CLINICAL, PSYCHOLOGICAL, GENETIC, NEUROPHYSIOLOGICAL AND SOCIAL PROGNOSIS OF DEPRESSIVE DISORDERS IN ADOLESCENTS

Mykhaylova E. A., Bagatska N. V., Matkovska T. M., Belyaeva E. E., Mitelyov D. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Depression remains one of the most common mental disorders affecting more than 350 million persons worldwide, according to WHO estimation, which in turn increases the global disease burden and becomes one of the major causes of disability. Object and methods. 156 children aged 7-11 years with depressive disorders (DD) and 128 adolescents aged 12-18 years with recurrent depressive disorders (RDD) were examined. The following methods were used: clinical and psychopathological; psychological; neurohormonal; genealogical and cytogenetic; neurophysiological. Wald’s Sequential Estimation Procedures was used with determination of symptom informative value according to Kulbak to calculate the prognostic significance of the studied factors in RDD formation. Results. Clinical, biological, psychological, genetic, social-demographic, neurohormonal, neurophysiological factors of disease formation were determined on the basis of a comprehensive examination of sick children and adolescents. Among the clinical symptoms of depression at the stage of depressive disorder manifestation in children aged 7-11 years during puberty, the most significant in RDD formation are: low progress in studies (Prognostic Coefficient (hereinafter PC)=+5.1), anxiety (PC=+4.1), social isolation (PC=+4.9), low self-esteem (PC=+5.0). Among the high-risk symptoms, suicidal behavior (PC=+4.7), addictive behavior (PC=+4.3), guilt feeling (PC=+4.0), cognitive dysfunction (PC=+3.9), communication deviations (PC=+3.3), tension headache (PC=+2.5), enuresis (PC=+2.4), obesity with insulin resistance (PC=+2.1), anxiety syndrome (PC=+1.7) obsessive syndrome (PC=+1.5), phobic syndrome (PC=+1.2) are registered obvious more frequently. Among the biological risk factors of RDD formation in adolescents, the signs of minimal brain dysfunction at an early stage of ontogenesis (PC=+4.8), prenatal burden (PC=+4.2), frequent colds in early childhood (PC=+5.4), signs of cerebral organic insufficiency (PC=+3.2), presence of closed craniocerebral trauma in anamnesis (PC=+2.4) are identified. Among the genetic risk factors for RDD progress the following are identified: presence of hereditary burden to depressive disorders (PC=+8.0) and mental diseases (PC=+3.2), increase in chromosomal aberrations level from 3.1% (PC=+6.9) and above (PC=+9.0). Social-demographic factors of RDD predication in children in puberty (place of living, education of parents, famile financial provision, mother’s age at the time of child birth under 25 years, lack of work and parents bad habits, etc.) are identified. Among the psychological risk factors of RDD formation in adolescents the highest predictive value have: infantilism (PC=+3.4), anxiety (PC=+1.9), suicidal thoughts (PC=+1.7), intensity of psychological indicators on depression scale CDRS-R (PC=+1.7), poly-accentuation of personality traits presence (PC=+1.6). Among the psychosocial stressors of RDD prediction in children at puberty are identified: conflicts in the family (PC= + 2.7), combined stressors (PC=+2.3), school bullying (PC=+3.4), father leaving from the family (PC=+1.9), impaired relationships with peers (PC=+1.8). Neurophysiological markers of RDD progress according to factor analysis of Kolmogorov-Sinai entropy electroencephalography parameters are selected. It was found that RDD formation in adolescents is realized in conditions of neurotransmitter systems imbalance, which has certain sexual characteristics and determines the variety of clinical manifestations of depressive disorder: reduced melatonin levels, regardless the clinical variant of depression (PC=2.4) and reduced serotonin levels in anxiety (PC=2.8), behavioral (PC=2.2) and phobic (PC=2.4) variants of depression. Thus, RDD formation in adolescents is influenced by neurobiological, genetic, social-psychological factors, age reactivity, neurophysiological changes in central nervous system, neurotransmitter disorders – dysfunction of brain neuroregulatory systems. Technology of risk predicting of depressive disorder progress will prevent social maladaptation of adolescents and preserve the labor potential of the younger generation.

depressive disorders, recurrent depression, risk factors, children, adolescents.

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«Bulletin of problems biology and medicine» Issue 2 Part 1 (150), 2019 year, 163-167 pages, index UDK 616.89-008.454-053.6:159.922.73

10.29254/2077-4214-2019-2-1-150-163-167