The nervous system plays a decisive role in the functioning of the human body and performs many functions. Even a minor disruption in her work can lead to the development of serious neurological diseases. The occurrence of such pathologies in children, unfortunately, is a fairly common phenomenon, and neuropathy is not the last among them.

Basic information about pathology

Childhood neuropathy is a congenital or acquired anomaly in the development of the central nervous system. The onset of childhood neuropathy is accompanied by symptoms such as:

• increased excitability;
• lack of appetite;
• upset digestion and sleep;
• frequent manifestations of various kinds of allergic reactions;
• in some cases, phenomena such as tics and stuttering may occur.

Neuropathy, depending on the number of affected nerves, is divided into:

• mononeuropathy - damage to one or more single nerves, which can develop in parallel or sequentially;
• polyneuropathy - the pathological process covers multiple nerve formations, in particular, spinal and cranial nerve trunks. The lesions develop at the same time.

To date, there are 4 levels of neuropsychic response (formulated by V.V. Kovalev):

A special place is occupied by auditory neuropathy (hearing impairment, in which there is a distorted transmission of sound to the brain). With this type of neuropathy, the child often has a delay in speech development.

Auditory neuropathy was recently identified, but it has already been established that one of the main causes of its occurrence in most cases is a genetic factor (heredity).

In order for the treatment to be prescribed in a timely manner, it is very important to know for what reasons this pathology may arise and how exactly it proceeds (what symptoms may be accompanied by).

Causes and symptoms

The main causes of pathology in a child are:

• infectious lesions (neuropathy, which occurs as a result of the pathological effects of infections on the body, including intrauterine ones);
• injuries received (neuropathy that occurs as a result of the injury);
• diabetes;
• compression-ischemic neuropathy (occurs as a result of compression of the nerve fiber in the area of ​​the bone canal).

The reason for the development of this pathology can also be an unfavorable (difficult or difficult) course of the mother's pregnancy, accompanied by such phenomena as:

• stress and depression;
• birth asphyxia;
• severe toxicosis;
• chronic diseases.

Symptoms of neuropathy depend on its type, age, causes of occurrence and other factors, but the general clinical picture is as follows:

Depending on the symptoms that arise, specialists also distinguish 2 main groups of patients:

1. Children with an unstable psyche, manifestations of increased excitability (nervousness) and affective outbursts, followed by severe fatigue.
2. Weakened children, which is manifested by a depressed state and hysterical attacks.

Neurological diseases cause many inconveniences for children and parents. Therefore, if such violations are observed, it is necessary to seek help from specialists.

Diagnostics and treatment

To identify neuropathy (making an accurate diagnosis), you will need a set of diagnostic measures:

Therapy regimen

The treatment tactics are determined by the attending physician. Most often, with neuropathy, therapy is carried out, which also includes a complex of medical and pedagogical actions. Drug treatment is carried out with the appointment of the following medications:

Physiotherapeutic measures are also useful for a child diagnosed with neuropathy: gymnastics, massage and water procedures (water baths, swimming, contrast showers and sub-aquatic massage).

Alternative treatments are rarely prescribed to treat neuropathy in children. But sometimes teas from a variety of medicinal herbs, which have a sedative effect, can be recommended for use. Can be applied:

• Linden;
• mint;
• motherwort;
• Melissa;
• St. John's wort;
• chamomile;
• oregano.

Alternative medicine should be used as directed and under the strict supervision of the attending physician, as it can not only fail to provide a therapeutic effect, but also harm (especially for the treatment of pediatric patients).

Normalization of the psychological state of a child with neuropathy plays an almost dominant role, therefore it is very important how parents will cope with the manifestations of this pathology. A few rules for parents:

• communicate with the child calmly and with restraint (do not go to the cry);
• do not jerk with constant reproaches, remarks and prohibitions (children with this neurological disorder are extremely impressionable);
• you should not constantly give in and indulge (tantrums are often just a way of manipulation);
• show love without going to extremes;
• do not reward the child with sweets (children with neuropathy often suffer from allergies and digestive disorders).

Prophylaxis

With timely treatment of neuropathy, the prognosis is favorable. In the absence of adequate treatment and the correct psychological impact on the child, later parents may face many problems: egocentrism, irascibility, hysteria, exorbitant exactingness, etc.

Preventive measures are:

If the baby has this pathology, parents should be patient, since the therapy of this disease is a rather long and exhausting process. It is important to understand that a child's capriciousness in this case is not a sign of spoiledness, but a serious health problem.

For neuropathy in children, hyperexcitability, excessively rapid exhaustion, impaired appetite and digestion, sleep disorders, the development of tics and stuttering, and the appearance of various allergic reactions are characteristic. Very often such similar symptoms are experienced by children with mental retardation or the so-called mental retardation. But comparing these 2 different diagnoses is unacceptable.

Today in medicine, the term neuropathy means a number of specific mental disorders that are inherent in early childhood. Neuropathic children are active, curious, overly emotional, and have a sharp mood swings. It is very difficult for them to calm down and control themselves.

Hearing the diagnosis - neuropathy or congenital childhood nervousness, parents have many questions, the answers to which we will try to give in this article.

The main causes of the disease

According to doctors, one of the main reasons for the development of such an ailment is an unfavorable course of pregnancy:

• stress;
• some chronic diseases;
• excessive toxicosis;
• birth asphyxia.

In the first months of your baby's life, you should very carefully monitor the course of diseases, how the baby carries them (dyspeptic disorders, infections).

The child is actively developing, and the nervous system is under enormous stress. Mild organic damage to some areas of the brain may occur.

Injuries, infections and even vitamin deficiencies can also be the cause.

Neuropathy in children: symptoms

• Congenital children's nervousness manifests itself most often from the first days of life. The baby is restless, does not sleep, reluctantly takes the breast, shudders at the slightest noise. Crying and screaming for no reason. In the future, frequent regurgitation, constipation or diarrhea are possible.
• After 2 years, it is very difficult for babies to concentrate on one thing, they are not assiduous, they quickly get tired.
• Signs of neuropathy can be headaches, asthmatic attacks, fainting, sudden fluctuations in blood pressure.

Symptom specialists distinguish two groups of patients:

1. Children have unstable emotions, increased excitability, affective outbursts, followed by severe fatigue.
2. Patients of the other group have increased exhaustion, depression, hysterical attacks. It is difficult for them to adapt to changes in life, they are not self-confident.

Subsequently, children's nervousness turns into other neuropsychiatric disorders.

Types and forms of the disease

Doctors identify the types of neuropathy:

• Peripheral. This type of disease is caused by a disorder of the peripheral nervous system. It affects the nerve endings that are located in the limbs of a person.
• Cranial. Causes disruptions in the work of one of the 12 pairs of cranial nerve endings. As a result, vision or hearing may be impaired.
• Autonomous. Affects the autonomic nervous system. She is responsible for the work of the heart, digestion and other important functions of the body.
• Local. This type of ailment can damage only one or a group of nerves in a specific area of ​​the body. Symptoms come on suddenly.

Possible complications and consequences

It very rarely happens that all neuropsychiatric disorders disappear by the age of 6-7 years.

But in most cases, the symptoms only worsen (there are vegetative-vascular disorders, disorders of the motor sphere, childhood neurosis develops) and a background is created for the formation of psychopathy.

At the age of two, hyperkinetic syndrome may already appear, that is, children become hyperactive, but not purposeful. Mental processes regress.

In the future, night fears and nightmares often occur, and breathing disorders periodically occur. There may be complaints of pain in the heart and abdomen.

Paroxysmal disorders appear as a complication. Patients suffer from emotional instability, fearfulness, enuresis and encopresis.

Diagnostic measures

In case of manifestation of several, even at first glance, unclear symptoms that may resemble neuropathy, you should immediately consult a doctor (pediatric neurologist).

After examining the child's appearance, you need to undergo a standard examination:

• a general blood test, which will determine the ESR (in other words, the rate of erythrocyte blood cell sedimentation);
• extended urine analysis;
• chest x-ray;
• measure plasma glucose after meals;
• do electrophoresis of whey proteins.

Depending on the results, doctors prescribe further examination tactics. Electromyography is performed, the speed of the patient's nerve impulse is measured and the nerve fiber is taken for biopsy.

How is the treatment carried out?

Treatment of neuropathy is carried out as a complex of medical and pedagogical actions. Measures are taken to control the symptoms of the disease and combat the root cause of the disease.

Medicines are prescribed only by a doctor. It can be:

• fortifying agents;
• and so-called sedatives.

A short course is prescribed a solution of sodium bromide 1% (200 mg) and caffeine-sodium benzoate 0.05 g, 1 teaspoon three times a day. Enemas with sodium sulfate are used in preschool age.

Under the supervision of a doctor, adolescents undergo treatment with mild tranquilizers. It can be Librium (from 10 to 30 mg per day), as well as Seduxen (from 5 to 20 mg), Aminazin (no more than 100 mg per day). But most often it is advised not to resort to medicines, especially at an early age.

• taking vitamins;
• water procedures;
• gymnastics;
• massage;
• and complete rest to allow nerve cells to recover.

Do I need rehabilitation after treatment

After treatment of the pathology of the nervous system, the child needs home rehabilitation. But parents should understand that severe damage to the nerve fiber in childhood, unfortunately, cannot be repaired.

When undergoing a rehabilitation course, it is very important that children pay special attention to physical exercises, become tempered, and often stay in the fresh air. You should definitely adhere to all the recommendations of the attending doctor unquestioningly. Consult a child psychologist, pediatrician.

Means and methods for the prevention of neuropathy

Prevention of neuropathy is, first of all, to ensure the normal conditions of pregnancy.

And after the birth of a child, pay special attention to balanced nutrition, educational and hygienic measures, rationally organize the child's employment and rest.

Parents' experience

As the statistics of the forums where the topic of neuropathy in children was discussed, parents still coped with the disorders in children.

It is known that in addition to drug treatment, they used other measures. They tried to surround the child with care and affection, performed therapeutic massages, enrolled children in the pool or took them to the sea.

Doctor advises

It is important to recognize the signs of neuropathy in a child in a timely manner and contact a medical center. Try to ensure that your child grows and develops in an atmosphere of love and calmness, adhere to a constant regimen and avoid high emotional / physical stress.

Video to the article

Children's nervousness is due to both biological and microsocial causes, but most often a combination of them. Biological causes- traumatic, infectious, toxic and other harmful effects during conception, during pregnancy, childbirth, in the first months or years of life, as well as adverse hereditary influences. TO microsocial reasons include the experiences of a pregnant or new mother, inappropriate parenting and unfavorable conditions for a child in childhood. Oftentimes, microsocial causes are so closely related to biological causes that they are difficult to separate.

The fate of a person to a large extent depends on a relatively short period from the moment of conception of a child to the first breath of a newborn. Pregnancy proceeds in different ways, depending on whether it is desirable, annoying, or, even worse, is perceived by a woman as a disaster and unacceptable for a man, a future father.

Here are several possible situations that contribute to an unfavorable course of pregnancy.

1. The woman is pregnant, she happily informed her husband about this, and he is categorically against the birth of a child. I decided: "I will wait for the child." But pregnancy was perceived in conflict, and a dark shadow of discontent had already fallen on her. Later, the father will fall in love with the child, will fall in love with the child and the paternal grandmother, who tormented her daughter-in-law during pregnancy with quarrels and reproaches. However, the evil has already happened - a neuropathic, difficult child is growing up in the family. Doubts and hesitations of a woman about the birth of an unborn child, her fears and concerns, discontent of her husband and mother-in-law, causing painful experiences of the pregnant woman, affect the condition and development of the fetus. There is an opinion that children who were born into a family where parents live in love and harmony are beautiful, self-confident and optimistic.

2. And here is another everyday situation. Love, declaration of desire to marry and initiation of sexual activity before marriage. But the wedding, happy and exciting, took place when the expectant mother was in her second month of pregnancy. Preparations, guests, three days of noisy fun. Congratulations, an abundance of impressions. The guests were smoking, a cloud of cigarette smoke enveloped the bride in a veil, she sipped a glass of champagne. Then a trip to the cities and the sea, new meetings, new congratulations. And at this time, the laying of the heart, nervous system and sensory organs of the fetus occurs. Emotional stress is accompanied by the release of anxiety hormones into the mother's blood, through the umbilical cord they enter the fetus, which is not indifferent to him. At the 5th month of intrauterine development, the fetus feels an increase in the heart rate in an agitated mother. He tenses when the mother is restless, relaxes when she is resting. At 6-7 months, the fetus reacts to a sharp change in the position of the mother's body, is calm, if the pregnant woman is not agitated. Therefore, if the expectant mother is a lot nervous, there is a risk of giving birth to a child with congenital nervousness - neuropathy. According to doctors' observations, 63.2% of mothers of neuropathic children had severe shocks during pregnancy.

The woman suffers from chronic tonsillitis, cholecystitis, she has dental caries, pyelonephritis. She had not frivolously prepared for the pregnancy, as the pregnancy "caught her off guard." To be treated now? But medications, pain and fear experienced during dental or ENT procedures are contraindicated in pregnancy. In the first months of pregnancy, you should not take medications without vital indications. Medicines can accumulate in the tissues and organs of the fetus, and the negative consequences of their exposure can affect after many years. Not to be treated? But it gets worse. As a result of intoxication at the focus of infection in a pregnant woman, the fetus is literally poisoned.

If a pregnant woman spends nine extremely important months in her life in a stuffy room, sleeps with a closed window, walks a little, then the fetus develops under conditions of oxygen starvation - hypoxia. As a result, the child may be born with less intellectual capabilities.

If the pregnancy was unfavorable and the child was born weak, not only the neonatal period - the first month of life, not only the first year of life will be complicated. Upbringing, character formation, personality in general will be complicated. A weak child is restless, has a poor appetite, and is slowly gaining weight. The doctor often visits the house where he lives. Parents are concerned about his health; he receives more attention than his brother or sister; he enjoys special privileges and somehow catches it. As a result, from the very first year of life, a difficult character is formed in the child. The child has already grown stronger, but remains too demanding. He wants to eat, but in the beginning to cheat, be capricious. Every trifle, a natural departure, he performs not just, but with a pretense. Parents are alarmed, but he has achieved what he wanted: he is again in the spotlight. He is only a year or two, but he is already selfish, hysterical.

Another of the most common causes of children's nervousness is suppression of the child's temperament. In the classical version, temperament is a manifestation of the pace of mental processes (Strelyau Ya., 1982). The properties of temperament can also be defined as an energetic characteristic of mental properties (Merlin V.S., 1973). Temperament is subject to age-related changes, primarily associated with the maturation process (Strelyau Y., 1982). The well-known point of view of I.P. Pavlov on the predominance of extreme types of temperament in neuroses (Pavlov I.P., 1938). According to V.N.Myasishchev, the state of anxiety and fear, anxious suspiciousness, resentment and explosiveness, realized depending on temperament, cause reactions of an emotive nature, turning into a state of neurosis when not understood by others (Myasishchev V.N., 1973). In the concept of V.I. Garbuzov, the main pathogenic contradiction in neuroses lies in the discrepancy between the environmental influence and the innate type of response - temperament (Garbuzov V.I., 1977). The latter is considered by V.I. Garbuzov in terms of choleric, sanguine and phlegmatic temperament. Melancholic temperament is combined with phlegmatic, since it is rare in childhood and is more likely a clinical variant than a normal variant. We also adhere to a similar opinion, since this also allows us to more evenly distribute temperament along the polar scale "choleric - sanguine - phlegmatic." As a leading criterion of temperament, we use the rate of occurrence of mental and motor reactions. Accordingly, a choleric person during an interview is defined as “quick, impetuous, speaks quickly, thinks, does”; phlegmatic - as "slow, unhurried, slowly speaks, thinks, does"; sanguine - as the average of two characteristics.

The characters arising from temperament are especially clearly manifested when overcoming extreme circumstances, when their carriers, acting in different ways, effectively solve a common problem. Parents, for one reason or another, “do not like” the child’s temperament, and they try to change it, “improve” it. This happens especially often when, for example, the impetuosity of a sanguine child irritates a phlegmatic mother, or, conversely, when the mother has a sanguine temperament, and the child is phlegmatic. In such cases, the choleric person wants to see docile, the sanguine person - calm and quiet, the phlegmatic person - mobile and quick.

Traditionally, microsocial causes of childhood nervousness or difficulty include unfavorable living conditions of the child. Speaking about the unfavorable conditions of a child's life, one should, first of all, bear in mind the rejection of his parents; the absence of a father in the family, especially when it is acutely experienced by the child; the father's abuse of alcohol, as a rule, accompanied by the father's conflicting behavior, quarrels in the family, the father's exclusion from the upbringing process; a chronic conflict situation in the family. Adults should remember that all this affects the child. His interests suffer the most, his upbringing is difficult and often irreversibly violated. The child experiences, he is morally depressed, neurotic, often withdraws into himself, behaves negatively. His temperament is completely suppressed, or some of his features are sharpened when others are suppressed, a difficult character is formed in him.

Paradoxical as it may seem, a difficult childhood and a child whom they love, if they are fixed on it, they live with it, enveloping it with attention, suffocating it with excessive solicitude. They are furiously jealous of other adults, not leaving him alone for a moment with himself. In such cases, the child does not grow up on time, or, on the contrary, grows up prematurely. This kind of love weighs on him. The child is not able to play the role of “the meaning of life”, “anchor” for an adult. Responsibility not due to age for another, closure on one person, narrowing of the child's communication world, the situation of “Siamese twins”, when the role of one of them is played by a mother or grandmother, often lead to neurosis.

Now let's look at the formation of ideas about what is “allowed” and what is “not”. “You can” and “you can't” arise as a reaction to “I want”. “I want” is an important issue. Perhaps, the process of upbringing is concentrated around the satisfaction or refusal to “want”. From "I want" the claims of a person grow. Temperament is aimed at achieving “I want”. “I want”, as well as “I do not want,” appears already up to a year. It is from “I want” that the problem of “not allowed” and “you can” is born, from “I don’t want” - the super problem “must”. From the ways of its resolution in the first year of life and up to 5 years, in many ways and most often it depends on what kind of person a person will become - socially prosperous or selfish, difficult. Here are the roots of nervousness - from its first manifestations to neurosis, psychosomatic states.

Another leading cause of childhood nervousness or difficulty is mental retardation of children. This reason is the most upsetting and hurtful discovery for parents, which gives them confusion and guilt. She brings nervousness into the family, sometimes discord and darkens the relationship both between the parents and between them and the child to the point of rejection of him with a decisive statement: “ We had all sorts of things in our family, but there were no fools”. Children, wanting to humiliate such a child as painfully as possible, call him, their peer a fool, or even write on the wall “ Kolya is a fool”. And there is nothing more offensive for our Kolya. A child with mental retardation becomes difficult and uncomfortable already in kindergarten. All children go to the right, and he goes to the left. For some reason, everyone is funny, but it is not clear to him why. Such a child is often offended by everyone. He does not understand the teacher, she - his. The incomprehensible seems to him dangerous or hostile. The child is disoriented, and therefore anxious, fearful, depressed. At school, he is also among the laggards. The teacher does not hide her annoyance, he interferes with her, and she involuntarily bursts out: "Clueless!" Children in elementary grades are friends with those whom the teacher appreciates and rejects those with whom she is unhappy. They despise him, and he also begins to despise himself. He closes in on himself. He is silent when it is necessary to answer, he is silent, even if he can answer, and this makes his situation even more complicated. The child is confused and seems stupider than he really is. If the mental retardation is not deep and lies in the fact that it is difficult for a child to comprehend the complex, abstract, theoretical, and in concrete, everyday, practical issues he orients himself like everyone else, then such a child feels his lack of understanding, worries, gets nervous, and he can a neurosis occurs. If the mental retardation is profound and the child overestimates his capabilities, believing that others are to blame for his failures, that they find fault with him, then he begins to protest, defiantly, defiantly defies adults, and proves his “rightness” to his peers with his fists. Girls in such cases are prone to hysterical reactions, and their protest can be expressed in an excessively early interest in intimate relationships. In the end, continuous sanctions, elaborations, bother these children, especially adolescents, cause them to have a hostile attitude towards school, and lead to difficult behavior. They are looking for understanding and self-affirmation in the street company, but even there mentally undeveloped children are used to “pull chestnuts out of the fire,” they fail and often get into trouble. As a result, they develop a neurosis, and as a rule, hysterical.

In the relationship between biological and microsocial causes of children's nervousness or difficulty, the presence of physical defect The child has. A physical defect is a delay in physical development, deviations in it, genetically unfavorable physical data. The child is physically weak, awkward, poorly coordinated, awkward, small in stature. Children offend such a child, do not take into the game. Which one is the goalkeeper, defender or striker if you smash him with your finger? Such a person cannot stand on his feet in the game. The teacher, the teacher is angry because he literally has to be led by the hand. In physical education lessons, he annoys the fact that in a group form of classes he requires individual care. The child perceives his unfavorable physical characteristics as inferiority. He is ashamed, offended and scared. He avoids going to physical education classes. The need to undress in front of everyone and appear in a funny way is excruciating for him. Even illness is a joy to him, because at least for a short time it relieves him of the ridicule of his peers, caused by the fact that he cannot, like them, jump, run, pull himself up on the bar. It is not difficult for everyone to offend him. As a result, the child himself begins to despise himself. Men who were the smallest and weakest at school know well what it is, and often remember those years with bitterness. If the child is fat, clumsy, then they laugh at him too, tease him, do not take into the game. In the end, he, being humiliated, begins to self-deprecate. An unfortunate situation, often leading to children's nervousness.

Defects in appearance are also found in children: they squint their eyes, the shape of the nose, ears or the face as a whole are clearly ugly, the hand, leg or neck, and the chest are disfigured. Such children, if not teased, are tacitly rejected by their peers, and a child with a defect in appearance realizes this early and suffers secretly. The most important thing for a person is infringed - a sense of dignity, the baby's need to be no worse than others. You cannot comfort a child with a statement like “they don’t drink water from the face”. This is perceived as an attempt to reconcile him with what is impossible to reconcile with. It is necessary to try to eliminate the defect in a timely manner, and if it cannot be eliminated, psychologically compensate.

Chronic illness is also perceived as a physical defect. Childhood is spent in hospitals, the child is bedridden for a long time, misses school, sadly looks out the window at those playing hockey and football. Children avoid the painful, tease and disrespect it. And he begins to relate to himself as well. Even an elderly person finds it difficult to get used to the role of the chronically ill; for a child this is completely unbearable. Childhood and chronic illness are incompatible concepts. Chronic illnesses are a common cause of children's nervousness or difficulties, a source of hard feelings. A physical defect darkens childhood, leads to its perception as joyless, difficult and, accordingly, refers to unfavorable living conditions. Wise and loving parents will never allow their child to be the last in anything. Every child has a certain talent, a zest, developing which parents will reconcile the child with his physical or other handicap, preserving his sense of dignity and joy of life.

Another common cause of childhood nervousness is divorces in families. The father leaves the family either on his own or displaced by his wife. In either case, his departure is, first of all, a tragedy for the children. Divorce does not happen immediately. Children feel disagreements in the family, the growing alienation of their parents. Neuroses often occurred in children 1-3 years before the parents divorced, and the mother, on reflection, agreed - the neurosis began from the time when tension was just beginning in the family. Divorce of parents for a child is a disaster, betrayal, humiliation. He does not understand his reasons, is childishly uncompromising and cannot forgive his father. Older children are ashamed of their father's departure, hide it from their peers, feel fear of the future, and experience a deterioration in life after a divorce. The duality of the situation - the condemnation of the father and the longing for him - neuroticizes the child. It is even worse if he believes that his mother is to blame for his father's departure. The departed father and paternal grandmother often just assure him of this. He now lives only with his mother. He would have to rally with her, but he is at odds with his mother, conflicts with her, and the trouble doubles. The child does not understand a lot, and therefore his experiences are even more difficult. Frustration with parents is fatal. How can he, after what happened, believe in everything else in life? And the child becomes nervous and difficult.

A child's nervousness or difficulty can be caused by the appearance of a stepfather in the family. No matter how carefully the mother treats the child's father, the baby is used to it, perceives this attitude as normal, and is not jealous. A child fights with his father for his mother if he has already been made overly selfish. But even then, the cause of the conflict is not in the father. He, then, fights for the mother against everyone and even against her work. But the child perceives the stepfather in conflict. Before his appearance, the child lived with his mother alone, and she completely belonged to him. And he compares the situation before the appearance of his stepfather with what has become now. And if a woman who has suffered from loneliness, having married, becomes less attentive to the child, believing that he will not go anywhere, and the second husband, like the first, can leave, then the child begins a struggle with his stepfather, who, as it were, took his mother away from him. ... This is a difficult struggle in which a child can only win if he is sick. And he falls ill with neurosis, often hysterical. Then the mother is faced with a difficult choice, but before choosing in favor of the child, she fights with him, and his neurotization intensifies.

Neurotic and neurosis-like disorders are found, as a rule, not in isolation, but in various combinations. Most often they manifest themselves in the form of stuttering, involuntary twitching of the eyelids, muscles of the face, neck, (tics, hyperkinesis), bedwetting (enuresis), sleep disturbances, etc. The fertile ground on which they arise is a weakened nervous system. Therefore, it is no coincidence that such children are usually lethargic, whiny, irritable, often with a lowered mood, poor appetite, and a tendency to fear. As a rule, their sleep is disturbed and it becomes superficial, anxious, accompanied by dreams that cause a feeling of fear and anxiety.

Children's nervousness is not a specific form of the disease, but a collective term to denote behavioral disorders in a child, manifested in increased irritability, tearfulness, disobedience, stubbornness, unmotivated mood swings, increased impressionability, and often bad sleep with frightening dreams. It can be caused by at least three sets of causes: somatic diseases (diseases of internal organs, foci of infection, frequent colds, etc.), current or past organic diseases of the brain, psychogenic factors (neuroses, neurotic reactions or neurotic states). In some cases (and quite often), increased excitability is noted in children from the first months of life. This condition is most often diagnosed by doctors as neuropathy, or early childhood nervousness. Practically the same meaning is put into the concepts of "congenital nervousness", "constitutional nervousness", "neuropathic constitution", "nervous diathesis". Outwardly, this manifests itself in restless behavior, rapid exhaustion and autonomic disorders: children often and outwardly cry, scream for no reason, suck poorly, and sometimes completely refuse to breast. After feeding, profuse regurgitation and vomiting often occur, which may become habitual over time. Often there are intestinal disorders in the form of bloating and constipation or, conversely, increased peristalsis (contractile movements) and diarrhea, but even with a thorough physical examination, changes in the gastrointestinal tract are usually not detected. Sleep disturbance is characteristic, especially at night. Children do not fall asleep for a long time, require special attention, in some cases they may not sleep all night. If a dream occurs, then it is very superficial with shuddering or periodic crying. Awakening comes from the slightest rustle. Parents fearfully await nightfall, caress the child, carry it in their arms, swing it, distract its attention in various ways and kind of appease it. Sometimes it seems that the child is hungry, and when he is worried, he is given a breast. But this only aggravates the increased excitability and negativism. The slightest unforeseen change in nursing habits and feeding conditions increases overall emotional and motor anxiety. Such children are especially sensitive to changes in meteorological conditions (room temperature, air humidity and AR -) -

While awake, children with neuropathy often suck on their fingers, bite their nails, and swing rhythmically from side to side. They have a difficult transition to chewing and eating solid food. They usually do not tolerate any changes in the external environment. The appearance of a new person, a new toy or picture can cause violent negative emotions.

According to the well-known child psychiatrist V.V. Kovalev, neuropathy is the most common syndrome of mental disorders at an early age. Its external manifestations in the case of proper upbringing and the necessary treatment gradually decrease and in most cases disappear by 2.5-3 years of age. However, even in preschool age (4-6
years), such children can sometimes remain irritability, increased affective excitability, rapid exhaustion. At the same time, unbridled behavior at home is often combined with fearfulness, isolation and fears in an unfamiliar environment, unwillingness to be in a children's team. The child usually gets used to the mother, tries not to let her go a step away from him.

There are various reasons for early childhood nervousness. Significant importance is attached to hereditary factors. It has been found that in 70-80% of cases, one or both parents of such children are excitable. Abnormal prenatal development of the fetus also plays an important role. When mothers are interviewed in detail, it is often possible to find out that they suffered from toxicosis during pregnancy, suffered various diseases or nervous shocks (the latter factor is now of great importance), worked in occupational hazards or performed hard physical work.

The given data determine the main direction of preventive measures. This is, first of all, the creation of the necessary conditions for the normal course of pregnancy and childbirth. It is known that a child's life begins not from birth, but from the first days of pregnancy. Consequently, a pregnant woman should be in especially favorable, "privileged" conditions. However, one should not think that any toxicosis of pregnancy and any infection will necessarily negatively affect the formation of the nervous system of the unborn child. It is also necessary to take into account the role of hereditary predisposition to diseases of the nervous system in the family, alcoholism of parents, various coincidences and many other factors. The correct upbringing of the child and the conduct of various recreational activities with him is essential.

Parents often turn to doctors for increased physical activity of the child, which is difficult to control and correct. This condition is referred to as hyperactivity, or motor disinhibition. It can be a continuation of early childhood nervousness, or it can occur in a previously healthy child. Such children do not know literally a minute of peace. They are constantly on the move, quickly change their occupation, are fussy, mobile, absent-minded, cannot focus their attention for a long time (according to the figurative expression of the parents, the child “walks on his head” all the time). They are badly affected by the remarks of their elders, they are often whiny, restless, capricious, do not fall asleep well at night and often shudder in their sleep.

A common feature of hyperactive children should be noted. At an early age, they have a rather rapid mental and. physical development. One might get the impression that this is a very gifted, brilliant child. However, in preschool age and especially in the first years of schooling, it turns out that the mental development of such children is at an average level. At the same time, they may have increased abilities for a certain type of activity (music, mathematics, technique, playing chess, etc.).

Much still remains controversial and unclear about the causes of hyperactivity in children. It can be the result of mild or moderate damage to the nervous system of the child during the mother's pregnancy and during childbirth; the hereditary factor also plays a significant role. It has been established that many parents of such children in childhood also had similar disorders, and in some cases, as adults, they are also characterized by increased irritability, fussiness, emotional lability and imbalance of character. Against the background of hereditary factors and early organic damage to the nervous system, defects in upbringing are also of no small importance, especially the inconsistency of requirements for the child on the part of the parents or an overly strict and demanding attitude towards them. An unconscious reaction of protest arises, which manifests itself both in the form of motor excitement and in the form of rudeness, disobedience, and negativism.

Hyperactivity in children often requires special treatment. In educational work, one should take into account the child's increased motor activity, his distraction and behavior. In this regard, games should, first of all, be mobile, it is necessary to change the activities of such children. It is necessary to give the most expedient practical way out of such a child's hyperactivity. If at the same time he does not sleep well, especially at night, you can take long walks the day before, up to moderate fatigue. If a hyperactive child is identified with a tendency to a certain type of activity, this should also be used as much as possible in education.

ISPiP named after Raoul Wallenberg

Abstract on the topic:

"Psychopathology of childhood".

Performed by a student of group 05/14

"Clinical psychology"

Kulaeva Ya.E.

Disorders of the cognitive process …………………………… ..4

Disorders of sensations ………………………………… .4

Perceptual disorders ………………………………… 5

Attention Disorders ………………………………… ... 7

Memory Disorders …………………………………… ... 8

Thought disorders ………………………………… .9

Affective and effector disorders ... ... ... ... ... 10

Emotional disorders …………………………………… ..10

Disorders of the emotionally volitional sphere …………… 15

Disorders of effector functions (motor-volitional) ……………………………………………………… .17

The main psychopathological syndromes ………………… 18

1. Syndrome of early childhood neuropathy ………………… 18

2. Hyperdynamic syndrome ………………………… 19

3. Syndrome of leaving home and vagrancy ………… .19

4. Syndrome of fears ………………………………………………… 20

5. Syndrome of pathological fantasizing ………… ..21

6. The syndrome of early childhood autism ………………… ..21

7. Dysmorphophobia syndrome …………………………… ..22

8. Cerebrasthenic syndrome ……………………… ... 22

9. Consciousness disorder syndrome …………………… ... 23

10. Convulsive syndrome …………………………… .25

11. Psychoorganic syndrome …………………… .26

References ………………………………………… 29

Childhood psychopathology- science, is a part of child psychiatry, which studies the general patterns and development of child and adolescent mental disorders, aimed at creating methods of therapeutic correction.

Disorders of the cognitive process

Disorders of sensations

Agnosia - a disorder of sensations("A" - negation, "gnosis" - knowledge). The clinic describes the characteristics of optical, acoustic, olfactory, gustatory and tactile agnosia.

With optical agnosia that occurs when the occipital lobe of the cerebral cortex is damaged (congenital or acquired insufficiency), the patient does not remember or does not recognize objects, although he sees them and gives a descriptive characteristic.

For acoustic agnosia(lesion of the left hemisphere) the patient does not distinguish the sounds of speech, does not understand the speech of others. In these cases, one speaks of sensory aphasia in adults or sensory alalia in children. When the right hemisphere is damaged, the patient does not recognize objects by their characteristic sound (the patient is brought a ticking clock to his ear when the visual analyzer is excluded, he says “something is ticking, but I don’t know that”).

With olfactory and gustatory agnosia the patient accordingly does not distinguish between smells and taste.

With tactile agnosia the patient does not recognize objects by feeling them.

Agnosia arise when the primary fields of the corresponding analyzer are damaged and can be considered both in neurology and in psychiatry with various organic and functional disorders. In childhood, insufficient development of sensations or their lack of formation is often noted.

Children, adolescents, and adults may experience change in sensitivity threshold: decrease or increase, as well as senestopathy.

Increasing the thresholds of sensitivity- mental hyperesthesia - a sharp increase in susceptibility to normal or weak stimuli. An example is cases when children cannot tolerate certain types of clothing, sudden noise. They are capricious, cry. Such conditions are observed in children with neurotic reactions.

Lowering the sensitivity threshold- means a decrease in the reaction to acting stimuli (hypesthesia). Patients do not perceive irritation sufficiently. Such states are observed in reactive states.

Mental anesthesia- complete decrease in sensitivity on the part of one or several analyzers with their anatomical and physiological preservation: mental deafness, blindness, loss of the sense of taste or smell. Such conditions are observed in severe stressful conditions.

Senestopathies- a variety of vague, unpleasant, painful sensations in different parts of the body and internal organs in the absence of pathology in them. Such states are found in various neurotic reactions.

Perceptual disorders

Illusions- this is a distorted perception of reality. In healthy people, illusions can arise in poor lighting or poor hearing, in a state of emotional stress or fatigue. An illusory perception can arise in a child at a high temperature, and then spots on the wall or drawings on the carpet are perceived as fairy-tale characters. It can be assumed that in all cases there is a diffuse protective inhibition (equalizing phase), which causes a distorted perception of really existing objects and phenomena.

Illusions can also be observed in mentally ill patients with delusional states, when the patient perceives the speech of others as hostile statements. In such cases, they speak of verbal (verbal) illusions. Patients may experience affective illusions with various forms of delirium, expressed in the fact that patients in their own way perceive the appearance of others: joyful or sad, and give an appropriate reaction.

Hallucinations- these are false perceptions (deception of the senses), not associated with real-life objects or phenomena, but which are the fruit of painful brain activity. Hallucinations are observed only in people who are in a state of mental disorder, they arise in the mind of a person regardless of his will. Distinguish between optical, acoustic, gustatory, olfactory and tactile hallucinations. They can be simple in the form of sparks, isolated sounds, shouts, voices, odors, altered taste, touch, and more complex visual and auditory hallucinations in the form of perception of objects, people or animals, speech and music.

Doctor V.Kh. Kandinsky (1880) described the difference between true and false hallucinations (pseudo-hallucinations).

With true hallucinations all objects and phenomena are located outside the patient, the patient can talk about who he sees and with whom he talks, perceiving them realistically. The patient's behavior changes: with visual hallucinations of an unpleasant nature, the patient covers his face with his hands, hides, runs away, with auditory hallucinations, if the patients hear pleasant music or dialogue, they sit quietly, thoughtfully, listening to conversation or music. If the words perceived by the patient are not pleasant to him, then he plugs his ears, turns away.

Pseudohallucinations which are observed only in schizophrenia, are of a different nature. It seems to the patient that all his thoughts sound, are open and accessible to those around him. The patient's behavior changes: he ties his head with a handkerchief or towel, throws on a hospital gown so that no one can hear or see what he is thinking.

How independent forms of perception disorders act psychosensory disorders characterized by a change in the perception of the environment: shape, size, distance, supplemented by a violation of the perception of the body scheme. Patients complain of incomprehensible sensations: it seems to them that one arm or leg has become longer, the road is bumpy, objects are perceived now far away, now close. Walking, writing, behavior is upset. Such symptomatology of psychosensory disorders is observed in children and adolescents who are ill or have had a viral infection with encephalitic phenomena.

Derealization- This is a violation of the perception of the surrounding reality, the shape and size of the object, distance and time. Surrounding objects may appear reduced or enlarged. In a new place, it seems to the sick that they have already been here, and they perceive the usual home environment as someone else's.

Depersonalization- distorted perception of one's own body or its parts.

These conditions are observed in psychosensory disorders after the transferred viral neuroinfections.

Visual and auditory hallucinations can be observed in children aged 5-7 years with somatic and infectious diseases against a background of high temperature. In these cases, hallucinations are of an elementary nature: flickering sparks, the appearance of some contours, faces, calls, knocks, noises, voices of animals and birds, the images of which children perceive as fabulous. With mental illness (schizophrenia), hallucinations can become more complex: for example, with visual hallucinations, vividness, vividness of ideas, a tendency to fantasize, children talk about their visions. Sometimes visual hallucinations are frightening, imperative (command) character: children see terrible animals, robbers, from whom they run, hide, perform some kind of action. After 12-14 years of age, adolescents have gustatory and olfactory hallucinations, which often leads to refusal to eat. In these cases, hallucinations continue for a long time, the patient's behavior changes.

Attention disorders

Attention disorders include exhaustion, distraction and stuckness.

Attention disorders can be caused by various factors: social and biological. To social factors environmental distractions can be attributed to attention disorders. In the cerebral cortex, new foci of excitation arise, which, according to the dominant law, become dominant, attract attention, inhibiting other parts of the cerebral cortex.

For biological reasons Attention disorders include the weakness of active attention - the inability to prolonged tension in the direction of one object and the difficulty of concentrating, due to the weakness of the tone of the cerebral cortex, a decrease in the function of the second signal system. The fragility of active attention can be caused by a number of factors.: suffered a skull injury, vitamin deficiency, malnutrition and overwork ..

Attention fatigue may be due to the weakness of the cortical processes. Such a decline in active attention is observed in children and adults who have suffered a traumatic brain injury or infection with encephalitic phenomena.

Another type of attention disorder is distraction, pathological mobility of cortical processes with a predominance of passive attention, manifested by a quick, unreasonable change in activity, the productivity of which is sharply reduced. Such conditions are observed in children who have suffered a birth traumatic brain injury or early infections with subsequent weakness of the activity of the cells of the cerebral cortex. In this case, the instability of active attention is combined with restlessness, mobility, hyperactivity.

Another type of attention disorder is stuckness, poor switching of attention from one object to another, due to the low mobility of cortical processes. Jams are observed in children and adults with organic brain lesions and manifests itself in speech, in drawings and in work.

All types of attention disorders (distraction, fatigue, stuckness) always indicate the organic or functional basis of damage to the nervous system and require the supervision of a doctor, educator and teacher over the child's condition, as well as the identification of other disorders that require specialized help.

Memory disorders

The causes of memory disorders are different.: postponed craniocerebral trauma, infections and intoxication, vascular and trophic disorders, seizures that alter the cortical structure.

Types of memory disorders: amnesia, hypomnesia, hypermnesia, paramnesia.

Amnesia- complete loss of memory ("a" - negation, "mnezis" - memory). Distinguish anterograde and retrograde amnesia.

Anterograde amnesia- this is a loss of memory for the entire period when a person was in an unconscious state, the cells of the cerebral cortex were inhibited and no irritation reached them.

Retrograde amnesia- a loss of memory of events preceding the disease, injury or condition with loss of consciousness (epileptic seizure, diabetic coma, heart failure). The duration of retrograde amnesia depends on the severity of the brain damage.

Affective amnesia (psychogenic)- these are memory lapses for some periods of life or for certain details associated with mental trauma. At the same time, unpleasant memories, details of the conflict, closely related to difficult experiences, are displaced, forgotten.

Hypomnesia- a decrease in the volume or weakening of memory. This condition occurs after an injury, intoxication, or infection. In these cases, after the transferred lesion of the medulla, the activity of the cells of the cerebral cortex is weakened. This is manifested in the rapid forgetting of the information received. Such conditions are typical for children with mental retardation, mental retardation and other consequences of organic brain damage.

When the blood vessels are hardened, less blood comes through them and the activity of the cells of the cortex is weakened, which also leads to a decrease in the volume of memory. This is senile hypomnesia, in which older people remember well what was “once” and do not remember what happened today. Hypomnesia always has an organic basis.

Hypermnesia- an increase in the volume of memory, when people remember and store in memory for a long time signals that have come to the corresponding areas of the cortex. These features of memory are manifested in a person's life from early childhood and acquire a persistent character.

Paramnesia- false memories, which are subdivided into confabulations and pseudo-reminiscences, and are observed in mentally ill or elderly people.

Confabulations- fabrications, when patients talk about events in which they took part, when in fact these events did not happen or they happened to someone else, taken from books or movies.

Pseudo-reminiscence- these are false memories when the patient talks about events that may have happened to the patient, but shifted in time.

Various forms of memory disorders can be observed in children with organic lesions of the central nervous system accompanied by intellectual disability.

With hydrocephalus due to previous skull trauma or meningitis, mechanical memory may predominate. Children have a sense of reasoning when they talk a lot about everything that attracts their attention, without going into the meaning of what was said. This condition is due to the weakness of cortical processes, insufficient generalizing function of the cortex.

Thought disorders

Thinking- the highest stage of cognitive activity, which is based on the processing of the received information (sensations and perceptions), their analysis and synthesis. 2 types of violations of the thought process: quantitative and qualitative.

Quantitative thinking disorders are manifested in the form of limitation of mental activity or its underdevelopment with mental retardation ( ZPR) or mental retardation ( oligophrenia). In adolescents and adults, the decay of mental activity - dementia, observed in chronically current mental processes.

Qualitative disorders mental activity is observed in various neuroses and psychoses and manifests itself in a disorder of the rate of mental activity, obsession and delirium.

Violation of the pace of mental activity due to the predominance of excitement or inhibition in the cerebral cortex.

Accelerated flow of thoughts up to the fragmentation of thinking. In these cases, the formation and change of associations is accelerated, one image is replaced by another, an influx of thoughts arises. The sequence is broken, the loss of logical connections between parts of sentences is growing. The process of thinking is characterized by disorder, and statements become incomprehensible, absurd. The accelerated pace of thinking is combined with agitated behavior that fits into a certain manic syndrome.

Delayed thought process observed with the predominance of inhibition in the cerebral cortex. Patients complain of a lack of thought, "there is some kind of emptiness in the head." A slowdown in the rate of mental activity is observed in depressive conditions.

Another form of disorder is circumstantial thinking - detailing, in which the patient leaves the given topic, speaks in detail, repeats and cannot switch to the continuation of the main topic. Excessively detailed thinking, stuckness and poor switchability, viscosity of thinking are characteristic of children and adults with organic lesions of the central nervous system (epilepsy, psychoorganic defect).

One of the forms of thought disorder is reasonableness, in which the patient does not answer the asked question, but begins to reason, lecture the interlocutor. At the same time, the patient's verbal production is lengthy and remote from the essence of the issue. Such features of speech utterance can be observed with psychosis, with hydrocephalus.

One of the forms of mental disorders can be perseveration and stereotypes, which are characterized by the repetition of the answer to the first asked question. At the same time, there is a long-term dominance of any one thought, one idea, which are based on the stuck associations. Such states of inhibition are observed in patients with cerebral hemorrhages or brain tumors.

Disjointed, torn thinking is characteristic of a number of infectious diseases occurring with high fever, as well as in patients with schizophrenia. At the same time, thoughts are not united with each other, but are separate fragments in which there is no analysis and synthesis, there is no ability to generalize, speech is meaningless.

Autistic thinking characterized by the subject's isolation from the outside world, his isolation, immersion in his own experiences, insufficiently consistent with reality.

Thinking disorders include obsessive thoughts (obsessive syndrome). These are thoughts from which the patient cannot get rid of, although he understands their uselessness. Obsessive thoughts can arise in practically healthy people, in neurotics and in the mentally ill. Obsessive thoughts in neurotics are more complex and persistent. This is also a focus of stagnant arousal, but deeper. The patient is critical of his condition, but cannot free himself from his experiences. Obsessive thoughts in neurotics can have a different character and manifest themselves in the form of irresistible desires, drives and fears.

Obsessive fears or phobias, varied and difficult to overcome. A thought may arise, and with it fear, before performing a task or action, especially in an atmosphere of excitement, tension. Children develop a fear of punishment for poorly completed homework or a poor grade at school. The same thoughts, and with them fears, may appear in a teenager or adult performing a difficult task in an unfavorable environment. Sometimes logophobia(fear of speech) manifests itself in the presence of one person, a strict educator or teacher at school, while in the presence of another person who calmly and kindly treats the child, these thoughts and fear are absent.

Obsessive thoughts in mentally ill people are persistent, patients are not critical of them and do not seek help. According to its clinical picture, obsessive thoughts in mentally ill patients are close to delusional ideas and do not lend themselves to dissuasion.

Overvalued ideas are observed in adolescence and are characterized by certain characteristics. If emotionally brightly colored thoughts prevail in a person's consciousness, then they speak of the presence of overvalued ideas. These thoughts are not ridiculous, but the patient attaches such great importance to them, which they objectively do not have. Overvalued ideas are not accompanied by a burdensome sense of imposition and a desire to free themselves from the wrong way of thinking.

Delirium and delusional ideas occur as a result of brain disease. Delirium can occur against the background of a disturbed consciousness during infection or intoxication, at the height of a painful state (high temperature or alcohol poisoning), when patients pronounce individual words or short phrases that are not related to the environment.

Crazy ideas- these are incorrect judgments that do not correspond to reality, inferences that cannot be dissuaded. Patients are under the influence of thoughts that have arisen in them, ideas that change their behavior. Delusional ideas are systematized, pronounced against the background of intact consciousness, accompany a mental disorder, and can be observed for a long time. Delusional ideas can be combined with hallucinations.

Delusional ideas vary in content: ideas of attitude, persecution, poisoning, jealousy, greatness and enrichment, invention, reformism, litigation and others.

Most common forms of delusional statements: relationship ideas and pursuit ideas. At crazy ideas of enrichment patients talk about their untold riches. At delusional ideas of greatness they call themselves the names of great people. At crazy ideas of invention patients design various devices. At delusional litigation patients write complaints to various organizations, endlessly sue for some rights. One of the types of delusional ideas is characterized by an underestimation of his personality, the patient is convinced of his worthlessness and uselessness, inferiority (delusional ideas of self-abasement). In patients in these cases, a depressive state occurs, in which they consider themselves to be bad, insignificant. Hypochondriacal delirium characterized by unfounded convictions and statements of the patient that he has an incurable disease and he must die soon.

Along with the primary delirium, it is possible to isolate sensory (figurative) delirium, which is characterized by a disorder of sensory cognition, develops against the background of other mental disorders, is visual in nature with many images perceived fragmentarily, forming images, guesses, fantasies, which explains its incoherence and absurdity. There are various forms of sensual delirium.

Delirium of self-accusation manifests itself in the fact that the patient ascribes to himself various mistakes, misdeeds, which were in reality or significantly increased, up to a crime. Such conditions occur in adolescents who have suffered a skull injury or encephalitis. With delirium exposure the patient believes that his thoughts, actions, deeds are due to the extraneous influence of hypnosis, radio waves, electric current. Persecution delirium lies in the fact that the patient considers himself surrounded by enemies seeking to destroy him or harm him, and therefore takes various precautions to prevent this from happening. Among the forms of sensual delirium are also described self-deprecating delirium, damage, nihilistic, expansive, fantastic, religious, erotic, jealousy, cosmic impact, etc. Unsystematic delirium, called paranoid, is incoherent, based on guesses and assumptions.

Affective and effector disorders

Emotional disorders

Euphoria- long-term pathologically elevated mood, inappropriate to the environment. Euphoria is observed in children and adolescents with organic psychosis, with mental illness caused by certain infections, with reactive psychosis.

Depression- depressed mood, inappropriate to the environment, accompanied by melancholy, self-accusation, motor and speech inhibition, painful sensations in the body, a sharp decrease in drives. Depression occurs under the influence of external and internal factors and is always a symptom of a psychogenic reaction. In puberty (adolescence), depression can be observed in severe somatic diseases and reactive conditions.

Dysphoria- an emotional disorder characterized by constant dissatisfaction with the environment, the actions of relatives or medical personnel, food, angry irritable melancholy, a tendency to aggressive actions, often with altered consciousness, a feeling of fear and delusional ideas. Dysphoria can be observed for several hours or several days, typical for patients with epilepsy, skull trauma and alcohol abuse.

Emotional weakness represents a mood swings from good (with elements of euphoria) to low mood (with elements of depression), with periods of easily coming tearfulness. In preschool children, emotional weakness is a physiological phenomenon: they do not know how to restrain themselves and therefore react violently, not embarrassed by the presence of strangers, and show their joy or anger, but with age, the ability to regulate emotions is developed.

Emotional ambivalence manifests itself by the simultaneous realization of opposite feelings to the same object (love and hate coexist at the same time). Most often, ambivalence is observed in schizophrenia, less often in hysterical psychopathy.

Apathy- excessive decrease in emotional excitability, complete indifference and indifference to the environment, to oneself, lack of desires and motives, complete inactivity. It occurs in various mental illnesses (intellectual disability, psychogenia and other conditions).

Emotional dullness observed in cases where the patient does not respond to external stimuli and their own sensations. Similar conditions are observed in chronically current forms of schizophrenia.

Negativism- unmotivated opposition, resistance to any external influence, refusal to perform actions. Passive negativism characterized by resistance to any change in the position of the body and limbs. Opposing any instructions or performing actions opposite to those required is called active negativism... The concept of "negativism" refers to pathological resistance, therefore, the stubbornness of children, which has its own reasons, is called negativism by mistake.

Pathological affect- a strong, short-term, suddenly arising negative emotion, accompanied by anger, indignation, rage, destructive action, sometimes brutal murder. Such conditions can be observed in children and adolescents who have suffered a traumatic brain injury, in adolescents and young people who abuse alcohol. In some cases (a combination of a skull injury and alcohol consumption), the pathological affect may be accompanied by a disorder of consciousness, delirium, and subsequent amnesia. Persons who have committed crimes in a state of pathological passion with a disorder of consciousness are recognized as insane. Children and adolescents with such conditions can be observed in kindergarten and at school.

The frequency of emotional disorders in children is due to the physiological characteristics of their mental activity, the weakness of active inhibition, the instability of metabolic processes, the function of the endocrine system and the peculiarities of the course of critical periods in the development of children and adolescents.

Emotional volitional disorders

Will Is a conscious purposeful mental activity .

Instincts Are innate reflexes inherited from a person's ancestors. Instincts include: food, defensive, sexual, parental.

Motive- This is an act of comprehension, that is, a critical attitude to desire in accordance with real possibilities.

Volitional activity- This is an action aimed at the realization of a consciously set goal, purposeful mental activity.

Volitional processes can be disrupted in various forms and are characterized by various manifestations.

In patients with manic depressive syndrome there is an increase in volitional activity, manifested in increased activity, indefatigability, verbiage, heightened good mood.

A decrease in volitional activity is accompanied by inactivity, apathy, a sharp decrease in motor activity and is observed in some mental disorders (reactive and endogenous psychoses).

Attractions- these are phylogenetically old, inherited, unconditionally complex reflex (instinctive) vital reactions aimed at preserving the genus and extending the species. With some lesions of the cerebral cortex, impairment, disinhibition of drives is possible.

Violation of the food instinct. Cravings for food are observed in the form of an increase in the food instinct (gluttony, greed). Such conditions are observed in patients with encephalitis and are called bulimia. Most often you have to deal with suppression of food cravings. Persistent refusal to eat (anorexia) leads to exhaustion of the patient. Stubborn refusal to eat can be associated with a delusional mood (delusional ideas of poisoning, etc.) or a belief that food is made from poor quality products. Peak symptom- eating inedible items. Coprophagia- eating feces. Refusal to eat can be observed with various forms of stupor, with states of depression, with hysteria.

Perversion of drives under certain conditions: pregnancy, in patients with concussion, some psychoses. The perversion of the food reflex is manifested in the desire to eat one food or refuse another.

Suicidal drive(suicide about mania) is usually associated with mental disorders and is observed in adolescents and young people with reactive psychosis, drug addiction, alcoholism. Mentally ill people often show great ingenuity and perseverance in the implementation of their suicidal intentions. Close to the urge to deprive oneself of life is the urge to self-mutilation, which is often carried out impulsively. This often occurs against the backdrop of delusional and hallucinatory experiences.

In a psychiatric clinic, a prominent place is occupied by sexual desire disorders: increased or decreased sexual arousal, sexual perversion, which can be observed in various mental illnesses and conditions.

Erotism- hypersexuality, expressed in adolescents in the form of frequent and prolonged erections, erotic fantasies, masturbation

Hyposexuality- a decrease in sexual desire, manifested in adolescents by a lack of interest in the opposite sex.

The most common form of sexual desire disorder is homosexuality(attraction to people of the same sex). In the history of homosexuals, there are often features of impaired attraction from childhood, which are most clearly manifested in adolescence and young age (interest in certain games, jewelry, girls' clothes and vice versa).

Other forms of violation include transvetism, pathological attraction to dressing up in clothes of the opposite sex, as well as interest in things of the opposite sex.

Young children ( pedophilia), sexual intercourse with animals ( bestiality), attraction to statues ( Pygmalion)other. Such deviations as sadism and masochism have long been known. Sadism- characterized by the desire to hurt another person in order to achieve sexual satisfaction. Masochism- receiving sexual gratification or pleasure from the inflicted pain or humiliation delivered by a partner.

In psychiatry, a large number of impulsive drives: attraction to vagrancy (dromomania), arson (pyromania), theft (kleptomania). In contrast to obsessive states, impulsive drives are acutely arising urges and aspirations that subjugate the entire consciousness and behavior of the patient. They are characterized by meaninglessness and arise for no reason. Such conditions are observed in schizophrenia and psychopathies.

Disorders of effector functions (motor-volitional)

Motor-volitional disorders with a predominance of the excitatory process include hyperbulia- an increase in volitional activity associated with an increase in drives. It can manifest itself in the form:

Manic arousal, in which the patient is constantly in the activity: without completing one work, he begins another, while talking a lot, the mood is cheerful, the appetite is increased. In such patients, hypersexuality, aggression, and disinhibition of behavior can be observed.

Catatonic excitement, which, unlike manic arousal, is not purposeful and is expressed by stereotypical movements, chaos, pretentiousness. These changes in the patient's behavior are characteristic of schizophrenia.

Hebephrenic arousal, which is characterized by mannerism, silly behavior, an abundance of ridiculous postures, jumps, jumps, antics. In adolescence, the symptomatology is supplemented by disinhibition of the lower drives. These conditions are seen in schizophrenia.

Hysterical excitement after fright. A person runs without looking back and for a long time cannot stop, understand what happened. A form of hysterical excitement also includes a hysterical attack.

All forms characterized by a weakening of volitional activity (hypobulia) or a stop of action belong to motor-volitional disorders with a predominance of the inhibitory process - stupor:

Depressive stupor in which the patient is in the same position for a long time, speaks softly, finds words with difficulty, his movements are slowed down and performed with difficulty. Such states can be observed in manic depressive psychosis in the phase of depression, in senile depression.

Catatonic stupor characterized by immobility and mutism (refusal to talk, silence). There is a state of waxy flexibility (catalepsy) - the patient can be given any position and he does not change it for a long time, for example, he does not lower the raised hand until it drops itself. Such conditions are observed in schizophrenia.

Hebephrenic stupor characterized by a dichotomy (splitting) of activity, negativism, expressed in the fact that patients perform actions opposite to those they are asked for. These conditions are seen in schizophrenia.

Hysterical, or psychogenic, stupor occurs after mental trauma: with fright, sudden grief, natural disaster. An external manifestation is a general lethargy up to complete numbness.

The main psychopathological syndromes.

1. Syndrome of early childhood neuropathy

Syndrome of early childhood neuropathy or "congenital childhood nervousness" (VV Kovalev, 1979) is the most common syndrome of mental disorders in early childhood (0 to 3 years). The main place in the structure of the syndrome is occupied by a sharply increased excitability and pronounced instability of autonomic functions, which are combined with general increased sensitivity, psychomotor and affective excitability and rapid exhaustion, as well as with more or less pronounced traits of inhibition in behavior (in the form of fearfulness, fearfulness, fear of all new). Among the somatovegetative disorders, dysfunctions of the digestive system, respiration, and cardiovascular disorders predominate. In children, there is an increased sensitivity to various stimuli in the form of increased motor restlessness, affective arousal, tearfulness, changes in body position. Instinctive disorders in the form of an increased sense of self-preservation, the expression of which is fear and poor tolerance of everything new. Fears are manifested in the intensification of somatovegetative disorders: refusal to eat, weight loss, increased moodiness and tearfulness at any change in the situation, change in the regime, conditions of care, placement in a children's institution. With age, children with "true" neuropathy may experience dysfunction of internal organs, against which somatic disorders are formed. These symptoms can affect people of all ages, but they begin in early childhood.

2. Hyperdynamic syndrome

Hyperdynamic syndrome (motor disinhibition syndrome), which is also referred to as the syndrome of hyperactivity, occurs in the age period from 1.5 to 15 years, but is most pronounced in preschool age. The main components of the hyperdynamic syndrome are considered: general motor restlessness, restlessness, an abundance of unnecessary movements, lack of focus and, often, impulsivity of actions, impaired concentration of active attention. In some cases, there are: aggressiveness, negativism, irritability, explosiveness, a tendency to mood swings. The behavior of children is characterized by the desire for constant movement, extreme restlessness. They continuously run, jump, then sit down for a while, then jump up, touch and pick up objects that fall into their field of vision, ask many questions, often do not listen to the answers. Their attention is attracted for a short time, which makes it extremely difficult to conduct educational work with them. In connection with increased motor activity and general excitability, children easily enter into conflict situations with peers and educators or a teacher due to a violation of the daily routine, while completing class assignments, etc.

This syndrome is most often found in the long-term consequences of early organic brain lesions, which led to its identification with the so-called syndrome of "minimal cerebral dysfunction" (MMD). Hyperdynamic syndrome is formed against the background of MMD and can be combined with other syndromes resulting from early brain damage.