Risk Factors for the Increase in Frequency and Earlier Manifestation of Depression in Adolescent Population of Today

Abstract

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.