SOME FEATURES OF DEPRESSION WITH SUICIDAL BEHAVIOR IN LATE LIFE (CLINICAL, PSYCHOPATHOLOGICAL AND PATHOPSYCHOLOGICAL ASPECTS)
Introduction. Depressive disorders in old age are often not recognized or inadequately treated, aggravate the course and prognosis of comorbid pathology, lead to disability, to even greater physical decline, worsen the quality of life not only of patients, but also of their environment; lead to suicidal behavior. With depressive disorders in old age, there is a weakening of cognitive functions, manifested in difficulty in performing complex tasks, slowing down the pace, impaired concentration and difficulties in making decisions. However, in psychometric studies of the ability to reproduce, significant differences from healthy elderly people are often not revealed.
The aim to identify some clinical and psychopathological features of depression with suicidal behavior at a late age.
Materials and methods of research. The work was carried out in the Republican Scientific and Practical center of Mental Health of the Ministry of Health of the Republic of Kazakhstan. The material was used by patients with depression with suicidal behavior at a late age who underwent inpatient treatment at the RSPCMH MH RK in 2016-2021. The main research methods were clinical-psychopathological, clinical-catamnestic, the duration of the catamnesis ranged from 1 to 6 years. An experimental psychological method, psychometric scales were also used: the scales of personal and situational anxiety (according to Spielberger), the scale of depression (according to Tsung) to determine the severity of depression and anxiety.
Results. The observation showed that the course of psychosis in the patients of the study group was characterized by the development of repeated seizures (only 5 patients suffered one attack, which may be explained by the short period of catamnestic observation). In 8 cases, these were monopolar seizures within the framework of recurrent depressive disorder. In other cases, along with depressive attacks, hypomanic states also occurred, most often in the form of short-term mood swings. The patients were quite critical of their illness and at the same time were afraid of a recurrence of seizures. Almost all patients retained residual affective symptoms. Erased hypomanic or subdepressive states occurred autochthonously or in the form of reactions to various external stimuli.
Conclusions. Depressive disorders in late life have a number of clinical features that represent high suicidogenicity. The predominance of anxiety depressions in the picture of psychosis, often with agitation; hypochondriac disorders, including hypochondriac ideas from anxiety and phobic fears to hypochondriac delirium with various algic sensations, increase the suicidal danger of patients.
Gulnara I. Altynbekova1, https://orcid.org/0000-0002-6642-4602
Assylkhan D. Kuttybaev2, https://orcid.org/0000-0001-7856-2765
Kuanysh S. Altynbekov2,3, https://orcid.org/0000-0003-3755-0914
1 "Kazakh-Russian Medical University", Almaty c., Republic of Kazakhstan;
2 NAO "Asfendiyarov Kazakh National Medical University", Almaty c., Republic of Kazakhstan;
3 Republican Scientific and Practical Center of Mental Health, Almaty c., Republic of Kazakhstan.
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Altynbekova G.I., Kuttybaev A.D., Altynbekov K.S. Some features of depression with suicidal behavior in late life (clinical, psychopathological and pathopsychological aspects) // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 4, pp. 140-145. doi 10.34689/SH.2023.25.4.017Related publications:
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