A SYSTEM APPROACH TO TREATMENT AND REHABILITATION CARE FOR PATIENTS IN AN OUTSTANDING CHILDREN AND ADOLESCENT PSYCHIATRIC NETWORK

Golovina A.G., Shmakova O.P.
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Abstract

Taking into account the modern understanding of the multifactorial nature of mental pathology, an integrated approach to helping these patients determines the need for psychosocial rehabilitation, in addition to clinical therapy. For child and adolescent psychiatry, the issue of structuring psychosocial rehabilitation seems particularly relevant (due to the severity of the outcomes of child and adolescent mental illnesses) and poorly studied. The purpose of this work was to analyze the results of practical activities on social rehabilitation of minor patients, with the formation of proposals for comprehensive support for these patients in the outpatient network. The study material was a cohort of 1203 patients (m. - 914 (76%), female - 289 (24%)) who initially applied to a psychoneurological clinic in childhood and adolescence. They were followed clinically and follow-up until adulthood (catamnesis was carried out upon reaching the age of 23-25 years (1095 patients - 91%)). Research methods: clinical-psychopathological, psychometric, clinical-follow-up, statistical. Results: Based on the results of the clinical follow-up study, it could be concluded that medical and social assistance to minor patients should be reformatted in the direction of more active identification of initial mental disorders; During the initial contact, it is necessary to build trusting relationships with relatives and the patients themselves, and engage in their psychoeducation. The issues discussed with relatives are similar to those that are subsequently discussed with teenagers. The topic is dealt with in an individually adapted manner for each interlocutor. Identification and discussion with parents of the most problematic areas of the child’s life should culminate in the development of rehabilitation programs to develop lost or undeveloped daily functioning skills. Conclusion: In general, achieving highly functional clinical and social remission in patients suffering from early mental disorders is a complex problem, the final solution of which is associated with future achievements in a number of areas of clinical and social sciences. At the present stage, it is necessary to apply a systematic approach and use the advanced achievements of modern clinical and social psychiatry.
在一个杰出的儿童和青少年精神科网络中为患者提供治疗和康复护理的系统方法
考虑到现代人对精神疾病多因素性质的理解,帮助这些病人的综合方法决定了除临床治疗外,还需要社会心理康复。对于儿童和青少年精神病学而言,社会心理康复的结构问题似乎尤为重要(因为儿童和青少年精神疾病的后果非常严重),但对这一问题的研究却很少。这项工作的目的是分析未成年患者社会康复实践活动的成果,为这些患者在门诊网络中获得全面支持提出建议。研究对象是最初在儿童和青少年时期到精神神经科诊所就诊的 1203 名患者(男 - 914 人(占 76%),女 - 289 人(占 24%))。对他们进行了临床跟踪和随访,直至成年(在 23-25 岁时进行了病理检查(1095 名患者 - 91%))。研究方法:临床心理病理学、心理测量学、临床随访、统计学。研究结果根据临床随访研究的结果,可以得出结论:对未成年患者的医疗和社会援助应朝着更积极地识别初始精神障碍的方向进行改革;在初始接触期间,有必要与亲属和患者本人建立信任关系,并参与他们的心理教育。与亲属讨论的问题与随后与青少年讨论的问题类似。针对每个对话者的不同情况,讨论的主题也各不相同。在与家长确定并讨论儿童生活中最有问题的领域后,应最终制定康复计划,以发展已丧失或未发展的日常生活技能。结论:总的来说,使早期精神障碍患者的临床和社会功能得到高度缓解是一个复杂的问题,其最终解决与未来在临床和社会科学的多个领域取得的成就息息相关。在现阶段,有必要采用系统的方法,利用现代临床和社会精神病学的先进成果。
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