529531. Posted with permission ...

529531. Published with permission from Russian Medical Journal

Night sleep in depression

J. Levin, SI Staffs, IG Hanoun clinical picture of depression (D) is composed of affective, motor, autonomic and dissomnicheskih disorders, which introduces the problem of sleep disorders in terms of the most relevant in this disease. As used in this case, the term "dissomnicheskie" reflects the diversity of these disorders, including both insomnicheskie and gipersomnicheskie manifestations. According to various statistics, the participation of sleep disorders in a cycle of sleep - waking at A is 83 - 100%, which is apparently due to different methodological possibilities of evaluation, since the objective polysomnographic studies - it is always 100%. Such obligate cycle disorders sleep - waking at D is based on common neurochemical processes. Serotonin, breach of mediation which play a crucial role in the genesis of the D, not only has outstanding significance in the organization of d-sleep, but also in the initiation of REM sleep (FBS). This also applies to other biogenic amines, particularly norepinephrine and dopamine deficit which has a value in the development of D, and especially The sleep-wake cycle. Sleep disorders can be as basic (and sometimes the only) complaint, disguising D, and one of many. This is particularly evident in the example of the so-called hidden (masked) D, because this form of pathology of sleep disorders may be leading, and sometimes the only manifestation of the disease. It is believed that the "torn sleep or early morning awakening, along with a decrease in awakenings and a decrease in capacity for emotional resonance can serve as an indication of the presence of D in the absence of a dreary mood. So far there is no conclusion of the presentation of the salient features of sleep disorders in various forms of D, though it has long been noted for their great phenomenological diversity. Changes in sleep are characterized by reduction of endogenous D d-sleep, a shortening of the latent period of FBS, increasing density of rapid eye movement (REM - one of the major phenomena that characterize the FBS), frequent awakenings. When psychogenic D in the structure of insomnia with sleep disorders dominated by compensatory lengthening of sleep in the morning, while in endogenous depression often recording part of the night and early final awakening. Marked decrease in the depth of sleep and increased physical activity. Revealed marked reduction of stage IV sleep. On the background of a reduction in stage IV and frequent awakenings are often noted an increase in the surface phase of slow wave sleep stages (FMS) (I, II stages). Increases the number of transitions from stage to stage, indicating that instability in the cerebral mechanisms for maintaining sleep stages. In addition, the characteristic feature was an increase in the number of awakenings during the last third of the night. A substantial change in the organization of the deepest stages of FMS is also indicated by the phenomenon of ad sleep.

STEP FOUR - to answer these questions.

A) Immediate plans Like when drawing up short-term plans, the next case should be planned on a regular basis, every day (or evening before or morning - someone as comfortable). Please list all day. For convenience, you can separate the case from mandatory non-binding (for example, highlighting their different colors). II. WARNING. Very often it happens that during the investigation of a subject appear extraneous thoughts, I want to get distracted and so on, especially when the subject is not the favorite. And in this case, additional methods to concentrate, make sure not to be distracted. Can advise the following. First, prepare a designated place to study. There should be nothing more that could distract attention (eg, photos). Second, the posture must be "collected" and not fall apart. It is better not to sit in an armchair, and solid stool. Third, you can turn a quiet background music, obscure other sounds that may distract you. For a better mastery of the material requires an active approach to business. In studying the subject, while reading the book stresses the importance of place, discharge them, Outline. Many of you probably, in the study (usually - a foreign language) use the card with the words. Very useful method. It can be used for all other subjects, writing, for example, the rules of Russian language, the laws of physics, mathematical formulas, etc. Verified also that the degree of assimilation of the material increases group lessons. Known also by such a method STUDY (in English it's called "survey, question, read, recite, review", or SQ3R, ie, "review, question, read, paraphrase, repetition). FIRST STEP - an overview of the material: browse titles and scamper to represent the total content. The second step - to each subject (title) to formulate one question. The third step - read the text and in the course of reading trying to find answers to these questions. STEP FOUR - to answer these questions. The fifth and final step - repeat material (dwelling on the difficult places.) III. REMEMBERING To good to pass the exam, need a lot to learn, remember. Therefore, memorization - a key point. So, we must learn well and much to remember. Here are a few methods to train the memory at all. To remember, for example, telephone number 231-97-75, you can divide all the numbers into groups and come up with for each group of simple association. For example: 23 - the age of his brother, 1977 - the year of his birth, 5 - month of birth. Instead of seven units of information was only three, and they belong to the same person. To memorize the names of new acquaintances, you can use this method: to repeat the name aloud (for example, often referring to him by name). It is known that auditory information is retained longer in memory, rather than visual (though this is not true for all), so-to-remember phone number that you see written, repeat it aloud several times.

References: 1. Kiryushchenkov AP ..

Literature: 1. Kiryushchenkov AP Tarahovsky ML Effect of drugs on the fetus. M., 1990. 271. 2. Arnon J., Shechtman S., Ornoy A. The use of psychiatric drugs in pregnancy and lactation / / Isr. J. Psychiatr. Relat Sci. 2000. Vol. 37, N 3. P.205222. 3. Autret E., Rey E., Laugier J. et al. Retentissement neonatal de la consommation de benzodiazepines au cours de la grossesse / / Therapie. 1987. Vol. 421, N 3. P.305310. 4. Cohen L.S., Heller V.L., Bailey J.W., et al. Birth outcomes following prenatal exposure fluoxetine / / Biol. Psychiatr. 2000. Vol. 48, N 10. P. 9961000. 5. Dean C., Kendell R.E. The symptomatology of puerperal illneses / / Brit. J. Psychiatr. 1981. Vol. 139, Aug. P.128133. 6. Elia J., Katz I.R., Simpson G.M. Teratogenicity of psychotherapeutic medication / / Psychopharm. Bull. 1987. Vol. 23, N 4. P.531586. 7. Goldstein D.J., Corbin L.A., Fung M.C. Olanzapineexposure pregnancies and lactation: early experience / / J. Clin. Psychopharmacol. 2000. Vol. 20, N 4. P.399403. 8. Kerns L.L. Treatment of mental disorders in pregnancy: A review of psychotropic drug risk and benefits / / J. Nerv. Ment. Dis. 1986. Vol. 174, N 11. P.652659. 9. Kulin N.A., Pastuszak A., Sage S.R., et al. Pregnancy outcome following maternal use of the new selective serotonine reuptake inhibitors: A prospective controlled multicentre study / / JAMA. 1998. Vol. 279, N 23. P.1873. 10. McBride W.G. Limb deformities associated with iminodibenzyl hydrochloride / / Med. J. Aust. 1972. Vol. 1, N 10. P.492. 11. McNeil T.F., Blennow G. A prospective study of postpartum psychoses in a highrisk group. 6. Relationship of birth complication anf neonatal abnormality / / Acta Psychiatr. Scand. 1988. Vol. 78, N 4. P.478484. 12. Meltzer E.S., Kumar R. Puerperal mental illness, clinical features and classification: A study of 142 mother and baby admissions / / Brit. J. Psychiatr. 1985. Vol. 147, Dec. P.647654. 13. Misri S., Burgmann A., Kostaras D. Are SSRI safe for pregnant and breastfeeding women? / / Can Fam. Physician 2000. Vol. 46, Mar. P.626628, 631633. 14. Nurnberg H., Prudic J. Guidelines for treatment of psychoses during pregnancy / / Hosp. Comm. Psychiatr. 1984. Vol. 35, N 1. P.6771. 15. Rao J.M., Arulappu R. Drug use in pregnancy: How to avoid problems / / Drugs 1981. Vol. 22, N 5. P.409414. 16. Safra M., Oakley G. Association between cleft lip with or without cleft palate and prenatal exposure of diazepam / / Lancet. 1975. Vol. 2, N 7933. P.478480. 17. Saxen I., Saxen L. Association between maternal intake of diazepam and oral clefts / / Lancet. 1975. Vol. 2, N 7933. P.498. 18. Targum S.D. Dealing with psychosis during pregnancy / / Amer. Pharmacy 1979. Vol. NS, N 9. P.1821. 19. Ticknor C.B., Vogstberger K.N. Development of psychosis during premature labor / / Hosp. Comm. Psychiatr. 1987. Vol. 38, N.4. P.406407. 20. Weistein M.R., Goldfield M.D. Cardiovascular malformation with lithium use during pregnancy / / Amer. J. Psychiatr. 1975. Vol. 132, N 5. P.

Descriptions of functional disorders ...

Descriptions of functional impairment using pregnant ? ? older antipsychotics also scarce: identified isolated cases of withdrawal syndrome in newborns whose mothers had for a long time received neuroleptic therapy, and respiratory failure when used in late pregnancy of high doses of chlorpromazine. Kakihlibo intellectual disorders in preschool children exposed to prenatal exposure to neuroleptics was not detected [8]. Reports of use during pregnancy, atypical antipsychotics are scarce. States, inter alia, the possible increased risk of miscarriage and stillbirth [7]. The conclusion is thus clear that the use of psychotropic drugs during pregnancy should be limited, and women of childbearing age receiving psychotropic medications should avoid pregnancy. In the case of urgent need to use these drugs a potential teratogenic risk should be correlated with the severity of mental disorder. Moreover, since the impact of new drugs (neuroleptics, antidepressants) on the fetus are currently not sufficiently investigated, preferably appoint ? old ?, more predictable with respect to the teratogenic effects of drugs [2]. Given the above information, a number of recommendations on the use of psychotropic drugs during pregnancy [6,14]: to avoid the use of psychotropic drugs in the first trimester of pregnancy during the development of a pregnant woman's level of psychotic mental disorders shows hospitalization for a decision on the appointment of therapy is recommended obtain consent to treatment, not only from the patient, but also from her husband in urgent need of psychotropic treatment of the "old", well-studied drugs should be preferred, since the teratogenic risk of new has not been studied, appropriate use of minimally effective doses of drugs, although it shall not aim at any price is fully arrest the symptoms, as this may require higher doses of drugs that increase the risk of complications for the fetus, is not desirable to use a combination of psychotropic drugs; reduction and removal of drugs should be conducted as quickly as possible, except pharmacological remission, when the cancellation of treatment can lead to an exacerbation of the disease, should exercise careful clinical and instrumental control over the fruit, especially in the early period, for early detection of pathology during pregnancy should be close collaboration between psychiatrists and obstetricians, patients need to be watched and the postpartum period, because at this time increases the risk of (acute) psychiatric disorders an important step in working with pregnant, especially mental disorders, is to create a favorable psychological environment and preparation for childbirth.

But should the contrary - not to object to ...

With the ability to think and relaxed, self - prerogative of a mature personality. That's personality. As our Bulavanov: "Well, why argue for nothing? It's a lot of boys early adolescence. Always and everywhere the same - but let's for argument. " We must strive not to object, but to understand the opponent. People often agree when there is no objection. But should the contrary - not to object only when the well can not agree. "Our commander is what we always said at every opportunity. What do we, nothing to express their own opinions?

Exam Preparation

I. PLANNING. Ability to manage your time - this is one of the most important skills. The sooner you learn how to do it, the better will be your learning process in the future. You've probably noticed that the best students (and more often - girls) - is not necessarily the most intelligent. But as a rule, it is disciplined and able to organize their time. And very often during my studies, especially in high school, need to learn a lot, but time is short. So if you can plan your time, and mood will be better (from what you were buried under a pile leaning Affairs), and score higher. His plan is best broken down into three types: long-term, short term and the next. And most importantly - buy great diary, where you all my plans will be recorded. a) Long-term plans is the plans that you are planning on a quarter or a semester in advance. Check to notepad vacations and holidays, and weekdays (if you're still up and running). It is further necessary to fix the date, relating to school (as soon as they become known): tests, reports, term papers, exams, etc. Oh, and do not forget about entertainment: concerts, theater, etc. And now, set yourself deadlines for each case by doing the following: great things to share more small, being allocated to the reserve (remember that normally any case it takes longer than you think in the beginning). Then you have for each case based on the deadlines, make a weekly schedule for its implementation. The result will be your action plan for the entire period. And it would be good to hang on to a prominent place (eg on the wall above the desk) to as much as possible he was in front of your eyes. b) Short-term plans Do you already have a weekly plan. Now you have to plan out every week on days and hours. This is best done in a specific day of the week (eg Sunday) for the week ahead. How and when planning long-term cases, you should make a plan is strictly necessary to do (like work, school, time on the road) and install it for all Affairs of the timing of their implementation. This takes into account time of day at which you have the maximum efficiency (for each person it is his), and highlight it for self-study. And remember: it's better to do every day for an hour than once a week, but a day. should begin classes with the more difficult subjects, leaving the more easy for you at the end of classes.

Lithium salt feature products ...

Lithium salts lithium feature of drugs is that they are not metabolized in the body. Their pharmacokinetics determined by the intensity of excretion by the kidneys, the level of which changes during pregnancy. This leads to the need to modify the scheme of using the drug in pregnant women. Thus, increased renal clearance of lithium requires increasing doses to maintain its optimum concentration in the blood. At the same time a sharp decline in glomerular filtration and clearance of lithium after birth can lead to intoxication [1,6]. It is believed that a single dose of lithium for pregnant should not exceed 300 mg, and the level of therapeutic blood concentrations should be maintained at the expense of the reception frequency. Monitoring drug concentrations in blood should be performed weekly. In general, however, especially the use of lithium during pregnancy are determined mainly by the risk of pathogenic effects on the fetus. Lithium is relatively easy to pass through the placenta and is found in fetal blood. Data on the effects of lithium during pregnancy in women more systematically compared with those of other psychopharmacological agents. In order to systematize this has been introduced so-called lithium-sensitive (Lithium Register). According to him, the level of the anomalies of the cardiovascular system and, in particular, Ebstein anomaly (severe tricuspid insufficiency) is significantly higher in cases of drinking by women during pregnancy in lithium than in the general population [20]. Thus, lithium is contraindicated in the first trimester of pregnancy, but its use in this dangerous period can not serve as an absolute indication for abortion. So, for the control of the cardiovascular system (16 weeks) and Ebstein anomaly diagnosis (23 weeks) may be used echocardiography [2.20]. Neonatal lithium intoxication may be manifested in the form of so-called syndrome of flaccid child. In children, a decline of muscle tone, drowsiness, shallow breathing, cyanosis, inhibition of sucking and grasping reflex, and absence of Moro reflex [6,8]. Reported effects can last up to 10 days after birth. As an alternative drug for the prevention of mood phases can be used carbamazepine. This drug is considered to be reliable enough when alone, but the risk of congenital malformations increases significantly when it is combined with other anticonvulsants [6]. Neuroleptics Neuroleptics penetrate easily through the placenta and rapidly detected in the tissues of the fetus and amniotic fluid. However, as a rule, preparations of this group do not cause major malformations in children born to mothers who took it during pregnancy [14]. Reports of congenital anomalies in their use are scarce and can not be clear systematization. This is especially important that a number of drugs in this group (etaperazin, haloperidol) is sometimes appointed by the obstetricians in small doses in early pregnancy as an antiemetic.

But in the army I was fortunate (lucky in life - a great power).

It helps to communicate with animals. Dog or cat brings joy more than expensive trips and trendy shops. And every day, and selflessly. - Women are often depressed because they are no longer so young as ever. Is there a psychological cure for this disease? - I think that experience serious concerns about his age - is evidence of psychological immaturity. In the life of so many interesting things at any age! It is necessary that it was filled to the brim, and then did not want to come back. If you have a good recall how in his youth had a problem, it will rejoice that they have already passed. For example, I was terribly shy, terribly unhappy child. And now I live and enjoy every day, every hour of life. And the back is not desirable. All of that precious cargo of knowledge, skills "to deal with life, feel free and happy, doing something, I would not change anything. Catherine Blagonravova

You're argumentative, but ...

 I am 29 years old. In grade 8, I noticed that, that I may say - I have always had an objection. I really liked classmate, and she was a wayward girl, and felt that a real man, it's like D'Artagnan - broke out on any occasion and ready to fight back at any time. This, she said, when we mindlessly went by on the avenue in October, arguing before the blue in the face of everything. Rather, they argued, and I walked in silence with all together and looked at her. It was then that she stopped and said that there Leh, it will be easy to live - he agrees with all, no one argues. Such as I, the suspension does not rush, with people like me, do not cook meals, and if they cook - it will not porridge and gruel. These words were to me like a cold shower, but what's there as a shower, as natural a slap. Since then I began to argue with everyone. First, in school and then home. I always learned well, a lot of reading. And once began to argue - my assessment became worse - what a teacher like that I'm constantly arguing? I finished school, whatever - with a bunch of three ways in the certificate. Before the army began to hang out in a very questionable company, and God knows what would all this lead. But in the army I was fortunate (lucky in life - a great power). Served in the artillery. The battalion commander Capt. Bulavanov was very intelligent men - a thorough, balanced in his judgments, and in cases of precocious maturity (he is in fact then and tridtsatnika was not). Never argued - always listen carefully and say your word. He never yelled at us - privates and sergeants who never raised his voice and the officers of Division I did not know (thank God!), What is hazing - in our division that be just could not. We are not afraid of their officers, we are honored as their senior, smart, well versed in the business. Themselves tried their utmost to be like them, imitating them in everything - in his words and demeanor, even in his walk. I'm in the army knew perfectly well that having an opinion - does not mean to be inveterate arguer.

Tranquilizers Tranquilizers ...

Tranquilizers Tranquilizers are widely used not only in mental health, but the actual midwifery practice. They can easily pass through the placental barrier. After intravenous injection of diazepam women in childbirth, he is found in fetal blood after 5 minutes, with a concentration higher than in maternal blood [1]. This can lead to accumulation of drug in the blood of the fetus. In addition, newborns increased as compared with adults elimination half of the drug, and its significant amount can be determined in the blood for a long time after birth. Revealed that the application of diazepam in the first trimester of pregnancy increases the risk of neonatal cleft palate, upper lip and the development of inguinal hernia [16,17]. Long-term use of the drug during pregnancy can lead to its accumulation in fetal tissues (particularly in adipose tissue and liver) and condition thereby toxic effects. Newborns can be marked muscular hypotonia, hypothermia, hyperbilirubinemia [6]. Possible respiratory depression until it stops and violations of the sucking reflex [1,3]. The use of diazepam in low doses during childbirth, as a rule, does not provide kakogolibo adverse effects on the fetus, but high doses can lead to seizures in newborn asphyxia, reduced muscle tone, abnormal metabolic responses to temperature decrease. The possibility of toxic effects of diazepam (and other tranquilizers) in the fetus and the newborn makes cautious to recommend its use during pregnancy, although in most cases to identify kakielibo functional impairment in excess of the level found in children whose mothers did not take diazepam, failed. This is probably due to the short duration and relatively low doses of the drug used. When using antidepressants tricyclic antidepressants may increase the likelihood of congenital skeletal anomalies, mainly limb malformations [10]. However, these data do not appear until the end unconvincing. Apparently, this group of drugs has a relatively low teratogenic, at least in nizkihsrednih doses and at later stages of pregnancy. The use of ultrahigh doses leads to multiple severe congenital malformations in the fetus. When using tricyclic antidepressants in late pregnancy may experience neonatal functional impairment related to, inter alia, cholinolytic action of drugs: urinary retention, tachycardia, respiratory disorders, peripheral cyanosis, increased muscle tone, tremors, clonic jerks [6.15]. The risk of using drugs during pregnancy, a new generation, and, in particular serotonin reuptake inhibitors, has been studied enough. There is also evidence of the absence in these cases expressed malformations in children [9], although reports of the possibility of them not sharply marked pathology in the postpartum period [4.13].

Differentiation of these states ...

The division of these states contributes to the detection of asthenic facade to reduce the vital tone, feeling somatopsychic changed, the depressive response, communication slowness of action and reaction is not to increase the threshold of response to external stimuli, which is typical for states of stupefaction, and with ideomotor retardation, the presence of diurnal variation, diffuse anxiety, a sense of the vital prognosis. Pregnancy Fault on the background of existing psychotic symptoms in schizophrenic patients tend to have no significant influence on clinical disease, which corresponds to the usual stereotype of the morbid process. In some cases in the last trimester may, however, a sharp aggravation of symptoms of the attack, which is characterized up to this long-standing subacute. It should be noted that the prenatal and childbirth in patients with schizophrenia in cases of prolonged poor pregnancy usually occur with few complications. Were significantly more pregnancy complications observed in patients with a more favorable course of episodic process. In connection with the development of a number of cases of psychotic disorders in pregnancy raises the question of indications for an interruption. It is obvious that it is necessary to solve a strictly individual. The only absolute indication for psychiatric production of artificial abortion are only those that pose a threat to life of the mother and fetus: eclampsia and status epilepticus. In other cases it is necessary to take into account numerous factors that predict deterioration in mental status due to pregnancy and childbirth. Adequate preventive measures can allow a pregnancy to term even if the woman suffered a psychosis in one of the phases of the generation period. In these cases, we recommend protection against pregnancy for 34 years after suffering a psychosis. At the same time, repeated (more than two), psychosis associated with childbirth, may serve as a basis for contraception. It should also recommend protection against pregnancy in case of unfavorable schizophrenic process with frequent exacerbations, protracted and severe personality changes, despite the fact that the psychosis of pregnancy are well kurabelnymi. The use of psychotropic drugs during pregnancy are discussed at the outset of their application in psychiatry and do not become less relevant. It is believed that up to 8090% of pregnant women take drugs, with 10% 35% use psychotropic drugs. Safety problems of drugs, including psychotropic, funds in the gestational period has different aspects: on the one hand, takes into account the risk of their pathogenic effects on the fetus, on the other hand the severity of pathological disorders in the future mother to warrant the use of them. The general rule here is to use drugs only when the risk of complications for mother or fetus when not using the medication outweighs the risk of side effects.

It is also important to understand that annoying husband, and not to do so.

And praise, praise, praise. - Today, many women spoil the life of envy: a colleague has bought a luxurious fur coat, and I'm only a sheepskin coat, his neighbors, "Mercedes" and we "Lada". What can I advise them to find peace? - First, realize that the rich have problems. I have many patients - their wives or girlfriends new Russian. With the terrible depression. One says: her beau invited to the restaurant, gave the wonderful flowers. And suddenly ringing cell. He is being transferred to the subscriber with a few words and then said to her: "Oh, because you are now two thousand dollars" nedozhal! "This is the most innocuous example. In wealthy varies psychology skudeyut emotions. Often irretrievably broken fine family atmosphere, which flourishes in an atmosphere of relative affluence and tranquility. - You can call any bans, through which must not overstep the woman if she wants to keep the peace in the family? - must avoid the psychological pressure on men than is often err wife. Every person in the family should be their personal space, where there is no entry to anyone. It is also important to understand that annoying husband, and not to do so. For example, many women consider it their duty to question the man about all his affairs and the movements of the day. And it may be, it is not necessary - want to just relax in the evening watching television. And do not roll scenes reproach. Better behave so that he spoke about his problems when the need arises. And then not to be distracted by household chores, do not say: "now disabled chops and listen to you. "Under the absolute prohibition of sexual failure should be the husband and his past relationships with women. not desirable also to sort things out" piping hot "to respond to insult with malicious words. It is better to wait until the emotions calm down and calmly talk the next day. No need to force men to do something out of a sense of duty. Do not talk too much about their illnesses, whining, tantrums suit. wives take care of the sick, not because they are sick, but because they are loved. - Sometimes it can be deduced from sanity a trifle: the street someone cursed, looked askance colleague. What do you do in such cases so as not to spoil the mood? - It's very simple: if a woman tells you that you have a gaudy dress, then most likely it just jealous that her figure can not wear that. As soon as you will understand the motive of such ill will, once it becomes easy. - And how you can maintain the mood of each day? - Start the morning with, remember the good things you have or had a life. Behave as though you are beautiful and lucky, even if you feel terribly notorious. Get up in front of a mirror and smile at myself, been told that you look great. And if you feel tired and broken, when nothing was not happy and not help - urgently needed breathing space. If I can not go to sea, then at least spend the whole day in the countryside - and reappear forces.

Health to you and many years of life ...

You health and many years of life. And faith, great faith in the recovery. Source: Online edition of "Planet Health" № 13 February 2004 on the site LTD "MediaRoom" www.ph.ru

Help the mentally ill during pregnancy

MD AB Shmukler Institute of Psychiatry, Ministry of Health, Moscow Representation of the relationship of mental disorders with reproduction dates back to ancient times. Meanwhile, the bulk of research devoted to postpartum psychosis and mental disorders during pregnancy have been studied considerably less. This is probably due to their much lower prevalence. Thus, the risk of developing psychosis the generation period (GP) in the general population is 0,1-0,25% [18]. In this case, to postpartum psychosis accounted for 45% -86% of all psychoses GP for lactation (ie, during feeding) - 10% -42%, and psychosis gestation period - 3% -15%. It is believed that the level of severe mental disorders during pregnancy is the same or even lower compared with the level of pain out of childbirth, but it increases sharply after birth, exceeding even the incidence of disease in nulliparous women. Postpartum psychosis occur with a frequency of 1-2 per 1000 births [12, 19]. Psychosis during pregnancy should include team nosological group. In this case, the pregnancy itself does not cause psychosis (except eklampticheskih), and can only provoke the onset or exacerbation of existing mental health problems. Psychotic disorders can contribute to various somatic pathology developing in this period. Are essential psychological difficulties (family discord, loneliness, death of loved ones) [5, 11]. In general, however, pregnancy encompasses health, the deterrent factor. A quickening of psychotic disorders was observed only in the last trimester of pregnancy and reaches a maximum at 615 days after birth. The most common disorder of pregnancy is a depression of various etiologies. Moreover, if the shallow level of disorder observed in early pregnancy, the major depressive disorders often develop in later stages [5]. Sufficiently characteristic is anxious depression. Sometimes the expressed ideas of self-accusation. After birth, often marked deterioration with a tendency to prolonged duration. Schizophrenia is one of the most common during pregnancy, mental illness, second in frequency only psychogenic illness. Bouts of schizophrenia, developing itself in pregnancy, are often transient, and affective disorder levels observed shortly before birth, characterized by blurred, unexpressed violations. However, you can select ? ? critical periods in the second (at 1,822 weeks) and last trimester (weeks in 3439) are most vulnerable to bouts of schizophrenia. Affective disorder at the initial stage of developing in the later stages of pregnancy episode schizophrenia tend to be atypical in nature, necessitating a differential diagnosis with mental activity in severe forms of late toxicosis of pregnancy.

Maybe something they recommend? - Do not harass myself and my husband.

They're going from a cold, indifferent, inhospitable home. To catch the moment in a relationship, cold, and try to understand each other. If it is very difficult to understand, seek a good psychologist. - Many women feel that their main rival - the work. Maybe something they recommend? - Do not harass myself and my husband. If a person earns money, if he painted all the time on the clock and it happens a little at home, a wife must do all that the family has become "an island" problem-free, comfort and peace. Do not ask her husband about his affairs - he has enough work and worries. Do not cut that does not help around the house - it is better to hire a housekeeper, if very difficult. Pays little time for children - free from all that hinders communication with them. Many men today is a difficult and dangerous work, and women have exacerbated the difficulties his stupid attitude. I say one of his friend, whose husband is a big businessman: "You just think, tomorrow it can kill, and you pilish it!" Another mistake: quite often we women think that if they have "the stamp in the passport, then the more they worry about. Home go to zatrapeze and work - in the ceremonial form. Like, what for her husband to try. Although it was his score is really important. Moreover, it is often not a lack of funds. One of my very wealthy patient walks through the house in a jogging suit most shirpotrebnogo species. I asked her: "Do not meet her husband's home in an elegant dress?" And it is not necessary. Such an attitude towards herself and her husband - a sign of hidden depression, indifference to the world. It happens that my husband almost did not notice how much it is dressed wife. But this does not mean that we should not try. The man did not really pay attention to details, but what you look well-groomed, he will notice. So keep your appearance at a level that will allow you to feel beautiful and elegant. One to do this every week to visit a beauty salon, the other - to buy a new scarf, the third - to swim in the pool or dye your hair. But the feeling that you care about yourself, just reflect on your appearance, in his movements, his eyes glitter. And changes in your appearance will be noticed. - Most disappointing that men can not take care, do not have small courtesies that are so easily can make a woman happy for at least an hour a day. Is it possible that they teach? - Can. And it is not difficult. You do not need to consider tokens of themselves for granted, and encouraged for every small step in this direction. And over the opposite situation banter, not to lose a sense of humor. For example, the husband brought a birthday bouquet of gladioli, which you can not stand. He approached the case like a man: in his view, the larger the bouquet, the better. Do you like little tea roses. What should I do? Of course, not to get upset and even more so not to show it - is still praise, because people have tried to make it better, in your wisdom. And on occasion to tell what colors are more like them.

Insist day, every 3-4 hours ...

This day, every 3-4 hours shaking the contents, then pour the juice of one lemon and stir thoroughly. Insist 7 days in a cool dark place, shaking the contents in a day. Take 1 tsp 3 times a day strictly for 30 minutes before eating. The course of treatment - 3 months. 1 month break and then treated for 3 months. · Massage - spread with honey and massage the back juxtaspinal area (on both sides of the spine, from neck to tailbone) movements, as "separating" the skin from underlying tissues (vertebrae do not touch, because manipulation of the spine itself can only produce a medical specialist ). This should be done in courses for 10 massages in a day. Repeat every 2 months during the year. · Tablespoon of honey stirred in a glass of boiled water at room temperature (barely warm!). Take 1 / 3 cup 3 times daily before meals for 3 months. · Broth oats. 1 cup washed oat pour 1-m liter of spring water at room temperature, the present 10 hours. Put on low heat, simmer 30 minutes. Remove from heat, wrap and let stand for 12 hours. Drain. Top up to its original volume, ie up to 1 liter of spring water. Take 100 ml. 3 times a day before meals. Course - a half months. Break 1 month and repeat the course - 1,5 months. So - 1 year. Do it necessarily. · Mummies (pharmaceutical drug), 1 capsule or tablet (0,2 g.) in the morning on an empty stomach, drink a 2-3-sipping warm milk or grape juice. The course is 20 days. Break - 1 month and again the course - 20 days. So - a year. Sure! · Infusion of liquorice bare: 1 tablespoon of root fill a thermos in the 1 st cup of boiling water. Infuse 5 hours. Take 1 tablespoon 4 times a day. The course is 1 month. Break 1 month and again rate - 1 month. So - 1 year. Sure! · Bath Seats: 10 tablespoons chopped dry grass Hyperici pour 5 liters. water, bring to a boil and immediately remove from heat. Insist (with the lid closed) until the infusion temperature of 37 degrees, drain. Baths taken daily for an hour before bedtime. The course is 3 weeks. Break 3 weeks and then a course - 3 weeks. So - 8 months. Desirable. · Lemon juice. The method of prof. Smoking: start with 1 lemon, and each day increase of 1 lemon. Reach up to 8 lemons and back. Juicing and diluted equally hot water. Consumed per day in 3-4 intakes. Breaks between courses of 3 months. During the year. Desirable. · Daily for 3 months of drinking tea from a herb Oregano. Sure! · 2 tablespoons dried herbs Oregano (1910) Pour 200 ml. boiling water. For 2 hours, drain. Take the form of heat for 30 minutes before meals for 2 / 3 cup 3 times a day. · Daily consumption of tea from a mixture of Hyperici with Melissa. Vitamin Group B - Courses and complexes of amino acids - the same rates. • And for mandatory care neurologist (a smart and friendly to you - it is very important), and the fulfillment of its purposes. Remember - people are cured of any disease, if they believe that is possible.

But does not require a successful ...

All the above means and methods of treatment per se can provide only a temporary, not lasting results. Necessary not only to change their lifestyles, but also their inner world, to learn to breathe. The syndrome of burnout - is still not completely formed illness, not clinical psychopathology, but as they say in scientific medicine, the state of preexisting diseases. So that the earlier we start treatment, so it will be effective and promising. And even better to prevent this disease. Stop, look, remember that life is not just a job, career, money. Embellish and enrich the lives of gay, interesting communication, art, music, literature, nature. But all this wonderful diversity may depreciate if too bright and wasteful to "burn" even very important.

Consultant - EA Shaposhnikov, professor, academician of the Academy of Natural Sciences, a specialist in medical psychology. 8-903-742-49-13

Praise Men

Every woman knows how the health and well-being depend on the internal order. How to overcome the complexes, which prevent us from being happy, says a well-known writer, author of popular books on psychology: Psychological cocktail for the ladies, "" Tailed therapists and others, Ph.D. Olga Romanova Arnold. - What is most difficult for women to be happy? Perhaps the lack of a suitable mate? - In order not to feel miserable and do not curse fate, we must learn to properly build relationships. First of all make claims to itself, to decide what do you want from men. And look for someone who meets your requirements, rather than hope that someone will be able to re-according to their ideals. If you're gonna build a house and family, raise children, you need a person with certain qualities. But when love is most important and vibrant feeling to look for someone who can give it. But does not require a successful businessman that he was sensitive and unselfish, but on the romance - quiet home life. To the person who makes money all day, helping around the house. Or someone who has enjoyed success in women, remained faithful to a single. Our women and it is from this suffering. They want to combine in one person too much, they can never forgive or ignore the lack of certain qualities. For example, a common mistake: A woman meets with a married man and hopes that by spreading it with his wife, will live with it well, without change. Will not. If he cheated on his wife, it is likely to change and to her. - Treason can poison any married life. Is it possible to prevent it? - Yes, if a woman is not married philanderer by nature, which will always be what it is. Usually the man did not run away from home, where he was greeted with joy. Where it's always warm laughter and sounds, where it waits for a delicious dinner, where he's just that he is not the-best. Where is his only love and try to make him feel good.

Occupies a special place promising ...

You must be cured Who to contact? What should I do? Tip one: first of all not to lose time and money on healers, home-healers, who are usually superficial and often ungrammatical assess the situation, promising a magical success in business and personal life. In fact, even such diagnostic methods as an electroencephalogram, electrocardiogram, magnetic resonance tomography, at the initial stage of burnout in 75-80% of cases did not reveal significant abnormalities. Treat emotional burnout syndrome need to view the achievements of world medicine, in the most modern scientific standards. The proposed treatments are effective and safe. These include mandatory systematic restorative exercises, different types of acupuncture, kineziokorrektsii, manual treatment (Shiatsu, special types of activating or sedating massage), homeopathy, herbal medicine. Important place in the elimination syndrome takes medication - are good vitamins, drugs that improve cerebral blood flow, brain metabolism, as well as tools that address the emotional stress and insomnia. Applied psychophysiological self-regulation, is particularly effective autogenic training, vegetative balancing, poznotoni-cal and breathing exercises, competent doctors perform sessions cranio-spinal harmonization, neurolinguistic programming, psychoanalysis. A special place is a promising method of biofeedback (biofidbek), helps the patient to influence their physiological processes, psychological function, to correct them. In the complex treatment of the disease is no template approach is strictly individual, with a focus on fast and deep cure. The quality of life, level of social, personal adaptation to life difficulties, resistance to a variety of diseases. Without adequate levels of physical activity, and this running, and swimming, and biking, and skiing, get rid of the disease is almost impossible - the exercises will intensify the emotional-vegetative centers of the brain. Systematic actively overcoming consumer or professional inactivity - is the foundation for all other tools and techniques that are by themselves in isolated non-comprehensive application, can provide only a temporary, unstable result. We must begin to live fully, learn to listen to bird songs, favorite music, smell the flowers, admire nature. Harmless to read something for the soul. In the health center is desirable to include activities home physiotherapy: morning douches, and in the evenings to conduct courses (7-10 days), therapeutic baths with sea salt, pine and valerian extract. In recent years, the fashion is intense coloration water safe dyes (color therapy). Important role in treatment plays a varied balanced diet that includes fresh vegetables, fruits, herbs. Once a quarter to have a good multivitamin cycles of therapy with the addition of trace elements and biologically active substances (adaptogens, enzymes and others).

Use drugs eucalyptus ...

Use of eucalyptus products, Spirulina, drugs (pharmacy), Ginseng, Schisandra, Eleutherococcus long courses (six weeks), changing them. And, preferably, "Tserebrum compositum '(produced in Germany) in capsules. And here it is: • 100 ml. medical alcohol + 100 ml. 100 ml of liquid ammonia. purified kerosene + 1950 bodyagi powder (pharmaceutical preparation) + 5 pieces of red pepper bitter (pre-crank on the grinder). All this is thoroughly mixed. mixture of the present in dark and cool place 7 days, one day stirring the contents. For external use only - rub (not rude!) along the spine. For the first time - just one or two of rubbing. · Good oil cream (or Vaseline) back. By the usual rules of supply medical jar on his back (but not the area of ??the spine!) and slowly drive along the spine - to the sides of the so-called paravertebral lines. cupping-glass for the first time do not prisasyvat strongly to avoid the pain. Gradually (in the next few days) the vacuum in the medical bank may increase, but within reasonable limits). These procedures can be done close to the breast spine and the lumbar spine and sacrum. This is a very effective method of treatment. The first time it is necessary that your family medical procedure for setting banks have shown and taught them that health care workers. · 200 ml of juice of onion mix thoroughly with a glass of honey . Take 1 tablespoon 3 times a day for 1 hour before meals. The course of 2 months. Break 1 month and over the course 2 months. · Chopped fresh pine needles - 5 tablespoons, pour 0.5 liters of boiling water. At low heat cooking 10 minutes (with the lid closed). To insist, encased, 12 hours, drain. This dose is taken in the form of heat per day in small sips, a little podslaschivaya broth. The course of 2 months. This is a wonderful tool in multiple sclerosis, disseminated encephalomyelitis. · 12 g fresh rhizomes and roots of Elecampane cook for 10 minutes in 0,5 l port. Take 50 ml 3 times daily before meals with the general weakness of the body and as a tonic. The course is 1 month. Break 1,5 months and again 1 month course. rhizomes harvested with the roots of Elecampane or autumn, after the death of aerial parts, or early spring before regrowth, observing precautions - to work with gloves on. shaking the ground, cut with knives aerial parts and quickly washed in cold water. Then thick and long rhizomes and roots are cut into pieces length of 10-15 cm, which in turn are cut longitudinally and removed simultaneously from the dead parts. Drying should be in the attic under a tin roof or under a shed with good ventilation, spreading a layer of 5-7 cm on paper or cloth and often stirring. · Elecampane rhizome powder (pharmaceutical preparation) to take small doses (on the tip of a knife), washed down with water 2 times daily before meals. Remember that medications should not be taken Elecampane renal diseases. · head of garlic clean, wipe, fold in a jar and pour 1 th cup of unrefined sunflower oil.

At the same time for all the symptoms ...

All this is combined with excessive self-conceit, the revaluation of the significance of his personality and his case. Gradually formed earlier indifference to hobbies, to all sorts of hobbies. The same applies to family relationships. A person with symptoms of burnout develops emotional coldness, which looks to others as selfish, even callousness, the patients themselves do not notice it. True, and the relatives perceive such behavior is not as spiritual impoverishment, and as a result of overwork and overload at work. With the deepening of emotional distress, often by the scrolling impressions of the day begins to disturb insomnia, superficial sleep, early awakening (hours 5-6 am), after which you can not fall asleep again. As a result of lack of sleep a person feels overwhelmed, my head does not work, and to assemble internally, additional efforts are required. Over time, there is apathy, deteriorating concentration, becoming less memory and intelligence. All this was very oppressive and disturbing, especially at a time when you need to quickly make fully informed, a decision fraught with consequences. At the same time for all symptoms of no treatment for the medical and psychological assistance, as a rule, not a speech. When relatives are beginning to sound the alarm, the answer usually hear: "That you have to go to a psychologist or psychotherapist. And I have everything in order. Do not bother to work someone has to support his family." Why be afraid of provoking and predisposing factors for burnout can be transferred as a common disease, most often severe influenza, and many of the negative environmental impacts (electromagnetic smog, toxic substances in the urban atmosphere, the excess radiation). The underlying causes of diseases are associated with a slowly increasing dysfunction of the emotional-vegetative centers of the brain due to chronic stress. At the same intellect, especially its analytical and logical function, does not suffer. The patient's behavior also remains sufficiently flexible and constructive. Violated a higher emotions: warmth, understanding the feelings of others, disappears ability to capture subtle nuances in communication. Surrounding call such people crackers. But it is only at first, then the functional disorders of the psyche apply to internal organs. There is increased sensitivity to fluctuations in weather in the form of headaches, discomfort and back pain, joint pain, and sometimes discomfort on the part of the heart, stomach, bladder, and so on. And after 3-4 months, symptoms vascular dystonia. Blood pressure jumps, there are interruptions in the work of the heart, often lost appetite, upset sexy tone, decreased immunity. It turns out that people in their prime, like and well, but feels like a squeezed lemon. And against this backdrop that often appear fears for his health, which may be intrusive.

Try to understand this and accept ...

Try to understand it and accept what happened. If you get it, you can be proud of themselves. Of course, the cure for this condition does not exist (except time, of course). Nevertheless, you can try to soften it, taking St. John's wort broth. St. John's wort is a fairly strong natural anti-depressant. decoction is prepared as follows as follows: 1 tbsp. spoonful of dry grass should fill in 1 cup boiling water, cook for 5 minutes. Take before meals for 1 / 3 cup 3 - 4 times a day. There is a pharmacy and drug Hypericum in capsules is very convenient for the reception (Aristoforat be made in Germany). But buy it in Russia, unfortunately, quite difficult. * * * "The second autumn in a row I have no reason reduces mood. Especially bad feeling in the morning. I'm very thin, poor sleep, disturbed cycle. I tried to take nozepam , tazepam, seduksen, but nothing helps. What do I do? Tatiana C., Belgorod. "- you list the symptoms suggest that you suffer from endogenous depression. endogenous depression are those that arise independently of any external causes, as a result of violations occurring in the brain of biochemical processes. The fact that these drugs do not help you, it is understandable. After all, they are not intended for treatment of depression. Such states are fairly well treated, but treatment may spend only a doctor. So do not waste time in vain, drop the false shame and refer to a psychiatrist. * * * "In recent years, I have to work hard. In order to improve performance, I take tincture of ginseng. Harmless it? Irina L. Malakhovka." - widely believed, according to which drugs plant completely harmless. Unfortunately, this is not entirely correct. Ginseng - a fairly strong natural psychotropic drug, and like any strong medicine, it has its side effects and contraindications. In particular, the drug is not recommended for use in hypertension, acute infectious diseases, the propensity to tumors. Contraindicated he and a number of mental disorders. In case of overdose or too long reception of ginseng can cause increased excitability, irritability and insomnia. Therefore, in the event you have such effects reduce the dose. Do not take medication in the evening. After 40 days Reception to make a break for 2 weeks. Keep in mind that taking the drug in the autumn and winter is most effective. Daria Kostrova

Multiple Sclerosis

· Smile every morning for 3 minutes and myself in the mirror. sure, I do not vainly made this recommendation in the first place! Smile includes powerful defense system. So the nature invented. Smile - a code that is needed to enable the body's defenses. It opened a great French physician Albert Coue. Although it is written more ancient Egyptian and ancient Chinese doctors. And Only at the end of XX century in modern laboratories is a fact explained. • Use necessarily royal jelly (a bee it is always).

With 6-7-grade the most important ...

The seventh class. In adolescence (13-17 years) - children (themselves no longer consider themselves as such) are the most vulnerable, like "dig" in themselves and others attribute to heightened attention to his own person. Teen to think that he "lives on stage." With 6-7-grade the most important is the view peers, who, unfortunately, not always kind and fair. At this age your child is very important to "be like everyone else, to have what everyone has to ride wherever go all ... Team dictates everything - from hair to brand mobile phone, and woe to the" white crow "who can not meet . Detail about this in the printed journal. Mila Blinov Source: Journal of Health "№ 10 2004 at the site http://www.zdr.ru/zdr_tmn0410a5/php 

Shine on, it is clear that not extinguished

Evgeny Shaposhnikov, psychotherapist highest category Doctor of Medical Sciences, Academy of Natural Sciences, Professor. It turns out you can not only get sick from bad, but a good life. If your being comfortable, slow-moving lifestyle, and the working day lasts 25 hours, you get a chance to become the owner of modern ailments, called "the syndrome of burnout." This term originated 10-20 years ago, in the economically prosperous countries such as Germany, Switzerland, England and Austria. This disease is not proletarian poor regions of the world where people inject, malnourished and do not relax fully. It suffers from the so-called elite - the representatives of management, intellectual professions: managers, computer specialists, administrators, businessmen, in general, those who are on duty had to endure a lot of professional, personal and social stress. In men, emotional burnout syndrome occurs almost 1.5-2 times more often than women, possibly due to their greater involvement in a major, responsible management, and in order. that their emotional sphere of genetically less well developed, but prudence, steadiness and self-mastery, in contrast, are more pronounced. After the computer revolution of this modern disease increasingly began to speak in Russia. The problem started when acquire not only medical, psychological, and become socially significant. The reason - not only in undermining the performance of socially active contingent of the population, deterioration of quality of life and health, but also in social disorder and personal contacts. Enemy must know in person How to recognize the creeping disease? Learn syndrome of burnout can be the most typical symptoms - emotional instability, which manifests as irritability, mood swings, reduced interest in everything that is not related to work. In my head obsessively revolve mainly professional problems, remember the colleagues at work, with someone mentally clarified the relationship, engaging in dialogue. Against this background, there is indifference to everything that is not directly related to production issues.

During the reception, the New Passito undesirable ...

During the reception, the New Passito undesirable driving. At the same time advise you each morning from 15 - 20 minutes of gymnastics, 2 - 3 times a week to go in the pool or jogging. Very useful in menopausal disorders training autogenic training. Recommend, for example, the following simple exercise: lying for 10 minutes consistently try to relax all the major muscle groups starting with the person and ending stops. At the same time instills a sense of pleasant heaviness and heat in the muscles. After this 10 minutes spend autosuggestion feeling of rest, relaxation and health. Perform each exercise 2 times a day (once required before bedtime). More about anger management you can learn from popular science books. Especially useful book Levi "The art of being themselves." * "I'm very shy. Because of this, I find it hard to communicate with people. How can I overcome its" complex "? Ludmila K., Khabarovsk?. - Most people hesitate because of the presentation to his excessive demands. They think that in the eyes of others, they may seem "stupid", not literate, educated. In fact, others, usually not too concerned about our level of intelligence and erudition. In all its problems, its life, and no one catches the moment when you make a mistake in the conversation. So do not try to seem extremely intelligent, educated encyclopedic, very fun. Be yourself. More "Train" in communication. The theme is to have a conversation you can always find: it could be the weather, work, read books, memorable movies . During the conversation often be interested companion cases: most people like to talk about themselves. "I am 25 years old. The nature of their work activities, I often have to speak before a large audience. In such situations, I always blush, especially in the presence of superiors. How do I get rid of it? Valentina V., Omsk. "- Perhaps my words will seem sacrilegious, but still try to treat your problem with humor. After all, you blush because they are afraid to blush. On the contrary, are afraid to blush because the blush. Turns vicious circle. So try to tear it up, take away fear and give it all around, and the bosses in the first place, how well do you know how to blush. Men are often like that. And I'm giving you the assurance that after your overly serious attitude to the problem of change on "frivolous" harassing you display disappear by themselves. * "Six months ago I had a misfortune: dead loved one. Until now, I can not get over it, often crying, everything goes wrong. Can I somehow alleviate this condition? Anastasia M., Kaluga. "- Each event in our life has its meaning. And tribulations that all of us in varying degrees to comprehend, too, have their meaning: the meaning of overcoming them. Overcoming them, we grow spiritually, we become stronger, learn to master themselves. And, no matter what, raise your head and continue to live.

Of course, nobody can give you ...

Of course, no one can give you absolute assurance that there will not relapse, but the likelihood that extremely small. Practically, it is the probability of schizophrenia healthy person. Common in the population of the rumors about incurability this disease do not correspond to reality. Also note that in Russia, a diagnosis of schizophrenia is put very well, and it is quite possible that, say, in the U.S. you would have such a diagnosis no one raised. In psychiatry, all concepts are relative. So I suggest you leave your fears and live normal, productive life. Otherwise it may happen that the fear of the disease will cause you more harm than the disease itself. "I smoked 5 - 7 cigarettes a day. I would like to quit smoking, tried to do it, but, unfortunately, nothing happened. What you need to take in order to get rid of this habit? Oksana P., Moscow. - Do you smoke relatively few, so I advise you to quit "in one fell swoop, rather than gradually. In order to "cut off his path of retreat", I recommend you to put friends and relatives aware of the fact that you decided to quit. Then you will be harder to smoke in their presence, because it will show your weakness. Well, if you quit smoking together with someone of your friends - you can psychologically help each other. During disaccustoming the habit more likely to visit museums, exhibitions and other places where smoking is prohibited. Women are often not so much smoke because of addiction to nicotine, but because of attachment to the various smoking attributes: lighters, cigarette packs. Fussing with these objects some reason it seems aesthetic. Try replacing these manipulations on the manipulation of any other items not related to smoking. This could be knitting, some sort of puzzle or something else, at your discretion. Do not forget about sports. Take your vitamins, especially C and Group B. And remember: in this case everything depends on you. * "I am 47 years old. I have a very hard climax occurs: worried frequent hot flushes, palpitations, poor sleep, headaches, severe irritability, extreme tiredness. What do I do? Svetlana V. Batts. - I recommend you take the following herbal collection, designed specifically for the treatment of menopausal disorders. Mix for 4 beats and Leonurus herb woodruff and 3 share the grass cottonweed, 2 share hawthorn flowers and leaves of blackberry 5 shares. 4 tbsp. spoon mixture should insist in 1 liter of boiled water and take 1 / 2 cup 3 times a day, 1 hour after eating. Do not exceed the specified dosage: please note that in large doses is toxic woodruff. If you can not buy the ingredients for the above fee, you can use the pharmacy drug Novo Passito, which is based on substances of plant origin. Take medication to 3 teaspoons per day. Divide the daily dose so that by 1 / 4 it had in the morning and afternoon and 1 / 2 - in the evening.

It is said that Moscow and in this respect has gone his own way.

At each clinic and hospital work clinical expert commission. Should go to this commission, it would hold a thorough examination of the patient and may decide to go beyond the list recommended by the "standard". - It is said that Moscow and in this respect has gone his own way. Is that - additional benefits for the residents of the city? - No, it in no case are not talking about additional benefits. Just in Moscow adopted a new procedure for vacation soft drugs. Now Muscovites can not buy them in pharmacies, and pharmacy kiosks in clinics. This is convenient because it stands does not make such a large mark-ups, as pharmacies. Medicine at the kiosk is much cheaper. Hence, the load on the city budget, through which dispensed soft drugs is much smaller. Or should I say this: with the same load on the budget Muscovites will get more drugs. But there is one disadvantage. If the kiosk, which is attached to the patient, the drug of choice is not available, then buy it in pharmacies, kiosks or other patient was not entitled. Anatoly LELEVR

Traps school yard

In addition to the "reasonable, good and eternal" we are often carried away from school is something not so good, but very durable - complexes. With some of them we get the feel Olga Karabanova, doctor of psychological sciences, professor of psychology Department of Psychology, Moscow State University. First class. Modern first-graders usually come to school well prepared intellectually - they already know how to write, read and count, they know (or think they know!) A lot of different things. And here lies in wait for their first challenge - it begins to seem that they do not teach anything new here, and various useful from their point of view of information they routinely receive in other places (with the screen, from computer games, conversations at home and on the street). If at this moment is not interested in the content of school curriculum - and with the teachers rarely want to bother! - And will remain with them for life, "Complex passive observer." Second class. "Losers" and "student" - these labels, hanging in the school, often remain for life. And who knows what more can this life to poison ... "Losers" sure that he and "flounder" is useless, he still did not reach and do not jump above him - so many thoughts to contribute to some teachers, putting the estimate only by inertia. A "student" for life climbs out of his way to meet the expectations of the public and does not drop its "flag", which is sometimes dragging and forces there and do not need it to anyone ... Fifth grade. It happens in junior high child's performance in all subjects, well behaved, loudly reciting verses - just a gift for a teacher who begins to constantly praise him and put everything in the example. In the transition to secondary school is changing the system requirements, get new teachers, who had once to search for approaches to each student. And if at the same time the former "uspeshnika" no outstanding ability or not they are deeply hidden, there is a serious internal conflict.

However, this result has not yet ...

However, this result is not an indication for the abolition of the treatment. Rejection of its continuation is fraught with high frequency (20-50%) relapse. Supportive (antirelapse) antidepressants, as shown in all types of depression, is appointed for at least 4-6 months after arresting the main manifestations. Upon completion of the course of therapy should be a gradual reduction in dose as break the drugs can cause "withdrawal syndrome" with severe autonomic disorders. Patients with recurrent depression and bipolar disorder require long-term (at least several years, and sometimes a lifetime) preventive therapy. Such therapy in case of recurrence of depression according to the severity, duration, and the multiplicity of episodes by using antidepressants. Effective collaboration of psychiatrists with the structures of primary care, ensuring an adequate treatment of depression - a pledge optimize the treatment process in the field of mental pathology. Published with permission from Russian Medical Journal.

Tips therapist

Today, the questions our readers answers PhD, psychotherapist, psychoanalyst, State Research Center for Preventive Medicine, Dmitry B. Aniskin. "I worry about insomnia. In this regard, I take the night pill radedorma. How long can you take this drug? Alla K., Stavropol. - Preparations of a group of drugs, which include radedorm, should not take too long. Maximum permissible period of continuous reception - 1 month. Otherwise, develops and addictive drugs to fail. Necessary to increase the dose, and if a person tries to refuse the drug, the dream completely mess up. This produces addiction - substance abuse. As a possible alternative to the chemotherapy drugs would recommend that you use the following folk remedy for insomnia. Mix 3 tbsp. spoon of honey, 2 tbsp. spoon hot unboiled milk, 1 tbsp. spoonful of tincture of valerian, 1 / 2 tbsp. tablespoons apple cider vinegar and take this mixture for half an hour before bedtime. Can repeat the reception after an hour in case of insufficient effect. Chemical over the counter medicines can be used occasionally, such as after severe stress. Note, incidentally, that the best of modern hypnotics (both in terms of safety and therapeutic effect) is imovan. But it also should not be taken haphazardly. * "Five years ago I suffered a mental disorder. Accidentally learned the diagnosis: schizophrenia. After the treatment I feel good, a lot of work, doing household chores. However, constantly worried about the idea that I was terminally ill and that the attack again . How great is the danger of relapse? "What can I do to prevent this? Olga S., Magadan. - After a five-year period of light you can consider yourself completely mentally healthy.

The general scheme of dosing usually ...

The general scheme of dosing usually determines the half-life of the drug (the time during which the organism is derived from half the dose of the drug). However, individual differences make major amendments to the scheme of therapy, so the order for drugs may vary in different patients and change during treatment of the same patient. Selection of an adequate dose timoanaleptikov remains one of the most difficult questions in the treatment of depression. The recommendations contained in this respect the instructions for use of any funds, provide only general information about the "therapeutic window" based on the averaged data obtained in clinical trials. It does not take into account any individual sensitivity, nor the possibility of comorbid pathology of internal organs, which determines the somatic condition of the patient. In common practice, especially when combined affective and somatic pathology, daily doses of antidepressants (even first-line drugs) should be lower than used in psychiatry (Table 2). If necessary, increase the daily dose of the increase (titration) is carried out gradually with careful monitoring of changes in psychic and somatic in the area. Neurochemical mechanisms that are affected by antidepressants, have inertia, in connection with this timoanaleptichesky effect in some cases develops gradually. This fact should be borne in mind and not to interrupt therapy, if its result is not found in the first few days. However, with no effect over 1 to 2 weeks inevitably raises the question of modification of treatment. Upon reaching the desired effect daily dose reduced gradually: a rapid dose reduction or withdrawal of the drug can cause withdrawal symptoms, the deterioration of both mental and physical condition. In some cases, even with complete reduction of affective disorders is necessary to continue treatment. Treatment of depression consists of three phases: the cropped, supportive and preventive. Cropped therapy is conducted in several stages according to the algorithm shown in the diagram (Fig. 1). Fig. 1. Algorithm for treatment of depression (scheme) In the general medical practices are feasible therapeutic effects related to phase 1 - 3B. Thus it is desirable to determine the need for psychiatric consultation, especially with somatic diseases. Intensive methods (stages 3B - 4), providing intravenous drip of psychotropic drugs, and even more so - electroconvulsive therapy (ECT) - the competence of psychiatric services. Moreover, such effects are shown with heavy, psychotic levels of depression or chronic, resistant to treatment conditions. In identifying such trends physician working in the establishment of general medicine, must submit a patient to a psychiatrist. Cropped treatment effects can achieve a reduction of depressive symptoms up to complete the reverse of depression and remission (intermission).

But suppose a woman does not ...

And then some of them sell them on the market. Now your doctor is very strict control over the amount of prescribes medicine. No one pharmacy will not release the medicine at the concessional without a prescription. A doctor writes a prescription only medicine, and then on the amount that the patient really needs. - Which of our citizens, but rather women citizens, is entitled to preferential receipt of medicines? - First of all, this woman - member of the Great Patriotic War. As well as widows and deceased veterans of that war and widows of military personnel. Their medicines dispensed free of charge. Many women have suffered as a result of the Chernobyl accident in 1986 and at Mayak in 1957, during nuclear weapons tests at the Semipalatinsk test site. This is mainly residents of the Bryansk, Tula, Leningrad, Chelyabinsk regions and the Altai region. They are also entitled to free medicines. The same right I have a disabled group and the non-working disabled group II and group III with disabilities, officially recognized as unemployed, that is, be registered at the Employment Service. Some women are entitled to free medicines by profession. These are women - soldiers, a contributor to police and tax police, judges and prosecutors. The same privilege enjoyed wives of judges and prosecutors and their children under the age of 18. Over half the cost of dispensing women victims of political repression in the 30-50's and then rehabilitated, as well as having the title of "Honorary Donor". Old-age pensioners receiving pensions at the minimum size, too, get the medicine at half price. - And if, say, a woman is not included in the exempt groups, but she has a very serious disease and it does not have to pay for medicine. What then? - In these patients, too, should benefit. You can get free drugs in oncology, hematology, rheumatic diseases, bronchial asthma, tuberculosis, AIDS, syphilis, endocrine disorders (diabetes, Addison's disease, pituitary dwarfism), nervous and mental diseases (multiple sclerosis, myasthenia gravis, cerebellar ataxia, Parkinson's disease , schizophrenia, epilepsy). For more information on this list can be found in the clinic. In addition, the right to free medicines are patients with myocardial infarction, surgery for prosthetic heart valves, transplant of organs and tissues. - Recently, in pharmacies, many new drugs, including imported and very expensive. The patient has the right to choose any medication? - The choice belongs not to the patient and doctor. A doctor prescribes medicine according to accepted and approved within each subject of federation "standard of care." In this "standard" includes those medicines that, in the opinion of our doctors are the most effective for the treatment of a disease. - And if the patient knows that she needs some new medicine, but it is not listed, the recommended "standard"? - Out of this delicate situation is the way out.

Such therapy allows maximum ...

Such therapy can very quickly cut short depression, despite rising while the risk of collateral (such as neurotrophic and somatotropic) actions, as well as adverse interactions with STH means. Antidepressants are highlighted in this series (amitriptyline, imipramine, clomipramine), MAO inhibitors should be used with great caution. In somatic patients, especially in elderly and senile patients, their use carries a risk of confusion (delirious state, occurring with impairment of consciousness, disorientation in time, space and its own state, changes in sleep cycle - waking, disorders of attention and memory, flash psychomotor agitation, illusory, hallucinatory phenomena). The signs of confusion is possible with parenteral administration of other drugs of this series, such as benzodiazepine derivatives (diazepam, etc). Likelihood of confusion is greatly increased in individuals who abuse alcohol and drugs, as well as during combination therapy, including both psychotropic and somatotropic some means (AV Medvedev, 1999). The importance of early recognition of the state of confusion. When an erroneous diagnosis is often confused attempts to relieve symptoms of psychomotor agitation and hallucinatory disorders by forcing psychotropic effects (increasing doses of psychopharmacological drugs, etc.), which is fraught with significant worsening of the condition. Manifestation of even short-term (often nocturnal) episodes of confusion - a testimony to the complete cessation (when appropriate detoxification activities) or to modify psychopharmacological therapy (dose reduction, treatment of first-line drugs). You should also remember that in the primary care network should be given a minimum of psychotropic drugs (1-2 drugs). This is due to their possible interactions are not always well-known general practitioner, as well as the chance of side effects. Single or double dose of medication that does not destroy significantly the daily routine of patients and preventing professional activities, the most expedient in the hospitals of the general type, and especially in the outpatient setting. Effectiveness of therapy depends not only on the properties of the drug, but also on the way to its introduction, dose, regimen, and such seemingly less obvious factors as the ratio of the patient and his relatives to the treatment. The choice of antidepressants depends on factors such as age, somatic condition of the patient, and tolerance (the individual sensitivity) to psychotropic drugs. Must also take into account past experience of the patient (for episodes of mental disorders in history) and information about the features of the reaction to the therapy of his close relatives if they were treated with psychotropic drugs.

The main thing is that the child did not take ...

Most children notice erotic scenes in various films and ask questions that do aunt and uncle? And here a small child who had the opportunity to observe the affection of parents can be satisfied with the answer: "They love each other." The main thing is that the child is not perceived by chance seen the proximity of violence. (Needless to say, the demonstration of violence generally better to remove your child from our "blue screens".) And as for the viewing of erotic magazines kids at that age, which is called adolescence: the ideal - not to hide from them films of this kind, not allowed to speak about them and not to shame young for it. Craving for erotic information during teenage hypersexuality is natural, and if you impose your parental veto kids watch a movie with friends - so even with them is not always successful commentary. So what is the best - the younger children to watch these movies with their parents. Abroad at tape of this kind is often exactly what they write: "Do not show teenagers without a parent." Of course, in this case, it is important to the reaction of parents. Our, Russian - certainly the majority of absolutely illiterate. If children are accidentally caught them watching erotica ancestors immediately turn off the TV, turn red, something mumbler in his defense ... In general, as stolen. And then the child learns two things. First: erotic - it's dirty, but watching it - even dirtier. And the second: his own parents in need of this dirt. How he will then treat them if they are in his perception of almost libertines? Therefore, joint viewing of such films with teenage children can be recommended only for those parents who are confident in the adequacy of their response. After all, parents need it later on this viewing, to give everything going healthy evaluate and respond to questions. And if they are ashamed and silly giggles, and then get annoyed (especially if they themselves have sexual problems), better than these parents at this session is not inviting. Because no benefit from them, and harm - no problem.

Free medicine

A lot of questions now arises when it comes to preferential receipt of drugs. Our questions are answered by the Deputy Head of the organization and quality of care Health Ministry Olga SHEENKO. - The fact that there are benefits, they know everything. And what are these benefits? - The essence is that a certain category of our citizens have the right to free medicines. Or to obtain drugs with pay half the cost. - For free - this means the patient or the patient comes into any pharmacy and line the pockets of any medication? As he wants, and takes so much? So? - No, this process is regulated, abuse does not often happen. Although at first, when there were special privileges, and observed what you say. The patients, mostly elderly people, wrote out prescriptions for themselves preferential certainly more drugs than they needed in fact.

And then the question arises: why ...

In general, sexual information is given to children on the rise: three year old child, say, a question: "Where do babies come from?" Enough to reply: "From the tummy." Six-year are not going to tell you that a child develops from a special cell. And older children may well have to learn how this cell appears in the tummy. If a young child asks what is the difference boys and girls (this issue can be triggered by the fact that the kid sees as "goes to pot" of the opposite sex), you can tell him that there are men like my father, and women like my mother. Women grow from girls, and men - from boys. And it's just two different kinds of people. The child is older, he will be able to consider the picture in the appropriate children's books, we can already show how the different structure of the genitalia boys and girls. Now - about the books. Today there are many special children's sexological literature. Whether to give the child such books, and when? Alas, man is by nature can not learn in life only one or two people. He necessarily require multiple sources of knowledge for building a broad outlook. In the same way with sex education. Of course, the parents give the basic information, but nevertheless "visual aids" in the form of special children's books (and not adult magazines and anatomical atlases) can help them to answer children's questions. And since the books are of varying quality, first view such an acquisition themselves. And, of course, avoid sentences like: "When you grow up - to learn." Especially when it has another connotation: "Go away!" Or "Go away!" Because the child is going, but will satisfy their curiosity of other, more primitive sources. And please - the soil for future intimate complex is ready. But this time the parents information can be an antidote to the vulgar and dirty stories that a child might hear in a kindergarten or in the yard. In any case, it is important that the child to trust you. And that kind of information that he heard from your mouth means more than that tell him on the street. And for this not to alienate children do not make them close and be left alone with their questions. And another thing: do not be fooled by the child, telling him "about the stork." Because now a lot of "enlightened" children who will raise your "immaculate" scion of a laugh. What they tell him - you can imagine, but these stories will be accepted as truth, and your attempts to save the "integrity" of the child may seem quirky to him lie. And then the question arises: why father and mother lie? Probably because the kids really come out of the dirtiest places, and nothing in all this there is no good ... Here is a possible outcome of your desire to retain a child's virginal purity of mind! In fact, many kids learn that they have not brought any storks, with a sigh of relief: "That's good! And I thought I was a non-native ... "The kids like that they - the product of their own parents and most of that on there home (because with a deficit fondling children sometimes do not feel sufficiently parents' love to you!), But not throw in some odd stork.

Effect is amplified as we continue ...

The effect increases as the continuation of treatment. Zoloft is used to treat all types of depression of varying severity. Sertraline has a positive effect in patients with anxious depression and sleep disorders, anxiety reduction is much faster than with fluoxetine. In the case of a mixed-anksiozno melancholy affect vital manifestations are reduced in parallel, followed by normal mood, there is an increase of mental activity, suicidal thoughts disappear and somatoform disorders. In small doses (100 mg / day) drug is used prophylactically in recurrent depression. Furthermore, sertraline is used to treat obsessive-phobic disorders. In these cases, the best effect is achieved with the appointment of 150-200 mg / day for 8-12 weeks. Since the half-life of the drug is about one day, he applied in a single dose - 50-200 mg / day (minimum and optimum dose - 50 mg). If necessary, increase the dose of 50 mg / day 1 day a week. For preventive purposes it suffices to 50-100 mg per day. Zoloft is effective and safe for all ages: children, adults and elderly patients. The uniqueness of the drug is that the individual selection of doses, depending on age, is not required. The drug does not increase the influence of alcohol, carbamazepine, haloperidol on cognitive and psychomotor function, while the reception. Sertraline does not cause sedation and has no effect on psychomotor function, is not addictive, does not have cardiotoxic effects, well tolerated by patients with cardiovascular diseases. Proved high efficacy for obsessive-compulsive and panic disorders, generalized anxiety. With prolonged use Zoloft does not increase tolerance and become addicted. The wide use of Zoloft to treat depression caused by: high efficiency (an antidepressant effect comparable with that of classical antidepressants) was well tolerated in combination with the low number of side effects, soft, balanced action, uniform effect on all components of depressive affect (anxiety, depression, apathy ) effect on anxiety-depressive, depressive, phobic and depressive-hypochondriacal condition; ease of use (once a day, there is no need for selection of optimal dose), the absence of marked sedation, which allows to keep the rhythm of life and social activity. For second-line drugs classified traditional timoanaleptiki - monoamine oxidase inhibitors - MAOI (their use in modern psychiatric practice due to the high toxicity is extremely limited) and tricyclic antidepressants - tricyclics. Medicines of this series have a pronounced psychotropic effect, shown for use in psychiatric institutions, where the ratio of risk-benefit "of treatment in relation to the severity of depression is shifted in favor of intensive therapy.

Of course, all is good in moderation ...

And another question, first of all interested parents: when to start talking "about it" with a child? Many consider: when the child begins to ask questions himself. In fact, education sex education (rather than just giving information about sex) began almost from the cradle. And the main condition upbringing harmoniously developed personality in intimate terms - harmonious sexual life of the parents to the existence of which they are not sanctimonious. The first time a child learns about sex, not when starting to ask the question "Where did I come, and when the mother and father do not hesitate to his tenderness and affection. Why is swearing and shouting, and even fights with the parents the child can demonstrate (at least so many moms and dads are not shy in front of the children to sort things out), and the love and tenderness - it is impossible? Of course, do not invite children into her bedroom, but to show the child that the parents love each other that they may sit arm in arm, talking to each other a gentle tone of affectionate words - this is the first intimate information plan, designed for children. After the child is not just interested in intimate matters, and the matter is not even in the normal childhood curiosity. Just a child begins to treat yourself to a particular gender, and therefore asks the questions. A father and mother, between whom there is no intimate harmony, can not educate the children literate attitude toward sex. And the kid in front of which Mom and Dad are constantly swearing, then he can not understand that man and woman come together and live together because they love each other. At best, he said, believe me, but deep down in the rest of their lives to make sure that his own parents are deceived. And probably, not only for love. Other adults, afraid to grow up "sexual abuse" of children, depriving them of basic needs - parent caresses. At one time, all the popular medical journals kept repeating: "Do not take the child on your hands, do not pat, do not kiss, do not bother him - it could provoke an unhealthy sexual feelings in children." And many parents believe this sanctimonious belief, eventually brought an absolutely senseless children - in all respects, not only in terms of sex. Children grew up with the problems in assessing their own appearance, did not know how to love either himself or others, and in intimate relationships were completely devoid of sensuality, introducing sex only as a set of coarse repetitive actions. In fact the child for health needs to his parents kiss, hug and gently squeezed. In the end, so he, too, feels loved, needed and important. Of course, all is good in moderation, and do not want to zatselovyvat and zalaskivat child. But when he asks in his hands - it does not mean that he is naughty. Just kids sometimes need to feel the warmth and tenderness of parental hands. So after all: what and how much to talk about sex when the child begins to ask questions? The main rule here is: the information must be available, but do not tell a child more than what it needs.

This second, revised and enlarged ...

This second, revised and expanded edition is published in 2003), but the volume of this publication can confine ourselves to brief information on the use of antidepressants. As with other psychotropic drugs, antidepressants are classified depending on the application (general medicine - Psychiatric Clinic) for first and second series (Table 1). Among the first-line drugs including antidepressants past generations (pharmacological properties of antidepressants are considered in accordance with the modern unitary theory of the pathogenesis of depression, which postulates an imbalance of serotonin-and noradrenegricheskih systems in the brain, affecting the classification of contemporary antidepressants are subdivided into selective serotonin reuptake inhibitors - SSRIs, reversible inhibitors of monoamine oxidase type A - OIMAO-A selective blocker of the reuptake of norepinephrine - SBOZN, double-acting drugs (selective serotonin reuptake inhibitors and norepinephrine - SIOZSiN, noradrenergic and specific serotonergic antidepressant - ASCRAS), selective serotonin reuptake stimulants - SSOZS.) best suited to the requirements of primary care network. This is the minimum severity of adverse neurotrophic and somatotropic effects that could disrupt the function of internal organs and central nervous system and / or lead to a worsening of somatic and mental pathology, limited signs of behavioral toxicity; minimal teratogenic, embryotoxic and neonatal effects, does not preclude the ( although in exceptional cases) pharmacotherapy during pregnancy and lactation, low probability of adverse interactions with somatotropic drugs, safety in overdose, ease of use (ability to assign a fixed dose or minimal need for its titration). Among this group should be given the drug Zoloft (sertraline), widely used in the treatment of depression and obsessive-compulsive disorders. Zoloft (sertraline) - a drug bicyclic structure, a derivative of naphthylamine - a powerful selective serotonin reuptake inhibitor, it does not cause blockade of muscarinic, serotonin, adrenergic and GABA-ergic receptors. Therefore, the drug had little cholinolytic, cardiotoxic and sedative properties. Pharmacokinetic characteristics as Zoloft would accumulate the positive properties of the whole group of antidepressants. Drug concentration in blood is reached 6-8 hours after his admission. Equilibrium concentration of drug in the blood is set in a week. The basis of the profile of psychotropic activity is distinct timoanalepticheskoe action with a weak stimulant component. Although the first signs of improvement already appear in the 1 st week of therapy, to achieve an obvious effect requires 3-4 weeks and sometimes 6-8 weeks.

About such incidents in the home they say - "jinxed".

As told Professor Vinogradov, one day asked him for help a young couple on the verge of divorce. It turned out that all the fuss of the fact that she - Lark (rises in the morning and prevents him from sleep), he - Owl (read at night and refuses to fall asleep next to his half). Trying to convert each other, people got to the point: it - insomnia and depression, he - chronic fatigue and reduced potency. Remember: pronounced owls and larks do not alter it. Do you want to be together - looking for a reasonable compromise . You do not need to adjust to other people's biorhythms. does not require that knocks out a partner of rut. You just need to calculate the time when you both are most active, and to hold it together, in what currently is not denying. A full sleep - the holy. He (it) nedosypaet. And you can become a victim: metabolism up to obesity and atherosclerosis, chronic fatigue, decreased sex drive. thyroid pain? Everything in the house upside down flies often happens that the illness of a family member of all other makes neurotics. And himself a "source" can this not even suspect. Case. In one quite happy family suddenly went awry. As if the air hung irritability, frustration with one another, the scandals began. The children - two, husband of depression. about such cases at home they say - "bewitched." This went on until the psychiatrist did not send the woman to an endocrinologist. It turned out that she had problems with the thyroid gland - hyperthyroidism. After treatment, peace in the family recovered. By the way turns out that some diseases do so, that "the reel" flies the whole family. Especially strong negative energy message given: Thyroid hormone disorders (source "emits" the aggression and irritability), uterine fibroids, breast (depressive wave); adenoma and congestive prostatitis (aggression, depression, angry), heart problems, especially the postinfarction state , asthma (anxiety, fear, general anxiety). Elena Ion Health & Beauty from Gloryon

Source: Journal of Planet HEALTH "at http://www.rekicen.ru/php/content.php?group=0&id = 1821 

Where are the storks ...

For many parents this question wording can sometimes cause even the outrage: it is said, is important for us that can and should tell the child about sex and how to do it - we parents with their child themselves face it. However, I should note that the form of information here, too, plays an important role. First of all, and I would like to give parents some guidance on how not to tell your child about sex. • Do not need to specifically put the child opposite him in an attitude of obedient disciples, and said: "It's time you learn about sex." • Do not need to crush and blush like a child caught your question yourself for something obscene. • Do not be silent about this subject, pleading hackneyed phrases like: "This is for you too early," "grow up - to find out" or even: "Where have you picked up those issues?" • Do not need to build a sex cult, forcing the child the information that he does not need, and if it will be interesting, it is only painful, problematic, scary.

In the classification of mental disorders ...

In the classification of mental disorders, as adopted in the U.S. (DSM-IV), among the research criteria for mixed anxiety-depressive disorder, placed in the diagnostic class of "Anxiety Disorders", presented the following characteristics. Diagnostic criteria for mixed anxiety-depressive disorder. · Persistent or recurrent mood disorder with features of dysphoria lasting at least 1 month. and the identification of 4 or more of the following 10 symptoms: difficulty concentrating, sleep disturbance (difficulty falling asleep, sleepiness or restless that offers no rest sleep) feeling of weakness or loss of energy, irritability, anxiety, tearfulness, a tendency to excessive fear, anticipation of the worst; hopelessness (the deep pessimism about the future), low self-esteem or sense of inferiority. · Disorder accompanied by clinically significant distress and / or disturbances in social, occupational or other important areas of activity. Depressive episode usually ends with complete recovery (intermission) with a return to premorbid level of functioning. However, 20-30% of patients in remission observed residual depressive symptoms (primarily asthenic and somatovegetative), which without adequate maintenance therapy may persist for a long time (months or even years). In 1 / 3 of patients with relapses, the disease takes a recurrence (phase) for - recurrent depressive disorder. In this case, depressive phase of affective disorder may be replaced by the opposite pole - hypomania (mania). Evaluation of current depression - the only one depressive episode, recurrent (recurrent) depression, bipolar disorder (the change of depressive and manic phases) - is of great clinical significance. No less important is to assess the condition of the patient and determine treatment options and forms of care for the differentiation of depression severity: minor (subdepressii) - F32.0, moderate (moderate) - F32.1 and heavy - F32.2. Methods of treatment of depression treatment of depression in general medicine is largely borrowed from a psychiatric practice - the leading place belongs to pharmacotherapy with the predominant use of antidepressants (timoanaleptikov). For half a century elapsed since the synthesis of the first antidepressant drugs in this class have fully confirmed their priority in the treatment of depression. In this case, along with medication should be used physio-, phyto-and psychotherapy with elements of psycho-correction, as well as other sotsioreabilitatsionnye effects, including psihoobrazovatelnuyu work with active involvement of the patient and his family in the healing process, which significantly increases Compliance (SN Mosolov, 2002 ). Effective treatment of depression is impossible without knowing not only the spectrum of psychotropic activity timoanaleptikov (antidepressants), and clinical properties of drugs belonging to all major classes of psychotropic drugs (Detailed data on the spectrum of clinical activity, side effects, interactions with psycho-and somatotropic drugs and their tactics use in the treatment of depression in primary care networks are in the book, written under the editorship of the author of this publication.

A typical feature of depression is ...

A typical feature of depression is also a circadian rhythm (right - the "true" or inverted - "untrue"): improved or (less frequently), deterioration of health in the evening. In the traditional nosological classification of affective disorders are differentiated depending on origin. Respectively allocated endogenous, constitutional, psychogenic, somatogenic (organic) depression, which can entirely determine the clinical picture throughout the illness or detect comorbidity with other forms of (mental or physical) illness. In today's international classification of diseases - ICD-10, in which mental and behavioral disorders are classified on the syndromal principle, the main importance is given to clinical relevance of the observed disorder following a set of standardized diagnostic criteria. Diagnostic criteria for depressive episode. Main symptoms: · depressed mood, which is obvious in comparison with the inherent patient norms prevailing almost daily and most of the day and continued for at least 2 weeks. regardless of the situation; · distinct reduction of interest or pleasure in activities normally associated with positive emotions · decreased energy and fatigue; · no history of hypomanic or manic states. Additional symptoms: · decreased ability to concentrate and focus; · reduced self-esteem and sense of self-doubt; · idea of ??self-abasement and / or guilt (even mild depression); · dark and pessimistic vision of the future; · thoughts or actions associated with suicide · disturbed sleep; To decrease the appetite. Diagnostic class "Affective disorders» (F30 - F39) in ICD-10 includes the categories: current depressive episode (F32), recurrent (repeating), depression (F33), bipolar disorder, with the change of depressive and manic phases (F31), as well as chronic disorders mood (F34), combining cyclothymia (F34.0) and dysthymia (F34. 1). Central place in the taxonomy of the affective pathology is the category of "depressive episode (major depression, unipolar or unipolar depression, autonomic depression). Among the non-psychotic affective disorder level allocated in the ICD-10, but under the category of "Neurotic, stress-related and somatoform disorders, in a separate section shall be made" mixed anxiety and depressive disorders »(F41.2). Clear diagnostic criteria for this disorder, observed mainly in the primary care network in this classification are not available. Provides only a general definition according to which state in these cases corresponds to anxious depression (mild or unstable), characterized by a combination of anxiety and depressive manifestations in the presence of at least a few vegetative symptoms (eg, tremor, palpitations, abdominal discomfort). Mixed anxiety and depressive disorders are diagnosed in the case of the relative balance of these manifestations.