Integrating the Concept of Creative Psychopharmacotherapy and Group Psychotherapy in Clinical Practice.

Modern psychiatric treatment is largely dictated by national and international guidelines rested on evidence-based data, including psychopharmacotherapy and psychotherapy. An alternative to the rigid application of official guidelines and criterion for the standards of treatment in psychiatric practice is the concept of creative psychopharmacotherapy. It is a concept based on the integration of different approaches to a person as whole, mental disorders and their treatment into person-centered clinical practice. In this sense, group psychotherapy and creative psychopharmacotherapy today are part of the overall integrative efforts in psychiatry. Neuroscientific discoveries suggest that they share similar neural pathways that lead to changes in brain function and symptoms relief. Various integrative elements make group psychotherapy and psychopharmacotherapy in combination more effective and efficient. The integration of the concept of creative psychopharmacotherapy and group psychotherapy into everyday clinical practice can improve treatment options as well as clinical practice by creating opportunities for research and development of new modalities of overall treatment.

Child Neglect - Causes and Consequences.

INTRODUCTION: Child neglect is one of the most prevalent forms of child abuse. Neglect can be defined as a lack of sufficient attention, responsibility and protection that matches the age and needs of the child. There is no theory that fully explains why neglect of children happens. Three different causal models of neglect are given: parental deficit model, ecological deficit model and ecological-transaction model. Exposure to neglect in childhood may have a negative impact on the development of the child and cause short-term and long-term health, emotional, cognitive, academic and social difficulties. The aim of this paper was to provide a comprehensive theoretical overview of neglect of children causes and consequences. METHODS: In this paper, we used review articles and meta-analyzes about child neglect causes and consequences published on Medline. RESULTS: Child neglect has a relatively high prevalence rate compared to other types of child abuse. Several studies suggest that the impact of neglect on the health and development of the child is just as negative as the impact of other types of abuse. Children who experience neglect in early childhood are more likely to have health, cognitive, emotional and social consequences in later life. A significant number of studies suggest the existence of a link between child neglect and risk factors related to parents, the child and the environment. CONCLUSIONS: Child neglect is determined by multiple risk areas and is considered as the result of a complex interaction of risk factors present in children and in their care environment. Neglect may have long-term consequences for all aspects of the health and functioning of the child.

Psychological characteristics of war veterans after the war in Bosnia and Herzegovina.

Aim To determine psychological characteristics of war veterans after the war in Bosnia and Herzegovina (B&H). Methods The study included 207 war veterans with war experience in B&H. Evaluation of veterans was conducted by the Harvard Trauma Questionnaire (HTQ)-B&H version, Emotion Profile Index (EPI), Life Style Questionnaire (Life Style index - LSI). Results Veterans who show symptoms of posttraumatic stress disorder (PTSD) had more traumatic experiences and higher level of traumatization than veterans who did not show PTSD symptoms (p=0.000). Low level of reproduction, incorporation, lack of control, self-defence and exploratory and acceptable responses (p=0.000), lack of control (p=0.025) and deprivation (p=0.013) were shown on the emotional profile by war veterans suffering from post-traumatic stress disorder. Negation, intellectualization and compensation were coping strategies for traumatic experiences and symptoms of PTSD, used by war veterans. Conclusion War veterans with post-traumatic stress disorder experienced more traumatic experiences and show more severe symptoms of post-traumatic stress disorder. In the emotional profile, there was a lower level of emotional states, and coping strategies with posttraumatic stress disorder were negating, intellectualization and compensation. The treatment of post-traumatic stress disorder is becoming a conspicuous public health problem.

Post-traumatic stress disorder and coping styles of war veterans twenty years after the war from Tuzla Canton.

Aim To analyse symptoms of posttraumatic stress disorder and coping strategies of war veterans in Tuzla Canton twenty years after the war in Bosnia and Herzegovina (BiH). Methods The study analysed a group of 120 war veterans from the Tuzla Canton who had experience of the war in BiH. For assessment of posttraumatic stress disorder Harvard Trauma Questionnaire was used, a version for Bosnia and Herzegovina and for assessment of coping styles Life Style Index was used. Results Concerning number of traumatic experiences of war veterans, it was found that they suffered 12 traumatic experiences. Most often traumatic experience was the participation in fighting and shelling (90.0%), knowledge of injuries in combat or landmine injuries of family members or friends (75.8%), exposure to snipers (74.2%). The most important were the symptoms of numbnessemotional numbness (2.62%), the symptoms of intrusion (2.58%) and the severity of the symptoms of PTSD (2.39%). The most common strategy of dealing with veterans of war was a projection (68.31%) and intellectualisation (56.20%). Conclusion War veterans have experienced polytraumatic experiences in war and show increased expression of symptoms of posttraumatic stress disorder, emphasised psychosocial problems with a common defence mechanism in the form of projections twenty years after the war. War veterans are in need of continuous treatment in order to reduce long-term consequences of war trauma.

Emotional Profile of Women Victims of Domestic Violence.

INTRODUCTION: Research indicates that women victims of domestic violence show significant cognitive changes, emotional numbing, and avoidance of interpersonal relationships. AIM: The aim of this research was to analyze emotional profile of women victims of domestic violence, and to determine the relationship between dimensions of emotions and frequency of women exposure to domestic violence. METHODS: The research was conducted on the sample of 169 women, 111 were victims of domestic violence and 58 were women who did not experience domestic violence. Plutchik's Emotions Profile Index (EPI) was used for measuring of the emotion profile, and the Modified Inventory of Domestic Violence for measuring experiences of different types of violence. Basic socio-demographic data were also collected. RESULTS: Significant differences between women victims of domestic violence and women who did not experience domestic violence were found in a few dimensions of emotional profile. Women victims of domestic violence had higher results in the dimensions of deprivation/depression and aggression/destruction, while women who did not experience domestic violence had higher results in dimensions of reproduction and incorporation. Aggression was in significant negative correlation with reproduction, incorporation and self protection, whereas it was significant positive correlation with deprivation and opposition. There were significant and positive correlation between the dimensions of aggression and deprivation and frequency of all three forms of domestic violence and age of women. CONCLUSION: According to results obtained in this research, it can be concluded that women victims of domestic violence have significantly more intensive negative emotional dimensions in comparison to women who were not abused. Women victims of domestic violence with higher frequency of abuse describe themselves as more sad, apathetic, lonely, angry, quarrelsome and less sociable. Prominence of negative emotions, deprivation and aggression, can be factor of risk for mental health disorders and for re-victimisation of women victims of domestic violence.

Behavioral Problems and Emotional Difficulties at Children and Early Adolescents of the Veterans of War with Post-Traumatic Stress Disorder.

INTRODUCTION: Behavioral problems and emotional difficulties at children of the veterans of war with post-traumatic stress disorder (PTSD) have not been researched entirely. In our country, which has a lot of persons suffering from some psychological traumas, this trauma seems to continue. AIM: The aim of this study was to determine the exposure, manifestations of behavioral problems and emotional difficulties at children and early adolescents, whose fathers were the veterans of war demonstrating post-traumatic stress disorder symptoms. RESPONDENTS AND METHODS: The analyzed group comprised 120 school age children (10-15 years of age), whose parents/fathers were the veterans of war. The children were divided into two groups, and each group into the following two age sub-groups: 10-12 (children) and 13-15 (early adolescents) according to PTSD presence at their fathers - veterans of war. PTSD symptoms at fathers, veterans of war, were assessed using the Harvard Trauma Questionnaire-Bosnia and Herzegovina version and MKB-10 - audit of criteria. To assess the behavioral problems of children, the Child Behavior Checklist for parents was used, and to evaluate the neuroticism at children Hanes-Scale of neuroticism-extraversion was used while the depression level was evaluated using the Depression self-rating scale (DSRS). To analyze the obtained results, SPSS 17 program was used. The value p <0. 05 is considered significant. RESULTS: Children of fathers, the veterans of war, demonstrating the PTSD symptoms show more problems in activity, social and school conduct as well as in symptoms of behavioral problems compared to the children whose fathers do not demonstrate the PTSD symptoms (p<0. 001). Children of the war veterans demonstrating the symptoms of the post-traumatic stress disorder show significant difference at neuroticism sub-scales (p<0.001). Negative correlation between PTSD and activity, social and school conduct has been determined (p <0. 01), while positive correlation was determined between PTSD of war veterans with symptoms and neuroticism at children (p <0. 01). Depression symptoms are found at 17.5% children, while 28.3% are in the risky group and the girls demonstrate higher depression level. CONCLUSION: Children and early adolescents of fathers - veterans of war with post-traumatic stress disorder show significant differences in competencies, behavior, emotional difficulties and neuroticism. Significant correlation was found between psychopathology of parents - fathers the veterans of war and their children. Impact of psychological conditions of fathers - the veterans of war with post-traumatic stress disorder to children is strong and they represent a significant risky group for development of mental disorders.

Falls in hospitalized acute stroke patients.

UNLABELLED: THE AIM of this study was to analyze the fall frequency and some of its characteristics in hospitalized acute stroke patients. PATIENTS AND METHODS: It was analyzed 1809 acute stroke patients hospitalized at the Department of Neurology in period of one year. A fall was defined as any unplanned "touch to the floor" of any part of a patient's body, excluding the feet. RESULTS: Out of 1809 acute stroke patients, 1544 (85.35%) had cerebral infarction (CI) and 265 (14.65%) intracerebral hemorrhage (IH). In group of patients that fell (61/3.3%), 49 (80.33%) had infarction and 12 (19.67%) (p = 0.25) had hemorrhage. Out of 61 patients that fell, 42 (68.86%) suffered from impaired spatial orientation and 47 (77.05) were aphasic. The neurological deficit, impairments of spatial orientation and presents of aphasia were highly correlated with falls (p < 0.001). The most frequent falls occurred by night night (38 or 62.29%) and in the first five days of hospitalization (44 or 72%). In most cases (52%) the falls caused minor injuries like contusion and lacerations of skin and did not require special medical treatment. CONCLUSION: Hospitalized acute stroke patients have no high risk of falling (3.3%), and the incidence of serious injury is low. The falls are more frequent in the first five days of hospitalization (72%) and occur mostly during the night (62.29%). Severity of neurological deficit, impaired spatial orientation and aphasia are highly correlated with falls.