IntroductionCurrently there exists a need of individualized approach to the diagnostics and treatment of organic depression.The aim and objectiveis to explore the relationship between age of onset and the etiological factors of organic depressive disorder (F06.32 according to ICD-10).Methodsclinical, clinical-psychopathological, anamnestical-catamnestical, statistical.Results50 patients with organic depressive disorder (F06.32) in comparing to 25 patients with major depressive disorder (F33) were studied.Differences in age of onset is shown in the Figure 1.Distribution of patients with organic depressive disorder (n = 50) and recurrent depressive disorder (n = 25) by age of manifest.Overall age of onset of depression in patients with organic depressive disorder was significantly later than in patients with recurrent depressive disorder (p<0.05).The patients with organic depressive disorder with onset after 45 years constitute relatively homogeneous pool, with a clear tendency to separate from the rest of the patient`s population. They have a different spectrum of etiologic factors compared to patients with earlier onset of disease.Births, episyndrome and infectious-allergic encephalopathy as etiologic factors identified in our material only in patients with onset younger than 45 years. Coronary heart disease, myocardial infarction, atherosclerotic encephalopathy, operations, pancreatitis were identified only after 45 years.Hypertension was more common after age 45. An uncertain etiological factor is much greater in case of late onset. An earlier onset was characterized by more clear causality of depression.These data support the view of the necessity of separation involutional depression from the other depressive disorders.
Introduction:In spite of good development of laboratory and instrumental methods of diagnostics of brain and mental disorders, there remains an insufficiency of methods for etiology differentiation, especially clinical-psychopathological in psychiatry.The aim and objective:is to evaluate the differential diagnostic's opportunities in estimation of clinical phenomena's complexity for identification of neurotic, organic or endogenous genesis of disorders.Methods:expert estimation, statistical.As the experts 7 certified specialists (psychiatrists, psychologists and others) were involved.In the research the academically definitions and the clinical case descriptions of the following clinical phenomena were estimated:Conversion, obsession, neurasthenia, phobia, derealisation/depersonalization, anxiety (partly specific for neurotic, stress-related and somatoform disorders);True hallucinations, confusion, amnesia, fixation hypomnesia, anecphoria (partly specific for organic mental disorders);Pseudo hallucinations, delusion of control, automatism, paralogia, emotional withdrawal, autism, ambivalence (common symptoms of schizophrenia);Inability to feel, sadness, lassitude, euphoria, excitement as the signs of endogenous affective disorders.Mainly non-specific phenomenon - persecutory delusions.Thus were obtained 14 estimates for each item on a 100-point scale.Results:Dispersion of majority ranges was too high to get significant differences. But 6 from 7 experts significantly (p<0.05) and 1 tendentionally (p<0.01) rated 3 symptoms (autism, conversion and paralogia) as relatively more complex as compared with 7 more simplex phenomena (anxiety, confusion, euphoria, excitement, neurasthenia, phobia and sadness) by U-Wilcoxon-Mann-Whitney criteria.Conclusion:established ranges of psychopathological phenomena's complexity reveal non-linear relations to etiology but in some cases they can be useful instrument of differential diagnostics of mental disorders.
Introduction:In Ukrainian practice of medical health and social work also in the World there is big cooperation between neurologists and psychiatrists in assistance to the people with disabilitating neurological diseases. The successes of neurology, neuropsychiatry, neuropsychopharmacology and related sciences give the hope to these patients. The significance of mental disturbances after neurological pathology is very high.The aim and objective:were to explore the impact of mental disturbances in the forming of the severity of disability due to the nervous system diseases.Methods:clinical, clinical-psychopathological, anamnestical-catamnestical, statistical.Results:From 2477 clinically examined patients 1344 had disability and 1103 were applying for disability due to neurological diagnosis. In the continuum of disabled patients were included the patients with 3rd group of disability (706), 642 had 2nd group and 26 had 1st most severe group of disability according to Ukrainian legislation.937 disabled patients and 351 applying for disability were examined once. Other patients (437 disabled persons) and (342 applying for disability patients) were observed for: 1 year (533), 2 years (67), 3 – 7 years (11). For 112 patients the group of disability was changed (increased) from no degree to 3rd or from 3rd to 2nd and from 2nd to 1st (most rarely). In this group the increasing of number of psychopathological symptoms is significantly higer than in the group of 421 other patients by U-Wilcoxon-Mann-Whitney criteria.Conclusion:The severity and dynamics of mental disturbances are the important factors influencing on severity of desadaptation in patients with disabilitating neurological diseases.
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