Features of Psychotherapy in Elderly Patients with Affective Disorders in the Outcome of a Pathological Reaction of Grief

Abstract

The relevance of the work is due to the high prevalence and insufficient degree of study of the outcomes of the pathological reaction of grief (PRG) at a late age. Approaches to the treatment of these disorders, often carried out without taking into account the age factor, are not sufficiently developed. The various psychotherapeutic techniques used in PRG are contradictory and poorly structured. Solving these problems will not only achieve good quality remissions, but also prevent endogenization and chronification of mental disorders. The appearance of a new coronavirus infection, accompanied by high mortality, makes the problem of PRG therapy particularly relevant. Objective: to study the features of psychotherapy of depression in late-aged people with a history of PRG. Design: the work is a fragment of an open non-randomized study of patients with PRG, conducted in the Department of geriatric Psychiatry of the Federal State Budgetary Institution of the National Research Center. Inpatient patients over 60 years of age were studied. The clinical-psychopathological and catamnestic methods were used. Pharmaco-and psychotherapy was used. Results: 60 patients were examined, the majority were women, the average age was 66 years, patients with a first — time depressive episode prevailed-45% and recurrent depressive disorder — 28%. The majority (97.7%) of patients had delayed symptoms of PRG. The features of personality, age factors affecting the course of the disease and the peculiarities of psychotherapy are analyzed. Conclusions: the use of an integrated approach (a combination of psychopharmacotherapy and various types of psychotherapy) to the treatment of depressive disorders in the outcome of PRG is justified.