Citation

Aragona M, Alliani D, Vella G. Minerva Psichiatr. 1997; 38(3): 151-164.

Copyright

(Copyright © 1997, Italian Society of Social Psychiatry, Publisher Edizioni Minerva Medica)

DOI

unavailable

PMID

unavailable

Abstract

Depression is the most frequent complication of obsessive-compulsive disorder, but the current opinion that depression is secondary to the impairment and distress due to obsessions, is justified only when an understandable development from the obsessive-disease 'erlebnis' is detectable. Endogenous characteristics are instead present in other cases of secondary depression, as well as in the forms of obsessions and depression concomitant and cyclic, and in those that start with depression and are complicated by obsessions. From a critical review of the literature it appears that the association between obsessions and depression is not merely an addition of different pathologies, but that there is a specificity: in these patients depression has a younger age of onset, is more lasting and more frequently treatment-resistant, with a higher level of anxiety and more relapses. Nevertheless this depression is also less severe and with less psychotic symptoms than 'pure' depression. During a phase of depression, obsessions are lost in 13% of the patients, show transformation into delusions from 5,8 to 12% and persist in the others, sometimes tacking a depressive-like diurnal variation, often acquiring obsessive impulses with aggressive and killing content against the patient itself and his family, terrifying and painfully fought. Two problems remain open: if the patient can act his impulses or if obsessions protect him from suicide, and if mania can be present or not in these patients. In both cases further studies are needed.

Language: it

Keywords

Comorbidity; Depression; Obsessive compulsive disorder