Differential diagnosis of climacteric depression

Mental disorders that manifest themselves in the climacteric period are varied, and diagnostic difficulties often arise, especially in disorders of the affective circle. Since this was related to the development of differential diagnostic criteria for menopausal depression and other depressive disorders developing in the menopause. There are 3 types of depressive disorders in menopause.       

  1. Climacteric depression develops along with vegetative-vascular and endocrine disorders, usually in premenopausal women (39-56 years). Depression is characterized by a depressed mood, a decrease in interest in oneself and surrounding events, and the appearance of fear for one’s health. The cause of this depression is estrogen deficiency, as well as a violation of the adaptive mechanisms in the endocrine system. In women with a depression increases appetite and libido, sleep disturbances in connection with hot flashes. Usually, the severity of depression does not exceed dysthymia.                     
  2. Psychogenic depression can occur as a result of significant mental trauma and does not depend on the manifestations of the menopause. Psychogenic depression is divided into neurotic and reactive. Reactive depression is characterized by a short period of numbness, disturbed sleep, appetite, affective disorders with feelings of guilt. After acute experiences, vegetative-vascular symptoms appear.       
  3. Neurotic depression is characterized by a less severe disorders, but in patients may receive a state of stupor and hopelessness. The emerging suicidal thoughts are caused by a pessimistic view of the future. In such patients, sleep is often disturbed due to persistent memories.     

During menopause or perimenopause, endogenous depression may reappear, characterized by depressed mood, loss of interest in favorite activities, inability to enjoy, decreased self-esteem, and sleep disturbances. Hot flashes in patients completely disappear, which is evidence of a milder neurotic level of disorder.   

Thus, due to hormonal changes, the adaptation of the body is disturbed, which is accompanied by depression. In the case of the development of endogenous depression, the climacteric period plays a role in the implementation of the genetic predisposition, which should be taken into account when prescribing treatment. 

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