Podtip post-traumatskog stresnog poremećaja ili komorbidni psihotični poremećaj i procena sposobnosti za vojnu službu
Sažetak
Uvod. Dosadašnja istraživanja ukazuju da još uvek postoje dijagnostička razmatranja da li je u pitanju psihotični podtip posttraumatskog stresnog poremećaja (PTSP) ili komorbidni psihotički poremećaj (KPP). Specifičnost vojne sredine, zahteva kod svakog mentalnog poremećaja brižljivu evaluaciju kapaciteta za obavljanje vojne službe (VS). Prikaz bolesnika. Prikazan je podoficir, star 34 godine, koji je nakon mirnodopskog traumatskog događaja ispoljio simptomatologiju PTSP (prema Dijagnostičkom i statističkom priručniku za mentalne poremećaje – DSM IV). Pored traume u odraslom dobu, bolesnik je bio izložen i traumatizaciji u ranom detinjstvu, zbog suicida oca. Nakon tretmana lekovima i kognitivno-bihevioralnom psihoterapijom, postignuta je remisija i bolesnik je vraćen na svoju dužnost. Nakon novog stresa, uslovljenog nepovoljnim faktorima radne sredine, došlo je do ispoljavanja i psihotične fenomenologije. Nakon dvogodišnjeg psihijatrijskog lečenja, bolesnik je ocenjen “Nesposoban” za VS. Zaključak. Rana trauma i/ili PTSP su predisponirajući faktori za KPP, dok dijagnostički entitet – PTSP psihotični podtip, zahteva dalje istraživanje. Procena sposobnosti za VS kod bolesnika sa psihotičnim poremećajem, na osnovu našeg iskustva, nameće potrebu za, najmanje, dvogodišnjim psihijatrijskim lečenjem, što je u skladu sa istraživanjem sporovedenim u britanskoj armiji.
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