nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2026-3-49-56nnp-2858Research ArticleORIGINAL INVESTIGATIONSОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ И МЕТОДИКИFollow-up of the first depressive episode: prevalence and factors associated with the development of recurrent depressive disorder and bipolar affective disorderКатамнез первого депрессивного эпизода: частота и факторы, ассоциированные с развитием рекуррентного депрессивного и биполярного аффективного расстройствhttps://orcid.org/0009-0000-1148-2787БогатовТ. В.BogatovT. V.

119048, Москва, ул. Трубецкая, 8 

8, Trubetskaya St., Moscow 119048 

https://orcid.org/0000-0001-6071-2796ТихоноваЮ. Г.TikhonovaYu. G.

Юлия Гулямовна Тихонова 

119048, Москва, ул. Трубецкая, 8 

Yulia Gulyamovna Tikhonova 

8, Trubetskaya St., Moscow 119048 

tikhonova_yu_g@staff.sechenov.ruhttps://orcid.org/0009-0000-1139-6459ЕфремоваМ. Н.EfremovaM. N.

119048, Москва, ул. Трубецкая, 8 

8, Trubetskaya St., Moscow 119048 

https://orcid.org/0000-0002-0013-5031ИванецН. Н.IvanetsN. N.

119048, Москва, ул. Трубецкая, 8 

8, Trubetskaya St., Moscow 119048 

https://orcid.org/0000-0001-8386-758XКинкулькинаМ. А.KinkulkinaM. A.

119048, Москва, ул. Трубецкая, 8 

8, Trubetskaya St., Moscow 119048 

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)»РоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian Federation2026200620261834956Copyright © Bogatov T.V., Tikhonova Y.G., Efremova M.N., Ivanets N.N., Kinkulkina M.A., 20262026Богатов Т.В., Тихонова Ю.Г., Ефремова М.Н., Иванец Н.Н., Кинкулькина М.А.Bogatov T.V., Tikhonova Y.G., Efremova M.N., Ivanets N.N., Kinkulkina M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/2858

The high prevalence and tendency to relapse associated with depressive disorders highlight the need to investigate the long-term outcomes of a first depressive episode.

Objective

Objective: to determine the prevalence and identify the factors associated with the development of recurrent depressive disorder (RDD) and bipolar affective disorder (BAD) following inpatient treatment for a first depressive episode.

Material and methods

Material and methods. A retrospective cohort study was conducted involving 237 patients hospitalised with a first depressive episode between 2013 and 2017. The follow-up period was up to 12 years.

Results

Results. RDD developed in 20.3% of patients, and BAD in 12.2%. Factors associated with the development of RDD included older age (median 51 years; p=0.034), chronic psychological trauma (p=0.016), episode duration of more than 60 days prior to hospitalisation (p<0.001) and a family history of mental illness (p<0.001). Factors associated with the development of BAD were younger age (median – 35 years; p=0.043), male gender (p<0.001), a disharmonic premorbid personality (p<0.001), a history of mood swings (p=0.002), alcohol abuse (p<0.001) and a family history of mental illness (p<0.001). An early (within 6 months) exacerbation was associated with a short first hospital stay (median – 15 days; p<0.001) and irregular adherence to maintenance therapy (p<0.001).

Conclusion

Conclusion. One in three patients develops chronic affective disorder following their first depressive episode. The identified prognostic markers make it possible to identify high-risk groups for RDD and BAD as early as the first hospitalisation, thereby enabling the personalisation of treatment strategies.

Высокая распространенность и склонность к рецидивированию депрессивных расстройств обусловливают необходимость изучения отдаленных исходов первого депрессивного эпизода.

Цель исследования – определить частоту и выявить факторы, ассоциированные с развитием рекуррентного депрессивного расстройства (РДР) и биполярного аффективного расстройства (БАР) после стационарного лечения первого депрессивного эпизода.

Материал и методы

Материал и методы. Проведено ретроспективное когортное исследование 237 пациентов, госпитализированных с первым депрессивным эпизодом в 2013–2017 гг. Катамнез составил до 12 лет.

Результаты

Результаты. РДР развились у 20,3% пациентов, БАР – у 12,2%. Факторы, ассоциированные с развитием РДР, – старший возраст (медиана – 51 год; p=0,034), хроническая психотравма (p=0,016), длительность эпизода до госпитализации более 60 дней (p<0,001) и наследственная отягощенность (p<0,001). Факторы, ассоциированные с развитием БАР, – молодой возраст (медиана – 35 лет; p=0,043), мужской пол (p<0,001), дисгармоничный преморбид (p<0,001), колебания настроения в анамнезе (p=0,002), злоупотребление алкоголем (p<0,001) и наследственная отягощенность (p<0,001). Раннее (в течение 6 мес) обострение ассоциировалось с короткой первой госпитализацией (медиана – 15 дней; p<0,001) и нерегулярным приемом поддерживающей терапии (p<0,001).

Заключение

Заключение. У трети пациентов после первого депрессивного эпизода формируется хроническая аффективная патология. Выявленные прогностические маркеры позволяют уже на этапе первой госпитализации выделить группы высокого риска РДР и БАР для персонализации терапевтических стратегий.

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The authors declare that there are no conflicts of interest present.