Predicting the development of chronic depressive disorder

Introduction. Depressive disorders with a protracted or chronic course are characterized not only by a highprevalence in the population and often stronger severity, but also by complexity, variability, polymorphism, a highlevel of comorbid mental disorders, a high risk for suicide, frequent requests for help and repeated hospitalizations, adecrease in quality of life and social functioning, high economic costs of treatment. Objective: to develop a methodfor predicting the development of a depressive disorder with a chronic course, based on an assessment of acombination of factors that affect the risk of its occurrence. Material and Methods. The study was carried out on thebasis of the departments of borderline conditions and the day hospital of the Irkutsk Regional Clinical Hospital No. 1,the Irkutsk Regional PND. During inpatient and outpatient therapy, patients (n=310) with a verified diagnosis of adepressive episode (F32), recurrent depressive disorder (F33) according to ICD-10 were examined, the age of thedisease manifestation was in the range of 25-55 years. The main group (n=92) included 84 women and 8 men with acurrent chronic (lasting more than 2 years) depressive episode. The comparison group (n=218) was also dominated bywomen (188 versus 30) with recurrent depressive disorder without a protracted and chronic course with an averageduration of a depressive episode of 5.4±2.2 months. The main research methods were clinical-psychopathological andclinical-catamnestic. The first-degree relatives of the proband were examined by the clinical and genealogicalmethod. Multivariate statistical analysis was performed on 251 signs for each patient. Linear discriminant analysiswas used to develop a predictive model. Results. A mathematical model has been developed for predicting thedevelopment of a chronic course of a depressive disorder based on an analysis of risk factors, including family historyof mental illness (mood disorders, schizophrenia, alcoholism, personality disorders), the presence of factors ofresidual organic damage (perinatal pathology, severe childhood infections), age, mild traumatic brain injury) andconcomitant cerebrovascular pathology (stage 2 dyscirculatory encephalopathy), adverse early childhood experience(death of a parent, upbringing in a dysfunctional family, physical and sexual abuse), marital status (widowhood), preillness personality traits (harmonious or disharmonious), the presence of actual prolonged psychotraumatic situations,the gradual pace of the onset of a depressive episode, resistance to previously conducted adequatepsychopharmacotherapy. Conclusion. The proposed forecasting method makes it possible to identify a group ofpatients at risk for chronic depressive disorder for special preventive and therapeutic measures.