Тювина Н.А., Балабанова В.В., Воронина Е.О. Кафедра психиатрии и наркологии ГБОУ ВПО «Первый Московский государственный медицинский университетим. И.М. Сеченова» Минздрава России, Москва, Россия 119021, Москва, ул. Россолимо, 11, стр. 9 Представлены Neurology, Neuropsychiatry, Psychosomatics. 2015;7(2):75-79. DOI: http://dx.doi.org/10.14412/20747(2):75-79. DOI: http://dx.doi.org/10.14412/ -27117(2):75-79. DOI: http://dx.doi.org/10.14412/ -2015 Гендерные особенности депрессивных расстройств у женщинПол определяется как совокупность биологических генетически детерминированных половых признаков орга-низма и характеризует биологические различия между муж-чиной и женщиной. Гендер (род, социальный пол) несет бо-лее широкую смысловую нагрузку и подразумевает половую принадлежность не только на биологическом, но и на лич-ном, социальном, психологическом уровне. Совокупность половых (биологических) и гендерных признаков определя-ет мужественность (маскулинность) и женственность (фе-минность). Эмоции человека также обусловлены биологи-ческими (генетическими, нейроморфофизиологическими, гормональными) и социально-психологическими половыми различиями, что отражается и на патологических эмоцио-нальных реакциях, в частности депрессивных.Различия понятий «пол» и «гендер» были введены се-ксологом Д. Мани в 1955 г. До этого времени термин «ген-
Objective: to study the clinical features of depression in women compared with men. Patients and methods. 120 women aged 18-65 years with recurrent depressive disorder (RDD; ICI-10 F33) (a study group) and 67 men of the same age with RDD (a control group) were clinically examined using a specially designed schedule and the Montgomery-Asberg Depression Scale. Results. The clinical picture and the course of RDD have gender differences. The earlier onset of the disease in women with a large number of depressive attacks and lower quality remissions is due to the relationship and mutual influence of menstrual and reproductive function and depression. Such typical symptoms of endogenous depression, as slow thinking, anhedony, decreased sleep duration and early morning awakenings, as well as diurnal swings of mood with its deterioration in the morning, were characteristic for most women and men. The pattern of depression in women is more commonly characterized by anxiety; ideas of self-accusation; suicidal thoughts; avoidance of contacts with others; weakness; fatigue; decreased or increased appetite; sleep onset insomnia; lack of sleep feeling. That in men is more often marked by symptoms, such as melancholy; motor retardation; decreased motivation; somatic symptoms of depression (tachycardia, constipation); comorbid panic attacks; and concomitant diseases of the cardiovascular, respiratory and genitourinary systems. Men more frequently abuse alcohol and other psychoactive substances. Conclusion. The revealed features of depression in women and men will be able to more accurately diagnose and to prescribe adequate therapy.
Тювина Н.А., Воронина Е.О., Балабанова В.В., Гончарова Е.М. России, Москва, Россия 119021, Москва, ул. Россолимо, 11, стр. 9 Цель исследования -изучение отдельных аспектов взаимосвязи и взаимовлияния менструально-генеративной функции и депрес-сивных расстройств у женщин. Кафедра психиатрии и наркологии ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)» Минздрава
Nonsuicidal self-injuries (autotomy, self-inflicted destruction, self-mutilation) is a variant of autoaggression in a patient without the intent to take his/her own life. Patients with the consequences of self-injuries receive help from physicians of various specialties, who often cannot determine their motivation for autoaggressive actions, since it is associated with mental disorders. The paper presents data on phenomenology, some classifications and motivation of nonsuicidal self-injuries. Various mental disorders are noted to be the most common cause of autoaggressive behavior. The paper describes a clinical case of a female patient who has mutilated her face for a long time, hiding the cause of her autoaggressive action. A detailed clinical and psychopathological analysis of her medical history and mental status allowed for classifying hypochondriacal delirium within schizophrenia as a cause of self-mutilating actions. The motivation for this behavior was to fight against a pseudotumor, for which the patient suffered pain and prolonged suppurative processes on the skin of the face, without visiting physicians.
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