Depression in the Perinatal Period: Course and Outcome of Depression in the Period from the Last Trimester of Pregnancy to One Year after Delivery in Primiparous Mothers.

Background and Objectives: One of the most significant psychiatric problems in women is depression related to the perinatal period. Our study aims to determine the frequency and course of depressive symptomatology in the perinatal period with particular reference to objective rate and outcome of postpartum depression. Materials and Methods: One hundred and eighty-eight pregnant/postnatal women were included in a prospective, longitudinal, observational study during which the depressive symptomatology was estimated at the third trimester of pregnancy, and the first, sixth, and twelfth month' postpartum. All participants completed a semi-structured sociodemographic questionnaire constructed for research purposes, the Edinburgh Postnatal Depression Scale, Toronto Alexithymia Scale, Beck Anxiety Inventory, and The Mood Disorder Questionnaire at each time point. Postpartum depression diagnosis was confirmed by a trained and certified psychiatrist with long-standing experience. For a better understanding of the trajectory of depressive symptomatology and genuine postpartum depression, we classified depression into those with new-onset and those left over from the previous observation period. Results: In general, 48.9% of participants in the study were depressed at some point during the investigation. A total of 10.6% of women were depressed in the third trimester. The highest percentage of new-onset depression (25%) was in the first month after giving birth and was maintained for up to six months, after which the appearance was sporadic. Most of the postpartum depression resolved in the period from the first month to the sixth month after childbirth (20.7%). The episodes mainly had characteristics of unipolar depression. Conclusions: Our results imply that a new onset of depression is most intensive during the first six months, and after that, it is sporadic. Further studies are needed to explore whether all depressive symptomatology in the postnatal period is the same, or perhaps postpartum depression, classified in this way, has specific characteristics, etiology, and consequently different treatment and preventive options.

Choosing a COVID-19 vaccination site might be driven by anxiety and body vigilance.

Background: The occurrence of COVID-19 led to the rapid development of several vaccines which were distributed around the world. Even though there had been a vast amount of information about both virus and vaccination, this process was potentially related to increased anxiety and thus affected the vaccination process. Objective: The present study examined anxiety levels and body vigilance in subjects reporting for COVID-19 vaccination at different vaccination sites. Methods: Instruments used included general socio-demographic questionnaires and specifically constructed ones such as generalized anxiety disorder (GAD), body vigilance scale (BVS), and coronavirus anxiety scale (CAS). Results: A total of 227 subjects enrolled in the study reported mild GAD and CAS scores and relatively low scores on BVS. When the subjects were divided according to a vaccination site (under supervision and non-supervised), it turned out that subjects vaccinated under supervision were more anxious (higher GAD and CAS) and had their body vigilance increased. Conclusion: In conclusion, there is a need for highlighting the importance of efficient planning and organization of vaccination process, since to a certain extent it is driven by both anxiety and body vigilance.

Nonsuicidal Self-Injury and Suicidal Beliefs in Adolescent Inpatient.

Background and Objectives: Although nonsuicidal self-injury (NSSI), by definition, excludes suicidal intent, numerous studies show associations between NSSI and suicidal phenomena in clinical and outpatient adolescent samples. Given the growing interest in the relationship between NSSI and suicidal phenomena, the present study aimed to investigate the relationship between NSSI and suicidal beliefs in adolescent psychiatric inpatients. Materials and Methods: The study sample included 50 adolescent inpatients at a specialized facility, with a mean age of 15.44 ± 1.39, who fulfilled DSM-5 criteria for NSSI. For study purposes, we use the Ottawa Self-Injury Inventory (OSI) and Brief Suicide Cognitions Scale (B-SCS). Statistical data processing was performed in the R software 4.3.0 (R Core Team, Vienna, Austria). Results: Of all NSSI functions, the Internal ER function score was the highest (18.72 ± 7.08), followed by External ER (8.10 ± 3.11), Social Influence (5.88 ± 5.37), and Sensation Seeking (3.44 ± 2.98). The mean Craving (C) score was 14.06 ± 7.51. The mean value of the B-SCS score was 19.54 ± 5.24. It was found that the B-SCS score is significantly related to Internal ER (r = 0.441, p < 0.001) and Craving (r = 0.297, p = 0.036). The multivariable model shows that internal ER function and participants' age are significantly related to the B-SCS score. Conclusion: Despite the limitations of the study, it is emphasized that cognitions occurring across the fluid suicidal belief system alone do not fully capture the complexity of suicide, but assessing the suicidal belief system in NSSI inpatient adolescents could nevertheless provide helpful information for identifying individuals who may have an elevated vulnerability to experiencing suicidal ideas and behaviors over time.

Possible impact of COVID-19 pandemic and lockdown on suicide behavior among patients in Southeast Serbia.

Individuals with serious mental illness are more affected by emotional reactions, including suicidal behavior due to COVID-19 and psychosocial consequences of pandemic. The current cross-sectional study aimed to explore the possible association of COVID-19 and suicidal behavior (suicide ideation and attempt) before and during pandemic-associated lockdown in Serbia. We retrospectively reviewed the clinical records of 104 adult psychiatric inpatients admitted at Psychiatric Clinic, University Clinic Center Nis, Serbia, after ending lockdown and compared the obtained results with 181 adult psychiatric inpatients admitted during the same period in 2019 and 2018. Suicide ideation were more frequent in 2020 comparing with 2019 and 2018 (25 vs 12.5%, vs 9.41%; p < 0.05). Around 28% of patients with suicide attempts were exposed daily to the information related to COVID-19 coming from social media, while this frequency was significantly lower, only 7.55% (p < 0.1), among patients with no suicide ideation or attempts. Adjustment disorder was more frequent among patients with suicide attempts in comparison to the patients with suicide ideation (32 vs 11%), especially in patients without suicide ideation and attempts (32 vs 0%, p < 0.001). Of all studied patients with suicide attempts during 2020, 60% were not in the previous psychiatric treatment before admission.

Perceived stress among university students in south-east Serbia during the COVID-19 outbreak.

BACKGROUND: The COVID-19 pandemic has brought into focus the mental health of the student population. The study aimed to analyze the psychological response to the COVID-19 outbreak in terms of perceived stress and its related factors among university students in south-east Serbia. The study was conducted during the increased incidence of COVID-19 in Serbia. METHOD: A total of 434 students from the public university in south-east Serbia enrolled in the study and completed the measures of socio-demographic data, the perceived stress scale (PSS-10), the Coping Strategy Indicator (CSI) and the General Health Questionnaire (GHQ-28). The data were analyzed through quantitative and qualitative methods. RESULTS: Study findings suggest that the mean perceived stress score was placed to 20.43 (± 7.67). Our model showed that female gender, higher scores on anxiety/insomnia and depression subscale as well as the coping strategy avoidance predicted higher perceived stress, while higher scores on social dysfunction were related to the reduced perceived stress scores.  CONCLUSION: Notwithstanding the study limitation, findings provided authentic data of stress reactions of the students in south-east Serbia during the COVID-19 outbreak. The findings confirm the need to examine students' experiences in emergencies and crises, as well as to make a plan for online stress management programs that would help alleviate stress during a global pandemic.

The risk for nonpsychotic postpartum mood and anxiety disorders during the COVID-19 pandemic.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) appears to be the largest pandemic of our times. The aim was to recognize the risk factors for nonpsychotic postpartum mood and anxiety disorders (NPMADs) in women during the pandemic and state of emergency police lockdown in Serbia. METHODS: We assessed 108 postpartum women who completed the Edinburgh Postnatal Depression Scale (EPDS) and an additional survey constructed for this study. We also used the additional, previously mentioned survey, in 67 healthy age-matched women with children who were ≥2 years of age. The additional survey allowed us to gain insight into the impact of the pandemic as well as postpartum period on the risk of NPMADs. RESULTS: In 16 (14.8%) subjects we found a score ≥10 on EPDS. Higher rates on the EPDS were noticed in elderly, single, and unemployed, women who lost their jobs due to the pandemic, or women who were dissatisfied with their household income (p < 0.05). The risk of NPMADs was linked significantly to quarantine, and social isolation, the absence of social support, as well as having emotional problems. Postpartum women, compared to non-postpartum women, were more anxious and had feelings of helplessness during social isolation. CONCLUSION: Understanding the factors that increase the risk of NPMADs during the pandemic could help prevent mental disorders during a possible future pandemic.

Mental health of medical personnel during the COVID-19 pandemic.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic caused significant changes in the everyday functioning of the general population, as well as medical workers. Medical personnel, especially those in direct contact with COVID-19 patients, could have increased levels of stress, anxiety, and depression. The objective of this study was to explore the mental health status of medical personnel in Serbia during the pandemic by assessing stress levels, symptoms of anxiety, and depression. METHODS: This cross-sectional study was conducted as an online-based survey, in the period from 8 April to 14 April 2020, during the COVID-19 pandemic. The study included 1678 participants, and the snowball sampling technique was used to reach healthcare professionals. The level of stress and symptoms of depression and anxiety were assessed among medical personnel in Serbia by the 10-item Perceived Stress Scale (PSS), the Beck Depression Inventory IA (BDI-IA), and the 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. RESULTS: A total of 1678 participants completed the survey, with a mean age of 40.38 ± 10.32 years, of which 1,315 (78.4%) were women, and 363 (21.6%) were men. Out of these, 684 (40.8%) participants were medical personnel, and 994 (59.2%) were people of other professions. Frontline medical personnel reported higher scores on all measurement tools than second-line medical personnel (e.g., mean PSS scores: 19.12 ± 5.66 versus 17.53 ± 5.71; p = .006; mean GAD-7 scores: 8.57 ± 6.26 versus 6.73 ± 5.76; p = .001; mean BDI-IA scores: 9.25 ± 8.26 versus 7.36 ± 7.28; p = .006). Binary logistic regression showed that the probability of developing more severe anxiety symptoms doubles in frontline medical personnel. CONCLUSION: Our findings suggest that frontline medical personnel is under an increased psychological burden during the COVID-19 pandemic, having higher levels of stress, anxiety, and depression than second-line medical personnel. Adequate measures should be taken to relieve this burden and preserve the mental health of frontline medical personnel.

Metronidazole- and levofloxacin-induced psychotic disorders in chronic kidney patient.

We present a case which reports the occurrence of psychotic disorders after metronidazole and levofloxacin therapy in a chronic kidney patient while being treated for enterocolitis and urinary infection. A 48-year-old female was admitted to a hospital for the placement of a peritoneal dialysis catheter due to indicated peritoneal dialysis. During admission, symptoms of enterocolitis and urinary infection had occurred, so metronidazole and levofloxacin were introduced into therapy, respectively. After 4 days of metronidazole and 3 days of levofloxacin therapy, the patient became confused, disoriented, with signs of delirium. Since the diagnosis of psychoorganic disorder was made, the therapy with lorazepam and haloperidol was initiated, while metronidazole and levofloxacin were discontinued. Complete recovery 4 days after discontinuation indicates that the patient has experienced antibiotics-induced neurotoxicity. This is the first report of expressed neurotoxicity after the combination of metronidazole and levofloxacin in chronic kidney patients.

Nonsuicidal self-injury among adolescents in south-east Serbia.

BACKGROUND: Nonsuicidal self-injury (NSSI) refers to the deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned. The aim of this study was to explore the variety of self-injury behaviors as well as the function of NSSI among adolescents in South-East Serbia. METHODS: The study included 50 adolescents of both sexes, aged 13-18 years, who had deliberately engaged in self-injury at least once. A general socio-demographic questionnaire and the Inventory of Statements About Self-Injury (ISAS) were used in the study. RESULTS: The average age of the respondents was 15 (1.17); the most common NSSI methods were cutting (60%), followed by biting and severe scratching (14%); the average age of onset was 14.12 (0.77); the majority confirmed experiencing pain during self-injury (42%); the respondents more commonly performed NSSI when they were alone (68,0%); in 90% of the cases, the time elapsed between sensing the urge to self-injury and acting on it was less than 1 h; the majority of the respondents stated that they did not want to stop self-injuring (56%). In terms of the NSSI function, the obtained scores were the highest for affect regulation 3.36 (1.47), self-punishment 1.90 (1.39) and marking distress 1.72 (1.26). In terms of gender, there was a statistically significant difference for the antidissociation (P = .043), interpersonal influence (P = .004) and revenge (P = .019). CONCLUSION: The results may have practical implications when it comes to taking preventive and therapeutic measures in the vulnerable adolescent population.

Prescribing practices in Southeastern Europe - focus on benzodiazepine prescription at discharge from nine university psychiatric hospitals.

There is much concern about the widespread long-term use of benzodiazepines. Our manuscript addressed its use in the region of Southeastern Europe, which seems extensive, but insufficiently explored. At nine university psychiatric hospitals (Croatia, Macedonia and Serbia), we retrospectively analyzed discharge summary documents to find the prevalence of discharge benzodiazepine prescriptions and the prescribed benzodiazepine doses. This study included 1047 adult subjects and showed that 81.9% of them had benzodiazepines prescribed in the discharge summary document, with high mean daily dose of around 5mg lorazepam equivalents. Factors associated with the prescriptions were exclusively clinical factors (diagnosis of schizophrenia spectrum disorders, more lifetime hospitalizations, psychiatric comorbidity, co-prescription of antidepressant or mood stabilizer, shorter duration of the hospitalization), while socio-demographic factors were not found to influence benzodiazepine discharge prescriptions. Similarly, factors which influenced the prescription of higher daily benzodiazepine dose were more lifetime psychiatric hospitalizations and co-prescription of antidepressant or mood stabilizer, as well as the diagnosis of mental/behavioral disorders due to substance use and co-prescribed antipsychotic. Our data are emphasizing an urgent need for guidelines and improved education of both health care professionals and patients, in order to prevent long term benzodiazepine (mis)use and related side-effects.

Evaluating empathy in adolescents with conduct disorders.

BACKGROUND/AIM: According to currently available data, there is no research dealing with evaluating empathy in adolescents with conduct disorders in our region. The aim of the research was to examine the differences in the severity of cognitive and affective empathy in adolescents with and with no conduct disorder, as well as to examine the relationship between cognitive and affective empathy and the level of externalization in adolescents with conduct disorder. METHODS: This research was conducted on 171 adolescents, aged 15 to 18, using the Interpersonal Reactivity Index, Youth Self-Report and a Questionnaire constructed for the purpose of this research. RESULTS: The results showed that adolescents with conduct disorder had significantly lower scores for Perspective Taking (t = 3.255, p = 0.001), Fantasy (t = 2.133, p = 0.034) and Empathic Concern (t = 2.479, p = 0.014) compared to the adolescents in the control group, while the values for Personal Distress (t = 1.818,p = 0.071) were higher compared to the control group, but the difference was not statistically significant. The study showed a statistically significant negative correlation between Perspective Taking and aggression (r = -0.318, p = 0.003) and a negative correlation between Perspective Taking and the overall level of externalizing problems (r = -0.310, p = 0.004) in the group of adolescents with conduct disorder. CONCLUSION: This research contributes to better understanding of behavioral disorders in terms of individual factors, especially empathic reactivity. Preventive work with young people who have behavioral problems associated with empathy deficit disorder proved to be an important tool in preventing the development, or at least relieving the symptoms, of this ever more common disorder.

Perceived parental acceptance/rejection, some family characteristics and conduct disorder in adolescents.

BACKGROUND/AIM: Conduct disorder is characterized by repetitive and persistent presence of dissocial, aggressive and defiant behavioral patterns, thus represents important public issue with comprehensive and far-reaching consequences both for the individual and society. The aim of this study was to investigate the differences in sociodemographic family characteristics and the prominence of parental acceptance/rejection dimensions in groups of adolescents with and without conduct disorder, as well as to examine the connection between parental acceptance/rejection dimensions and externalizing symptoms in the group of adolescents with conduct disorder. METHODS: This research was conducted on 134 adolescents, aged 15 to 18, using the Parental Acceptance/Rejection Questionnaire (PARQ child), Youth Self-Report (YSR), and a questionnaire constructed for the purpose of this survey. RESULTS: The results showed that the number of adolescents with conduct disorder coming from divorced families was significandy higher than from complete families (44.8% vs 13.4%, respectively; p < 0.001). Also, in this group of adolescents there was a statistically significantly higher number of parents suffering from psychiatric disorders compared to the controls (31.3% vs 8.9%; respectively; p = 0.001). The perceived rejection dimension and the total index of maternal acceptance/rejection were significantly higher in adolescents with conduct disorder than in those with no such disorder (132.30 ± 38.05 vs 93.91 ± 26.29 respectively; p < 0.001). Similar results were found for paternal acceptance/rejection dimension (129.40 ± 39.58 vs 86.10 ± 15.95 respectively; p < 0.001). Adolescents with conduct disorder and severe perceived maternal and paternal rejection showed a significantly higher average score on the subscale of externalizing symptoms (14.55 ± 4.45 and 13.27 + 5.05) compared to adolescents with conduct disorder and lower total index of parental acceptance/rejection (8.32 ± 5.05 and 8.28 ± 5.08). CONCLUSION: The results suggest that adolescents with conduct disorder perceive their parents as more rejecting and less warm and supportive compared to adolescents without conduct disorder. The perception of significant and severe parental rejection was associated with a significantly higher averaged score on the subscale of externalizing symptoms in the group of adolescents with conduct disorder compared to those with no such disorder. It was found that adolescents with conduct disorder most often come from large families, have divorced parents or parents with multiple psychiatric disorders.

Anxiety in patients with acute coronary syndromes

Background and Objectives: Anxiety is frequently encountered in acute coronary syndrome. It is believed that the prevalence of anxiety among cardiac patients is between 15 and 50%. The goal of our study was to determine whether there is an association between current anxiety and anxiety tendency in patients with acute coronary syndrome. A secondary goal was to establish possible distinct features of acute coronary syndromes in patients with the anxiety. Methods and results: Our study included 30 patients suffering from acute coronary syndrome. To obtain additional data on physical and mental health, we applied specially designed and validated questionnaires. In a groups without the anxiety and intensive anxiety there were no patients, while in the group with mild anxiety there were 21 patients (70%) and 9 patients had moderate anxiety (30%). The average number of hospital treatments was significantly higher in patients with moderate anxiety (average 2.3). Patients who were first time hospitalized due to cardiovascular disease, at the highest percentage (81%) had low current anxiety. Those patients who had intensive anxiety traits and propensity to anxiety response had the highest average number of hospital days (9 days). Patients who had intensive anxiety traits had the lowest values of internal locus of control (had feeling that only themselves were cause of the disease). Conclusions: Current anxiety and anxious personality structure are strongly associated with the course of the coronary heart disease. In particular, this refers to the length of hospital stay and number of hospitalizations (AU)

[Illness perception in chronic obstructive pulmonary disease].

INTRODUCTION: The aim of the study was to investigate illness perception in patients with chronic obstructive pulmonary disease (COPD), and to explore its relation to socio-demographic and illness/treatment-related characteristics. MATERIAL AND METHODS: 44 consecutive COPD patients answered the general questionnaire (which identified data on gender, age, education, economic status, employment, personal estimate of family relations quality) and IPQ-R (which evaluates the illness perception components). The data were statistically processed using T-test, Mann-Whitney U-test, one way anova, and correlation analysis. RESULTS: COPD patients perceived their illness predominantly negatively. The markers of negative illness perception were female gender: older age, medium economic status, being employed, and high number of hospital treatments. The self report of good family relations was associated with both positive (strong belief in personal control) and negative illness perception (belief in serious consequences). Believing that external causes were predominantly responsible for the illness onset was related to the positive illness representation and to a lower education level. CONCLUSION: Illness perception in COPD patients is negative and associated with certain socio-demographic and illness/treatment-related characteristics; this may have implications for detecting and modifying negative perception patterns in patients at risk.

[Quality of life of patients with unipolar depression].

INTRODUCTION: Quality of life has gained increasing attention as an important component of functional outcome in mood disorders. The aim of our study was to investigate the relationship between unipolar depression and quality of life. MATERIAL AND METHODS: The group consisted of 84 patients with unipolar depression (depressive episode or recurrent depression, without psychotic presentation) and 30 healthy controls. We applied socio demographic questionnaire, World Health Organization Quality of Life-Brief and The Patient Health Questionnaire - 9. RESULTS: The impact of unipolar depression on quality of life was significant. The patients had significantly lower scores in all 4 domains of quality of life (Physical health, Psychological health, Social relations, Environment) compared with healthy controls. The biggest influence was on physical (43.71 vs. 76.67) and psychological (36.01 vs. 65.83) domains. The quality of life decreased with the increase of severity of depressive episode and duration of current episode, as well as with incidence of depressive episodes. The absence of emotional relationship had also a very negative influence. There were no differences in quality of life between male and female depressive patients. The level of education had an impact on physical and psychological domain. DISCUSSION: Generally, the quality of life in unipolar depression is very modest. One of the reasons for such influence could be the main pathological factor in depression--negative view of self world and future. Beside that, the reason could be significant psychological suffering and decreased function in depression. CONCLUSION: Unipolar depression has negative influence on quality of life.

[Influence of psychological and coronary parameters on coronary patient rehospitalization].

INTRODUCTION: Psychological reactions are often comorbid with coronary risk factors and could be important for a six-month outcome. OBJECTIVE: Determination of anxiety level, depression and aggression, persistence of risk health behaviour, stress life events, and coronary risk factors after coronary event and a predictive value of those parameters for six-month rehospitalization. METHODS: In the group with Angina Pectoris (E1=30) and the group with Acute Myocardial Infarction (E2=33), there were applied, at baseline and after 6 months, the following: Semistructured Clinical Interview based on ICD-10, for depressive episode and anxiety disorder, Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), KON-6 sigma Scale for aggression, Holms-Rahe Scale (H-R) for stress events and Questionnaire for risk behaviour: alcohol consumption, smoking, lack of physical activity. Group differences were assessed by t-test and chi-square test, p < 0.05, regression analysis for assessing initial variables, a predictive value for six-month rehospitalization. RESULTS: After acute coronary event, the anxiety and depression levels were mild and aggression was low in E1 and mild in E2. Stress event score was significantly higher in E2 (H-R = 115.18) than in E1 (H-R = 72.20), p < 0.05. After 6 months, the results were the same except for a significantly lower stress event score in E1 (H-R = 49.48), and in E2 (H-R = 91.65), but still significantly higher than in El. Coronary parameters were reduced, smokers' rate was increased in El. Alcohol consumption, hypercholesterolaemia and hereditary tendency were predictive for six- month rehospitalization. CONCLUSION: After acute cardiac event, hospitalized coronary patients had a mild anxiety, depression and aggression level as well as after six months. The infarct patients had experienced more stress life events in the previous year than the angina patients. Risk health behaviour did not change in the following six months, with the increased smokers' rate in the angina group. Alcohol consumption, smoking and heredity were predictive for rehospitalization.

Depressive phenomenology in regard to depersonalization level.

BACKGROUND: It has been found that in patients suffering from unipolar depression, associated depersonalization symptomatology is more intense compared to healthy controls, and also that there is a positive correlation between depression and depersonalization. According to data that may be found in the literature, there is a relatively high prevalence of depersonalization symptomatology in unipolar depressions. Our study was aimed at finding whether the presence of depersonalization was related to a specific phenomenological expression of depressive symptomatology in unipolar depression. SUBJECTS AND METHODS: The study included 84 subjects suffering from unipolar depression without psychotic features. Based on the Cambridge Depersonalization Scale (CDS) score, the subjects were divided into two groups - a group with associated depersonalization (CDS>or=70) (40 subjects) and a group with subsyndromal depersonalization (CDS<70) (44 subjects), the later one being treated as a control group. The groups were compared in regard to the intensity of depressive symptomatology, depressive symptoms frequency and the depressive symptoms duration. The General Socio-Demographic Questionnaire, the Cambridge Depersonalization Scale and The Patient Health Questionnaire - 9 were used. RESULTS: The depressive patients with depersonalization had predominantly severe episodes, almost all patients had feelings of sadness, insomnia, and decrease of energetic potentials. The biggest difference between the groups, in terms of greater number of manifest symptoms in the patients with depersonalization, was for psychomotor disturbances (agitation or retardation), insomnia, decrease of energetic potentials and concentration. At the same time, 75% of the subjects with associated depersonalization had anhedonia, sadness/dysphoria, insomnia and decrease of energetic potentials continuously present. Unlike this group, the control group subjects experienced sadness, appetite problems, concentration and motor behavior changes almost half as frequently. Particularly significant were the differences regarding suicidal thoughts. It was shown that in the group with depersonalization there was a higher percentage of patients with suicidal thoughts, mostly continuously present, which represent a significant suicidal risk factor. CONCLUSION: Unipolar depression, associated with depersonalization is more severe in its intensity .It has a bigger number of manifest symptoms which have a tendency to continuous duration. A special focus is on the negative impact on the occurrence and lasting presence of suicidal thoughts.