Медицинский совет (Mar 2021)
Stress in children and adolescent is a burning issue of today
Abstract
Introduction.Stress and stress-induced disorders are not uncommon in pediatric practice. The range of causal stressors (information environment, gadgets, pandemic, armed conflicts, etc.) has expanded significantly these days. The article depicts the main clinical manifestations of stress reactions, pathogenetic mechanisms of their development, provides rational approaches to the therapy of elimination of stress manifestations and consequences in children and adolescents from a pediatric perspective.Objective:To study the influence of stress on the psychoemotional sphere and cognitive functions in children aged 7 to 9 years from the armed conflict zone in the Donbass.Materials and methods. 234 children of primary school age were included in the study, of whom 123 children had lived at the armed conflict zone in Donbass for a year. The psychoemotional state and cognitive functions status were determined by children’s tests using a scoring method to assess test results.Results and discussion.The tests with a scoring method to assess test results showed that 100% of children from the armed conflict zone had a chronic stress, 63% had a moderate to severe stress, a high frequency of various types of phobias, as well as impaired concentration and memory.Therapeutic approaches to the management of stress reactions directly depend on the cause and clinical manifestations of such reactions. The therapy strategy includes among other things general strengthening actions, psychotherapy, symptomatic and pathogenetic methods of treatment. In addition, both acute and chronic stress leads to intracellular magnesium deficiency and increased urinary magnesium wasting, as a large amount of catecholamines is released under stress conditions, which contributes to shifting magnesium out of cells. The magnesium deficiency results in increased permeability of cell membranes for calcium ions, which creates conditions for electrical instability and excessive excitability of cells, most significantly of neurons. This is reflected in the fact that the process of excitation prevails over inhibitory reactions, and stress reactions develop as the clinical manifestations. It has been established that an adequate balance of magnesium increases the adaptive capabilities in people. Its neurotropic effects made it possible to consider magnesium as an effective pathogenetic agent that can increase stress resistance, stress management, and activate the body’s adaptive reserves.Conclusion. The causal stressors are manifold, the paediatrician has to deal with stress reactions in children much more often than doctors of other specialties. Magnesium supplements currently form the basis of treatment and rehabilitation actions in children with stress.
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