Title Izazovi i mogućnosti liječenja shizofrenije u dječjoj i adolescentskoj dobi Title (english) Challenges and treatment options for schizophrenia in children and adolescents Author Josipa Bilinovac Mentor Lidija Bach-Rojecky (mentor)Committee member Lidija Bach-Rojecky (predsjednik povjerenstva)Committee member Živka Juričić (član povjerenstva)Committee member Ivan Pepić (član povjerenstva)Granter University of Zagreb Defense date and country 2021-07-09, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Shizofrenija je složeni neurorazvojni poremećaj s deficitima u kogniciji, afektu i socijalnim odnosima te zahtijeva brzo liječenje kod prvih znakova psihotične epizode. Iako se rijetko pojavljuje kod djece, incidencija shizofrenije stalno raste nakon što nastupi pubertet. Psihotične poremećaje tipično karakteriziraju pozitivni (sumanutosti, halucinacije, katatoni ili motorni simptomi, dezorganizirano ponašanje i tijek misli), kao i negativni simptomi (apatija, siromaštvo govora, povlačenje iz okoline). U djece i adolescenata vrlo je teško razlučiti postojanje „patoloških“ halucinacija u odnosu na dječju igru. Što je dijete mlađe dijagnoza shizofrenije je teža i izazovnija. Adolescencija je vrlo osjetljiv period života te se bolest teže podnosi nego u odrasloj dobi. Neki mladi pacijenti oboljeli od shizofrenije dožive samo jednu epizodu bolesti, dok ih većina doživi više. Oporavak je nekompletan u prosječno 80 % slučajeva u kojima su adolescenti imali više od jedne epizode bolesti. Prognoza kod 50 % dječjih shizofrenija je nepovoljna, a pogoršava je raniji i postepen početak bolesti, zbog čega je vrlo važno pravovremeno prepoznavanje simptoma, postavljanje dijagnoze i početak liječenja.Antipsihotici su lijekovi koji se koriste u liječenju shizofrenije te smanjuju simptome bolesti. Dijele se na prvu (tipični) i na drugu generaciju (atipični). Mehanizam djelovanja antipsihotika prve generacije je antagonizam D2 dopaminskih receptora, ali i neselektivno djelovanje na druge središnje i periferne receptore, dok je blokada serotoninskih 5-HT2A receptora i razlika u načinu djelovanja na dopaminske D2 receptore karakteristična za anitpsihotike druge generacije. S obzirom na razlike u mehanizmima djelovanja antipsihotika prve i druge generacije, prisutne su i razlike u neželjenim učincima. Ekstrapiramidalni sindrom, distonije te ostali motorički poremećaji nalik na parkinsonizam, karakteristični su za tipične antipsihotike, dok atipični antipsihotici većinom uzrokuju metaboličke, kardiovaskularne i antikolinergičke nuspojave.Cilj svih terapijskih pristupa je što brža i bolja kontrola kliničke slike, uz praćenje i kontrolu neželjenih učinaka kako bi se omogućio kontinuirani razvoj i normalno funkcioniranje djeteta i adolescenta u socijalnom i obiteljskom okruženju.
Abstract (english) Schizophrenia is a complex neurodevelopmental disorder with deficits in cognition, affect, and social relationships and requires prompt treatment at the first signs of a psychotic episode. Although it rarely occurs in children, the incidence of schizophrenia increases steadily after puberty. Psychotic disorders are typically characterized by positive symptoms (insanity, hallucinations, catatons or motor symptoms, disorganized behavior and flow of thought), as well as negative symptoms (apathy, lack of communication, social distance). When we talk about children and adolescents, it is difficult to determine the existence of true hallucinations in relation to children's games. The younger the child the diagnosis of schizophrenia is more problematic. Adolescence is a very sensitive period and it is more difficult to be affected by psychosis in the middle of adolescent development than when the disease begins in adulthood. Some young patients with schizophrenia have experienced only one episode of the disease, while most of them experience more. Recovery is incomplete in an average of 80 % of cases adolescents had more than one episode of the disease. The prognosis in 50 % of children with schizophrenia is unfavorable and worsens the earlier and gradual onset of the disease, so it is very important in a timely manner recognizing symptoms, making a diagnosis, and starting treatment. Antipsychotics are drugs that are used in the treatment of schizophrenia and act in a way to reduce symptoms of the disease. They are divided into the first generation of antipsychotics (typical) and the second generation of antipsychotics (atypical). The mechanism of action of first-generation antipsychotics is antagonism of D2 dopamine receptors, but also nonselective action on other central and peripheral receptors, while blockade of serotonin 5-HT2A receptors and differences in the mode of action on dopamine D2 receptors are characteristic for the second-generation antipsychotic. Because of differences in the mechanisms of action between the first and second generation antipsychotics, there are also differences in side effects. Extrapyramidal syndrome, dystonic reactions and other motor disorders similar to parkinsonism are characteristic of typical antipsychotics, while atypical antipsychotics mostly causes metabolic, cardiovascular, anticholinergic side effects. The goal of all therapeutic approaches is to control the clinical picture as quickly and as well as possible, with monitoring and control of side effects to allow continuous development and normal the functioning of the child and adolescent in the social and family environment.
Keywords
shizofrenija
djeca
adolescenti
antipsihotici
tipični anitpsihotici
atipični anitpsihotici
nuspojave lijekova
Keywords (english)
shizophrenia
children
adolescents
antipsychotics
typical antipsychotics
atypical antipsychotics
side-effects of drugs
Language croatian URN:NBN urn:nbn:hr:163:724655 Study programme Title: Pharmacy Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2022-02-09 15:09:23
