Patients' attitudes and values, their concept of illness and health as well as their previous experiences with medication may significantly affect the subjective response to antipsychotics. Quality of Life (QOL) has holistic concept that includes consideration of economic development, social vitality and environmental health. For most of the researches, QOL has an umbrella concept, which covers all aspects of life and includes physical and mental health, family relations, friendship, employment, leisure activities, medical treatment and quality of care, psychological and social benefit. In the domain of mental health, increasing the quality of treatment can be demonstrated through improvements of QOL of those using the mental health services. When measuring QOL in patients taking antipsychotics, it is important to acknowledge that a variety of factors may influence the QOL outcomes: these include side effects and daily dosage of the antipsychotic, depressive and negative symptoms, duration of treatment, and subjective tolerability.
There are connection between use of cannabis and many psychiatric disturbances in adolescents, especially "cannabis psychosis", depression, panic attacks and suicide. Negative effects could occur either as a result of a specific pharmacological effect of cannabis, or as the result of stressful experiences during the intoxication of cannabis in young people. Potentially is very dangerous high frequency suicidal ideation among cannabis users.
Algorithms and guidelines in treatment of schizophrenia behind which is the consensus of experts, institutions and associations are more and more in use among psychiatrists. However, the final conclusion about them will be possible only after their use in everyday practice with full freedom of psychiatrists to make changes according their personal judgment about risk and benefit of treatment.
The existence of two or more diagnoses (psychiatric, or a combination with somatic) in one person leads to a dilemma when choosing psychopharmacs for the treatment of the patient. There are no acceptable and comprehensive guidelines or algorithms for the treatment of innumerable possible combinations of psychiatric and somatic disorders. A strategy for treatment of such conditions is needed.
Bosnia and Herzegovina (BH) is located on the western part of the Balkan Peninsula. It has an area of 51 210 km2 and a population of 3 972 000. According to the Dayton Agreement of November 1995, which ended the 1992–95 war, BH comprises two ‘entities’ – the Federation of Bosnia and Herzegovina (FBH) and the Republic of Srpska (RS) – and the District of Brcko. The administrative arrangements for the management and financing of mental health services reflect this. The FBH, with 2 325 018 residents, is a federation of 10 cantons, which have equal rights and responsibilities. The RS has 1 487 785 residents and, in contrast, a centralised administration. Brcko District has just under 80 000 residents.
In this study is represented the relationship between suicidal thoughts and psychoactive abuse. In study were involved 202 students of Banjaluka's secondary schools. By questioned for risky behaviour of adolescents was found 28.7% of them have suicidal thoughts, and 144 haven't suicidal thoughts. Students from both groups use alcohol but there are not statistically significant differences among groups. The representative sample was 202 students from Banjaluka's secondary schools. The results showed that 28.7% of them have suicidal ideas. From examined students 20.2% used cannabis, and 4% other psychoactive substances, 56.9% alcohol and 35.6% smoke cigarettes. In the group with suicidal ideas, use of psychoactive substances is 8.6%, alcohol use in 63.7% cases and cannabis 36.2%, and smoking cigarettes in 48.2% cases. We may conclude that misuse of psychoactive substances is more present in group with suicidal ideas, except in case of alcohol, which was also high in group with suicidal ideas, but without statistical significances. It is also possible to conclude that there is important connection between use of psychoactive substances and presence of suicidal ideas as first step toward a suicide in adolescents.
The aim of this study were to determine which antipsychotic are currently in use, to establish which doses are administrated to patients, to find out is there a practice of proscribing simultaneously more then one antipsychotic drug, to determine whether antipsychotic are proscribed in divided doses, to establish whether there is, besides antipsychotics, treatment with other medicaments (co-administration), especially with antiparkinsonics. The research (study) is epidemiological-clinical prospective, descriptive and analytical and it was conducted at University hospitals in Sarajevo, Tuzla and Mostar. Criteria for inclusion, non-inclusion and exclusion from the study were precisely defined as a mean for formation of sample. Based on this hypothesis were established, zero and alterative. According to zero hypothesis in the treatment of schizophrenia at University hospitals in FBiH new antipsychotic drugs are in use, small doses are proscribed (up to 20 mg), not more then one antipsychotic drug is used simultaneously, antipsychotics are administrated once a day and alongside with antipsychotics other medicaments are not co-administrated, especially antiparkinsons. The results of our study are showing that majority of patients are treated with classical antipsychotics. Minority of patients is treated with atypical neuroleptics like olanzapine, which is proscribed only in Sarajevo. Use of risperidone and ziprasidone is registered also only in Sarajevo, but only small number of patients is treated with these drugs. Most frequent antipsychotics were promazine and haloperidol. The range between minimal and maximal daily dose of promazine was from 50 to 450 mg/daily, and for haloperidol from 1 to 75 mg/daily. Above-mentioned drugs were administrated in an average from two to three times a day. Alongside with antipsychotics, other drugs were used. Most frequent was the use of biperidine in oral and parenteral formulation, as well as nitrazepam and diazepam. The importance of this study is following: data are useful for the current mental health care reform in FBiH, results will point out place and position of FBiH in contemporary world trends in the treatment of schizophrenia, they will contribute to rational use of antipsychotic therapy, they will point out possible ways in reduction of side effects, often dangerous adverse effects of antipsychotics, and they will give contribution to faster rehabilitation of schizophrenics with the reduction of financial means for the treatment of patients with schizophrenia.
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