[Diagnosis and therapy of neurotic depressions]

The causes of depressive syndroms differ from case to case. Frequently, the cause of disease cannot be reliably determined from the cross-sectional picture alone. Rather, it is necessary to give careful consideration to heredity, longitudinal analyses, and psychodynamics. The etiopathogenesis of neurotic depressions is discussed for the four different forms of neurosis by reference to the classification of neuroses recommended in Bad Elster in 1969. To make the psychodynamics of neurotic depressions understandable, loss of object, oral regression, pathological narcissism, and defense against aggressions are used in the sense of metaphoric model concepts and discussed in detail. Psychotherapy and its principal objectives are not only discussed in respect to genuine neurotic depressions, but it is also shown how it can be made an integral part of a differently accentuated, predominantly somatic therapy.