Psihološko-psihijatrijski čimbenici kronične vrtoglavice

Investigations demonstrated a correlation between oto-neurological illnesses manifested subjectively by instability and dizziness and anxiety and other psychiatric disorders. The concept of chronic vertigo offered a systematic approach to patients with a lasting dizziness not caused by an evident patophysiological vestibular damage. According to newer neurobiological investigations, there are three subtypes of chronic dizziness: otogenic, psychogenic and interactive. Nowadays there is a greater diagnostic accuracy and insight into the basic pathophysiological processes of the vestibular migraene, post-concussional syndrom and dysautonomias that can cause chronic dizziness. Selective serotonin reuptake inhibitors, rehabilitation therapy for restoring the balance, and cognitive- behavioural therapy can be effective in treatment, but this effectiveness is limited.Istraživanja su pokazala da postoji povezanost između nekoliko neuro-otoloških kliničkih stanja koja se javljaju subjektivnim osjećajem nestabilnosti i vrtoglavice uz anksioznost i druge psihijatrijske simptome. Pojam kronične subjektivne vrtoglavice ponudio je sustavni pristup bolesnicima sa ustrajnom vrtoglavicom koja nije uzrokovana očitim patofiziološkim vestibularnim oštećenjem. Sukladno sa novim neurobiološkim istraživanjima postoje tri podtipa kronične subjektivne vrtoglavice (otogeni, psihogeni, interaktivni) koje čine fizički i psihološki simptomi. Danas postoji veća dijagnostička točnost i uvid u temeljne patofiziološke procese vestibularne migrene, postkontuzijskog sindroma mozga i distonije autonomnog živčanog sustava, koji mogu prouzročiti simptome nalik kroničnoj subjektivnoj vrtoglavici. Selektivni inhibitori ponovne pohrane serotonina-SIPPSa, rehabilitacijska terapija ravnoteže i kognitivno-bihevioralna terapija pokazuju ograničenu, ali korisnu učinkovitost u liječenju kronične subjektivne vrtoglavice

Psihološko-psihijatrijski čimbenici kronične vrtoglavice

Investigations demonstrated a correlation between oto-neurological illnesses manifested subjectively by instability and dizziness and anxiety and other psychiatric disorders. The concept of chronic vertigo offered a systematic approach to patients with a lasting dizziness not caused by an evident patophysiological vestibular damage. According to newer neurobiological investigations, there are three subtypes of chronic dizziness: otogenic, psychogenic and interactive. Nowadays there is a greater diagnostic accuracy and insight into the basic pathophysiological processes of the vestibular migraene, post-concussional syndrom and dysautonomias that can cause chronic dizziness. Selective serotonin reuptake inhibitors, rehabilitation therapy for restoring the balance, and cognitive- behavioural therapy can be effective in treatment, but this effectiveness is limited.Istraživanja su pokazala da postoji povezanost između nekoliko neuro-otoloških kliničkih stanja koja se javljaju subjektivnim osjećajem nestabilnosti i vrtoglavice uz anksioznost i druge psihijatrijske simptome. Pojam kronične subjektivne vrtoglavice ponudio je sustavni pristup bolesnicima sa ustrajnom vrtoglavicom koja nije uzrokovana očitim patofiziološkim vestibularnim oštećenjem. Sukladno sa novim neurobiološkim istraživanjima postoje tri podtipa kronične subjektivne vrtoglavice (otogeni, psihogeni, interaktivni) koje čine fizički i psihološki simptomi. Danas postoji veća dijagnostička točnost i uvid u temeljne patofiziološke procese vestibularne migrene, postkontuzijskog sindroma mozga i distonije autonomnog živčanog sustava, koji mogu prouzročiti simptome nalik kroničnoj subjektivnoj vrtoglavici. Selektivni inhibitori ponovne pohrane serotonina-SIPPSa, rehabilitacijska terapija ravnoteže i kognitivno-bihevioralna terapija pokazuju ograničenu, ali korisnu učinkovitost u liječenju kronične subjektivne vrtoglavice

Psiho-onkološki pristup oboljelima od raka dojke

Nearly three-quarters of patients with breast cancer have some form of depression. The main cause of the depression is fear, often lifelong, concerning the diagnosis of cancer itself, eventual recurrence, appearence of metastases, final outcome of the desease, but also the possible surgical mutilationof the patient and possible genetic transmission of malignant desease to the offsprings. The high incidence of mental disorders in patients with malignant diseases requires the inclusion of psychiatrist in the therapy team. This could ameliorate the patients quality of life and influence the kind of therapy applied, as well as the final outcome of the disease.Gotovo tri četvrtine oboljelih od karcinoma dojke ima neki oblik depresije. Depresija je najčešće uzrokovana strahom, često cjeloživotnim, zbog dijagnoze maligne bolesti, kao i zbog stalne mogućnosti povrata bolesti i neizvjesnog ishoda liječenja. Eventualna kirurška mutilacija bolesnika, kao i mogući genetički prijenos maligne bolesti na potomsvo, također mogu uzrokovati strah i depresiju kod bolesnika. Budući da je pojavnost psihičke promijenjenosti kod oboljelih od malignih bolesti velika, smatra se da je uključenost psihijatra u liječenje bolesnika s malignim bolestima neophodna. Time se omogućuje bolja kvaliteta života bolesnika i povoljniji ishod liječenja

Genetski polimorfizmi serotoninskog i dopaminskog sustava u odnosu na nasilje i agresiju u shizofreniji

Schizophrenia is a chronic disorder that ultimately leads to a decline in cognitive, social and emotional functioning. Although the aetiology of the disorder is still unknown, it is most likely multifactorial, with equal importance of environmental and genetic factors. It has been hypothesized that those same factors influence aggressive symptomatology and possibly even violence in schizophrenia. The association between schizophrenia and aggressive behaviour is well documented; however, the impact of genetic alterations and gene polymorphisms on the incidence and type of violence in this group of patients has rarely been the focus of scientific research. Both violence and aggression are complex behavioural patterns that lead to difficulties in the comparability of genetic studies and limits their clinical applicability. In this review paper we systematically presented findings from studies examining the association between gene polymorphisms of the dopamine and serotonin systems and aggressive symptoms and violent behaviour in schizophrenia.Shizofrenija je kronična bolest, rekurentnog tijeka, koja u konačnici dovodi do propadanja kognitivnih i emocionalnih funkcija. Iako etiologija same bolesti nije u potpunosti poznata, najvjerojatnije je multifaktorijalna, uz podjednaku važnost okolišnih i genetskih čimbenika. Premda većina psihijatrijskih pacijenata nije nasilna, dobro je poznata povezanost između shizofrenije i agresivnog ponašanja. Također je poznato da brojni psihološki i socijalni čimbenici utječu na pojavu nasilja u pacijenata sa shizofrenijom, ali je nedovoljno istražen utjecaj genetskih promjena i polimorfizama gena na pojavu nasilja u ovoj skupini pacijenata. Nasilje i agresija su kompleksan obrazac ponašanja što dovodi do poteškoća u usporedivosti genetskih studija i kliničkoj primjenjivosti istih. U ovome radu su sistematizirano prikazana dostupna saznanja o potencijalnoj povezanosti polimorfizama gena s implikacijama na serotonergičko i dopaminergičko funkcioniranje i agresivnih simptoma te nasilnog ponašanja u shizofreniji

(ANTI)STIGMA OF PEOPLE WITH DEMENTIA

Demencija kao progresivna bolest predstavlja zdravstveni, obiteljski, ali i društveni rizik. Simptomi su kompleksni, očituju se kako na kognitivnoj tako i na bihevioralnoj razini te s odmakom vremena postaju sve teži. Zbog toga, oboljela osoba više ne može samostalno skrbiti o sebi te joj je neophodna pomoć druge osobe u zadovoljavanju svakodnevnih potreba. Uz ovu se bolest snažno veže stigma kao multidimenzionalan koncept koji u sebi nosi spoznaju da je pojedinac različit po nekom obilježju te kao takav odstupa od društveno prihvatljivih normi. Ovaj rad daje pregled teorija stigme, opisuje proces stigmatizacije i upravljanje stigmom te rizične čimbenike koji pogoduju stvaranju i održavanju stigme u društvu prema oboljelima od demencije. Prikazani su brojni programi redukcije stigme na međunarodnoj razini s ciljem da osobe s demencijom postanu vidljive i vrednovane na jednak način kao i drugi članovi zajednice.Dementia, as a progressive illness, represents health, familial, as well as a social risk. The symptoms are complex, and they manifest themselves on both the cognitiveand the behavioral level. Therefore, the ill person cannot take care of themselves and the help of another person to meet their daily needs is required. A stigma called a „multidimensional concept“ is often connected with this illness, which carries with it the realization that the individual is different in some characteristics and as such deviates from socially acceptable norms. This paper provides an overview of stigma theories, describes the process of stigmatization and stigma management, as well as risk factors that contribute to the creation and maintenance of stigma towards people with dementia in society. Numerous stigma reduction programs are presented internationally with the aim of making people with dementia visible and valued in the same way as other members of the community

Dental Status as a Quality Control Health Care Parameter for Children with Disabilities

The aim of this study was to determine the level of dental health condition in children with disabilities and to find out weather dental health status might be used as a quality control parameter regarding overall health care for disabled children. Disabled and healthy children from 3 to 17 years old were examined. There were 86 boys and 34 girls in each group. Dental health status was evaluated using the World Health Organization diagnostic criteria for decayed, missing and filled teeth. The relations between mean decayed, missing and filled teeth index for primary, mixed and permanent dentition showed no statistically significant differences among groups. Our results showed that disabled children have evenly level of dental caries as their healthy peers. One can conclude that organized health care for disabled children have positive influence on dental care, too. Furthermore, dental status as an indicator of dental care level might be used as a parameter for quality control regarding overall health care for disabled children

Dental Status as a Quality Control Health Care Parameter for Children with Disabilities

The aim of this study was to determine the level of dental health condition in children with disabilities and to find out weather dental health status might be used as a quality control parameter regarding overall health care for disabled children. Disabled and healthy children from 3 to 17 years old were examined. There were 86 boys and 34 girls in each group. Dental health status was evaluated using the World Health Organization diagnostic criteria for decayed, missing and filled teeth. The relations between mean decayed, missing and filled teeth index for primary, mixed and permanent dentition showed no statistically significant differences among groups. Our results showed that disabled children have evenly level of dental caries as their healthy peers. One can conclude that organized health care for disabled children have positive influence on dental care, too. Furthermore, dental status as an indicator of dental care level might be used as a parameter for quality control regarding overall health care for disabled children

Consultation-liaison psychiatry and psychosomatic medicine, A University Hospital Center Sestre milosrdnice model

Kroz ovaj rad prikazujemo aktivno djelovanje Odjela konzultativno-suradne psihijatrije i psihosomatske medicine kao prvog i trenutno jedinog formalno osnovanog odjela takve vrste u Republici Hrvatskoj. Aktivnosti iz područja Konzultativno-suradne psihijatrije se u Kliničkoj bolnici “Sestre milosrdnice” odvijaju praktički od samog osnutka psihijatrije u bolnici, već desetljećima. Također Odjel kao zasebna organizacijska jedinica postoji unazad šest godina. U radu Odjela za konzultativno-suradnu psihijatriju i psihosomatsku medicinu istaknuli bi važnost konzultacije i suradnje između specijalista tjelesne medicine i psihijatara, te naglašavamo značajnu ulogu psihosomatskog aspekta u tjelesnoj bolesti. Također težište rada je isticanje važnosti uloge psihijatra u otkrivanju, dijagnostici i liječenju tjelesnih bolesnika s psihijatrijskim komplikacijama, a ostatku medicinskog tima ukazati da je svaki bolesnik osoba sa biološkom, psihološkom i socijalnom dimenzijom ili drugim riječima njegovanje holističkog, biopsihosocijalnog pristupa svakom bolesniku bio on samo tjelesni bolesnik ili i bolesnik s psihijatrijskim tegobama.The aim of this paper is to demonstrate an active participation of the Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine as the first and currently the only formally founded department of that kind in Croatia. Consultation-liasion psychiytry in Sestre milosrdnice has been present for decades, from the time when psychiatry department was founded at the hospital. Nevertheless, Department as an organizational unit has been active for the last six years. It is important to emphasize the cooperation and consultation between the specialists in “somatic” medicine and psychiatrists as well as to point out a psychosomatic aspect in physical illness. Moreover, the importance of psychiatrist’s role in discovering, providing diagnosis and treating “somatic”patients with psychiatric complications must be placed in the focus, and the rest of the medical team needs to be aware that each patient has its own biological, psychological and social dimension which requires a holistic, bio-psycho-social approach regardless of the patient’s physical or mental disorder