Современные подходы к диагностике и терапии тревожно-депрессивных расстройств в условиях первичной медико-санитарной помощи

Abstract

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.