| Abstract | Uvod: Utjecaj psiholoških čimbenika kod ovisnika o alkoholu i razvoja zloćudnog tumora usne šupljine i orofarinksa gotovo je potpuno neistražen. Ovo istraživanje pretpostavlja važnost obrambenih mehanizama, crta osobnosti i korištenja strategija suočavanja u formiranju psihosomatskog odgovora. Cilj: Istražiti rane obiteljske relacije, korištenje mehanizama obrane, crte osobnosti, stilove suočavanja i razinu stresa u bolesnika oboljelih od zloćudnog tumora usne šupljine i orofarinksa, koji su ujedno ovisnici o alkoholu, u odnosu na ovisnike o alkoholu i zdravu populaciju Ispitanici i postupci: U istraživanju je sudjelovalo 79 bolesnika, ovisnika o alkoholu koji su oboljeli od zloćudnog tumora usne šupljine i orofarinksa, od čega je 51 bolesnik zadovoljio uključne kriterije. Istraživanje je provedeno na Klinici za maksilofacijalnu kirurgiju u Kliničkom Bolničkom Centru Rijeka u periodu 2005-2009. godine. Ujednačene usporedne skupine bile su ovisnici o alkoholu i zdrava populacija. Provedena je psihijatrijska anamneza i MINI (Mini International Neuropsychiatric Interview) upitnik. Ispitanici su ispunili opći demografski nestandardizirani upitnik, Upitnik životnog stila i obrambeni mehanizmi (ŽS), Profil indeksa emocija (PIE), Upitnik stilova suočavanja sa stresnim situacijama (COPE) i Ljestvicu životnih događaja (SRRS). Rezultati: Prosječna dob prve skupine ispitanika bila je 57, 02 ± 8, 87 godina, bilo je 21, 6% žena i 78, 4% muškaraca. Većina je ispitanika imala je srednju (36 (70, 6%)) ili nižu (13 (25, 5%)) stručnu spremu. Ispitne skupine su se značajno razlikovale po teškom djetinjstvu (p<0, 001) uz zlostavljanje (p=0, 004). Ovisnici o alkoholu oboljeli od zloćudnog tumora usne šupljine i orofarinksa znatno su manje koristili primitivne obrane: regresiju (p=0, 004), i premještanje (p=0, 013), a ovisnici o alkoholu više su koristili neurotske obrane: kompenzaciju (p=0, 005) i intelektualizaciju (p<0, 001). Statistički značajna razlika između tri grupe ispitanika nađena je na slijedećim varijablama: reprodukcija (F=3, 356 ; p=0, 038), inkorporacija (F=4, 377 ; p=0, 014), opozicionalnost (F=5, 941 ; p=0, 003) i bias (pristranost) (F=4, 517 ; p=0, 012). Najniže rezultate na varijabli agresivnosti postigla je prva skupina. Statistički značajna razlika dobivena je na faktoru 3 gdje ispitanici iz prve (M=52, 90±14, 06 ; p=0, 010) i ispitanici iz druge skupine (M=52, 90±12, 37 ; p=0, 048) postižu značajno više rezultate od ispitanika iz treće skupine (M=45, 16±16, 75). Analiza stresnih događaja pokazala je statistički značajne razlike (F=3, 602 ; p=0, 030). Ispitanici iz druge skupine (M=265, 69±177, 00) postižu statistički značajno više rezultate od ispitanika iz treće skupine (M=188, 04±146, 34 ; p=0, 008). Zaključak: Rezultati istraživanja pokazuju važnu ulogu psiholoških čimbenika u razvoju zloćudnih tumora usne šupljine i orofarinksa u multifaktorijalnoj etiopatogenezi te bolesti. |
| Abstract (english) | Introduction: Influence of psychological factors in alcoholics with oral and oropharyngeal cancer has barely been explored. The hypothesis in this research is that defense mechanisms, personality traits and the use of coping strategies have considerable importance in formation of psychosomatic response.
Aim: To examine early family relations, personality traits, the use of defense mechanisms, coping styles and the level of stress in alcohol dependent patients diagnosed with oral and oropharyngeal cancer, compared to alcohol dependent persons without malignant tumors and healthy population.
Participants and methods: The research included 79 alcohol dependent persons diagnosed with malignant tumor of the oral cavity and oropharynx, of which 51 satisfied the research inclusion criteria. The research was conducted at the Maxillofacial Clinic, University Hospital Center Rijeka, Croatia, from 2005 to 2009. The matching control groups consisted of alcoholics and healthy population. We established the history of psychiatric diseases and applied the Mini International Neuropsychiatric Interview. Participants also corresponded to a general demographic non-standardized questionnaire, the Revised Questionnaire of Life Style and Defense Mechanisms, the Profile Index of Emotion (PIE), the COPE Questionnaire and the Social Readjustment Rating Scale (SRRS).
Results: The first group of participants had the mean age of 57.02 ± 8.87 years; 21.6 % were women and 78.4% men. Majority of the participants had secondary (36 (70.6%)) or primary education (13 (25.5%)). The research groups showed significant differences relating to difficult childhood (p<0.001) including abuse (p=0.004). Alcohol dependent participants suffering from oral and oropharyngeal cancer significantly less frequently used primitive defense mechanisms of regression (p=0.004) and displacement (p=0.013) compared to alcoholics without malignant tumors, who significantly more often used neurotic defense mechanisms – compensation (p=0.005) and intellectualization (p<0.001). The three groups of participants showed statistically significant differences in the following variables: reproduction (F=3.356; p=0.038), incorporation (F=4.377; p=0.014), oppositionality (F=5.941; p=0.003) and bias (F=4.517; p=0.012). As for aggression variable, the first group had the lowest scores. Furthermore, the groups significantly differed in factor 3 – the first group (M=52.90±14.06; p=0.010) and the second group of participants (M=52.90±12.37; p=0.048) had significantly higher scores than the third group (M=45.16±16.75). The analysis of stressful events also showed statistically significant differences (F=3.602; p=0.030). The second group had statistically higher scores than the third group (M=265.69±177.00; M=188.04±146.34; p=0.008).
Conclusion: The research results suggest that psychological factors have an important role in development of oral and oropharyngeal cancer and its multifactoral etiopathogenesis. |
