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.
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References
2. Beutel, M. E., Jünger, C., Klein, E. M., et al. Noise annoyance is associated with depression and anxiety in the general population- the contribution of aircraft noise. PLoS ONE. 2016. Vol. 11, No. 5.
3. Gonda, X., Petschner, P., Eszlari, N., et al. Genetic variants in major depressive disorder: From pathophysiology to therapy. Pharmacology and Therapeutics. 2019. Vol. 194. Р. 22–43.
4. Okbay, A., et al. Genetic variants associated with subjective well-being, depressive symptoms, and neuroticism identified through genome-wide analyses. Nat. Genet. 2016. Vol. 48, No. 6. P. 624–633.
5. Flint, J., Kendler, K. S. The Genetics of Major Depression. Neuron. 2014. Vol. 81. P. 484–503.
6. Huezo-Diaz P, Perroud N, Spencer EP, Smith R, Sim S, Virding S et al. CYP2C19 genotype predicts steady state escitalopram concentration in GENDEP. J Psychopharmacol 2012; 26: 398–407.
7. Stingl JC, Brockmoller J, Viviani R . Genetic variability of drug-metabolizing enzymes: the dual impact on psychiatric therapy and regulation of brain function. Mol Psychiatry 2013; 18: 273–287.
8. Hedenmalm K, Guzey C, Dahl ML, Yue QY, Spigset O. Risk factors for extrapyramidal symptoms during treatment with selective serotonin reuptake inhibitors, including cytochrome P-450 enzyme, and serotonin and dopamine transporter and receptor polymorphisms. J Clin Psychopharmacol 2006; 26: 192–197. Front. Pharmacol., 21 April 2021 | https://doi.org/10.3389/fphar.2021.650027.
9. Cognitive behavior therapy : basics and beyond / Judith S. Beck.–2nd ed. - Published by The Guilford Press. - New York, 2011.-414p.
10. Becvar, D. S., & Becvar, R. J. (1999). Systems theory and family therapy: A primer (2nd ed.). Lanham, MD: University Press of America
11. Nan, J. K. M., & Ho, R. T. H. (2017). Effects of clay art therapy on adult outpatients with major depressive disorder: A randomized controlled trial. Journal of Affective Disorders, 217, 237–245. https://doi.org/10.1016/j.jad.2017.04.013
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