Показатели качества сна, пищевого поведения, эмоциональных и поведенческих характеристик у мальчиков-подростков с ожирением

Введение. Актуальной задачей является изучение индивидуальных клинических вариантов ожирения в отдельных группах пациентов, в т. ч. у мальчиков-подростков.

Цель. Изучить гетерогенность показателей качества сна, эмоциональных и поведенческих характеристик, пищевого поведения у мальчиков-подростков с ожирением.

Материалы и методы. Обследовано 164 подростка в возрасте 14–17 лет: 137 – с ожирением и 27 – практически здоровых. Исследование качества сна проводилось по шкале сна и бодрствования подростков. Для выявления симптомов нарушений поведения и эмоциональной сферы использовался опросник Ахенбаха. Для оценки отдельных вариантов изменения пищевого поведения, включая ограничительное, эмоциональное и экстернальное, применялся голландский опросник пищевого поведения.

Результаты. Были выделены 6 кластеров наблюдений. Первый состоял из подростков, не имеющих выраженных нарушений пищевого поведения, однако с нарушениями мышления и высокой агрессией на фоне соматических жалоб. Второй – дети с выраженными нарушениями сна, пищевого поведения на фоне низкой социальной адаптации и высокого уровня агрессии. Третий – подростки с отсутствием явных изменений пищевого поведения, хорошим качеством сна, отсутствием выраженных психологических проблем. Четвертый – социально адаптированные подростки, однако с выраженными интернализованными проблемами и эмоциональным пищевым поведением. Пятый – без выраженных проблем в социальной и эмоциональной сфере, однако имеющих нарушения пищевого поведения на фоне выраженного девиантного поведения и элементов агрессии. Шестой – из социально адаптированных подростков с выраженным ограничительным пищевым поведением и отсутствием нарушений эмоциональной сферы и соматических жалоб. Большинство клинически здоровых детей относились к третьему, наиболее благоприятному кластеру, тогда как подростки с ожирением имели более разнообразное представительство кластеров, и отнесение пациентов к любому кластеру в сравнении с третьим было значимым предиктором нарастания z-скора ИМТ.

Выводы. Выявлены существенные различия эмоционально-поведенческих характеристик подростков с ожирением, которые следует учитывать при выборе тактики лечения.

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