Complex approach to early diagnostics of mental disorders in adolescents with somatic diseases

Abstract

Objective — to create a set of psychodiagnostic measures for premorbid detection of mental disorders of adolescents with somatic illness.Methods and subjects. Complex examination of 329 adolescent has been carried out. Clinical‑psychopathological, socio‑demographic, pathopsychological, follow‑up and statistical research methods were applied.Results. The studies found that almost half of those adolescent (155 people, 47.11 %) had psychosomatic complaints, as well as the presence of significant correlations between the influence of stress and the severity of complaints about the digestive system (r = 0, 83; p < 0.05), cardiovascular (r = 0.74; p < 0.05) and nervous system (r = 0.61; p < 0.05) disorders. Questionnaire «Thermometer» scale more often showed overestimated self‑esteem in adolescents with anxiety‑phobic syndrome, and underestimated — in depressive syndrome. The investigation of the level of depression revealed the highest level in adolescents who complained of several systems (60.71 %), as well as respiratory disorders (55.56 %) and gastrointestinal symptom complex (53.33 %). The analysis of school anxiety showed a high level of anxiety in the group with respiratory symptom complex (11.11 %), with a combination of several syndromes (7.14 %) and with neurotic symptom complex (6.82 %). Results of a studying of anxiety in adolescents by Ch. D. Spielberger questionnaire (modified by AD Andreeva) indicate that schoolchildren of older adolescence, including girls (46.59 ± 10.20 points), and orphans (35.56 ± 6.10 points) have the highest level of anxiety. According to this, psychological research at school, surveys of parents and teachers objectively form groups of maladapted adolescents, who are then recommended to have psychoprophylaxis of psychosomatic pathology. The stages of diagnostics of mental disorders in adolescents with somatic diseases have been substantiated and developed: 1) creening using clinical and psychological research to identify persons with a tendency to psychosomatic disorders, 2) randomization using clinical and psychological techniques to diagnose the clinical features of mental disorders in the risk group.Conclusions. Adolescents have symptoms of psychosomatic pathology, which are clinically manifested in the form of variable somatic signs — stomachache, pain in chest and joints; motor tension; heart failure; paresthesia in the absence of somatic pathology; demonstrative behavior, irritability, decreased physical and mental activity, feelings of anxiety, worry, difficulty concentrating, headaches and sleep disturbances. Clinical and psychopathological symptoms in adolescents with psychosomatic disorders were manifested with varying frequency depending on age and social origin and are represented by the following syndromes: convertible, anxiety‑phobic, depressed, anxiety‑dysphoric, somatized with mixed affect, asthenic with a significant difference for all cases (p < 0.05). Significantly (p < 0.05) higher frequency of psychopathological syndromes was found in the groups of middle and older adolescents, as well as adolescents from single‑parent families. Significantly (p < 0.001) depressive syndrome was more common in people with choleric temperament (56.25 %), asthenic — in sanguine (42.6 %) and choleric temperament (30.0 %), and anxiety‑phobic and conversion syndromes were defined evenly with all types of temperament. It was established that the risk factors of the formation of maladaptation (68.5 % of adolescents) are: depressive syndrome, emotional instability, asthenic syndrome. Personal characteristics of adolescents with psychosomatic disorders are characterized by a higher frequency of hypochondria — 38.71 %. At the same time, apathy, as a property of personality, regardless of the presence of psychosomatic disorders is not inherent in adolescents.