[Dual diagnosis: depression and alcohol use disorder]. / Dvoinoi diagnoz: «depressiya¼ i «rasstroistvo upotrebleniya alkogolya¼.

A combination of depression and alcohol use disorder (AUD) is a typical and most common example of a dual diagnosis at the intersection of general psychiatry and addiction psychiatry. A comorbidity of depression and AUD is more common than it can be brought about by mere coincidence, which might be explained to some extent by the synergetic effect of both diseases, with each of them complicating the course and worsening the prognosis of the other. Treatment protocols for patients with depression and comorbid AUD include antidepressants, specific medications for alcohol dependence, and psychotherapy. The first-line antidepressants in the treatment of patients with a comorbid combination of depression and alcohol use disorder, as in other clinical situations implying use of antidepressants, are selective serotonin reuptake inhibitors (SSRIs). Fluvoxamine has certain advantages over the other SSRIs in the treatment of patients with a depression and comorbid AUD.

[Agoraphobia with panic disorder combined with depression]. / Simptomokompleks agorafobii s panicheskim rasstroistvom, komorbidnyi s depressiei.

OBJECTIVE: The aim of the study was to investigate the course of agoraphobia with panic disorder combined with the major depressive disorder to establish positive and negative prevalence predictors. MATERIAL AND METHODS: The sample consisted of 49 women. The average age was 41.5±9.9 years. All patients (n=49; 100%) had symptoms of agoraphobia with panic disorder (F40.01) (n=49; 100%) and recurrent depressive disorder with mild (F33.01) (n=33; 67.3%) or moderate (F33.11) (n=16; 32.7%) severity. The duration of the disease by the time of inclusion in the study was from 2 to 5 years. Clinical-psychopathological, clinical-follow-up, clinical-dynamic, and statistical methods were used. RESULTS AND CONCLUSION: Two types of agoraphobia prevalence with panic disorder were identified. Type I is a relatively favorable one with complete remissions of phobic anxiety and affective disorders (n=29; 59.2%). Type II is an unfavorable one with constant phobic anxiety symptoms (n=20; 40.8%). The predictive factors of the unfavorable type of agoraphobia with panic disorder (APD) combined with depression were psychogenic situations, astheno-vegetative disorders at the onset of APD, gastrointestinal symptoms, senestopathy, fear of going crazy, or loss of control in the structure of a panic attack (PA), morning PA, vertebral artery syndrome, diseases of the gastrointestinal tract, panic attacks with provocation, depression with hysteroform symptoms in pre-manifest period APD, the age at the time of the debut APD, professional status, occupational psychogenic, family microclimate, health problems, endocrine system diseases, severe agoraphobia.

[The differences in the estimation of depression severity by psychiatrists and patients during the combined treatment with agomelatine (a multicenter study "EMOTSIA")]. / Razlichiya v otsenke tyazhesti depressii vrachami i patsientami v protsesse kombinirovannoi terapii agomelatinom (mul'titsentrovoe issledovanie «EMOTsIYa¼).

AIM: To compare the prognosis of depression severity estimated by the physician and by the patient based on the treatment outcome. MATERIAL AND METHODS: One hundred and seven patients with depression were examined. Mental status was assessed with HАМ-D, SHAPS, CGI-S, CGI-I, PGI-S, PGI-I and VAS. A data analysis was performed. RESULTS: There were differences in the estimation of depression severity by psychiatrists and patients. Moreover, the scores on HАМ-D and CGI-S were not consistent when assessed by psychiatrists. As the severity of depression decreased and patient's state improved during the treatment with agomelatine (valdoxan), the assessments of the changes by the psychiatrist and the patient became similar. CONCLUSION: Agomelatine (valdoxan) is effective and tolerable in the treatment of depression of any severity. The differences between the psychiatrist's and patient's estimation of the depression severity at baseline using different psychometric scales can level the prognostic value of treatment outcome.