Показания для направления к специалисту

 

Направление к психиатру показано в следующих случаях:

 

·

 

Терапевт считает, что пациент страдает тяжелым депрессивным расстройством,

дистимией в течение длительного времени, меланхолической депрессией или

 

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депрессивным расстройством с психотическими симптомами, а также выявляет

наличие суицидальных мыслей.

 

·

 

·

 

·

 

·

 

 

·

 

·

 

Терапевту требуется совет относительно назначения психотропных препаратов

(например, вопрос о назначении антидепрессантов пациентам с хроническим

болевым синдромом).

 

Пациент страдает депрессивным расстройством, резистентным к проведению

стандартного курса терапии антидепрессантами.

 

Терапевт выявляет у пациента серьезные нарушения социального

функционирования, которые не могут быть обусловлены текущим соматическим

заболеванием.

 

Пациент в прошлом подвергался сексуальному насилию или перенес тяжелую

психическую травму другого рода, что требует проведения специализированного

психологического вмешательства, которое не может осуществить терапевт или врач

общей практики.

 

Пациент проходил лечение по поводу другого психического заболевания, например,

как шизофрении.

 

В случае отсутствия клинического эффекта при проведении лечения к 4 – 6 неделе от

начала терапии, возникает необходимость в смене антидепрессанта, назначении

дополнительных препаратов в схему лечения или проведении ЭСТ под контролем

врача‐психиатра.

 

Направление к специалисту также оправдано при возникновении тяжелых депрессивных

расстройств у больных, принимающих одновременно несколько препаратов, которые могут

вступать в лекарственные взаимодействия или оказывать непосредственное влияние на

возникновение депрессивных симптомов.

 

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