Magistarski radovi

Radanović-Grugurić Ljiljana
FUNKCIONALNI POREMEĆAJI ŠTITNJAČE I DEPRESIJA.
Medicinski fakultet Sveučilišta u Zagrebu. Zagreb, travnja 1996.

Magistarski rad je izrađen na Psihijatrijskoj klinici Medicinskog fakulteta Sveučilišta u Zagrebu, Osijek, Klinička bolnica Osijek, Huttlerova 4., Mentor: Prof. dr. Nikola Mandić

SAŽETAK

U svakodnevnoj kliničkoj praksi opazili smo pojavu depresivnih poremećaja u bolesnika s funkcionalnim poremećajem štitnjače. Ta činjenica nas je motivirala da pokušamo procijeniti učestalost te pojave, te da odredimo bitne značajke depresivnog poremećaja u tih bolesnika.
Istraživanjem smo obuhvatili 30 bolesnica oboljelih od hipertireoze, 23 bolesnice oboljele od hipotireoze, te 28 bolesnica oboljelih od unipolarne major depresije. Iz skupina bolesnica s funkcionalnim poremećajem štitnjače potom smo izdvojili one bolesnice koje su zadovoljavale kriterije za klinički značajan depresivni poremećaj: 17 bolesnica oboljelih od hipertireoze i 16 bolesnica oboljelih od hipotireoze. Te bolesnice su se nadalje komparirale sa skupinom bolesnica oboljelih od unipolarne major depresije.
U istraživanju smo kao mjerne instrumente rabili Hamiltonovu ocjensku ljestvicu za depresije, Zungovu Ljestvicu za samoocjenjivanje depresivnih, te Ljestvicu općih kliničkih dojmova. Bolesnicama smo određivali koncentracije triiodthyronina (T3), thyroxina (T4) i thyrotropina (TSH) u serumu.
Rezultati istraživanja su otkrili da dvije trećine bolesnica s funkcionalnim poremećajem štitnjače (33 bolesnice) imaju klinički značajan depresivni poremećaj. On je bio nešto više zastupljen u bolesnica oboljelih od hipotireoze nego u bolesnica oboljelih od hipertireoze, ali ne značajno. Depresivni poremećaj u bolesnica s funkcionalnim poremećajem štitnjače značajno je slabije bio izražen nego u bolesnica oboljelih od unipolarne major depresije.
Bolesnice oboljele od hipertireoza slabije su izražavale simptome inhibicije nego bolesnice oboljele od unipolarne major depresije.
Bolesnice oboljele od hipotireoze su slabije izražavale simptome agitacije negoli bolesnice oboljele od unipolarne major depresije.
Bolesnice oboljele od hipertireoze pretežito su ispoljavale simptome agitacije, a bolesnice oboljele od hipotireoze simptome inhibicije.
Zaključili smo da je pojava depresivnih poremećaja u bolesnica s funkcionalnim poremećajem štitnjače relativno česta. Tu populaciju bolesnica možemo smatrati potencijalno rizičnom, te tako joj i pristupati radi pravovremenog dijagnosticiranja i liječenja depresivnog poremećaja čime se izbjegava mogućnost njegove kronifikacije.

- SUMMARY

In everyday psychiatric practise we noticed very frequence of depressive disorders in patient with thyroid dysfunction. By that fact we were motivated to estimate the frequence of the depressive disorders and their specific characteristics in the patients with thyroid dysfunction.
The research was carried out on 30 female patients with hyperthyroidism, on 23 female patients with hypothyroidism and on 28 female patients with unipolar major depression. From the group of the patients with thyroid dysfunction we picked up the patients with clinically significant depressive disorders: 17 with hyperthyroidism and 16 with hypothyroidism. These female patients were compared to female patients with unipolar major depression.
During our research we used Hamilton Rating Scale for Depression, Zung’s Self- Rating Depression Scale and Clinical Global Impression (CGI). The serum concentration of triiodothyronine (T3), thyroxine (T4) and thyrotropin (TSH) for each patient were determinated.
The research results showed that most of the patients with thyroid dysfunction (33) had clinically significant depressive disorder. The depressive disorder was more frequent in patients with hypothyroidism than in patients with hyperthyroidism but not significantly.
Depressive disorders in patients with thyroid dysfunction were less intensive than in patients with unipolar major depression.
The patients with hyperthyroidism had less intensive symptoms of inhibition than the patients with unipolar major depression.
The patients with hypothyroidism had less intensive symptoms of agitation than the patients with unipolar major depression.
The patients with hypoerthyroidism usually had symptoms of agitation while the patients with hypothyroidism usually had symptoms of inhibition.
Regarding the results obtained it can be concluded that depressive disorders are very frequent in the patients with thyroid dysfunction. Such patients should be treated as potencially risky and therefor intime diagnosis and treatment of depressive disorders is recommended in order to avoid it’s possible cronification.