Depressiyaning turli xil tashxislari

Vikipediya, ochiq ensiklopediya

Bemorlar eng ko'p tashxislanadigan psixiatrik kasalliklardan biri bo'lgan depressiya. Butun dunyo bo'ylab aholining turli qatlamlarida tobora ko'payib borayotgan tashxis qo'yilmoqda[1][2]. Birgina Qo'shma Shtatlardagi depressiya har yili 17,6 million amerikalik yoki har 6 kishidan 1 nafariga ta'sir qiladi. Depressiyaga uchragan bemorlarda 2-toifa diabet, yurak-qon tomir kasalliklari va o'z joniga qasd qilish xavfi yuqori bo'ladi. Yaqin yigirma yil ichida depressiya butun dunyo bo'ylab nogironlikning ikkinchi asosiy sababiga aylanishi kutilmoqda va yuqori daromadli mamlakatlarda, shu jumladan, Qo'shma Shtatlarda. O'z joniga qasd qilish holatlarining, taxminan, 75 foizida shaxslar o'limidan oldin o'tgan yil ichida, 45-66% oldingi oyda shifokorga murojaat qilgan. O'z joniga qasd qilish natijasida vafot etganlarning taxminan uchdan bir qismi o'tgan yili ruhiy salomatlik xizmatlari orqali aloqada bo'lgan, beshdan bir qismi oldingi oyda[3][4][5][6][7]


Depressiya kabi ko'plab psixiatrik kasalliklar kam yoki umuman tibbiy ma'lumotga ega bo'lmagan sog'liqni saqlash mutaxassislari tomonidan tashxislanadi va asosiy sababni to'g'ri ko'rib chiqmasdan simptomlarni ko'rsatish asosida amalga oshiriladi, ko'pincha differentsial tashxislarning yetarli skriningi o'tkazilmaydi[8][9][10][11][12][13] Bir tadqiqotga ko'ra, "tibbiy bo'lmagan ruhiy salomatlik xizmati xodimlari o'z bemorlarida niqoblangan tibbiy kasalliklarni tan olmaslik xavfi yuqori bo'lishi mumkin"[14]

Noto'g'ri tashxis yoki o'tkazib yuborilgan tashxislar davolanishning yetishmasligi yoki samarasiz va potentsial zararli davolanishga olib kelishi mumkin. Bu esa asosiy sababchi bo'lgan holatning buzilishni yomonlashtirishi mumkin[15][16] Konservativ hisob-kitoblarga ko'ra, barcha psixologik alomatlarning o'n foizi tibbiy sabablarga ko'ra bo'lishi mumkin, [17] bir tadqiqot natijalariga ko'ra, jiddiy ruhiy kasalligi bo'lgan shaxslarning taxminan yarmi "asosan tashxis qo'yilmagan va davolanmagan umumiy tibbiy sharoitlarga ega. Psixiatrik alomatlarni keltirib chiqarishi yoki kuchaytirishi mumkin"[18][19]

Newsweek jurnalida noto'g'ri tashxis qo'yilgan depressiya holatida yozuvchi yillar davomida depressiyadan davolangan.Uning ruhiy tushkunligining so'nggi 10 yilida simptomlar yomonlashdi, natijada ko'plab o'z joniga qasd qilishga urinishlar va psixiatrik kasalxonaga yotqizilgan. Nihoyat, MRT o'tkazilganda, u shish borligini ko'rsatdi. Biroq, unga nevropatolog buni yaxshi ekanligini aytdi. Simptomlar yomonlashganidan keyin va boshqa nevrologning ikkinchi fikriga ko'ra, o'simta olib tashlandi. Operatsiyadan keyin u endi depressiya belgilariga ega emas ed.

Bakterial-virusli-parazitar infektsiya[tahrir | manbasini tahrirlash]

MRI miya tekshiruvi: Neyrosistiserkoz
  • Lyme kasalligi ; Bu kiyik shomil ( Ixodes scapularis ) orqali yuqadigan spiroxete bakteriyasi Borrelia burgdorferi tomonidan qoʻzgʻatilgan bakterial infeksiya. Lyme kasalligi turli xil tibbiy va nevropsikiyatrik kasalliklarning alomatlarini taqlid qilishga moyilligi uchun "buyuk taqlidchi" nomini olgan kasalliklar guruhidan biridir[20][21] Lyme kasalligi qisman, serologik testlarning murakkabligi va ishonchsizligi natijasida aniqlanmagan kasallikdir.
Milliy miqyosda Lyme borreliozining tez o'sishi va og'ir nevrologik shikastlanishning oldini olish uchun antibiotiklarni davolash zarurati tufayli, ruhiy salomatlik mutaxassislari uning mumkin bo'lgan psixiatrik taqdimotlaridan xabardor bo'lishlari kerak.

Qon buzilishi[tahrir | manbasini tahrirlash]

Anemiya - qizil qon tanachalari sonining kamayishi yoki qondagi gemoglobinning normal miqdoridan kamroq. Depressiya belgilari jamiyatda yashovchi keksa insonlarning umumiy populyatsiyasida kamqonlik bilan bogʻliq.
  1. College Students Exhibiting More Severe Mental Illness, Study Finds
  2. Lambert KG (2006). "Rising rates of depression in today's society: Consideration of the roles of effort-based rewards and enhanced resilience in day-to-day functioning". Neuroscience & Biobehavioral Reviews 30 (4): 497–510. doi:10.1016/j.neubiorev.2005.09.002. PMID 16253328. 
  3. Depression and Suicide Andrew B. Medscape
  4. González HM; Vega WA; Williams DR; Tarraf W; West BT; Neighbors HW (January 2010). "Depression Care in the United States: Too Little for Too Few". Archives of General Psychiatry 67 (1): 37–46. doi:10.1001/archgenpsychiatry.2009.168. PMID 20048221. PMC 2887749. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2887749. 
  5. "Contact with mental health and primary care providers before suicide: a review of the evidence". The American Journal of Psychiatry 159 (6): 909–16. June 2002. doi:10.1176/appi.ajp.159.6.909. PMID 12042175. PMC 5072576. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=5072576. 
  6. "Contact of mental and nonmental health care providers prior to suicide in Taiwan: a population-based study". Canadian Journal of Psychiatry 53 (6): 377–83. June 2008. doi:10.1177/070674370805300607. PMID 18616858. https://archive.org/details/sim_canadian-journal-of-psychiatry_2008-06_53_6/page/377. 
  7. "Suicide and recency of health care contacts. A systematic review". The British Journal of Psychiatry 173 (6): 462–74. December 1998. doi:10.1192/bjp.173.6.462. PMID 9926074. 
  8. "Errors of Diagnosis in Pediatric Practice: A Multisite Survey". Pediatrics 126 (1): 70–9. July 2010. doi:10.1542/peds.2009-3218. PMID 20566604. PMC 2921702. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2921702. 
  9. Margolis RL (1994). "Nonpsychiatrist house staff frequently misdiagnose psychiatric disorders in general hospital inpatients". Psychosomatics 35 (5): 485–91. doi:10.1016/S0033-3182(94)71743-6. PMID 7972664. 
  10. Clinical errors and medical negligence Femi Oyebode; Advances in Psychiatric Treatment (2006) 12: 221-227 The Royal College of Psychiatrists
  11. Scheinbaum BW (1979). "Psychiatric diagnostic error". Schizophrenia Bulletin 5 (4): 560–3. doi:10.1093/schbul/5.4.560. PMID 515705. https://archive.org/details/sim_schizophrenia-bulletin_1979_5_4/page/560. 
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  13. Small GW (December 2009). "Differential Diagnoses and Assessment of Depression in Elderly Patients". The Journal of Clinical Psychiatry 70 (12): e47. doi:10.4088/JCP.8001tx20c. PMID 20141704. 
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  17. When Psychological Problems Mask Medical Disorders: A Guide for Psychotherapists. Morrison J: New York, Guilford, 1997 ISBN 1-57230-539-8
  18. Previously undetected metabolic syndromes and infectious diseases among psychiatric inpatients. Psychiatric Services Rothbard AB,et al: 60:534–537,2009
  19. "Physical illness manifesting as psychiatric disease. II. Analysis of a state hospital inpatient population". Archives of General Psychiatry 37 (9): 989–95. September 1980. doi:10.1001/archpsyc.1980.01780220027002. PMID 7416911. 
  20. "Lyme disease: a neuropsychiatric illness.". The American Journal of Psychiatry 151 (11): 1571–83. November 1994. doi:10.1176/ajp.151.11.1571. PMID 7943444. https://archive.org/details/sim_american-journal-of-psychiatry_1994-11_151_11/page/1571. 
  21. "Higher prevalence of antibodies to Borrelia burgdorferi in psychiatric patients than in healthy subjects.". The American Journal of Psychiatry 159 (2): 297–301. February 2002. doi:10.1176/appi.ajp.159.2.297. PMID 11823274. https://archive.org/details/sim_american-journal-of-psychiatry_2002-02_159_2/page/297.