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Psihijatrija danas
2009, vol. 41, br. 1-2, str. 5-16
jezik rada: srpski
vrsta rada: istraživački članak

Stresogeni životni događaji i unipolarna depresija
Bokonjić Srđana, Lečić-Toševski Dušicab, Peruničić Ivanaa, Pavlov-Sofronijević Jasminaa, Bokonjić Jelicac, Jovanović Nikolaa
aUniverzitet u Beogradu, Medicinski fakultet, Institut za mentalno zdravlje
bInstitut za mentalno zdravlje + Medicinski fakultet, Beograd
cDom zdravlja 'Dr. Simo Milošević', Beograd

Sažetak

Poslednjih četrdeset godina istraživanja stresogenih životnih događaja (SŽD) u fokusu su istraživanja depresije, ali priroda veze između njih i unipolarne depresije još uvek je nejasna. Integrativni pristup lečenju depresije podrazumeva razmatranje brojnih etioloških faktora, među kojima važno mesto imaju SŽD koji prethode depresivnoj epizodi. Cilj ovog istraživanja bio je da se ispitaju stresogeni životni događaji koji prethode prvoj i rekurentnoj epizodi unipolarne depresije. Uzorak su činili 55 pacijenata Dnevne bolnice za afektivne poremećaje Instituta za mentalno zdravlje koji su dijagnostikovani prema MKB-10 kriterijumima kao prva ili rekurentna depresivna epizoda: umerena, teška i teška sa psihotičnim simptomima. Kontrolnu grupu sačinjavale su 55 zdrave osobe kod kojih nikada nije bio dijagnostikovan nijedan psihijatrijski poremećaj. U istraživanju su korišćeni: semistruksturisani psihijatrijski intervju, socio-demografski upitnik, Paykelova skala životnih događaja, upitnici za procenu partnerskih i porodičnih relacija, kao i stresora vezanih za radno mesto i materijalno stanje (koji su specijalno konstruisani za ovu studiju). Inicijalna evaluacija SŽD odnosila se na poređenje ukupnog broja SŽD između studijske i kontrolne grupe. U sledećem koraku stresori ispitivane grupe korelirani su sa kontrolnom grupom, pojedinačno i po klasterima. Analizirali smo i odnos frekvenci SŽD i depresivne epizode, s obzirom na njenu težinu i rekurentnost. Naši rezultati su pokazali da SŽD prethode prvim i rekurentnim depresivnim epizodama unipolarne depresije u signifikantno većem broju (p<0.01) u odnosu na kontrolnu grupu. Oni asociraju jače sa prvom nego sa rekurentnim epizodama (p<0.05). Težina depresivne epizode nije korelirala sa brojem SŽD koji joj prethode. Najzastupljeniji su bili stresori vezani za lošu materijalnu situaciju i nezaposlenost, promenjene ili pogoršane uslove rada, loše bračne i porodične relacije ispitanika, kao i smrt ili tešku bolest bliskog člana porodice i tešku organsku bolest ispitanika. Prema našim nalazima stesori koji prate socijalnu tranziciju u našoj zemlji predstavljaju značajan faktor rizika za nastanak depresije. Naši rezultati sugerišu da SŽD u vezi sa (odraslom) decom, roditeljima i širom porodicom predstavljaju značajniji faktor rizika za razvoj depresije u našoj sredini, nego u 'zapadnim kulturama'. Diskutovane su moguće terapijske implikacije naših nalaza, kao i neka ograničenja u istraživanju SŽD.

Ključne reči

depresija; životni događaji; porodica; socijalne promene

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