ПСИХИЧЕСКИЕ И КОМОРБИДНЫЕ ХРОНИЧЕСКИЕ СОМАТИЧЕСКИЕ БОЛЕЗНИ У ДЕТЕЙ И ПОДРОСТКОВ

Abstract

The need to analyze the phenomenon of a combination of diseases of various nature is dictated by its high prevalence and insufficient knowledge; it is known, that their comorbidity aggravates the course of the underlying disease, worsening its prognosis. Information about comorbidity is insufficiently systematized, materials about particular combinations of certain mental disorders with somatic ones prevail, there is clearly not enough information about the coexistence of mental and somato-neurological pathology recorded in children and adolescents. Objective: to study the prevalence and nosological distribution of chronic somatic, neurological, infectious comorbid diseases detected in children and adolescents suffering from mental disorders; analyze the social adaptation of these patients. Material and methods. We examined 602 patients, 410 boys (68%) and 192 (32%) girls, who were observed on an outpatient basis in one of the neuropsychiatric dispensaries in Moscow. The study included only cases of a combination of mental and chronic somatic, neurological, infectious and other diseases. To rank patients according to the level of social functioning in adolescence, the «Map of registration of social skills and abilities of adolescents with chronic mental disorders» was used. Research methods: clinical-psychopathological, statistical. Results. The most common comorbid pathology was orthopedic diseases, in the second place was the pathology of vision, in the third place was endocrine pathology, the fourth place was taken by neurological diseases, the fifth place was the pathology of the ENT organs. In combinations of mental and comorbid disorders, pathogenetic variants were observed: 1. comorbid diseases accompanied mental disorder; 2.comorbid and mental disorders were pathogenetically associated with each other, or occurred as a result of a single primary disorder or disease; 3. somatic diseases were mental complications; 4. The occurrence of somatic diseases was explained by the side effects of psychotropic therapy. The severity of social inadequacy depended both on the severity of mental pathology and on the severity and number of somatic diseases. A comorbid disorder can cause more significant difficulties in certain areas of life than the underlying disease. Conclusion. Comorbidity is a multicomponent negative phenomenon. To reduce the incidence of comorbid pathology and achieve its maximum compensation, a multidisciplinary approach is required.