Koltsova H. Gender-oriented psychotherapy in complex treatment of depressive disorders of different genesis

The aim of present research was to study the clinical psychopathological and pathopsychological features of depressive disorders associated with suicidal behavior, to develop a personalized system of complex therapy and prevention of suicidal behavior, to evaluate its effectiveness. A comprehensive survey of 147 patients with depressive disorders (76 females and 71 males) associated with suicidal behavior was conducted. According to the established diagnosis, patients were divided into 3 clinical groups: I – patients diagnosed with a moderate or severe depressive episode without psychotic symptoms (F32.1, F32.2), II – recurrent depressive disorder moderate or severe episode without psychotic symptoms (F33.1, F33.2), III – bipolar disorder current episode of moderate or severe depression without psychotic symptoms (F31.3, F31.34). The main group (MG) consisted of 105 patients (55 females and 50 males), who participated in our program of suicide prevention; control group (CG) – 42 patients (21 women and 21 men), who received standard regulated therapy in the hospital. It was found that the clinical and psychopathological structure of depressive disorders in men were dominated by sad (in recurrent depressive disorder), anxious (in a depressive episode of bipolar disorder), apatho-adynamic (with a depressive episode) types; in women the sad (in a depressive episode), anxious (in a depressive episode of bipolar disorder) and senesto-hypochondriac (in a recurrent depressive disorder) variants were dominated. It has been established that suicidal attempts are more often performed by men with recurrent depressive disorder and women with depressive episode of bipolar disorder, suicidal decisions and intentions occur more often in men with depressive episode of bipolar disorder and in women with recurrent depressive disorder, passive and active suicidal thoughts consistently occur in all patients regardless of the genesis of depressive disorder. A gender-personified system of therapy for depressive disorders and prevention of suicidal behavior with differentiated use of psychopharmacotherapy, individual and group psychotherapy and psychoeducation has been developed and tested. The high efficiency of the offered therapeutic program is established, patients of the main group were reached the steady therapeutic effect, which remained within 2 years.