DEPRESSIVE-DISORDERS - PSYCHOPATHOLOGY, P SYCHODYNAMIC AND PSYCHOTHERAPEUTIC ASPECTS

Depressive syndromes are the most common mental disorders among the ge neral population. The scientific view concerning the prevalence and co urse of depression, particularly with regard to the frequency of chron icity and death by suicide, has changed during the last decade. Today interest is focused on the problem of recurrent, chronic, and/or suici dal depression. Diagnostic procedures center on the psychopathological description of a ''depressive syndrome'' or ''depressive episode'' op erationalized by number, duration and severity of symptoms according t o ICD-10, in which etiological concepts such as ''neurotic'' or ''endo genous'' depression are no longer used. However, such terms as ''react ive'', ''neurotic'', or ''endogenous'' depression are still used now i n daily psychiatric and psychological diagnostic and treatment strateg ies. There is a growing consensus worldwide that a combination of psyc hotherapeutic, biological and social treatment strategies is desirable . In the first treatment phase a warm, empathetic patient-therapist re lationship should be established (with the aim of acting against hopel essness, preventing suicidal behavior, providing positive reinforcemen t with regard to the patient's daily activity program, etc.). In a sec ond phase, psychodynamic insight-oriented, cognitive, behavioral, and family-oriented psychotherapies should be used. Antidepressants are re commended for the control of symptoms.