Title Odgovor na psihosocijalni stres u bolesnika s prvom psihotičnom epizodom Title (english) Response to psychosocial stress in patients with a first psychotic episode Author Linda Rossini Gajšak73153953270105562043 Mentor Martina Rojnić Kuzman (mentor)Committee member Dolores Britvić (predsjednik povjerenstva)Committee member Irena Drmić-Hofman (član povjerenstva)Committee member Trpimir Glavina (član povjerenstva)Granter University of Split Defense date and country 2023-11-30, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 616 - Pathology. Clinical medicine Abstract Rezultati istraživanja odgovora na psihosocijalni stres u bolesnika s prvom psihotičnom epizodom (PPE) su vrlo raznoliki. Cilj ovog rada je bio istražiti razlike u odgovoru na stres između bolesnika s PPE i kontrolne populacije (KP) te utvrditi promjene u odgovoru na psihosocijalni stres između prve akutne epizode i nakon 18 mjeseci liječenja. Dodatni ciljevi bili su istražiti povezanost odgovora na psihosocijalni stres s psihopatologijom u skupini bolesnika. Rad je proveden na Klinici za psihijatriju Kliničkog bolničkog centra Zagreb i Neuropsihijatrijskoj bolnici „Dr. Ivan Barbot― Popovača u razdoblju od 1.3.2015 do 31.12.2017 godine. Naše je istraživanje podijeljeno u dva dijela: presječno istraživanje s ciljem utvrđivanja razlika u odgovoru na psihosocijalni stres između 54 bolesnika s PPE i 64 osobe iz kontrolne populacije (KP) i prospektivno praćenje 40 bolesnika tijekom 18 mjeseci. Našim rezultatima je potvrđeno da kod osoba u akutnoj fazi PPE tijekom psihosocijalnog stresa dolazi do promjena koncentracije salivarnog kortizola statistički značajno drukčijih nego kod osoba bez psihotičnog poremećaja (η2 = 0,04; p = 0,043), no nije potvrđeno da se nakon 18 mjeseci standardnog liječenja smanjuju razlike između populacije s PPE i KP. Uočena je statistički značajna povezanost između bazalne koncentracije salivarnog kortizola i ukupnog rezultata PANSS ljestvice (ρ = 0,29; p = 0,034) i podljestvice pozitivnih simptoma. Zaključno, naši rezultati potvrđuju važnost vulnerabilnosti na psihosocijalni stres za nastanak PPE kod bolesnika. Također, rezultati potvrđuju da je vulnerabilnost na stres prisutna i nakon dugoročnog liječenja bolesnika s PPE, neovisno o akutnoj psihopatologiji. Stoga je nužno da se u dijagnostici PPE uključi i utjecaj psihosocijalnog stresa na razvoj i progresiju bolesti. Također, nužno je da liječenje osoba s PPE obuhvaća integrirani biopsihosocijalni pristup s inkorporiranim psihosocijalnim metodama kojima je cilj povećanje sveopće rezilijencije na psihosocijalni stres.
Abstract (english) The results of research on responses to psychosocial stress in patients with first episode
psychosis (FEP) are very diverse. The aim of this study was to investigate differences in the
response to stress between patients with FEP and the control population (CP) and to determine
changes in the response to psychosocial stress between the first acute episode and after 18 months
of treatment. Additional goals were to investigate the association between responses to psychosocial
stress and psychopathology in patients with FEP. The research was performed at the Psychiatry
Clinic of the Clinical Hospital Center Zagreb and the Neuropsychiatric Hospital „Dr. Ivan Barbot―
Popovača in the period from March 1, 2015 to December 31, 2017. Our study was divided into two
parts: a cross-sectional study to determine differences in response to psychosocial stress between 54
patients with PPE and 64 people from the control population (CP), and a prospective follow-up of
40 patients to determine changes in response to psychosocial stress between the first acute episodes
during the period of 18 months. Our results confirmed that in persons in the acute phase of the FEP
during psychosocial stress there are statistically different changes in salivary cortisol concentrations
from person without a psychotic disorder (η2
= 0,04; p = 0,043), but it was not confirmed that after
18 months of standard treatment differences between the population with FEP and CP are reduced.
A statistically significant correlation was observed between the basal concentration of salivary
cortisol and the total score of the PANSS scale (ρ = 0,29; p = 0,034) and the subscale of positive
symptoms.
In conclusion, our results confirm the importance of vulnerability to psychosocial stress for
the development of FEP in patients. Also, the results confirm that vulnerability to stress is present
even after long-term treatment of FEP patients, regardless of acute psychopathology. Therefore, it is
necessary to include the influence of psychosocial stress on the development and progression of the
disease in the FEP diagnostics. Also, it is necessary that the treatment of FEP patients includes an
integrative biopsychosocial approach with incorporated psychosocial methods in order to increase
overall resilience to psychosocial stress.
Keywords
Shizofrenija
Psihički stres
Keywords (english)
Schizophrenia
Psychological Stress
Language croatian URN:NBN urn:nbn:hr:171:472561 Promotion 2023 Study programme Title: Translational Research in Biomedicine - TRIBE Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2023-12-11 08:02:12
