The membership somatovegetative ...

The membership somatovegetative disorders to cases of ND can with certainty be judged upon detection of patients with persistent nausea, pain in upper abdomen, lack of appetite and other gastrointestinal complaints, when a stomach ulcer or duodenal ulcer has healed. Similarly an "affective" origin "common" symptoms indicates detection of fatigue, sleep disorders, decreased libido, anhedonia, persisting in the clinical picture, despite the successful treatment of SP (coronary heart disease, hypothyroidism, etc.). To the fore in a number of issues lingering diagnosis of ND is a necessary differentiation of depression with mood disorders, emerging in the continued progression of mental illness [AB Smulevich, 1997]. The urgency of this problem is dictated by the following circumstances. Patients exhibiting symptoms like progressive mental illness in need of psychiatric supervision and often in an intensive pharmacotherapy. Medical aid this category of patients requires special conditions and opportunities provided in specialized psychiatric facilities or somatopsihiatricheskom department multidisciplinary hospital. As shown by the experience of psychiatrists working in hospitals for general care, prolonged ND more likely to be differentiated from affective disorders in schizophrenia, and delimits in elderly patients with affective manifestations of atrophic processes in the brain (presenile dementia). Differentiation of depression, emerging in schizophrenia are usually based on exclusion (or the observed) as a psychopathological disorders inherent progradient endogenous process, as well as signs of schizophrenic defect. The presence of depression, even in the picture blurred, subpsihoticheskih manifestations of hallucinatory-delusional Register (hails, auditory delusions commenting or mandatory nature, sounding thought, haptic hallucination, a rudimentary idea of ??the impact of harassment, a special value) greatly facilitates the diagnosis of schizophrenia. As a sign of Procedure of the disease appear as gradual complication pictures of affective manifestations as a result of accession is not peculiar to NW (heteronomous) pain. Among the latter, it should be noted senestopatii - painful, not giving a precise description of experience (contraction, burning, and transfusions) is not relevant to the localization of anatomical structures. Along with senestopatiyami can manifest cenesthesia and visceral hallucinations. On the procedural nature of suffering can testify, and expansion of the hypochondriac phobias, get character panfoby and combined with phobias of abstract content, and adherence hypochondriac delusions. Differentiation of ND, manifest in somatically elderly patients with atrophic processes of the brain is relevant in connection with the fact that depression may develop later in the prodromal stage of Alzheimer's disease.