Iritabilnost kod dece i adolescenata: Savremeni pogledi i kliničke implikacije
Sažetak
Iako se patološka razdražljivost dugo proučava, intenzivna istraživanja poslednjih dvadesetak godina donela su značajne nalaze o njenoj etiologiji i potencijalnim terapijama. Ovaj pregled prikazuje savremena shvatanja, dijagnostičke aspekte, neuropsihobiološke karakteristike i lečenje razdražljivosti kod dece i adolescenata. Razdražljivost se danas shvata kao povećana sklonost ka ljutnji koja se stabilno ispoljava tokom vremena. Iako sama po sebi nije poremećaj, razdražljivost je kardinalni simptom poremećaja protivljenja i prkosa sa hroničnom razdražljivošću-ljutnjom. Prisutna je i kao pridruženi simptom kod različitih internalizujućih i eksternalizujućih poremećaja, a posebno se povezuje sa depresijom, anksioznim poremećajima, autizmom i poremećajem sa deficitom pažnje i hiperaktivnošću. Pretpostavlja se da nastaje usled smanjene tolerancije na frustraciju i sniženog praga za percepciju spoljnih stimulansa kao pretećih, kao i da je nasledna odlika značajno zavisna od sredinskih uticaja. Lečenje se bazira na farmakološkim, nefarmakološkim i kombinovanim tretmanima, pri čemu su antipsihoticima druge generacije dokazano najefikasniji. Šire shvatanje razdražljivosti kao složenog transdijagnostičkog, psihopatološkog fenotipa raspoloženja, kognicije i ponašanja, a zajedničkog imenitelja različitih poremećaja, ima važne kliničke implikacije, naročito za rano prepoznavanje, pravilno dijagnostikovanje i efikasno lečenje.
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