ANXIETY AND DEPRESSIVE DISORDERS IN GENERAL MEDICAL PRACTICE: TOPICAL ISSUES AND UNSOLVED PROBLEMS

2021 ◽  
pp. 14-22
Author(s):  
A. A. Kirpichenka ◽  
Keyword(s):  
General Practitioners ◽  
Medical Practice ◽  
Depressive Disorders ◽  
Psychiatric Care ◽  
Modern Medicine ◽  
General Medical Practice ◽  
Foreign Countries ◽  
The Republic ◽  
Somatic Diseases ◽  
Quality Diagnosis

Diagnosis of anxiety and depressive disorders in general medical practice is a very important problem of modern medicine. This review article provides basic information about the epidemiology and economic burden of anxiety-depressive disorders, their comorbidity with other mental and somatic diseases, and the connection with suicidal behavior. According to the Decree of the Ministry of Health of the Republic of Belarus dated 02.03.2020 № 13 «On approval of the clinical protocol» «Diagnosis and treatment of patients with mental and behavioral disorders by general practitioners», this article focuses on depression, generalized anxiety, panic, mixed anxiety and depressive disorder in general medical practice. Relevant issues of low quality diagnosis of anxiety and depressive disorders are identified, which are associated both with the complexity of the clinical picture of the diseases in question and with organizational problems. Particular attention is also paid to the need for further integration of psychiatric care into general medical practice while increasing its accessibility and quality. For this, it is necessary to continue studying the best practices of foreign countries in which family and general practitioners have been providing psychiatric care to patients for many years.

Anxiety Disorders in General Medical Practice

2016 ◽  
pp. 55-59
Author(s):  
Liudmyla Dzyak ◽  
Olena Tsurakalenko
Keyword(s):  
Anxiety Disorders ◽  
Medical Practice ◽  
Modern Medicine ◽  
Early Initiation ◽  
Diagnosis And Treatment ◽  
General Medical Practice ◽  
Timely Diagnosis ◽  
Adequate Therapy ◽  
Medical Network

Timely diagnosis and early initiation of adequate therapy of disorders of the alarming spectrum (AS) remains one of the urgent tasks of modern medicine. The article considers aspects of diagnosis and treatment of AS in General medical network, particularly were described the currently recommended schemes of application of the drug Eglonil and benefits of this drug. Eglonil demonstrates the possibility of wide application of different variants of anxiety disorders, which gives the drug a special status among other psychotropic compounds.

scholarly journals D.D.Pletnev about mental symptoms in the picture of purely somatic diseases: lessons of history and today

2013 ◽  
Vol 4 (2) ◽  
pp. 5-11
Author(s):  
N. P Garganeeva
Keyword(s):  
Depressive Disorders ◽  
Modern Medicine ◽  
Emotional Disturbances ◽  
Integrative Approach ◽  
Scientific Investigations ◽  
Co Morbidity ◽  
Inner Organs ◽  
Mental Symptoms ◽  
In The Beginning ◽  
Somatic Diseases

The article is dedicated to brief statement of priority scientific investigations of the distinguished domestic therapist, Professor Dmitry Dmitriyevich Pletnev, having made significant contribution into development of clinical direction of psychosomatic medicine in Russia. At the level of diagnostic and conclusive possibilities of his time in the beginning of the XXth century, the scientist has grounded those scientific positions which currently are broadly studied in the aspect of co-morbidity of cardiovascular diseases and mental disorders of anxiety-depressive spectrum. D.D.Pletnev, one of the first clinicians-therapists has paid attention to difficulties of differential-diagnostic evaluation of state of somatic patients with psycho-emotional disturbances «depressive affects and neurosis of anxiety». Many papers of the scientist dedicated to study of «mental symptoms in picture of purely somatic diseases», what in the modern medicine is interpreted as various manifestations of neurotic and affective disorders in diseases of inner organs, wrongly forgotten, remain relevant at present as well. As perspective scientific directions, questions of integrative approach to study of interrelationship of pathology of cardiovascular system, anxiety and depressive disorders of neurotic and affective level are discussed.

The Confidential Patient: The Social Construction of Therapeutic Relationships in General Medical Practice

1996 ◽  
Vol 44 (2) ◽  
pp. 187-203 ◽  
Author(s):  
Carl May ◽  
Christopher Dowrick ◽  
Michael Richardson
Keyword(s):  
Political Economy ◽  
Social Construction ◽  
General Practitioners ◽  
Medical Practice ◽  
Power Relations ◽  
Interpersonal Relationship ◽  
Therapeutic Relationships ◽  
Institutional Identity ◽  
General Medical Practice ◽  
The Social

The interpersonal relationship between doctor and patient is fundamental to general medical practice. In this paper we explore the ways in which general practitioners make sense of the changing political economy of this relationship, as it is restructured by ideas about the patient as consumer, and as it increasingly constitutes the consultation as a point of interaction that may be intrinsically therapeutic. In particular, we explore the ways in which the consultation is the site of negotiated power relations between doctor and patient, and is the site of the doctor's negotiation of powerful discourses of professional and institutional identity.

scholarly journals The Study of Suicidal Behavior and Indicators of Electrolyte Blood Composition in Borderline Mental Disorders under the Influence of Combined Psychopharmacotherapy

2020 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Suicidal Behavior ◽  
Depressive Disorders ◽  
Negative Impact ◽  
Human Life ◽  
Personality Development ◽  
Combined Treatment ◽  
Professional Activity ◽  
Urgent Task ◽  
The Republic ◽  
Somatic Diseases

The formation of new approaches to the treatment of neurotic disorders, taking into account pathogenetic mechanisms, is an urgent task in neurology and psychiatry, due to the high prevalence of this group of diseases, the risk of developing suicidal behavior, a negative impact on the quality of human life, aggravating the course of somatic diseases, contributing to the development of physical and mental and social maladaptation with limited professional activity and disability. According to the WHO, in 2015 Anxiety Depressive Disorder (MAD) caused 50 million people to be disabled. A disappointing forecast of WHO experts is that while maintaining current trends in the spread of the disease by 2020, TDR will be in second place after coronary heart disease in the number of years lost due to disability [6]. In this regard, the purpose of this study was to study the structure of depressive disorders, suicidal behavior of patients in the Republic of Mordovia (Russia), as well as to study the characteristics of the course of psychopathological anxiety-depressive disorders in the framework of the most frequent nosological forms of diseases in Mordovia - neurotic and reactive depressions, as well as chronic forms - neurotic personality development in comparison with psychopathy under the influence of traditional psychopharmacotherapy and combined treatment with antioxidant drugs.

scholarly journals Modern approaches to the diagnosis and treatment of mixed anxiety-depressive disorders in primary health care

2021 ◽  
Vol 5-6 (215-216) ◽  
pp. 53-62
Author(s):  
Natalya Raspopova ◽  
◽  
Maria Dzhamantayeva ◽  
Yerbol Nurkatov ◽  
Laila Uteniyazova ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Practice ◽  
Depressive Disorders ◽  
Anxiety And Depression ◽  
Outpatient Basis ◽  
General Medical Practice ◽  
Symptoms Of Depression ◽  
Clinical Observations ◽  
Primary Health

The relevance of this work is due to the wide prevalence of mixed anxiety-depressive disorders among general medical practice patients. At the present stage of development of the psychiatric service in the Republic of Kazakhstan, a new concept has been developed that assumes the transfer of a number of borderline mixed anxiety-depressive disorders to the competence of PHC doctors with the need for their treatment with modern antidepressants. The purpose of this work. Development and implementation in general clinical practice of modern methods of diagnosis and treatment of mixed anxiety-depressive disorders. Material and methods. 30 patients with mixed anxiety-depressive disorders of the borderline level, who were treated on an outpatient basis (Nursultan) was examined. The study was conducted using international psychometric scales: Hospital Anxiety and Depression Score (HADS), Hamilton Anxiety and Depression Rating Scale (HDRS, HAM-A). Results and discussion. As a result of the study, it was found that among patients with mixed anxiety-depressive disorders who were treated on an outpatient basis, young people of working age from 21 to 50 years (83.3%) prevailed, in whom psychogenic anxiety-depressive disorders accounted for 60%. In the course of clinical observations, objective data were obtained indicating that when treating depressive states of mild and moderate severity with Mianserin drug on an outpatient basis, by the end of the second week of treatment, there is a fairly pronounced positive dynamics in the reduction of symptoms of depression. By the end of the second month of taking this drug (8 weeks), most patients had no symptoms of depression. Conclusions. Practical clinical observations have shown that the modern Mianserin antidepressant, possessing a wide range of clinical effects combining thymoanaleptic action proper with anti-anxiety, sedative and hypnotic effects is well tolerated by patients and can be recommended for widespread use in the treatment of mixed anxiety-depressive disorders in general medical practice. Keywords: depression, anxiety, primary health care, general medical practice, antidepressants.

Are computerized interviews equivalent to human interviewers? CIDI-Auto versus CIDI in anxiety and depressive disorders

1998 ◽  
Vol 28 (4) ◽  
pp. 893-901 ◽  
Author(s):  
L. PETERS ◽  
D. CLARK ◽  
F. CARROLL
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Medical Practice ◽  
Depressive Disorders ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Computer Attitudes ◽  
Generalized Anxiety ◽  
General Medical Practice ◽  
Icd 10

Background. The equivalency of the Composite International Diagnostic Interview delivered by human interviewers (CIDI) and its computerized version (CIDI-Auto) was examined for anxiety and depressive disorders.Methods. Subjects were 40 patients at an Anxiety Disorders Clinic and 40 general medical practice attenders. The CIDI-Auto and CIDI were administered in counterbalanced order on the same day and measures of computer attitudes and the acceptability of the two interview formats were also taken.Results. The CIDI-Auto and the CIDI were found to be equally acceptable to subjects on the dimensions of comfort and preference, while the CIDI-Auto was rated as less embarrassing but too long in comparison with the CIDI. The agreement between the two formats was acceptable with kappa values for ICD-10 diagnoses being above 0·65 and for DSM-III-R diagnoses above 0·5 except for two diagnoses (generalized anxiety disorder and dysthymia). Discrepancies between the two formats were predicted by computer attitudes and not by computer experiences or the tendency to respond in a socially desirable fashion.Conclusions. It is concluded that the CIDI-Auto in its self-administered form is an acceptable substitute for the CIDI for suitable subjects.

scholarly journals The effectiveness of the treatment of sleep disturbances in anxiety-depressive disorders of neurotic and organic genesis

2021 ◽  
pp. 43-47
Author(s):  
Yuliia Liashchenko ◽  
Liudmyla Yuryeva
Keyword(s):  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Medical Practice ◽  
Sleep Disturbances ◽  
Depressive Disorders ◽  
Combined Treatment ◽  
Underlying Disease ◽  
Severity Scale ◽  
General Medical Practice ◽  
Insomnia Severity

Sleep disturbance is one of the most frequent complaints of patients in general medical practice. The highest comorbidity of dysomnias was observed with anxiety and anxiety-depressive disorders. A bi-directional relationship has been found, suggesting that sleep disorders and anxiety-depressive disorders may aggravate each other, complicate treatment and provoke a relapse. The aim of this study was to evaluate the efficacy of the treatment of sleep disorders in patients with neurotic and organic anxiety-depressive disorders. In order to reach this goal 120 patients with anxiety-depressive disorders with sleep disorders (60 patients with disorders of neurotic genesis and 60 — with isorders of organic genesis), who were divided into 4 groups according to the genesis of the disorder and the treatment regimen, were studied. The evaluation of the dynamics of sleep disturbance correction was carried out using clinical and psychopathological methods supplemented by the Insomnia Severity Scale (Morin Ch. M.), descriptive and analytical statistical methods. It was found that combined treatment (psychopharmacotherapy and psychotherapy) of sleep disorders in patients with anxiety-depressive disorders of neurotic and organic genesis was more effective compared to patients who received only pharmacological treatment aimed at the correction of the underlying disease.

ASPECTS AND POSSIBILITIES OF USING THE CLUSTER APPROACH IN DEVELOPING THE EFFECTIVENESS OF ZIYARAH TOURISM

2020 ◽  
Vol 10 (3) ◽  
pp. 19-26
Author(s):  
Anvar Khudoyarov ◽  
Keyword(s):  
International Organizations ◽  
Tourism Industry ◽  
Economic Aspects ◽  
Cluster Approach ◽  
Cluster Management ◽  
Foreign Countries ◽  
Management Method ◽  
The Republic

This article describes how the Republic of Uzbekistan establishes and develops relations with international organizations and foreign countries in the field of tourism, increases the flow of tourists to our country, creates all conditions for tourists, improves the quality and culture of services, and also provides the tourism industry. The organizational and economic aspects of tourism regulation by the cluster management method are considered

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