Ormel et al., 1990; L.R. Derogatis ...

Ormel et al ., 1990; LR Derogatis et al., 1992; TL Schwenk, 1994). But even in cases where depression is getting the correct qualifications, only 13% of patients assigned antidepressants (D. Mischoulon et al., 2001). The reasons nedovyyavleniya depression are considered a time limit set for the GP for an examination, the patient's bias (and often himself a doctor) against the statement of mental disorders, lack of awareness about the doctor's clinic and diagnosis of depression. It should be emphasized that the detection of depression in primary care networks poses significant challenges. Among them - the risk of both hyper-(risk of overdiagnosis is 1,5-8% (Cohen LG, 1993)), and (which happens more often) gipodiagnostiki. Practical experience has shown, due to gipodiagnostiki only 1 out of 10 patients receiving the necessary specialized assistance. Most are ill-founded appointments, and treatment is inadequate, eclectic and inefficient. And this is despite the fact that the frequency of use of psychotropic drugs in second place after the antibiotics, and about 25% of all prescriptions issued, the world falls on those funds, and 2 / 3 of the appointments do not neurologists and psychiatrists and other doctors. No accident that among the priority health problems in the near future, contained in the WHO report on world health in 2001, put forward the challenge of psychopharmacological treatment of mental disorders, primarily depression at the place of seeking care at a minimum of stigmatization and discrimination of patients receiving such treatment. Discussion of problems of treatment of depression is necessary to preface a brief clinical description of states that are attributable to this category. Depression - a mental disorder characterized by depressed mood (gipotimiey) with a negative, pessimistic assessment of himself, his position in the present, past and future. Along with depression (in typical cases, as a vital depression), depression includes ideatornoy and motor retardation with decreased motivation to work or agitation (up to agitation). Inherent depressive patients with mental hyperalgesia (heartache) involves psychologically nondeducible guilt, decreased self-esteem, suicidal tendencies, and painful physical self-awareness - with "somatic" symptoms (sleep disturbances with difficulties falling asleep and early awakening, a sharp decrease in appetite until depressed with anorexia weight loss of 5% or more of the source during the month, decreased libido, menstrual irregularities until amenorrhea and other somatovegetative dysfunction), which may determine the clinical picture. Depressed mood persists throughout the depressive episode (episode), and little subject to fluctuations depending on changing circumstances of life.