Клинико-психопатологические особенности депрессий при органических заболеваниях головного мозга в позднем возрасте

Abstract

Study Objective: Comprehensive study of the clinical and psychopathologic structure and assessment of the affective disorder nosology in organic cerebropathies in elderly people. Study Design: observational comparative clinical study. Materials and Methods. We have examined 105 patients over 50 years old (mean age: 61.3 ± 7.6 years) with affective disorders and organic cerebropathies (F06; F30–39; F43). Subjects were divided into two groups: 49 patients with organic central nervous system (CNS) diseases and prevailing affective symptoms in their psychoorganic syndrome (Group 1); 56 patients with affective disorders and an organic cerebropathy late in their life (Group 2). We used the clinical psychopathologic method, Montgomery – Asberg Depression Rating Scale, Hospital Anxiety and Depression Scale, and Mini Mental State Examination. Study Results. Significant differences were found in the distribution of the primary etiological factor of organic cerebropathies. Group 1 had mostly mixed etiology (42.8%), while Group 2 had toxic CNS damages (33.9%). There were large intergroup differences in affective disease nosology: Group 1 patients had mostly organic depressions (51.2%), and recurrent depressions (36.7%). Group 2 patients had recurrent depressions and bipolar effective disorders. Significant differences were found in the age of disease manifestation (54.8 and 39.4 years, respectively, р < 0.001) and disease duration (6.5 and 19.9 years, р < 0.001). Group 1 patients had mostly chronic and recurrent depressions, while Group 2 patients had bipolar and recurrent disease (р < 0.001). The number of past depressive events differed a lot as well: 3.1 and 6.4 (р = 0.03). Group 2 patients had more cases of severe dreary and anergic depression. Conclusion. Clinical and psychopathologic features of affective disorders in organic cerebropathies in elderly people are polymorphic symptoms, including various ratios of depressive and psychoorganic syndromes. Depressions in elderly people with organic cerebropathies have their distinguishing structure, clinical course and require a number of additional diagnostic examinations and division into two types depending on the relation between the time of affective pathology onset and organic cerebropathies. Keywords: depression in elderly people, late depression, organic cerebropathies, affective disorders, cognitive disorders.