The dissertation is devoted to a comprehensive analysis of depressive disorders in patients with epilepsy in the interictal period, to investigations of their clinical and psychopathological characteristics, pathopsychological features and mechanisms of formation of the specifics of psychopathological conditions, clinical and psychopathological characteristics, pathopsychological determinants, and mechanisms of formation of interictal depression in order to solve the problem of improving their diagnosis and therapy. The study involved 149 persons, of whom three main and one control research groups were formed. The main research groups presented 109 patients with epilepsy with interictal depressions: the main group 1 - patients with organic depressive disorders (F06.32) - 41 patients; the main group 2 - patients with psychogenic depressive disorders (adaptation disorders F 43.21-43.23) - 31 patients; the main group 3 - patients with endogenous depressions (depressive episode F32.0-32.2 and recurrent depressive disorder F33.0-33.2) - 37 patients. The control group of the study consisted of 40 patients with epilepsy without signs of depressive pathology. Taking into account the goals and objectives of the study, clinico-psychopathological, psychometric, psychodiagnostic and statistical methods were used.
It was determined that the clinical manifestations of depression in epilepsy had their own specifics depending on the form of depressive pathology. Somato-hypochondria manifestations with somatic anxiety and asthenia prevailed in the structure of organic depressions. In the structure of psychogenic depressions during epilepsy, along with depressive manifestations, symptoms of an anxiety spectrum were expressed. The leading place in the structure of endogenous depressions belonged to the symptoms of the astheno-anergic spectrum with the addition of “classic” depressive manifestations (insomnia, guilt, weight loss, as well as genital symptoms).
It had been found out, that the pathopsychological mechanisms of the formation of depressive disorders in patients with epilepsy involved features of socio-psychological adaptation, manifestations of aggression, characterological characteristics and the specificity of the psychological response to the disease. Taking into account the peculiarities of psychopathological conditions, clinical and psychopathological manifestations and pathopsychological factors in the formation of depressive disorders in the interictal period of epilepsy, an integrated program for the treatment of depression has been developed. It is implemented using psychopharmacotherapy, psychotherapy and psycho-education. The results of testing proved its high efficiency and effectiveness, which were confirmed by a significant improvement in the conditions of patients, reduction of psychopathological symptoms, and positive changes in the structure of the internal picture of the disease. Keywords: epilepsy, interictal period, organic depressions, psychogenic depressions, endogenous depressions, psychopathological conditions, clinical and psychopathological manifestations, syndromic structure, pathopsychological features, mechanisms of formation, diagnostic signs, integrated therapy program.
