[Predictors of suicidal behaviour in adolescents with depressive disorders]

[Experience of clinical use of fluvoxamine for the treatment of comorbid depression in childhood and adolescence]

OBJECTIVE

To identify the frequency of administration of fluvoxamine, to determine the main targets of the drug and the expediency of its use in depression of various genesis in children and adolescents.

MATERIAL AND METHODS

To assess the frequency of prescribing fluvoxamine, 195 medical histories of patients who were inpatients in the children's department of the Mental Health Research Center in 2023 were analyzed. To assess the dynamics of depression during treatment with fluvoxamine, a clinical group was formed of 12 patients aged 10 to 15 years (age 13.1±3.6 years) who received fluvoxamine for the treatment of depression with comorbid obsessive-compulsive and anxiety-phobic disorders. Clinical and psychopathological, psychometric (Hamilton Depression Rating Scale - HDRS) and statistical research methods were used.

RESULTS

In total, in 2023, fluvoxamine was received by 20% (n=37) of all inpatient patients of child age (from 7 to 16 years). All patients received combination therapy. The therapeutic targets were comorbid depressive, obsessive-compulsive and anxiety symptoms developing in the structure of nosologically heterogeneous states, with the dominance of schizophrenic spectrum disorders. Against the background of the use of the drug fluvoxamine for 4 weeks in the clinical group, there was a significant reduction in depressive symptoms on the HDRS. Adverse events during complex therapy were observed in 20% of patients, but were not severe, did not require discontinuation of therapy and were unreliably associated with the use of fluvoxamine.

CONCLUSION

The use of the fluvoxamine provides reduction of depressive symptoms within the framework of various nosologies, and is characterized by sufficient safety. The variety of therapeutic targets of the fluvoxamine, including antidepressant, anti-anxiety, cognitive effects, is certainly a significant advantage of the studied fluvoxamine for use in childhood.

[Clinical features of depression in adolescents with schizotypal disorder]

OBJECTIVE

To study the clinical features of depressive disorders in adolescents with schizotypal disorder (STD).

MATERIAL AND METHODS

Were examined 87 adolescents with STD (F21), taken for outpatient or inpatient observation in 2018-2020. Of these, 26 patients were selected (12 males, 14 females, mean age 12.7±2.9 years) diagnosed with clinically significant depression (F32). To assess the severity of depression, the Hamilton Depression Rating Scales (HDRS) and the Beck Depression Self-Assessment Questionnaire (BDI) were used. The SPQ questionnaire was used to quantify the presence of STD symptoms.

RESULTS

Depressive disorders were observed in 28% of all examined patients with STD. Signs of dysontogenesis were observed in 92% of the examined. The duration of depressive episodes before the start of treatment averaged 8.7 months, and until therapeutic remission was achieved, an average of 12.6 years. A mild depressive episode according to the HDRS scale corresponded in 23.1% of patients with a moderate degree in 61.5% and a severe one in 3.8%. At the same time, according to the BDI questionnaire, the results were different: there was no mild degree of depression during treatment, moderate-severe degree was detected in 8 (30.1%) patients, in the remaining 16 (61.5%) - extremely severe degree. Suicidal thoughts were noted in 76.9% of the surveyed, while the parents knew about their presence only in 27.0% of adolescents. A suicidal attempt was made by 3 patients (11.5%), one of them repeatedly. Non-suicidal self-injurious behavior was found in 38.5% of patients.

CONCLUSION

Depressive episodes in adolescents with STD are noted chkasto, characterized by the duration and severity of symptoms. Subjective depressive experiences, primarily internal feelings of longing, ideas of failure and guilt, as well as the frequency of anti-vital thoughts and self-injurious behavior, are much more pronounced in adolescents than they demonstrate in everyday life.