Posttraumatic stress disorder (PTSD) is a heritable (h2 = 24–71%) psychiatric illness. Copy number variation (CNV) is a form of rare genetic variation that has been implicated in the etiology of psychiatric disorders, but no large-scale... more
Posttraumatic stress disorder (PTSD) is a heritable (h2 = 24–71%) psychiatric illness. Copy number variation (CNV) is a form of rare genetic variation that has been implicated in the etiology of psychiatric disorders, but no large-scale investigation of CNV in PTSD has been performed. We present an association study of CNV burden and PTSD symptoms in a sample of 114,383 participants (13,036 cases and 101,347 controls) of European ancestry. CNVs were called using two calling algorithms and intersected to a consensus set. Quality control was performed to remove strong outlier samples. CNVs were examined for association with PTSD within each cohort using linear or logistic regression analysis adjusted for population structure and CNV quality metrics, then inverse variance weighted meta-analyzed across cohorts. We examined the genome-wide total span of CNVs, enrichment of CNVs within specified gene-sets, and CNVs overlapping individual genes and implicated neurodevelopmental regions. Th...
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Objectives Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental events and characterized by high emotional distress, re-experiencing of trauma, avoidance and hypervigilance. The present study uses... more
Objectives Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental events and characterized by high emotional distress, re-experiencing of trauma, avoidance and hypervigilance. The present study uses polygenic risk scores (PRS) derived from the UK Biobank (UKBB) mega-cohort analysis as part of the PGC PTSD GWAS effort to determine the heritable basis of PTSD in the South Eastern Europe (SEE)-PTSD cohort. We further analyzed the relation between PRS and additional disease-related variables, such as number and intensity of life events, coping, sex and age at war on PTSD and CAPS as outcome variables. Methods Association of PRS, number and intensity of life events, coping, sex and age on PTSD were calculated using logistic regression in a total of 321 subjects with current and remitted PTSD and 337 controls previously subjected to traumatic events but not having PTSD. In addition, PRS and other disease-related variables were tested for association with PT...
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Sexual functioning of war veterans is significantly under-explored. During devastating aggression on Bosnia-Herzegovina (BiH) around 400 thousand soldiers were included in combats. It is estimated that more than 100 000 persons were... more
Sexual functioning of war veterans is significantly under-explored. During devastating aggression on Bosnia-Herzegovina (BiH) around 400 thousand soldiers were included in combats. It is estimated that more than 100 000 persons were killed, and more than 60 000 them were soldiers. Vast majority of them were deployed since war is ended. We found high prevalence of sexual dysfunctions in war veterans. Also significant difference in several areas of sexual functioning between war veterans with and without symptoms of posttraumatic stress disorder was found.
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Study ObjectivesSleep problems are common, serving as both a predictor and symptom of posttraumatic stress disorder (PTSD), with these bidirectional relationships well established in the literature. While both sleep phenotypes and PTSD... more
Study ObjectivesSleep problems are common, serving as both a predictor and symptom of posttraumatic stress disorder (PTSD), with these bidirectional relationships well established in the literature. While both sleep phenotypes and PTSD are moderately heritable, there has been a paucity of investigation into potential genetic overlap between sleep and PTSD. Here, we estimate genetic correlations between multiple sleep phenotypes (including insomnia symptoms, sleep duration, daytime sleepiness, and chronotype) and PTSD, using results from the largest genome-wide association study (GWAS) to date of PTSD, as well as publicly available GWAS results for sleep phenotypes within UK Biobank data (23 variations, encompassing four main phenotypes).MethodsGenetic correlations were estimated utilizing linkage disequilibrium score regression (LDSC), an approach that uses GWAS summary statistics to compute genetic correlations across traits, and Mendelian randomization (MR) analyses were conducted...
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The risk of posttraumatic stress disorder (PTSD) following trauma is heritable, but robust common variants have yet to be identified. In a multi-ethnic cohort including over 30,000 PTSD cases and 170,000 controls we conduct a genome-wide... more
The risk of posttraumatic stress disorder (PTSD) following trauma is heritable, but robust common variants have yet to be identified. In a multi-ethnic cohort including over 30,000 PTSD cases and 170,000 controls we conduct a genome-wide association study of PTSD. We demonstrate SNP-based heritability estimates of 5–20%, varying by sex. Three genome-wide significant loci are identified, 2 in European and 1 in African-ancestry analyses. Analyses stratified by sex implicate 3 additional loci in men. Along with other novel genes and non-coding RNAs, a Parkinson’s disease gene involved in dopamine regulation, PARK2, is associated with PTSD. Finally, we demonstrate that polygenic risk for PTSD is significantly predictive of re-experiencing symptoms in the Million Veteran Program dataset, although specific loci did not replicate. These results demonstrate the role of genetic variation in the biology of risk for PTSD and highlight the necessity of conducting sex-stratified analyses and exp...
Research Interests: Genetics, Anxiety Disorders, Mental Health, Biotechnology, Biology, and 15 moreMedicine, Prevention, Multidisciplinary, Humans, Clinical research, Female, Journal Article, Male, Heritability, Human Genome, Sex Factors, European Continental Ancestry Group, Genetic Association, Nature Communications, and Genetic predisposition to disease
Bosnia and Herzegovina (BH) is located on the western part of the Balkan Peninsula. It has an area of 51 210 km2 and a population of 3 972 000. According to the Dayton Agreement of November 1995, which ended the 1992-95 war, BH comprises... more
Bosnia and Herzegovina (BH) is located on the western part of the Balkan Peninsula. It has an area of 51 210 km2 and a population of 3 972 000. According to the Dayton Agreement of November 1995, which ended the 1992-95 war, BH comprises two ‘entities’ - the Federation of Bosnia and Herzegovina (FBH) and the Republic of Srpska (RS) - and the District of Brcko. The administrative arrangements for the management and financing of mental health services reflect this. The FBH, with 2 325 018 residents, is a federation of 10 cantons, which have equal rights and responsibilities. The RS has 1 487 785 residents and, in contrast, a centralised administration. Brcko District has just under 80 000 residents.
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Post-traumatic stress disorder (PTSD) is a common and debilitating disorder. The risk of PTSD following trauma is heritable, but robust common variants have yet to be identified by genome-wide association studies (GWAS). We have collected... more
Post-traumatic stress disorder (PTSD) is a common and debilitating disorder. The risk of PTSD following trauma is heritable, but robust common variants have yet to be identified by genome-wide association studies (GWAS). We have collected a multi-ethnic cohort including over 30,000 PTSD cases and 170,000 controls. We first demonstrate significant genetic correlations across 60 PTSD cohorts to evaluate the comparability of these phenotypically heterogeneous studies. In this largest GWAS meta-analysis of PTSD to date we identify a total of 6 genome-wide significant loci, 4 in European and 2 in African-ancestry analyses. Follow-up analyses incorporated local ancestry and sex-specific effects, and functional studies. Along with other novel genes, a non-coding RNA (ncRNA) and a Parkinson’s Disease gene,PARK2, were associated with PTSD. Consistent with previous reports, SNP-based heritability estimates for PTSD range between 10-20%. Despite a significant shared liability between PTSD and ...
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Posttraumatic Stress Disorder (PTSD) is characterized by an overactive noradrenergic system conferring core PTSD symptoms such as hyperarousal and re-experiencing. Monoamine oxidase A (MAO-A) is one of the key enzymes mediating the... more
Posttraumatic Stress Disorder (PTSD) is characterized by an overactive noradrenergic system conferring core PTSD symptoms such as hyperarousal and re-experiencing. Monoamine oxidase A (MAO-A) is one of the key enzymes mediating the turnover of noradrenaline. Here, DNA methylation of the MAOA gene exonI/intronI region was investigated for the first time in regards to its role in PTSD risk and severity. MAOA methylation was analyzed via direct sequencing of sodium bisulfite treated DNA extracted from blood cells in a total sample of N=652 (m=441) patients with current PTSD, patients with remitted PTSD and healthy probands (comparison group) recruited at five centres in Bosnia-Herzegovina, Croatia, and the Republic of Kosovo. PTSD severity was measured by means of the Clinician-Administered PTSD Scale (CAPS) and its respective subscores representing distinct symptom clusters. In the male, but not the female sample, patients with current PTSD displayed hypermethylation of three CpGs (Cp...
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IntroductionAlexithymia consider a cluster of cognitive and affective characteristics that include: inability of recognizing and describing emotions, difficulties in distinguishing feelings and physical sensations during emotional... more
IntroductionAlexithymia consider a cluster of cognitive and affective characteristics that include: inability of recognizing and describing emotions, difficulties in distinguishing feelings and physical sensations during emotional arousal, narrowed capacity for imagination and externally oriented cognitive style. Several studies links alexithymia with increased risk for physical and mental damage. Symptoms of alexithymia are documented in persons who develop PTSD in response to different types of traumatic events.ObjectivesTo examine alexithymia in war veterans.AimsTo determine whether alexithymia is significantly more present in war veterans with PTSD.MethodsCross-sectional study of 205 war veterans tested by Harvard Trauma Questionnaire and by Toronto Alexithymia Scale (TAS-20).ResultsOut of 205 war veterans 89 (43.4%) of them have alexithymia. Significantly more veterans with PTSD (78 or 75%) than without PTSD (11 or 10.9%) has alexithymia (Chi2 = 88.955, P < 0.001) was found ...
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To establish the prevalence of metabolic syndrome and its parameters in group of patients with schizophrenia in polypharmacy - receiving first generation antipsychotics versus clozapine alone treated group. 48 outpatients with... more
To establish the prevalence of metabolic syndrome and its parameters in group of patients with schizophrenia in polypharmacy - receiving first generation antipsychotics versus clozapine alone treated group. 48 outpatients with schizophrenia divided into two groups: the first group of 21 patients in polypharmacy with first generation antipsychotics, and the second group of 27 patients treated with clozapine alone were assessed for the presence of metabolic syndrome. We used logistic regression models to assess the relationship between metabolic syndrome and antipsychotic therapy, gender and age. Metabolic syndrome was found in 52.1% of all subjects. Compared to first generation antipsychotics polypharmacy, the monopharmacy with clozapine was associated with elevated rates of metabolic syndrome (28.6% vs. 70.4%, p=0.004). With regard to particular parameters of metabolic syndrome, the elevated plasma triglycerides were significantly more present in subjects within Clozapine group (p=0...
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The aim was to analyse contacts network and satisfaction with contacts among children of parents with post traumatic stress disorder (PTSD). The sample consisted of 100 pupils (age 10 to 15) from two randomly chosen schools. Children were... more
The aim was to analyse contacts network and satisfaction with contacts among children of parents with post traumatic stress disorder (PTSD). The sample consisted of 100 pupils (age 10 to 15) from two randomly chosen schools. Children were selected from general population, lived with both parents who have had war traumatic experiences. They agreed to participate in psychometric research. We divided them in two groups: observed (0) group of children (N=50) whose parents were showing symptoms of post traumatic stress disorder (PTSD) and control (C) group of children (N=50) whose parents did not show symptoms of PTSD (evaluated by Harvard trauma questionnaire-BiH version). Contact network was examined by a Map of Contact Network which includes contact and satisfaction with persons in close environment. In relation to gender representatives of fathers and mothers, sample was homogenous. The most important persons in children whose parents are showing symptoms of PTSD were schoolmates (88...
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Background: To establish the prevalence of metabolic syndrome and its parameters in group of patients with schizophrenia in polypharmacy – receiving first generation antipsychotics versus clozapine alone treated group. Subjects and... more
Background: To establish the prevalence of metabolic syndrome and its parameters in group of patients with schizophrenia in polypharmacy – receiving first generation antipsychotics versus clozapine alone treated group. Subjects and methods: 48 outpatients with schizophrenia divided into two groups: the first group of 21 patients in polypharmacy with first generation antipsychotics, and the second group of 27 patients treated with clozapine alone were assessed for the presence of metabolic syndrome. We used logistic regression models to assess the relationship between metabolic syndrome and antipsychotic therapy, gender and age. Results: metabolic syndrome was found in 52.1% of all subjects. Compared to first generation antipsychotics polypharmacy, the monopharmacy with clozapine was associated with elevated rates of metabolic syndrome (28.6% vs. 70.4%, p= 0.004). With regard to particular parameters of metabolic syndrome, the elevated plasma triglycerides were significantly more present in subjects within Clozapine group (p=0.03). Logistic regression analysis showed that female gender (p= 0.004), older age (p=0.56), and clozapine treatment (p= 0.005) were significantly associated with metabolic syndrome. Discussion: Results of this study are consistent with other studies, which showed that patients receiving Clozapine are at higher risk for metabolic abnormalities. Conclusion: Compared to polypharmacy with first generation antipsychotics, the higher prevalence of metabolic syndrome is found in patients treated with Clozapine alone. The most prevalent metabolic disorder is dyslipidemia. Female gender, older age, clozapine treatment are significantly associated with metabolic syndrome.
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Autori u radu iznose primjenu radionica kao terapijskih intervencija u proradi traumatskog događaja kod djece. Stvaranjem atmosfere povjerenja i omogućavanjem komunikacije kroz lutkarske kreacije, scenski izraz, muziku i crtež te igru kod... more
Autori u radu iznose primjenu radionica kao terapijskih intervencija u proradi traumatskog događaja kod djece. Stvaranjem atmosfere povjerenja i omogućavanjem komunikacije kroz lutkarske kreacije, scenski izraz, muziku i crtež te igru kod djece se dolazi do traumatskog događaja, omogućava se prorada i uči kako se nositi s traumom i posljedicama traumatskog iskustva. U raduje analizirano 112 djece prognanika školskog uzrasta s politraumatskim iskustvima iz OŠ Podrinje u Mihatovićima, a koja su bila uključena u dvije ili više radionica z.o intenzivnog dvomjesečnog tretmana.In this paper authors present the application of therapeutic interventions aimed to alleviate trauma experience among children. The creation insofar atmosphere of trust and making possible the communication trough a puppet’s creations stage effect, music, drawing and play activities, it is possible to come to a traumatic experience among children, to work trough trauma and learn how to cope with trauma experience an...
In recent decades, it has been recognized that certain behaviors resemble addictions to alcohol and other psychoactive substances (PAS). Based on the results of research for such behaviors, many authors have found that it is justified to... more
In recent decades, it has been recognized that certain behaviors resemble addictions to alcohol and other psychoactive substances (PAS). Based on the results of research for such behaviors, many authors have found that it is justified to consider them addictions not related to PAS or "behavioral" addictions and that in the classifications of mental disorders should be in the same group with addictions related to PAS. Compulsive activities that may include gambling, Internet use, playing video games, sex, eating, and shopping based on epidemiological and neurobiological characteristics have similarities to PAS addictions. Recognition of clinical and neurobiological similarities between the described behaviors and behaviors related to PAS use resulted in the inclusion of gambling disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and online gaming disorders are classified as conditions for further research. In the 11th revisi...
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Background: People with mental and behavioural disorders have low satisfaction of quality of life, due to numerous symptoms, as well as poor interpersonal relations, communications skills, low tolerance on frustration.Aim: The aim of this... more
Background: People with mental and behavioural disorders have low satisfaction of quality of life, due to numerous symptoms, as well as poor interpersonal relations, communications skills, low tolerance on frustration.Aim: The aim of this paper was to evaluate whether there has been an improvement in satisfaction with the quality of life after the application of group therapyMethods: The study included 100 patients who attended group therapy, for a period of 6-12 weeks. The instruments used at the beginning and at the end of the treatment were Outcome Questionnaire-45 which measured symptoms distress, interpersonal relations, and social roles, and MANSA questionnaire that measured satisfaction with the quality of life. Results: In total sample (N = 100) there was approximately equal number of women and men (51% vs. 49%). The average age of the subjects was 48.11 ± 7.91. Majority of respondents had depressive disorder (45%). Measuring the mean values obtained on the OQ-45 questionnai...
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In this work is presented most frequently traumatic experience that had children during the war, level of traumatization, and discovery most frequently post-traumatic stress reactions. The works covering are school children age until 7... more
In this work is presented most frequently traumatic experience that had children during the war, level of traumatization, and discovery most frequently post-traumatic stress reactions. The works covering are school children age until 7 since 15 year with polytraumatic stress experience.
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AimTo establish predictors of insight in patients with schizophrenia with regard to symptoms severity, executive functioning, level of education, marital status, age, and number of hospitalizations.Subjects and methodsA cross-sectional... more
AimTo establish predictors of insight in patients with schizophrenia with regard to symptoms severity, executive functioning, level of education, marital status, age, and number of hospitalizations.Subjects and methodsA cross-sectional study was conducted on 60 consecutive outpatients with schizophrenia. Positive symptoms were established with 4-item Positive Symptom Ranking Scale (PSRS), and negative symptoms with Brief Negative Symptoms Assessment (BNSA). The level of insight was established with Self-Appraisal of Illness Questionnaire (SAIQ). Executive functions were established with Wisconsin card sorting test, and three verbal subtests from Wechler's Intelligence Test: information, similarities, and calculating. All neuropsychological tests were administered by psychologist educated in administration of these and other neuropsychological tools.ResultsPredictive statistical model identifies age and illness duration as negative, and higher level of education, and being marrie...
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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... more
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.
Majority of Bosnia-Herzegovina (BH) residents were exposed to cumulative traumatic events during and after the (1992-1995) war, which demanded emergency organizing of psychosocial support as well as psychiatric-psychological treatment of... more
Majority of Bosnia-Herzegovina (BH) residents were exposed to cumulative traumatic events during and after the (1992-1995) war, which demanded emergency organizing of psychosocial support as well as psychiatric-psychological treatment of psychotraumatized individuals. To describe organizing of psychosocial help during and after the BH war, institutional treatment of psychotraumatized in the frame of mental health service reform program with an overview on the model of psychosocial support and psychiatry-psychological treatment of psychotraumatized persons of Tuzla Canton region. The retrospective analysis of functioning in the Department for traumatic stress disorders on the Psychiatry Clinic in Tuzla for the 1999-2003 period has been described in regard of number, gender, age and trauma related mental disorders of referred patients. In the observed period, 8.329 of patients in the outpatient care program were included, 617 of inpatients were treated in the Clinic, while 301 of pati...
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Table S2. Bivariate correlations of study predictor and criterion variables (DOCX 35 kb)
Over the past few decades, there are evidences that scientific paradigm is changed from disciplinary to transdisciplinary approaches. The question of sustainability science, novel ways for production and coproduction of knowledge and a... more
Over the past few decades, there are evidences that scientific paradigm is changed from disciplinary to transdisciplinary approaches. The question of sustainability science, novel ways for production and coproduction of knowledge and a matter of accomplishment for real world problems represent a big challenge for scientific and academic community. Transdisciplinary team-based research, integration of knowledge from different disciplines and a view into complex societal problems from different perspectives can make a contribution for production of new, practice-oriented knowledge, applied for social problems solution. Going to the transdisciplinary approach is especially valuable in social sciences, where collaborative practice became a necessary normative.In this paper authors, first in the context of theoretical considerations describe possible applications of transdisciplinary research in Bosnia and Herzegovina, as post-conflict, transitional community. The second part of article ...
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The stigmatization of mentally ill patients has negative labelling, marginalization and exclusion of people simply because they have a mental illness. Stigma has negative consequences for the individual and his family, as well as for... more
The stigmatization of mentally ill patients has negative labelling, marginalization and exclusion of people simply because they have a mental illness. Stigma has negative consequences for the individual and his family, as well as for psychiatry as a profession and the entire community. Stigma weakens the mentally ill, reinforcing a sense of alienation, which has negative consequences on the course of the illness. The media can inform the public about the treatment of mentally ill patients by conveying correct information, who can then act positively towards improving the quality of treatment. Stigma and self-stigma create a feeling of low self-esteem and fear of rejection, due to which mentally ill people avoid the media and very rarely speak publicly about their illness. The realization of information rights is very delicate and it is reflected through two opposing but substantially equivalent human rights: 1. Right to information, 2. Right to privacy. Which of the two rights will ...
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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... more
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 im...
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After the war in Bosnia-Herzegovina, mental illness is very prevalent. With little knowledge about mental health, the stigma of mental illness is still pervasive in many communities. To combat this prejudice, we describe mental health... more
After the war in Bosnia-Herzegovina, mental illness is very prevalent. With little knowledge about mental health, the stigma of mental illness is still pervasive in many communities. To combat this prejudice, we describe mental health promotion strategies which can empower individuals and educate the communities in which they live.
Research Interests: Health Promotion, Public Opinion, Mental Health, Community-Based Mental Health Services, Prejudice, and 11 moreHealth Education, Medicine, War, Health Care reform, Humans, Mental Disorders, Information Dissemination, Psychology of Power, Bosnia Herzegovina, Community Based Mental Health Services, and Psychiatria
In Central and Eastern European countries, after abandoning communism, significant political, economic and social changes occurred, followed by the increase in income inequality and social disparity. The goal of this study was to examine... more
In Central and Eastern European countries, after abandoning communism, significant political, economic and social changes occurred, followed by the increase in income inequality and social disparity. The goal of this study was to examine the relationship between psychological symptoms and monthly income of employees in companies undergoing privatization. The study included 258 workers from seven companies undergoing privatization in the Tuzla Canton region. For the study purposes, the Brief Symptom Inventory (BSI) and a general questionnaire with questions about socio-demographic characteristics, income, and workplace, were used. Monthly income of the majority of workers (207 or 80.2%) was below the monthly income in Bosnia and Herzegovina. Workers with salaries below the average salary for Bosnia and Herzegovina have pronounced somatization, anxiety, paranoia, interpersonal sensitivity and hostility. The BSI scale yielded significant negative correlation between the level of monthl...
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While individual analytic therapy is still in its early stages of development, group analytic therapy and group psychotherapy in general are considerably advanced in comparison to other talking therapies, and are often used in healthcare... more
While individual analytic therapy is still in its early stages of development, group analytic therapy and group psychotherapy in general are considerably advanced in comparison to other talking therapies, and are often used in healthcare settings and in private practice. All forms of psychotherapy offered in healthcare institutions are covered by health insurance. Most activities related to providing psychotherapy or undergoing training in various therapeutic modalities are not regulated by adequate laws or other regulations, nor does a definitive registry of psychotherapists exist. A majority of psychotherapists in healthcare institutions are (neuro)psychiatrists, but other helping professions are also often involved in providing therapies, with psychologists usually preferring cognitive-behavioural therapy.
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Background: Coronavirus disease 2019 (COVID-19), like any other pandemic, has imposed an unprecedented threat to physical and mental health to all nations, worldwide. There is no enough evidence in the literature in this area. The present... more
Background: Coronavirus disease 2019 (COVID-19), like any other pandemic, has imposed an unprecedented threat to physical and mental health to all nations, worldwide. There is no enough evidence in the literature in this area. The present study has been done to explore the organization of psychiatric services in Bosnia and Herzegovina (BH) to meet mental health needs of BH citizens during the particular restrictive measures caused by COVID-19 pandemic. Materials and Methods: This online survey has been done for BH psychiatric institutions. Data were collected from psychiatric institutions in the mental health network of BH. A total of 38 complete responses have been received. Results: Of 38 study participants, three were the departments of psychiatry in university clinical centers, two were psychiatric hospitals, four were psychiatric wards in general hospitals, 27 were community mental health centers, and two were institutes for alcoholism and drug addiction. During the pandemic, all services functioned on a reduced scale, adhering to measures to protect and self-protect both staff and service users. Protective equipment was provided to staff in some institutions in a timely and complete manner and in some in an untimely and incomplete manner. Consultative psychiatric examinations were mainly performed through telephone and online, where it exists as a standard patient monitoring protocol. The application of long-acting antipsychotics was continuous with adherence to restricted and protective measures. In opiate addiction replacement therapy services, substitution therapy was provided for a longer period to reduce frequent contacts between staff and patients. Individual and group psychotherapy continued in reduced number using online technologies, although this type of service was not administratively regulated. An initiative has been given to regulate and administratively recognize telepsychiatry by health insurance funds in the country. A number of psychological problems associated with restrictive measures and fear of illness have been reported by patients as well as by the professionals in mental healthcare teams. There were no COVID-19-positive patients seeking help from institutions that responded to the questionnaire. In one center, infected people with COVID-19 from abroad sought help through the phone. Only one involuntary hospitalization was reported. The involvement of mental health professionals in the work of crisis headquarters during the design of the COVID-19 pandemic control measures varies from satisfactory to insufficient. Education of staff, patients, and citizens was regular with direct instructions through meetings, press, and electronic media. Conclusions: During the COVID-19 pandemic in BH, all psychiatric services functioned on a reduced scale, adhering to measures to protect and self-protect staff and service users. All patients who asked for help have been adequately treated in direct inpatient or outpatient mental healthcare or online, despite telepsychiatric services not being recognized in health system in BH. There were neither infected patients nor staff with COVID-19 in the psychiatric institutions who responded in this research. A large-scale, multicenter study needs to be performed to get a broader picture and to guide us for future better service planning and delivery.
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Research Interests: Psychology and Medicine
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Research Interests: Psychology and Medicine
Research Interests: Psychology and Medicine
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Stigma and recovery "from" and "in" mental illness are associated in many various ways. While recovery gives opportunities, makes person stronger, gives purpose and meaning to their lives and leads to social inclusion,... more
Stigma and recovery "from" and "in" mental illness are associated in many various ways. While recovery gives opportunities, makes person stronger, gives purpose and meaning to their lives and leads to social inclusion, in the same time stigma reduces opportunities, reduces self-esteem and self-efficacy, reduces the belief in own abilities and contributes to social exclusion through discrimination. The recovery of a person with mental illness means to get and keep hope, to understand their own possibilities and impossibilities, active living, to be autonomous, to have a social identity and to give meaning and purpose of our own lives. The care system, recovery-oriented, provides help and support to people with mental disorders in his/her recovery, which contributes to reduction of self-stigma, to the elimination of stigmatizing attitudes and beliefs in mental health services which consequently may have a positive reflection in reducing the stigma of mental illness...