Priročnik o izkušnji osebnostne motnje

When we talk about personality disorders, people usually have a very emotional reaction, with pain and unpleasant emotions being the most common. Those who have a relationship with a person who has a personality disorder, usually do not know what they are facing, but they do experience feelings of unease, despair, sadness, anger and depression, while doubting their own experience and perception of the world. Family and friends often feel like they are “caught in a relationship web”, which keeps getting more and more tangled, instead of untangling. Personality disorders cause everyone a lot of suffering, anger and disappointment, manifesting in every dimension of the human experience, but the behavior of a person with a personality disorder and the responses from the environment are actually a lot more predictable than you might imagine. In order to present this demanding and little-known topic to the widest range of readers, the handbook uses stories of everyday people to illustrate how their experiences of personality disorders intertwine with stress, mood disorders and problems with addiction. It also presents the process of identifying individual personality disorders and various options of self-help and recovery. The handbook is intended for anyone who is interested in the field of personality disorders, is personally facing mental health problems, or has a relative who is dealing with these issues.Ko govorimo o osebnostnih motnjah, se ljudje navadno odzovejo zelo čustveno. Največkrat se pojavijo boleča in neprijetna čustva. Tisti, ki so vpeti v odnos z osebo z izkušnjo osebnostne motnje, praviloma ne vedo, s čim se soočajo, občutijo pa nelagodje, obup, žalost, jezo in depresijo in dvomijo o lastnem doživljanju in dojemanju sveta. Bližnje osebe se pogosto počutijo, kot da bi bile »ujete v klobčič odnosa«, ki se kar naprej zapleta, ne pa razpleta. Osebnostne motnje povzročajo vsem veliko trpljenja, jeze in razočaranja in se kažejo v vseh razsežnostih človekovega bivanja, vendar so vedenje osebe z izkušnjo osebnostne motnje in odzivi okolice bolj pričakovani in predvidljivi, kot bi si lahko predstavljali. Da bi to zahtevno in pri ljudeh premalo poznano tematiko čim bolj približali najširšemu krogu bralcev, je v priročniku z zgodbami običajnih ljudi prikazan preplet njihovih izkušenj osebnostnih motenj, stresa, motenj razpoloženja in težav zaradi zasvojenosti. Predstavljeno je tudi, kako poteka prepoznavanje posamezne osebnostne motnje in kakšne so možnosti samopomoči in okrevanja

COMORBID ANXIETY IN PATIENTS WITH PSYCHOSIS

A diagnosis of psychosis has tended to discount the considerable degree of emotional disorder associated with it, in a manner that may also inform psychological treatment options. Depression and anxiety are often associated with schizophrenia. Up to 40% of people have clinical levels of depression and anxiety symptoms could occur in 60% of patients with chronic psychotic disorder. Among emotional problems depression and depressive symptoms are well recognised and treated with success, whereas anxiety is a less known phenomenon and has not been studied as much as depression. Comorbid anxiety disorders or symptoms (social phobia, panic disorder, obsessive compulsive disorder, and post-traumatic stress disorder) occur in patients with psychosis in the same way as in patients who have only anxiety disorder. This comorbidity adversely affects outcome, and it may also reflect on processes underlying the development of psychotic symptoms. The present review highlights some major characteristics of anxiety and psychosis and also some aspects of coping and treatment strategies for anxiety in patients with psychosis

Stres in anksioznost

Na stresne okoliščine se vsi odzivamo podobno. Stres je normalno odzivanje na spremenjene okoliščine in sam po sebi ni duševna ali telesna motnja, pogosto pa je sprožilni dejavnik za vrsto duševnih in telesnih motenj. Krepitev duševnega zdravja in preprečevanje nastanka duševnih motenj temelji predvsem na povečevanju odpornosti na stres in reševanju vsakodnevnih težav na način, da se stres zmanjšuje. O duševnih motnjah vemo bistveno manj kot o prehladu, sladkorni bolezni ali drugih zdravstvenih težavah, poleg tega jih še vedno spremljajo stigma, sram, nerazumevanje in močan strah. Številni zato odlašajo z iskanjem pomoči, si skušajo pomagati sami ali se zatekajo k neustreznim rešitvam. V priročniku je posvečena posebna pozornost prepletenosti stresa in motenj razpoloženja ter pojasnilom, kaj se dogaja v našem telesu, ko je v stresu in kakšne so lahko dolgoročne posledice. S pomočjo osebnih zgodb običajnih ljudi je predstavljeno, kako poteka prepoznavanje anksioznih motenj, kakšne so razlike med različnimi vrstami anksioznih motenj ter kakšne možnosti so na voljo za samopomoč in zdravljenje

Vodič po motnjah razpoloženja

V življenju se nenehno učimo obvladovati različne stresne okoliščine, s čimer povečujemo svojo prožnost in odpornost nanje. Za dobro duševno zdravje pa je pomembno tudi načrtno povečevanje prožnosti in odpornosti na stresne okoliščine. Motnje razpoloženja so neposredno prepletene s stresom in odpornostjo nanj, zato je prvo poglavje posvečeno motnjam, ki jih povzroča stres, sledijo anksiozne motnje, depresija in bipolarna motnja razpoloženja. Opisi so kratki, jedrnati in vodijo k iskanju dodatnih informacij. Vodič zaokrožujejo praktični nasveti, kako prepoznati težave v duševnem zdravju, kako ukrepati in kakšne oblike pomoči so na voljo. Posebna pozornost je namenjena predstavitvi inovativne izobraževalne platforme OMRA, prve tovrstne pri nas. Platforma ponuja širok nabor orodij, namenjenih najširšemu krogu javnosti (spletna stran, delavnice, tiskovine, novičniki) in s pomočjo katerih so predstavljeni vzroki in posledice motenj razpoloženja ter različne oblike pomoči/samopomoči

Depresija in bipolarna motnja razpoloženja

V razvitem svetu je depresija ena najpogostejših duševnih motenj. Prizadene lahko kogarkoli in močno ovira vsakodnevno delovanje. Depresija je ozdravljiva, mogoče jo je preprečiti, predvsem pa je mogoče doseči, da se ne ponovi. Bipolarna motnja razpoloženja je prav tako pogosta in mnogokrat jo zamenjamo za druge duševne motnje. Spada med resne duševne motnje, vendar jo je mogoče uspešno zdraviti, preprečevati ponovitve in človek lahko z njo živi povsem običajno in uspešno. O duševnih motnjah še vedno ne zmoremo v naši družbi odkrito in brezskrbno govoriti, saj jih spremljajo stigma, sram, nerazumevanje in močan strah. Ljudje zato pogosto odlašajo z iskanjem strokovne pomoči, si skušajo pomagati sami in se včasih zatekajo tudi k neustreznim rešitvam. Zato priročnik o prepoznavanju in obvladovanju depresije in bipolarne motnje razpoloženja, s pomočjo osebnih zgodb običajnih ljudi pojasnjuje, kako poteka prepoznavanje teh dveh motenj, kakšno je življenje z njima ter kakšne so možnosti za samopomoč in zdravljenje

Enduring personality changes in patients living at home and challenges for community nursing

Introduction: Personality and behaviour disorders include enduring personality changes which cannot be attributed to brain injury or disease. Traumatic experiences can cause personality vulnerability. The research aimed to determine the characteristic enduring personality changes, the risk factors and the quality of life of patients living in their home environment. Methods: The field research is based on a quantitative method. The data were gathered through a structured questionnaire. The sample consisted n = 606 of patients (18.56 %) from the Central Slovenia region, aged between 20 and 92 years. The data were processed using descriptive statistics, the χ2 test, group classification and discriminant analysis. Results: The enduring personality changes are present in 9 % (n = 53) of the patients who tend to be older, with lesser educational attainment. Only a quarter of the enduring personality changes patients (n = 10) are receiving psychiatric treatment. Among the groups of patients with or without enduring personality changes statistically significant differences have been observed in relation to their past experiences with a traumatic event (p < 0.001), level of independence in the performance of the activities of daily living (p < 0.001), incidence rate of chronic pain (p = 0.002), social integration (p = 0.016), suicidal thoughts (p < 0.001) and incidence rate of comorbidity of somatic illnesses and psychological disorders (p < 0.001). Discussion and conclusion: Results of the study point to the share of enduring personality changes patients living at home in which the condition remains largely unrecognized, untreated and shadowed by other mental and physical health issues. Community nurses play a crucial role in timely recognition and detection of the changes and the patients' referral to multidisciplinary treatment. A national research project conducted by community nurses is needed to highlight the prevalence, treatment and good practice in the delivery of pertinent services

Effects of Training Program on Recognition and Management of Depression and Suicide Risk Evaluation for Slovenian Primary-care Physicians: Follow-up Study

Aim To implement and evaluate an educational program for primary care physicians on recognition and treatment of depression and suicide prevention. Method The study was conducted in 3 Slovenian neighboring regions (Celje, Ravne na Koroškem, and Podravska) with similar suicide rates and other health indicators. All primary care physicians from Celje (N = 155) and Ravne na Koroškem (N = 35) were invited to participate in the educational program on depression treatment and suicide risk recognition. From January to March 2003, approximately half of them (82 out of 190; educational group) attended the program, whereas the other half (108 out of 190; control group 1) and physicians from the Podravska region (N = 164; control group 2) did not attend the program. The prescription rates of antidepressants and anxiolytics before and after the intervention were compared between the studied regions. Also, suicide rates three-years before and after the intervention were compared. Results From 2002 to 2003, there was a 2.33-fold increase in the rate of antidepressant prescriptions in the educational group (P < 0.05) and only 1.28-fold (P < 0.05) and 1.34-fold (P < 0.05) increase in control groups 1 and 2, respectively. However, the 12% decrease in suicide rate in the intervention regions was not significantly greater than the 4% decrease in the non-intervention region (P > 0.05). Conclusion Our training program was beneficial for primary care physicians’ ability to recognize and manage depression. However, there was no significant decrease in local suicide rates

Exploring the role of drug-metabolising enzymes in antidepressant side effects

Abstract Rationale: Cytochrome P450 enzymes are important in the metabolism of antidepressants. The highly polymorphic nature of these enzymes has been linked to variability in antidepressant metabolism rates, leading to hope regarding the use of P450 genotyping to guide treatment. However, evidence that P450 genotypic differences underlie the variation in treatment outcomes is inconclusive. Objectives: We explored the links between both P450 genotype and serum concentrations of antidepressant with antidepressant side effects, using data from the Genome-Based Therapeutic Drugs for Depression Project (GENDEP), which is a large (n = 868), pharmacogenetic study of depressed individuals treated with escitalopram or nortriptyline. Methods: Patients were genotyped for the enzymes CYP2C19 and CYP2D6, and serum concentrations of both antidepressant and primary metabolite were measured after 8 weeks of treatment. Side effects were assessed weekly. We investigated associations between P450 genotypes, serum concentrations of antidepressants and side effects, as well as the relationship between P450 genotype and study discontinuation. Results: P450 genotype did not predict total side effect burden (nortriptyline: n = 251, p = 0.5638, β = -0.133, standard error (SE) = 0.229; escitalopram: n = 340, p = 0.9627, β = -0.004, SE = 0.085), study discontinuation (nortriptyline n = 284, hazard ratio (HR) = 1.300, p = 0.174; escitalopram n = 376, HR = 0.870, p = 0.118) or specific side effects. Serum concentrations of antidepressant were only related to a minority of the specific side effects measured: dry mouth, dizziness and diarrhoea. Conclusions: In this sample where antidepressant dosage is titrated using clinical judgement, P450 genotypes do not explain differences between patients in side effects with antidepressants. Serum drug concentrations appear to only explain variability in the occurrence of a minority of specific side effects.SCOPUS: ar.jinfo:eu-repo/semantics/publishe