Principles of therapy of cognitive impairment in depressive disorders
Summary. The aim was to develop and evaluate the effectiveness of a comprehensive program of therapy and rehabilitation (CРTR) for patients with cognitive impairment (CI) in depressive disorders (DD). The proposed CРTR for patients with CI in DD implemented in four stages: diagnostic, therapeutic, rehabilitation and prophylactic. The diagnostic stage included a clinical and psychopathological assessment of the patients’ CI, an analysis of anamnestic data, clinical symptoms, dynamics and prognosis of the disease, the relationship of clinical and socio-psychological factors. The therapeutic stage included a set of pharmacotherapy and psychotherapy measures aimed at correcting CI, stopping DD, normalizing the psycho-emotional state, social adaptation and readaptation of the patient. The rehabilitation stage included a set of pharmacotherapy and psychotherapy measures aimed at restoring cognitive functions, strengthening the effect of antidepressant therapy, and restoring the patient’s social functioning. The preventive stage designed to maintain a normal psycho-emotional state, effectively resist stress, and prevent the recurrence of depressive disorders. In approbation of the developed CPTR, 97 patients with CI in DD make up the main group, who passed the CPTR course according to the developed program. The control group consisted of 93 patients with CI in DD who underwent a course of therapy according to traditional schemes. The effectiveness of the proposed CPTR in patients with CI in DD were proved, which consists in a more pronounced reduction of clinical manifestations of DD, improvement of cognitive functions, reduction of maladaptive and increase in adaptive strategies for cognitive regulation of emotions, improvement of social functioning in the main spheres of life.
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