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3ANALYSIS OF PSYCHOPATHOLOGICAL AND NEUROPHYSIOLOGICAL CHANGES OF CHILDREN WHO GREW UP ALONE Abdurazaqova Robiya Sheraliyevna
Assistant of the department of psychiatry, medical psychology and narcology, Samarkand State Medical University, Samarkand, Republic of Uzbekistan https://doi.org/10.5281/zenodo.8358775
Abstract. In this study, we conducted a clinical-epidemiological and psychometric examination of children left without parental care. We found out that they have a moderate level of anxiety, depressive state and character accentuation, demonstrativeness and hyperthymic types "drinking alcohol with harmful consequences".
Keywords: children left without parental care, anxiety, depression, demonstrativeness, hyperthymic type.
Аннотация. В данном исследовании мы провели клинико-эпидемиологическое и психометрическое обследование детей, оставшихся без попечения родителей. Выявлено, что у них отмечается умеренный уровень тревожности, депрессивное состояние и акцентуация характера, демонстративность и гипертимный тип «употребление алкоголя с вредными последствиями».
Ключевые слова: оставшиеся без попечения родителей, тревожность, депрессия, демонстративность, гипертимный тип.
Introduction. The subject of special attention in our country is the mental health of children and adolescents. A special category is represented by social orphans. Therefore, an in-depth assessment of mental health and further study of the features of bioelectric brain activity of children left without parental care are still relevant in the framework of studying the health of the child and adolescent population.
In the strategic directions of the state policy in the field of health and education, the topic of children's health remains a priority and especially important for the implementation of the model of sustainable development of our country. At the same time, a special and rather large socio-demographic group has long been formed in society - social orphans [1, 2]. mental disorder deviant behavior.
It is believed that this category of children is more vulnerable to mental disorders. The main psychopathological disorders of social orphans are depression, suicide, anxiety, aggressiveness, mental retardation, cognitive impairment and addictive disorders. There are also deviations in bioelectric activity in children's homes. It is shown that they have atypical functioning of neuronal networks - a decrease in the power of the main rhythm and an increase in slow-wave activity of the theta and delta ranges.
Numerous studies have proved that orphaned children have a disturbed psyche, behavioral abnormalities, lag in psychomotor and physical development, as well as worse indicators of somatic health compared to children living in families. In addition, the children of orphanages are characterized by a tendency to delinquency, alcoholism, anesthesia, a high level of impulsivity and aggressiveness [3-5].
In this regard, the study of the mental state, including the prevalence of narcological pathology among children left without parental care, is today one of the urgent and important tasks for modern society.
The purpose of the study: To evaluate the psychopathological and neurophysiological profile of children in the Centers for Helping children left without parental care.
Materials and methods. A survey of 15 Centers for helping children left without parental care was conducted, a total of 516 children were examined. The overwhelming majority of these were children left without parental care (persons under the age of 18, 44 who were left without the care of one or both parents due to the absence of parents or the deprivation of their parental rights). The following methods were used in this study: clinical-psychopathological, psychometric, neurophysiological and statistical. Psychometric diagnostics was carried out using standardized screening techniques: the Spielberger-Khanin questionnaire, M. Kovach, the Basadarki questionnaire, Leonhard-Shmishek questionnaire, the suicide risk questionnaire (modified by T.N. Razuvaeva) and the Raven test.
Out of 516 minors, an EEG study was conducted on 328 children from orphanages. The control group included 64 children who were brought up in their biological families. By gender and age, the comparison group did not differ from the group studied. EEG registration was carried out using a portable portable electroencephalograph recorder "Encephalan-EEG" (Russia) using 21 electrodes, with a discrediting frequency of 200 Hz. Spectral power indicators recorded from 19 standard leads were calculated. Spectral power (CM) was calculated for theta, alpha, alpha-1 (low frequency), alpha-2 (high frequency) and beta rhythms. The frequency-amplitude characteristics and topographic distribution of EEG rhythms were studied using spectral analysis of the EEG.
Statistical processing of the obtained data was carried out using the standard statistical software package "Statistica 10.0" and R-Studio version 4.1.1. using Pearson chi-square (x2).
Results and discussions. Of the 516 children examined, 39.4% (n=203) were girls and 60.6% (n=313) were boys aged 10 to 17 years (the average age was 13.6 ± 2.2 years). The overwhelming majority of pupils have a burdened inheritance due to alcoholism of one or both parents - 86.6% (n=447), respectively, these children were brought up in conditions of neglect, and their parents were deprived of parental rights due to an antisocial lifestyle (drunkenness, improper child care).
The analysis of the clinical examination of children showed a fairly high prevalence of mental pathology. So, 69,4% (n=358) of children have various mental disorders. Intellectual disorders are more often detected (57.3%): organic mild cognitive disorders (F06.7), mixed specific developmental disorders (DD) (F83), organic non-psychotic disorders due to mixed diseases (F06.82); there are also behavioral and emotional disorders (42,7%): socialized behavior disorder (F91.2), depressive behavior disorder (F92.0), anxiety behavior disorder (F92.8) and hyperkinetic disorder (F90.1).
When analyzing the psychopathological profile of children, the level of anxiety was assessed. Thus, situational anxiety was more often detected at the average level - 63,9% (n=330), low and high levels were detected in 19,4% (n=100) and 16,7% (n=86) of cases, respectively. Personal anxiety in most cases in children was of an average level - 57% (n=294), a low level was detected in only 14.2% (n=73), and a high level - in 28,8% (n=149), that is, almost every 3rd child of an orphanage has high personal anxiety. Comparative sex analysis showed statistically significant differences between boys and girls: for example, high-level personal anxiety was more often detected in girls - 37,4% (n=76) than in boys, whose indicator was 23.3% (n=73) (p = 0,001).
The determination of the level of depression showed that half (51,6%) of the pupils of the surveyed Centers have a depressive state from mild to severe: 32% (n=165) of children have mild depression, 6% (n=31) - moderate depression, and a pronounced depressive state was detected in 13.6% (n=70) children. It should be noted that there are also gender differences in the manifestation of a depressive state: pupils are more likely to have a depressive state - 18,7% (n=38) (p = 0,006) than boys - 10,2% (n=32).
In the study of suicidal risk, such a factor as "maximalism" (infantile maximalism of value attitudes, affective fixation on failures) was identified in the first place - 15,3% (n=79), in the second place - "social pessimism" (negative concept of the surrounding world, perception of the world as hostile, does not correspond to the ideas of normal or satisfactory for human relations with others) - 12,2% (n=63), and on the third - "breaking down cultural barriers" (search for cultural values and norms that justify suicidal behavior or even make it attractive to some extent) - 8,7% (n=45). The antisuicidal factor (a factor that removes the global suicidal risk) was manifested only in 26.7% (n=138) of pupils, that is, in the vast majority of cases (73.3%) of the examined children, the antisuicidal orientation is at an average or even low level.
When assessing the level of aggression using the Basadark technique, attention is drawn to the presence of high-level aggressiveness in 3,3% (n=17) children, average - in 12,6% (n=65) and low - in 84,1% (n=434). At the same time, hostility (resentment, suspicion) was detected at an average level in 20,5% (n=106).
Comparative sex analysis showed that boys are slightly more aggressive than girls (p = 0.04; p = 0.01), however, they do not differ from each other in terms of hostility.
When determining the type and severity of accentuated personality traits, it was revealed that every 3rd pupil - 37% (n=191) has one or another accentuation of character.
Most often, hyperthymic, labile, affectively exalted and excitable types of character accentuation are detected. At the same time, in boys, tendencies to accentuation were slightly more often detected - 56,5% (n=177; p=0,02), and in girls, character accentuation was significantly more common - 45,8% (n=93; p=0,001).
When assessing the level of intelligence using the Raven technique, the following data were obtained: the level of intelligence above average (IQ=100-110) was detected in 10,8% (n=56) children; average (IQ=90-100) - in 19.6% (n=101), below average (IQ=80-90) - in 35,5% (n=183), borderline (IQ=70-80) - in 24,4% (n=126) and a level below borderline (IQ=50-70) was detected in 9,7% (n=50) children.
During the spectral analysis, it was revealed that in social orphans, the alpha rhythm has a dominant focus in the parietal-central and anterior parts of the brain with a decrease in its activity in the temporal zones. The prevalence of alpha rhythm in the right hemisphere was also revealed. The average CM value for all cortical zones was 36,7 MV, which is less than the average CM of the alpha rhythm in the control group - 43,3 MV. A comparative analysis with children living in families revealed a statistically significant decrease in CM alpha rhythm in orphans in the parietal-central (72,4 ± 66,9 and 105 ± 78,6; p = 0,0009) and the posterior temporal regions of the predominantly right hemisphere of the brain (19,1 ± 1,2 and 30,6 ± 22,7; p = 0.0001). There were no significant differences in the spectral power of the low-frequency alpha1 rhythm in orphans relative to the control group.
However, as for the high-frequency alpha2 rhythm, there is a statistically significant difference in CM. Thus, in children of orphanages, the amplitude of the alpha2 rhythm is
significantly lower than CM relative to the control group in all cortical zones, especially in the central (10,1 ± 6,84 and 13,7 ± 8,12; p = 0,0006) and temporal regions (5,93 ± 6,03 and 9,81 ± 7,32; p = 0,0001). In the main structure of the EEG of orphaned children, the theta rhythm by the average percentage among other rhythms was 33,9% and this indicator is statistically higher than in the control group - 30,9% (p = 0,03). The average value of the CM rhythm in all cortical zones was 30.0 mv.
Theta rhythm is most pronounced in the frontal and central areas.
It should be noted that there are significant differences in the percentage of theta rhythm. Thus, by its percentage content, theta activity in children of orphanages is statistically more pronounced in the central cortical zones - C3 (where 1 is the control, 2 is the main group): 33,2% (1) and 36,6% (2) (p = 0,03); C4: 31,5% (1) and 36% (2) (p = 0,008); Pz: 23,7% (1) and 29% (2) (p = 0,001); in parietal areas - P3: 24,3% (1) and 28,8% (2) (p = 0,008); P4: 21,7% (1) and 25,9% (2) (p = 0,008) and in occipital cortical zones - O1: 17,1% (1) and 19,3% (2) (p = 0,04); O2: 17% (1) and 19,9% (2) (p = 0,01). Comparative statistical analysis also showed significant differences in beta activity between the groups. Thus, there is a statistically significant weakening of the CM beta rhythm in the parietal-central (23 ± 12.8 and 28.3 ± 13.9; p = 0.004) and temporal (9.37 ± 7.5 and 13.2 ± 7.67; p = 0.0004) cortical zones in orphans relative to the control group.
Conclusions. Thus, a comprehensive clinical psychopathological and neurophysiological analysis revealed various mental health disorders in the pupils of the examined Centers for helping children left without parental care. High rates of mental pathology (69,4%) were revealed mainly due to organic mild cognitive disorders, behavioral disorders and disorders of psychological development. Every 3rd child of the orphanage has high personal anxiety, every 2nd - a depressive state from mild to severe. At the same time, there are various suicide risk factors with a low antisuicidal factor. During the EEG study and spectral analysis, significant differences in EEG rhythms were revealed in orphans compared with children from families. Children left without parental care are characterized by a decrease in the power of the main alpha rhythm mainly in the rostral cortical zones, an increase in the specific weight of theta activity in the central zones, as well as a weakening of the power of the beta rhythm in the parietal-central and temporal regions. Such EEG signs may be an indicator of insufficient maturation of brain structures and dysfunction of neurotransmitter systems in orphaned children. In connection with the data obtained, early detection and correction of psychopathological signs and treatment of existing mental disorders in children left without parental care are of no small importance.
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