Symptoms and symptom clasters of monopolar depression and their connection with therapy

Assoc. Prof. Aleksey Pavlichenko, MD, PhD, Russia

Director, Moscow Institute of Mental Health, Moscow Medical University “Reaviz”, Moscow, Russia

According to the modern international classifications, to diagnose depression it is necessary that five symptoms out of nine (or ten) must be present for most of the time, almost every day, for at least two weeks, with the obligatory presence of depressed mood or decreased interests. The ICD-11 divides depressive symptoms into three clusters (affective, cognitive-behavioral, and somatic) that may be clinically useful. There have been attempts to link specific depressive symptoms to response to different antidepressants and specific psychotherapy. Antidepressants have been shown to be more effective for major affective symptoms and for sleep-related symptoms and not as effective for “atypical” symptoms. Some evidence supports the fact that a symptom profile, in addition to the diagnosis of depression itself, may be of value in predicting response to specific antidepressants or a particular type of psychotherapy.