Depression, anxiety, and stress in infertile couples during the COVID-19 pandemic: the consequences we face.

OBJECTIVE: Postponing assisted reproductive technology treatment can cause pronounced mental health problems. The aim of this study was to examine the level of depression, anxiety, stress, and overall infertility-related distress experienced by infertile couples during the pandemic, as well as the differences between men and women in the examined variables and the correlations between them. METHODS: A total of 131 participants were included in the study, 65 men and 66 women. They were selected based on their responses in the Fertility Problems Inventory (FPI); the Depression, Anxiety, and Stress Scale-21 (DASS-21); and a general data questionnaire provided to them at the time of IVF. RESULTS: The levels of depression, anxiety, and stress in women and men resided within the normal range. Depression (p<0.05), anxiety (p<0.01), stress (p<0.01), and social concern (p<0.05) were more pronounced among women. Significant correlations were found between depression, anxiety, stress, and global stress and its three dimensions: social concern, sexual concern, and relationship concern. CONCLUSIONS: During the pandemic, women undergoing assisted reproductive technology treatment experienced significantly higher levels of depression, anxiety, stress, and overall infertility-related stress than men. Furthermore, depression, anxiety, and stress were apparently correlated with overall infertility-related stress.

Early intervention programme for patients with psychotic disorders in "Sveti Ivan" Psychiatric hospital (RIPEPP) - sociodemographic and baseline characteristics of the participants.

BACKGROUND: Psychiatric hospital "Sveti Ivan" in Zagreb, Croatia, offers an outpatient Early intervention programme for patients with psychotic disorders (RIPEPP), consisting of psychoeducational workshops and group psychodynamic psychotherapy. The aim of this study was to describe sociodemographic and baseline characteristics of the participants, in order to provide better understanding of this population, and to assist with the development of more effective therapeutic approaches. SUBJECTS AND METHODS: Since 2008, a total of 245 patients with first episodes of psychosis and their family members participated in the programme. They filled out several questionnaires within the framework of the programme evaluation, but for the purposes of this study, only data collected on sociodemographic questionnaire and the Health of the Nation Outcome Scales (HoNOS) are presented. RESULTS: Majority of the participants were male (66%), at the average age of 28 (SD=6.6), living with their parents (73.5%). Most of them finished secondary school (45.7%) but almost a quarter of the sample (23.7%) is currently studying at university. The average duration of untreated period was 101.60 days, with a median of 30 days. According to results of HONOS questionnaire, upon entry into the programme, the patients most often listed cognitive functioning (attention, concentration, memory) and professional issues (performance of work tasks and activities tied to work) as the most problematic areas. CONCLUSION: The findings of this study provide more detailed description of the beneficiaries of the RIPEPP programme, which can contribute to forming future programmes for the prevention of psychotic disorders.

Personal space of war veterans with PTSD - some characteristics and comparison with healthy individuals.

BACKGROUND: The aim of this study was to determine the size of personal space among war veterans with PTSD, compared to healthy individuals, and to examine its associations with some sociodemographic and clinical characteristics. SUBJECTS AND METHODS: Participants were 83 male war veterans with chronic PTSD and 85 healthy male employees of the medical institutions. Preferred interpersonal distances were assessed by using a stop-distance technique, where male and female research assistants approached the participants from four directions (front, behind, left, right). The patients filled out The Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD). RESULTS: War veterans with PTSD preferred significantly larger interpersonal distances compared to healthy participants. Larger personal space size was preferred by those who had children, and the largest preferred distances were observed for the approaches from behind. Both samples preferred larger distances when approached by a male person. CONCLUSION: The findings of this study contribute to increased understanding of the personal space in patients with PTSD, and may be implemented into prevention of aggressive behavior during psychiatric treatment, and into development of more effective therapeutic strategies.

Personality characteristics of psychotic patients as possible motivating factors for participating in group psychotherapy.

BACKGROUND: This study aimed to examine the relationship between some personality characteristics of patients diagnosed with psychotic disorders and the quality of their engagement in psychodynamic group psychotherapy. Given that previous research has shown that self-stigma is significantly negatively associated with the engagement of patients, the measure of self-stigma was used as a correlate of patients' motivation to participate in group psychotherapy. SUBJECTS AND METHODS: A total of 48 outpatients (52.1% women; mean age 35.30 years) attending group psychodynamic psychotherapy completed The Inventory of Personality Organization, The Pathological Narcissism Inventory, The Measure of Parental Style, The Relationship Questionnaire, and The Internalized Stigma of Mental Illness scale. RESULTS: The findings showed that patients with higher levels of self-stigma have unhealthy attachments styles, perceived their mothers' parental style as indifferent and achieved greater scores on narcissistic vulnerability scale. They are also are prone to primitive psychological defences, have poorly integrated identity, and achieved lower scores on reality testing dimension. CONCLUSION: Taking into account the limitations of this study, these findings may contribute to improved understanding of the quality of participation and engagement of psychotic patients in group psychotherapy, and may help to develop more effective therapeutic approaches.

Quality of life of patients with schizophrenia treated in foster home care and in outpatient treatment.

BACKGROUND: The Sveti Ivan Psychiatric Hospital in Zagreb, Croatia, offers foster home care treatment that includes pharmacotherapy, group psychodynamic psychotherapy, family therapy, and work and occupational therapy. The aim of this study is to compare the health-related quality of life of patients with schizophrenia treated in foster home care with that of patients in standard outpatient treatment. METHODS: The sample consisted of 44 patients with schizophrenia who, upon discharge from the hospital, were included in foster home care treatment and a comparative group of 50 patients who returned to their families and continued receiving outpatient treatment. All patients completed the Short Form 36 Health Survey Questionnaire on the day they completed hospital treatment, 6 months later, and 1 year after they participated in the study. The research also included data on the number of hospitalizations for both groups of patients. RESULTS: Though directly upon discharge from the hospital, patients who entered foster home care treatment assessed their health-related quality of life as poorer than patients who returned to their families, their assessments significantly improved over time. After 6 months of treatment, these patients even achieved better results in several dimensions than did patients in the outpatient program, and they also had fewer hospitalizations. These effects remained the same at the follow-up 1 year after the inclusion in the study. CONCLUSION: Notwithstanding the limitations of this study, it can be concluded that treatment in foster home care is associated with an improvement in the quality of life of patients with schizophrenia, but the same was not observed for the patients in standard outpatient treatment. We hope that these findings will contribute to an improved understanding of the influence of psychosocial factors on the functioning of patients and the development of more effective therapeutic methods aimed at improving the patients' quality of life.

Influence of intraoperative cerebral oximetry monitoring on neurocognitive function after coronary artery bypass surgery: a randomized, prospective study.

OBJECTIVES: Postoperative cognitive decline is common after cardiac surgery, but it is often unrecognized at the time of hospital discharge. However, it has a great impact on patient's quality of life. Cerebral oximetry with the INVOS (IN Vivo Optical Spectroscopy) system provides the possibility of non-invasive, continuous measurement of regional cerebral oxygen saturation (rSO2), which can improve patients' outcome. The aim of this study was to examine whether cerebral oximetry can decrease the incidence of cognitive decline after coronary artery bypass grafting. METHODS: We have performed a prospective, randomized study with 200 patients enrolled. Patients were divided into INVOS interventional group and CONTROL group without monitoring of cerebral oximetry. A standardized interventional protocol was performed in the INVOS group to maintain rSO2 above 80% of the patient's baseline value or above 50% of the absolute value. Cognitive evaluation was performed in all patients before and 7 days after surgery. Logistic regression was used to reveal predictors of cognitive decline. RESULTS: The incidence of cognitive decline 7 days after surgery was significantly lower (P = 0.002) in the INVOS interventional group (28%) than in the CONTROL group (52%). Intraoperative use of INVOS monitoring was associated with lower incidence of cognitive decline (odds ratio 0.21). In addition, predictors of cognitive decline revealed by multivariate logistic regression were older age, higher EuroSCORE and SAPS II (Simplified Acute Physiology Score) values, lower educational level and persistence of preoperative atrial fibrillation. Patients with prolonged rSO2 desaturation, defined as rSO2 area under the curve (AUC) of more than 150 min% for desaturation below 20% of baseline or AUC of more than 50 min% for desaturation below 50% absolute value, had an increased risk of cognitive decline. CONCLUSION: Postoperative cognitive outcome was significantly better in patients with intraoperative cerebral oximetry monitoring. Prolonged rSO2 desaturation is a predictor of cognitive decline and has to be avoided.

Changes in aspects of cognitive functioning in young patients with schizophrenia during group psychodynamic psychotherapy: a preliminary study.

BACKGROUND: The "Sveti Ivan" psychiatric hospital in Zagreb, Croatia, offers an outpatient Early Intervention Program for psychotic patients. This program consists of psycho-educational workshops and group psychodynamic psychotherapy. Two important objectives of the program are improving and maintaining adequate cognitive functioning. AIMS: The current study examined changes in aspects of cognitive functioning in young patients with schizophrenia after 18 months and after 3 years of psychodynamic group psychotherapy. METHODS: The study included 28 patients who attended the Early Intervention Program for young patients with psychotic disorders; 10 patients had completed only the psycho-educational part of the program (comparative group), and 18 patients continued with group psychodynamic psychotherapy (experimental group). All patients completed the Revised Beta Examination. RESULTS: We observed a trend in the experimental group to achieve higher scores than the comparative group. The results for both groups tended to increase with time, and this increase was greater in the experimental group. CONCLUSIONS: While acknowledging the limitations of this preliminary study, we conclude that participating in psychodynamic group psychotherapy is related to increases in the cognitive functioning of patients with schizophrenia, and our results provide a sound basis for future research.

Dreams and fantasies in psychodynamic group psychotherapy of psychotic patients.

Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness.

Early intervention program for psychotic disorders at the psychiatric hospital "Sveti Ivan".

The Early intervention program for the first episodes of psychotic disorders (RIPEPP) at the Psychiatric Hospital "Sveti Ivan" in Zagreb encompasses patients hospitalized due to various psychoses (acute psychotic disorder, schizophrenia, schizoaffective and delusional disorder, bipolar affective disorder with psychotic symptoms) in the "critical period" of illness, i.e. within five years after the occurrence of the first symptoms. The RIPEPP Program consists of an in- and out-patient part, and includes psychotherapeutic and psychoeducative components as well as the administration of antipsychotics. The Psychotherapeutic part, conducted by psychotherapists - group analysts, comprises psychodynamic group psychotherapy for patients and for family members. The Psychoeducative part, led by cognitive-behavioral therapists, is carried out through educative interactive workshops for both patients and their family members. The paper describes the theoretical framework, as well as the professional, personnel, educative and organizational basis of the Program, the principles of evaluation and some experiences after five years of implementation.