Abstract
Introduction: Depressive disorders are one of the most complex and pressing problems of modern psychiatry; important scientific and practical importance is the study of the pathomorphosis of depression. The aim of the study is to study the features of clinical pathomorphosis of depressive disorders, taking into account the age factor. Materials and methods: Medical documentation of 115 men and 121 women with depressive disorders who applied for psychiatric care in 1971-1995 were studied, and 81 men and 108 women with similar depressive disorders who applied for medical care in 2015-2018 were examined clinically. Results and conclusions: In modern patients, pathomorphosis is most pronounced in young patients (under 30 years of age): asthenia and pessimism were more common in them (65.9% versus 81.9%, p<0.05), suicidal thoughts (52.7% versus 68,7%, p<0.05), dyssomnias. In this age group, there was a decrease in anesthetic symptoms (34.8% versus 12.2%, p<0.01) with an increase in depressions with psychopathological symptoms, mainly in the form of obsessions (42.9% versus 59.0%, p<0,05), depressions with disturbances of biological rhythms, mainly in the form of postsomnic disorders (73.6% versus 96.4%, p<0.05), with vegetative-somatic disorders (63.7% versus 79.5%, p<0.05), asthenic (67.0% versus 81.9%, p<0.05) and agitated symptoms (26.4% versus 39.8%, p<0.05). In the middle age group (30-44 years), the share of vital forms of depression in the structure of depressive symptoms decreased (65.8% versus 44.6%, p<0.01) and depressions with senesto-algic symptomatology (6.6% against 9.6%, p<0.05). In patients of the older age group (45 years and more), the main trends in clinical pathomorphosis were a decrease in anhedonia (90.9% versus 70.7%, p<0.01) and low self-esteem (89.4% versus 65.9%, p<0.01), as well as an increase in apathetic depressions (13.6% versus 29.3%, p<0.05). The general tendency of modern pathomorphosis of depressive disorders is the reduction of vital forms of depression with an increase in depressions with asthenic, anxious and somatic symptomatology.
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