[Comparative evaluation of depressive disorders in women and men]. / Osobennosti depressivnykh rasstroistv u zhenshchin i muzhchin.

AIM: To study clinical characteristics of depression in women and men. MATERIAL AND METHODS: One hundred and twenty women, aged from 18 to 65 years, and 67 age-matched men with the diagnosis of recurrent depressive disorder (RDD) (ICD-10 F33) were examined using a specially developed survey. RESULTS: Differences in the clinical picture and course of RDD in women and men were found. RDD in women develops at an earlier age, the number of attacks is greater but remissions are longer. However, complete remission is achieved more frequently in men. Most typical effect in the structure of depression in women is anxiety whereas melancholy prevails in men. Daily mood fluctuations and suicidal thoughts are characteristic of women. Motor retardation and decreased motivation are more frequent in men. Ideas of self-blame, avoidance of contacts with other people, adynamia, persistent sense of fatigue are more common in women. Sleep disorders are equally common in men and women but falling asleep disturbance and lack of sleep feeling are more common in women. Somatic symptoms of depression are generally more common in men as well as concomitant diseases of cardiovascular, respiratory and genitourinary systems. Men are more likely to abuse alcohol and other psychoactive substances. CONCLUSION: The identified characteristics of depression in women and men allow more accurate diagnosis and treatment recommendations.

[The differential diagnosis and treatment of depressive disorders in climacteric transition]. / Depressii u zhenshchin, manifestiruiushchie v period klimakteriia.

AIM: To study clinical symptoms of menopause depression, develop differential diagnostic criteria and consider treatment aspects. MATERIAL AND METHODS: One hundred and fifty women, aged 41-65 years, with mental disorders developed in different periods of menopause (perimenopause, menopause and post menopause) were studied. RESULTS AND CONCLUSION: Four types of depression were diagnosed: climacteric (n=46), psychogenic (n=35), endogenic (n=42) and involutional (n=27). Clinical characteristics of each type are presented in the aspect of correlations between psychopathological and climacteric (somatic) symptoms. Therapy of the depressions is discussed in light of literature on psychopharmacological, hormonal treatment and psychotherapy. The efficacy of antidepressants, in particular valdoxan (agomelatine), is highlighted.

[Prevention and treatment of mental disorders in women during the climacteric period]. / Profilaktika i lechenie psikhicheskikh narushenii u zhenshchin v klimaktericheskom periode.

The authors review problems of the treatment and prevention of mental disorders in climacteric women depending on the etiopathogenetic mechanisms of their origin. Group I included women with mental disorders accompanying vasomotor manifestations of the climacteric syndrome. To prevent and treat these disorders, of great importance is their diagnosis at the initial stage in the premenopausal period, particularly within the framework of the premenstrual syndrome. It is pathogenetically justified that this group patients be administered replacement hormonal therapy. Still, if mental disorders are aggravated, the hormonal drugs or their combinations with psychotropic agents should be withdrawn. Group II included women with psychogenous and endogenous mental diseases that occurred for the first time in the climacteric period. In this group patients, hormonal therapy should be withdrawn to prevent exacerbation of the health status and adequate treatment be instituted.

[The clinical picture and therapeutic principles in mental disorders in women with a postoperative climacteric]. / Klinika i printsipy terapii psikhicheskikh rasstroistv u zhenshchin s posleoperatsionnym klimakteriem.

49 patients after ovariectomy (OE) and 26 women after hysterectomy (HE) were examined. Psychiatrist's care was necessary for all of them because of marked mental disorders. The development of asthenic and dysthymic disorders was most typical after OE. OE induced the increase of depressive symptoms which acquired the neurotic and reactive signs when additional factors joined. Mental disorders after HE occurred as psychopathological symptoms of pseudopremenstrual syndrome and depressive and asthenic alterations in the pattern of menopausal syndrome. The development of hypochondriac personality was found in 22.5% of cases after OE and in 46.1% of patients after HE. Principles of therapeutic policy (correction of vegetovascular disturbances by combined application of substitution hormonal therapy, psychotropic drugs and psychotherapy) are formulated.

[The psychiatric aspect of the climacteric syndrome: its clinical picture and treatment]. / Psikhiatricheskii aspekt klimaktericheskogo sindroma: klinika i lechenie.

A total of 130 patients with the climacteric syndrome associated with mental disorders were examined by psychiatrists. Two groups of patients were distinguished. In Group 1 specific climacteric disorders ('flushes', excessive sweating, etc.) were the major components, whereas mental disorders (asthenic, phobic, hysterical, depressive) were just concomitant. In Group 2 the climacteric syndrome resulted in development of various mental diseases, mostly neuroses, depressions of various origins, superworship ideas. Recommendations on psychotropic therapy of these disorders were developed and contraindications against the use of hormonal therapy formulated.