А. А. Кирпиченко, А. Н. Барышев
УО «Витебский государственный ордена Дружбы народов медицинский университет»
Диагностика тревожных и депрессивных расстройств у пациентов общемедицинской амбулаторной практики является весьма насущной проблемой современной медицины. В данной обзорной статье представлены основные сведения об эпидемиологии и экономическом бремени тревожно-депрессивных расстройств, их коморбидности с другими психическими и соматическими заболеваниями, связи с суицидальным поведением. Согласно Постановлению Министерства здравоохранения Республики Беларусь от 02.03.2020 № 13 «Об утверждении клинического протокола «Диагностика и лечение пациентов с психическими и поведенческими расстройствами врачами общей практики»» в данной статье сделан акцент на депрессию, генерализованное тревожное, паническое, смешанное тревожное и депрессивное расстройства в общей врачебной практике. Обозначены актуальные вопросы низкого качества диагностики тревожно-депрессивных расстройств, которые связаны как со сложностью клинической картины рассматриваемых заболеваний, так и с проблемами организационного характера. Особое внимание обращается на необходимость дальнейшей интеграции психиатрической помощи в общую врачебную практику с одновременным повышением её доступности и качества. Для этого необходимо продолжить изучение передового опыта зарубежных стран, в которых семейные врачи и врачи общей практики оказывают психиатрическую помощь пациентам уже на протяжении многих лет.
ключевые слова: тревога, депрессия, общая врачебная практика
Anxiety and depressive disorders in general medical practice: topical issues and unsolved problems
А. A. Kirpichenka, A. N. Baryshev
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 No. 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.
keywords: anxiety, depression, general medical practice
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40. Walker, E. R., Druss B. G. Mental and Addictive Disorders and Medical Comorbidities // Current Psychiatry Reports – 2018. – Vol. 20, № 10.
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