Jankuvienė, Odeta

Objective: suicide is one of the core health problems in the global society. One of the predominant causes of death among young Europeans is suicide. Recent statistic data on suicide proves that Lithuania is one of the leaders in this range. The goal is to define and compare the peculiarities of suicide behavior among teenagers of different sex. Methods: 109 teenagers were researched in the age group of 14 to 17 (52 boys and 57 girls), they were treated in Kaunas University of Medicine Psychiatry Clinics Children – Teenagers Department after they had tried to commit a suicide. Results: Researching teenagers’ mode of suicide, the correlation between mode of suicide and sex was defined (?2=19,29, lls=3, p=0,0001). Only every fourth (25,0 %) teenager – boy used medicaments for killing himself, whereas even two thirds of girls (64,9 %) took medicine to commit a suicide (p<0,001). Self inflicted wound (32,7 %) was prevailing in the group of boys comparing with the group of girls (15,8 %) (p<0,05); hanging as a suicide method was eight times more frequent between the boys than the girls - accordingly 13,5 % and 1,8 % (p<0,001). Conclusions: research data suggests that teenage boys and girls manner of suicide implies statistically significant differences.

Objective: Suicides rate, especially among young people in Lithuania, is the highest in Europe. The goal is to define and compare the peculiarities of suicide behavior among teenagers of different sex. Methods: 109 teenagers were researched in the age group of 14 to 17 (52 boys and 57 girls), they were treated in Kaunas University of Medicine Psychiatry Clinics Children – Teenagers Department after they had tried to commit a suicide. Medical documentation and authors’ concluded structuralized questionnaire were used to evaluate anamnesis data. Results: More than one half of boys and girls tried to commit a suicide for the first time, the other part of researched teenagers attempted this repeatedly (46,2 % of boys and 42,1 % of girls). Researching suicide environment, the correlation between suicide surroundings and sex was established (?2=9,21, lls=2, p=0,01). Three fourths (75,4 %) of girls chose parental home surroundings, whereas only every second boy chose the surroundings of parental home (51,9 %) (p<0,05). Quite the same percentage of researched boys and girls - accordingly - 17,3 % and 15,8 % percent chose school and friend environment; the percentage of boys who chose other environment (remote places) was triple larger than the percentage of the girls in this group - accordingly 30,8 % and 8,8 % (p<0,01). Conclusions: research data suggests that suicidal behavior of teenage boys and girls implies statistically significant differences.

Purpose: To ascertain the opinion of psychiatrists of the factors those determine antidepressants selection. Material and methods: An original questionnaire of 30 questions, which deals with reliance of antidepressants selection according to the subtype of depression, was represented for a quarter of all Lithuanian psychiatrists. Results: Respondents for depression with obsession – 36% chose paroxetine. It is interesting that despite the controversial opinion about the TCA prescribing according to their side effects profile and safety to use, our respondent chose amitriptyline for the melancholic depression with suicidal thoughts (50.2%) and for the anesthetic depression (28%). In some cases there is no unanimous opinion among the psychiatrists – data scattering was received in selection, the respondents chose different antidepressants from different groups in similar frequency. For the treatment of the adynamic depression – 7.6% – amitriptyline, 12.1% – citalopram, 10.6% – reboxetine, 10.6% – venlafaxine, for the anxious depression – 15.2% – amitriptyline, about 20% – citalopram, 15.2% – mirtazapin, for the anesthetic depression – 14.3% – escitalopram, 9% – sertraline, 8.3% – venlafaxine. There is no clear tendency or prevailing antidepressant. Conclusions: Psychopathological peculiarity of depression can be one of the most important criteria in antidepressant selection. However, in many cases, the subtype of depression is ascertained empirically and based solely on the personal experience and clinical practice of the psychiatrist. There are no clear diagnostic criteria or practical guidelines for the reliable verification of the psychopathological subtype of depression, which would allow for the selection of a more adequate and prompt treatment for the patient.

Mental and neurological disorders due to cerebrovascular changes are quite frequent, but are very rarely analyzed in connection with morphological changes in blood vessels. OBJECTIVE: To analyze correlation between clinical symptoms and histological changes of human a.basilaris. METHODS: We retrospectively studied relation between histological changes of a.basilaris and psychoneurological state in 10 cases of 40-70 years old patients, who died by accident. RESULTS: Analyzing retrospectively case histories we found such symptoms in psychical neurological state: basilar syndrome, emotional lability, rapid changes of mood, asthenia. 6 patients were diagnosed basilar syndrome by neurologists, 4 patients were diagnosed symptoms of F 06 group (according to ICD-10). Histological changes in a.basilaris were reduced amount of elastic fibre in blood-vessel media, increased quantity of collagen fibre and widening of intima. CONCLUSIONS: Most frequent symptoms correlating with a.basilaris structural changes were basilar syndrome and organic mood, anxiety disorders.

Objective: because of the increasing rates of suicides, especially among young people, suicidal behavior becomes more and more actual problem in many countries. Lithuania is known as a country where suicides rate is the highest in Europe. The goal is to find out and compare gender differences in teenagers suicidal behavior relations with depression, personal peculiarities. Methods: two groups of teenagers from 14 to 17 were researched: cases (who tried to commit a suicide, N=109) and control group (without suicidal anamnesis, N=218). Aiming to establish teenagers’ diagnoses in cases group, clinical psychiatric research was performed, in accordance with ICD- 10 classification of mental and behavioural disorders diagnostic reference requirements, diagnoses distribution was compared in relation to sex. Minnesota Multiphasic Personality Inventory (MMPI) was used to evaluate personalities in both groups, obtained profiles were compared among groups and sex. Results: depression diagnosis (F32) was established only to 22,9% of teenagers, more cases were established among boys than girls (p<0,001). Adjustment disorders (F43) and disorders of conduct and emotions (F91-92) diagnoses were more frequent among girls (p<0,001). Cases group boys in MMPI profile more often than girls had greater scales of depression, psychasteny and anxiety, girls, relatively, had greater scales of hysteric, psychopathic and mania (p<0,05). Conclusions: Depression is less frequent than adjustment disorders and disorders of conduct and emotions among the teenagers who tried to commit a suicide. The researched boys proved to be more inclined to depression and girls implemented more hysteria and psychopathic personality attributes.

Objective: Suicidal behavior becomes more and more actual problem in many countries. Lithuania is known as a country where suicides rate, especially among young people, is the highest in Europe. The goal of this research was to establish the coherence between family, psychosocial characteristics and teenagers’ suicide behavior. Methods: Two groups of teenagers from 14 to 17 were researched: the analyzed group (N=109) and the control group (N=218). To evaluate anamnesis, psychosocial factors of the researched teenagers, structural questionnaire, concluded by the authors was presented. Seeking to establish the coherence between psychosocial factors and suicide behavior, the comparisons were made between the frequencies of this factor among 14 – 17 year old teenagers, having no suicide anamnesis and the teenagers who have tried to commit a suicide. Results: The data analysis proved the statistically reliable evidence that in analyzed group both male and female teenagers, who have tried to commit a suicide, live in not full families (p<0,001). The frequent behavior in such families is addiction of both or one of the parents to alcohol (p<0,001); physical punishment is not an exception (p<0,001). The teenagers who have tried to commit a suicide indicated that they more often than the teenagers in the control group fell badly or even very badly among their contemporaries (p<0,001) and most of their time they spend alone (p<0,001). Conclusions: According to the results, the psychosocial factors and teenagers suicidal behavior are related, but only they themself can’t predeterminate the suicide.

STUDY OBJECT: To evaluate the opinion of nurses and nursing students about patients belonging to sexual minorities. METHODS: The study was performed using of anonymous questionnaire at the Hospital and Nursing department of Kaunas University of Medicine. 32 general practice nurses from departments of Ophthalmology, Nephrology, Thoracic Surgery and 22 nursing students took part in the survey. RESULTS: It was found, that the attitude of nurses towards sexual minority was more negative (55 percent). The attitude of students was more neutral (53 percent), however there was no significant statistical difference (p=0,32). Evaluating the influence of age to the attitude, we determined that all nurses with negative attitude towards sexual minorities were more than 40 years old. When analyzing the influence of work experience to the attitude, it was found, that most of nurses (37 percent) showing negative attitude had work experience more than 15 years. Most nurses (37 percent) and nursing students (50 percent) were thinking that homosexuality is the result of nurture. When determining the influence of education level to the attitude towards sexual minorities, it was found, that nurses with negative attitude, had college and university education and most of students with negative attitude (92 percent) had secondary education.

GOAL: The goal of this work is to research the relation between the spinal cord injuries and depression symptoms. METHODS: the researched group is made up of 26 patients in early period of trauma treated in KMU Neurorehabilitation department. They were recovering after different level spinal cord injuries. There were 10 women and 16 men, 25-40 years old. All researched patient were given the HAD questionnaire that helped to observe the symptoms of depression. RESULTS: research results shows that more than a half of patients (56.25 percent) suffer of depression in early period after trauma. The difference in gender groups is very small: 60 percent of women and 56.25 percent of men after the results of research had depression. CONCLUSION: the spinal cord injury makes an influence on patient’s emotional state and very often may cause the depression symptoms.

Study object: This study was aimed to depict some psychological features characteristic for children suffering from stomach pain. Methods: Two projective tests “House – Tree - Person” and “Kinetic Family Drawing” were used. 60 children suffering from stomach pain were tested. The control group consisted of 30 basically healthy children. Results: Analysis of collected data has shown that unsociability, poverty of emotions, very high level of anxiety are characteristic for children suffering from stomach pain. Ill children show high level of insecurity, hostility and antagonism to the family. Also difficulties in communication, complicated family situation were characteristic for the group of sic children.

STUDY OBJECT: to ascertain the opinion of Lithuanian psychiatrists on depression treatment approach according to the type of depression. METHODS: an original questionnaire of 30 questions, which deals with reliance of antidepressants selection according to the peculiarity of the depression psychopathology. RESULTS: Respondents for organic depression chose mostly mirtazapin (47.4%), for depression with obsession – 35.3% chose paroxetine. It is intresting that despite the controversial opinion about the TCA prescribing according to their side effects profile and safety to use, our respondent chose amitriptylinum for the melancholic depression with suicidal thoughts ( 42.1%) and for the anaesthetic depression ( 28%). The study results showed that in some cases there is no unanimous opinion among the psychiatrists – data scattering was received in antidepressants selection, the respondents chose different antidepressants from different groups in similar frequency. For instance, for treatment of the adynamic depression - 7.5? - amitriptyline, 12? - citalopram, 10.5 ? - reboxetin, 10.5 ? - venlafaxin, 4.5 ? - mirtazapine, for the anxious depression - 15% - amitriptyline, 18.8% - citalopram, 15% - mirtazapine, for the anaesthetic depression – 14% - escitaloprami, 9% - sertraline, 8.5% - venlafaxine . There is no clear tendency nor prevailing antidepressant. CONCLUSIONS: The clinical variety of depression is posing serious task for practitioners – to choose adequate therapy and right antidepressant. Data scattering shows that in some cases guidelines for antidepressant selection would significantly relieve the work of practitioners.