Расстройства депрессивного спектра в неврологической практике: есть ли место под солнцем, или кто должен лечить пациентов?

Abstract

In the cases of majority of neurological diseases the symptoms of depression have significant influence on the worsening of the quality of patient’s life, regardless of the severity of the neurological disorders. In the most of neurodegenerative diseases the symptoms of depression often precede the appearance of neurological symptoms. Within recent years, numerous studies have been published demonstrating that disorders of depressive spectrum can be considered as a predictor of some types of dementia. Existing data regarding the methods of therapeutic intervention for depression in the clinical practice are rather scarce, scattered and often based on the «personal experience» of neurologists and psychiatrists. In some patients the diagnostics of depression in the context of neurological disorders can be difficult due to the difficulties in the establishing the contact with the patient as well as cognitive deviations related to neurological disorders. In order to facilitate this task, the effective screening diagnostic methods have been developed for the diagnosis of depression in the context of neurological diseases. The results of clinical studies performed within recent years confirm the important role of the neurologist for the evaluation and the treatment of the symptoms of depression, both at the initial stage and at the stage of remission. The purpose of the current review is to systematize the accumulated data on the disorders of depressive spectrum in the context of neurological practice, as well as to demonstrate the role of neurologist in the process of diagnosis and treatment of the symptoms of depression in neurological diseases.