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2011, vol. 50, br. 3, str. 81-89
Dijagnoza i tretman depresije kod osoba sa intelektualnom ometenošću
aVocational College for Preschool Teachers, Kruševac
bKlinički centar Kragujevac, Klinika za psihijatriju
cKlinički centar Kragujevac, Klinika za neurologiju
dUniverzitet u Kragujevcu, Fakultet medicinskih nauka

e-adresakatarinat@vaspks.edu.rs
Ključne reči: intelektualna ometenost; depresija; dijagnostikovanje depresije; terapija depresije
Sažetak
Rad sa teorijskog aspekta razmatra problem dijagnostikovanja i terapije depresivnih poremećaja kod osoba sa zaostajanjem u intelektualnom razvoju oslanjajući se, pre svega, na rezultate dosadašnjih istraživanja, u kojima se naglašavaju etiološke, simptomske (patoplastične), dijagnostičke i terapijske specifičnosti kada su u pitanju depresija i njeni korelati kod ove populacije. Tek 70-tih godina prošlog veka postaje jasno da neki kognitivni i bihejvioralni simptomi nisu, kao što se do tada mislilo, deo i posledica sindroma intelektualne ometenosti, već znak postojećeg mentalnog poremećaja, što se označava terminom 'dvojna dijagnoza'. Posmatranje sindromskih skupina genetskih poremećaja koji kao posledicu imaju ometenost u intelektualnom razvoju dovelo je do svojevrsnog sužavanja kruga genetskih sindroma koji nose povećan rizik oboljevanja od depresije i njenih korelata, kao što su npr. Daunov sindrom, Fragilno X sindrom i Prader-Vili sindrom. Potencijalan dijagnostički problem kod osoba sa intelektualnom ometenošću, a kada je u pitanju depresija, mogu predstavljati tendencije 'dijagnostičke zamagljenosti' simptoma depresije, koji često ostaju prikriveni abnormalnim ponašanjem i poremećajima prilagođavanja, posebno kod osoba sa težim oblicima intelektualne ometenosti. Kao mogući način prevazilaženja tih problema neki autori su predložili koncept 'bihejvioralnih ekvivalenata depresije' ili u ponašanju evidentnih poremećaja koji se mogu dovesti u vezu sa depresijom, kao što su: socijalno povlačenje, agresivnost, hostilnost, iritabilnost i psihomotorna agitacija. Intenziviranje ovih obrazaca u ponašanju može biti znak razvijanja depresije, pa u tom smislu ovo gledište predstavlja korisnu polaznu tačku. Kada su u pitanju terapijski pristupi, postoji opšta tendencija potenciranja psihofarmakoterapije depresije, iako ima sve više istraživanja koja dokazuju povoljne efekte kognitivno-bihejvioralne i pshoanalitičke psihoterapije.
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O članku

jezik rada: engleski
vrsta rada: pregledni članak
objavljen u SCIndeksu: 27.01.2012.