[Depression with obsession of contrast content]

Twenty depressed patients (according to ICD-10) with obsessions of contrast content (homicidophobia--4 patients, suicidophobia--12, other contrast obsessions--4 cases) were examined. The affective disorders belonged to polar areas of a depressive spectrum: anxious depressions (with a prevalence of manifestations of positive affectivity in the form of somatopsychic hyperstesia) and existential depressions (with domination of manifestations of negative affectivity in the form of alienation of the vital functions). In anxious depressions there were compulsive obsessions of contrast content (12 patients), while in existential ones impulsive obsessions (8 cases). Compulsive obsessions of contrast contents (fear of a lack of self-control pronounced in the form of the attacks of lissophobia) were formed at the height of an anxious-depressive affect. Impulsive obsessions of contrast contents (fear of self-damage with elements of an obsessive drive to its realization) were formed during depressive devitalization and were exceeded by suicidal ideas. Comorbidity of depressive and obsessive manifestations was realized by a peculiar type of interrelations with formation of "convergent" symptoms which reflected an increase of severity of depressive disorders.