Abstract
Currently, there is a global trend towards an increase in the incidence of type 1 diabetes mellitus (DM 1) among children and adolescents. It is characterized by a lifelong progressive course, manifested by endocrine and somatic disorders, as well as neurological and mental complications. The risk of the development of emotional disorders, cognitive dysfunction, adjustment disorder is largely determined by the microsocial environment of a child with DM 1. Objective — to study role of family in the formation of the disorders inmental and psychological health of children and adolescents with severe DM 1. Materials and methods. Examinations involved 285 patients with DM 1(126 children and 159 adolescents). The investigation design included clinical and psychopathological method, pathopsychological method, sociopsychological interviewing of a child and his/her family, test “Family sociogram”, projective picture tests “Housetreeman”, “Me and my disease”, “Kinetic picture of the family”. Results. It has been established that the level of psychological health of family of a child with DM 1 corresponded to the normal indicator in 20 % of cases. The factors have been determined that destabilize psychological health of the family, typology of family relationships with a sick child and their role in the formation of persistent neuropsychiatric complications. The factors of the microsocial environment affecting the formation of sociopsychological maladjustment of a child with DM were determined. The following risk factors of the formation of mental and neurological disorders in DM 1 children have been identified: the age of endocrine disease (DM)onset less than 7 years, the disease duration ≥ 5 years, frequent fluctuations in of glycemialevel, unsatisfactory self-control of the disease, late diagnosis of early and late complications related to the central nervous system, insufficient compliance, pathological types of family sociogram. An alternative method for diagnosing psychological problems in children and adolescents with diabetes the use of projective methods has shown a high information content of target detection for the correction of emotional and behavioral disorders in the conditions of system «Life with diabetes».Conclusions. Socio-psychological patterns of maladaptation of children and adolescents with type 1 diabetes mellitushave been identified, which is important for determining the strategy of therapeutic intervention, socio-psychological support and prevention of social handicap.
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