The purpose of the study was to study the clinical and psychopathological phenomenology of the initial stage of depressive disorders in the context of clinical pathomorphosis. Materials and methods. Features of clinical symptoms of the initial stage of depressive disorders in the comparative aspect in the context of clinical pathomorphosis based on the analysis of medical records of 236 patients who were treated for depressive disorders in 1971-1995 (ICD-9 codes 296.1, 296.3) and clinical examination of 245 patients with depressive disorders in 2015-2019 (ICD-10 codes F 31.3, F 31.4, F 32.0, F 32.1, F 32.2, F 33.0, F 33.1, F 33.2) are considered. Results and discussion. It was established that there is a predominance in the clinical picture of modern depressive disorders of low mood (in general in 91.4% of patients, 91.6% of men and 91.3% of women, p>0.05), dyssomnia (93.1%, 92.5% and 93.5%, respectively, p>0.05), anxiety, fear (84.5%, 78.5%, 89.1%, respectively, p<0.01), asthenia (82.4%, 77.6% and 86.2%, respectively, p>0.05), somatic vegetative symptoms (82.9%, 77.6% and 87.0%, respectively, p<0.01), apathy (78.8%, 69.2% and 86.2%, respectively, p<0.01) and ideas of self-humiliation and self-blame (69.8%, 72.9% and 67.4%, respectively, p<0.01), and the relatively low prevalence of obsessive symptoms (55.1%, 54.2% and 55.8%, respectively, p<0.05), emotional lability (51.0%, 54.2% and 48.6%, respectively, p<0.01) and cognitive impairment (45.3%, 43.9% and 46.4%, respectively, p<0.05) with a predominance of emotional lability and ideas of self-humiliation and self-blame in men, and manifestations of anxiety, fear, apathy, cognitive impairment, obsessive and somatic vegetative symptoms in women, which gives grounds to consider that the main predictors of depressive disorder at the initial stage of low mood are dyssomnia, anxiety fear, asthenia and somatic vegetative symptoms. The revealed features suggest the presence of a clinical pathomorphosis of depressive disorders. The clinical pathomorphosis of the initial stage of depressive disorders is in a significant reduction in the clinical picture of low mood, ideas of self-abasement and self-blame, emotional lability and cognitive impairment, and an increase in anxiety, fear, asthenia, apathy, obsessive symptoms and obsessive-compulsive symptoms, with significantly greater gender differentiation of clinical symptoms of depression. Conclusion. The identified patterns are embedded in the general trend towards polymorphism and clinical undifferentiation of modern depressive disorders, significant involvement of patients with sleep disorders, asthenic, apathetic and somatic vegetative symptoms, which requires revision of diagnostic strategies and individualization of diagnosis. The identified patterns can be used for early diagnosis of depressive disorders and prevention of depression
Keywords: depressive disorders, pathomorphosis, clinical symptoms
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