Characteristics of premorbid stage in patients with treatment-resistant depression
Characteristics of premorbid stage in patients with treatment-resistant depression

Summary/Abstract: Introduction: The burden of treatment-resistant depression (TRD) is represented by thestrong impact on patient functionality, significant deterioration of the quality of life, isolationand stigmatization of the individual. TRD patients incur the highest direct and indirectmedical costs among those with major depressive episode, costs that increase with diseaseseverity.Purpose: To study the role of predisposing and precipitating factors in the emergence,development and maintenance of TRD.Methods: Descriptive cohort study of 612 patients with TRD, using methods of clinicalresearch, psychological tests, analytical epidemiology, descriptive epidemiology, andmathematics.Results: The factors predisposing to the development of TRD have been systematized. It hasbeen clearly demonstrated that affective, somatic, and stress-related disorders in TRD patientfamily are the most common hereditary factors. Disappointment, low level of emotionalsupport during childhood (p <0.05), loss of one parent (p <0.01), use of physical force inchildren (p <0.05), anxiety as a personality trait in the premorbid period (p <0.05), andintroversion (p <0.05) are other factors that have statistical significance.Conclusions: The determining role of precipitating factors in TRD triggering and of favoringfactors in its maintenance have been identified. The impact of personal negative stressfulevents such as abandonment, separation, divorce, death was demonstrated.

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