Papers by Mirna Sisek- Šprem
Ephemerides theologicae Zagrabienses, 2022
Kriza je vrlo teško stanje nakon kojeg se očekuje ili razrješenje ili katastrofa. U kriznoj se si... more Kriza je vrlo teško stanje nakon kojeg se očekuje ili razrješenje ili katastrofa. U kriznoj se situaciji osoba susreće s opasnostima koje ne može razriješiti poznatim načinima rješavanja problema, što može izazvati poteškoće na kognitivnom, ponašajnom, emocionalnom i tjelesnom planu. U radu se prikazuje utjecaj kriznih situacija na psihičko stanje pojedinca, s naglaskom na krize koje su 2020. godine pogodile Hrvatsku (pandemija i potresi) kao i terapijske mogućnosti koje u kriznim situacijama pruža logoterapija. Hoće li krizna situacija dovesti do psihičkog oboljenja, ovisi o značajkama krize i osobinama pojedinca koji je krizi izložen. U društvu u kojem mnogi pate zbog osjećaja besmislenosti života, krizne situacije lako mogu dovesti do psihičkih bolesti. Logoterapija, psihoterapijska tehnika koja u svoje središte stavlja volju za smislom kao pokretačku snagu ljudskog života, pojedinca upućuje na prihvaćanje života kao zadatka, uz naglašavanje njegove duhovne dimenzije, može u vrijeme današnjih kriza biti od preventivne i kurativne važnosti.
Influence of Serum Testosterone Level on Aggression in Women with Schizophrenia
Psychiatria Danubina, 2021
BACKGROUND Unlike in female population, the effect of testosterone on aggression in men has been ... more BACKGROUND Unlike in female population, the effect of testosterone on aggression in men has been investigated countless times so far. A scarce number of studies have examined the effect of testosterone on aggression in women. The results obtained so far are inconsistent for some studies indicated a positive, whilst others showed a negative correlation. Since testosterone turned out to be an important factor related to aggression in men, the aim of our study was to investigate whether this correlation existed in aggressive female patients with schizophrenia. SUBJECTS AND METHODS The sample consisted of 120 women, aged from 18 to 45 years, diagnosed with schizophrenia by DSM-5 criteria. Those who were breastfeeding or suffered from specific hormonal or other physical disorders were excluded from the study. They were divided into two groups of 60 - those with aggressive behavior and those with nonaggressive behavior. Psychopathology was measured by several tests (Positive and Negative ...
Hospital treatment of persons with Alzheimer's disease and other dementias
Hospitalizacija bolesnika s demencijom cesto je nezaobilazna tijekom dugogodisnjeg lijecenja, no ... more Hospitalizacija bolesnika s demencijom cesto je nezaobilazna tijekom dugogodisnjeg lijecenja, no važno je isto tako istaknuti da ona može biti potencijalno stresno iskustvo za bolesnika i obitelj. Dok je nekim bolesnicima potrebno bolnicko lijecenje samo zbog simptoma povezanih s demencijom, mnogi ljudi s Alzheimerovom bolescu također imaju ozbiljne komorbiditete, kao sto su infekcije, srcane bolesti, fraktura kuka. Rizik od komplikacija tijekom boravka u bolnici prilicno je visok, pa je stoga svakako preporucljivo izbjeci nepotrebne hospitalizacije osoba s demencijom. U ovoj fazi lijecenja posebno je važna suradnja strucnog osoblja i njegovatelja, kao i zajednicko planiranje zbrinjavanja osoba s demencijom nakon bolnickog lijecenja.
Referentni centar Ministarstva zdravstva za Alzheimerovu bolest i psihijatriju starije životne dobi
Agresivnost je posljedica kompleksnog djelovanja kliničkih, bioloških i društvenih čimbenika koji... more Agresivnost je posljedica kompleksnog djelovanja kliničkih, bioloških i društvenih čimbenika koji kod bolesnika sa shizofrenijom još uvijek nisu dovoljno istraženi (1). Dio autora smatra da su ti bolesnici skloniji heteroagresivnom ponašanju (1-4), a drugi da je kod njih rizik za heteroagresivno ponašanje jednak onom u osoba kod kojih nije postavljena niti jedna psihijatrijska dijagnoza (5,6). Često se navodi da nije dobro povezivati agresivnost s određenom psihijatrijskom dijagnozom (jer se time stigmatiziraju bolesnici) nego s različitim čimbenicima rizika među kojima se ističu antisocijalne osobine ličnosti, klinička slika te zloporaba psihoaktivnih tvari (1,4,7-9). Postavlja se pitanje po kojim se to osobinama izdvajaju bolesnici sa shizofrenijom koji su bili agresivni ili počinili ubojstvo od ostalih shizofrenih bolesnika.
Influence of Hormonal Status and Menstrual Cycle Phase on Psychopatology in Acute Admitted Patients with Schizophrenia
Psychiatria Danubina, 2018
BACKGROUND The gender differences in onset, symptom severity, and outcome of schizophrenia are no... more BACKGROUND The gender differences in onset, symptom severity, and outcome of schizophrenia are now thought to support the hypothesis that sex hormones may also have a role in etiology, as well as treatment, of schizophrenia. A number of reproductive hormones may be implicated, including testosterone, progesterone, or luteinising hormone, and thus it is important to acknowledge that there is a complex interplay of hormones occurring. This study was introduced to highlight the effect of the menstrual cycle, and sex hormones on female patients with schizophrenia. SUBJECTS AND METHODS The sample consisted of 31 consecutively acute admitted women, aged 18 to 45 years with schizophrenia diagnosed by DSM-5 criteria. The sample consisted of women who were regulary menstruating and to be undergoing regular hormonal fluxes. Each subject was enrolled and received psychopathology and hormone (estradiole, progesterone, testosterone) assessments. Psychopathology was measured with Positive end Neg...
Alzheimerova bolest – Priručnik za pacijente, obitelji i njegovatelje
Bolničko liječenje osoba s Alzheimerovom bolešću i drugim demencijama
Slika shizoafektivne psihoze kao psihijatrijska manifestacija Cushingove bolesti: prikaz slučaja
Čimbenici Rizika Iznenadne Smrti U Hospitaliziranih Psihijatrijskih Bolesnika
Psihogerijatrija u klinici za psihijatriju
Lijec̆nic̆ki vjesnik, 2020
In the past decade research has shown that searching for a meaningful life has a positive effect ... more In the past decade research has shown that searching for a meaningful life has a positive effect on a person's overall health and in reducing the risk of certain diseases, including dementia, stroke and heart attack. LOGOTHERAPY can be used to empower the elderly because it: • encourages patients towards a meaningful lifestyle and actions (most satisfying when directed at others) • seeks out the patient’s strengths, talents and aspirations from youth • directs patients toward an active attitude about life • focuses on identifying positive moments • helps patients find peace with the past • designs daily activities, especially those that restore the patient's sense of being needed by others • emphasizes the value of every moment Among psychiatric patients the elderly are one of the most sensitive groups of patients due to: • a lifetime of trauma • somatic comorbidities • sensitivity to pharmacotherapy • medical and social issues • frequently isolated and less functional There...
Disfagija i pneumonija povezane s uporabom kvetiapina
Background: The prevalence of hyperprolactinemia among psychiatric patients receiving antipsychot... more Background: The prevalence of hyperprolactinemia among psychiatric patients receiving antipsychotic medications was estimated to be between 30% and 70%. A review of the literature on prolactin and schizophrenia symptoms suggests that the correlation between them is complex and not limited to the adverse effects of antipsychotics. Relations with specific symptom dimensions have not been found consistently across studies. The association between increased prolactin and recurrent episodes of schizophrenia needs to be replicated in larger samples and in a population of female patients. The aim of this study was to find out whether elevated prolactin is related to specific symptoms or dimensions of schizophrenia, which is a heterogenic entity.Subjects and methods: The sample consisted of 119 consecutively acute admitted women, aged 18 to 45 years with recurrent schizophrenia diagnosed on bases of DSM-5 criteria. Assessment for all the enrolled subjects comprised a psychiatric evaluation ...
Socijalna psihijatrija, 2019
Kod svakog bolesnika, a osobito onog s neizlječivom bolesti kao što je demencija, neophodan je ho... more Kod svakog bolesnika, a osobito onog s neizlječivom bolesti kao što je demencija, neophodan je holistički pristup.
Socijalna psihijatrija, 2019
Uvod: Osobe s demencijom osjetljivije su na razvoj različitih komplikacija/neželjenih događaja u ... more Uvod: Osobe s demencijom osjetljivije su na razvoj različitih komplikacija/neželjenih događaja u odnosu na osobe iste dobne skupine bez demencije. Češće se zaprimaju u bolnicu, gdje imaju veću prevalenciju komplikacija i povećanu smrtnost. Cilj: ispitati učestalost hitnih premještaja bolesnika s demencijom zbog tjelesnih komplikacija iz Klinike za psihijatriju Vrapče na somatske odjele drugih bolnica. Metode: U ovom retrospektivnom istraživanju analizirali smo podatke bolesnika s demencijom koji su liječeni od 1. siječnja do 31. kolovoza 2019. godine na Odjelu psihogerijatrije u Klinici za psihijatriju Vrapče s naglaskom na vrijeme trajanja hospitalizacije i razloge otpusta koji su doveli do premještaja s Odjela. Rezultati: Od siječnja do kraja kolovoza 2019. godine na Odjel psihogerijatrije u Klinici zaprimljeno je ukupno 256 bolesnika (67,97 % žena i 32,03 % muškaraca). Prosječna dob žena bila je 80,5, a muškaraca 76,4 godina. Premješteno na somatski odjel (bolnicu) bilo je 28 % bolesnika (40,24 % muškaraca, 23 % žena), a od toga 39 % u prvih sedam dana od dolaska u bolnicu. Pneumonija je bila vodeća somatska dijagnoza kod 19 % premještenih. Prosječno trajanje hospitalizacije među svim ispitanicima bilo je kod muškaraca 33,08 dana, a kod
The longitudinal course of schizophrenia: testosterone and progression of the negative symptoms
Nordic Journal of Psychiatry, 2019
Abstract Background: The longitudinal course of schizophrenia shows a high level of heterogeneity... more Abstract Background: The longitudinal course of schizophrenia shows a high level of heterogeneity with testosterone as a possible factor in the variety of clinical outcomes. Aim: Evaluation of the course of schizophrenia in male patients over an eight-year period and of the possible testosterone effects on changes in clinical features. Subjects and methods: The initial study population consisted of 120 male schizophrenic patients (aged 18–40) hospitalized in the University Psychiatric Hospital Vrapce in 2009. Patients were classified into nonaggressive (control, n = 60) and aggressive (n = 60) groups. In 2017, we reassessed 85 patients (67,5%) from the initial sample. Symptoms of schizophrenia were determined using the Positive and Negative Syndrome Scale (PANSS) and compared with the total serum testosterone level taken at the inclusion in the study. The distribution of values for individual variables was determined using the Smirnov–Kolmogorov test; for all further analyses, the appropriate non-parametric test was used. Results: The control group showed a statistically significant negative correlation between testosterone and negative PANSS. The initial PANSS scores, compared to those at the follow-up, showed a statistically significant reduction in positive and general symptoms in all groups, with the greatest reduction in the control group. Conclusion: We found a reduction in positive and general symptoms of schizophrenia among all patients and no changes in negative symptoms. Inverse correlation between testosterone and negative symptoms was found only in the control group, but there was no testosterone influence on the progression of any PANSS subscales.
Socijalna psihijatrija, 2019
S obzirom na kontinuirano povećanje broja starijih osoba u ukupnoj populaciji u Hrvatskoj, za oče... more S obzirom na kontinuirano povećanje broja starijih osoba u ukupnoj populaciji u Hrvatskoj, za očekivati je da će se broj starijih osoba s akutnim psihičkim smetnjama koje zahtijevaju hitno zbrinjavanje sve više povećavati. Najčešći psihički poremećaji kod starijih osoba su: depresivni poremećaji, kognitivni poremećaji, demencija, poremećaji vezani uz uzimanje alkohola, poremećaji vezani uz druga zdravstvena stanja i lijekovima izazvani poremećaji. Gerijatrijski bolesnici bi u pravilu prvo trebali biti pregledani od strane stručnjaka somatske medicine (internista, neurologa, kirurga) prije nego što se upućuju u hitnu psihijatrijsku službu, kako bi se ustanovilo da su primarne smetnje iz psihijatrijske domene. Izražena depresija, suicidalnost, agitacija, sklonosti lutanju i ostalim rizičnim ponašanjima kod kuće, izražena anksioznost i smanjena sposobnost brige o sebi, glavni su razlozi hospitalizacije kod ovih bolesnika. / Related to the fact of the continuous increase in the number of elderly people in the total population of Croatia, it can be expected that the number of elderly people with acute psychiatric disorders that require emergency care will increase. The most common psychiatric disorders found in the elderly are depressive disorders, cognitive disorders, dementia, alcoholrelated disorders, disorders related to other health conditions and drug-induced disorders. Geriatric patients should, generally speaking, first be reviewed by a psychosomatic medical specialist (internist, neurologist, surgeon) before they are sent to psychiatric emergency services in order to establish that the primary complaint is connected with the psychiatric domain. Pronounced depression, suicidality, agitation, wandering tendencies and other home-based risk behaviours, with anxiousness and reduced self-care ability, are the main reasons for hospitalization.
European Psychiatry, 2017
IntroductionSingle-photon emission computed tomography (SPECT) is a valid method for measuring re... more IntroductionSingle-photon emission computed tomography (SPECT) is a valid method for measuring regional cerebral blood flow (rCBF). Recent studies regarding rCBF in patients with first episode psychosis (FEP) reported heterogeneous results, but were limited with small sample size. Neuroimaging can help us in setting the diagnosis of illness, as well as in following the progress and finding more effective treatment for psychotic disorders.ObjectivesTo compare, baseline alterations of the rCBF using SPECT with psychopathological status in FEP during acute phase.AimsTo investigate the changes of rCBF in patients with FEP during acute phase.MethodsWe conducted a study on 40 drug – naïve patients with FEP at acute phase of illness during their hospitalization at Zagreb University hospital centre. The diagnosis was confirmed using diagnostic and statistical manual of mental disorders, fifth edition. rCBF was measured with SPECT and psychopathological status rated with the Positive and Neg...
European Psychiatry, 2016
IntroductionPrevious studies have demonstrated that family history is associated with earlier age... more IntroductionPrevious studies have demonstrated that family history is associated with earlier age at onset, severity of positive and negative symptoms, and the duration of untreated illness. Hereditary factors may contribute a vulnerability for antisocial and/or violent behaviour per se, and for other stable characteristics such as aggressive behaviour.AimTo analyze the impact of family history of schizophrenia and aggressive behavior among members of family on severity of disease and aggressive behavior of patients.MethodThe study population consisted of 120 male schizophrenic patients classified into non-aggressive (n = 60) and aggressive (n = 60) groups, based on indication for admission in hospital (aggression/anything else but aggression). For severity of disease, we assessed psychopathology using the Positive and Negative Syndrome Scale (PANSS), the number of hospitalizations and the total equivalent dose of therapy (collected from medical record). The presence of a family his...
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Papers by Mirna Sisek- Šprem