www.ksmf.org/arhimed   arhimed@ksmf.org   [5/10/2025 6:48:32 PM] http://www.ksmf.org/arhimed/poglej.asp?id=50 Psihosomatika pri umsko manjrazvitih otrocih Avtor: Tomo Havlicek, Jurij Bon Mentor: prof.dr. Miloš Kobal Somentor: prof.dr. Martina Tomori Uvod : Duševno manjrazviti otroci predstavljajo skupino, ki zaradi svojih lastnosti zahteva posebno pozornost pri zdravstveni obravnavi. V današnjem casu skušamo njim in njihovim družinam pomagati z individualno prilagojeno obravnavo, ki otroka cim manj trga iz njegovega okolja. Vprašanje duševnega zdravja duševno manjrazvitih otrok se v tem okviru pojavlja šele v zadnjih dvajsetih letih, ko pricenjamo govoriti o "dvojni diagnozi" otrok, torej soobstajanju duševnih motenj in duševne manjrazvitosti. Zaradi relativne nerazvitosti podrocja pa ostaja še veliko nejasnosti na podrocjih razpoznave duševnih motenj, njihovih vzrokov, dejavnikov, ki vplivajo nanje, ter njihove zdravstvene obravnave. Pri raziskavah in zdravstveni obravnavi duševnih motenj pri duševno manjrazvitih otrocih se priporoca uporaba standardiziranih vprašalnikov za razpoznavo duševnih motenj, ki pomenijo poenoten in objektivnejši pristop k problemu. Namen : V raziskavi smo poskušali ugotoviti, ali se duševno manjrazviti otroci po svojih telesnih in socialnih znacilnostih razlikujejo od duševno ustrezno razvitih otrok. Obenem so nas zanimali vplivi razlicnih demografskih, telesnih in socialnih dejavnikov na stopnje duševne manjrazvitosti. Z uporabo standardiziranega vprašalnika smo poskušali ugotoviti kaj o pojavljanju duševnih motenj pri duševno manjrazvitih otrocih, mehanizmih njihovega nastanka in vplivih demografskih, telesnih in socialnih dejavnikov nanje. Poskušali smo ugotoviti tudi ustreznost zdravstvene obravnave morebitnih prisotnih duševnih motenj. Metode : V raziskavo smo vkljucili 46 duševno manjrazvitih otrok in 50 duševno ustrezno razvitih otrok. Podatke o njihovem razvoju, sedanjem telesnem zdravju in socialnih znacilnostih smo izlocili iz njihovih zdravstvenih kartotek. Znake duševnih motenj smo pri duševno manjrazvitih otrocih iskali z vprašalnikom " Developmental Behavior Checklist ", ki so ga izpolnjevali razredni ucitelji otrok. Rezultati : Med skupinama duševno manjrazvitih in duševno ustrezno razvitih otrok smo ugotovili statisticno pomembne razlike v znacilnostih njihovega razvoja in telesnega zdravja v casu raziskave. Odkrili smo statisticno znacilne povezave med stopnjami duševne manjrazvitosti in terminom poroda otrok, hospitalizacijami v otroštvu ter obiskovanjem razlicnih oddelkov vzgojno varstvenih zavodov. Pri 7 od 46 duševno manjrazvitih otrok smo ugotovili prisotnost duševnih motenj. Ugotovili smo tudi statisticno znacilne povezave med pojavljanjem duševnih motenj in stopnjami duševne manjrazvitosti, boleznimi v casu razvoja otrok in v casu raziskave ter nekaterimi socialnimi dejavniki. Dva od sedmih otrok z ugotovljeno duševno motnjo sta bila v casu raziskave v strokovni obravnavi. Sklepi : Rezultati potrjujejo klinicno in raziskovalno uporabnost vprašalnika, ugotovljene povezave pa nakazujejo socasnost in soodvisnost telesnih dogajanj, socialnih vplivov, duševne manjrazvitosti in duševnih motenj tako v razvoju kot v sedanjem zdravstvenem stanju otrok. Zaradi ugotovljene soodvisnosti še posebej poudarjamo pomen preventive pri obravnavi duševno manjrazvitih otrok in verjetno neustreznost zdravstvene obravnave duševnih motenj pri njih. «» [Abstract / English version] Psihosomatika pri umsko manjrazvitih otrocih Author: Tomo Havlicek, Jurij Bon Mentor: prof.dr. Miloš Kobal Co-mentor: prof.dr. Martina Tomori Introduction: Children with mental retardation constitute a group with special medical needs. The objective today is to help them and their families with individually adapted assistance, which enables the child to remain in his domestic environment. The issue of mental health among children with mental retardation has became important only recently, when the term "dual diagnosis" -coincidence of mental illness and mental retardation - was applied. At present there is still much vagueness regarding the recognition of mental illness, possible causes and factors that influence mental illness and medical treatment applied. Use of standardised checklists is recommended for identification, treatment and research of mental illnesses, because they show the results in more objective and standardised way. Purpose: Our aim was to find out if there are differences in physical and social characteristics between children with mental retardation and children without disabilities. We were also interested in influences of various demographic, physical and social factors on the level of mental retardation. We tried to determine the incidence of mental illnesses among children with mental retardation, to learn about the origins and mechanisms of their development and find out about the influences of demographic, physical and social factors on them. We also tried to assess the appropriateness of medical treatment of mental illnesses present. Methods: 46 children with mental retardation and 50 children without disabilities participated in our study. Data about their development, present physical health and social characteristics were obtained from their medical records. Signs of emotional and behavioral disturbances were determined with the use of Developmental Behaviour Checklists, which were completed by the class teachers. Results: We have found statistically significant differences in characteristics of development and present physical health between children with mental retardation and children without disabilities. We have found statistically significant correlation between the level of mental retardation and time of birth, hospitalisations during childhood and attendance to developmental department in kindergarten. Mental illness was determined in 7 children with mental retardation. We have also found statistically significant correlation between the incidence of mental illness and level of mental retardation, diseases during the childhood and diseases present in the time of the study and some of the social characteristics. Two of seven children with present mental illness were receiving psychiatric assistance in the time of the study. Conclusion: The results confirm clinical and research value of Developmental Behavior Checklist. Correlations observed indicate the coincidence and interdependence of physical occurrences, social influences, mental retardation and mental illness during development of the children and at their present state. We emphasize the importance of prevention and globally oriented treatment of children with mental retardation. We also draw attention to possible deficiencies in medical treatment of mental illnesses among them.