Dorozhenok I Iu
Zh Nevrol Psikhiatr Im S S Korsakova. 1998;98(11):14-8.
Twenty depressed patients (according to ICD-10) with obsessions of contrast content (homicidophobia--4 patients, suicidophobia--12, other contrast obsessions--4 cases) were examined. The affective disorders belonged to polar areas of a depressive spectrum: anxious depressions (with a prevalence of manifestations of positive affectivity in the form of somatopsychic hyperstesia) and existential depressions (with domination of manifestations of negative affectivity in the form of alienation of the vital functions). In anxious depressions there were compulsive obsessions of contrast content (12 patients), while in existential ones impulsive obsessions (8 cases). Compulsive obsessions of contrast contents (fear of a lack of self-control pronounced in the form of the attacks of lissophobia) were formed at the height of an anxious-depressive affect. Impulsive obsessions of contrast contents (fear of self-damage with elements of an obsessive drive to its realization) were formed during depressive devitalization and were exceeded by suicidal ideas. Comorbidity of depressive and obsessive manifestations was realized by a peculiar type of interrelations with formation of "convergent" symptoms which reflected an increase of severity of depressive disorders.
对20名（根据国际疾病分类第10版）患有反差内容强迫观念的抑郁症患者进行了检查（恐杀症——4例患者，恐自杀症——12例，其他反差强迫观念——4例）。情感障碍属于抑郁谱系的两极区域：焦虑性抑郁症（以体感性过敏形式表现的积极情感占优势）和存在性抑郁症（以生命功能异化形式表现的消极情感占主导）。在焦虑性抑郁症中有反差内容的强迫性强迫观念（12例患者），而在存在性抑郁症中有冲动性强迫观念（8例）。反差内容的强迫性强迫观念（以恐松弛症发作形式表现出的对缺乏自我控制的恐惧）在焦虑抑郁情绪的高峰期形成。反差内容的冲动性强迫观念（对自我伤害的恐惧以及有实现自我伤害的强迫性冲动因素）在抑郁性活力丧失期间形成，且自杀观念更为严重。抑郁和强迫表现的共病是通过一种特殊类型的相互关系实现的，即形成“趋同”症状，这反映了抑郁障碍严重程度的增加。
