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Background: The occurrence of suicidal thoughts and behaviors is rather frequent among war veterans, particularly those suffering from posttraumatic stress disorder (PTSD). Understanding factors present within these individuals that increase suicide risk may inform prevention efforts. The present study aimed to determine whether the dimensions of temperament and character are associated with various aspects of suicidality among Croatian war veterans with PTSD. Subjects and methods: A sample of 72 Croatian male war veterans (mean age 52.33 years) diagnosed with PTSD was gathered at the National Center for Psychotrauma between May and October 2014. The participants completed the Temperament and Character Inventory - Revised (TCI-R) and the Suicidal Behaviors Questionnaire - Revised (SBQ-R). Results: Zero-order analyses revealed that temperament dimension Harm avoidance and character dimension Self-directedness were moderately associated with the total risk for suicide (i.e., the SBQ-R total score), while Persistence and Cooperativeness showed significant but weaker relations. Different dimensions of suicidality were associated with different personality traits. Harm Avoidance was shown to be significantly increased among the subgroup of war veterans with high suicidal risk. Conclusions: Notwithstanding some limitations of this study, these findings could help extend our understanding of the elevated suicide risk in war veterans with PTSD. Detection of individuals displaying high Harm Avoidance and low Self-Directedness might facilitate prevention of suicidal behaviors in this population.

Previous research has documented multiple chains of risk in the development of PTSD among war veterans. However, existing studies were mostly carried out in the West, while they also did not analyze specific symptom clusters of PTSD. The aim of this study was to examine the role of socio-demographic characteristics, war experiences and subjective quality of life in the prediction of three clusters of PTSD symptoms (i.e., avoidance, intrusion, hyperarousal). This study comprised 184 male participants who have survived war imprisonment during the Croatian Homeland War in the period from 1991 to 1995. The data was collected through several self-report measuring instruments: questionnaire on socio-demographic data, war experiences (Questionnaire on Traumatic Combat and War Experiences), subjective quality of life (WHO-Five Well-being Index), and PTSD symptoms (Impact of Events Scale - Revised). The level of three symptom clusters of PTSD was found to be moderate to high, as indicated by the scores on the IES-R. Results of the three hierarchical regression analyses showed the following: traumatic war experiences were significant predictors of avoidance symptoms ; traumatic war experiences and subjective quality of life were significant predictors of hyperarousal symptoms ; and traumatic war experiences, material status and subjective quality of life were significant predictors of intrusion symptoms. These findings support the widespread belief that the development of war-related PTSD is accounted for by multiple chains of risk, while traumatic war experiences seem to be the only predictor of all three symptom clusters. Future research should put more emphasis on specific PTSD symptom clusters when investigating the etiopathogenesis of this disorder among war- affected populations.

Report a case of mania in a 65-year- old Caucasian male with past medical history pertaining tocpsychiatric problems, hypertension, chronic renal insufficiency, non insulin dependent diabetes mellitus and heart transplantation. These symptoms were terated with quetiapine.

In this poster the authors show the correlation between type A personality, state-trait anxiety in male patients after myocardial infarction

The heart and mind are intimately linked. Patients with severe mental disorders have increased mortality rates compared with the general population and the leading cause of premature death is cardiovascular disease (CVD). Despite their high prevalence and substantial medical impact, comorbidity between cardiac conditions and psychiatric illnesses frequently go undiagnosed and untreated. It is very interesting to investigate the impact of mental health on cardiac disease and what is the complex underlying mechanism that links theese two conditions.

Suicidal behavior is a major health risk in schizophrenia. The aim of this study was to evaluate serum cholesterol concentrations and some socio-demographic parameters in suicidal and non-suicidal men suffering from schizophrenia. Results of this study show that there were no differences in socio-demographic parameters between suicidal and non-suicidal schizophrenic patients but there was a difference in the level of cholesterol (lower in suicidal patients). Duration of untreated psychosis was higher in suicidal patients, which could means that suicidality is a process determined by many different factors including time of treatment. Suicidal patients in our study have been more seriously ill than non-suicidal (had higher scores on PANNS and HDRS-17) and we explained these findings by the fact of damage associated to higher time of non-treatment. Our results show that cholesterol has an important role in distinguishing suicidal from non-suicidal patients, which, if confirmed on a higher number of patients and in more studies, may be of considerable clinical significance. Clinical management of suicidal states is based on integrative approach and includes ensuring immediate safety, the use of psychosocial techniques to address depression and psychosocial stressors, and targeted pharmacotherapy for psychotic and depressive symptoms.

War as a human disaster of major significance has led to an increase in the number of suicides committed by people suffering from mental disorders. Considering the results of similar research, we were particularly interested in the effect that war has on the incidence of suicide among of people with mental disorders. The research included 16, 362 patients with mental disorders, treated at the Clinic for Psychiatry at the Clinical Hospital Split during the nine-year time frame which were divided into pre-war (April 6(th) 1988 -April 7(th) 1991), wartime (April 6(th) 1991 -April 7(th) 1994) and post-war (April 6(th) 1997 - April 7(th) 2000) periods. We studied the effects of how wartime events upon people with mental disorders in terms of their suicide rates, taking into account gender, age group, and the diagnosis under which they were treated. In our research, we found a statistically significant difference in suicide incidence between three observed periods (prewar April 6(th) 1988 -April 7(th) 1991 ; wartime April 6(th) 1991 - April 7(th) 1994 ; and postwar April 6(th) 1997 -April 7(th) 2000) with the incidence being the highest during the wartime period (chi(2) = 9.98: p = 0.007). Out of 16, 362 patients treated at the clinic during the observed timeframe, a total of 78 people committed suicide. Twenty-two patients committed suicide during the first three year pre-war period ; 36, during the three year wartime period ; and 20, during the third three year post-war period. With this research we intended to offer a better understanding of the complexity of the suicide problem of mental patients as a phenomenon.

Among one of the biggest difficulties in diagnosis and treatment of Attention Deficit/Hyperactivity Disorder (AD/HD) is firstly the involvement of different persons, especially parents and teachers, who, together with experts, make the unavoidable subjects in the process of detecting and treating children with AD/HD. Adding to that the standards of living environment, the process becomes even more complex. The aim of this research is to detect if there is a difference in the assessment of AD/HD, given by the parents and teachers in two urban areas, which have culturally and geographically different characteristics (Middle European and Mediterranean). The assessments of children’ s behavior were conducted in two randomly selected schools ; one in Zadar (Mediterranean town on the Adriatic coast) and the other in Zagreb (Middle European city). The children were evaluated by the experts using DSM IV as a gold standard, and by the parents and teachers using Conners rating scales. Analysis of results showed that there were differences in assessment of AD/HD among experts and parents/teachers, and among parents from two towns. Different results given by parents in Zadar and Zagreb, we reasoned, were obtained because of different sensitivity to the problems of hyperactive/impulsive/attention deficiency children's behavior.

Previous studies have shown an association between low concentration of serum cholesterol, as well as high concentration of serum cortisol, in suicide behavior. The aim of this study was to evaluate whether men after a violent suicide attempts have different serum cholesterol and cortisol concentrations than those who attempted suicide by non-violent methods. Venous blood samples were collected within 24 h of administration, to study concentrations of serum cholesterol and cortisol. The sample consisted of 31 male subjects suffering from schizophrenia, addmitted in a general hospital after suicide attempt, and was compared with 15 schizophrenic nonsuicidal male controls. Patients with a violent suicidal attempt were found to have significantly lower cholesterol levels and significantly higher cortisol levels than patients with non-violent attempts and the control subjects. Our findings suggest that suicide attempts should not be considered a homogenous groups. The hypothesis of an association of violent suicidal attempts and peripheral biological markers ( cholesterol and cortisol) was supported by our findings.

U radu smo prikazali neurobiologiju suicidalnog ponašanja s posebnim naglaskom na serotoninski neurotransmiterski sustav.

In our case, there are opened question about causing dyskinesia, whether it is caused by neuroleptics or been independent parameter in psychosis. Important fact is that clozapine and risperidone make significant improvement in clinical features.

Diskinezija je dugo bila razmatrana isključivo kao nus pojava terapije antipsihoticima. Činjenica da je relativno učestala i potencijalno ireverzibilna, svrstava ju u možda najtežu posljedicu uzimanja terapije. No, nevoljni pokreti ne moraju biti kod psihijatrijskih bolesnika isključivo posljedica farmakoterapije, već mogu biti i sastavni dio pojedinih psihijatrijskih bolesti. Cilj ovog rada je evaluacija iskustava vezanih uz istraživanje spontane diskinezije u shizofreniji, s naglaskom na potencijalne rizične čimbenike i patofiziološke mehanizme nastanka.

MDMA, GHB, Ketamin, flunitrazepam, addiction, youth

Findings from numerous studies suggest an association between low cholesterol levels and suicidal behavior in patients with different psychiatric diagnoses. The aims of this case-control study were to test whether cholesterol levels in male suicidal patients (N=20) with borderline personality disorder (BPD) are lower than in male non-suicidal patients (N=20) with BPD and male healthy control group (N=20), and to evaluate the influence of structured individual psychoanalytic psychotherapy on suicidal behavior. The groups were matched for age and body mass index (BMI). Results showed that serum cholesterol levels did not differ significantly between suicidal and non-suicidal BPD patients and healthy controls. The level of psychopathology (measured by Brief Psychiatric Rating Scale and Hamilton Depression Rating Scale) was significantly higher in the group of suicidal patients, which indicates the importance of evaluating particular clinical symptoms in BPD, in order to prevent suicidal behavior. Non-suicidal male patients suffering from BPD received more frequently structured individual psychoanalytic psychotherapy prior to the hospitalization than suicidal group. These results emphasized the role of this type of psychotherapy in preventing suicidal behavior in BPD patients.

SUMMARY Contemporary psychiatry pays more and more attention to the patient’s capacity regarding acceptance of psychiatric drugs. Understanding the basis of our treatment’s effectiveness becomes more challenging. To understand psychiatric treatment psychiatrists must pay full attention to mentalizing and the conditions under which this basic human capacity becomes impaired especially in those suffering from personality and eating disorders. This paper discusses the meaning and clinical applications of the mentalizing related to psychopharmacotherapy for personality and eating disorders patients, including suicidality.

The aim of the present study was to explore possible differences between serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and cortisol concentration in patients with major depressive disorder (MDD) with melancholic features, and MDD with atypical features. As secondary aim, we investigated possible associations with clinical features such as suicidal ideation, number of episodes, duration of depression and symptomatology severity. We included 55 MDD patients (32 with melancholic features and 23 with atypical features) and 18 healthy controls. When compared to healthy controls, MDD with melancholic or atypical features showed higher CRP and IL-6, but not TNF-α. Cortisol concentration was higher in MDD with melancholic type, in comparison to the atypical type of MDD or controls. A positive correlation was found between the severity of depressive symptoms, concentrations of IL-6 and cortisol in the MDD group with melancholic features, while a negative correlation was observed between IL-6 and CRP in the MDD group with atypical feature. Also, in the MDD group with atypical features, there was a correlation between the severity of anxiety symptoms based on the Hamilton Rating Scale for Anxiety (HARS), concentration of CRP, and the duration of symptoms. In conclusion, we observed several differences in serum CRP, IL-6, and cortisol concentrations in MDD patients considering clinical features as well.