NESUICIDALNO SAMOPOVREĐIVANJE KOD ADOLESCENATA SA POREMEĆAJIMA EMOCIJA I PONAŠANJA: KLINIČKE KARAKTERISTIKE I VEZA SA SUICIDALNOŠĆU
Sažetak
Uvod: Nesuicidalno samopovređivanje (engl. Nonsuicidal self-injury, NSSI) definiše se kao zaseban entitet u petoj reviziji Dijagnostičkog i statističkog priručnika za mentalne bolesti (DSM-V), i to kao ,,poremećaj za dalje istraživanje“. Iako NSSI u osnovi nema suicidalnu nameru, istraživanja pokazuju da se ono neretko javlja udruženo sa suicidalnim fenomenima, a ova povezanost još uvek nije dovoljno razjašnjena.
Cilj rada: Glavni cilj našeg rada predstavljao je ispitivanje kliničkih karakteristika NSSI u populaciji adolescenata sa poremećajima emocija i ponašanja, uz poseban osvrt na njegovu povezanost sa suicidalnošću.
Materijal i metode: Istraživanje je obuhvatilo 100 starijih adolescenata sa depresivnim poremećajima, anksioznim poremećajima, poremećajima prilagođavanja i mešovitim poremećajima ponašanja i emocija, lečenih u dnevnoj bolnici. Podaci su dobijeni iz postojeće medicinske dokumentacije i obuhvatili su informacije o NSSI i suicidalnim fenomenima, psihijatrijskim simptomima, dijagnozi, skorovima skala za procenu depresije i funkcionalnosti i podatke iz lične i porodične anamneze.
Rezultati: U našem uzorku NSSI je bilo češće prisutno kod devojaka i među mlađim adolescentima. Kada je reč o značajnim kliničkim karakteristikama, ovaj fenomen je bio povezan sa većim skorovima depresivnih simptoma na prijemu i otpustu, češćim prisustvom simptoma iz kategorije hipobulija-anhedonija, paničnim napadima, doživljajem tenzije i nemira, heteroagresivnim manifestacijama, učestalijim korišćenjem alkohola i graničnim poremećajem ličnosti. Prisustvo NSSI je takođe bilo značajno povezano sa prisustvom suicidalne ideje u nekom trenutku života, kao i težim stepenom suicidalnosti. Među pacijentima sa NSSI pokušaji suicida javljali su se učestalije kod onih koji su bili zanemareni u detinjstvu, kod osoba zlostavljanih u mlađem uzrastu, kod prisustva niže funkcionalnosti na prijemu, prisustva kognitivne usporenosti, kao i onih sa problemima saradljivosti na prijemu.
Zaključak: Visok nivo zastupljenosti nesuicidalnog samopovređivanja kod adolescenata sa poremećajima emocija i ponašanja, kao i brojne kliničke specifičnosti, mogu da govore u prilog izdvajanju ovog fenomena kao posebnog dijagnostičkog entiteta. Pronađene veze sa suicidalnošću uz specifične korelate mogu biti od kliničkog značaja u smislu usmeravanja preventivnih koraka.
Ključne reči: nesuicidalno samopovređivanje, samopovređivanje, adolescenti, suicidalnost
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