First depressive episode in the dynamics of personality disorders in adolescence

Krylova E.S.

doi:https://doi.org/10.17116/jnevro202112105235

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OBJECTIVE

To determine clinical and psychopathological specifics of the first depressive episode (DE) in the context of formation of personality anomalies and their dynamics in adolescence.

MATERIAL AND METHODS:

Two hundred and thirty-seven patients (180 male, 57 female), aged 16 to 25 years, with the first DE and comorbid personality disorder (PD) were clinically observed and psychopathologically evaluated. Later 149 patients from this group participated in the follow-up study.

RESULTS

The first DE with PD in adolescence is characterized by psychopathological variety due to PD type and age factor. Diagnosis of PD in adolescence is based on pathological traits, while affective impairment is a separate dimension. PD determines the clinical features of the first DE and all spectrum of affective disorders. The high conjugation of the first DE with autoagressive behavior confirms their suicidal risk. Autoagressive behavior is noted in 201 (84.8%) patients, of which 59 (29.4%) had non-suicide self-injury (NSSI) and 14 (70.6%) had suicidal activity. The follow-up study identified variants of further dynamics of PD with comorbid affective spectrum disorders after the first DE developed in youth that had prognostic value: unipolar major depression in schizoid PD (13 (37.1%) patients), cluster C PD (8 (26.7%)); bipolar affective disorders in borderline (42 (28.2%)) and narcissistic (16 (40.0%)) PD; recurrent depressive disorder in PD of cluster C (14 (46.7%)).

CONCLUSIONS

The revealed clinical and psychopathological features will contribute to the creation of a unified model for predicting affective disorders and the formation of therapy standards.

Keywords:

youth

adolescence

personality disorder

depressive episode

Authors:

Krylova E.S.

Mental Health Research Center

ORCID: 0000-0002-6644-5454

Received:

01.03.2021

Accepted:

23.03.2021

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