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2017, vol. 68, br. 4, str. 12-19
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Procena rizika za suicid u odnosu na strukturu ličnosti kod obolelih od depresije
Risk assessment of a suicide in relation to a personality structure in patients with depression
aUniverzitet u Beogradu, Medicinski fakultet, Srbija bUniverzitet u Beogradu, Medicinski fakultet, Srbija + Klinički centar Srbije, Klinika za psihijatriju, Beograd, Srbija
e-adresa: sojewicm@gmail.com
Sažetak
Uvod: Pitanje suicidalnog rizika i uopšte suicidalnosti predstavlja jedan od najvećih izazova u psihijatrijskoj proceni. Ovo pitanje je praćeno obimnim naučno - istraživačkim stremljinjima u cilju ostvarivanja što preciznije procene suicidalnosti i suicidalnog rizika. Cilj: Ovo istraživanje ima za cilj validaciju psihopatoloških konstukata ličnosti izolovanih putem MMPI-a (Minesota multifazni inventar ličnosti) i HAM-D (Hamiltonova skala depresivnosti) u odnosu na zabeleženu suicidalnost kod ispitanika. Takođe, ispituje se povezanost standardnih kliničih varijabli, sociodemografskih varijabli i stepena suicidalnosti. Materijal i metode: Uzorak sačinjavaju pacijenti na stacionarnom lečenju na Klinici za psihijatriju, sa dijagnozma F32 i F33. Podaci su prikupljeni intervjuom, upitničkom metodom i iz zvanične medicinske dokumentacije. Prediktorske varijable predstavljaju skorovi na MMPI-202 i HAM-D-u, standardne kliničke i sociodemografske varijable. Kriterijumske varijable predstavljaju skor na SBQ-R (Upitnik suicidalnih ponašanja), kao mera suicidalnosti, i kategorička varijablja kojom se izražava prisustvo suicidalnih pokušaja u prošlosti. U obradi rezultata korišćene su: deskriptivna statistika, bivarijantna korelacija, regresiona analiza, poređenje aritmetičkih sredina i kanonička diskriminaciona analiza. Rezultati: Dobijena je pozitivna značajna korelacija između sucidalnosti i skala depresivnosti, paranodnosti, shizofrenije, anksioznosti, socijalne izolacije, psihoastničnosti, kao i broja hospitalizacija. Kao jedini pouzdani prediktor suicidalnosti izdvaja se depresivnost. Zaključak: Pokazano je da psihopatološki konstrukti izolovani MMPI-em jesu povezani sa suicidalnošću, ipak, zaključuje se da su neophodna dodatna istraživanja u cilju preciznije identifikacije kvaliteta i načina povezanosti koje se ostvaruju između testa i suicidalnosti.
Abstract
Introduction: The issue of suicidal risk ,and suicide in general, represents one of the biggest challenges in psychiatric evaluation. This issue is covered by an extensive scientific work with the purpose of creating the most precise evaluation of suicide and suicide risk. Aim: The main goal of this research is to validate psychopatological constructs of a personality isolated by MMPI-a and HAMD in relation with measured suicidal rate among the subjects in question. Also, goal of this research is to explore possible connections between standard clinical and sociodemographic variables with rate of suicidality. Material and methods: The sample group consists of patients that are based on the stationary ward of a psychiatric clinic, diagnosed with F32 and F33. All the data was collected by interview, questionnaire and official medical documentation. The prediction variables are presented by the score on MMPI-202 and HAM-D, and standard clinical and sociodemographic variables. Criteria variables represent the score on SBQ-R, as a measure of suicidal tendencies, and a category variable which marks the presence of suicide attempts in the past. During the data analysis, the following methods were used: descriptive statistics, bivariate correlation, regression analysis, comparisment of arithmetic mean and canonical discriminant analysis. Results: The research showed a positive and significant correlation between suicidal tendencies and the scales of: depression, paranoia, schizophrenia, anxiety, social isolation, psychoastenia and the hospitalization count. The only one reliable predictor of suicidalty is depression. Conclusion: The research concludes that the psychopathological constructs, isolated by MMPI, are connected with suicidal tendencies. However, the conclusion is that further research is necessary in terms of determining the quality and way of the connections that are achieved between the test and the suicidality.
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