On psychosocial pathomorphosis of depression

Abstract

Introduction

The concept of depression has long been a matter of controversy. Sociocultural factors greatly influence the phenomenology of depression and the meaning that patients assign to their symptoms.

Objectives

The aim is to determine the changes in the phenomenology of depression over the past decades.

Methods

To compare the proportions of biologically mediated symptoms of typical recurrent melancholic depression with the ideator components of the depressive syndrome and a depressive decrease in reactivity. We compared the archival data of one of the authors (V.N.K.) obtained in the study of depression: 1980-1987 (first group) and 2014-2020 (second group). The groups are age-comparable (21-64 y.o.). The Hamilton Depression Scale has been used to assess depression (score of 21–32, in both groups).

Results

Basic, i.e., biologically mediated symptoms, were not statistically different in the study groups. Whereas symptoms associated with emotional reactivity, the patient’s introspective abilities and capacity to identify and verbalize feelings - in the second group, were statistically rare, except for anhedonia, which, on the contrary, came to the fore. Based on some longitudinal studies of the dangers of excessive reliance on computer-mediated communication, one could foresee such contrasting phenomenology changes, which were especially clearly manifested in young patients.

Conclusions

Over the past decades, there are changes in the phenomenology of depression. The same underlying disorder can produce different clinical presentations, and agreement on a pathological entity does not necessarily mean deal with a descriptive label.