RESUMEN
BACKGROUND: Suicides are among the leading causes of death in the world and pose a major public health problem. It is not yet entirely clear to what extent the 2019 coronavirus pandemic (COVID-19) affects suicide rates, but is likely to result in an increase in risk factors for suicidal behaviors. The research objective was to compare the suicide rate in 2019 with the suicide rate in 2020 in the Republic of Croatia. SUBJECTS AND METHODS: A cross-sectional study was conducted for the period from January 2019 to December 2020. The necessary data on persons who committed suicide in the Republic of Croatia in that period were collected in cooperation with the Osijek-Baranja County Police Department. The number of suicides in that period was statistically processed according to demographic characteristics, suicide motives, days of the week and months by years. RESULTS: There was no significant difference in the total number of suicides comparing 2019 and 2020. Observed by months, significantly more suicides were committed during February 2020 compared to February 2019 (χ2-test, p=0.04). According to marital status, in 2019 compared to 2020, significantly more suicides were recorded among married persons (χ2-test, p<0.001) and among those who were unemployed (χ2-test, p<0.001). Persons with the status of veterans committed suicide significantly more often in 2019, compared to 2020 (χ2-test, p<0.001) During 2019, compared to 2020, significantly more suicides were committed by persons working in service and trade occupations (χ2-test, p=0.001). CONCLUSION: At the beginning of the pandemic in Croatia, in February 2020, there was a significant increase in suicides compared to 2019, which may indicate that the spread of the pandemic since the end of 2019, with uncertainty and cataclysmic atmosphere, had a negative effect on mental health.
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COVID-19 , Suicidio , COVID-19/epidemiología , Croacia/epidemiología , Estudios Transversales , Humanos , Pandemias , Suicidio/psicologíaRESUMEN
BACKGROUND: According to DSM-IV cancer is a stress event with influence on development of posttraumatic stress disorder (PTSD) but in many crysis, sometimes it is hard to define concrete stressor. PTSD ussually appears in the first three moths after trauma, but can be delayed for months or years. It is hard to diferentiate psychiatric states and specific treatment methods have different impact on PTSD symptoms. Aim was to evaluate impact of different psychiatric treatment methods on development and treatment of PTSD in patients with newly diagnosed breast cancer. SUBJECTS AND METHODS: Sample consisted of 120 women with breast cancer during radiotherapy on Department for Oncology on University Hospital Osijek. Patients were divided in four groups and each group was treated with different psychiatric treatment method (psychopharmacology and/or psychotherapy, control group with no treatment). We used detailed clinical examination with psychiatric interview (DSM-IV criteria), specially structured non-standardized questionnaire for ethyological factors and LASC for PTSD. Data was analyzed by adequate statistical methods. RESULTS: Although most of participants didn't have complite PTSD, some symptoms were present, and in some women were intensive, so they should be the main group for psychiatric tretment. We found falling values of PTSD symptoms in group treated with combination of psychotherapy and psychopharmacology and raising values in a control group. They are at risk of developing whole clinical picture of PTSD during time. CONCLUSIONS: Our results prove the need for constant evaluation of PTSD development during oncology treatment and positive effects of combined psychiatric treatment on reduction of PTSD symptoms.
Asunto(s)
Neoplasias , Trastornos por Estrés Postraumático , Femenino , Humanos , Trastornos por Estrés Postraumático/psicología , Psicoterapia , Encuestas y Cuestionarios , Manual Diagnóstico y Estadístico de los Trastornos MentalesRESUMEN
Being diagnosed with breast cancer is a traumatic event that can lead to development of different mental disorders and influences all aspects of affected woman's life. Anxiety and Depressive Disorders in physically ill people still don't have clear diagnostic criteria which make diagnosis and treatment very difficult since different psychiatric therapeutic approaches have different effects. The aim was to evaluate influence of separate and combined psychotherapeutic approach (psychodynamic and cognitive-behavioral) and psychopharmacotherapy on decrease of anxiety and depression in breast cancer patients. The sample consisted of 120 subjects divided into four groups. The first group of patients was treated with psychopharmacotherapy, the second group received psychotherapy, the third group was treated with the combination of psychopharmacotherapy and psychotherapy, and the fourth group of patients didn't receive any kind of psychiatric treatment. We used psychotherapeutic interview with detailed clinical assessment using DSM-IV criteria for mental disorders, specially structured non-standardized questionnaire for assessment of etiological factors in development of mental disorders, Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D). The subjects filled the questionnaires on entry, one moth and two months after the beginning of research. Psychotherapeutic treatment was conducted once a week. All of the therapeutic approaches of liaison psychiatrist applied in the treatment of women with breast cancer are successful in reduction of anxiety and depression. Liaison psychiatrist's combined approach of psychopharmacological and psychotherapeutic treatment of breast cancer patients with depression obtained better results than separate approach.
Asunto(s)
Neoplasias de la Mama/psicología , Trastorno Depresivo/diagnóstico , Servicios de Salud Mental/organización & administración , Depresión/terapia , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Earlier experience of psychological trauma of a close person can through a transgenerational transfer influence traumatic reactions of a person going through a trauma at present, resulting in a repetition of earlier traumatic experiences and a development of a variety of mental disturbances. Purpose of our study was to evaluate the influence of transgenerational transfer on the development of Posttraumatic stress disorder (PTSD) in women with diagnosed breast cancer that had a family member with diagnosed cancer. The sample mainly consisted of 120 women treated in a Department of Oncology, Osijek University Hospital Center with diagnosis of newly discovered breast cancer, during the conduction of radio therapy having values Hamilton depression scale (HAM-D) from > or = 8 to < or = 24 or values Hamilton anxiety scale (HAM-A) from > or = 17 to < or = 30. Psychotherapeutic interview with a detailed clinical overview and with applying diagnostic criteria according to DSM-IV for mental disorders, specially structured non-standardized questionnaire for etiologic factors evaluation of the beginning of examinees' mental disorder, Los Angeles Symptom Checklist of PTSD symptoms (LASC), Hamilton's scale for anxiety evaluation (HAM-A) and Hamilton's scale for depression evaluation (HAM-D) were used. Results show that 61 (51%) of patients have a family member with diagnosed cancer. The average total value on LASC for examinees that had a family member with diagnosed cancer was slightly higher (22.92) in comparison to those who had no such family member (20.88). No statistically significant connection was found between having a family member with diagnosed cancer and the average total value on LASC. Although no connection was established between having a family member with diagnosed cancer and the average value on LASC in women with diagnosed breast cancer, transgenerational transfer of emotions seems to be important in their traumatic reactions, but it is still insufficiently researched and it is a challenge for future researches leaving many complicated issues open.
Asunto(s)
Neoplasias de la Mama/psicología , Trastornos por Estrés Postraumático/genética , Adulto , Anciano , Familia , Femenino , Humanos , Persona de Mediana Edad , Calidad de Vida , Trastornos por Estrés Postraumático/psicologíaRESUMEN
Having breast cancer represents traumatic stress event that can influence development of psychiatric disorders during psychological adjustment. The aim of research was to investigate influence of liaison psychiatric approach on quality of life in patients with breast cancer. Sample consisted of 120 women with breast cancer treated on Department for Oncology in University Hospital Osijek. Patients were in liaison psychiatric treatment for two months. They were estimated on the first day, after one and two months of treatment. We used psychiatric interview and DSM-IV criteria, specially structured non-standardized questionnaire for estimation of potential ethyological factors for psychiatric disorders and WHOQOL-BREF for estimation of quality of life. We found that liaison psychiatric approach improved quality of life in patients with newly diagnosed breast cancer.
Asunto(s)
Adaptación Psicológica , Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Psicoterapia , Calidad de Vida , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Satisfacción del Paciente , Adulto JovenRESUMEN
After the war in Croatia, many people are suffering from posttraumatic stress disorder (PTSD). The aim of this research was to analyse the impact of symptoms of PTSD and their intensity on working ability of those patients. Two groups of patients with PTSD hospitalized at Psychiatric Department of osijek Clinical Hospital were interviewed. The first one consisted of 80 patients who were (by psychiatrist) estimated as able to work, and the second of 80 patients who were estimated as unable to work. In this research we used ICD-10 classification for diagnosis of PTSD, self-estimate scale for evaluation of intensity of simptoms of PTSD, Brief psychiatric ratin scale (BPRS) and medical files. Data were statistically arranged by SAS. Working status is correlated to values on Brief psychiatric rating scale (BPRS) and self-estimate scale for evaluation of symptoms intensity of PTSD. Work disability was statistically significantly correlated to: earlier appearance of symptoms of PTSD, more frequent reminding of stressor by live memories, and symptoms intensity. The intensity of symptoms was statistically more significantly correlated to work ability than their form, and the number of stressors lived through the war (through more severe illness) had more influence on work ability than characteristics or durability of a stressor.