[Contribution of pubertal psychobiological processes to the formation and clinical manifestations of juvenile depressions].

Based on the study of 486 patients, aged from 16 to 25 years, key features of psychopathology of juvenile depressions were specified. They included bluntness and atypism of a depressive triad with insignificant expression and rudimentariness of the thymic component per se, a large proportion of cognitive disorders and psychopathy-like disturbances, a higher frequency of special overvalued syndromes of metaphysical and dysmorphophobic character. Types of juvenile depressions were singled out as follows: depressions with the clinical picture of juvenile asthenic failure, dysmorphophobic, metaphysical, heboid, psychasthenic-like, depersonalization, senestho-hypochondriac depressions as well as depressions with obsessive-phobic disorders and with "psychogenic contents". The efficacy of the combined use of serotoninergic antidepressive drugs (SSRI) and antipsychotics (flupentixol, trifluoperazine, quentiapine, amisulpride ziprasidone) was confirmed and the high selectivity with respect to cognitive and overvalued disorders as well as to the impairment of mental activity was demonstrated. Correlations between therapeutic effectiveness of separate SSRI drugs and types of juvenile depression were found. The importance of complex approach, including not only psychopharmacotherapy but also cognitive-behavioral psychotherapeutic methods, is emphasized. Current concepts of peculiarities of neuroplastic changes in the human brain underlying manifestations of "puberty mentality" and their pathogenetic and pathoplastic contribution to the formation of juvenile depressions are discussed.