Child maltreatment predicting more severe psychiatric and biological phenotype among adolescent patients with depressive symptoms

Mitkovic-Voncina, Marija; Leštarević, S.; Pejović-Milovančević, Milica; Radosavljev-Kircanski, Jelena; Kalanj, Marko; Lečić-Toševski, Dušica

doi:10.1016/j.euroneuro.2018.11.587

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“…Ovo je u skladu sa studijom koja navodi da zanemarene i zlostavljane osobe sa depresivnim ispoljavanjem imaju veći rizik za suicid (32). U prilog ovim rezultatima ide i teorija koja kaže da zlostavljani pacijenti imaju težu kliničku sliku (33,34) i to, pre svega, oni kod kojih je početak zlostavljanja u mlađem uzrastu i da ih karakteriše povećan rizik za suicid i smanjen terapijski odgovor u odnosu na nezlostavljane sa istom dijagnozom (35). Što se tiče kliničke slike pacijenata sa NSSI koji su imali pokušaje suicida, karakterišu ih lošija opšta funkcionalnost, kognitivna usporenost i manja saradljivost u terapijskom kontaktu, što mogu biti ekvivalenti naučene bespomoćnosti koja se povezuje sa suicidalnošću (36).…”

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“…Lero M. et al Nesuicidalno samopovređivanje kod adolescenata sa poremećajima emocija i ponašanja: kliničke karakteristike i veza sa suicidalnošću. MedPodml 2019, 70(3): [32][33][34][35][36][37][38] Uvod: Nesuicidalno samopovređivanje (engl. Nonsuicidal self-injury, NSSI) definiše se kao zaseban entitet u petoj reviziji Dijagnostičkog i statističkog priručnika za mentalne bolesti (DSM-V), i to kao ,,poremećaj za dalje istraživanje".…”

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Nonsuicidal self-injury among adolescents with disorders of emotion and behavior: Clinical characteristics and association with suicidality

Lero¹,

Živanović²,

Mitkovic-Voncina³

2019

Medicinski podmladak

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Introduction: Nonsuicidal self-injury (NSSI) is defined as a separate entity in the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as a "condition for further study". Although the NSSI is not driven by suicidal intention, studies do show its association with suicidal phenomena, but this relationship is still unclear. Aim: The aim of this paper was to examine the characteristics of the NSSI phenomenon among adolescents with disorders of emotion and behavior, with special emphasis on its association with suicidal behavior. Material and methods: The study included 100 older adolescents with depressive disorders, anxiety disorders, adjustment disorders and mixed disorders of conduct and emotion, who were treated in day hospital. The data was obtained from the existing medical records and included information on NSSI and suicidal phenomena, psychiatric symptoms, diagnoses, rating scales for depression and global functioning, and data from personal and family history. Results: In our sample, the NSSI was more common in girls, and among younger adolescents. When it comes to clinical characteristics, this phenomenon was associated with higher depression symptom scores at admission and discharge, the presence of hypobulia-anhedonia, panic attacks, tension and restlessness, hetero-aggressive manifestations, more frequent use of alcohol and borderline personality disorder. It was also significantly associated with the presence of suicidal ideation during life, as well as with more severe suicidality level. In NSSI patients, suicidal attempts were more common among those who were neglected in childhood, with younger age of maltreatment onset, those with lower global functioning on admission, with cognitive problems, and with problematic compliance at admission. Conclusion: The high prevalence of NSSI in our sample, as well as numerous clinical features associated with it, may speak in favor of this phenomenon as a separate diagnostic entity. The observed association with suicide can be of clinical significance in terms of directing preventive steps.

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