Comprehensive program of therapy and rehabilitation of patients with cognitive impairments in depressive disorders

Abstract

The relevance of the study is due to the high prevalence of depressive disorders and significant negative medical and social consequences of the disease, which affect the decrease in the quality of life and social functioning of patients. A comprehensive program of therapy and rehabilitation (CPTR) for patients with cognitive impairment in depressive disorders was developed and its effectiveness was evaluated. The proposed CPTR for patients with cognitive impairment with depressive disorders implemented in four stages: diagnostic, therapeutic, rehabilitation and prophylactic. The diagnostic stage included a clinical and psychopathological assessment of the patients’ cognitive disorders, an analysis of anamnestic data, clinical symptoms, dynamics and prognosis of the disease, the relationship of clinical and socio-psychological factors. The therapeutic stage included a set of pharmacotherapy and psychotherapy measures aimed at correcting cognitive impairment, stopping depressive disorders, normalizing the psycho-emotional state, social adaptation and réadaptation of the patient. The rehabilitation stage included a set of pharmacotherapy and psychotherapy measures aimed at restoring cognitive functions, strengthening the effect of antidepressant therapy, and restoring the patient’s social functioning. The preventive stage designed to maintain a normal psycho-emotional state, effectively resist stress, and prevent the recurrence of depressive disorders. In approbation of the developed CPTR, 97 patients with cognitive impairment with depressive disorders make up the main group. The control group consisted of 93 patients with cognitive impairment with depressive disorders who underwent a course of therapy according to traditional schemes. The effectiveness of the proposed CPTR in patients with cognitive impairment with depressive disorders were proved, which consists in a more pronounced reduction of clinical manifestations of depressive disorders, improvement of cognitive functions, reduction of maladaptive and increase in adaptive strategies for cognitive regulation of emotions, improvement of social functioning in the main spheres of life. Keywords: cognitive impairment, depressive disorders, therapy and rehabilitation, social functioning.