Kyrylyuk S. Differential diagnosis of depression considering to its modern phenomenological picture

The thesis is dedicated to the study of clinical and pathological peculiarities of modern picture of melancholic and anxious depression changed by socio-cultural factors. Necessary changes in primary diagnostics of the mentioned types of depression are substantiated; specification of personality characteristics and specific forms of processing of depressive disorder in the studied categories of patients is proved. The study is based on the sequential design with selection of two groups of patients. The total number of cases selected for research upon screening was 200. Out of these, 80 were eliminated according to the selection criteria in the course of symptom analysis. Group 1 - 60 patients with melancholic depression (F.32, F.33); group 2 - 60 patients with anxious depression (F.41.2). One of the most substantial results of the study was combination of procedures of fixation of 'active' and 'passive' complaints for identification of clinical and psychopathological peculiarities of the course of current depressive disorders; this allowed carrying out the clinical verification of the subjective presentation of depressive disorders. Patients in both groups (of melancholic and anxious depression) did not consider the classic triad of depression to be leading in their condition; rather, the main complaints of patients of the group of melancholic depression were the 'vital' ones. Patients with melancholic depression presented with two culture-specific phenomena related to processing of their depressive conditions: these were syncretic thinking and pseudoautistic social withdrawal. Syncretic thinking presented as a specific standpoint where depression was a result of 'the evil eye' as it was formulated by the patients; this was related to the failure to take on the responsibility for their own suffering. In its clinical sense, this phenomenon in melancholic depression was a defense position aimed at justifying the patients' vital inability. The pseudoautistic social withdrawal manifested in the form of 'contamination infection' idea, usually formulated as 'not to catch or transmit the disease'; it was caused by fear of sharing their experience and perceiving depressive experience of others. An optimum package of tools of phenomenological standard diagnostic differentiation of depressive disorders is suggested, considering the discovered clinical, pathological, social, cultural, and psychological phenomena.