[Chronic depressions (author's transl)].

The definition of chronic depression necessarily calls for a review of the concept of recovery which in psychopathology is not clearly and univocally defined. The percentage of chronic evolution among depressive patients either as a persistence of depressive symptoms or as an impairment of social and professional role, ranges from 12 to 15%. Chronic depression raises psychopathologic and nosographic problems as well as clinical ones. In fact chronic depressives are often not correctly diagnosed, inadequately treated and destined to be affected by an over increasing inability. The chronic evolution of depression may result as a concurrence of several factors: a neurotic personality, an inadequate antidepressant maintenance treatment, an inappropriated use of minor tranquillizers as the only treatment. The occurrence of physical impairement, the continuous nature of depression and the resistance of antidepressant treatment may be also considered. Moreover the psychodynamic mechanisms aroused by the depressive experience and the secondary advantages of the illness may plan an effective role maintaining depressive symptomatology.