Mikhanovskaya N. Psychopatology in children of an early age with perinatal CNS damage: mechanisms of formation, clinical picture and correction

Українська версія

Thesis for the degree of Doctor of Science (DSc)

State registration number

0511U000498

Applicant for

Specialization

  • 14.01.16 - Психіатрія

01-06-2011

Specialized Academic Board

Д 64.566.01

State institution "Institute of Neurology, Psychiatry and Narcology, National Academy of Medical Sciences of Ukraine"

Essay

Cause and effect interrelationships between biological, socio-psychological and clinico-psychopathologic factors, which determine formation of psychopathologic disturbances at an early age, were established on the basis of systemic approach to estimating the results of integrated clinico-psychopathologic, clinico-anamnestic and psychodiagnostic methods of studying 475 children aged from 3 months to 5 years with perinatal CNS damage and their mothers. Pathogenetic mechanisms of psychopathologic disturbances formation were defined with consideration of specificity in dysregulative, emotional and behavioral features in children, and the character of child-mother relationships. Estimation of degree and severity of the disturbances was performed using the criteria of general clinical picture. On the basis of the data obtained there were singled out 3 clinical variants in the course of mental disorders: emotionally labile, anxious-apathetic, and emotionally-nondifferentiated. Specificity and severity of their manifestations were determined by complex impact of biological and sociopsychological factors, that is by severity of neurologic deficit and quality of the child-mother interaction. There were also singled out 4 variants of maternal behavior in interaction with children: manipulative-avoidance, anxious, depressive and mixed. There was shown the dependence of the singled out variants formation on emotional deviations of mothers, clinical variant of psychopathological disturbances, and on pronouncedness of neurologic deficiency in children. Basing on the early-age mental disorders international classification ("0-3 Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood") there was performed systematization of psychopathologic disturbances in children with consideration of clinical variants of their course, severity of perinatal brain damage, terms and quality of the major psychics organizers and motivation systems of mental development, somatic health status in children and types of attachment in mother-child diads. Based on the data obtained in psychodynamic approach there were substantiated, worked out and tested certain methods of medico-psychological interactive assistance model, which foresaw some steps, directed on the child, mother, and their interaction. Key words: children of an early age, psychopathologic disturbances, child-parent relationships, diagnosis, correction.

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