22 research outputs found
Percipirana socijalna podrÅ”ka pacijenata ukljuÄenih u psihoterapijski tretman
Paper is theoretically grounded in the model of social support. The aim of presented research is to gain insight in the perceived level of social support for people in hospital conditions due to the diagnostic criteria and forms of treatment. The proposed model is a multi-source support model. The sample of the study consists of 51 participants who were enrolled in some form of treatment in the University Psychiatric Hospital VrapÄe, since the beginning of February to the end of April 2017. Multidimensional Scale of Social Support (MSPSS), was used. The highest score of perceived support is experienced by significant others (M= 5.72). Interestingly, weakest result of the perceived support by participants was obtained on the subscale of support experienced by the family (M = 5). Negative significant was found between perceived social support and age; support is negatively related to age. Older participants rated a lower level of support than the younger ones (-279*, Pearsonās correlation coefficient). There are no differences or significant correlations in the perception of social support, gender and form of treatment of participants.Rad je teoretski utemeljen na modelu socijalne potpore. Cilj predstavljenog istraživanja je steÄi uvid u percipiranu razinu socijalne potpore ljudima u bolniÄkim uvjetima zbog dijagnostiÄkih kriterija i oblika lijeÄenja. Predloženi model je model podrÅ”ke iz viÅ”e izvora. Uzorak studije sastoji se od 51 sudionika koji su primljeni na neki oblik lijeÄenja na Klinici za psihijatriju VrapÄe, od poÄetka veljaÄe do kraja travnja 2017. KoriÅ”tena je Multidimenzionalna skala socijalne potpore (MSPSS). NajveÄu ocjenu opažene podrÅ”ke imaju životni partneri (M = 5,72). Zanimljivo je da je najslabiji rezultat percepcije podrÅ”ke od strane ispitanika postignut na subskali potpore koju su doživjeli od obitelj (M = 5). NaÄena je negativna povezanost izmeÄu percepcije socijalne podrÅ”ke i dobi; podrÅ”ka je negativno povezana s godinama. Stariji sudionici ocijenili su nižu razinu potpore od mlaÄih (-279 *, Pearsonov koeficijent korelacije). Ne postoje razlike ili znaÄajne korelacije u percepciji socijalne podrÅ”ke, spolu i obliku lijeÄenja sudionika
EXPERIENCE IN ONLINE THERAPY DURING THE COVID-19 PANDEMIC AND ITS INFLUENCE ON EVENTS IN THE GROUP
U kontekstu aktualnih globalnih zbivanja uslijed pandemije struÄnjaci u podruÄju mentalnog zdravlja prepoznali su nužnost ponude alternativnih naÄina pružanja potpore i lijeÄenja te su se mnogi prvi puta naÅ”li u situaciji provoÄenja online usluga/terapija. Rad prikazuje iskustvo u gotovo Äetiri mjeseca online rada grupe voÄene u okviru izobrazbe iz grupne analize te
rasvjetljuje odreÄena zbivanja i promjene koje su se dogodile tijekom grupnog rada u virtualnom okruženju. Grupa koja se dvije godine sastajala uživo, unatoÄ odreÄenim teÅ”koÄama i acting outu jednog Älana, uspjela se prilagoditi novom settingu te je ostvarila napredak u radu. Rad istiÄe prednosti online terapije u smislu dostupnosti pomoÄi i potpore u vrijeme naglaÅ”enih potreba, kontinuiteta rada i napredovanja u terapiji do ponovnog nastavka rada uživo, ali upozorava i na izazove virtualnog settinga koji zahtijeva prilagodbu svih sudionika terapije, u smislu oÄuvanja grupnih granica, prevladavanja separacijske anksioznosti, tehniÄkih i komunikacijskih teÅ”koÄa i drugih specifiÄnih pojava koje utjeÄu na terapijski rad.In the context of global events during the pandemic, experts in the field of mental health have recognized the necessity of offering alternative modes of providing support and treatment, and many of them have engaged in conducting online services/therapy for the first time. Herein we present our experience in conducting online group work over almost 4 months, which was performed as part of group analysis training and which has brought certain event and changes to light that took place during group therapy in a virtual environment. The group, which had previously met face-to-face for two years, was able to
adjust to the new setting and achieve progress despite certain difficulties and an episode in which one group member acted out. This article presents the advantages of online therapy regarding the availability of help and support during a period of increased patient needs and in achieving continuity of treatment as well as progress in therapy until face-to-face meetings become possible once more, but we also describe the challenges tied to the virtual setting, which requires adjustments from all therapy participants with regard to maintaining boundaries within the group, overcoming separation anxiety, technical and communication difficulties, and other unique factors that influence group therapy
Sindrom sagorijevanja struÄnjaka mentalnog zdravlja: psihijatrijska bolnica
Burnout is frequently mentioned as a problem in the mental health field. As a type of prolonged response to chronic job-related stressors, has a special significance in health care where staff experience both psychological-emotional and physical stress. The aim of the paper was to determine the level of stress in professionals working in psychiatric hospital, as well as to explore possible differences in stress level regarding the different characteristic of participants as sex, level of education, marital status, working hours etc. The Burnout Clinical Subtypes Questionnaire was used. Study was conducted from July to December 2014, and from April to May 2015. The sample of 141 participants who work in mental health profession consists of 39.9% male and 68.1% female, average age of 38.98 years. Overall results show that participants have lower scores on all subscales. The results showed that there is moderate burnout experience in the sense that participants feel overload when they try to maximize their reward by taking on a volume and pace of work that become excessive. This questionnaire can be a very useful instrument for future evaluation and designing interventions and different treatment strategies for subtypes of burnout.Burnout (sagorijevanje) se Äesto spominje kao pojava u podruÄju mentalnog zdravlja. RijeÄ je o prolongiranom odgovoru na kroniÄne stresore vezane uz posao, te kao takav ima poseban znaÄaj u zdravstvu gdje je emocionalni i fiziÄki stres nerijetko iskustvo osoblja. Cilj rada je odrediti razinu stresa kod struÄnjaka koji rade u psihijatrijskoj bolnici, kao i istražiti postoje li razlike u razini stresa obzirom na razliÄite karakteristike sudionika kao Å”to su spol, stupanj obrazovanja, braÄni status, radno vrijeme itd. U radu je koriÅ”ten Upitnik sagorijevanja na poslu sa kliniÄkim podtipovima (The Burnout Clinical Subtypes Questionnaire ā BCSQ). Studija je provedena od srpnja do prosinca 2014., te od travnja do svibnja 2015. Uzorak Äini 141 sudionik, struÄnjaka u podruÄju zaÅ”tite mentalnog zdravlja, zaposlenih u psihijatrijskoj bolnici, 39.9% Äine muÅ”karci, a 68.1% žene, prosjeÄne dobi 38. 8 godina. Ukupni rezultati pokazuju da sudionici imaju niže rezultate na svim subskalama. Rezultati su pokazali da postoji umjereno iskustvo sagorijevanja na poslu, na naÄin da Äe sudionik osjeÄati preoptereÄenje kada pokuÅ”ava poveÄati svoju naknadu radeÄi prekovremeno. Ovaj upitnik može biti vrlo koristan instrument za buduÄe procjene i programiranje intervencija, kao i za razliÄite strategije lijeÄenja pojedinih podtipova sagorijevanja na poslu
Suicidality and Depression
Osobe s mentalnim poremeÄajima poÄine
oko 90% svih suicida. Afektivne bolesti (velika depresija,
bipolarni poremeÄaj i shizoafektivni poremeÄaj) najÄeÅ”Äe su
dijagnoze meÄu poÄiniteljima i Äine 60 do 70% udjela u suicidima.
Doživotni rizik od suicida kod bolesnika s depresijom
je 15%. Neki Äimbenici suicidalnog rizika su: suicidalna ili
homicidalna promiŔljanja, namjere ili planovi; pristup sredstvima
za poÄinjenje suicida i njihova letalnost; prisutnost
psihotiÄnih simptoma, imperativnih halucinacija ili teÅ”ke
anksioznosti; zlouporaba alkohola ili psihoaktivnih tvari; povijest
i ozbiljnost prijaŔnjih pokuŔaja te obiteljska anamneza. U
kliniÄkoj praksi je važno procijeniti rizik od suicidalnog
ponaŔanja i njegov intenzitet. Kako suicid nije mentalni
poremeÄaj ili psihijatrijska dijagnostiÄka kategorija, glavnina
tretmana odnosi se na depresivni poremeÄaj. Nema specifiÄne
farmakoterapije u lijeÄenju suicidalnog ponaÅ”anja, ali
se primjenjuju razliÄite skupine lijekova. Velika je kontroverza
mogu li odreÄeni lijekovi poveÄati sklonost ekspresiji suicidalnog
ponaÅ”anja ili preveniraju njegov poÄetak kod osoba
pod poveÄanim rizikom. LijeÄenjem simptoma djelujemo na
ekspresiju suicidalnog ponaŔanja. Ipak, istraživanja pokazuju
da je nedavni porast u propisivanju antidepresiva pridonio
padu suicida. SpecifiÄni naÄini lijeÄenja suicidalnog
ponaŔanja su: 1. somatska terapija i 2. psihoterapija. Izbor
psihofarmaka ovisi o težini bolesti, suicidalnom riziku, sigurnosti
i uÄinkovitosti lijeka, nuspojavama ili interakcijama s
drugim lijekovima, bolesnikovoj suradnji, socijalnoj potpori i
tjelesnom komorbiditetu. Preventivni postupci obuhvaÄaju
adekvatno i pravovremeno prepoznavanje osnovne psihijatrijske
bolesti, komorbiditeta te suicidalnog ponaŔanja
bolesnika uz uvoÄenje odgovarajuÄih psihofarmaka, psihoterapijskih
i psihosocijalnih postupaka.People with mental disorders commit about
90% of all suicides. Affective disorders (serious depression,
bipolar disorder and schizoaffective disorder) are diagnosed in
60% to 70% of suicides. A lifetime risk of suicide in people
suffering from depression is 15%. Some suicidal risk factors
include: suicidal or homicidal thoughts, intentions and plans;
access to the methods for committing suicide and their lethality;
presence of psychotic symptoms, imperative hallucinations
or serious anxiety; abuse of alcohol or psychoactive substances;
history and seriousness of previous attempts, and
positive family history. In clinical practice, it is important to
evaluate the risk of suicide and its intensity. As suicide is neither
a mental disorder nor a psychiatric diagnostic category,
the treatment mainly focuses on a bipolar disorder. Although
there is no specific pharmacotherapy, various drug classes
are used. The question whether certain drugs can intensify or
prevent suicidal behavior in people with increased risk is very
controversial. By treating the symptoms, we influence the
expression of suicidal behavior. However, the research shows
that a recent increase in the prescription of antidepressants
contributed to a drop in the suicide rate. Specific therapies for
suicidal behavior include: 1) somatic therapy and 2) psychotherapy.
The choice of psychopharmaceuticals depends on
disease stage, suicidal risk, drug safety and efficacy, side
effects or interactions with other medications, patient compliance,
social support, and physical comorbidity. The preventive
procedures comprise adequate and timely recognition of the
underlying psychiatric disease, comorbidity (psychiatric or
physical) and suicidal behavior in patients along with the introduction
of appropriate psychopharmaceuticals and psychotherapeutic
and psychosocial procedures
Mental Health of Persons with Alzheimerās Disease
Cilj ovog rada je prikazati mentalno zdravlje osoba oboljelih od Alzheimerove bolesti opisivanjem neuropsihijatrijskih
simptoma koji se javljaju tijekom bolesti te putem sustavnog prikaza istraživanja prevalencije navedenih simptoma.
Neuropsihijatrijski simptomi Alzheimerove bolesti su simptomi koji ukljuÄuju promjene liÄnosti, poremeÄaje
raspoloženja, motoriÄkih aktivnosti i brojne druge promjene koje osim samog oboljelog mogu opaziti i osobe u
okolini bolesnika (lijeÄnici, njegovatelji i dr.). TakoÄer, simptomi negativno utjeÄu ne samo na oboljele, veÄ i na osobe
oko njih (obitelj, njegovatelji, sustav skrbi za oboljele, te cjelokupno druŔtvo).
Rad prikazuje Alzheimerovu bolest opÄenito i njezine neuropsihijatrijske simptome njihovim definiranjem, opisom,
naÄinom tretmana, mjerenjem i grupiranjem. U radu je prikazana i prevalencija neuropsihijatrijskih simptoma, te
su nalazi dobiveni sustavnom analizom dostupnih istraživanja usporeÄeni s nalazima ranijih istraživanja. Tako su
najÄeÅ”Äi bili simptomi apatije, depresije i iritabilnosti, a najrjeÄi simptomi euforije i halucinacije, Å”to je bilo u skladu s
nalazima ranijih istraživanja (uz manja odstupanja, koja su takoÄer prikazana u radu). S obzirom na oÄekivani porast
starijih osoba u druÅ”tvu te samim tim i oboljelih od raznih vrsta demencije (od kojih je Alzheimerova bolest najÄeÅ”Äa),
oÄekivano je da Äe rasti interes kako za samu bolest, tako i za njezine simptome.This paper aims to describe the mental health of patients with Alzheimerās disease, considering the neuropsychiatric
symptoms appearing over the course of the illness and a systematic review of research studies on the prevalence of the
symptoms. The neuropsychiatric symptoms of Alzheimerās disease involve altered personality traits, mood and motor
disorders, and numerous other signs apparent not only to patients but also to other people (physicians, caregivers, etc.).
Namely, besides the patients, the symptoms equally affect their environment (family, caregivers, system of care for people
with the disease, and the entire society).
This paper presents Alzheimerās disease in general and its neuropsychiatric symptoms, through their definition, description,
treatment interventions, measurement, and classification. The paper also discusses the prevalence of neuropsychiatric
symptoms, contrasting the findings from the systematic review with the results of previous research studies. Accordingly,
the symptoms of apathy, depression, and irritability tend to prevail, while euphoria and hallucinations seem the least
prevalent, which is consistent with the research findings from previous studies (with minor deviations, also presented in
the paper). Given the projected increase of the elderly population and, accordingly, more people suffering from different
types of dementia (most often Alzheimerās disease), the interest in the disease and its symptoms is expected to further
increase in the future
ULOGA SOCIJALNOG RADNIKA U SOCIOTERAPIJSKIM I PSIHOSOCIJALNIM POSTUPCIMA KOD OSOBA S RIZIKOM RAZVOJA DEPRESIJE UZROKOVANE STRESNIM ŽIVOTNIM DOGAÄAJIMA
Prikazano je znaÄenje stresnih životnih dogaÄaja u razvoju depresije te uloga socijalnog radnika u prevenciji depresivnog
poremeÄaja socioterapijskim i psihosocijalnim postupcima. U stresne životne dogaÄaje se ubrajaju: smrt
supružnika, zatvorska kazna, smrt Älana uže obitelji, Äin samoubojstva Älana uže obitelji, nemoguÄnost vraÄanja duga,
beskuÄniÅ”tvo, ozbiljnija bolest užeg Älana obitelji, nezaposlenost, razvod, raspad obitelji. Brojna istraživanja su pokazala
da neki od tih stresnih dogaÄaja mogu uzrokovati razvoj depresivnog poremeÄaja djece i odraslih. Aktivnosti socijalnog
radnika obuhvaÄaju brojne postupke, ukljuÄujuÄi i one zakonski regulirane, usmjerene na prevenciju stresnih dogaÄaja
i javljanje depresije, ali i na rehabilitaciju osoba oboljelih od depresije. Ovo podruÄje zahtijeva daljnje istraživanje s
ciljem iznalaženja Å”to uÄinkovitijih modela socijalne zaÅ”tite
PSYCHOSOCIAL ASPECTS OF BORDERLINE PERSONALITY DISORDER
GraniÄni poremeÄaj liÄnosti najÄeÅ”Äe se javlja u kasnoj adolescenciji ili mlaÄoj odrasloj dobi, a njegova najjasnija prezentacija je u odrasloj dobi, nakon zavrÅ”etka psiholoÅ”kog sazrijevanja. Simptomi ovog poremeÄaja manifestiraju se nestabilnim afektom, impulzivnim ponaÅ”anjem, poremeÄajem identiteta, nestabilnim interpersonalnim odnosima i moguÄim pogreÅ”kama u testiranju realnosti Å”to sve može rezultirati znaÄajnim poteÅ”koÄama osobnog, obiteljskog, roditeljskog, socijalnog i radnog funkcioniranja. PrognostiÄki dodatnu otegotnu okolnost predstavljaju i Äesti komorbiditeti (afektivni poremeÄaji, anksioznost i zlouporaba sredstava ovisnosti itd). EtioloÅ”ki Äimbenici poremeÄaja su mnogobrojni i nedovoljno poznati, a na razini danaÅ”njih saznanja ukljuÄuju interakciju bioloÅ”kih predispozicija i okoliÅ”nih faktora. U lijeÄenju i skrbi za osobe s graniÄnim poremeÄajem liÄnosti, uz psihoterapiju i socioterapiju (i po potrebi farmakoterapiju), neophodna je i primjena sveobuhvatnih psihosocijalnih intervencija pri Äemu kljuÄnu ulogu imaju socijalni radnici. Pravodobno prepoznavanje etioloÅ”kih Äimbenika i poduzimanje mjera iz nadležnosti socijalnih radnika u okviru sustava socijalne skrbi može pridonijeti prevenciji javljanja ovog poremeÄaja liÄnosti, dok mjere i intervencije koje se primjenjuju prema oboljelim osobama mogu pomoÄi u njihovoj rehabilitaciji i dobrobiti, kao i dobrobiti Älanova njihove obitelji.Borderline personality disorder most commonly occurs in late adolescence or young adulthood, while its most clear presentation appears in adulthood, upon completion of psychological maturation. The symptoms of the disorder are manifested by unstable affect, impulsive behaviour, identity disorder, unstable interpersonal relationships and possible errors in reality testing, which can all lead to significant difficulties in personal, familial, parental, social and work functioning. Frequent comorbidities (affective disorders, anxiety and substance abuse, etc.) are further aggravating factors in terms of prognosis. Etiological factors of the disorder are numerous and not well known, but present findings indicate that they include an interaction of biological predispositions and environmental factors. In the treatment and care of persons with borderline personality disorder, in addition to psychotherapy and sociotherapy (and pharmacotherapy if necessary), comprehensive psycho-social interventions are essential, where social workers play a key role. Timely identification of etiological factors and measures within the competence of social workers in the welfare system can contribute to the prevention of this personality disorder, while measures and interventions applied to the affected persons can contribute to their rehabilitation and well-being, as well as the well-being of their family members
Impact of the COVID-19 Pandemic on Patients with Anxiety and Depressive Disorders
Pandemija COVID-19 svojim utjecajem na tjelesno zdravlje te kao potencijalna životna ugroza ima znaÄajne reperkusije na mentalno zdravlje u smislu posljediÄnog psiholoÅ”kog distresa i pojave simptoma psihiÄkih poremeÄaja. Navedeni utjecaj je dodatno otežan mjerama socijalne izolacije kao jednim od naÄina sprjeÄavanja Å”irenja pandemije. Utjecaj pandemije na oboljele od anksioznih i depresivnih poremeÄaja može se manifestirati kroz inadekvatnu i maladaptivnu prilagodbenu reakciju koja rezultira pretjeranom tjeskobom ili pak pogorÅ”anjem simptoma osnovnog poremeÄaja, odnosno recidivom poremeÄaja. S druge strane, oboljelima znaÄajno otežava baÅ”tiniti i pozitivne strane adaptacijskog naprezanja u smislu jaÄanja otpornosti, odnosno fleksibilnosti zdravih snaga liÄnosti. GledajuÄi s aspekta oboljelih od anksioznih i depresivnih poremeÄaja u okviru ove pandemije, nameÄe se potreba za akceptiranjem Äinjenice kako se radi o vulnerabilnoj populaciji kojoj je potrebno osigurati promptnu i Å”to obuhvatnije organiziranu dostupnost kontinuirane psihijatrijske skrbi.The impact of the COVID-19 pandemic on physical health and as a potentially life-threating condition, has significant repercussions on mental health by consequent psychological distress and the appearance of symptoms of mental disorders. Social isolation, as an epidemiologic measure, represents additional adverse impact on mental health. The pandemicās influence on patients with anxiety and depressive disorders may manifest as an inadequate and maladaptive response resulting in excessive anxiety or worsening of the symptoms of the underlying disorder. Given the patientās lack of psychological flexibility, it is more difficult for them to inherit the positive aspects of the adaptive effort needed to strengthen their resilience. Patients with anxiety and depressive disorders are a vulnerable population for whom the pandemic poses an additional psychological burden. It is therefore essential to ensure prompt, comprehensive, and continuous psychiatric care