ABSTRACT
Depression is a common mental disorder with various symptoms and often accompanied with unexplained painful physical symptoms. Patients, especially in primary care, often present only with somatic symptoms and depressed mood is overlooked. On the other hand, psychiatrists don't pay enough attention to somatic or painful symptoms in patients with depression. The connection between depression and accompanying painful physical symptoms is not completely understood although some common neurobiological pathways are proposed. To achieve good clinical outcome all depression symptoms should be recognized and treated. In this review we focus on painful physical symptoms which could not be explained by somatic illness or the intensity can not be explained by physical disease and are attributed to somatic symptoms of depression. The aim of this review is to provide the basic necessary information for clinicians/psychiatrists on depression with painful physical symptoms, presenting the terminology, epidemiology, differential diagnostics, neurobiological background, psycho-social aspects and treatment strategies.
Subject(s)
Depressive Disorder/complications , Pain/complications , Antidepressive Agents/therapeutic use , Biofeedback, Psychology , Cognitive Behavioral Therapy , Depressive Disorder/physiopathology , Depressive Disorder/therapy , Humans , Neural Pathways/physiopathology , Pain/physiopathology , PsychotherapyABSTRACT
In this review of Psychosis and gender we will present the relevant. Treatment principles and consider the foreign and local published data.
Subject(s)
Psychotic Disorders/epidemiology , Acute Disease , Adult , Age Factors , Aggression/psychology , Antipsychotic Agents/therapeutic use , Combined Modality Therapy , Comorbidity , Female , Humans , Male , Middle Aged , Patient Readmission/statistics & numerical data , Psychiatric Status Rating Scales , Psychotherapy , Psychotic Disorders/psychology , Psychotic Disorders/therapy , Sex Factors , Substance-Related Disorders/epidemiologyABSTRACT
Usher syndrome, the most common case of deaf - blindness, may be associated with various psychiatric disorders. Inability of communication through spoken language in association with progressive visual impairment affects diagnostics and management in case of co-morbidity with mental disorder. A patient with Usher syndrome and psychiatric symptoms is described and the difficulties in psychiatric assessment in her case are discussed. A 28 years old woman with hearing impairment diagnosed at the age of 3 months and progressive pigmentary retinopathy diagnosed at the age of 19 years, has been treated for ADHD in childhood, eating disorder in adolescence and psychosis-like disorder in adult life. Direct observation of patient behavior and the effects of pharmacotherapy were the main diagnostic procedures, since the use of sign language and handwriting was very limited. The limitations of management are discussed.
