Problems of depression in neurological practice

   Introduction. Depressive disorders have ceased to be only the task of psychiatrists. Depression is detected in patients with a somatic and neurological profile as a reaction to the disease, and may be the cause of the disease. The number of above-mentioned pathologies remains unknown to date. The main task for health care organizers is the need to build an algorithm for the identification, registration and treatment of depressive disorders in patients with combined pathologies. This article discusses depressive disorders in patients with multiple sclerosis.

   The purpose of the study: to study depressive disorders and factors influencing depression in patients with multiple sclerosis.

   Materials and methods. 203 patients with clinically confirmed diagnosis of MS participated. Taking into account the course of the disease, MS patients were distributed: with a remitting (RRS) type of MS course 88.2 % (179 people) and 11.8 % (24 people) with a secondary progressive course (RRS). The average age of the examined patients with remitting course (RRS) ranged from 15 to 63 years, on average 38 ± 10 years. The age of the examined patients with HPV is in the range from 29 to 65 years, on average (46 ± 9.00) years. The majority of patients had a disease duration of less than 20 years, on average 8.23±6.57 years. The average age of onset of the disease is 30.2±10.5 years. The duration of the disease is 9.84 ± 0.73 years, while the level of disability of patients (score in points on the Expanded Disability Status Scale/EDSS) at the time of examination was 2.89 ± 0.16 points. The disability index varied in patients with RRS2.89 ± 0.16 points, in patients with RRS (5.0 ± 0.24) points.

   Results and discussion. 55.7 % (113 people) of MS patients were diagnosed with depression, of which 80.5 % (91 people) and 19.5% (22 people) of patients with a remitting (RRS) course and a secondary progressive course of the disease (RRS). More than 54.8 % (62 people) had mild and moderate depressive manifestations, 39.8 % (45 people) most often had mixed anxiety-depressive disorder, recurrent depressive disorder, then depressive episodes. It was revealed that the development of depression in patients with a remitting course is influenced by: «disease duration» PC p = 0.00333**, «disability level» p = 0.0457* and «personal anxiety» p = 0.0194. In patients with a secondary progressive course, depression is influenced by the following factors: «situational» p = 0.0398* and «personal anxiety» p = 1.740. The social status determined that patients with «MS without depression» who were married were statistically less likely to suffer from depression and maintained their working capacity longer (p < 0.001).

   Conclusion. Depressive disorders are the leading disorders in neurological patients, but their number and severity of symptoms are often ignored by specialists. Therefore, the health authorities are faced with the task of building a clinical and organizational algorithm for the identification of depressive disorders, as well as their timely medical correction.

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