The full-scale armed aggression of the russian federation against Ukraine has triggered a massive mental health crisis. According to WHO projections, approximately 9.6 million Ukrainians may suffer from mental disorders, with anxiety-depressive disorders (ADD) being the most prevalent. The pathogenetic heterogeneity of ADD determines the low efficacy of unified pharmacotherapy and the necessity to transition to personalized psychiatry. The aim of this review is to theoretically substantiate a model of clinical-pathogenetic phenotypes of ADD in war-related distress and to define the therapeutic perspectives of a phenotype-oriented approach. Based on an analysis of current scientific data, five pathogenetic phenotypes are described as well as neuroinflammatory, oxidative-methylation, neurotrophic-dysregulatory, stress-dysregulatory and neuromediator-dysregulatory. For each phenotype, the leading neurobiological mechanisms, clinical profile, specific biomarkers, and differentiated therapeutic approaches are characterized. The advantages of the phenotype-oriented approach are substantiated: increased rate of therapeutic response, reduced time to remission, objective monitoring of treatment efficacy, risk stratification, and pharmacogenomic prediction. The proposed model provides a scientific basis for implementing personalized psychiatric care for the affected population of Ukraine.