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[慢性抑郁症的临床心理病理学方面]

[The clinico-psychopathological aspects of chronic depressions].

作者信息

Pukhovskiĭ A A

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 1993;93(2):68-73.

PMID:8048311
Abstract

Study of the clinical and psychopathological features of depressions in 40 inpatients, whose states corresponded to the criteria of chronic depressive disorders as described in different papers and classifications, including ICD-10 and DSM-III-R, made it possible to distinguish two types of staged development of chronic depressions: with acute or gradual onset. The possible criteria of chronicity of depressions are as follows: combination of hypersthenic, hyperthymic and sensitive traits in heredity, combination of hyperthymic hysterical and sensitive traits in premorbid personality, early appearance of affective disorders, presence of long-term periods of affective disorders of a subclinical level in life history, bipolar type of the course of these disorders, reactive-provoked depressive episodes with melancholic structure, a history of apathic adynamic subdepressive disorders in the preexisting course of illness, anxiety in acute episodes, disharmony in elements of the depressive triad, hypochondriacal preoccupation of self-accusational ideas, neurotic symptoms in the structure of acute episode, the 'out' direction of the "accusational vector" already during this stage, appearance of such phenomena as "verbalization of affect", "Sunday impairment', "forced hyperactivity", tendency to hospitalism, hypomanic "windows", appearance of egocentric, grumble, capricious features, sharpness of sensitive and hysterical features of premorbid personality in depressive states.

摘要

对40名住院患者的抑郁症临床和精神病理学特征进行研究,这些患者的状态符合不同论文和分类(包括ICD - 10和DSM - III - R)中所描述的慢性抑郁症标准,这使得区分慢性抑郁症的两种分期发展类型成为可能:急性起病型或逐渐起病型。抑郁症慢性化的可能标准如下:遗传中强体力型、情感高涨型和敏感特质的组合;病前人格中情感高涨型、癔症型和敏感特质的组合;情感障碍早期出现;生活史中存在长期亚临床水平的情感障碍期;这些障碍病程的双相类型;具有抑郁结构的反应性诱发抑郁发作;既往病程中有情感淡漠性动力不足性亚抑郁障碍病史;急性发作时的焦虑;抑郁三联征各要素之间的不协调;疑病性先占观念、自责观念;急性发作结构中的神经症症状;在此阶段“指责向量”的“外向”方向;出现“情感言语化”“周日功能损害”“强迫性多动”、住院倾向、轻躁狂“窗口期”;出现以自我为中心、爱抱怨、任性的特征;抑郁状态下病前人格敏感和癔症特征的尖锐化。

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