In the main group of patients with recurrent depressive disorders, women dominated (79.55%), most prevalent age group was from 50 to 59 years old (34.09%), higher education was quite prevalent (45.45%), most individuals were living in the city (77.27%), married – 70.45%, and did not have a permanent job (57.50%). It should be noted that among unemployed only 4.4% reached retirement age. The comparison group by age, place of residence, marital status, and social employment rates did not differ from the main one.

The main group included individuals with recurrent depressive disorders without rapid cycles in the medical history and complete remission of previous episodes (Table 1). According to the Table 1, in the vast majority of examined patients, a history of 3 to 5 depressive episodes was recorded, taking into account the current (52.27% of subjects). In 31.82% of this category of patients, this episode was second. In 15.91% of patients, there were more than 5 depressive episodes during the disease’s course. The duration of the current depressive episode in the examined patients in the vast majority of cases was from 2 weeks to 6 months (65.91%). In a large number of patients, the duration of the episode was between 6 months and 12 months (25.00%). The duration of the episode more than 12 months was observed in 9.09% of cases.

The duration of the previous remission in 36.36% of patients with recurrent depressive disorders was estimated between 6 and 12 months, 34.09% of patients - between 12 and 24 months and 29.55% of patients - more than 24 months.

The structure of clinical and psychopathological manifestations of the depressive spectrum in patients with recurrent depressive disorders was characterized by the presence of affective, motivational, cognitive, psychomotor and somatic disorders, among which more pronounced were: depressed mood (100%), decreased activity and initiative (88.64%), sense of lack of perspective (84.09%), decreased concentration (86.36%), and mental exhaustion (81.82%). Psychomotor disturbances in recurrent depressive disorders were represented mainly by retardation (56.82%), somatic ones - physical fatigue (84.09%) and sleep disorders (79.55%).

The analysis of preferred coping strategies showed that 59.43% of people without mental disorders were inclined to use adaptive coping strategies, 18.81% used relatively adaptive and 20.75% - maladaptive coping strategies (Fig. 1A). In patients with the recurrent depressive disorder, 38.83% of the patients used an adaptive, 27.18% - relatively adaptive and 33.98% - maladaptive coping strategies (Fig. 1B). The statistical analysis of the results showed that individuals without mental disorders were more likely to use adaptive coping strategies (p ≤ 0.05, DK = 1.72, MI = 0.16), while patients with the recurrent depressive disorder - maladaptive coping strategies (p < 0.05, DC = 1.65, IM = 0.23).

A detailed analysis of coping behavior has shown that among the cognitive copings in patients with recurrent depressive disorder the most pronounced were: problem analysis (23.53%), confusion (20.59%) and establishing self-value (14.71%), and in individuals without mental disorders - problem analysis and preservation of self-control (28.57% and 22.86% respectively) (Fig. 2).

Among the emotional coping strategies in patients with the recurrent depressive disorder, passive cooperation (29.41%), inhibition of emotions (23.53%), and self-blame (14.71%) prevailed. In the comparison group, 62.86% of the people were inclined to perceive difficult situations with confidence in their solution optimistically. In the analysis of behavioral responses, it was determined that patients with recurrent depressive disorder tended to use the strategy of cooperation (23.53%), treatment (20.59%) and retreat (20.59%), and healthy - cooperation (31.43%), distraction (22.86%) and constructive activity (11.42%).

Statistical analysis confirmed the obtained data about the predominance of such strategies as retreat (p < 0.05, Kulback’s Diagnostic Coefficient (DC) = 4.75, Kulback’s informativeness measure (IM) = 0.33), confusion (p < 0.025, DC = 8.58, IM = 0.76), passive cooperation (p < 0.01, DC = 6.30, IM = 0.71) and self-excitation (p < 0.05) in patients with recurrent depressive disorder and strategies of distraction (p < 0.05, DC = 4.95, IM = 0.46), constructive activity (p < 0.05), preservation of self-control (p < 0.05, DC = 5.89, IM = 0.50), and optimism (p < 0.0001, DC = 6.33, IM = 1.84) in persons without mental disorders.

The analysis of the results obtained from the Self-Actualization Test (SAT) showed relatively low scores in all indicators (Figure 3). Thus, it was determined that patients in the main group were inclined to focus only on one of the segments of the timeline (past, present or future) and to discretely perceive their life path (31.16 (Mean) ± 15.90 (SD) ​​points).

Low indicators of contact were identified, which was manifested in the tendency to avoid subject-subject communication (27.95 points), as well as low levels on self-esteem and self-acceptance scales (30.21 and 33.87 points, respectively). The score on the support scale can indicate a high degree of dependence, conformality, independence, a prevalence of external locus of patient’s control (39.54 points). The patient's ability to spontaneously and directly express their feelings (35.39 points), their own negative emotions (irritation, anger, and aggression) (36.22 points) was combined with a low reflection of their needs and feelings (39.34 points)

Patients with the recurrent depressive disorder were not inclined to seek self-actualization (42.27 points) and were inflexible in realizing their values and behavior, as well as in interactions with others (37.78 points). Also, in this group, low indicators of cognitive needs and creativity were determined in patients with the recurrent depressive disorder (38.02 and 33.83 points, respectively).

Individuals without mental illness were characterized by high scores on such scales as: orientation in time, valuable orientation, flexibility in behavior, self-esteem and self-perception (58.99, 58.38, 59.31, 59.21, and 54.90 points, respectively), which testified to the ability of subjects to live in present, to perceive their own way of life in a holistic manner, the presence of flexibility of behavior and goals of self-actualization, positive qualities of character, to respect and to accept oneself what they are. Also, were established personality features that were in line with the normative level: the prevalence of the internal control locus (52.55 points), adequacy in understanding and manifestation of their own feelings (46.38 and 49.36 points respectively), the ability to establish deep and emotionally-rich contacts with people (51.32 points), propensity to positive perception of others (48.52 points), and the presence of cognitive needs and creative orientation of the personality (48.39 and 47.26 points, respectively).

The statistical analysis of the results demonstrated and confirmed the described differences between patients with recurrent depressive disorder and the comparison group, which consisted of lower scores for patients on the scale: time Orientation (p < 0.0001, t = 5.9881), support ( p < 0.0001, t = 5.481), value orientation (p < 0.0001, t = 4.817), flexibility of behavior (p < 0.0001, t = 5.921), spontaneity (p < 0.002 , t = 3.274), self-esteem (p < 0.0001, t = 4.797), self-acceptance (p < 0.0001, t = 4.881), acceptance of aggression (p < 0.006, t = 2.818), t = contact (p < 0.0001, t = 3.965), cognitive needs (p < 0.01, t = 2.577) and creativity (p < 0.0001, t = 3.795).

Also, during the study, a correlation analysis was conducted on the number of episodes depending on the personality traits in patients with the recurrent depressive disorder (Table 2).

It has been determined that the presence of 2 episodes in the history of patients is related to the time orientation (r = 0.457), flexibility of behavior (r = 0.467), and contact (r = 0.448). The increase in the number of episodes (3-5 episodes) was associated with rigidity (r = -0.473), decrease in motivation (r = -0.464), discreteness in perception of their own lifestyle (r = -0.447), inability to spontaneously manifest their own emotions (r = - 0.494), low self-admission (r = -0.466).

The increase in the number of episodes (more than 5) was due to fixation of attention at one of the time segments (past, present or future) (r = -0.626), the devastation of the value-motivational sphere (r = -0.572), low self-acceptance indicators (r = -0.402 and r = -0.644 respectively,), decrease in contact (r = -0.470), difficulties in expressing their own emotions, especially aggression (r = -0.405 and r = -0.472, respectively).

A correlation analysis between the number of episodes with the peculiarities of the coping strategies of patients with the recurrent depressive disorder was also conducted (Table 3).

In the first episodes, patients were inclined to, on the one hand, to fix difficulties (r = -0.549), feel confused (r = 0.621), were not inclined to accept the prevailing situation (r = -0.485), tried to distract (r = 0.455) and hoped for help from others (r = 0.416). In repeat episodes, patients tended to be locked up in the current situation (r = -0.408), tried to cope with it with religion (r = 0.431) or through contact with help from others (r = 0.492), as well as through passive co-operation or avoidance of the situation (r = 0.479 and r = 0.498, respectively).

In repeat episodes, patients experienced confusion (r = 0.487), obedience (r = 0.637), tended to retreat from difficulties because they did not feel their strength to master the situation (r = 0.420) and were inclined not to share their experiences with others (r = -0.587).

The authors declare that no competing interests exist.