Therapy of recurrent depressive disorders taking into account hereditary, pharmacogenetic, and social factors.

Abstract

Treatment should take into account all important factors and links of pathogenesis, such as heredity, social factors, pharmacogenetic features.The object of the study is 175 patients with recurrent depressive disorders (RDD) who sought help from the «Institute of Neurology, Psychiatry and Narcology of the National Academy of Sciences of Ukraine» SI and 46 people from the general population without mental disorders. The purpose of the study is to determine the specifics of RDR therapy based on identified hereditary, pharmacogenetic, and social factors in the development of depression and targets of psychotherapeutic influence.Research methods are clinical-psychopathological, genealogical, determination of pharmacogenetic markers, psychometric, psychodiagnostic, statistical.A differentiated complex system of RDD therapy has been developed, taking into account the main socio-environmental, clinical and genealogical factors, stress resistance and individual psychological characteristics, analysis of genetic polymorphism CYP2D6*4 (rs3892097), CYP2C19*2 (rs4244285) and MDR1 (rs1045642) and includes pharmacotherapy , psychotherapy, psychoeducation, based on the principles of: complex therapy; observance of phasing, sequence of implementation; differentiated nature of therapy depending on clinical manifestations of depressive disorder and personal characteristics of patients; combination of individual and group psychotherapy methods; optimal duration of therapy; continuity in the process of corrective measures; provision of psychoprophylactic recommendations.