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Although a major public health and social concern globally, limited data exist on substance use and their effects among adolescents living in low- and middle-income countries. This study evaluated the relationships between alcohol/drug use and quality of life (QOL) among adolescents in general populations from India, Indonesia, Nigeria, Serbia, Turkey, Bulgaria, and Croatia. The sample included 2,393 adolescents. The Pediatric Quality of Life Inventory (PedsQL) was used for QOL assessments, the Strengths and Difficulties Questionnaire (SDQ) was used for mental health problems, and the CRAFFT self-report questionnaire was administered for eliciting alcohol/drug use. Alcohol/drug use was significantly associated with lower levels of QOL. In particular, substance use among older male adolescents, adolescents with overt psychopathology, or adolescents in lower socioeconomic status was associated with greater reductions in levels of QOL. [ABSTRACT FROM AUTHOR]

The Pediatric Quality of Life Inventory™ Family Impact Module (PedsQL™ FIM) is a health-related quality of life and family functioning questionnaire for parents of children with chronic conditions. The aim of this study was to develop the Croatian version of the PedsQL™ FIM and to evaluate its psychometric properties. The study included 212 parents of children with chronic gastrointestinal disorders (GID) and those of healthy children. All parents completed the PedsQL™ FIM, PedsQL™ 4.0 Generic Core Scales (PedsQL), and World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). The Croatian version of the PedsQL™ FIM was developed following strict procedures for the translation and cross-cultural adaptation process (i.e. forward translation, reconciliation, backward translation, and pre-testing). Psychometric analyses included testing internal consistency reliability (Cronbach's coefficient) and aspects of construct validity (Spearman's correlation coefficients, known-groups comparison method, and exploratory factor analysis-EFA). Cronbach's α of 0.7 and above were found for all scales. Parents of healthy children reported significantly higher all PedsQL™ FIM scores than parents of children with GID. Correlations between the PedsQL™ FIM and WHOQOL-BREF scales ranged 0.07-0.56. The EFA found 6 factors to explain 73.79 % of the total variance. Finally, the PedsQL™ FIM correlated moderate to high (range 0.46-0.64) to all PedsQL™ scores. The measure is feasible, short, and easily scored. It has appropriate internal consistency reliability and acceptable construct validity. However, more studies about validity are needed that will include other children with chronic conditions considering that a questionnaire validation is an iterative process. [ABSTRACT FROM AUTHOR]

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Background: A significant number of citizens, including a great proportion of doctors, both psychiatrists and doctors of other specialties, decided to emigrate from Croatia after Croatia entered the EU in 2013. Aim of research was to investigate possible differences in satisfaction with life and work between 3 groups: emigrants psychiatrists (EP), emigrants physicians of other specialties (E), and psychiatrists currently working in Croatia (C)., Subjects and Methods: Personal Wellbeing Index (PWI), Work Ability Index (WAI) and some qualitative research questions were used in an anonymous online survey which was conducted in autumn 2019. Link to the survey was shared on different social networks, while 138 physicians were approached directly by e-mail. Response rate: 87% for EP group (representative sample for group of psychiatrist emigrants from Croatia), 48% for E group, and 28% for C group. In total, 62 physicians, 44 of them emigrants (20 EP and 24 E). This study was voluntarily led. Psychiatrists from our sample emigrated mostly to Scandinavia in 65% of cases and to West Europe in 30% of the cases. Other physicians emigrants from our sample emigrated to Middle Europe in 29%, to West Europe in 25%, and to Scandinavia in 42% of the cases., Results: Satisfaction with standard of life, future security and life achievements are significantly higher in EP than in C. Satisfaction with integration in community and satisfaction with close relationships are significantly higher in E than in EP. WAI score of the 3 groups placed them all in the same category "good work ability". For all emigrants and their family members, major challenges after emigration were found to be communication (language), integration into the community, and loss of friends and family connections. 70% of emigrants plan to return to Croatia in the future, depending on better living conditions (income), change in the political situation in Croatia (reduction of corruption), and change in people's mentality., Conclusions: This voluntary study showed high satisfaction with life and good work ability among psychiatrists who emigrated from Croatia, together with some challenges for them and their family members with language, work, integration into the community, and loss of friends and family connections. Majority plan to return to Croatia depending on political and economic changes in Croatia.

Background and Aims: Internet use has increased worldwide exponentially over the past two decades, with no up-to-date cross-country comparison of Problematic Internet Use (PIU) and its correlates available. The present study aimed to explore the pattern and correlates of PIU across different countries in the European and the Asian continent. Further, the stability of factors associated with PIU across different countries were assessed., Materials and Methods: An international, cross-sectional study with a total of 2749 participants recruited from universities/colleges of eight countries: Bangladesh, Croatia, India, Nepal, Turkey, Serbia, Vietnam, and United Arab Emirates (UAE). Participants completed the Generalized Problematic Internet Use Scale -2 (GPIUS2) assessing PIU, and the Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS) assessing the depressive and anxiety symptoms., Results: A total of 2643 participants (mean age 21.3 ± 2.6; 63% females) were included in the final analysis. The overall prevalence of PIU for the entire sample was 8.4% (range 1.6% to 12.6%). The mean GPIUS2 standardized scores were significantly higher among participants from the five Asian countries when compared to the three European countries. Depressive and anxiety symptoms were the most stable and strongest factors associated with PIU across different countries and cultures., Discussion and Conclusions: The PIU is an important emerging mental health condition among college/university going young adults, with psychological distress being the strongest and most stable correlate of PIU across different countries and cultures in this study. The present study highlighted the importance of screening university and college students for PIU., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: The authors aimed to assess and compare problematic internet use among medical students enrolled in a graduate degree course in one school each from Croatia, India, and Nigeria and to assess correlates of problematic use among these students., Methods: The questionnaire included a sociodemographic profile of participants and Young's Internet Addiction Test., Results: The final analysis included 842 subjects. Overall, 38.7 and 10.5 % of respondents scored in the mild and moderate categories. Only a small fraction (0.5 %) of students scored in the severe category. Being male and spending more time on the internet were correlated with problematic internet use. Moreover, a significantly higher proportion of participants who scored above the cutoff used the Internet for browsing, social networking, chatting, gaming, shopping, and viewing pornography. However, there was no difference between the two groups with regard to using the internet for e-mailing or academic activities., Conclusions: It is important to address problematic internet use among medical students. The correlates can help identify those at increased risk.

Aims: Suicidal ideation and sleep-related problems are associated with many common psychopathological entities in early adolescence. This study examined possible association between suicidal ideation and sleep-related problems., Methods: A cross-sectional study was performed in classroom settings at 840 early adolescents 11-13 years of age. Of those, 791 adolescents fully completed the data and thus represent an actual sample. Suicidal ideations were assessed with three dichotomous (yes/no) items: 'I often think about death'; 'I wish I was dead'; 'I often think about suicide.' A composite measure of perceived sleep-related problems was formed by combining items from the Junior Eysenck Personality Questionnaire (Do you find it hard to sleep at night because you are worrying about things?), Children Depression Inventory (It is hard for me to fall asleep at night), and two additional dichotomous questions (I often was not able to fall asleep because of worrying; At times I was not able to stay asleep because of worrying). This score mainly assessed difficulties in initiating or maintaining sleep., Results: A total of 7.1% adolescents reported suicidal ideation and 86.7% of them had sleep problems. Sleep-related problems were associated with any suicidal ideation and each type of ideation separately., Conclusion: This study suggests association of sleep problems and suicidal ideations in early adolescence. Therefore, clinicians should evaluate this population for sleep disturbances, as they might be a marker of increased risk for suicidality., (© 2013 Wiley Publishing Asia Pty Ltd.)

The aims of this study were to identify the aspects of family functioning which are associated with the course and remission of schizophrenia and to explore relations between aspects of family functioning and family history of schizophrenia. The subjects were 90 patients, treated at the Clinical hospital centre in Rijeka, Croatia, with diagnosed schizophrenia (F20.0 to F20.5) and without psychiatric comorbidity. The patients were organized into three groups depending on the treatment status during the calendar year that preceded the year in which the survey took place: patients with schizophrenia who received an outpatient care and were maintaining favourable remission, patients who were hospitalized once to twice and patients who were hospitalized at least three times in the precedent calendar year. The treatment status was used as an indicator of the course of the illness. A Family Functioning Scale was applied and the data on the absence/presence of schizophrenia in the family history were collected through the examination of previous medical records. The lowest prevalence of familial schizophrenia was found among the patients who were maintaining favourable remission. Among the three groups statistically significant differences were found regarding the following family functioning variables: expressiveness, family sociability, democratic family style. Also there were observed statistically significant differences in the family functioning depending on the presence/absence of the schizophrenia in the family history that included following domains: family cohesion, external locus of control and democratic family style. Our study gives support to the conclusion that family functioning of persons with schizophrenia differs depending on the course of the illness and presence/absence of schizophrenia in the family history.

One of the most important factors of successful substance abuse treatment is the early start of the same treatment. Recent selection method for identification of Croatian adolescents in the substance abuse risk that has been using drug tests from urine samples, has been simple and exact on the one hand, but on the other, has been very rare and usually guided by the pressure of parents or the court. Besides, such method presented the source of legal and ethical questions. So, the proposal of application of standardized psychological tests during systematic medical exams of Croatian adolescents at the age range of 15-22 years could help with the early detection of those adolescents who were in the substance abuse risk or already had the developed addiction problem.

Integrative approach to treatment of psychiatric patients incorporates a variety of therapeutic procedures that overlap and are not mutually exclusive. Their objective is unique: to heal and to restore patients' proper functioning in their family, work and social environments alike. Treatment often requires integration of various therapeutic approaches. In this paper we report the efficacy of an integrative model in the case of a female patient who developed a clinical picture of psychotic depression after giving birth. Taking an individual approach alongside the continuous use of psycho pharmacotherapy enabled us to look for an appropriate model of hospital and ambulatory treatment, namely psychotherapeutic setting. This example proved individual psychotherapy to be a complementary method to psycho pharmacotherapy. This was due to a strong feeling of shame that prevented the patient from opening up and dealing with her inner conflict in the previous group treatment. Integrative and personalised treatment has resulted in a relatively quick recovery and return to her everyday duties.