Predisponirajući čimbenici agresivnoga ponašanja u muškaraca oboljelih od paranoidne shizofrenije

doctoral thesis

• Title (english): Predictive factors of aggressive behavior in men suffering from paranoid schizophrenia
• Author: Marija Kudumija Slijepčević; MBZ: 346710
• Mentor: Vlado Jukić (mentor)
• Committee member: nije dostupno (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2014-10-29, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

Cilj: Specifičnosti potencijalnih prediktivnih rizičnih čimbenika nasilja i nasilnih prijestupa kod pacijenata s paranoidnom shizofrenijom u Hrvatskoj još nisu istraženi i u potpunosti rastumačeni. Na temelju literature i često citiranih prediktivnih čimbenika rizika u drugim zemljama osmišljeno je presječno istraživanje s ciljem testiranja potencijalnih sličnosti i/ili specifičnosti rizičnih čimbenika u skupini hrvatskih pacijenata. Metoda: Presječno istraživanje muških (hospitaliziranih) pacijenata koji boluju od paranoidne shizofrenije sa (N=100) ili bez (N=100) povijesti fizičkog nasilja i nasilnih prijestupa provedena je simultano u nekoliko bolnica u Hrvatskoj tijekom perioda od jedne godine. Podatke o njihovim sociodemografskim karakteristikama, trajanju perioda neliječenja bolesti, zloupotrebi alkohola, suicidalnom ponašanju, osobinama ličnosti i uvidu u bolest kod obje su grupe pažljivo prikupili stručni specijalisti, a usporedio ih je iskusni stručnjak za biomedicinsku statistiku. Zatim je upotrjebljen model binarne logističke regresije kako bi se utvrdili potencijalno značajni prediktori nasilja i nasilnog ponašanja pacijenata. Rezultati: Istraživanje je pokazalo da su trajanje perioda neliječenja bolesti (DUP – Duration of untreated psychosis) prije prvog kontakta sa psihijatrijskom službom te zloupotreba alkohola visoko prediktivni za nasilnu forenzičku povijest. Od svih pozitivnih prediktivnih čimbenika nasilja i nasilnih prijestupa rezultat viši od 8 na AUDIT testu zloupotrebe alkohola pokazao se u modelu regresije kao najsnažniji pozitivni prediktivni čimbenik. Uz to, indeks psihopatije, emocionalna stabilnost i savjesnost su se također pokazali kao značajni pozitivni prediktivni čimbenici. Nasuprot tome, ekstraverzija, ugoda i intelekt našli su se među negativnim prediktivnim čimbenicima za nasilje i nasilne prekršaje.

Zaključak: Rezultati našeg istraživanja snažno podržavaju postojanje veze između zloupotrebe alkohola i neprepoznatih simptoma bolesti i rizika za nasilje i nasilne prekršaje kod oboljelih od shizofrenije. Nadamo se da će ovo otkriće i dalje omogućiti unapređenje strategija zaštite javnog i mentalnog zdravlja u ovoj osjetljivoj skupini bolesnika. Isto tako, naša studija naglašava potrebu za dodatnim istraživanjima u budućnosti kako bi se istražile neke potencijalne osobitosti hrvatskoga uzorka (npr. starija dob forenzičkih pacijenata) na koje je ukazalo naše istraživanje.

Abstract (english)

Aim: The specifics of the potential predictive risk factors of violence and violent offending in patients with paranoid schizophrenia in Croatia have not yet been studied or fully understood. Based on the body of literature and commonly cited predictive risk factors in other countries a cross-sectional study was designed with aim to test the potential similarities and or specificities of the risk factors in the Croatian patient group. Method: The cross-sectional study of male (in)patients with paranoid schizophrenia with (N=100) or without (N=100) history of physical violence and violent offending was conducted simultaneously in several hospitals in Croatia during a one year period. The data pertaining to their sociodemographic characteristics, the duration of the untreated illness phase (DUP), alcohol abuse, suicidal behavior, personality features and the insight into the illness belonging to the both groups of patients were carefully collected by trained specialist researchers and compared by experienced biomedical statistician. Additionally, the binary logistic regression model was then used to determine potential significant predictors of violence and violent behavior of patients. Results: In this study, the duration of the untreated illness (DUP) prior to first contact with the psychiatric services and alcohol abuse were shown to be highly predictive of the violent forensic history. Of all the positive predictive factors for violence and violent offending, scoring more than 8 on the AUDIT test for alcohol abuse was found in the regression model as the strongest positive predictive factor. Additionally, psychopathy index, emotional stability, conscientiousness were also found as significant positive

predictive factors. Conversely, extroversion, pleasantness and intellect were amongst significant negative predictive factors for violence and violent offending. Conclusion: The association between alcohol abuse and unrecognized symptoms of desease and the risk for violence and violent offending in schizophrenia was strongly born out by results of our study. It is hoped that this finding will further inform and enable improved public and mental health prevention strategies in this vulnerable patient group. Equally, our study highlighted the need for further prospective studies in order to investigate some potential particularities of Croatian sample (e.g. older age of the forensic patients) which were suggested by our research.

• Keywords: medicina
• Keywords (english): medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:678087
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
• Type of resource: Text
• Extent: 99 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-05 08:41:03