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.