“Distant but Still Connected” – Cognitive Behavioural Therapy in the Treatment of Obsessive-Compulsive Disorder During a Health Crisis

Cilj rada je prikazati slučaj desetogodišnjeg dječaka koji boluje od opsesivno-kompulzivnog poremećaja, opisati simptome poremećaja kod dječaka te prikazati kognitivno-bihevioralni tretman uz terapiju psihofarmacima. Dječak u dobi od 10 godina i 4 mjeseca dolazi na hitni pregled dječjem i adolescentnom psihijatru zbog pogoršanja teškoća iz anksioznog kruga, te se pregledom psihijatra ustanovi dijagnoza opsesivno-kompulzivnog poremećaja. U svakodnevnom funkcioniranju dječaku se javi opsesivna misao prijetećeg sadržaja, a cilj njegovih kompulzija bio je smanjiti povišenu razinu tjeskobe te prevenirati neki zastrašujući događaj, koji nije bio specificiran. Dječak je uključen u kognitivno-bihevioralni tretman uz psihofarmakološku terapiju propisanu od strane dječjeg i adolescentnog psihijatra. Zbog pandemije korona virusa tretman je prilagođen novonastalim okolnostima te se tijekom pandemije tretman održavao putem video poziva. U tretmanu opsesivno-kompulzivnog poremećaja u dječjoj i adolescentnoj dobi od iznimne je važnosti pravovremena dijagnostika i uključivanje u tretman, kao i uključenost roditelja u terapijski proces. Kognitivno-bihevioralna terapija je pokazala uspješnost u redukciji anksioznih teškoća dječaka, što je u skladu i s mnogobrojnim znanstvenim istraživanjima, pa se kognitivno-bihevioralna terapija smatra terapijom izbora u liječenju opsesivno-kompulzivnog poremećaja kod djece i mladih. Aktualna zdravstvena kriza promijenila je način pružanja psihoterapije u svijetu što zahtijeva i daljnje prilagođavanje novonastalim uvjetima, kako terapeuta tako i primatelja psihoterapijskih usluga.The aim of this paper was to present a case of a ten-year-old boy suffering from Obsessive Compulsive Disorder, to describe the symptoms of the disorder and to present cognitive-behavioral treatment with psychopharmaceutical therapy. A boy aged 10 years and 4 months came in for an urgent examination to a child and adolescent psychiatrist due to worsening anxiety difficulties, and a psychiatric examination established a diagnosis of obsessive-compulsive disorder. An obsessive thought of threatening content came to mind in the daily functioning of the boy, and the goal of his compulsions was to reduce the elevated level of anxiety and prevent some frightening event, which was not specified. The boy was then included in cognitive-behavioural treatment with psychopharmacological therapy prescribed by the child and adolescent psychiatrist. Due to the coronavirus pandemic, the treatment was adapted to the new circumstances and during the pandemic the treatment was maintained via video call. In the treatment of Obsessive Compulsive Disorder in children and adolescents, timely diagnosis and involvement in treatment, as well as the involvement of parents in the therapeutic process are of utmost importance. Cognitive Behavioural Therapy has shown success in reducing the boy’s anxiety difficulties, which is in line with numerous scientific studies, so cognitive-behavioural therapy is considered the therapy of choice in the treatment of Obsessive Compulsive Disorder in children and adolescents. The current health crisis has changed the way psychotherapy is provided in the world, which requires further adaptation to the new conditions, both for therapists and recipients of psychotherapeutic services

Suicidality and suicide prevention among children and youth of parents with a mental disorder: The analysis of the situation in Croatia

Istraživanja pokazuju kako je suicid jedan od vodećih uzroka smrti od ozljeda u Hrvatskoj. Među djecom koja imaju suicidalne ideje i namjere, nije zanemariv broj djece čiji roditelji imaju mentalne poteškoće, stoga se ova analiza problema suicidalnosti usmjerava upravo na suicidalnost među djecom čiji roditelji imaju mentalnih poteškoća. U ovom radu detaljno je analizirana suicidalnost među djecom i mladima čiji roditelji imaju mentalni poremećaj, objašnjeni su osnovni pojmovi važni za razumijevanje i analizu problema. U ovom radu detaljno su navedeni i objašnjeni rizični i zaštititni čimbenici u objašnjenju razvoja suicidalnosti kod djece i mladih čiji roditelji imaju mentalne poteškoće. Rad objašnjava različite teorije etiologije suicidalnosti s posebnim naglaskom na prevenciju suicida među mladima u Republici Hrvatskoj, ističući nedostatak sustavne i kontinuirane prevencije na nacionalnoj razini. Problem suicida kod djece i mladih izražen je problem koji zahtijeva djelovanje institucija na nacionalnoj i lokalnoj razini.The research shows that suicide is one of the leading causes of death from injuries in Croatia. Among children who have suicidal ideas and intentions, the number of children whose parents have mental disabilities is not negligible, so this analysis of the problem of suicide focuses on suicide among children whose parents have mental disabilities. In this paper, suicidality among children and youth whose parents have a mental disorder is analyzed in detail, the basic concepts important for understanding and analyzing the problem are explained. This paper details and explains the risk and protective factors in explaining the development of suicide in children and youth whose parents have mental difficulties. The paper explains various theories of the etiology of suicidality with emphasis on suicide prevention among youth in the Republic of Croatia, emphasizing the lack of systematic and continuous prevention at the national level. The problem of suicide in children and youth is a problem that requires the action of institutions at the national and local levels