Neurology bulletin

In article results of the analysis of a problem of expediency and efficiency of digital methods of self-regulation as addition to face-to-face psychotherapy are carried out. On the basis of the review of evidential researches (meta-analyses and systematic reviews) the validity of application of methods of digital psychotherapy is shown. Scientific data on efficiency of a technique of Master Kit intended for independent work of the person with the beliefs, installations, emotional states (fears, touchiness), unaccepted qualities, a self-assessment are provided. It is noted that despite polarity of opinions of professionals and clients/patients on need of more widespread introduction of self-regulation with use of mobile applications, this approach is evidence-based and expedient. It is noted that the considerable number of clients and patients inclines to the self-help choice more and more actively. The conclusion that transition only to techniques of the self-help is similar to self-treatment which not always appears an adequate measure is drawn. Self-regulation not an alternative of face-to-face psychotherapy, but apps are not identical to the qualified psychotherapists. But the choice remains for the consumer of psychotherapeutic services.

The birth and upbringing of a child with a mental development condition causes the mother to search for special ways to adapt to a difficult life situation. Mothers of children with mental disorders such as autism spectrum disorder, mental retardation and cerebral palsy are in a situation of many years of crisis. The aim of our study was to consider the characteristics of the psychological characteristics of women mothers raising children with mental dysontogenesis. The study involved 200 women mothers. We used the following methods: a study of personality traits of R. Kettell (16PF) and a study of coping behavior of E.Heim (1988), as well as a mathematical regression analysis of significant differences in psychological characteristics of personality, behavior and attitudes in three groups of mothers depending on type mental dysontogenesis of their children. It was found that in the psychological portrait of all the mothers studied, neurotic and emotional dysfunctions, reduced control of emotions and behavior, the use of non-adaptive coping strategies and impaired mental adaptation are noted. In each group of mothers, distinctive characteristics of personality traits and coping strategies were found, which should be taken into account when working with such mothers. Our study may be useful in preventing emotional and behavioral disorders and psychological support for mothers raising children with mental dysontogenesis. Timely psychological diagnosis of the mothers themselves will help to identify maladaptive personal characteristics, and the provision of psychological assistance to mothers of sick children will help to form a constructive attitude towards the child and his mental defect. This will lead to an understanding of the need to identify constructive models of women's social adaptation and the development of special routes for psychological and pedagogical support for such mothers.

Purpose. Type 1 diabetes mellitus is one of those chronic somatic diseases in which the solution of medical problems is inextricably linked to a whole complex of psychological problems. The main condition for successful treatment and prevention of complications is the constant active involvement of the patient in the treatment process. In this regard, factors such as the immediate social environment, especially the family, are of particular importance. The aim of the study is to identify the features of child-parent relationships in families of adolescents with type 1 diabetes, and their impact on the formation of the adolescent's attitude to the disease.

Methods. The study used tests "Teenagers about parents", "Family sociogram", a questionnaire on the study of parental attitudes, a diagnostic test of the attitude of adult family members to the child's disease, a projective drawing test "My disease".

Results. According to the results of the survey, it can be said that the attitude of adolescents to their disease is generally adequate, except in rare cases of increased anxiety and communication problems. At the same time, teenagers are distinguished by egocentrism, because they are often the center of attention of the whole family and wait for a special attitude. In the case where the mother's excessive control activity of teenagers, they consider their decision-making. High mental tension of the mother in connection with the disease of the child leads to the formation of his emotional-negative attitude to his disease. The mother, unlike the teenagers, the harder it is to adapt to their disease, exhibit excessive emotional concentration and anxiety, and connecting with the child and the fixation on the satisfaction of its needs.

Summary. Adolescents with type 1 diabetes are characterized by egocentrism and expect special care towards themselves, at the same time negatively assessing the strict control of behavior in the case of the disease on the part of the mother. Both positions do not contribute to the formation of such an attitude to the disease, which would be characterized by a high degree of their own activity and responsibility. High neuro-mental tension of the mother in connection with the disease, her experience of stress, anxiety leads to the formation of a teenager emotionally negative attitude to his disease, making it difficult to adapt to the disease. Mothers who demonstrate a pronounced emotional concentration on the child and the satisfaction of his needs, contribute to the formation of fixation of the child on the disease.

The main treatment for syringomyelia associated with Chiari Type 1 malformation is surgery – decompression of posterior cranial fossa, in order to eliminate the cerebrospinal fluid flow block at the craniovertebral transition level.  However, successful surgical treatment does not always lead to regression of syringomyelia symptoms.  The literature presents controversial data about factors affecting the postoperative outcome. We examined 44 patients, who underwent decompression of the posterior cranial fossa, in order to assess the postoperative dynamics of syringomyelia associated with Chiari Type 1 malformation and to identify predictive factors.  Analysis of clinical and neurovisual parameters before surgery and at the distant postoperative stage (2 years or more after treatment) made it possible to determine the frequency of the dynamics of spinal symptoms and symptoms of the large occipital foramen and identify the main factors affecting the postoperative outcome.

A recent analysis of factors preventing patients with somatoform disorders from timely visit to a psychiatrist showed that along with clinical, socio-demographic, psychological and other causes, self-stigma phenomenon holds a specific place in the formation of a psychiatrist escape behavior. The article deals with the analysis of some historical aspects of stigma in psychiatry, manifestations of self-stigma attitude in patients with border psychic disorders deserve special attention.  The importance to introduce destigma psych-educational programs into the primary health care settings is emphasized.

The discussion continues about the place of instrumental assessment approaches in evidence-based medicine. The position of the validity of psychometry to objectify the assessment of treatment outcomes, including in group generalizations and in transcultural studies, is being defended. The selection of criteria for evaluating the effectiveness of antidepressant therapy is discussed.