Mental health of disabled children: a preventive aspect

The aim is to identify the priority directions for preventing mental disorders in disabled children following a comprehensive analysis of clinical, social, psychological, ethnic and cultural characteristics over 2009– 2017. Materials and methods. 2,204 people were included in the study: disabled children, students of remedial schools aged 7–18 years old (n = 834); parents of disabled children (n = 772); teachers working in various educational facilities (n = 217); respondents of the survey identifying people’s attitude towards children with disabilities (schoolchildren, students, adults, n = 381). Clinical, psychological and statistical methods were used in the study. To identify depression and anxiety in children, Children’s Depression Inventory (CDI), Childhood Myositis Assessment Scale (CMAS), PedsQL inventory, survey on coping strategies (E. Heim) and adapted questionnaires for suicidal risk and alexithymia were used. For adult participants, the Quality of Life Scale, Hamilton Anxiety Rating Scale, Hospital Anxiety and Depression Scale (HADS), and a questionnaire identifying the attitude towards children with disabilities were applied.

Results. A high prevalence of mental disorders in children with disabilities (62.7–95.2%) was identified, and the levels of anxiety, suicidal risk, alexithymia were determined. Children’s families were characterized by impaired structure (50%), parenting styles resulting in pathologies (71.5%), low income level (60%), low qualifications of parents and unemployment (13%), alcohol abuse (17.6%), victimized attitudes and low satisfaction with the psychological criteria of quality of life, combined with low level of anxiety. For teachers, the levels of anxiety and depression and signs of burnout were revealed, and the features of their interaction with disabled children in the educational process were described. The attitude of different social groups to children with disabilities was studied. The methodological conditions for carrying out research and organizing medical and psychological care were formulated.

Conclusion. Prevention of mental disorders in disabled children includes identification of early signs of anxiety, depression, suicidal risk and assessment of the quality of life and work. This is ensured by a reasonable choice of research methods, psychosocial rehabilitation with involvement of beloved people, and increase in the tolerance level towards children with disabilities in the society. 

1. Makushkin Ye.V., Baybarina E.N., Chumakova O.V., Demcheva N.K. Fundamental tasks and problems of children’s mental health care in Russia. Psychiatry. 2015; (4): 5-11 (in Russ.).

2. Shalimov V.F., Novikova G.R. Children’s psychiatry and inclusive education as a problem of interdisciplinary interaction. Conferences ASOM. 2016; 4: 2415-2421 (in Russ.).

3. Kistenyova R.A., Kistenyov Yu.V., Pekker Ya.S., Brazovskiy K.S., Brazovskaya N.G., Fokin V.A. Correction of psycho-emotional stress among primary schoolchildren with special educational needs with the use of adaptive biofeedback. Bulletin of Siberian Medicine. 2010; (2): 113-118 (in Russ).

4. Bokhan N.A., Voevodin I.V., Mandel A.I., Abolonin A.F. Suicidal and parasuicidal risk-taking behaviour among highly educated young people: dichotomy of forming and differentiated abilities of cognitive-behavioural coping-therapy. Suicidology. 2019; 10 (1): 27-35 (in Russ.). https://doi.org/10.32878/suiciderus.19-10-01(34)-27-35.

5. Grankina I.V., Ivanova T.I. The impact of mental disorder on the manifestation of deviant behavior in children: clinical, psychological and social analysis. Transbaikalian Medical Bulletin. 2016; (1): 22-28 (in Russ.).

6. Abolonin A.F., Nazarova I.A., Stoyanova I.Ya., Gusev S.I. Aggression as a factor of delinquent behavior (gender aspect). Siberian Herald of Psychiatry and Addictionpsychiatry. 2015; (4): 58-66 (in Russ.).

7. Polozhiy B.S., Fritlinskiy V.S., Ageev S.E. The rate of suicide among minors in Russia. Russian Journal of Psychiatry. 2016; (5):52-54 (in Russ.).

8. Levkovskaya O.B., Shevchenko Yu.S. Non-suicidal self-injuring behavior in adolescents: contemporary explanatory approaches. Mental Nealth Iissues of Shildren and Adolescents. 2015; (1): 105-116. (in Russ.).

9. Beesdo K., Pine D.S., Lieb R. Wittchen H.-U. Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder. Arch. Gen. Psychiatry. 2010; 67: 47-57.

10. Carrellas N.W., Biederman J., Uchida M. How prevalent and morbid are subthreshold manifestations of major depression in adolescents? A literature review. J. Affect Disord. 2017; 1 (210): 166-173. https://doi.org/10.1016/j.jad.2016.12.037.

11. Wesselhtsft R.T. Childhood depressive disorders. Dan. Med. J. 2016; 63 (10): B5290.

12. Kovalev V.V. Semiotics and diagnosis of mental diseases in children and adolescents. Moscow: Meditsina Publ., 1985: 288 (in Russ.).

13. World Health Organization. International Classification of Functioning, Disability and Health (ICF). Geneva : World Health Organization, 2001: 299. URL: http://psychiatr.ru/download/1313?view=1&name=ICF_18.pdf.

14. Bjorck-Akesson E., Wilder J., Granlund M., Pless M. The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention-feasibility and usefulness as a common language and frame of reference for practice. Disabil Rehabil. 2010; 32 (1): 125-138. https://doi.org/10.3109/09638288.2010.516787.

15. Koren’ Ye.V. Psychosocial rehabilitation of children and adolescents with mental disorders in modern conditions. Social and Clinical Psychiatry. 2008; 18 (4): 5-14 (in Russ.).

16. Bornman J. The World Health Organization’s terminology and classification: application to severe disability. Disability and Rehabiliation. 2004; 26: 182-188.

17. Lollar D.J., Simeonsson R.J. Diagnosis to function: classification for children and youths. J. Dev. Beha.v Pediatr. 2005; 26 (4): 323-330.

18. Sukharev A.V. Methodology of ethno-functional psychodiagnostics. Journal of Rractical Rsychologist. 1997; (2): 53-65 (in Russ.).

19. Kupriyanova I., Dashiyeva B., Karaush I. Method of suicidal risk identifying for subsequent correction in adolescents with musculoskeletal system disorders and sensory disorders, accompanied by disorders of psychological development, students of correctional schools. Patent of RF 2539400. Application № 2013152564/14 from 26.11.2013. Epubl. 20.01.2015. Byul. (2): 8 (in Russ.).

20. Kupriyanova I.E, Karaush I.S., Dashieva B.A. Method of detecting alexithymia for subsequent correction in adolescents with sensory impairments, accompanied by impaired psychological development. Patent of RF 2599345. Application № 2013152564/14 from 20.04.2015. Epubl. 10.10.2016. Byul. (28): 8 (in Russ.).

21. Gundarov I.A. A quality of life chart. Siberian Nealth. 1995;(1):15-16 (in Russ).

22. Dashieva B.A. Ethnocultural features of mental health of children and adolescents with disabling diseases: avtoref. dis. … d-ra med. nauk. Tomsk, 2015: 48 (in Russ.).

23. Karaush I.S. Mental health of children with sensory impairments: avtoref. dis. … d-ra med. nauk.Tomsk, 2016: 49 (in Russ.).

24. Molotkova N.Yu. Clinical characteristics and quality of life of children with mental retardation and mental disorders: avtoref.dis. … kand. med. nauk. Tomsk, 2016: 23 (in Russ.).

25. Bourke-Taylor H., Howie L., Law M., Pallant J.F. Self-reported mental health of mothers with a school-aged child with a disability in Victoria: A mixed method study. Journal of Rediatrics and Shild Nealth. 2011; 48 (2):153-159.

26. Braich P.S., Lal V., Hollands S., Almeida D.R. Burden and depression in the caregivers of blind patients in India. Ophthalmology. 2012; 119 (2): 221-226.

27. Esbjorn B.H., Pedersen S.H., Daniel S.I., Hald H.H., Holm J.M., Steele H. Anxiety levels in clinically referred children and their parents: Examining the unique influence of self-reported attachment styles and interview-based reflective functioning in mothers and fathers. Br. J. Clin. Psychol. 2013; 52 (4): 394-407. https://doi.org/10.1111/bjc.12024.

28. Abramov V.A., Studzinskiy O.G., Abramov A.V., Grachev R.A. Public opinion as a prerequisite for stigmatization of patients with mental disorders. The Journal of Psychiatry and Medical Psychology. 2016; (1): 55-62 (in Russ.).