The study was conducted in a prospective design in the period 2018-2021. On the basis of the «Kryvyi Rih Multidisciplinary Hospital for the Provision of Psychiatric Care» (Kryvyi Rih, Ukraine), 154 persons born in 2003-2008, who were under the dispensary observation of an adolescent psychiatrist after reaching the age of 15, were examined. The primary contingent consisted of 108 (70.13%) boys and 46 (29.87%) girls, whose average age was 16.08 years. For objective reasons (change of permanent residence or refusal to continue participating in the study), 38 people were excluded at the second stage of the study. Thus, at the final stage of the study, 116 people with mild ID were examined. The contingent consisted of 74 (63.79%) men and 42 (36.21%) women.
Clinical-epidemiological, clinical-psychopathological, psychodiagnostic and statistical methods were used in the study.
The research was implemented in 2 stages.
At the first stage – when the child is first approached for psychiatric help, or when a diagnosis of mild ID is established, during reaching adulthood (17 years and 11 months).
At the second stage – catamnestic from 18 to 23 years old. The primary contingent consisted of 108 (70.13%) boys and 46 (29.87%) girls, whose average age was 16.08 years.
The scientific novelty of the obtained results is that for the first time the clinical-anamnestic features of the disease in persons with mild mental retardation ID of adolescence were established, in particular, two groups of risk factors for the occurrence of this disease were identified, which made it possible to determine the prognostic role of anamnestic factors in maintaining an adaptive level of life activity of this category of persons in adulthood; for the first time, the pathoplastic influence of socio-hygienic factors on the course of the disease in persons with mild ID of adolescence was determined, the impact of microsocial living conditions on the psycho-emotional state and level of adaptability of this category of persons was investigated, which made it possible to determine the most significant risk factors for the complicated course of the disease; for the first time, the influence of comorbid pathology on the course of the main disease in persons with mild ID of adolescence
was determined, the spectrum of the manifestation of different groups of comorbid pathology was investigated depending on its register, which made it possible to confirm the synergistic nature of the influence of concomitant neurological and somatic pathology on the development of psychopathological disorders in this category of patients; for the first time, the characteristics of the quality of life (QL) and social functioning (SF) in persons with mild ID of adolescence were determined, the influence of the family environment, living conditions and the level of intellectual preservation on the level of satisfaction with one's life and social adaptation was established, which allowed the development of a multi-level methodology for assessing the limitation of life activities persons with mild ID of adolescence and their rehabilitation program.
The practical significance of the obtained results lies in the fact that the nature of the mutual influence of comorbid somatic and neurological pathology and psychopathological disorders in persons with mild ID of adolescence has been established, which allows optimizing the rehabilitation process of the indicated contingent taking into account the spectrum of concomitant pathology; on the basis of the identified clinical-anamnestic and socio-hygienic factors, clinical and psychopathological characteristics, characteristics of the QL and SF of persons with mild ID of adolescence, a multi-level methodology for assessing the limitations of life activities of this category of persons has been developed, which significantly improves the process of diagnosing these conditions due to a more accurate definition level of adaptability and forms the basis for rehabilitation programs; developed 6 rehabilitation programs for persons with mild ID of adolescence, which, by selecting a congruent set of therapeutic measures depending on the level of life activity of the person, allows to improve the psycho-emotional state, educational, communicative and social-living skills, to increase the quality of life of persons with mild ID of adolescence.
