Difficulties in the diagnosis of depression ...

Difficulties in the diagnosis of depression in children is largely due to the problems of formulating a complaint and an inability to self-reports. In many cases, the crucial observation and attention of parents and teachers, as well as the position of alertness pediatrician about the possibility of child depression in explaining the causes of ill health or behavior changes, which in turn dictates the need for timely professional advice. Significant features distinguish the pathology of mood during the development of depression in adolescence and early adulthood. Actually gipotimiya or depressed mood manifested not sadness, but mostly a sense of unhappiness of existence, the experience of indifference to the loss of strength, loss of interest, impaired concentration, difficulties in perception of the educational material and complaints of memory impairment, dissatisfaction with the painful experience of his physical and mental imperfections. In adulthood, the reference signs of depression is usually considered to be clinical signs of inhibited dreary depression with depressive ideas of self-deprecation, guilt. Patients with such manifestations of depression are found mostly in hospital (but increasingly rare). Doctors often have to deal with depressive disorders at depth, but the clinical picture of depression almost obligate or at least very often becomes a manifestation of anxiety or feelings of anxiety, the severity of which may vary in different ranges. Typically, anxiety is accompanied by all sorts of fears, fear and most often it is the topic of health, with hypochondriacal concern. Vital experience of anguish and heartache replaced a variety of bodily sensations, often algicheskogo nature, while maintaining predominantly retrosternal localization. The painful experience of anxiety becomes pronounced physical character and described patients as a painful inner tension, painful emotion, inner trembling. Increased frequency of such atypical depression often associated with drug pathomorphism when the widespread use of psychotropic drugs caused a weakening of the severity of melancholic symptoms actually led to the transition of many mental disorders in the circular level with a more distinct phase-periodic flow. At the same time recognizes and immediate increase in the prevalence erased, "matte" forms of depression, symptoms often are characterized by resistance and resistance to therapy. Aware of the signs of over-imaginative, sometimes bizarre expressions in the transfer of their feelings and state as a whole allows us to differentiate abnormal sensations of pain syndromes with somatic diseases, in particular, cardialgia stenokarditicheskih of pain associated with coronary heart disease. Naturally, the recognition of the possibility of somatization of depressive symptoms should not lead to hyperdiagnosis depression and neglect the real physical illness or the need for its exclusion [13].