PROCENA RIZIKA ZA POJAVU PSIHOZE KOD ADOLESCENATA U KLINIČKOJ PRAKSI
Sažetak
Važnost stanja povišenog rizika (engl. Ultra Hight Risk ‒ UHR) za pojavu psihoze prepoznata je do te mere da se sindrom atenuisane psihoze smatra novom dijagnostičkom kategorijom u DSM-5 klasifikaciji. Predloženi kriterijumi za sindrom atenuisane psihoze zahtevaju prisustvo najmanje jednog od triju pozitivnih psihotičnih simptoma (sumanutosti, halucinacije, dezorganizovanog govora) u oslabljenom obliku, ispoljenog najmanje jednom nedeljno u poslednjih mesec dana. Da bi se govorilo o sindromu atenuisane psihoze, potrebno je da je u poslednjih godinu dana došlo do pojave ili pogoršanja simptoma i da simptomi uzrokuju uznemirenost i onesposobljenost osobe koja ih doživljava, kao i traženje pomoći. Jedan od uslova za postavljanje ove dijagnoze jeste i nemogućnost boljeg objašnjenja navedenih simptoma nekim drugim (DSM-5) mentalnim poremećajem.
U radu je prikazana strukturirana procena sindroma atenuisane psihoze kod sedamnaestogodišnjeg adolescenta i diskutovano je o njegovom implikacijama u dijagnostici i tretmanu. Za procenu su, pored kliničkog pregleda, korišćene Sveobuhvatna procena rizičnog mentalnog stanja (engl. The Comprehensive Assessment of At-risk Mental States ‒ CAARMS, version 2006) i Skala procene društvenog i profesionalnog funkcionisanja (engl. The Social and Occupational Functioning Assessment Scale ‒ SOFAS).
Procena sindroma atenuisane psihoze, posebno u adolescenciji, delikatan je zadatak za stručnjake za mentalno zdravlje. Značajno je da ona daje mogućnost da se identifikuju visokorizične osobe, da se rano interveniše ciljanjem prisutnih simptoma, da se smanji stres, da se poboljša funkcionisanje i sprečila ili makar uspori progresija psihotičnih simptoma do jasno ispoljene kliničke slike psihoze.
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