In 82% of patients, OMD reduced by the time of adulthood. Disorders with severe intellectual impairment, paroxysmal disorders, psychopathic syndrome, mixed forms of the disease were the causes of a lifelong disability in 3.6% of cases.
Objective: depression among adolescents is a serious public problem. The majority of genetic and clinical studies showed that early — onset depressions etiologically may be distinct from adult — onset depressions. Itis possible to assume some differences in aged-dependent risk profile between depressions at adolescence and adulthood.Aim: to study adolescent depressions for identification a number of novel risk factors for increase in frequency and early manifestation of the disorder.Patients and methods: outpatient adolescents registered in one of the Moscow psychoneurological dispensary at 1999–2019 years (total 1704 boys and girls). From the entire cohort we selected all participants appealed for medical aid in connection with depression (F3 of ICD-10) during last decade.Results: the significant increase in the incidence and early manifestation of adolescent depressions during last decade were revealed especially in girls with shift of male/female ratio from 3,1/1 in 2009 year to 1,8/1 in 2019 year. Some specific features of nowadays adolescent depressions are noted: beginning at an earlier age, increasing part of severe depressive episodes, growth of the autoaggressive behavior and suicidal potential. Novel links between adolescent depressions and risk factors are described. Some endocrinological changes resulting from premature pubertal timing and disordered circadian rhythms, social deprivation owing to socio-economic reforms with a lack of social support, low social expectations, absence of positive perspectives leading to low self-esteem and unwarranted self-criticism are turned out to be the most important factors heightening vulnerability to adolescent depressions.Conclusion: identification of pathogenetic mechanisms of adolescent depressions creates an opportunity for early target psychosocial intervention and might help to reduce risk for depression among youth.
In order to determine possible trends in the dynamics and characterological structure of personality in the General population caused by the COVID-19 pandemic, which is a long-term strong stressful effect and clinically and psychopathologically comparable to chronic personality changes after experiencing a disaster, the conditions predisposing to personal transformation, including clinical and prognostic patterns, are analyzed. The age-dependent nature of these changes is shown, and a number of features identified for different age groups are discussed.
Among all hospitalized on medical emergencies suicidal behavior was identified in 42%, repeated suicidal attempts were in 27% of boys and in 47% of girls. Mental disorders on admission and in the past history were found in 75%; 25% of the patients received psychiatric examination and treatment. Personality disorders and adaptation disorders were most prevalent; schizophrenia spectrum disorders made up 13%. Common features of suicidal behavior in adolescents were: the use of low fatal methods, mild expression of antivital feelings, short duration of pre-suicidal stage, suddenness of commitment of suicidal actions, an additional stressful event (conflict situation) for the development of suicidal behavior. Significant differences in the methods of realization of suicidal intentions, preferable character of suicidal behavior (blackmailing/demonstrative in girls, brutal and compulsive in boys) and typology of psychopathological symptoms were established.
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