Depresija u graničnom poremećaju ličnosti

master's thesis

• Title (english): Depression in borderline personality disorder
• Author: Tali Horvat
• Mentor: Aleksandar Savić (mentor)
• Committee member: Dubravka Kalinić (predsjednik povjerenstva)
• Committee member: Dražen Begić (član povjerenstva)
• Committee member: Aleksandar Savić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Psychiatry and Psychological Medicine); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry

Abstract

Granični poremećaj ličnosti psihijatrijski je poremećaj karakteriziran pervazivnom nestabilnošću u regulaciji emocija, kontroli impulsa, interpersonalnim odnosima i slici samoga sebe. Pokazuje visoke stope komorbiditeta s drugim psihijatrijskim dijagnozama, a među njima posebno se ističe komorbiditet s velikim depresivnim poremećajem, od kojeg će u nekom trenutku svog života patiti čak do 85 % bolesnika s borderline-om. Klinička obilježja ova dva poremećaja u velikoj se mjeri preklapaju što može dovesti do poteškoća pri dijagnostici, a zbog kompliciranja kliničke slike depresije pervazivnim simptomima poremećaja ličnosti češće je javljanje složenog kliničkog tijeka depresije s duljim trajanjem depresivnih epizoda, perzistiranjem depresivnih simptoma i slabijim odgovorom na konvencionalne metode liječenja. Iz tog se razloga javlja potreba za definiranjem smjernica i razvojem algoritma liječenja ovih pacijenata. Većina autora slaže se da treba pobjeći od loše navike propisivanja velikog broja lijekova ovim pacijentima, te farmakoterapiju promatrati samo kao dodatak psihoterapiji specifičnoj za borderline, od kojih je najpoznatija dijalektička bihevioralna terapija (DBT). Osnovu farmakoterapije još uvijek najčešće čine lijekovi iz skupine SIPPS (selektivni inhibitori ponovne pohrane serotonina), no razmatra se i potencijalno uvođenje stabilizatora raspoloženja, atipičnih antipsihotika, te drugih lijekova i njihovih kombinacija, kao i drugih oblika liječenja poput elektrokonvulzivne terapije i transkranijalne magnetske stimulacije. Uz još uvijek premalo objavljene literature na ovu temu te ograničenu učinkovitost dostupnih terapijskih metoda, potrebna su daljnja istraživanja koja će pružiti novi i uspješniji pristup liječenju pacijenata s ovim komorbiditetom.

Abstract (english)

Borderline personality disorder is a psychiatric disorder characterized by pervasive instability in emotion regulation, impulse control, interpersonal relationships, and self-image. It shows high rates of comorbidity with other psychiatric disorders, especially with the major depressive disorder, from which up to 85 % of borderline patients will suffer at some point in their lives. The clinical features of these two disorders largely overlap, which can lead to difficulties in diagnosis. Due to the complication of depression with the pervasive symptoms of personality disorders, there is a higher occurrence of a complex clinical course of depression, with a longer duration of depressive episodes, stronger persistence of depressive symptoms, and a weaker response to conventional methods of treatment. Hence, there is a need to define guidelines and develop a treatment algorithm for these patients. Most authors agree that the bad habit of polypharmacy in this population should be avoided, and that pharmacotherapy should only be considered as an addition to borderline-specific psychotherapy, the most well-known of which is dialectical behavior therapy (DBT). The basis of pharmacotherapy are still SSRIs (selective serotonin reuptake inhibitors), but the potential introduction of mood stabilizers, atypical antipsychotics and other drugs and their combinations, as well as other forms of treatment such as electroconvulsive therapy and transcranial magnetic stimulation, is also being considered. With still not enough published literature on this topic and the limited effectiveness of available therapeutic methods, further research is needed to provide a new and more successful approach to the treatment of patients suffering from this comorbidity.

• Keywords: granični poremećaj ličnosti; depresija; dijalektička bihevioralna terapija; antidepresivi; komorbiditet
• Keywords (english): borderline personality disorder; depression; dialectical behavior therapy; antidepressants; comorbidity
• Language: croatian
• URN:NBN: urn:nbn:hr:105:810858
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-02 21:09:44