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2DIAGNOSIS OF DEPRESSIVE AND SUICIDAL SPECTRUM DISORDERS IN STUDENTS OF A SECONDARY SPECIAL EDUCATION INSTITUTION
1Rotanov Aleksei Nikolaevich, 2Karshiyev Ziyadulla Hazratovich, 3Sharapova Dilfuza
Nematillayevna, 3Shernazarov Farrukh
1Northwestern State Medical University I. I. Mechnikova, Russian Federation city of Saint-
Petersburg
2Assistant of the department of psychiatry, medical psychology and narcology, Samarkand State Medical University, Samarkand, Republic of Uzbekistan 3Samarkand State Medical University Clinical ordenator in the direction of psychiatry,
Samarkand, Republic of Uzbekistan 4608 group students of Samarkand State Medical University Faculty of Medicine https://doi.org/10.5281/zenodo.10206214
Abstract. Psychologists have called the 20th century the age of anxiety, and the recently begun 21st century has already been called the age of depression. It is known that people with depressive disorders are prone to suicidal behavior. The problem of suicide is the most relevant in modern society. A number of authors argue that depressive states are common in cohorts of all age categories. Some scientists say that the total number of people who encroach on their lives is dominated by university students, the same indicator is recorded in the group of students of technical schools and vocational schools.
Keywords: diagnostics, depression, suicide, student.
Introduction. Suicide is usually seen as a social stress barometer. The relationship of the adolescent's value system to suicidal behavior is currently not well understood. Adolescence is not the most controversial and harmonious in relation to other age stages of a person's life. It is difficult to overestimate its significance-it is during this period that an individual becomes a person [1-3]. Psychological studies of children and adolescents show that the factors that influence the formation of the child's psyche are contradictory: in one case they contribute, in the other they prevent the optimal development of the child's personality. It is difficult to underestimate the role of the family in the process of human socialization. A family that introduces the child to society, introduces him to the basics. The child, under the influence of a whole set of surrounding stimuli, perceives them and processes incoming information, forms his own point of view, views, attitude to the world. Relationships in the family, the attitude towards the child by parents, can form an effective consumer-motivational system of the child, a positive outlook on the world and on himself in this world [4-7].
The same factors, but with other psychological content, can lead to the defective development of needs and motives, a decrease in self-esteem, distrust of others, a lack of communication with peers [8].
During the period of nanotechnological discoveries and rapid scientific development, the Internet is an integral part of life. Almost every home has a computer or laptop installed, which makes it much easier to perform educational tasks [9].
The same will cause a number of problems for the child and his family. The internet space includes the pros and cons of children's development. When studying the problem, it was found that 75% of children engage independently on the internet and only 25% do so under parental supervision. Often, an unsupported teenager, not understood by loved ones, searches the internet [10]. There you can find a huge number of sites on which a whole algorithm of actions on how to get rid of life is posted. You will be given a ready-made recipe, and there is no adult friend nearby who will reach out to help at that time. Suicides do not have a multidimensional understanding of the situation, the desire to move away from the problem or train offenders comes first. 99% of children who plan to commit suicide are eager to listen, they want to say everything they collect. When such a person is not there in time, they leave the message. A teenager should be busy on the social networks of the Internet so as not to sit for a long time and uncontrollably. Parents should understand how the child reacts to this information, whether he is able to digest it sufficiently, know his circle of communication and interests. If after school he is engaged in useful work according to his interests and potential opportunities, for example, sports, artistic or musical creativity, technical creativity, it will take less time to sit for hours on the Internet or in front of the TV, which is harmful to his health [11-13].
However, excluding the Internet from the child's life is not the way to go. The child was born and raised in a society where today the ability to own the internet is necessary. Nowadays, it is difficult to imagine a modern school without an "electronic diary" and an "electronic homework". The Internet, of course, is a useful and necessary invention of mankind, but for the normal development of the child, it should not become his main entertainment, the child should love his real life and not be a slave to cyberspace [14]. The analysis showed that preventive work among minors on the internet is carried out in 21 of the 67 (31.3%) regions of our country.
According to experts, only by the age of 21 does the self-defense reflex form normally in a person. Until this age, the emotional sphere is still unstable, and tragedy occurs when many factors are combined at the same time. During acute experiences, it is very common when a teenager makes a plan of revenge against his abusers [15].
Waiting for revenge, the child does not understand that it will be irrevocable care, and he will no longer be happy to teach his criminals [16]. Most often, according to official statistics, young people are hanged, put life-threatening wounds on themselves or take a fatal dose of poison [17]. In recent years, the abandonment of apartment buildings has become a popular method. It should be borne in mind that 60% of all suicides occur in spring (exacerbation of mental disorders) and early summer (school exams) [18].
Psychological analysis of specific suicide cases shows that suicide is usually characterized by such individual psychological characteristics: weakness, infantilism, sharpness of experiences, predisposition to introspection, shyness, shyness, reflexivity, hypersensitivity, introspection, impulsivity, lack of conformity, predisposition to doubt, instability of the emotional sphere, insecurity, dependence on others, failure to adequately process conflicts in the interpersonal sphere, impressiveness, introversion, excitability, mood instability, predisposition to depressive disorders, insufficient self-esteem. All these characteristic features form a state of mind that is prone to suicide when there is a situation that injures the individual. A person is depressed: he experiences anguish, is in a state of depression, anxiety, fear or indifference, joylessness, boredom. He easily develops feelings of despair, guilt, shame and shame [19-21].
According to foreign authors, "statistically indeterminate" suicide attempts are unfinished and repeated, including "completed" suicide attempts are likely [22].
According to a number of authors, the formation of suicidal behavior is a multi-factor process [23]. At present, it is customary to distinguish several main factors: biological, psychological, clinical, social [24]. A large proportion of modern authors believe that suicidal tendencies are more characteristic of people suffering from certain mental disorders [25]. Personal characteristics of patients play an important role in the formation of suicidal behavior [26].
Many scientists have developed different models and concepts of suicide behavior: Medical, Biological, socio-cultural, personological, models stress-diathesis model, but the nature and mechanisms of development of this phenomenon continue to be sufficiently clear [27-30].
To successfully prevent suicide, it is necessary to identify risk factors relevant to the existing context and reduce their impact by performing appropriate interventions. The suicide movement is multifaceted [31].
There are many factors and causal mechanisms that cause a person to commit suicide and, accordingly, a wide range of suicide prevention methods. According to foreign colleagues, one cause or stress factor is usually not enough to explain the reasons for suicide. Often several risk factors act in parallel, which together increase an individual's vulnerability to suicidal behavior [32-37]. Suicide prevention goes beyond the competence of only psychiatrists and must be addressed by creating a system that combines measures of a medical, psychological, social, legal and pedagogical nature. It is necessary to identify and eliminate the conditions that cause the risk of suicide in a timely manner [38].
The purpose of the study: Assessment of the risk of depression and suicide in students of a secondary special education institution.
Materials and methods. The study involved 100 respondents - College of Medicine students who had not previously been observed by a psychiatrist and narcologist between the ages of 17 and 28: 9 (9%) men and 91 (91%) women. The median age in the study group was 19.8±1.7 years. Respondents were asked to complete a CES-D questionnaire to identify depression of 20 questions and an SR-45 suicide detection test of 45 questions.
In all cases, at least six months have passed after the stress that led to PTSD. PTSD violence is psychometrically defined as the Mississippi scale, civil variant (MS) - T. M. Keane and the traumatic event Impact Assessment Scale (SHOVTS or IES-R) - M. J. Horowitz. suicide ideas were identified by positive answers to the question of suicide in one of three Tests of psychometric diagnostics: PTSD (Mississippi scale, MS), depression (BDI)-A. Beck, psychopathological symptomatology (SCL-90 - R) - L. R. Derogatis et al and the next conversation.
All data is presented as arithmetic mean (M) and standard deviation (SD).
However, parametric and non - parametric criteria have been used to determine statistical differences between groups (T - Student, u-manna-Whitney). The second is in the case of data deviation from the normal distribution determined according to the kolmogorovasmirnov criterion. Statistical processing was carried out using the SPSS program (version 13).
Results and their discussion. Prior to this study, an assessment of some socio-demographic indicators was carried out. The study group was dominated by those born and living in the city - 43%, slightly less in rural areas-40% and only 17% in sparsely populated villages. In the total number of respondents, only 8% were married, while 92% were single or divorced. A large proportion of students-63%-lived in hostels and 21% lived in a parent family. 8% of
respondents had their own home. During the study, 8% of students were employed in rented housing conditions.
Among all those studied, the depressive state was weakly expressed in 84 students (84%), while the mild depressive state was found in 15(15%) and the average in 1(1%) students. Students have not been diagnosed with severe depressive disorder. Among respondents, only four to 4% according to the diagnostic criterion can be included in a group with a high susceptibility to suicide reactions, and 40 (40%) in a group with a low risk of suicide.
There are grounds for predicting the occurrence of suicidal reactions in the future, which can be manifested only against the background of long-term mental trauma and (or) reactive States, according to the respondents 40 (40%), 16 (16%) - the predisposition to autoagressive spectrum reactions does not differ in high resistance.
Based on the data obtained, the emergence of suicidal ideas in PTSD is associated with high emotionality and low activity, while not necessarily existing at the same time, i.e.there are two options for malfunctions associated with the emergence of suicidal ideas. The first is based on a high feeling that reflects a person's sensitivity and weakness. He Was the Son of P. K. it "works" according to the concept of functional systems of Anoxin, which forms the basis of the theoretical construction of Fdsi, is used in cases where the resulting result is not suitable for the purpose (of course it is not carried out). The second variant of malfunction is based on the low weight of activity parameters, reflecting the level of both objective and communicative energy-dynamic interaction of a person with the environment. A decrease in the index of communicative activity means that there is no need for isolation, communication, which makes it impossible to attract external resources to find a way out of PTSD. A decrease in the index of intellectual activity indicates that there are not enough intellectual resources to study psychotravma and find ways out of PTSD. It is more difficult to explain the connection between the emergence of suicidal ideation and low psychomotor activity. It can be assumed that the emergence of suicidal ideation is related to one of two general biological strategies for stress response, namely decreased activity ("imaginary death"). However, according to the literature, such a reaction occurs immediately after a stressful event, and there is no connection with the strategy of behavior for a long time. Obviously, at the current level of knowledge, it is possible to determine only the presence of such a connection.
Since there is a statistically significant difference in the severity of FDSI indices between groups with and without suicidal ideation, we can talk about the possibility of compensatory effect: the high severity of one of the parameters "erases" the lowness of the other, reducing the risk of suicidal ideation. The most severe situation is when there is simultaneously a high total Yoe sensitivity and a low total Yoa activity, which is determined by the index of total Yoad flexibility, that is, in people prone to melancholy.
In a group with suicidal ideation, we can talk about smoothing out temperamental differences related to gender. At the same time, guys become more like girls, that is, more feminine, because high violence disappears the difference in parameters inherent in men (that is, under androgenetic control): activity in two areas - psychomotor (erm ergicity) and intellectual (Pi plasticity, si speed, IIa activity index). One can speak of uniform temperamental sexual alignment with respect to psychomotor emotion, as high severity of emotion in all three areas is associated with female gender. According to Lee Ellis, there are 12 male behavioral programs that are under androgenetic control, that is, related to the effects of androgens on the brain during
certain sensitive periods (perinatal and puberty). These include: aggressive erotic behavior, as well as aggressive, territorial; orientation in space; pain tolerance, slow assimilation of conditioned defense reflexes; low emotion in response to threat; persistence in task without reinforcement; weak contact with close relatives; desire to create groups (clubs, garage, fishing); search for new, complex stimuli and adventures; "predatory behavior" associated with hunting. According to the data obtained, in the group of guys with suicidal ideas in PTSD, these programs are less defined or not at all.
Conclusions. The study carried out allows extrapolating these methods - characterized by Ease of Use and assessment of the results obtained - to a wide population of students in order to timely identify disorders of the affective sphere and prevent autoagressive behavior as a form of exit from various nervous situations that occur on the path of personality formation. Only a multidisciplinary approach in the structure of educational and pedagogical activities of modern educational institutions can significantly reduce and prevent the social damage caused by suicide attempts of students.
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