Comparative characteristics of depressive disorders in patients with multiple sclerosis

The problem of depression in patients with multiple sclerosis raises many clinical questions concerning the genesis and clinical manifestations of depression, the relationship between affective manifestations and the form and type of the course of multiple sclerosis, and the mechanisms of formation of suicidal behavior in patients with this pathology. Symptoms of depression are very often observed in MS patients as a patient's reaction to a chronic disease and is short-term, a manifestation of focal brain damage, as well as a consequence of changes in the immunobiochemical profile (cytokines, biogenic amines). Depressive disorders often recede into the background and are often not recognized, since neurological symptoms occupy a leading position in the clinical picture. The purpose of this study is to investigate depressive disorders, as well as the features of their course in patients with multiple sclerosis. Patients and methods. The research included a study group of 113 participants with multiple sclerosis, MacDonald criteria 2005, 2010 (2017 edition), and a comparison group of 45 patients with organic depressive disorder. The A.T. Beck depression scale and the depression self-assessment scale developed at the V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology were used to identify depression. The diagnosis of depressive disorder was established in accordance with the ICD-10 criteria by a psychiatrist. The study used the Spielberger State-Trait Anxiety Inventory (adapted by Yu.L. Khanin) and L.D. Malkova's asthenic state scale (adapted by T.G. Chertova). The group included patients with remitting and secondary progressive types of the disease. Results and discussion. The study included data from dynamic follow-up of 158 patients: the study group consisted of patients with multiple sclerosis with depression 71.5% (113 individuals), of which 61.1% (69 individuals) with a remitting course and 38.9% with a secondary progressive course (44 individuals). The age of the patients at the time of examination ranged from 18 to 60 years, with mean age of 39.7±10.91 years. The majority of patients had a disease duration of less than 20 years, on average 8.23±6.57. The average age of onset of the disease is 30.2±10.5. The study has proved that the diagnosis of asthenia, regardless of the severity of depressive disorder, in patients in the study group corresponds to the values of (60.15±1.35) points, i.e. the asthenia clinical picture. The patients with secondary progressive multiple sclerosis differed in the older age of the disease (50.89 ± 1.97) years, the number of exacerbations (p=0.00094300***), and the level of disability at (5.0±0.24) points (p=0.00000000***) compared with the patients with remitting MS with depression (2.38±0.15). The comparison group of 45 people is represented by patients with organic depressive disorder (F06.32). Their mean age was (35.81±13.57) years. The number of depressive episodes detected in the anamnesis was within (2.3±1.18) cases. A close relationship was established in the factors of patients in the study group between "the duration of the disease" (9.84±0.73), "the number of exacerbations" (3.69±2.27) R=0.54 p