Objectives. To identify the clinical and pathopsychological features of juvenile depression with attenuated schizophrenia spectrum symptoms, as well as their value for early differential diagnostic and nosological assessment. Materials and methods. The study group consisted of 20 patients of juvenile age (19.7 ± 3.7 years) with first depressive episodes with attenuated schizophrenia spectrum symptoms (ASSS) (ICD-10 F32.1, F32.2, F32.3), who were divided into two subgroups: subgroup 1 had attenuated positive symptoms (APS) (19.3%) and subgroup 2 had attenuated negative symptoms (ANS) (45.1%). The comparison group consisted of 11 patients (mean age 19.4 ± 2.9 years) with depression without ASSS (F32.1, F32.2). The psychometric scales HDRS, SOPS, and SANS were used, along with pathopsychological methods and the Adult Personality Traits Questionnaire (APTQ). Results and conclusions. There was no significant between-group difference in the severity of depressive disorder. Patients with depression with ASSS, as compared with the comparison group, showed higher total scores on the SOPS ( p = 0.006) and greater severity of negative disorders on the SANS ( p = 0.006). Distortion of the generalization process was found in 60.0% of cases, impairments to immediate memory were found in 30.0% of patients, and associations were non-constructive in nature in 10.0% of patients. Indirect data showing that patients of the control group had higher levels of emotional integrity were obtained. These differences suggest that the pathogenesis of depression with ASSS involves not only an afferent mechanism, but also the endogenous schizophrenic process, while ASSS itself may be a reflection of the early stage of schizophrenia or markers for the risk of developing it.