Kako uspješno dijagnosticirati bipolarni poremećaj

master's thesis

• Title (english): How to effectively diagnose bipolar disorder
• Author: Martina Ostroški
• Mentor: Alma Mihaljević-Peleš (mentor)
• Committee member: Marina Šagud (predsjednik povjerenstva)
• Committee member: Dražen Begić (član povjerenstva)
• Committee member: Alma Mihaljević-Peleš (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Psychiatry and Psychological Medicine); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry

Abstract

Bipolarni poremećaj, ranije poznat kao manično-depresivna bolest, spada u skupinu poremećaja raspoloženja, te uzrokuje neobične promjene u raspoloženju, količini energije, razini aktivnosti i svakodnevnom funkcioniranju. Životna prevalencija poremećaja je 2% u općoj populaciji, no kako se često pogrešno dijagnosticira, njegov udio u populaciji vjerojatno je i veći. Najčešće pogađa mlađu populaciju, a javlja se s jednakom učestalošću u muškaraca i žena. Prema DSM-5 postoje četiri vrste bipolarnog poremećaja: bipolarni poremećaj tip I, bipolarni poremećaj tip II, ciklotimija i bipolarni poremećaj koji nije drugdje uvršten. Dijagnostika bipolarnog poremećaja je nespecifična i dugotrajna, pa je bipolarni poremećaj često dijagnosticiran i liječen kao unipolarna depresija. Do ispravne dijagnoze može proći i do 10 godina, jer da bi se postavila dijagnoza bipolarnog poremećaja potrebna je prisutnost maničnih ili hipomaničnih epizoda. Dva najčešće korištena instrumenta koji olakšavaju liječnicima dijagnosticiranje bipolarnog poremećaja su MDQ upitnik i HCL-32 upitnik. Upravo ti skrining instrumenti, odnosno praktični upitnici za čije ispunjavanje je potrebno odvojiti 5-10 minuta, mogu s velikom osjetljivošću detektirati oboljele već u ranim fazama bolesti. Idealno bi bilo kada bi se MDQ upitnik, kao odličan instrument za detekciju bipolarnog poremećaja tipa I, i HCL-32 upitnik, kojeg karakterizira visoka osjetljivost za bipolarni poremećaj tip II, uveli u redovan dijagnostički algoritam kod svih pacijenata s dijagnozom unipolarne depresije, a posebice ako je rezistentna na terapiju, kod adolescenata sa poremećajima raspoloženja i kod trudnica koje su posebno osjetljiva populacija za razvoj bipolarnog poremećaja. Definitivna dijagnoza obično zahtijeva opsežnu kliničku procjenu i medicinsku evaluaciju od strane specijalista psihijatrije. Ciljevi liječenja su rano otkrivanje, kontrola simptoma i profilaksa.

Abstract (english)

Bipolar disorder, formerly known as manic-depressive illness, belongs to a group of mood disorders, and causes unusual changes in mood, energy amount, the level of activity and daily functioning. Lifetime prevalence of the disorder is 2% in general population, but as it is often misdiagnosed, it’s prevalence in the population is probably higher. It mainly affects younger population and occurs with equal frequency in men and women. According to DSM-5, there are four types of bipolar disorder: bipolar I disorder, bipolar II disorder, cyclothymia and bipolar not otherwise specified disorder. Diagnosis of bipolar disorder is a non-specific and time-consuming, but bipolar disorder is often diagnosed and treated as unipolar depression. It can take up to 10 years to set a correct diagnosis and in order to do so it requires the presence of manic or hypomanic episodes. The two most commonly used instruments that facilitate the physicians to diagnose bipolar disorder are MDQ questionnaire and HCL-32 questionnaire. It is these screening instruments, or practical questionnaires which can take 5-10 minutes to fill out, can detect illness in the early stages of the disease with high sensitivity. The best thing would be when the MDQ questionnaire, as an excellent tool for the detection of bipolar I disorder, and HCL-32 questionnaire, which is characterized by high sensitivity for bipolar II disorder, would be part of a regular diagnostic algorithm for all patients with a diagnosis of unipolar depression, and in particular if it is resistant to therapy, in adolescents with mood disorders and in pregnant women who are especially vulnerable population for the development of bipolar disorder. The definitive diagnosis usually requires extensive clinical evaluation and medical evaluation by a psychiatrist. The goals of treatment are early detection, symptom control and prophylaxis.

• Keywords: bipolarni poremećaj; dijagnoza; MDQ upitnik; HCL-32 upitnik
• Keywords (english): bipolar disorder; diagnosis; MDQ questionnaire; HCL-32 questionnaire
• Language: croatian
• URN:NBN: urn:nbn:hr:105:233604
• 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
• Repository: Dr Med - University of Zagreb School of Medicine Digital Repository
• Created on: 2016-08-11 06:25:28