Ambulantná terapia 2/2008

AFFECTIVE DISORDERS – CURRENT SITUATION AND POSSIBILITIES OF TREATMENT

Depression and sadness has not the same meaning even if they are both frequently used for description of „sad“ od „depressed“ mood. From the psychiatric oiunt of view several types of depression can be recognized. Depression is very common, highly prevalent disorder with the life-time prevalence 4 – 6 % (substantial symptoms of depression) or 17 – 35 % (mild to moderate depressive disorders). In the pathogenesis of depression changes in turnover of neurotransmitters (5-HT, NA, DA) are taking place. ICD 10 defines several forms of affective disorders : depressive disorders (one unipolar or recurrent depression), bipolar disorder, dysthymia, cyclothymia, structural and symptomatic affective disorders. This is important to recognize „somatic syndrome“, „masked“ depression and depression with psychotic symptoms. For identification of depression for non-psychiatrists is very useful to use nine-items Questionnary of Health for Patient or modified version of Geriatric Scale of Depression for older people. The aim of treatment is to take off symptoms of depression, to restore premorbid functioning and to prevent relapses. In the treatment of depression antidepressants are mostly used (SSRIs, SNRIs and other), psychotherapy and electroconvulsive therapy. There are three phases of treatment: acute, maintenance and prophylaxis. Consultation with psychiatrist is strongly advised for patients treated by general practitioner or other specialist too.

Keywords: affective disorders, depression, diagnosis, treatment, antidepressants