Mmarina gegelaSvili, fsiqiatri, mmd.
zogierTi sakiTxiNneirofsiqologiuri disfunqciisa da qceviTi problemebis asakobrivi dinamikis Sesaxeb mozardebSi
kvleva ganxorcielda fond ‘’Global Initiative on Psychiatry ‘’ mxardaWeriT
kvlevis ZiriTad mizans warmoadgenda saqarTveloSi mcxovrebi bavSvebisa Dda mozardebis qceviTi problemebis gavrcelebis gansazRvra da im bio-fsiqo-socialuri faqtorebis Seswavla, romlebic gavlenas axdenen qceviTi problemebis ganviTarebaze. raTa am monacemebze dayrdnobiT momxdariyo bavSvTa da mozardTa fsiqikuri janmrTelobis efeqturi fsiqoprevenciuli zomebis SemuSaveba.
Mmasala da meTodi kvleva Catarda zogadsaganmanaTleblo skolebsa da kvlevaSi moculi iyo saqarTvelos barisa da maRalmTianeTis regionebi, qalaqebisa da soflis mosaxleoba,. gamoklvleul iqna 12-17 wl amde asakis 1374 mozardi, rogorc qalaqis, aseve raionis mcxovrebi
deviaciebis speqtris Sefaseba ganxorcielda socialur-ekonomikuri, fsiqologiuri, neirofsiqologiuri maxasiaTeblebis gaTvaliswinebiT, ramac saSualeba mogvca safuZvlianad gagveazrebina qceviTi problemebi iseTi informaciis moZiebiT, romelSic asaxuli iqneboda pirovnebis, rogorc, bio-fsiqo-socialuri arsebis zogierTi maxasiaTebeli, rac esoden mniSvnelovania bavSvTa da mozardTa fsiqikuri janmrTelobis dacvis adreuli intervenciebis dagegmarebisaTvis .
gamokiTxva vawarmoeT specialurad SemuSavebuli test-batareis saSualebiT kerZod:
fsiqosocialuri kiTxvari, neirofsiqologiuri disfunqciis gamovlenis mizniT viyenebdiT rei-teiloris tests. igi warmoadgens neiro-fsiqologiuri meTodikas, romeliTac gamokvleul iqna mexsierebis, mxedvelobiT-sivrciTi aRqmis unaris funqcionireba da kognitiuri procesis siCqare.
debo-rubinSteinis TviTSefasebis testi: rokiCis RirebulebaTa orientaciis sakvlevi testi
kvlevaSi miRebuli monacemebis _ fsiqosocialuri deviaciebis, centraluri nervuli sistemis disfunqciis da mozardTa TviTSefasebisa da RirebulebebaTa sistemebis statistikuri analizisTvis gamoyenebul iqna X2 testi da multivariaciuli logistikuri regresia.
mozardTa deviaciur qcevebad miviCnieT sazogadoebrivad miuRebeli qcevebi, maTi aRmocenebis sixSirisa da motivis gaTvaliswinebiT (anu mozardis mier fasdeboda Tu ara dadebiTad damokidebuleba konkretuli antisazogadoebrivi qcevis mimarT da atarebda Tu ara es qceva regularul xasiaTs). sazogadoebrivad saSiS delinqventur qcevebad CavTvaleT aseTis erTjeradi epizodic ki.
Cveni kvlevis amocanis Sesabamisad, Semdgom etapze ganvixileT is bio-fsiqo da socialuri faqtorebi, romlebmac SeiZleba gazardon qceviTi problemis aRmocenebis riski. Aaseve Seswavlil iqna deviaciuri qceveis asakobrivi dinamika;
Sedegebi
Kkvlevam gamoavlina, rom qceviTi problemebi sarwmuno kavSirSia neirofsiqologiur disfunqciasTan. Amitom Cvns statiaSi mimovixilavT neirofsiqologiuri disfunqciis rols mosazrebebs qceviTi problemebis aRmocenebaSi.
problemuri qcevis dinamika gogonebsa da vaJebSi asakTan mimarTebaSi:
problemuri qcevebis maCveneblebi asakTan erTad icvleba araerTgvarovnad. saxeldobr, piks aRwevs vaJebSi 14 ,xolo gogonebSi 15 wlis asakSi. gogonebsa da vaJebSi es maCvenebeli asakobrivi jgufebis mixedviT sakmaod gansxvavebulia, gogonebSi problemuri qcevis procentuli maCvenebeli izrdeba nela, Tan 13 wlis asakisaTvis aRemateba deviaciuri qcevis maCvenebels vaJebSi, Semdeg mrudi nela izrdeba da piks aRwevs 15 wlis asakisaTvis, xolo Semdeg nela eSveba qveviT. rac Seexeba vaJebs es maCvenebeli mkveTrad imatebs, 14 wlis asakisaTvis aRwevs piks da Semdeg eSveba qvemoT. aRsaniSnavia, rom 16-17 wlis asakSi gogonebSi problemuri qcevebis maCvenebeli isev aRemateba igive asakis vaJebSi problemuri qcevebis maCvenebels.
aRsaniSnavia agreTve qceviTi problemebis maCveneblis dinamikis mrudi da maTi daxloebiT erTnairi done pubertatis dasawyisSi da boloSi:; es garemoeba kidev erTxel adasturebs gavrcelebul azrs imis Sesaxeb, rom qceviTi problemebi, romlebic gamoxatuli da damaxasiaTebelia pubertatuli asakisaTvis, xSir SemTxvevaSi ganicdian reducirebas pu vinaidan Cveni kvleva ar moicavs mozardebs 17 wlis zeviT, is , Tu ra xdeba SemdgomSi, SesaZlebelia mxolod vivaraudoT. rodesac vakvirdebiT #1 grafiks, grafikis ganxilvisas iqmneba STabeWdileba, rom 17 wlis asakisaTvis SemTxvevaTa umravlesobaSi xdeba ‘’normaluri qcevebisaken’’ dabruneba. Mmagram nawilisa ki grZeldeba da Sesabamisad, zRvari normalur da problemur qcevebs Soris xdeba ufro mkveTri. Ees exebaDdelinqventur, suicidur,adiqtiur, qcevebis gamovlinebebs. romelTa mrudic 17 wlis asakidan mkveTrad iwevs zeviT.
statistikurma analizma cxadyo, rom mozardebs, romlebsac gamouvlindaT kognitiuri funqciebis siCqaris Seneleba, sarwmunod ufro xSirad aReniSnebaT qceviTi problemebi.( (X2=3.750, P<0.05)
igive SeiZleba iTqvas mozardebze, romlebsac gamouvlindaT problemebi mexsierebaSi, (X2=11.080 P<0.02), isini deviaciuri qcevebis mimarT specifiurobiT xasiaTdebian.
seriozuli qceviTi problemebis matarebel mozardebSi neirodisfunqciis sixSire sarwmunod ufro metia, vidre deviaciebis armqone mozardebSi. (Pearson Chi-Square=8.71 P<0.01).
neirofsiqologiuri disfunqcia aReniSneba gamokvleuli mozardebis 30%-s, xolo 70%-is parametrebi normas ar scildeba. neirofsiqologiuri disfunqciis maCvenebeli piks aRwevs 13 wlis asakSi, Semdgom eSveba qveviT da 16 wlis asakidan kvlav izrdeba. aseTi dinamikis axsna am etapze SesaZleblad ar migvaCnia da vfiqrobT saWiroa damatebiTi multidisciplinaruli neirobiologiuri da fsiqosocialuri kvlevis
grafiki 2 neirofsiqologiuri maCvenebeli mozardTa asakobrivi jgufebis mixedviT
sxvanairad rom vTqvaT, arasasurveli qceva, romelic warmoiSoba bavSvobaSi, an 12 wlis asakSi,rogorc grafikzea#1 warmodgenili, piks aRwevs 14-15 wlis asakSi, maSin rodesac, neirodisfunqciis piki modis 13wlis asakSi, xolo Semdeg klebulobs, SesaZloa, asakobrivi kompensaciis xarjze. e.i savaraudoa, rom swored am asakobriv SualedSi 13-14 xdeba problemuri qcevebis aqtiuri formireba. Tumca, rogorc adre aRvniSneT, es sakiTxi moiTxovs damatebiT kvlevas.
dRes dReobiT udidesi mniSvneloba eniWeba im meqanizmebis Seswavlas, romlebiTac xdeba devianturi qcevebis aRmoceneba-ganviTareba. Tanamedrove yvelaze gavrcelebuli hipoTezis Tanaxmad, agresiuli da zogadad deviantur qcevebis erT erT safuZvels warmoadgens mozardebis da bavSvebis mier socialuri signalebis araswori interpretacia; bavSvebi romelTac aReniSnebaT qceviTi darRvevebi da agresia, arasworad axdenen irgvlivmyofTa qmedebebis interpretirebas.saxeldobr, urTierTobas aRiqvamen rogorc mtruls da Sesabamisad, gaaCniaT problemebi socialur urTierTobebSi. sxvanairad rom vTqvaT, socialuri informaciis Semecneba da gadamuSaveba xdeba Taviseburad/arasworad. Aamdenad marTebulia sarwmuno dinamiuri kvlevis Catareba, romelic saSualebas mogvcemda Segvefasebina da ukeT gagvego is meqanizmebi, da neirodisfunqciis da sxva risk faqtorebis wvlili am meqanizmebis aRmocenebaSi romelTa meSveobiTac mozardebi myarad iTviseben deviaciuri qvevebs.
Marina Gegelashvili psychiatrist MD. Ph.D
Issues of neuropsychological disfunction and behavioral problems age dynamic in adolescents.
The purpose of the study was to determine the prevalence of behavioral problems in children and adolescents in Georgia, and to define the bio-psycho-social factors affecting and facilitating in development of behavioral problems in terms of effectively and purposefully planning children and adolescents Mental Health psycho-preventive measures.
Materials and Methods:
The present study represents the research focusing on psychosocial problems in adolescents’ behavior. The study was carried out in public schools – in total 1374 children and adolescents between 12-17,(males 42%, females-48%)
specially elaborated Psychosocial questionnaire ,– Rey- Tailor Complex Test and Recognition Trial (RCFT),Rubinstein Self-Evaluation Test (standardized for Georgian population),Rokich Value Test (standardized for Georgian population)
Statistics Sampling method was used.. The data was analyzed by the univariative tests - X2 test, multivariate (Dispersive) analysis, logistic regression
Results Statistical analysis revealed that the adolescents, who have impaired speed of cognitive function, have behavioral problems more often. (X2=3.750, P<0.05). The same is shown in adolescents who reveal disrupted memory pattern - they evidently frequently have behavioral problems. (X2=11.080 P<0.02), Iin the adolescents who have serious behavioral problems, frequency of neurodysfunction is higher than in the adolescents not having deviations (Pearson Chi-Square=8.71 P<0.01).
undesirable behavior, that develops in the childhood or at the age of 12 – as it is shown culminates at the age of 14-15; as for the neurodysfunction, it culminates at the age of 13 and then declines – it might be due to the age compensation, i.e. we might assume that at this age period (13-14) behavior disorder develops; though, as it has been mentioned above, this problem needs further research.
To reveal the mechanisms of behavioral problems in terms of incorrect interpretation of social signals and neuropsychological disfunction s contribution in this mechanisms, further research is needed
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