;35(1):1-14.
7. Iwata M, Ota KT, Duman RS. The inflammasome: pathways linking psychological stress, depression, and systemic illnesses. Brain, Behav. Immun. 2013;31:105-14. DOI: 10.1016/j.bbi.2012.12.008
8. Elliott R, Zahn R, Deakin J, Anderson I. Affective Cognition and its Disruption in Mood Disorders. Neuropsychopharmacology Reviews. 2011;36:153-82.
9. Williams LM. Precision psychiatry: a neural circuit taxonomy for depression and anxiety. Lancet Psychiatry. 2016;3:472-80.
10. Conradi HJ, Ormel J, de Jonge P. Symptom profiles of DSM-IV-defined remission, recovery, relapse, and recurrence of depression: the role of the core symptoms. Depress. Anxiety. 2012;29(7):638-45.
11. Hasselbalch BJ, Knorr U, Hasselbalch SG, Gade A, Kessing LV. The cumulative load of depressive illness is associated with cognitive function in the remitted state of unipolar depressive disorder. Eur. Psychiatry. 2013;28(6):349-55.
12. Barbot A, Carrasco M. Emotion and anxiety potentiate the way attention alters visual appearance. Sci. Rep. 2018;8:5938.
13. Fried EI, Nesse RM. Depression is not a consistent syndrome: an investigation of unique symptom patterns in the STAR*D study. J. Affect. Disord. 2015;172:96-102.
14. Maruta NO, Panʹko TV, Kalensʹka GYu. Diahnostychni kryteriyi depresyvnykh rozladiv na etapakh nadannya medychnoyi dopomohy. Ukrayinsʹkyy visnyk psykhonevrolohiyi. 2017;25:1(90):135. [in Ukrainian].
15. Shahyakhmetov FSh, Anokhyn PK, Shamanyna YYu. Vortyoksetyn: mekhanyzmy mulʹtymodalʹnosty y klynycheskaya éffektyvnostʹ. Sotsyalʹnaya y klynycheskaya psykhyatryya. 2016;26(4):84-96. [in Russian].
16. Vieta E, Sluth LB, Olsen CK. The effects of vortioxetine on cognitive dysfunction in patients with inadequate response to current antidepressants in major depressive disorder: a short-term, randomized, double-blind, exploratory study versus escitalopram. J. Affect. Disord. 2018;227:803-9.

«Bulletin of problems biology and medicine» Issue 4 (158), 2020 year, 160-166 pages, index UDK 616.895.4-036.1-052-008.46

10.29254/2077-4214-2020-4-158-160-166