In such cases, the ...

In such cases, the doctor's treatment recommendations are often viewed by patients as inadequate - they use unnecessarily high doses of drugs, not prescribed by the doctor and medication non-drug money, etc., which, in turn, may thus adversely affect the current EV . Finally, the increase in mortality in the comorbidity of depression and SZ in a number of works attributed to the presence of common mechanisms of pathogenesis, causing the possibility of "summation" of the two pathological processes. Thus, in patients with depression were found changes of immune regulation and neurotransmitter balance, whose appearance in the PFA may thus adversely affect the course of the disease. In particular, there are reports of increased blood concentrations of ACTH in depressed patients, b-endorphin, b-lipotropina, which in turn are associated with the appearance of defective lymphocyte subpopulations. Indicates that individuals suffering from depression, impaired synthesis of prostaglandins E1 and E2, are complicit in the process of inflammation [D. Evans et al., 1996]. In depressed patients revealed signs of improvement and "cholinergic tone" [D. Evans et al., 1996], which are associated with a variety of changes in autonomic regulation of organs and body systems (cardiovascular, respiratory, etc.). Among the clinical manifestations NW, affecting the possibility of demonstrations ND (their clinical picture seen in the publication of AB Smulevicha), you must indicate such a feature of the dynamics of somatic pain as catastrophic for (acute myocardial infarction, asthma status, hypertensive crisis), which often associated with the vital fear and panic attacks, as well as the severity of symptoms, accompanied by bodily discomfort (myocardial ischemia, cardiac arrhythmias, bronchospasm phenomena, etc.). Sense of bodily distress is compounded by inherent ND somatovegetative disorders: asthenia with reduced physical activity, and other algy somatized and conversion symptoms (weight loss, sleep disturbances, dizziness, tremor, tachycardia, chest pain, dyspnea, dyspepsia: bitterness dry mouth, constipation, flatulence). Typically, LP short duration (short-ND last no more than 2 - 4 months) and often are, even without treatment [AB Smulevich, 1997]. Inverse dynamics of affective (depressive) disorders are observed as the reduction of the manifestations of SZ and rehabilitation. However, in some patients the longer LP, the duration of which exceeds 6 - 12 months [AB Smulevich, 1997]. Among the factors contributing to the manifestation of such protracted ND, along with the manifestations of somatic diseases should be pointed out comorbid SP, actual psychopathological disorders (endogenous disease, reactive state, the manifestation of which is not related to SP), as well as on the deformation of the structure of personality, because of mental illness.