In the latter case, a ...

In the latter case, a "soil", which creates conditions for a protracted ND - acquired reactive lability with excessive sensitivity to any threat of bodily well-being and the accentuation of the alarming features of suspiciousness, neuroticism, rigidity, with evidence of violations of the solid sphere of self-consciousness (perception "body image"). Painting protracted LP [AB Smulevich, 1997; H. Koenig et al., 1988], gradually takes the shape of endogenomorfnoy depression. Formed vital disorders (depression, apathy, changes in circadian rhythm, expressed frustration sleep and appetite), and changing the contents of consciousness: fear for their own health ousted samouprekami. Patients repent that their helplessness cause inconvenience to the families and medical staff are all "burden", with the generalization of ideas of guilt of the accused himself of "simulation", claim that essentially they are healthy and only "assigned" his symptoms of somatic pain. Significant expression somatovegetative violations relative of wear proper affective manifestations of a depressive syndrome in psychopathological structure of ND causes certain difficulties associated with the diagnosis of depressive disorders. The fact that these somatovegetative Symptoms may occur and in some NW (coronary heart disease, asthma, effects of hypothyroidism, etc.) and act as a "common" for depression and somatic disease manifestations. The possibility of a differentiated clinical assessment related to the use of the developed in the department of pathology of borderline mental and psychosomatic disorders SCMH RAMS diagnostic criteria designed to identify depressive states in patients with manifest SO (see Annex 1) [AB Smulevich et al., 1997]. Among these criteria, the significance of somatovegetative disorders to affective (depressive) disorder is constituted by identifying a number of attributes. Among the latter are traditionally allocated to medical history, genetic correlates of depression, and to detect patients with symptoms of negative affectivity: dissatisfaction with the incompleteness of mental functions, the phenomenon of moral anesthesia and depressive devitalization (weakening or disappearance of the vital and somatochuvstvennyh instincts: sleeping, appetite, libido). Important diagnostic signs that supplies somatovegetative disorders to cases of ND, is a violation of psychosomatic correlations, reflected in the discrepancies manifestations and dynamics of such symptoms, severity and nature of the NW. Thus, an "affective" origin "common" symptoms seen, for example, dramatic weight loss and menstrual disorders in hyperthyroidism with a slight increase in thyroid hormone levels in blood, long algii in the chest in patients with coronary heart disease, localization and nature of which is not typical angina, persistent fatigue in iron-deficiency anemia is not accompanied by significant changes in the blood, prolonged agripniya in patients with asthma without nocturnal attacks of breathlessness.