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Нейроэндокринная перестройка в организме женщин в период климактерия часто сопровождается развитием климактерического синдрома с сопутствующими психическими нарушениями. Кроме того, в этот период могут манифестировать различные психиче-ские расстройства, в частности депрессии. В статье представлены результаты обследования 150 женщин в возрасте от 41 года до 65 лет, страдающих депрессивными расстройствами в климактерическом периоде. На основании полученных результатов рас-сматриваются депрессии различного генеза, возникающие у женщин в период пре-и постменопаузы, их связь с менопаузальными симтомами, а также социальными факторами. Изложены вопросы дифференциальной диагностики и основные принципы терапии депрессий, включая показания и противопоказания к назначению заместительной гормональной терапии и психотропных средств.Ключевые слова : депрессия, диагностика, период климактерия, климактерический синдром, терапия, антидепрессанты. Контакты: Нина Аркадьевна Тювина natuvina@yandex.ruДифференциальная диагностика и лечение депрессивных расстройств у женщин в период климактерияThe differential diagnosis and treatment of depressive disorders in menopausal women N.A. Tyuvina I.M. Sechenov First Moscow State Medical University Neuroendocrine reorganization in a menopausal woman is frequently accompanied by the development of the climacteric syndrome with concomitant mental disorders. Furthermore, various mental disorders, depressions in particular, can manifest themselves in this period. The paper presents the results of examining 150 women aged 41 to 65 years who had depressive disorders in menopause. Based on the findings, the author considers depressions of varying genesis occurring in women in the pre-and postmenopausal periods, their association with menopausal symptoms and social factors. She outlines the differential diagnosis of depressions and the basic principles of their therapy, including indications for and contraindications to hormone replacement therapy and the use of psychotropic drugs.Key words: depression, diagnosis, climacteric period, climacteric syndrome, therapy, antidepressants. Contact: Nina Arkadyevna Tyuvina natuvina@yandex.ru * В работе использованы термины, принятые в нашей стране и за рубежом. Климактерический период (климактерий) -период от конца репродуктивной стадии до полного прекращения функции яичников. Выделяют две фазы климактерия -пременопаузу и постменопаузу, которые разделены менопаузой -основным климактерическим феноменом. Менопауза -это последнее маточное кровотечение, обуслов-ленное гормональной функцией яичников. Пременопауза -начальный период снижения функции яичников, клинически характеризую-щийся нерегулярными менструациями. Постменопауза -период от последней менструации до полного прекращения функции яичников. Прекращение менструаций до 45 лет расценивают как раннюю менопаузу, после 55 лет -как позднюю. 67онных механизмов [3, 10,11]. В этих условиях воздействие дополнительных факторов может приводить к срыву адап-тации и появлению как соматовегетативных, так и психиче-ск...

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Objective: to study the clinical features of depression in women compared with men. Patients and methods. 120 women aged 18-65 years with recurrent depressive disorder (RDD; ICI-10 F33) (a study group) and 67 men of the same age with RDD (a control group) were clinically examined using a specially designed schedule and the Montgomery-Asberg Depression Scale. Results. The clinical picture and the course of RDD have gender differences. The earlier onset of the disease in women with a large number of depressive attacks and lower quality remissions is due to the relationship and mutual influence of menstrual and reproductive function and depression. Such typical symptoms of endogenous depression, as slow thinking, anhedony, decreased sleep duration and early morning awakenings, as well as diurnal swings of mood with its deterioration in the morning, were characteristic for most women and men. The pattern of depression in women is more commonly characterized by anxiety; ideas of self-accusation; suicidal thoughts; avoidance of contacts with others; weakness; fatigue; decreased or increased appetite; sleep onset insomnia; lack of sleep feeling. That in men is more often marked by symptoms, such as melancholy; motor retardation; decreased motivation; somatic symptoms of depression (tachycardia, constipation); comorbid panic attacks; and concomitant diseases of the cardiovascular, respiratory and genitourinary systems. Men more frequently abuse alcohol and other psychoactive substances. Conclusion. The revealed features of depression in women and men will be able to more accurately diagnose and to prescribe adequate therapy.

This paper presents the definition, epidemiology, etiological factors, and approaches to classifying infertility and describes the relationship between mental health and infertility in women. The problem of idiopathic infertility is analyzed from both obstetric/gynecological and psychiatric positions. The psychological factors influencing the reproductive function of a woman are disclosed. Mental health disorders potentiating infertility are considered. Attention is paid to that mental disorders are insufficiently and untimely diagnosed in women with reproductive disorders, that certain forms of psychopathology are masked by functional gynecological disorders, and that obstetricians/gynecologists have no specialized ideas of women's mental health, which may lead to unsuccessful infertility therapy.

Тювина Н.А., Воронина Е.О., Балабанова В.В., Гончарова Е.М. России, Москва, Россия 119021, Москва, ул. Россолимо, 11, стр. 9 Цель исследования -изучение отдельных аспектов взаимосвязи и взаимовлияния менструально-генеративной функции и депрес-сивных расстройств у женщин. Кафедра психиатрии и наркологии ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)» Минздрава

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Mild to moderate cognitive impairment (CI) in elderly and senile age may be caused by various neuropsychiatric diseases, including Alzheimer's disease (AD) and depression. The literature review presents the mechanisms of CI development in AD and depressive disorders, as well as their course, prognosis, and differential diagnosis. Mild and moderate depressions in AD, their clinical variants, course and treatment approaches are described. Treatment for CI is shown to focus on therapy of the underlying disease, in which the former occurs. Antidepressants are used to treat depression and depressive disorders in AD, by taking into account the efficacy and tolerability of the drugs at old age.