[Psychosocial pathomorphosis of depressions]. / Psikhosotsial'nyi patomorfoz depressii.

ABSTRACT

OBJECTIVE: The aim is to determine the changes in phenomenology of depressions (mostly of melancholic type with pronounced affect of sadness, chronobiological shift, neurovegetative changes and typical affect-congruent depressive ideas) over the past decades. MATERIAL AND METHODS: We've compared the archival data of one of the authors (V.N.K.) obtained in the study of depression within 1980-1086 years (1st group, 103 patients, 47 with recurrent depression and 56 with bipolar depression) and the data of the study of depression during 2015-2021 years with registration of symptoms with the same psychopathological scale at the same clinic for affective disorders (2nd group, 109 patients, 52 with recurrent depression and 57 with bipolar depression). The groups are age-comparable (21-59 y.o.). The Hamilton Depression Rating Scale (HDRS-17) has been used to assess the severity of depression (score of 21-32 in both groups). Statistics included frequency analysis with use of χ2 criterion. RESULTS: Biologically mediated symptoms (shortened sleep with early awakening, typical diurnal variations with vitalization of depressive affect and loss of energy mostly first half of day, decreased appetite, libido and motivation for any activity) were not statistically different in the study groups. Whereas symptoms associated with emotional reactivity and congruent depressive ideations like worthlessness, guilt, suicidal thoughts, as well as anaesthesia psychica dolorosa - were statistically rare in 2nd group, except anhedonia. The same time the facts which have been obvious amongst patients of 2nd group were the difficulties to verbalize their feelings, shortage of vocabular for reflections about their suffering, especially amongst young patients. CONCLUSION: The results of the study can indicate some changes in the phenomenology of depression over the past decades. Basically, the same underlying disorders can produce different clinical presentation, particularly concerning an awareness and verbalization of moral feelings and other emotions. One of the possible psycholinguistic assumption may be limited vocabulary for feelings because of spreading social networks with very poor and formal language instead of live direct communication.