| Abstract | Ciljevi istraživanja: Ciljevi ovog istraživanja bili su odrediti udio akutno psihotičnih dekompenziranih bolesnika koji su bili pod utjecajem kanabisa te ih usporediti s onim akutno psihotičnim bolesnicima koji nisu zloupotrebljavali kanabis.
Materijali i metode: Retrospektivno je analizirana medicinska dokumentacija akutno psihotično dekompenziranih bolesnika koji su liječeni na Klinici za psihijatriju KBC-a Split od 1. siječnja 2018. do 1. siječnja 2019. godine. Prikupljeni su podatci za: zlouporabu kanabisa, spol, dob, dob pri prvom kontaktu sa psihijatrom, broj hospitalizacija, obiteljski hereditet psihijatrijskih bolesti, heterodestruktivnost i autodestruktivnost.
Rezultati: U odabranom razdoblju, od 1. siječnja 2018. do 1. siječnja 2019. godine, istraživanje je obuhvatilo 676 bolesnika od kojih je 346 (51,2%) primljeno pod nekom od, po definiciji, kroničnih psihijatrijskih dijagnoza (F20, F22, F25). Od ukupnog broja ispitanika, njih 73 (10,8%) su imali dijagnozu mentalnog poremećaja i poremećaja ponašanja uzrokovanog upotrebom psihoaktivnih tvari. Bolesnike smo podijelili u skupinu koja je zloupotrebljavala kanabis u kojoj se nalazilo 113 ispitanika (16,4%) i u skupinu koja nije zloupotrebljavala kanabis gdje su 563 ispitanika (83,6%). Najviše je bolesnika koji su zloupotrebljavali kanabis primljeno pod dijagnozom akutnog i prolaznog mentalnog oboljenja (F23). Od cjelokupnog broja ispitanika, 403 su muškarci (60%), a 273 ih čine žene (40%). Među bolesnicima koji zloupotrebljavaju kanabis nalazi se 95 muškaraca (84%) i 18 žena (16%), (p<0,01). Prosječna životnu dob bolesnika koji zloupotrebljavaju kanabis iznosi 31,57 ± 7,64 godina, a za one bolesnike koji nisu zloupotrebljavali kanabis 45,41 ± 13,62 godina (p<0,01). Unutar skupine bolesnika koja je zloupotrebljavala kanabis prosječna dob prvog kontakta sa psihijatrom bila je 25,32 ± 6,78 godine, a među onima koji nisu zloupotrebljavali kanabis ta dob je prosječno iznosila 31,7 ± 13,48 godina (p<0,01). Među bolesnicima koji su zloupotrebljavali kanabis, 29 bolesnika (51,8%) imalo je pozitivan obiteljski hereditet mentalnih poremećaja, a 27 bolesnika (48,2%) negativan. U usporedbi sa skupinom ispitanika koja nije zloupotrebljavala kanabis nije utvrđena statistički značajna razlika što se obiteljskog herediteta mentalnih poremećaja tiče, kao ni u pogledu broja hospitalizacija. Dokazan je značajno veći stupanj heterodestruktivnosti u bolesnika koji su zloupotrebljavali kanabisa i to posebno u skupini ispitanika koji boluju od dugotrajnijeg psihotičnog poremećaja (F20, F22, F25), (p<0,05). Nije utvrđena statistički značajna razlika između bolesnika koji su zloupotrebljavali kanabis i onih koji nisu po pitanju autodestruktivnosti. (p>0,05).
Zaključci: Potvrđene su hipoteze da su bolesnici koji zloupotrebljavaju kanabis i koji su akutno psihotično dekompenzirani značajno mlađi bolesnici muškog spola naspram onih koji nisu zloupotrebljavali kanabis. Pitanje važnosti obiteljskog herediteta mentalnih poremećaja u bolesnika izloženim kanabisu ostaje otvoreno za daljnja istraživanja jer naše istraživanje nije pokazalo značajnu razliku među skupinama, a rezultati sličnih studija se razlikuju. Opovrgnutost hipoteze o većem broju hospitalizacija u bolesnika koji su zloupotrebljavali kanabis može se objasniti time što bi se taj parametar trebao pratiti prospektivno. Ispostavljeno je da se u skupini ispitanika koji boluju od dugotrajnijeg psihotičnog poremećaja (F20, F22, F25) nalazi značajna razlika među onima koji su zloupotrebljavali kanabis i onih kojih nisu po pitanju heterodestruktivnosti čime je potvrđena hipoteza da zlouporaba kanabisa može precipitirati goroj kliničkoj prognozi kronično oboljelih bolesnika. |
| Abstract (english) | Aims and Objectives: The aim of this study was to determine the proportion of acutely psychotic decompensated patients under the influence of cannabis and compare them to those acutely psychotic patients who did not consume cannabis.
Materials and Methods: We retrospectively analyzed medical records of acute psychotically decompensated patients treated at the Department of Psychiatry, University Hospital of Solit from January 1ˢᵗ 2018 to January 1ˢᵗ 2019. Data were collected for: cannabis abuse, gender, age, age at first contact with psychiatrist, number of hospitalizations, family heredity of psychiatric diseases, heterodestructivity and self-destruction.
Results: In the selected period, from January 1ˢᵗ 2018 to January 1ˢᵗ 2019, the study included 676 patients, of whom 346 (51.2%) were hospitalized as suffering from chronic psychiatric diagnoses (F20, F22, F25). Of the total number of subjects, 73 (10.8%) had a diagnosis of mental disorder and behavioral disorders caused by the use of psychoactive substances. We divided the patients into a group of cannabis users with 113 subjects (16.4%) and 563 (83.6%) in the non-cannabis group. Most of cannabis recipients were hospitalized as having the diagnosis of acute and transient mental illness (F23). Out of the total number of respondents, 403 are men (60%) and 273 are women (40%). Among cannabis users there are 95 males (84%) and 18 women (16%), (p<0.01). The average age of cannabis users is 31.57 ± 7.64 years, and those who do not consume cannabis 45.41 ± 13.62 years (p<0.01). Among cannabis users, the average age of first contact with the psychiatrist was 25.32 ± 6.78 years, and among those who did not consume cannabis, the average age was 31.7 ± 13.48 years (p <0.01). Among cannabis users 29 patients (51.8%) had a positive family history of mental disorders, and 27 patients (48.2%) had no family history of mental disorders. Compared with the non-consuming group of cannabis there was no statistically significant difference between the familial heredity of mental disorders and the number of hospitalizations. There is a significantly higher degree of heterodestruction in cannabis users, particularly in the group of subjects suffering from a longer lasting psychotic disorder (F20, F22, F25), (p<0.05). In the manner of self-destructiom, there was no statistically significant difference between the patients who consumed cannabis and those who did not (p>0.05).
Conclusion: Hypothesis that cannabis consumers who were acutely psychotically decompensate are significantly younger male male patients versus those who did not take cannabis was confirmed. The question of the importance of family heredity in mental disorders in patients exposed to cannabis remains open for further research because our research did not show any significant difference between the groups, and the results of similar studies differ. The objection to the hypothesis of a greater number of hospitalization in cannabis users can be explained by the fact that this parameter should be monitored prospectively. It was found that in the group of subjects suffering from longer-lasting psychotic disorder (F20, F22, F25) there is a significant difference between those who have consumed cannabis and those who have not in the manner of heterodestructivity, thus confirming the hypothesis that cannabis abuse may precipitate in poor clinical prognosis for chronic illness. |
