Riabokon N. Mixed anxiety-depressive disorders in children (clinical phenomenology, diagnosis, therapy)

In order to develop a comprehensive therapy program for children with mixed anxiety and depression, on the basis of the research of clinical psychopathological phenomenology, psychological, biological, social factors of their formation, 160 children 6 - 14 years of age with АDD were examined, control group - 100 practically healthy children of the same age. The frequency of АDD in different population of children's cohorts, the clinical phenomenology of АDD in the age aspect, the psychological component of АDD and the structure of the microsocial environment are determined. The role of social, biological, and psychological factors in the formation of the АDD is determined. The most important factors are: chronic conflicts in the family and in school, school boiling, excessive psycho-emotional load, pathological type of family system, low level of material support of the family, parenting, part-time family, parent's or other relatives in the military actions, burden of the perinatal period, psychopathology in the first year of life, frequent respiratory infections, the presence of somatic pathology. Children with АDD are the most frequently registered pathological types of families (divided, divided, rigorous, chaotic), which determines the vectority of psycho-educational, psycho-correction and psychotherapeutic assistance. A model of complex therapy for children with АDD was developed, which includes a diagnostic module (screening for early diagnosis of АDD at the primary level of medical care), a treatment and rehabilitation module (psychological correction, differentiated psychotherapeutic intervention, drug therapy) and a preventive module. The high effectiveness of the proposed therapeutic model was established: regression of anxiety and depressive symptoms, improvement of socio-cognitive functioning in 88.7% of children, fewer and fewer exacerbations of existing chronic somatic pathology were observed, which was confirmed by a decrease in the frequency of hospitalization in the somatic departments.