Character psychopathy, personality psychopathy in children and adolescents, how to treat psychopathy

The mental health of each person is a very delicate matter, the slightest fluctuations of which can lead to a number of negative consequences for the subsequent full-fledged social life.

In the modern world, according to statistics, every fifth resident of a large city is a carrier of a certain type of mental disorder. This is caused by an overactive rhythm of life, chronic fatigue and frequent stressful situations. The danger is that some people may not be aware of their illness for many years, attributing everything to fatigue and workload. And only at the moment when a failure occurs, it becomes clear that the reasons lie much deeper and it is necessary to look for them with a qualified specialist. Treatment of mental disorders. Symptoms and signs

Today, medicine knows many mental illnesses, which differ in different types of manifestation. However, there is one connecting link between all disorders - this is a combination of abnormal thoughts, emotions and behavioral reactions aimed at the patient himself or at people around him.

The most common mental health disorders are:

• depression;
• schizophrenia;
• panic attacks;
• eating disorders (anorexia, bulimia);
• mental retardation;
• autism;
• bipolar affective disorder;
• psychoses.

The specialized clinic “Salvation” provides a wide range of services and high-quality treatment for mental disorders. The symptoms and signs of each individual disease have their own character, which is why a competent approach and properly selected support guarantee significant improvements in health in the shortest possible time. Therefore, if you find that the behavior of your relatives has changed, they forget the names of objects, dates, faces, you should not self-medicate. Such signs indicate mental disorders and require the experienced eye of a specialist.

Symptoms of mental disorder

Each mental illness begins with the appearance of various symptoms, which, as a rule, one at a time do not raise any special questions from others and it can be difficult to collect them all into a single picture. However, careful observation of a person over several days will allow us to draw conclusions for taking further measures.

Symptoms of mental disorders in most cases are closely related to a person’s depressed state, which prevents him from performing daily routine activities. These symptoms include:

• physical (sleep disturbance, both in the direction of insomnia and vice versa, constant loss of strength even after proper rest; headache, etc.);
• behavioral (abuse of pills, cigarettes and other substances in large quantities, inability to perform work);
• cognitive (inability to think clearly, memory problems);
• perceptual (obsessive thoughts);
• emotional (constant feelings of anxiety and sadness).

The presence of several symptoms immediately indicates a problem and the need for professional consultation with a psychologist or psychotherapist. Identifying the causes and the possibility of making a diagnosis in the early stages will help quickly get a person out of such an undesirable state.

Causes of mental disorders

Some deviations in mental health can be caused by absolutely understandable reasons, for example, damage to a certain area or the entire area of ​​the brain, traumatic brain injury, intoxication or problems with blood vessels. While depression, schizophrenia and a number of other diseases are not tied to a specific factor, and even with numerous studies, it has still not been possible to establish an unambiguous cause for the development of pathologies.

The causes of mental disorders are:

• internal (genetics; developmental disorders at a certain stage of pregnancy; developmental abnormalities at an early age; somatic diseases that affect the functioning of the brain; immunological disorders; hormonal imbalance, etc.);
• external (chronic stress; alcohol and drug intoxication; consequences of encephalitis or meningitis infections; traumatic brain injuries; exposure to radiation).

Most often, the causes of mental disorders are a combination of various factors when, for example, an organism weakened by infections finds itself in a highly stressful environment. The presence of each factor and its level of effect on a particular person must be assessed by an experienced specialist.

Most doctors approach mental health disorders as a multifactorial disease, since even if the main cause of the problem is known, related issues also play an important role and must be taken into account in the treatment process. These include:

• human living conditions;
• features of upbringing and traditions in the family;
• surrounding society;
• general health;
• work and family environment;
• originality.

Determinants of mental health

Adolescence is a critical period for the development and consolidation of social and emotional habits that are important for mental well-being. These include developing healthy sleep patterns; regular physical activity; development of skills in the areas of coping with difficult situations, problem solving and interpersonal communication; and developing the ability to exercise emotional self-control. Favorable conditions in the family, school and surrounding society as a whole are also important. Approximately 10–20% of adolescents worldwide have mental health conditions that are not adequately diagnosed or treated (1).

The state of a teenager's mental health is determined by a number of factors. The increase in the number of risk factors an adolescent is exposed to increases their potential consequences for his or her mental health. Factors that may increase stress levels during adolescence include the desire for greater independence, the desire to meet peer expectations, the search for sexual identity, and the increasing availability and use of technology. The influence of media and gender norms can exacerbate the discrepancy between the reality in which a teenager lives and his aspirations or ideas about the future. Other significant determinants of adolescent mental health are their quality of life in the family and their relationships with peers. Recognized mental health risks include violence (including harsh parenting and peer bullying) and socioeconomic problems. Children and adolescents are especially vulnerable to sexual violence, which undoubtedly leads to poor mental health.

Some adolescents are at increased risk of mental health problems due to living conditions, stigma, discrimination or social exclusion, or lack of access to quality care and services. This applies to adolescents living in contexts of humanitarian crises and instability; adolescents suffering from chronic illness, autism spectrum disorder, mental retardation or other neurological disorders; pregnant teenagers, teenagers who have become parents or entered into early and/or forced marriage; orphans; and adolescents from ethnic or sexual minorities or other discriminated against groups.

Adolescents with mental health problems are, in turn, particularly vulnerable to social isolation, discrimination, stigma (which limits their willingness to seek help), learning difficulties, risky behaviour, physical ill health and human rights violations.

Signs of mental disorder

The peculiarity of mental illness is that there are no conditions, ages, nationalities or races for them. Absolutely every person, especially in the current world of multitasking and constant stress, is susceptible to threat. You can recognize the signs of a mental disorder with some careful observation of the behavior of others and your own.

1. No matter how crazy you go. Everyone has fear - of newness, forgetfulness, a pressing deadline, natural disasters and other similar things. Constant thoughts around what a person is afraid of, together with a series of nervous situations at home or at work, can cause neurosis and panic attacks. And when mental health is shaky, psychosomatics can also get involved. In such a set it is difficult to find the root cause, and the neglected process can result in a more serious mental illness.
2. Absent-mindedness. Conditions of constantly tight deadlines have a strong impact on the nervous system. It’s simply physically impossible to do everything, and you become distracted and forgetful. The nervous system cannot cope with overstrain and fails. As a result, the development of a mental disorder.
3. Not good enough. Beauty standards, fashion canons, and high standards lead to the emergence of a whole complex of mental illnesses. This includes depression, eating disorders and psychosis. N
4. Addiction. In addition to addiction to various alcoholic and psychotropic substances, which cause many mental disorders, psychologists have found that workaholism can also lead to unwanted diseases. Constant immersion in work matters, sleep disturbances and emotional burnout are slowly and surely preparing another person who needs the help of a psychotherapist.

People with mental disorders

As already mentioned, every person is susceptible to mental illness to varying degrees. Unfortunately, a healthy lifestyle and careful treatment of the nervous system cannot always guarantee the effect of “vaccination” against such diseases. People with mental disorders are not always the ones you often see in films. Not everyone wears white straitjackets, hears voices and sees things that others don't. Most people suffering from mental disorders are ordinary passersby whom you can meet on the way to work, neighbors at the nearest table in a coffee shop, and even friends and family. However, there are also more serious forms of the disease.

Mental disorders in adults

Most mental health problems in adults arise and develop against the general background of dissatisfaction with life, as well as particular stressful situations that can be accompanied both in the family and at work.

Bipolar disorder has gained widespread popularity because the number of patients it reaches is frightening. The disease manifests itself through frequent uneven mood swings, when a person, from vigorous activity, is transferred to a period of complete powerlessness, with the inability to eat, move and continue a full life.

Another most common mental disorder in adults is depression. Despite the fact that psychologists have long been trumpeting the danger of this disease, modern society still does not pay due attention to it and subsequently specialists have to treat more advanced forms that the person himself is not able to cope with.

Schizophrenia. May arise from dissociative identity disorder or as a separate disorder. As a rule, the disease develops against a background of disharmony and a tense nervous state over a long period of time, but schizophrenia can also develop on a completely stable neurological basis.

Women, as a separate category, are more susceptible to mental disorders than men. The most common diseases include manic-depressive psychosis, eating and sexual behavior disorders, delirium and alcohol addiction, nervousness and panic attacks.

Behavioral disorders in childhood

Childhood behavioral disorders are the second leading cause of disease burden among adolescents aged 10–14 years and rank eleventh among adolescents aged 15–19 years. Childhood behavioral disorders include attention deficit hyperactivity disorder (characterized by problems concentrating, hyperactivity, and acting without considering consequences that are inappropriate at that age) and conduct disorders (characterized by symptoms of disruptive or challenging behavior). Behavioral disorders in childhood can negatively affect adolescents' learning and may be a cause of illegal behavior.

Mental disorders in children

As every child goes through certain stages of his life, he faces a lot of problems and challenges. Some people endure all the difficult periods, but there are also those who are not ready for such conditions. Mental disorders in children can begin under the pressure of various factors.

1. The formation process is often accompanied by the child’s rejection of himself and his own body. This causes various behavioral reactions, such as overeating or, conversely, refusing to eat. This eating disorder can lead to anorexia or bulimia.
2. Peer bullying. Once one person stands out, he becomes a target for others. School bullying causes nervousness, psychosis, and depression. Suicidal thoughts may appear.
3. Tense situation in the family. A very common cause of mental disorders in children is an unhealthy environment. If constant violence occurs in front of a child, then a mental disorder is guaranteed and can subsequently cause the development of schizophrenia. In an attempt to escape from reality, children invent a different life for themselves and stop this process, especially in an advanced stage. It can be extremely difficult.
4. Congenital mental disorders of children can be caused by genetic predisposition, as well as unacceptable behavior of parents at the time of bearing the baby.

Why do children and adolescents develop mental and behavioral disorders?

A child is a “blank slate” whose personality begins to form from the moment he is born. The baby gradually learns to recognize those around him, monitors their reactions and relationships, and copies his elders. He is highly influenced by adults and lacks critical thinking skills.

Many of the life attitudes that will guide him in adulthood are laid down in the “personal outline” precisely at this time. A nervous and negative environment at home, quarrels, violence and other negative factors can cause serious harm to a child’s psyche and greatly affect his behavior and health even during this period.

The child gradually grows and develops, exploring the world around him. At the age of 10, he enters a unique period - adolescence. A “hormonal explosion”, a change in social status and the attitudes of others, new problems and difficulties - all this knocks the usual kidney out from under the child’s feet. The personality continues to develop, but in many aspects it becomes more vulnerable and susceptible to external influence.

During this period, it is especially important to protect adolescents from risk factors and severe shocks that can interfere with further development, as well as create health and mental problems in the future.

15% of children and adolescents under the age of 18 have a diagnosed emotional disorder, and less than half receive the necessary treatment on time. In another 10-20% of children at this age, mental disorders are not properly diagnosed at all.

The problem is that many parents and teenagers themselves do not realize the risks and are afraid to seek help from a doctor. Many are afraid that others will find out about their visit to a psychiatrist, and this will put an end to the child’s further successful career or normal life.

But if left untreated during childhood and adolescence, mental illnesses can become so ingrained in the personality that they cannot be cured in adulthood. Most incurable mental illnesses are mental disorders that could have been managed during childhood and adolescence.

The specialists of the KORSAKOV clinic know how to successfully solve mental and behavioral problems of adolescents and children. Qualified doctors conduct a thorough examination, prescribe effective drug therapy and psychotherapy. Modern treatment methods help prevent the development of serious mental illnesses and get rid of existing disorders.

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Levels of mental impairment

When diagnosing mental health diseases, doctors identify levels of mental disorder, depending on which decisions are made on further treatment and stabilization.

The first level is neurotic, which represents the appearance of various phobias, fears and neuroses, which can be caused by illness or some external factors. Divided into several types:

• neurasthenia (this implies nervous exhaustion of the body, weakness, apathy and irritability);
• obsessive-compulsive disorder (accompanied by an obsessive state when a person thinks that he hears or sees something that is not actually there);
• hysterical neurosis (refers to conditionally desirable types of disorder and begins when a person may benefit from it, although he himself may not be aware of such a reaction of the body).

The first level of violations is characterized by the beginning and end of the process in approximately limited periods. Such disorders most often affect people who have such a predisposition. However, various mental traumas can also trigger neurosis.

The second level is called psychopathic and is a reflection of all human personality disorders. These are certain nuances in behavior, as well as character traits that are present with a person throughout his life.

And the last level of disorders is psychosis (psychotic). This stage of the disease is accompanied by the appearance of hallucinations and delusions. Various manias, catatonia and mental confusion may also occur.

Causes of psychosis in children

The cause of psychosis lies in the failure of the normal functions of neurons, when the nervous system begins to work “with errors,” which is manifested by the characteristic symptoms of mental disorders.

There can be many reasons why a child may develop a psychotic state. Among the most likely we highlight:

• Hereditary factor. Parents can pass on genes that are responsible for predisposition to the disease.
• Epilepsy.
• Oxygen starvation during pregnancy and childbirth.
• Mental trauma.
• Mental illnesses, for example, schizophrenia, bipolar disorder, etc.
• Use of illegal drugs or alcohol by a teenager and some others.

Treatment of mental disorders

Depending on what disorder the patient suffers from, completely different treatment methods may be needed. In addition, it is worth considering that the treatment of mental disorders in each individual case is deeply individual and requires a careful approach.

The early stages of most diseases are not accompanied by severe problems, so doctors do not recommend placement in clinics and the use of aggressive therapy. If a person is independently able to recognize the presence of a problem, then the treatment process is based on consultations with a psychologist and psychotherapist and work to identify the causes that gave rise to the disease.

Diagnosing mental disorders in a mild form allows you to get by with “little blood” and build recovery in such a way that the patient will recover in a short time and can easily restore his mental health.

Treatment of neurasthenia in adolescents

Asthenia, predominantly of psychogenic origin, is very common in childhood and adolescent practice. This condition is commonly called neurasthenia. A number of authors consider it impossible for asthenia to occur under the influence of only psychological or only biological factors. Thus, A. Kreindler (1963), speaking about the psychogenic nature of asthenia, recognizes the importance of cerebrogenic, somatogenic factors in the development of the disease [4]. On the other hand, the importance of psychotraumatic influences for the formation of cerebrogenic and somatogenic asthenia is emphasized. Somatic diseases can reduce the threshold of sensitivity to psychogenicity.

Severe manifestations of neurasthenia occur more often against the background of somatic weakness. Their manifestation is facilitated by the presence of long-term or constant conflicts in the family, and the wrong (very tough and demanding) type of child upbringing. The psychological genesis of neurasthenia lies in the contradiction between inflated self-esteem and great aspirations, on the one hand, and reality, on the other hand. In this regard, it is worth noting the intrapersonal conflict of the type “I want, but I can’t” or “I want, but I’m sick,” which underlies neurasthenia [5].

The goals of this study were to clarify the clinical picture of neurasthenia in adolescents with school maladaptation and to evaluate the effectiveness of the use of the drug Nooclerin (deanol aceglumate) in the treatment of this pathology. Nooclerin has cerebroprotective properties with a distinct nootropic, psychostimulating and psychoharmonizing effect in asthenic conditions and memory disorders of various origins.

Materials and research methods

Under our supervision were 64 teenagers aged 14–17 years, residents of St. Petersburg, who went to the doctor with complaints of fatigue and poor performance at school. Among them there were 30 (46.9%) boys and 32 (53.1%) girls. The diagnosis was made based on ICD-10 criteria. To objectify the severity of asthenic disorders and their dynamics during the treatment process, a subjective asthenia rating scale (MFI-20) with 5 subscales was used. The intensity of fatigue was assessed using a visual analogue scale (VAS) (10-point version).

The level of anxiety was assessed using the self-esteem test by Ch. D. Spielberger, processed by Yu. L. Khanin.

Vegetological examination was carried out using the questionnaire of A. M. Vein (1991). Headaches were diagnosed according to the criteria of the International Headache Society (IHS-1988). The intensity of cephalgia was assessed using a VAS (10-point version).

Electroencephalography (EEG) was recorded from 19 electrodes located on the surface of the head in accordance with the international 10–20 system, at rest with eyes closed and open (3 min each). To control eye movements, an electrooculogram was recorded. Absolute EEG power was calculated and compared between groups of subjects in the θ- (4–7 Hz), α1- (7–12 Hz), β1- (14–20 Hz), β2- (20–30 Hz) ranges.

In addition, a psychophysiological study was conducted using TOVA (the Test of Variables of Attention), a continuous activity test that allows assessing the state of attention and the level of impulsivity in relation to normative data for each age. The test is based on presenting to the subject in random order significant (requiring a response) and insignificant (not requiring a response) stimuli that appear on the computer screen in the form of geometric shapes. The results of the study made it possible to quantify the degree of inattention (errors in missing significant stimuli), the level of impulsivity (errors in responding to insignificant stimuli) and the speed of information processing (response time) and stability of responses (response time dispersion).

Adolescents from the study group took the drug Nooclerin at a dose of 2 g/day (1 tsp. 2 times/day - morning and afternoon) for 1 month. No other therapy was administered during this period. The effectiveness of therapy was analyzed in a control study conducted after 1 month. after completion of the course of treatment. The proportion of responders was determined by the number of patients whose initial indicators of general asthenia (MFI-20) decreased by more than a third.

The control group consisted of 64 practically healthy adolescents.

Research results

The clinical picture in patients from the study group was characterized by polymorphic clinical manifestations and severe asthenic symptoms (Table 1, Fig. 1). The greatest severity of asthenia was noted in the following subscales: “reduced activity”, “general asthenia”, “decreased motivation”. It should be noted that these complaints arose during the school day and did not go away after rest. Increased sensitivity to external stimuli and to sensations from internal organs was recorded, which was reflected in numerous somatic complaints. Actually asthenic phenomena (general weakness, fatigue, exhaustion, lethargy, daytime sleepiness) were combined with comorbid disorders. The quantitative assessment of asthenic disorders is reflected in the diagram (Fig. 1).

Thus, in 52 cases (81.3%) patients from the study group had bilateral diffuse headaches of a pressing, compressive nature. Cephalgia occurred mainly in the 2nd half of the day and did not intensify during daily physical activity. In accordance with the criteria of ICD-10 and IHS-2003, we defined such cephalgia as tension headache (TTH).

Depending on the frequency of headache attacks, 2 groups were divided: adolescents with a frequent (episodic) form of tension-type headache (CHTH) and adolescents with a chronic form of tension-type headache (CHTH).

CHFN was recorded in 30 cases (46.9% of the total number of patients). The frequency of headache attacks was 3–10 rubles/month. These attacks, as a rule, occurred against the background of traumatic circumstances and stress. CHF was diagnosed in 22 cases (34.4% of the total number of patients). Adolescents in this group experienced headaches from 4 to 7 times a week, more often on weekdays, after school. Provoking factors were overwork and prolonged mental stress. The average intensity of cephalgia is presented in Table 1.

According to the vegetological examination using the questionnaire method of A. M. Vein, the average score for adolescents from the study group was 19.5 ± 5.6 (with a norm of up to 15 points).

The average level of reactive anxiety was 43.6±7.5 points; the average level of personal anxiety is 39.2±7.9 points (according to normative data, an increased level of anxiety is stated when the indicators are more than 30 points).

The psychophysiological TOVA study showed that patients in the study group had increases in inattention, impulsivity, and reaction time compared with the corresponding indicators in the control group. Noteworthy was the significant increase in the number of errors and the increase in reaction time in the 2nd half of the test (Table 2).

The results of quantitative EEG indicated that the bioelectric activity of the brain in adolescents with neurasthenia was characterized by a significant decrease in the spectral power of the α rhythm in the occipital leads compared with the corresponding indicator in the control group (Table 3).

Evaluation of treatment results showed that the proportion of responders after a course of Nooclerin was 68.8% (44 patients). In conversations with adolescents and their parents, a decrease in fatigue, improvement in attention, and memory were noted from 2–3 weeks. taking the drug. The proportion of non-responders was 28.1% (9 patients). It should be noted that the absence of dynamics was recorded in patients with a very high level of anxiety. When assessing the patients' condition using MFI-20, a significant improvement in indicators was recorded on the scales of general asthenia, mental asthenia, and decreased activity (Fig. 1). No significant improvement was recorded on the motivation reduction scale. In addition, there was a decrease in headache intensity in 17 patients (32.7% of all patients with cephalgia). Improvement was obtained in 6 patients with PCTH and 11 patients with CHF. There was a trend towards a decrease in average pain intensity after treatment, especially in chronic headache. This indicator was 4.1±2.9 points. The results of a repeated vegetological examination showed a significant decrease in this indicator after a course of Nooclerin (Table 1).

Tolerability of therapy in the main group can generally be characterized as good. In 3 cases there were complaints of difficulty falling asleep. After 3–4 days, the sleep of these patients returned to normal on their own, without drug correction. No other side effects were noted.

A repeated psychophysiological study after the course revealed a statistically significant decrease in inattention, impulsivity and reaction time (Table 2). There was also no significant reduction in anxiety.

Data from an electroencephalographic study after a course of Nooclerin showed that significant clinical improvement was accompanied by a restructuring of the rhythmic structure of the EEG. A comparative analysis of the results of an electroencephalographic study showed that after completing the course of Nooclerin, a significant increase in the power of the α-rhythm in the occipital regions was recorded (Table 3).

Discussion

A feature of recent asthenic disorders is the undoubted increase in somatization, and one of the most common forms of somatization disorders is called hypertension [6]. The results of the vegetological examination showed that the average score in patients with neurasthenia indicated the presence of autonomic dysfunction and was significantly higher than in the group of healthy subjects. Psychophysiological research data indicate a decrease in the level of attention and reaction speed in adolescents with neurasthenia.

When analyzing the functional state of the nervous system, great importance is attached to the α-activity of the brain, which characterizes the state of relaxed wakefulness. Conducted studies show that adolescents with neurasthenia are characterized by lower values ​​of α-rhythm power in the occipital leads compared to healthy peers, which indicates a deterioration in the functional state of the brain.

The use of Nooclerin in the treatment of asthenic manifestations against the background of school maladaptation is characterized by high efficiency. After treatment, there was a significant decrease in fatigue and asthenia. The greatest improvement was obtained on the scales of general and mental asthenia. It should be noted that positive changes appeared quite quickly.

The results of repeated psychophysiological and neurophysiological studies after a course of Nooclerin confirm clinical data on a decrease in the degree of exhaustion and an improvement in the functional state of the brain after treatment. It is important that the use of Nooclerin is not accompanied by significant unwanted side effects and complications.

It should be noted that after completing the course of Nooclerin, there is a decrease in comorbid disorders such as vegetative-vascular dystonia and tension-type headache. A greater effect was achieved in the treatment of chronic hypertension. This observation can be explained by our previous studies, which showed that if CGTH is more combined with anxiety disorders, then CGTH is often found in children with asthenic disorders [7].

A limitation of this study is the lack of long-term follow-up.

Thus, the use of the drug Nooclerin in the treatment of asthenic disorders in adolescents is highly effective. Considering the lack of effect of Nooclerin on anxiety, it can be assumed that the effectiveness of its use in combination with non-benzodiazepine anxiolytics will increase.

Treatment of mental disorders in adults

Mental disorders for different age categories differ in many ways, so the right approach to recovery is also selected taking into account the differences. For example, treatment of mental disorders in adults is often accompanied by the use of a group of antidepressant drugs, which is completely unacceptable when treating children.

Each disorder, be it autism or initial neurosis, requires its own techniques.

1. Depression. Treatment methods should be selected based on the severity of the disease. Depression in the early stages can be cured using traditional methods, as well as through the processes of socialization, the introduction of an active lifestyle and periodic visits to a psychologist. If we talk about advanced cases, treatment includes constant observation by a psychotherapist, in-depth study of the causes of occurrence with a psychologist, hypnosis and drug intervention.
2. In the first stages of development, doctors suggest treating bipolar disorder by restoring sleep patterns and giving up all substances that have a psychotropic effect on the human body (alcohol, drugs, tobacco). There are also effective medications that help prevent relapses. They are designed to stabilize the mood, protecting a person from depressing thoughts. Psychosocial support plays an important role in the treatment of bipolar affective disorder.
3. Dementia is one of those types of mental illnesses that cannot be completely cured. Today, there are a large number of medications that are only undergoing clinical trials. Treatment methods for this disorder come down to an integrated approach and careful care of the person.
4. Schizophrenia and neuroses in modern medicine can also be treated with medications, regular visits to psychologists and human socialization programs. Thanks to the correct management of the healing process, people suffering from this type of disorder can lead a full, happy life.

Just 15-20 years ago, some child psychiatrists denied the possibility of depression in childhood, considering it solely a reaction of a maturing or mature personality (7, 8, 13, 15). In recent years, many works have appeared, based, however, mostly on single observations, describing depressive states in primary school, preschool and even infancy (9). But even if doubts about the existence of depression in children have disappeared, disagreements in views on their phenomenology, nosological affiliation, prognostic and differential diagnostic criteria have become even more acute. The prevalence of depressive syndrome in childhood remains completely unclear, which is explained, first of all, by the uniqueness of the clinical picture, “maskedness”, “atypia of symptoms, in comparison with depression in adults and adolescents. Hidden behind the facade of children's whims, behavioral disorders, academic failure and “school phobias,” childhood depression does not always come to the attention of a psychiatrist and is often diagnosed only retrospectively. Apparently, W. Spiel (17) is right in believing that depression in childhood occurs much more often than it is diagnosed, but it manifests itself in “other psychopathological images” and, projected onto one or another phase of the child’s development, takes on various “guises” " In early childhood, depression has a psychosomatic expression, manifesting itself in digestion and sleep disorders, breakdown of contacts, and developmental delays. In preschool age, depression is more characterized by attacks of fear, lability of affect and motor disorders, and in primary school age - by periodic decline in performance, dysphoria and a feeling of joylessness of existence.

Even with early recognition of childhood depression, the question of its nosology often cannot be resolved unambiguously. Van Krevelen (11) believes that the germs of endogenous psychosis often remain unrecognized in children, and serious life trials are needed for this predisposition to reveal itself. The occurrence of a depressive state in a child in connection with a conflict situation, according to the author, does not contradict its endogenous nature. If in an adult depression is filled with remorse, then in a child the content of depression relates to what “types a child’s existence, that is, the attitude towards parents.” In depression, a child discovers a feeling of abandonment; what the adult attributes to his own guilt, the child shifts to others.

Noting significant difficulties in distinguishing endogenous depression from reactive ones, V. and R. Kuhn (12) emphasize that the child is characterized not so much by self-blame as by dissatisfaction with the whole world, the behavior of parents, friends, and teachers. They also recognize the influence of a psychogenic factor on the occurrence or increased intensity of endogenous depression and at the same time rightly note that “healthy children are more resilient than we tend to assume; therefore, unfavorable environmental conditions especially affect unhealthy children.”

W. Spiel (16, 17) also believes that when a child is depressed, the boundary between vital melancholy and reactive concern remains unclear, since childhood is the phase of human development where patterns of behavior are developed and where the internal is controlled by the external.

As a result of statistical analysis, N. Remschmidt et al. (14) identified symptoms characteristic of endogenous depression in a child: anxiety, fear of death, obsessive states, overvalued overestimation of problems, phobias, hypochondriacal fears, fear of school and “vitality disorders” (sleep disturbances, headaches, feeling of pressure in the chest, heaviness in the body, loss of appetite, sweating, etc.).

According to most authors (2, 3, 12, 14, 16), the diagnosis of endogenous depression in childhood should be made with great caution; with short periods of observation, it is often unfounded and unconvincing and is confirmed only by the further course of the disease. Meanwhile, the role of correct diagnosis of depression in the early stages of its manifestation is undeniable. The need for early treatment and timely prevention of these conditions makes the development of criteria for diagnosing depression in a child an extremely urgent problem.

This work is devoted to clarifying the phenomenological features of endogenous depression in children and identifying its typological variants.

We observed 65 patients (37 girls and 28 boys), whose manifest depression arose before the age of 10 years. In total, the BUT of depressive states suffered by patients in infancy, preschool and primary school age was analyzed. In 8 patients, depression first appeared at the age of 1 to 2 years, in 20 - from 3 to 6 years, and in 37 - from 7 to 10 years. In 56 cases, the diagnosis of paroxysmal schizophrenia (recurrent or fur coat-like) was established, and in 9 patients with short follow-up periods, the diagnosis required differentiation between cyclothymia and low-progressive paroxysmal schizophrenia. In most cases (49 patients), observation was carried out in the hospital of the Moscow Children's Psychoneurological Hospital No. 6 and subsequently on an outpatient basis. 16 children were not hospitalized and were observed only on an outpatient basis. In our material, there are few depressive states of infancy: only two patients were observed by us during their stay in the Children's Home at the height of depression, for the remaining 6 patients the descriptions were compiled from the words of their parents and with the help of documentation from non-psychiatric medical institutions. Erased outpatient forms of childhood depression are also completely absent, which is explained by the conditions of patient selection - in an inpatient psychiatric hospital and at a consultation appointment at the Research Institute of Clinical Psychiatry of the All-Russian Scientific Center for Mental Health of the USSR Academy of Medical Sciences.

Depressive states in most children occurred with somatic complaints, so pronounced and massive that they sometimes determined the clinical picture, especially in the first weeks and months of the disease. Complaints about physical distress were noted in 47 (72%) children and were extremely varied (palpitations, dizziness, nausea, bulging eardrums, burning sensation and pain in the chest, headache, pain when urinating, pain in the abdomen, back, legs, arms , heart, etc.), essentially representing a somatoalgic syndrome. The most common complaints in preschool children were abdominal pain, and in primary school children - headache complaints. They, as a rule, were of the same type, described in few words, unambiguously and simply. Most often, conditions with massive somatovegetative and algic disorders were not constant, but were repeated in the form of defined attacks, accompanied by fear, motor restlessness and crying. In combination with lethargy, increased fatigue (“legs are tired, they don’t want to walk,” “arms, legs are heavy,” “it’s difficult to walk, I could barely drag my briefcase”), loss of appetite, significant loss of body weight, changes in the child’s appearance, they created a picture of a severe physical illness and at first were the subject of attention of pediatricians or surgeons. In two girls, 7 and 8 years old, the leading picture of the disease was lack of appetite with severe physical exhaustion; depressive disorders were not detected for many months, which was the reason for repeated examinations in somatic hospitals and subsequently for their treatment in children's psychiatric hospitals as patients with true anorexia nervosa. On the contrary, in 3 patients, against a background of depression, gluttony, indiscriminate eating, and excessive weight gain were noted. Cardinal signs for distinguishing somatized depression from a somatic illness can be changes in behavior, forms of response, a sharp and unexpected “change in character” of the child with passivity, indifference, isolation, tearfulness or, on the contrary, anger, aggressiveness, the presence of anxiety and especially fear, the absence of pathology with aspects of internal organs, as well as changes in well-being during the day, corresponding to the peculiar circadian pattern characteristic of endogenous depression in children.

The children never complained about being “sad.” They defined their mood differently, most often as “boredom”: “bored”, “sad”, “unbearable”, “want to cry”, “heavy heart”, “stone on the heart”, “dark wall”. Apparently, some of these sensations were equivalent to the affect of vital melancholy, although the correct verbal expression of the mood was almost always absent before the age of 10. Ideas of self-blame and self-deprecation were rarely revealed, were fragmentary, episodic and were expressed in naive statements: “I’m bad because I don’t like jelly and casserole”, “I don’t know how to ride a bike”, “I offend my mother”, “I torture my mother, and my father turned gray “,” “I’m the sickest, the worst, I’m ashamed with children,” “I’m dirty and I don’t know how to study.” More common, especially in children of primary school age with depression with impaired academic performance and fear of school, were sensitive ideas of attitude: patients believed that teachers did not like them for stupidity, peers despised them, did not want to be friends, sought to offend, laugh at their clumsiness, bad academic performance, inability to play, that they are uninteresting, unpleasant, even parents give preference to other children in the family. Cotard’s nihilistic delirium, described earlier in children (1, 4), in our observations was extremely rare - in 2 patients, unstable and rudimentary: “I don’t have a throat, but a bag with veins,” “all airways are closed,” “I don’t nose, but only the appearance of a nose.” Other delusional ideas (“alien parents,” fragmentary hypochondriacal delusions) that accompanied depressive syndrome in 5 patients were also unstable and fragmentary.

In 48 patients (66%), the predominant affect was anxiety and fear, which usually increased in the evening and at night. The affect of anxiety, like the affect of melancholy, in the child was difficult to verbally define. Vague, pointless anxiety, accompanied by general anxiety, was short-lived and quickly turned into concrete fear: being left alone, losing his mother, fear that his mother would not come to pick him up at kindergarten, that on the way from work she would get hit by a car or be killed by bandits. Along with fear, which manifested the transitivism characteristic of childhood, there was also fear for oneself, one’s health, life, and future (“I’ll grow up and suddenly become a bad person, a bandit, end up in prison”). Fear with severe motor restlessness and sleep disturbance was always accompanied by the paroxysmal states described above with somatoalgic disorders. Often fear acquired the character of enormity (“destruction of the world”, “end of the world”, “death of all people”, “atomic war”, “neutron war”). Fear of the future, future life and impending death (one's own and that of one's parents) also, as a rule, arose in the form of short-term episodes with tears, ideational excitement, and many questions about life, death, and the meaning of life.

In several cases, the fear of death was paradoxically combined with suicidal tendencies. Persistent suicidal statements were observed in 18 patients (28%). They were especially frequent at the time of raptoid states: screaming, sobbing, constantly moving, breaking free from the hands of their parents, children complained that they could no longer live like this, that living was “tired”, “boring”, “hard”, “unbearable”, “ I’m scared”, “I don’t want to”, they said that they would kill themselves, poison themselves, stab themselves, throw themselves out of a window, but more often they asked to kill them: “to give them a cure for life.” In preschool, some children tried to starve themselves to death; one boy tried to sit in a bath of cold water for a long time in order to catch a cold and die; For the same purpose, a 6-year-old girl breathed frosty air through the window, and then, hoping to suffocate, covered her head with a blanket. In total, suicide attempts occurred in 12 children. Most often they were of a “short circuit” nature, but in 5 patients they were not associated with provoking psychogenia, were thoughtful and were noted at the height of the depressive state.

Increased tearfulness and constant readiness to cry were present in depression in all children, and they were more pronounced the younger the child was. Increased sensitivity, pity were also noted (children cried over a broken flower, a cut down Christmas tree, a killed beetle), and a regressive animation of objects. The behavior of children often acquired a puerile connotation. They did not let go of their mother, they asked to be picked up and rocked; infantile intonations appeared in their speech, imitating the pronunciation of their younger brothers and sisters. Meanwhile, the mood of the same patients often had a dysphoric tint: the children looked not so much sad as gloomy and gloomy; they were irritable, angry, dissatisfied with themselves and those around them, grumpy, expressed a lot of claims and reproaches, and sometimes even became angry and aggressive. A shade of mood of the Unlust type was noted in 34 patients (52%), but it never appeared in isolation, but was combined with somatic complaints, anxiety, fear, suicidal tendencies, and depressive ideational disorders.

One of the most pressing topics discussed in the pediatric-psychiatric literature is the issue of maladaptation associated with depression in children of primary school age. Due to the severity of somatic complaints and ideation disorders in childhood depression, academic failure, refusal to attend school, and fear of school are often regarded as the result of a somatic illness, true oligophrenia, or are derived from a conflict situation. At the same time, according to many authors (5, 6, 11, 14, 17, 19), intellectual failure and so-called pseudo-retardance are not only extremely common, but also the earliest signs of childhood depression.

In the analyzed material, school maladjustment was noted in 57 patients (88%) with manifest or repeated depressive attacks. Ideational inhibition played a leading role in the decline in academic performance. As a rule, it arose gradually and gradually increased, manifesting itself in difficulties in comprehending and remembering educational material. Children spent more and more time preparing homework, did not understand what they read, recited the text many times at home, could not remember it at the blackboard the next day, could not solve simple problems, confused counting, and made mistakes in basic calculations. They began to complain that they did not understand the teacher's explanations, lessons were often taught throughout the day with the help and constant encouragement of their parents, or they stopped doing homework altogether. They cried a lot, wailing that all their efforts were in vain, that “there will still be a bad mark.” Indeed, at the blackboard they spoke slowly, had difficulty finding words, answered questions after a long pause or fell completely silent. They could not concentrate, became extremely absent-minded, forgot to prepare homework, forgot notebooks and textbooks at home, which also caused bad grades and comments. They complained about memory loss, stupidity: “my memory has deteriorated,” “I’ve become completely stupid,” “I don’t know how to study,” “I’m trying to understand and I don’t understand.” Particularly serious difficulties in learning arose with the addition of such thinking disorders as sperrungs, influxes of thoughts, a feeling of emptiness in the head (“the thought disappears”, “what I was thinking about, I don’t remember”, “thoughts creep into the head on their own”, “knock on the head - it empty"). Additional difficulties arose in connection with changes in the field of motor skills. Slowness and awkwardness previously unusual for a child appeared. Children took a long time to get dressed, often because of this they were late for school, could not run or play with their peers during breaks, and looked lethargic and clumsy during physical education lessons. The handwriting often changed, they wrote ugly, dirty, rewriting pages many times. In parallel with the awareness of their inadequacy, inability, the feeling of their alienness in the children's group and the development of sensitive ideas, the relationship became more and more pronounced; silence and isolation; the children became sad, boring, stayed away from the class, stopped taking part in public affairs, preferring loneliness, that is “depressive autism” was on the rise. The peculiarity of the circadian rhythm of affect with the lack of improvement in well-being and mood in the second half of the day completely deprived the child of the possibility of compensation.

Depressive states in children, and especially in younger schoolchildren, in most cases had a complex structure, representing a combination of endogenous and exogenous, true depressive symptoms, uniquely manifested and modified by age-related characteristics, and a personal defensive reaction that occurs in response to one’s own failure, the inability to - continue to assimilate and remain part of the children’s team and those social measures of influence with which, due to the lack of recognition of the painful condition, such children were approached. Such personal reactions include various neurosis-like disorders, including so-called “school phobias,” hysteriform states, conflict, and behavioral disorders. “School phobias”—fear of school, teachers, crowds of children, answers at the blackboard, tests—were often accompanied by stuttering, selective mutism, withdrawal, running away, and complete refusal to attend school. With dysphoric mood, especially in the presence of Unlust, a component characteristic of depression of primary school age, the psychopathic “mask” of depression was most pronounced.

Enuresis and encopresis, described as symptoms of childhood depression (10), were observed, as a rule, against the background of prolonged erased depressive states in preschool children (enuresis - in 33%, encopresis - less often - in 7% of cases). Other neurosis-like disorders (tics, stuttering, phobias), which often arose long before the onset of depressive symptoms, significantly intensified at the height of the condition.

Vegetosomatic crises, fear, equivalents of melancholy, hysterical reactions were always short-term (from 10-15 minutes to 1.5 hours), accompanied by motor restlessness and so-called “excessive crying” with an uncontrollable flow of tears. Dysphoria was usually just as unstable, appearing in response to a negative situation in the form of similar paroxysmal states lasting from 1 to 3 hours. The described paroxysmal states of various colors, raptus and actuation states occurred very often - in 48 patients (74%).

The described symptoms were very rarely stable and formed the picture of a solid, monomorphic, syndromic completed depressive attack. The vast majority of patients were characterized by diversity and variability of symptoms, saturation with a variety of disorders, fragmentary and syndromic incomplete, in combination presenting a complex and mosaic clinical picture. This circumstance largely made it difficult to determine the typological affiliation of childhood depression. Nevertheless, depending on the prevailing symptoms, it was possible to identify the following variants of depressive syndrome in children: 1) somatized depression (23%); 2) Unlust - depression (20%); 3) depression with fear (19%); 4) anxiety-agitated depression (16%); 5) depressive “pseudo-retard” (12%); 6) sluggish dynamic depression (10%).

Moreover, these variants of depressive syndrome had a certain age preference. Sluggish depression predominated in young children (up to 3 years). On the contrary, somatized depression and depressive “pseudo-mortality” arose only in children of primary school age, mainly from 7 to 10 years old; the earliest age at which depression of this type manifested itself was 6 years. Anxiety-agitated depression, depression with fear and Unlust depression were observed over a wider age range - from infancy to school age. In case of repeated depressive states observed in 30 patients, with age there was a tendency towards their modification from tearful, flaccid depression in young children to depression with fear and dysphoria in older preschool age and depressive “pseudo-mortality” and somatized depression in younger schoolchildren.

The predominance of one or another affect (boredom, sadness, fear, anxiety, dysphoria) and its intensity during the day were inconsistent and depended on both external circumstances and the time of day. The state of motor skills was also changeable, with alternation of inactivity and sudden motor agitation. Depressions with constant lethargy, silence or mutism, impaired contact with others, and lack of motivation were rare and, as already indicated, were observed mainly in early childhood. In most cases, a continuous “pulsation” was noted in the mood, well-being and state of motor skills, which definitely depended both on the situation and on the specific circadian rhythm characteristic of childhood depression. Unlike adolescents and adults, the circadian rhythm of affect in depressed children was smoother, there was no improvement in well-being and mood in the afternoon, “recovery by 5 o’clock in the evening.” The “correct” daily rhythm of affect was extremely rare - in only 4 children. In most cases, in the first half of the day, lethargy, weakness, slowness, ideational inhibition, and a feeling of boredom were predominant; during the day, due to the general increased fatigue of the child - fatigue, drowsiness, headaches; By the evening, motor restlessness, tearfulness, irritability, and anger increased. Outlined short-term hysterically and dysphorically colored episodes, somatoalgic crises and raptoid states were usually observed in the afternoon. Late in the evening and at night, anxiety and fear became prevalent, accompanied by sleep disturbances, illusions, and pareidolia, closely associated with affect and reflecting the main content of affective experiences. In a subjective assessment of their condition, even preschool children clearly noted a deterioration in their health in the evening and were afraid of the onset of darkness and the approach of night. The performance of children of primary school age fell sharply in the afternoon, which is definitely associated both with the increase in anxiety and restlessness in the evening, and with the increased fatigue of the depressed child. Thus, throughout the day, in children with depressive states, affect and physical state, changing forms of manifestation, remained negative.

Variability and susceptibility to external influences affected not only the nature of affective and movement disorders during the day, but also the entire depression as a whole. Short phase, described as one of the characteristic features of childhood depression (18), was extremely rare in our observations: the duration of depression from 3 to 13 days was observed in only 3 patients, and from 2 weeks to 1 month in two. In 17 cases (26%) the duration of depressive states was 1-3 months, in 18 cases (27%) - from 4 to 6 months, in 5 (8%) - 7-11 months. and in 20 patients (31%) - more than one year. At the same time, the intensity of depressive symptoms was variable and was associated with the external situation and the physical condition of the child. The undulating nature of depression was noted in 54 (83%) children. Against the background of long-term dull depression, short (from several days to 1 month) episodes of depressive disorders of a psychotic level were usually observed, associated, especially in the early stages of the disease, with severe somatic illnesses or psychotrauma.

The role of exogeny as a provoking factor was also very high in the occurrence of manifest endogenous depression (57 patients - 87%). Moreover, the most common and significant psychogenic disorder for children of primary preschool age (up to 4 years old) was separation from the mother, from the family (placement in a hospital, sanatorium, 24-hour kindergarten, nursery, orphanage, etc.), and for older children 5 years - long-term dysfunctional family situation (scandals, cruelty of parents, death of parents). Much less often (in only 3 observations) depression occurred immediately after acute psychotrauma - fright, sudden death of the mother. It was possible to establish a coincidence of manifest depression with a psychotraumatic factor in 49 patients (75%). In some patients, the provoking factor was a combination of psycho-somatogenesis. In 8 observations (12%), the manifest depressive state was preceded by acute somatic hazards (toxic flu, severe tonsillitis, childhood infections, acute appendicitis). In only 8 patients, overt depression was not associated with a provoking factor. With repeated depressive states, dependence on exogeny decreased by more than half.

Summarizing the described features of childhood endogenous depression, it seems possible to draw the following conclusions. Childhood depression is characterized by the prevalence of ideation disorders and somatic complaints, the predominance of the affect of anxiety and fear, the lack of verbalization of the affect of melancholy, increased tearfulness, the rarity and naivety of ideas of self-blame and self-humiliation, the severity of the dysphoric background of mood, a tendency to paroxysmal episodes of fear, dysphoria, motor restlessness, somatoalgic crises, the uniqueness of the daily rhythm of affect, as well as the combination of affective symptoms themselves with a personal defensive reaction. The reactive nature of the onset of childhood depression does not contradict its endogenous nature. Symptoms of childhood depression are characterized by undulation, variability and polymorphism.

The phenomenology of childhood depression is significantly different compared to adult depression and pubertal depression. Depression in a child is always “masked.” But it is precisely “camouflage” that is the most characteristic feature of childhood depression and is typical for it. Therefore, the use of the term “atypicality,” which is very common in modern psychiatry, is hardly legitimate in relation to childhood depression.

LITERATURE

1. Bashina V. M., Pivovarova G. N. Clinical features of depressive disorders in paroxysmal schizophrenia in children. Zhuri, neuropathologist. and psychiatrist., 1972, issue. 10, p. 1535-1540.

2. Vrono M. Sh. Some features of depressive states in children with schizophrenia. In the book: Scientific and practical conference on child psychoneurology. M., 1973, p. 28-29.

3. Lapides M. I. Clinical and psychopathological features of depressive states in children and adolescents. In the book: Questions of child psychiatry. M., 1940, p. 39-76.

4. Semenovskaya E.I. On the issue of the periodic course of schizophrenia in early childhood. Journal neuropathol. and psychiatrist., 1972, No. 10, p. 1541—1546.

5. Agras S. The relationship of school phobia to childhood depression.—Amer. J. Psychiat. 1959, 116, 533-536.

6. Annell A. - L. Depressive states in childhood and adolescence. - In: Depressive states in childhood and adolescence. - Stockholm, 1972, 11-15.

7. Asperger H. - In: Opitz H., Schmid F. (Hrsg.). Handbuch der Kinder - heilkunde. — Berlin, 1969.

8. Korboz R. Gibt es Geisteskrankheiten im Kindesalter? — Schweiz. med. Wschr., 1958, 88, 703.

9. Eggers Ch. Depressive Syndrome in Kindesalter. Fortschr. Med., 1977, 95, 16, 1082-1088.

10. Frommer E. Depressive illness in childhood.— In: Coppen A. a. Walk U. (Ed.). Recent Development in affective disorders., 1969, 117-136.

11. Krevelen Van, Arn D. Zyklothymien im Kindesalter.— J. Acta Paedopsychiatrica, 1972, 38, 7/8, 202-210.

12. Kuhn V., Kuhn R. Drug therapy for depression in children. Indications and methods. - In: Depressive states in childhood and adolescence. - Stockholm, 1972, 455-459.

13. Mah1er MS Sadness and grief in infancy and childhood.— The Psychoanalytic study of the child, 1961, 16, 332-351.

14. Remschmidt H., Brechter V., Mewe F. Zum Krankheitsver-lauf und zur Personlichkeitsstruktur von Kindern und Jugendlichen mit en-dogen-phobischen Psychosen und reaktive Depressionen.— Acta Paedopsychiatrica, 1973, 40, 1, 2-16.

15. Schulder. - Cit, Stu11e H. Psychosen des Kindesalters. - In: Handbuch der Kinderheilkunde. Bd. 8/1, Berlin, 1969, 908-937.

16. Spiel W. Depressive Zustandbilder im Kindes-und Jugendalter.—In: Melancholie in Forschung. Klinik und Bechandlung.—Stuttgart, 1969.

17. Spie1 W. Studien uber den Verlauf und Erscheinungsf ormen der kind-lichen und juvenillen manisch-depressiven Psychosen.—In: Depressive states in childhood and adolescence.—Stockholm, 1972, 517-524.

18. Stutte H. Epochale Wandlungen in Diagnostik und Verlauf endogen-depress ver Psychosen des Kindesalters—In: Depressive states in childhood and adolescence.—Stokholm, 1972, 29–34.

19. Torre M., Rovera GG Aspects de 1insuffisance scolaire dans les etats depressifs de la preadolescence.—Amer. J. Orthopsychiat, 1969, 36, 346-351.

SUMMARY

We studied 110 depressive attacks in 65 children of preschool and primary school age, patients with paroxysmal schizophrenia and cyclothymia. The conclusions are drawn that the main features of childhood depression are their “masked” nature with the prevalence of ideation disorders and somatic complaints, the predominance of the affect of anxiety and fear, increased tearfulness, the rarity and naivety of ideas of self-blame, a tendency to paroxysmal episodes of fear, dysphoria, motor anxiety, somatoalgic crises, variability of depressive symptoms and its susceptibility to the influence of the external environment, the uniqueness of the circadian rhythm of affect, as well as the reactive nature of the occurrence of depressive disorders. 6 variants of childhood depression have been identified.

Treatment of mental disorders in children

Most mental disorders in children are caused by adolescence and the stage of personality development. If symptoms indicating the development of deviations are detected, it is necessary to stabilize the atmosphere in the family as much as possible, spend more time with the child, talk about topics that concern him and support him in the first uncertain steps without criticism and intimidation. A visit to a psychologist and obtaining an expert point of view will also not be superfluous and will help you correctly plan the process of dealing with an unwanted illness.

Some diseases, such as schizophrenia, which appear already in adolescence, require mandatory drug intervention. However, many other disorders do not require the addition of medications to the treatment of mental disorders in children, therefore, the creation of harmonious relationships with oneself and society should be taken into the hands of parents or psychological professionals.

Teenage panic attacks: causes, manifestations

Adolescence - from 10 to 17 years. At this time, the body is actively growing, physiology and psyche are changing.

An important stage in a child’s life is puberty. Puberty changes everything - the body, appearance, perception of oneself, the world around us. Increased hormonal levels cause sudden mood swings. The child tries to seem like an adult, but is not ready to take responsibility. This contradiction is reflected in the state of the teenager. He worries, negativity accumulates, sudden outbursts of uncontrollable emotions appear. A teenager is overcome by a panic attack, the signs of which are:

• confusion of thoughts;
• incoherence of speech;
• motor restlessness;
• headache;
• difficulty breathing, feeling of lack of air;
• pressure surges;
• cardiopalmus;
• trembling, chills;
• increased sweating;
• nausea;
• difficulty swallowing;
• numbness of hands and feet;
• pale or red skin;
• dry mouth;
• frequent urge to urinate.

The number of symptoms and signs of a panic attack in adolescents is 2 or more. To these are added the fear of death, a feeling of fear, a feeling of cardiac arrest. The condition lasts 10-15 minutes, occurs once a week/month or several times a day. During the period between attacks, the child may feel normal or, conversely, his behavior changes, depression sets in, sleep is disturbed, and muscles hurt.

These signs cannot be ignored. Panic provokes a nervous breakdown, epilepsy, heart disease, and vascular disease. Particularly severe cases lead to suicide. According to official data from Rosstat, over the past year, more than a third of 2,000 suicides occurred among people aged 12-16 years. Parents do not understand their children, impose their opinions on them, exert emotional pressure on the child, do not want to delve into the situation, and do not try to help. In addition to this - workload at school, fatigue, communication problems. The child's psyche cannot cope with this on its own, which leads to disastrous results.

Organic mental disorders

Mental illnesses that occur when a particular area or entire area of ​​the brain is damaged, due to various factors, are called organic mental disorders. This type of disorder includes multiple diseases that can occur due to external influences on the brain (traumatic brain injury) or internal processes (dysfunction). The main syndrome of organic disorders is damage to short-term memory. In such cases, a person remembers only those events, emotions and information that just happened. When repeated attempts are made to remember what happened, even after a few minutes, complete amnesia sets in. Often people “remember” certain moments in their lives, but when checked, this information turns out to be fictitious. The process of treating organic mental disorders includes an integrated approach, which involves medications, work with relatives and caregivers, as well as psychotherapy and psychopharmacotherapy.