medjournalМедицинский журналMedical Journal1818-426XБелорусский государственный медицинский университет10.51922/1818-426X.2026.4.40medjournal-471Research ArticleОБЗОРЫREVIEWSПолные особенности психических расстройств у женщин: гормональные, психологические и биологические аспектыComprehensive characteristics of mental disorders in women: hormonal, psychological, and biological aspectsКопытовА. В.KapytauA. V.

Минск

Minsk

НеденьЛ. Ч.NedenL. Ch.

Минск

Minsk

ОбъедковВ. Г.ObedkovV. G.

Минск

Minsk

УО «Белорусский государственный медицинский университет»РоссияBelarusian State Medical UniversityRussian FederationМинистерство здравоохранения Республики БеларусьРоссияMinistry of Health of the Republic of BelarusRussian Federation202627102026044045Copyright © Копытов А.В., Недень Л.Ч., Объедков В.Г., 20262026Копытов А.В., Недень Л.Ч., Объедков В.Г.Kapytau A.V., Neden L.C., Obedkov V.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medjournal.ejournal.by/jour/article/view/471

В статье представлен систематический анализ полных особенностей психических расстройств у женщин. Рассматривается роль гормональных факторов (эстрогены, прогестерон, кортизол) в патогенезе аффективных, тревожных, пищевых и других расстройств. Описываются психологические особенности женского реагирования – руминации, созависимость, склонность к интернализации эмоций. Анализируются критические периоды женского репродуктивного цикла (предменструальный синдром, перинатальный период, менопауза), в которые риск манифестации или декомпенсации психических расстройств значительно возрастает. Обосновывается необходимость полно-ориентированных подходов в психиатрической практике.

The article presents a systematic analysis of the gender characteristics of mental disorders in women. The role of hormonal factors (estrogens, progesterone, cortisol) in the pathogenesis of affective, anxiety, eating and other disorders is considered. The psychological features of the female response are described – rumination, codependency, and a tendency to internalize emotions. The critical periods of the female reproductive cycle (premenstrual syndrome, perinatal period, menopause) are analyzed, in which the risk of manifestation or decompensation of mental disorders increases significantly. The necessity of gender-oriented approaches in psychiatric practice is substantiated.

полная психиатрияпсихические расстройства у женщингормональный статусдепрессиятревожные расстройствапослеродовая депрессияменопаузапищевые расстройстваПТСРполные различияgender psychiatrymental disorders in womenhormonal statusdepressionanxiety disorderspostpartum depressionmenopauseeating disordersPTSDgender differencesReferencesАнгст, Дж. Коморбидные расстройства у пациентов с большой депрессией: клиническое значение // Психиатрия и психофармакотерапия. – 2002. – Т. 4, № 5. – С. 180–185Angst Dzh. Komorbidnye rasstrojstva u pacientov s bol'shoj depressiej: klinicheskoe znachenie [Comorbid disorders in patients with major depression: clinical significance] // Psihiatriya i psihofarmakoterapiya. – 2002. – T. 4, № 5. – S. 180–185 [In Ryssian].Миронова, О. И., Резниченко С. И. Ролевые конфликты и психическое здоровье работающих женщин // Психологические исследования. – 2020. – Т. 13, № 70. – С. 7. – URL: http://psystudy.ru (дата обращения: 10.04.2025)Mironova O. I., Reznichenko S. I. Rolevye konflikty i psihicheskoe zdorov'e rabotayushchih zhenshchin [Role conflicts and the mental health of working women] // Psihologicheskie issledovaniya. – 2020. – Vol. 13, № 70. – S. 7. – URL: http://psystudy.ru (data obrashcheniya: 10.04.2025) [In Ryssian].Тювина, Н. А. Полные особенности психических заболеваний // Неврология, нейропсихиатрия, психосоматика. – 2017. – Т. 9, № 2. – С. 4–10Tyuvina N. A. Polnye osobennosti psihicheskih zabolevanij [Comprehensive characteristics of mental illnesses] // Nevrologiya, nejropsihiatriya, psihosomatika. – 2017. – Vol. 9, № 2. – S. 4–10 [In Ryssian].Aleman, A., Kahn R. S., Selten J. P. Sex differences in the risk of schizophrenia: evidence from meta-analysis // Archives of General Psychiatry. – 2003. – Vol. 60, № 6. – P. 565–571.Aleman, A., Kahn R. S., Selten J. P. Sex differences in the risk of schizophrenia: evidence from meta-analysis // Archives of General Psychiatry. – 2003. – Vol. 60, № 6. – P. 565–571.Angst, J., Gamma A., Gastpar M. et al. Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies // European Archives of Psychiatry and Clinical Neuroscience. – 2002. – Vol. 252, № 5. – P. 201–209.Angst, J., Gamma A., Gastpar M. et al. Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies // European Archives of Psychiatry and Clinical Neuroscience. – 2002. – Vol. 252, № 5. – P. 201–209.Bäckström, T., Bixo M., Johansson M. et al. Allopregnanolone and mood disorders // Progress in Neurobiology. – 2014. – Vol. 113. – P. 88–94.Bäckström, T., Bixo M., Johansson M. et al. Allopregnanolone and mood disorders // Progress in Neurobiology. – 2014. – Vol. 113. – P. 88–94.Bandelow, B., Michaelis S. Epidemiology of anxiety disorders in the 21st century // Dialogues in Clinical Neuroscience. – 2015. – Vol. 17, № 3. – P. 327–335.Bandelow, B., Michaelis S. Epidemiology of anxiety disorders in the 21st century // Dialogues in Clinical Neuroscience. – 2015. – Vol. 17, № 3. – P. 327–335.Bloch, M., Schmidt P. J., Danaceau M. et al. Effects of gonadal steroids in women with a history of postpartum depression // American Journal of Psychiatry. – 2000. – Vol. 157, № 6. – P. 924–930.Bloch, M., Schmidt P. J., Danaceau M. et al. Effects of gonadal steroids in women with a history of postpartum depression // American Journal of Psychiatry. – 2000. – Vol. 157, № 6. – P. 924–930.Breslau, N., Davis G. C., Andreski P. et al. Sex differences in posttraumatic stress disorder // Archives of General Psychiatry. – 1997. – Vol. 54, № 11. – P. 1044–1048.Breslau, N., Davis G. C., Andreski P. et al. Sex differences in posttraumatic stress disorder // Archives of General Psychiatry. – 1997. – Vol. 54, № 11. – P. 1044–1048.Brinton, R. D., Yao J., Yin F. et al. Perimenopause as a neurological transition state // Nature Reviews Endocrinology. – 2015. – Vol. 11, № 7. – P. 393–405.Brinton, R. D., Yao J., Yin F. et al. Perimenopause as a neurological transition state // Nature Reviews Endocrinology. – 2015. – Vol. 11, № 7. – P. 393–405.Cohen, L. S., Soares C. N., Vitonis A. F. et al. Risk for new onset of depression during the menopausal transition // Archives of General Psychiatry. – 2006. – Vol. 63, № 4. – P. 385–390.Cohen, L. S., Soares C. N., Vitonis A. F. et al. Risk for new onset of depression during the menopausal transition // Archives of General Psychiatry. – 2006. – Vol. 63, № 4. – P. 385–390.Cyranowski, J. M., Frank E., Young E. et al. Adolescent onset of the gender difference in lifetime rates of major depression // Archives of General Psychiatry. – 2000. – Vol. 57, № 1. – P. 21–27.Cyranowski, J. M., Frank E., Young E. et al. Adolescent onset of the gender difference in lifetime rates of major depression // Archives of General Psychiatry. – 2000. – Vol. 57, № 1. – P. 21–27.Epperson, C. N., Steiner M., Hartlage S. A. et al. Premenstrual dysphoric disorder: evidence for a new category for DSM-5 // American Journal of Psychiatry. – 2012. – Vol. 169, № 5. – P. 465–475.Epperson, C. N., Steiner M., Hartlage S. A. et al. Premenstrual dysphoric disorder: evidence for a new category for DSM-5 // American Journal of Psychiatry. – 2012. – Vol. 169, № 5. – P. 465–475.Fairburn, C. G., Cooper Z., Doll H. A. et al. Risk factors for anorexia nervosa: three integrated case-control comparisons // Archives of General Psychiatry. – 1999. – Vol. 56, № 5. – P. 468–476.Fairburn, C. G., Cooper Z., Doll H. A. et al. Risk factors for anorexia nervosa: three integrated case-control comparisons // Archives of General Psychiatry. – 1999. – Vol. 56, № 5. – P. 468–476.Gavin, N. I., Gaynes B. N., Lohr K. N. et al. Perinatal depression: a systematic review of prevalence and incidence // Obstetrics & Gynecology. – 2005. – Vol. 106, № 5. – P. 1071–1083.Gavin, N. I., Gaynes B. N., Lohr K. N. et al. Perinatal depression: a systematic review of prevalence and incidence // Obstetrics & Gynecology. – 2005. – Vol. 106, № 5. – P. 1071–1083.Genazzani, A. R., Pluchino N., Luisi S. et al. Estrogen, cognition and woman’s risk of Alzheimer’s disease // Human Reproduction Update. – 2007. – Vol. 13, № 2. – P. 175–187.Genazzani, A. R., Pluchino N., Luisi S. et al. Estrogen, cognition and woman’s risk of Alzheimer’s disease // Human Reproduction Update. – 2007. – Vol. 13, № 2. – P. 175–187.Grabe, S., Ward L. M., Hyde J. S. The role of the media in body image concerns among women: a meta-analysis of experimental and correlational studies // Psychological Bulletin. – 2008. – Vol. 134, № 3. – P. 460–476.Grabe, S., Ward L. M., Hyde J. S. The role of the media in body image concerns among women: a meta-analysis of experimental and correlational studies // Psychological Bulletin. – 2008. – Vol. 134, № 3. – P. 460–476.Grant, B. F., Chou S. P., Goldstein R. B. et al. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder // Journal of Clinical Psychiatry. – 2008. – Vol. 69, № 4. – P. 533–545.Grant, B. F., Chou S. P., Goldstein R. B. et al. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder // Journal of Clinical Psychiatry. – 2008. – Vol. 69, № 4. – P. 533–545.Greendale, G. A., Huang M. H., Wight R. G. et al. Effects of the menopause transition and hormone use on cognitive performance in midlife women // Neurology. – 2009. – Vol. 72, № 21. – P. 1850–1857.Greendale, G. A., Huang M. H., Wight R. G. et al. Effects of the menopause transition and hormone use on cognitive performance in midlife women // Neurology. – 2009. – Vol. 72, № 21. – P. 1850–1857.Häfner, H. Gender differences in schizophrenia // Psychoneuroendocrinology. – 2003. – Vol. 28, Suppl. 2. – P. 17–54.Häfner, H. Gender differences in schizophrenia // Psychoneuroendocrinology. – 2003. – Vol. 28, Suppl. 2. – P. 17–54.Halbreich, U., Kahn L. S. Atypical depression, somatic depression and anxious depression in women: are they genderpreferred phenotypes? // Journal of Affective Disorders. – 2007. – Vol. 102, № 1–3. – P. 245–258.Halbreich, U., Kahn L. S. Atypical depression, somatic depression and anxious depression in women: are they genderpreferred phenotypes? // Journal of Affective Disorders. – 2007. – Vol. 102, № 1–3. – P. 245–258.Hamann, S. Sex differences in the responses of the human amygdala // The Neuroscientist. – 2005. – Vol. 11, № 4. – P. 288–293.Hamann, S. Sex differences in the responses of the human amygdala // The Neuroscientist. – 2005. – Vol. 11, № 4. – P. 288–293.Hankin, B. L., Abramson L. Y. Development of gender differences in depression: an elaborated cognitive vulnerabilitytransactional stress theory // Psychological Bulletin. – 2001. – Vol. 127, № 6. – P. 773–796.Hankin, B. L., Abramson L. Y. Development of gender differences in depression: an elaborated cognitive vulnerabilitytransactional stress theory // Psychological Bulletin. – 2001. – Vol. 127, № 6. – P. 773–796.Henderson, V. W., Brinton R. D. Menopause and mitochondria: windows into estrogen effects on Alzheimer’s disease risk and therapy // Progress in Brain Research. – 2010. – Vol. 182. – P. 77–96.Henderson, V. W., Brinton R. D. Menopause and mitochondria: windows into estrogen effects on Alzheimer’s disease risk and therapy // Progress in Brain Research. – 2010. – Vol. 182. – P. 77–96.Hoek, H. W. Incidence, prevalence and mortality of anorexia nervosa and other eating disorders // Current Opinion in Psychiatry. – 2006. – Vol. 19, № 4. – P. 389–394.Hoek, H. W. Incidence, prevalence and mortality of anorexia nervosa and other eating disorders // Current Opinion in Psychiatry. – 2006. – Vol. 19, № 4. – P. 389–394.Hudson, J. I., Hiripi E., Pope H. G. et al. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication // Biological Psychiatry. – 2007. – Vol. 61, № 3. – P. 348–358.Hudson, J. I., Hiripi E., Pope H. G. et al. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication // Biological Psychiatry. – 2007. – Vol. 61, № 3. – P. 348–358.Judd, L. L., Kessler R. C., Paulus M. P. et al. Comorbidity as a fundamental feature of generalized anxiety disorders // Acta Psychiatrica Scandinavica. – 1998. – Vol. 98, Suppl. 393. – P. 6–11.Judd, L. L., Kessler R. C., Paulus M. P. et al. Comorbidity as a fundamental feature of generalized anxiety disorders // Acta Psychiatrica Scandinavica. – 1998. – Vol. 98, Suppl. 393. – P. 6–11.Kaye, W. H., Fudge J. L., Paulus M. New insights into symptoms and neurocircuit function of anorexia nervosa // Nature Reviews Neuroscience. – 2009. – Vol. 10, № 8. – P. 573–584.Kaye, W. H., Fudge J. L., Paulus M. New insights into symptoms and neurocircuit function of anorexia nervosa // Nature Reviews Neuroscience. – 2009. – Vol. 10, № 8. – P. 573–584.Kessler, R. C., Berglund P., Demler O. et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication // Archives of General Psychiatry. – 2005. – Vol. 62, № 6. – P. 593–602.Kessler, R. C., Berglund P., Demler O. et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication // Archives of General Psychiatry. – 2005. – Vol. 62, № 6. – P. 593–602.Kessler, R. C., Sonnega A., Bromet E. et al. Posttraumatic stress disorder in the National Comorbidity Survey // Archives of General Psychiatry. – 1995. – Vol. 52, № 12. – P. 1048–1060.Kessler, R. C., Sonnega A., Bromet E. et al. Posttraumatic stress disorder in the National Comorbidity Survey // Archives of General Psychiatry. – 1995. – Vol. 52, № 12. – P. 1048–1060.Kudielka, B. M., Kirschbaum C. Sex differences in HPA axis responses to stress: a review // Biological Psychology. – 2005. – Vol. 69, № 1. – P. 113–132.Kudielka, B. M., Kirschbaum C. Sex differences in HPA axis responses to stress: a review // Biological Psychology. – 2005. – Vol. 69, № 1. – P. 113–132.Leadbeater, B. J., Kuperminc G. P., Blatt S. J. et al. A multivariate model of gender differences in adolescents’ internalizing and externalizing problems // Developmental Psychology. – 1999. – Vol. 35, № 5. – P. 1268–1282.Leadbeater, B. J., Kuperminc G. P., Blatt S. J. et al. A multivariate model of gender differences in adolescents’ internalizing and externalizing problems // Developmental Psychology. – 1999. – Vol. 35, № 5. – P. 1268–1282.McEwen, B. S. Estrogen actions throughout the brain // Recent Progress in Hormone Research. – 2002. – Vol. 57. – P. 357–384.McEwen, B. S. Estrogen actions throughout the brain // Recent Progress in Hormone Research. – 2002. – Vol. 57. – P. 357–384.Milad, M. R., Pitman R. K., Ellis C. B. et al. Neurobiological basis of failure to recall extinction memory in posttraumatic stress disorder // Biological Psychiatry. – 2010. – Vol. 66, № 12. – P. 1075–1082.Milad, M. R., Pitman R. K., Ellis C. B. et al. Neurobiological basis of failure to recall extinction memory in posttraumatic stress disorder // Biological Psychiatry. – 2010. – Vol. 66, № 12. – P. 1075–1082.Murray, L., Arteche A., Fearon P. et al. Maternal postnatal depression and the development of depression in offspring up to 16 years of age // Journal of the American Academy of Child and Adolescent Psychiatry. – 2010. – Vol. 50, № 5. – P. 460–470.Murray, L., Arteche A., Fearon P. et al. Maternal postnatal depression and the development of depression in offspring up to 16 years of age // Journal of the American Academy of Child and Adolescent Psychiatry. – 2010. – Vol. 50, № 5. – P. 460–470.Nolen-Hoeksema, S., Wisco B. E., Lyubomirsky S. Rethinking rumination // Perspectives on Psychological Science. – 2008. – Vol. 3, № 5. – P. 400–424.Nolen-Hoeksema, S., Wisco B. E., Lyubomirsky S. Rethinking rumination // Perspectives on Psychological Science. – 2008. – Vol. 3, № 5. – P. 400–424.Pigott, T. A. Gender differences in the epidemiology and treatment of anxiety disorders // Journal of Clinical Psychiatry. – 1999. – Vol. 60, Suppl. 18. – P. 4–15.Pigott, T. A. Gender differences in the epidemiology and treatment of anxiety disorders // Journal of Clinical Psychiatry. – 1999. – Vol. 60, Suppl. 18. – P. 4–15.Sansone, R. A., Sansone L. A. Gender patterns in borderline personality disorder // Innovations in Clinical Neuroscience. – 2011. – Vol. 8, № 5. – P. 16–20.Sansone, R. A., Sansone L. A. Gender patterns in borderline personality disorder // Innovations in Clinical Neuroscience. – 2011. – Vol. 8, № 5. – P. 16–20.Seedat, S., Scott K. M., Angermeyer M. C. et al. Crossnational associations between gender and mental disorders in the WHO World Mental Health Surveys // Archives of General Psychiatry. – 2009. – Vol. 66, № 7. – P. 785–795.Seedat, S., Scott K. M., Angermeyer M. C. et al. Crossnational associations between gender and mental disorders in the WHO World Mental Health Surveys // Archives of General Psychiatry. – 2009. – Vol. 66, № 7. – P. 785–795.Seeman, M. V. Gender differences in the prescribing of antipsychotic drugs // American Journal of Psychiatry. – 2004. – Vol. 161, № 8. – P. 1324–1333.Seeman, M. V. Gender differences in the prescribing of antipsychotic drugs // American Journal of Psychiatry. – 2004. – Vol. 161, № 8. – P. 1324–1333.Sit, D., Rothschild A. J., Wisner K. L. A review of postpartum psychosis // Journal of Women’s Health. – 2006. – Vol. 15, № 4. – P. 352–368.Sit, D., Rothschild A. J., Wisner K. L. A review of postpartum psychosis // Journal of Women’s Health. – 2006. – Vol. 15, № 4. – P. 352–368.Soares, C. N. Depression during the menopausal transition: window of vulnerability or continuum of risk? // Menopause. – 2013. – Vol. 21, № 2. – P. 198–200.Soares, C. N. Depression during the menopausal transition: window of vulnerability or continuum of risk? // Menopause. – 2013. – Vol. 21, № 2. – P. 198–200.Stewart, D. E., Rondon M., Damiani G. et al. International psychosocial and systemic issues in women’s mental health // Archives of Women’s Mental Health. – 2004. – Vol. 6, № 1. – P. 13–17.Stewart, D. E., Rondon M., Damiani G. et al. International psychosocial and systemic issues in women’s mental health // Archives of Women’s Mental Health. – 2004. – Vol. 6, № 1. – P. 13–17.Sullivan, P. F. Mortality in anorexia nervosa // American Journal of Psychiatry. – 1995. – Vol. 152, № 7. – P. 1073–1074.Sullivan, P. F. Mortality in anorexia nervosa // American Journal of Psychiatry. – 1995. – Vol. 152, № 7. – P. 1073–1074.Suppes, T., Leverich G. S., Keck P. E. et al. The Stanley Foundation Bipolar Treatment Outcome Network. II. Demographics and illness characteristics of the first 261 patients // Journal of Affective Disorders. – 2005. – Vol. 67, № 1–3. – P. 45–59.Suppes, T., Leverich G. S., Keck P. E. et al. The Stanley Foundation Bipolar Treatment Outcome Network. II. Demographics and illness characteristics of the first 261 patients // Journal of Affective Disorders. – 2005. – Vol. 67, № 1–3. – P. 45–59.Tolin, D. F., Foa E. B. Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research // Psychological Bulletin. – 2006. – Vol. 132, № 6. – P. 959–992.Tolin, D. F., Foa E. B. Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research // Psychological Bulletin. – 2006. – Vol. 132, № 6. – P. 959–992.Turk, C. L., Heimberg R. G., Orsillo S. M. et al. An investigation of gender differences in social phobia // Journal of Anxiety Disorders. – 1998. – Vol. 12, № 3. – P. 209–223.Turk, C. L., Heimberg R. G., Orsillo S. M. et al. An investigation of gender differences in social phobia // Journal of Anxiety Disorders. – 1998. – Vol. 12, № 3. – P. 209–223.Viguera, A. C., Whitfield T., Baldessarini R. J. et al. Risk of recurrence in women with bipolar disorder during pregnancy // American Journal of Psychiatry. – 2007. – Vol. 164, № 12. – P. 1817–1824.Viguera, A. C., Whitfield T., Baldessarini R. J. et al. Risk of recurrence in women with bipolar disorder during pregnancy // American Journal of Psychiatry. – 2007. – Vol. 164, № 12. – P. 1817–1824.Widiger, T. A., Anderson K. G. Personality and depression in women // Journal of Affective Disorders. – 2003. – Vol. 74, № 1. – P. 59–66.Widiger, T. A., Anderson K. G. Personality and depression in women // Journal of Affective Disorders. – 2003. – Vol. 74, № 1. – P. 59–66.World Health Organization. Depression and Other Common Mental Disorders: Global Health Estimates. – Geneva: WHO, 2017. – 24 p.World Health Organization. Depression and Other Common Mental Disorders: Global Health Estimates. – Geneva: WHO, 2017. – 24 p.

The authors declare that there are no conflicts of interest present.