DIAGNOSIS OF DEPRESSION.

The basis of timely and accurate recognition of psychosomatic disorders is, above all, the most thorough and comprehensive physical examination of the patient. It's no secret that some patients referred to as "hypochondriacs" simply because to reveal the organic background of suffering for one reason or another cannot. The most important condition to prevent misdiagnosis in the functional nature of seemingly pain and other psychosomatic disorders is therefore mandatory testing of each patient at least three specialists: internist, a neurologist and psychiatrist. Diagnosis of somatisation and hypochondriacally depression autonomic manifestations can be set (if relevant psychiatric symptoms) only when exhausted all the means already physical examination the patient.
No less significant and sometimes even more challenging it becomes at the same time a clear distinction of the true proportion of functional and organic in the clinical picture of each patient. Not all functional disorders should be considered psychogenic - they may have a somatic basis, not every disease that may be psychosomatic (eg, asthma or duodenal ulcer), certainly due to the psyche and is supported by traumatic influences. Determining the true relationship of psychosomatic and mental factors in the clinical picture of suffering - a prerequisite to adequate therapy.
Careful physical examination is absolutely necessary and to establish proper contact with the patient even if the absolute conviction of a doctor in a purely functional origin viscero vegetative disorders. Overcome with fear about their condition such patients are not being met, as a rule, some unsubstantiated assurances of doctors in that they have no serious physical illness. Only objective evidence of instrumental and laboratory investigations can reassure them and to become, at least, a consistent reference point therapy.
In the statement of undoubted functional disorders of psychogenic nature is necessary to solve one of the fundamental issues - the establishment of a neurotic or psychotic symptom levels.