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Installing on a study of the inquisitive individual internal picture of disease and just finished a history of re-assigns him a diagnosis of at least or even more important than the totality of objective data (mostly useless when viscera vegetative violations in the structure of masked depression and anxiety).
Skillfully assembled into account history and hereditary abnormalities, and some basic features of the patient's own path in life - "smooth" (although the patient's emotional stability often follows rather from circumstances favorable to it than that of the features of his personality) or, conversely, an uneasy and complex (with frequent changes attachments or places of work, unmotivated, from the standpoint of others, actions, and unexpected twists and turns of life, etc.). Considerable importance at the same time some stressful periods in the patient's life and personality traits such as the prevailing mood and attitude to their own health to disease. Increased attention should be changes in personality characteristics (to exclude endogenous cyclic phases of disease), especially the patient's response to stressful situations and the ease of switching psychosomatic, as well as the development or worsening of allergies on the background of depression, before it or after leaving it.
It is extremely important also receives the identification of periods of increased activity and asthenic depressive states of any origin in history (spontaneous or due to stressful situations, might be more light and did not require medical intervention, but, nevertheless, similar to the recent deterioration of health). It is desirable to detailed clarification of the circumstances preceding the commencement of the disease and its aggravations, and of course, the last degradation. Absolutely necessary, in addition, receive a clear, thorough understanding of the treatment, and often self-medication and the patient (as in similar conditions in the past, and at last worsening state of health) and its subjective relation to certain types of therapeutic effects and the individual known to him medicines (to clarify the preliminary prognosis and selection of the most rational therapy). |
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