- citati u SCIndeksu: 0
- citati u CrossRef-u:0
- citati u Google Scholaru:[
 ]
- posete u poslednjih 30 dana:3
- preuzimanja u poslednjih 30 dana:1
|
|
|
2012, vol. 140, br. 5-6, str. 344-349
|
|
Poremećaji prilagođavanja bolnički lečenih adolescenata - studija nadgledanja
Adjustment disorders in hospital treated adolescents: A follow-up study
aUniverzitet u Beogradu, Medicinski fakultet, Institut za mentalno zdravlje + Univerzitet u Beogradu, Medicinski fakultet bUniverzitet u Beogradu, Medicinski fakultet, Institut za mentalno zdravlje
e-adresa: s.popovicdeusic@imh.org.rs
Sažetak
Uvod. Poremećaji prilagođavanja su česta dijagnostička kategorija, naročito kod adolescenata. Oni pokrivaju širok spektar različitih emocionalnih i bihejvioralnih problema. Cilj rada. Cilj rada bio je da se ispitaju obeležja dijagnostičke kategorije 'poremećaji prilagođavanja' kod adolescenata koji su prvi put bolnički lečeni u Kliničkom odseku za decu i adolescente Instituta za mentalno zdravlje u Beogradu tokom pet uzastopnih godina i utvrdi ishod poremećaja tokom posmatranog perioda. Metode rada. Urađeno je retrospektivno ispitivanje bolnički lečenih adolescenata sa dijagnozom poremećaja prilagođavanja u periodu 2000-2004. godine. Nadgledanje je vršeno 5-10 godina nakon prvog otpusta iz bolnice. Rezultati. Tokom posmatranog petogodišnjeg perioda bilo je 75 bolnički lečenih adolescenata s poremećajem prilagođavanja. Osnovni uzorak činila su 24 ispitanika muškog pola (32%) i 51 ženskog pola (68%). Nakon 5-10 godina ispitana su 52 adolescenta (uzorak za nadgledanje), među kojima 16 mladića (30,77%) i 36 devojaka (69,23%). Ukupno je posmatrano 70% osnovnog uzorka. Nakon prve hospitalizacije dalje psihijatrijsko lečenje nastavilo je 58% adolescenata, a ono se odvijalo u vidu ponovnog bolničkog ili dispanzerskog lečenja. Zaključak. Tokom posmatranog perioda, 5-10 godina nakon prvog otpusta iz bolnice sa dijagnozom poremećaja prilagođavanja, 38% posmatranih adolescenata nekoliko je puta hospitalizovano. Kod njih je ishod poremećaja bio najgori, jer je tokom posmatranog perioda kod tri četvrtine dijagnostikovan novi poremećaj, i to iz kruga psihotičnih poremećaja.
Abstract
Introduction. Adjustment disorders represent a frequent diagnostic entity especially among adolescents. They involve a wide spectrum of various emotional and behaviour problems. Objective. The aim was to investigate characteristics of diagnostic category known as adjustment disorders among hospital treated adolescents for the first time at the Clinical Department for Children and Adolescents of the Institute of Mental Health in Belgrade, during five consecutive years, as well as to investigate the outcome of the disorder in follow-up period. Methods. We conducted a retrospective investigation of the first time hospital treated adolescents from Belgrade with discharge diagnosis of adjustment disorders during 2000-2004. The follow up was conducted 5-10 years after a first discharge from the hospital. Results. During the investigated period 75 adolescents from Belgrade were hospitalized for the first time with diagnosis adjustment disorder. From the studied patients the main sample was formed that included 24 (32%) males and 51 (68%) females. After 5-10 years a follow-up of 52 patients was conducted (sample at follow-up) which included 16 (30.77%) males and 36 (69.23%) females. Of the main sample, 70% of the patients were under follow-up. After the first hospitalization 58% of adolescents continued with further psychiatric treatment, either as rehospitalized or out-of-hospital patients. Conclusion. Our findings showed that 38% of adolescents under follow-up for 5-10 years after the first discharge from hospital with the diagnosis adjustment disorders had multiple hospitalizations. The outcome of the disorder among these patients was the worst, because three-quarters of the patients were rediagnosed in the follow-up period with a new psychiatric disorder, often from psychotic spectrum.
|
|
|
|
Reference
|
|
94 
|
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders. Washington: American Psychiatric Association
|
|
 
|
Andreasen, N.C., Hoenk, P.R. (1982) The predictive value of adjustment disorders: A follow-up study. American journal of psychiatry, 139(5): 584-90
|
|
|
Benton, T.D., Lynch, J. Adjustment disorders: Emedicine. Available from: http://www.emedicine.com/Med/topic3348.htm (August 2005)
|
|
|
Bronisch, T. (1991) Adjustment reactions: A long-term prospective and retrospective follow-up of former patients in a crisis intervention ward. Acta Psychiatrica Scandinavica, 84(1): 86-93
|
|
|
Carta, M.G., Balestrieri, M., Murru, A., Hardoy, M.C. (2009) Adjustment Disorder: Epidemiology, diagnosis and treatment. Clinical practice and epidemiology in mental health, 5: 15
|
|
|
Casey, P., Dowrick, C., Wilkinson, G. (2001) Adjustment disorders: Fault line in the psychiatric glossary. British journal of psychiatry, 179: 479-81
|
|
|
Casey, P. (2001) Adult Adjustment Disorder: A Review of Its Current Diagnostic Status. Journal of Psychiatric Practice, 7(1): 32-40
|
|
|
Fard, F., Hudgens, R.W., Welner, A. (1979) Undiagnosed psychiatric illness in adolescents. A prospective and seven year follow-up. Arch Gen Psychiatry, 35: 279-281
|
|
|
Greenberg, W.M., Rosenfeld, D.N., Ortega, E.A. (1995) Adjustment disorder as an admission diagnosis. American journal of psychiatry, 152(3): 459-61
|
|
|
Hedlund, J.L., Vieweg, B.W. (1980) The Brief Psychiatric Rating Scale (BPRS): A comprehensive review. J. Operat. Psychiatry, 11: 48-65
|
|
|
Jenkins, R., Lewis, G., Bebbington, P., Brugha, T., Farrell, M., Gill, B., Meltzer, H. (1997) The National Psychiatric Morbidity surveys of Great Britain: Initial findings from the household survey. Psychological medicine, 27(4): 775-89
|
|
1
|
Jones, R., Yates, W.R., Williams, S., Zhou, M., Hardman, L. (1999) Outcome for adjustment disorder with depressed mood: Comparison with other mood disorders. J Affect Disord, 55(1): 55-61
|
|
12
|
Kay, S.R., Fiszbein, A., Opler, L.A. (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia bulletin, 13(2): 261-76
|
|
13
|
Kessler, R.C., Sonnega, A., Bromet, E., Hughes, M., Nelson, C.B. (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry, 52(12): 1048-60
|
|
|
Laugharne, J., van der Watt, G., Janca, A. (2009) It is too early for adjusting the adjustment disorder category. Current opinion in psychiatry, 22(1): 50-4
|
|
|
Myers, J.K., Lindenthal, J.J., Pepper, I., Holzer, C.E., Leaf, P.J., Orvaschel, H. (1984) Six-month prevalence of psychiatric disorders in three communities 1980 to 1982. Arch Gen Psychiatry, 41:959-67
|
|
|
Newcorn, J.H., Strain, J. (1992) Adjustment disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 31(2): 318-26
|
|
|
Pelkonen, M., Marttunen, M., Henriksson, M., Lönnqvist, J. (2007) Adolescent adjustment disorder: Precipitant stressors and distress symptoms of 89 outpatients. European psychiatry, 22(5): 288-95
|
|
|
Popović-Deušić, S. (1994) Kliničko-epidemiološka istraživanja psihičkih poremećaja dece i omladine u urbanoj sredini. Beograd: Medicinski fakultet, doktorska disertacija
|
|
3 
|
Popović-Deušić, S.D. (1992) Klasifikacija psihičkih poremećaja dece i omladine u svetlu nove MKB-10 klasifikacije. Psihijatrija danas, vol. 24, br. 3-4, str. 317-329
|
|
|
Strain, J.J., Smith, G.C., Hammer, J.S., McKenzie, D.P., Blumenfield, M., Muskin, P., Newstadt, G., Wallack, J., Wilner, A., Schleifer, S.S. (1998) Adjustment disorder: A multisite study of its utilization and interventions in the consultation-liaison psychiatry setting. General hospital psychiatry, 20(3): 139-49
|
|
|
Strain, J.J., Diefenbacher, A. (2008) The adjustment disorders: The conundrums of the diagnoses. Comprehensive psychiatry, 49(2): 121-30
|
|
|
Strein, G., Wilkinson, G. (1998) Seminars in General Adult Psychiatry. London: Gaskell, Volumes 1 & 2
|
|
4
|
Svetska zdravstvena organizacija (1992) MKD-10 Klasifikacija mentalnih poremećaja i poremećaja ponašanja - klinički opisi i dijagnostička uputstva. Beograd: Zavod za udžbenike i nastavna sredstva
|
|
|
|
|