Baibarak N. The clinical and typological variants of recurrent depressive disorder with a prolonged course of disease

Based on a comprehensive clinical and psychopathological, psychodiagnostic, bio-chemical examination, patients were divided four clinical-typological variant of recurrent depressive disorder (RDD): I. Sad, II. Anxious-sad, III. Anxious-hypochondriac and IV. Depressed-dysthymic-apathetic (continual), which differ from each other a decrease in the favorability of the course and prognosis of the I-th to the IV-th variants, respectively. Dur-ing the course of the RDD following stages were identified: 1) Рhase-intermissional - more favorable, 2) Рhase-remissional - chronic. In between these stages separated the period of transition with the appearance of phenomena during remission of negative and positive affectivity. In the structure of the last describes a new symptom - the "echo of an-xiety." Variants differ from each other syndromal structure and syndromal dynamics, age manifest, the structure of period prior to disease, the spectrum of the preceding factors, the duration of the 1st stage, the number of phases in the 1st stage, the rate of the cycle "phase / remission" (in general is unfavorable for the prognosis of RDD factor). From the biochemical peculiarities of patients with RDD defined by various degrees of activation of the exchange of tryptophan, serotonin and melatonin. Recommendations on the duration and composition of the preventive treatment have been developed. The increase the complexity of depressive symptoms and the appearance of residual affective symptoms in remission are the indications to continue and strengthen preventive treatment.