[The clinico-psychopathological aspects of chronic depressions]

Study of the clinical and psychopathological features of depressions in 40 inpatients, whose states corresponded to the criteria of chronic depressive disorders as described in different papers and classifications, including ICD-10 and DSM-III-R, made it possible to distinguish two types of staged development of chronic depressions: with acute or gradual onset. The possible criteria of chronicity of depressions are as follows: combination of hypersthenic, hyperthymic and sensitive traits in heredity, combination of hyperthymic hysterical and sensitive traits in premorbid personality, early appearance of affective disorders, presence of long-term periods of affective disorders of a subclinical level in life history, bipolar type of the course of these disorders, reactive-provoked depressive episodes with melancholic structure, a history of apathic adynamic subdepressive disorders in the preexisting course of illness, anxiety in acute episodes, disharmony in elements of the depressive triad, hypochondriacal preoccupation of self-accusational ideas, neurotic symptoms in the structure of acute episode, the 'out' direction of the "accusational vector" already during this stage, appearance of such phenomena as "verbalization of affect", "Sunday impairment', "forced hyperactivity", tendency to hospitalism, hypomanic "windows", appearance of egocentric, grumble, capricious features, sharpness of sensitive and hysterical features of premorbid personality in depressive states.