Anorexia Nervosa

Povećanje učestalosti poremećaja hranjenja i potreba za višegodi¹njim liječenjem zavreðuju pojačanu pažnju kliničara. Klasifikacija poremećaja hranjenja sadrži: anoreksiju nervozu, bulimiju nervozu, prejedanje te atipičnu anoreksiju nervozu i atipičnu bulimiju nervozu. Anoreksija nervoza težak je i dugotrajan poremećaj hranjenja sa znatnim potencijalom za letalni ishod. U ovom je članku dan kratak pregled dijagnostičkih kriterija, kliničke slike, epidemioloških podataka, etiologije, mogućih ishoda i timski pristup u tretmanu anoreksije nervoze.Eating disorders are relatively common and potentially life - treating conditions experienced with increasing frequency by older children and adolescents mostly female. The diagnostic classification of eating disorders includes: anorexia nervosa, bulimia nervosa, binge eating, atypically anorexia and atypically bulimia nervosa. Anorexia nervosa is a very serious, long · term and potentially lethal eating disorder. This paper reviews the recent research literature on diagnostic criteria, clinical picture, epidemiological and etiological features related to anorexia nervosa. We have also discussed outcome and suggested team treatmen

IMA LI MEĐU RODITELJIMA DJECE S UPALNIM BOLESTIMA CRIJEVA VIŠE OBILJEŽJA OPSESIVNO-KOMPULZIVNOG POREMEĆAJA LIČNOSTI NEGO MEĐU RODITELJIMA ZDRAVE DJECE?

Obsessive traits, neuroticism, as well as obsessive-compulsive personality disorder (OCPD) may be notably found among adult patients with inflammatory bowel disease (IBD), while the results are not so clear among children with IBD. However, according to published data, all children with IBD who also have a psychiatric diagnosis have at least one parent with psychopathology. The majority of parents of children with IBD have a psychiatric diagnosis, predominantly personality disorder. Children with parental psychopathology differ from children without parental psychopathology in anxious and depressive features. Parents of children with “compulsive neurosis” or obsessive-compulsive disorder have a significant level of anancastic characteristics or OCPD. In the light of published data, we hypothesize that OCPD will be more prevalent in parents of children with IBD than in parents of healthy children. Findings regarding the presence of personality disorder in parents of children with IBD may help in the process of developing and implementing treatment interventions, which would include children with IBD, as well as their parents, in order to improve their relationship, since pathological personality is linked with interpersonal impairment and this relationship can further be stressed by the demands of IBD itself.Među odraslima oboljelima od upalnih bolesti crijeva (IBD) u značajnoj mjeri mogu biti prisutne karakteristike opsesivnosti, neuroticizma, ali i opsesivno kompulzivnog poremećaja ličnosti (OCPD), dok za djecu s IBD jasni rezultati o učestalosti nisu pronađeni. Prema dosadašnjim podacima sva djeca s IBD koja su ujedno imala psihijatrijski poremećaj imala su barem jednog roditelja s prisutnom psihopatologijom. U većine roditelja djece s IBD ustanovljen je psihijatrijski poremećaj. Pretežno se radilo o poremećaju ličnosti (PD). Djeca u čijih je roditelja prisutna psihopatologija razlikuju se od djece bez roditeljske psihopatologije u anksioznim i depresivnim obilježjima. Roditelji djece s “kompulzivnom neurozom” ili opsesivno kompulzivnim poremećajem imaju značajnu razinu anankastičnih karakteristika ili OCPD. U svjetlu dosada poznatih podataka iz literature moglo bi se pretpostaviti da će OCPD biti prisutniji u roditelja djece s IBD nego u roditelja zdrave djece. Utvrđivanje prisutnosti poremećaja ličnosti u roditelja djece s IBD moglo bi pomoći u razvoju i provedbi strategija liječenja koje bi uključivale djecu s IBD kao i njihove roditelje. Svrha takvih intervencija bila bi poboljšanje njihovog međusobnog odnosa s obzirom na to da je patološka osobnost povezana s interpersonalnim oštećenjem, a odnos između roditelja i djeteta može biti dodatno izložen stresu zbog zahtjeva koje donosi sama upalna bolest crijeva

Anorexia Nervosa

Povećanje učestalosti poremećaja hranjenja i potreba za višegodi¹njim liječenjem zavreðuju pojačanu pažnju kliničara. Klasifikacija poremećaja hranjenja sadrži: anoreksiju nervozu, bulimiju nervozu, prejedanje te atipičnu anoreksiju nervozu i atipičnu bulimiju nervozu. Anoreksija nervoza težak je i dugotrajan poremećaj hranjenja sa znatnim potencijalom za letalni ishod. U ovom je članku dan kratak pregled dijagnostičkih kriterija, kliničke slike, epidemioloških podataka, etiologije, mogućih ishoda i timski pristup u tretmanu anoreksije nervoze.Eating disorders are relatively common and potentially life - treating conditions experienced with increasing frequency by older children and adolescents mostly female. The diagnostic classification of eating disorders includes: anorexia nervosa, bulimia nervosa, binge eating, atypically anorexia and atypically bulimia nervosa. Anorexia nervosa is a very serious, long · term and potentially lethal eating disorder. This paper reviews the recent research literature on diagnostic criteria, clinical picture, epidemiological and etiological features related to anorexia nervosa. We have also discussed outcome and suggested team treatmen

Pervasive developmental disorders

Pervasive Developmental Disorders are very serious, lifelong treating conditions. The diagnostic category of Pervasive Developmental Disorders includes: Autistic Disorder, Rett Disorder, Childhood Disintegrative Disorder, Asperger Disorder and Pervasive Developmental Disorder Not Otherwise Specified. Epidemiological studies show their increasing incidence and it is, therefore, of great importance to have more knowledge and a better awareness of them. This paper reviews the recent research literature on diagnostic criteria, with similarities and differences among categories of Pervasive Developmental Disorders in their clinical picture, as well as the recommendation of a new view of Autistic Spectrum Disorders. A multidisciplinary team is of a great importance in clinical evaluation and treatment

PARENTAL PSYCHOPATHOLOGY IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE – A PILOT STUDY RESULTS

Background: There are very little literature data available on the prevalence of personality disorder in parents of children and adolescents suffering from inflammatory bowel disease. The purpose of this study was to assess the rate of parents meeting the criteria for a particular personality disorder according to the Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Methods: The study included 36 parents of children and adolescents (aged 7-18 years) with inflammatory bowel disease. Results: Half of the parents of children with inflammatory bowel disease scored at or above the threshold of diagnostic criteria for a particular DSM-IV disorder on Axis II, mainly obsessive-compulsive personality disorder. Overall, rigidity and inflexibility about morality were the most frequent obsessive-compulsive personality disorder criteria. Conclusion: Parental personality factors play an important role in the context of pediatric inflammatory bowel disease, although the question remains whether it is influencing or being influenced by the disease. As this study was cross-sectional, we cannot say with certainty if the obsessive-compulsive personality disorder features occur with a high prevalence in parents of children with inflammatory bowel disease as a result of carrying for a child with a chronic disease, or they are a maintaining or even precipitating factor in the frame of pediatric inflammatory bowel disease

Psychological approach to chronic low back pain

Kronična križobolja jedan je od najčešćih oblika kroničnog bola, među najčešćim je povodima onesposobljenosti i izostanaka s posla i među najčešćim razlozima traženja liječničke pomoći. Usprkos brojnim suvremenim metodama liječenja, oko 30 % bolesnika s akutnom križoboljom prelazi u kategoriju kroničnog bolnog sindroma, pri čemu bol preuzima dominaciju nad životom bolesnika, njegove obitelji i bliže socijalne okoline, te oštećuje kvalitetu života. U skladu s biopsihosocijalnim modelom aktualno je stajalište da psihološke čimbenike treba sagledati kao važne odrednice u doživljaju bola i ponašanja. Psihološki procesi nisu samo reakcija na bol, nego i integralni dio doživljavanja bola. U članku se razmatra djelovanje psiholoških čimbenika koji uključuju crte ličnosti, emocionalna stanja, kognitivne i ponašajne obrasce, stresore i mehanizme suočavanja, te daje kratak prikaz postavki pojedinih psiholoških modela razvoja kroničnog bola. Budući da neprepoznate i neliječene psihološke poteškoće mogu značajno negativno interferirati s uspješnošću rehabilitacije bolesnika s križoboljom, predlažu se načini probira koji mogu poslužiti kao smjernice u identificiranju bolesnika kojima je potrebna stručna psihološka pomoć. Evaluacije psiholoških tretmana pokazuju najveću učinkovitost kognitivno-bihevioralnog i samoregulirajućih tretmana (biofeedback, relaksacija i hipnoza) u unapređivanju emocionalnog i fizičkog funkcioniranja, reduciranju specifične onesposobljenosti povezane s bolom, smanjenju depresije, poboljšanju kvalitete života, smanjenju broja posjeta liječniku i upotrebe lijekova za suzbijanje bola, kao i trajanja bolovanja. Prema suvremenom imperativu interdisciplinarnog programa rehabilitacije bola u svakodnevnoj bi praksi trebalo težiti ka ostvarivanju uvjeta za simultane intervencije fizijatra, fizoterapeuta i psihologa. Takav način rada pokazao se najučinkovitijim pristupom u liječenju križobolja.Chronic low back pain is the most common form of chronic pain, one of the most common causes of disability and work absence, and the most common reason for requiring medical help. Despite of numerous contemporary methods of medical treatment, about 30 % of acute low back patients make a transition to chronic pain sindrom which makes pain dominant over patient’s life, his/her family and close social surroundings and also impairs the quality of life. A recent scientific view, in accordance with biopsychosocial model, is that psychological factors are important determinants of pain perception and behaviour. Psychological processes are not only a reaction to pain but also a part of integral pain perception. This article considers the effects of psychological factors which include personality traits, emotional states, cognitive and behavioural patterns, stressors and coping strategies, and it also gives a short overview of certain psychological models of chronic pain development. Whereas unrecognized and untreated psychological difficulties may have a significantly negative influence on efficacy of low back patient’s rehabilitation, there are several proposed guidelines for the identification of patients that need professional psychological help. Evaluations of different psychological treatments emphasize the results of cognitive behavioural tretament and self-regulation treatments (biofeedback, relaxation and hypnosis) as the most efficient in the improvement of emotional and physical functioning, pain and disability reduction, decrease of depression, enhancement of the quality of life, reduction of the number of visits to physician and the intake of pain relief pharmacotherapy, as well as in cutting down the period of work absence. According to the contemporary imperative of interdisciplinary pain rehabilitation programs, simultaneously implemented interventions of multidisciplinary teams which include a physician, a physical therapist and a psychologist, are emphasized as the most efficient approach to the treatment of low back pain patients

How successful we are in recognizing anorectic symptoms? : psychological and physical longitudinal follow - up of patients with anorexia nervosa

Longitudinalnim smo praćenjem obuhvatili 12 pacjentica oboljelih od anoreksije nervoze s ciljem evaluacije postupaka dijagnostike i liječenja. Prateći promjene u dijagnostičkim kriterijima (Dijagnostički i statistički priručnik duševnih bolesti · DSM IV) uočili smo da je u naših pacijentica najprije došlo do oporavka na planu fizičkih kriterija bolesti (povećanje težine i pojava menstruacije), ali da psihički kriteriji (strah od debljanja i poremećaj percepcije vlastita tijela) perzistiraju znatno duže. Anoreksija nervoza izrazito je dugotrajna bolest s tendencijom ka kroničnosti. Liječenje treba nastaviti i nakon tjelesnog oporavka (tjelesna teæina, menstruacija). Budući da smo našli i dosljedno predugo vrijeme (prosječno 14 mjeseci) od pojave prvih simptoma bolesti do pronalaženja dijagnoze, ističemo važnost ranog otkrivanja i dugotrajnog tretmana ove bolesti.Twelve patients with diagnosis anorexia nervosa have been prospectively follow-up with respect to evaluated the treatment regarding differences in diagnostic criteria (Diagnostic and statistical manual of mental diseases · DSM IV), academic, family and social functioning. Anorexia nervosa is a long treating disease with tendency toward chronicity. We recommend that treatment must go on after improvement in physical symptoms (body weight, period) because psychological criteria of illness (fear of becoming fat and disturbance in perception of own body) still persist. We found that the time from first signs of disease until the clear diagnose was to long (mean time is 14 months). We point out the importance of early diagnose and long-term treatment

How successful we are in recognizing anorectic symptoms? : psychological and physical longitudinal follow - up of patients with anorexia nervosa

Longitudinalnim smo praćenjem obuhvatili 12 pacjentica oboljelih od anoreksije nervoze s ciljem evaluacije postupaka dijagnostike i liječenja. Prateći promjene u dijagnostičkim kriterijima (Dijagnostički i statistički priručnik duševnih bolesti · DSM IV) uočili smo da je u naših pacijentica najprije došlo do oporavka na planu fizičkih kriterija bolesti (povećanje težine i pojava menstruacije), ali da psihički kriteriji (strah od debljanja i poremećaj percepcije vlastita tijela) perzistiraju znatno duže. Anoreksija nervoza izrazito je dugotrajna bolest s tendencijom ka kroničnosti. Liječenje treba nastaviti i nakon tjelesnog oporavka (tjelesna teæina, menstruacija). Budući da smo našli i dosljedno predugo vrijeme (prosječno 14 mjeseci) od pojave prvih simptoma bolesti do pronalaženja dijagnoze, ističemo važnost ranog otkrivanja i dugotrajnog tretmana ove bolesti.Twelve patients with diagnosis anorexia nervosa have been prospectively follow-up with respect to evaluated the treatment regarding differences in diagnostic criteria (Diagnostic and statistical manual of mental diseases · DSM IV), academic, family and social functioning. Anorexia nervosa is a long treating disease with tendency toward chronicity. We recommend that treatment must go on after improvement in physical symptoms (body weight, period) because psychological criteria of illness (fear of becoming fat and disturbance in perception of own body) still persist. We found that the time from first signs of disease until the clear diagnose was to long (mean time is 14 months). We point out the importance of early diagnose and long-term treatment