Diagnosis of severe depression ...

Diagnostics severe depression includes 3 main and 5 (at least) additional symptoms - criteria. For mild and moderate depression should take place 2 major and at least 3-4 additional symptoms. Following the diagnostic criteria, of course, necessary in the diagnostic process. But in practice it is important to take into account the peculiarities of the manifestations of depression, caused by late and difficult to identify these disorders. In geriatric practice, the most frequent shallow depression, moderate and light, but their symptoms are more difficult and to identify and interpret, that is itself the severity of clinical manifestations of depression in these cases prevents their timely identification and does not contribute a single interpretation. Difficulties in recognition of depression in the elderly are associated with the fact that patients themselves are less likely to identify depression as a mental disorder, to remember and associate with similar episodes. At least one third of patients do not treat depression as an illness, but as a psychological problem. Another problem, related primarily to mild late age of depression is a significant prevalence of so-called "atypical", "somatized" or "masked" depression. According to WHO, half of elderly depressed patients in general somatic practice suffer masked depression. In the diagnosis of masked depression of late life, the following supporting features: - identifying symptoms of depression - symptoms of recurrence somatonevrologicheskih symptoms in this condition and a history of daily fluctuations - premorbid personality traits that reflect the characteristics of reactivity, hereditary factors - discrepancy between somatic complaints and objective status - the dynamics of disparity disorders course and outcome of physical illness - the lack of effect of "somatic" treatment and a positive response to psychotropic drugs. In later life the most frequent cardiovascular and cerebro-vascular "mask" depression rasstroystvpod view CHD, hypertension. Marked relationship of chronic pain syndrome with depression. Apparently, the most specific for late age "mask" is a violation of cognitive function in the so-called "psevdodementnyh" depression. The phenomenon of somatization of depressive disorders in later life does not eliminate the importance of the problem a combination of depression and somatic diseases. Actually depressive symptoms (major and minor) exhibit distinct age-related features. Late-life depression - is primarily anxious depression. Anxiety can not have a specific content, but more often is accompanied by a variety of concerns, first and foremost - for his health and future. Anxious depressed mood is sometimes perceived as being painful. Patients often complain of painful inner turmoil with a sense of jitter in the chest, abdomen and sometimes in my head.