Danylova M. Depressive disorders in multiple sclerosis (clinics, diagnosis, therapy)

In the thesis on the base of an integrated clinical-psychopathological, psycho-metric, and pathopsychological examination of 238 patients with depressive disorders in multiple sclerosis (the main group) and 129 patients with multiple sclerosis without depressive disorders (the control group) etiopathogenetic factors, clinical-psychopathological peculiarities, pathopsychological mechanisms of depression for-mation in multiple sclerosis were defined and the system of therapy for these patients was worked out. It was determined that pathopsychological mechanisms of depression development in patients with multiple sclerosis were stipulated by an interaction of individual-personal peculiarities of a premorbid state, biological and constitutional factors, which were under influence of the frustration of needs of success and self-realization due to a severe demyelinizing disease. This resulted in a protective behavior in form of rejection of self-realization and contacts, "escaping" from real problems, self-isolation, aggression (auto-aggression), enhanced and supported the frustration, a feeling of own feebleness, helplessness, and guilt, and manifested clinically in form of depressive disorder. Basing on the results of clinical-psychopathological, psychodiagnostic and pathopsychological investigation the differential system of therapy for patients with depressions in multiple sclerosis was developed.