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Podsumowanie
Tabela 3. Częstość występowania objawów depresyjno-lękowych jako działań niepożądanych leków stosowanych u pacjentów pediatrycznych
Wiedza dotycząca skutków ubocznych farmakoterapii w populacji pacjentów pediatrycznych (tab. 3), w tym uważność w zakresie objawów związanych z zaburzeniami psychicznymi, ma bardzo duże znaczenie w procesie leczenia małoletniego pacjenta. Działania niepożądane leków u dzieci są częste, mogą nieść ze sobą negatywne skutki nie tylko somatyczne, lecz także w sferze psychicznej, a tym samym mieć znaczący wpływ na powodzenie leczenia oraz jakość życia pacjentów. Zaburzenia psychiczne były czwartą po zaburzeniach ogólnych, zaburzeniach skóry i tkanki podskórnej oraz zaburzeniach układu nerwowego najczęściej zgłaszaną grupą objawów. Zazwyczaj występujące zaburzenia związane są z zaburzeniami depresyjnymi i lękowymi, a im wcześniejszy wiek zachorowania u dziecka, tym bardziej prawdopodobne są trudności społeczne i zawodowe, gorsza jakość życia oraz większe problemy ze zdrowiem fizycznym i psychicznym, więcej epizodów depresji w ciągu życia i więcej prób samobójczych23. Szacuje się, że depresja powoduje większą niepełnosprawność u ludzi w wieku 10-24 lat niż jakakolwiek inna choroba26. Podobne dane kształtują się w odniesieniu do zaburzeń lękowych, które są wyniszczające i często powodują upośledzenie funkcjonowania społecznego i zawodowego pacjenta27,28. Ważny jest wgląd w występowanie i charakter psychiatrycznych powikłań stosowania farmakoterapii w populacji dziecięcej. Może to pomóc pediatrom w przewidywaniu i rozpoznawaniu tych reakcji, a co za tym idzie, we wdrożeniu efektywnych oddziaływań.
ABSTRACT
Anxiety and depressive disorders – what every pediatrician should look out for
One in four people will experience a mental disorder in adulthood, and around one in five people will experience a mental disorder at some point in childhood and adolescence. Most cases of mental disorders are actually believed to derive from early childhood or adolescence, causing a significant burden in later life. Half of all cases of psychopathology in one’s lifetime manifest most often at the age of 14. The prevalence of anxiety and depressive disorders is estimated at 5%-7% and 2%, respectively, at the age of 9-11 years, with some indications that the prevalence of anxiety may be even higher. These rates increase to 32% and 14%, respectively, during puberty. With regard to depressive and anxiety disorders in underage patients, it is particularly worth paying attention to the pharmacotherapy used in this group, which is related to the occurrence of this type of disorder. Adverse drug reactions (ADR) in pediatric patients are frequent; apart from somatic negative effects, they can produce negative effects also in the mental sphere and thus have a significant impact on the success of treatment and the quality of life of patients.
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