Zdorovʹe Rebenka (Feb 2016)
Biopsychosocial Model of Gastroduodenal Pathology in Children
Abstract
From the standpoint of the biopsychosocial model of medicine, the formation of gastroduodenal diseases occurs as a result of interaction of biological, psychoemotional and psychosocial factors. Contribution of each of them to the development of certain nosological entities of gastroduodenal pathology in children is not studied enough. Current study was aimed to investigate the contribution of biological, psychoemotional and psychosocial factors to the formation of various nosological entities of gastroduodenal pathology in children and correlation between them. Materials and methods. The study involved 83 children aged 6 to 11 years with gastroduodenal diseases. The control group consisted of 45 children who showed no somatic pathology. To analyze the value of certain factors in the development of gastroduodenal pathology in children, methods of multiple correlation and factor analysis were used. Results. The findings showed dominance of the role of psychoemotional and psychosocial factors in the formation of functional disorders of the stomach and duodenum and gastritis/gastroduodenitis, while in destructive forms of gastroduodenal pathology, contribution of biological factors was predominant. Heterogeneity of functional dyspepsia as nosologic entity was revealed — both risk factors for mucosal destruction and psychoemotional factors, which are typical for functional disorders, were of great value. This explains the different course of functional dyspepsia — in some cases it is non-progressive, when the disorder remains functional for decades, and in others — this is the first stage of the continuum «functional dyspepsia — gastritis/gastroduodenitis — ulcer». Conclusion. Formation of gastroduodenal diseases, their course, prognosis are determined by the combination of risk factors. Defining their role in each case will enable to individualize the treatment and prevention approaches and to increase their efficiency, perhaps by reducing the economic costs.
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