Psychological characteristics of the microsocial environment as predictors of remission among patients with depressive and anxiety neurotic disorders

The wide representation among the Russian population of depressive and anxiety disorders, manifested both in the form of independent nosological forms and in the form of comorbid conditions, determines the importance of studying the factors that determine their etiopathogenesis. The patient’ microsocial environment is traditionally considered as a significant predictor, largely determining the course of depressive and anxiety disorders. At the same time, there is a lack of studies revealing the ratio of the psychological content of relatives’ experiences with the severity of symptoms and clinical dynamics of the patient’s condition.

The aim of the study was to determine the value of the psychological characteristics of the microsocial environment of patients with depressive and anxiety disorders for predicting the clinical dynamics of their condition during inpatient treatment and in catamnesis (six months after discharge). Based on the investigation of 50 patients (17 men, 33 women, average age 27.81 [SD = 9.96] years) and 50 relatives (16 men, 34 women, average age 48.04 [SD = 11.45] years), it was shown that the nature of the relationship to the disease of a loved one and the perception of family situation by relative are interrelated with indicators reflecting the dynamics of patients’ remission. In particular, emotional support from a loved one contributes to the of the patient’s is improvement at the inpatient treatment phase. And the presence of understandable family rules, orderliness, hierarchical relationships, as well as attention to moral aspects in the family contributes to the stabilizatioin of remission in a delayed perspective.

The data obtained indicate the importance of a systematic approach in the psychotherapy of depressive and anxiety disorders, taking into account both the individual psychological characteristics of patients and the characteristics of their microsocial environment.

1. Minuhin S., Fishman Ch. Texniki semejnoj terapii. M.: Nezavisimaya firma «Klass». 1998. (In Russ.).

2. Neznanov NG, Sorokin MYu, Skripov VS, Esina KM. Epidemiology of mental disorders as a marker of psychiatric factors of the COVID-19 pandemic. Rossijskij psihiatricheskij zhurnal. 2023;1: 4-13. (In Russ.).

3. Shishkova A.M., Bocharov V.V., Chernaya Yu.S. Mnogomernaya sistema ocenki negativnyh posledstvij bolezni blizkogo u rodstvennikov bol’nyh s addiktivnymi rasstrojstvami metodicheskie rekomendacii. Diagnostika i lechenie psihicheskih i narkologicheskih rasstrojstv: sovremennye podhody: sbornik metodicheskih rekomendacij. Sankt-Peterburg.: KOSTA. 2021;4. (In Russ.).

4. Shishkova AM, Bocharov VV, Strizhitskaya OYu, Vuks AJa. Psychometric Properties of the “Level of Relatives’ Emotional Burnout” Questionnaire. Konsul’tativnaya psikhologiya i psikhoterapiya. 2021;29(2):100-118. https://doi.org/10.17759/cpp.2021290205 (In Russ.).

5. Shmatova YuE. Dynamics of statistical and sociological indicators of mental health of the Russian Population. Problemy razvitiya territorii. 2019;101(3):76–96 https://doi.org/10.15838/ptd.2019.3.101.5 (In Russ.).

6. E`jdemiller E.G., Dobryakov I.V., Nikol`skaya I.M. Semejny`j diagnoz i semejnaya psixoterapiya : uchebnoe posobie dlya sistemy` poslevuzovskogo obrazovaniya vrachej. Sankt-Peterburg : Rech`, 2006. (In Russ.).

7. Adelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS. Caregiver burden: a clinical review. JAMA. 2014;311(10):1052-1060. https://doi.org/10.1001/jama.2014.304.

8. Aggarwal S, Wright J, Morgan A, et al. Religiosity and spirituality in the prevention and management of depression and anxiety in young people: a systematic review and meta-analysis. BMC Psychiatry. 2023;23:729. https://doi.org/10.1186/s12888-023-05091-2

9. Buckman JEJ, Saunders R, O’Driscoll C, et al. Is social support pre-treatment associated with prognosis for adults with depression in primary care? Acta Psychiatr. Scand. 2021;143(5):392-405. https://doi.org/10.1111/acps.13285.

10. Busner J, Targum SD. The clinical global impres- sions scale: applying a research tool in clinical prac- tice. Psychiatry (Edgmont). 2007;4(7):28-37.

11. Buus N, Petersen A, McPherson S, Meadows G, Brand G, Ong B. The relatives of people with depression: A systematic review and methodological critique of qualitative studies. Fam. Process. 2023. https://doi.org/10.1111/famp.12927

12. Chen P, Harris KM. Association of Positive Family Relationships With Mental Health Trajectories From Adolescence to Midlife. JAMA Pediatr. 2019;173(12):e193336. https://doi.org/10.1001/jamapediatrics.2019.3336.

13. Gérain P, Zech E. Informal Caregiver Burnout? Development of a Theoretical Framework to Un- derstand the Impact of Caregiving. Front. Psychol. 2019;10:1748. https://doi.org/10.3389/fpsyg.2019.01748.

14. Girdhar A, Patil R. Caregivers’ Burden in Patients With Bipolar Disorder and Schizophrenia and Its Relationship With Anxiety and Depression in Caregivers: A Narrative Review. Cureus. 2023;15(10):e47497. https://doi.org/10.7759/cureus.47497.

15. Guerrero-Muñoz D, Salazar D, Constain V, Perez A, Pineda-Cañar CA, García-Perdomo HA. Association between Family Functionality and Depression: A Systematic Review and Meta-Analysis. Korean J Fam Med. 2021;42(2):172-180. https://doi.org/10.4082/kjfm.19.0166.

16. Kalra H, Kamath P, Trivedi JK, Janca A. Caregiver burden in anxiety disorders. Curr. Opin. Psychiatry. 2008;21(1):70-73. https://doi.org/10.1097/YCO.0b013e3282f2dfca.

17. Kamen C, Cosgrove V, McKellar J, Cronkite R, Moos R. Family support and depressive symptoms: a 23- year follow-up. J Clin Psychol. 2011;67(3):215-223. https://doi.org/10.1002/jclp.20765.

18. Keitner GI, Ryan CE, Miller IW, Kohn R, Bishop DS, Epstein NB. Role of the family in recovery and major depression. Am. J. Psychiatry. 1995;152(7):1002-1008. https://doi.org/10.1176/ajp.152.7.1002.

19. Kiecolt-Glaser JK, Wilson SJ. Lovesick: How Couples’ Relationships Influence Health. Annu. Rev. Clin. Psychol. 2017;13:421-443. https://doi.org/10.1146/annurevclinpsy-032816-045111.

20. Koumoutzis A, Cichy KE, Dellmann-Jenkins M, Blankemeyer M. Age Differences and Similarities in Associated Stressors and Outcomes Among Young, Midlife, and Older Adult Family Caregivers. Int. J. Aging Hum. Dev. 2021;92(4):431-449. https://doi.org/10.1177/0091415020905265.

21. Kronmüller KT, Backenstrass M, Victor D, Postelnicu I, Schenkenbach C, Joest K, Fiedler P, Mundt C. Quality of marital relationship and depression: results of a 10-year prospective follow-up study. J. Affect. Disord. 2011;128(1-2):64-71. https://doi.org/10.1016/j.jad.2010.06.026.

22. Leach LS, Butterworth P. Depression and anxiety in early adulthood: consequences for finding a partner, and relationship support and conflict. Epidemiol. Psychiatr. Sci. 2020;29:e141. https://doi.org/10.1017/S2045796020000530.

23. Lucchetti G, Koenig HG, Lucchetti ALG. Spirituality, religiousness, and mental health: A review of the current scientific evidence. World J. Clin. Cases. 2021;9(26):7620-7631. https://doi.org/10.12998/wjcc.v9.i26.7620.

24. van Servellen G, Heise BA, Ellis R. Factors associated with antidepressant medication adherence and adherence-enhancement programmes: a systematic literature review. Ment. Health Fam. Med. 2011;8(4):255-271.

25. Whisman MA, Robustelli BL, Labrecque LT. Specificity of the Association between Marital Discord and Longitudinal Changes in Symptoms of Depression and Generalized Anxiety Disorder in the Irish Longitudinal Study on Ageing. Fam. Process. 2018;57(3):649-661. https://doi.org/10.1111/famp.12351.

26. Wong JJ, Frost ND, Timko C, Heinz AJ, Cronkite R. Depression and family arguments: disentangling reciprocal effects for women and men. Fam. Pract. 2020;37(1):49-55. https://doi.org/10.1093/fampra/cmz048.