Child Neuropathy Syndrome: contents, criteria and principles of diagnostics

The principle of polyprofessional assessment is the most important condition of diagnostic procedure of mental disorders which is based on identification of all reasons causing these disorders. There are various approaches to systemize risk factors of disontogenesis. In recent years in Russian psychiatric literature the concept of mental diathesis is discussed as the special form of mental disontogenesis. Mental diathesis is thought to be a predisposition for various mental diseases. Concept of "neuropathy" in which clinical picture somatic symptoms are prevailed can be named as "somatovegetative diathesis". Such disorder proceeds with the expressed vegetative reactions and somatic lability, with instability of vegetative regulation. The data received by the most of researchers, and the results of our studying of the structure of a neuropathic syndrome allow us to believe that the acquired condition of immaturity of vegetative regulation used to be the cornerstone of a congenital or early neuropathy. Thus hypererethism and exhaustion with symptoms of lossed mental balance and asthenia also could be noted. The allocation of the clinical characteristics of the neuropathic syndromes allows us to formulate its obligate diagnostic criteria which can be considered as the general diagnostic criteria with some basic signs of a neuropathic syndrome. Neuropathic symptomocomplex seems the most structured in the early childhood and it can be diagnosed as an independent illness form - as a neuropathy syndrome. Thus it is admissible to speak about neuropathies when we meet the expressed structure of a syndrome satisfying to the general diagnostic criteria of neuropathy, but not only to separate psychopathological symptoms. These criteria unite all neuropathic forms and are necessary for diagnostics of neuropathic disorders. Unfortunately today neuropathy is excluded from diagnostic codes of ICD-10 in spite of the fact that in children's psychiatry this diagnosis in a number of countries is still applied in clinical practice. Moreover, it is considered that the neuropathic symptomocomplex is included as an initial stage into formation of many mental disorders of children's and adolescents' as a factor of "ground". Moreover, comparison of diagnostic criteria of a neuropathy syndrome to the categories of ICD-10 testifies that the clinical symptomatology of basic diagnostic criteria of neuropathy corresponds to the maintenance of the categories F80, F82, F83 and F84.

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