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Desire includes a subjective aspect and a motivational force which, apart from the sexual, pervades all spheres of human life. When it comes to expressing a desire in a group, this cannot be merely brought down to sexual desire. Sexual identity, or gender identity, in a group will affect the way the desire is expressed, and especially so when diverse sexualities are involved. The degree to which the members of a group will be able to express their desires in the group depends on a number of factors that may concern either the members, the conductor, or the group itself. Similar factors determine who the object of the desire will be: another member, the conductor, or the group as a whole.Topics pertaining to sexuality, especially when sexual differences are in question, are difficult to approach in a group process since sexuality is considered to be a personal thing, often accompanied by feelings of guilt or shame. Healthy discussions on the topic are often not held, especially concerning sexual differences. This way, a path opens towards prejudice and unnecessary stigma or pathologization of certain sexual features that are oftentimes just variations of some of sexual or gender identities. In recent times, we have seen a significant development in acceptance of sexual differences, as in society so in group therapy. Irrespective of the approach to the issues of sexual differences in a therapy group, sexual differences are present and affect most aspects of the group process. The task of group therapists is to face the changes concerning sexual differences and to adjust their own moral principles in order for the group to attain cohesion. Consequently, every member of the group would have the opportunity to express their desires “here and now”, including those of sexual nature, regardless of sexual differences., Pod željom se podrazumijeva subjektivni aspekt i motivacijska snaga koja, osim seksualnog, prožima sve sfere ljudskog života. Kada je u pitanju izražavanje želje u grupi, ne misli se isključivo na seksualnu želju. Seksualni odnosno rodni identitet u grupi, a osobito kad su u pitanju seksualne različitosti, utjecat će na način izražavanja želje u grupi. U kojoj će mjeri članovi grupe biti u stanju izraziti želje u grupi ovisi o više čimbenika povezanih s članovima grupe ili voditeljem kao i sa samom grupom. O sličnim čimbenicima ovisi i tko će biti objekt želje: drugi član u grupi, voditelj ili grupa kao cjelina. Teme koje se odnose na seksualnost, osobito seksualne različitosti, teško su dostupne u grupnom procesu, budući da se seksualnost drži osobnom temom, često uz prateći osjećaj krivnje i srama. Valjana rasprava na temu seksualnosti često izostaje, osobito kad je u pitanju seksualna različitost. Na taj način otvara se prostor predrasudama, a vrlo često i nepotrebnoj stigmi ili pak patologizaciji određenih seksualnih obilježja koja su često samo različitosti nekog od seksualnih odnosno rodnih identiteta. U posljednje vrijeme dolazi do znatnog napretka u prihvaćanju seksualnih različitosti i na društvenom planu i na planu grupne terapije. Bez obzira na koji način se pristupa pitanjima seksualnih različitosti u terapijskoj grupi, seksualne različitosti prisutne su i utječu na većinu aspekata grupnog procesa. Zadaća grupnih terapeuta jest suočiti se s promjenama na planu seksualnih različitosti i prilagoditi vlastita moralna načela kako bi grupa postigla koheziju i kako bi svaki član grupe bio u prilici izraziti želje „ovdje i sada“, uključujući i one seksualne prirode, bez obzira na seksualne različitosti.

Aim To compare the severity of posttraumatic stress disorder (PTSD) symptoms and of particular PTSD clusters among help-seeking veterans before and during the COVID-19 lockdown. The second aim was to identify the main coping strategies used. Methods Male war veterans (N=176) receiving outpatient treatment at the Referral Center for PTSD were assessed at baseline (12-18 months before the pandemic declaration in March 2020) and during the COVID-19 pandemic lockdown (March-June 2020). The Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, and The Brief COPE were used. Results Direct exposure to the virus in our sample was low, and the majority of participants followed the preventive measures. The severity of the overall PTSD symptoms and of clusters of symptoms significantly decreased compared with the first assessment. At the second assessment, all participants still fulfilled the PTSD diagnosis criteria. During the lockdown, the participants used emotion-focused and problem-focused coping rather than dysfunctional coping. Conclusion The severity of PTSD symptoms decreased during the lockdown. Further research is needed to study the trajectories of long-term psychopathology.

Pod željom se podrazumijeva subjektivni aspekt i motivacijska snaga koja, osim seksualnog, prožima sve sfere ljudskog života. Kada je u pitanju izražavanje želje u grupi, ne misli se isključivo na seksualnu želju. Seksualni odnosno rodni identitet u grupi, a osobito kad su u pitanju seksualne različitosti, utjecat će na način izražavanja želje u grupi. U kojoj će mjeri članovi grupe biti u stanju izraziti želje u grupi ovisi o više čimbenika povezanih s članovima grupe ili voditeljem kao i sa samom grupom. O sličnim čimbenicima ovisi i tko će biti objekt želje: drugi član u grupi, voditelj ili grupa kao cjelina. Teme koje se odnose na seksualnost, osobito seksualne različitosti, teško su dostupne u grupnom procesu, budući da se seksualnost drži osobnom temom, često uz prateći osjećaj krivnje i srama. Valjana rasprava na temu seksualnosti često izostaje, osobito kad je u pitanju seksualna različitost. Na taj način otvara se prostor predrasudama, a vrlo često i nepotrebnoj stigmi ili pak patologizaciji određenih seksualnih obilježja koja su često samo različitosti nekog od seksualnih odnosno rodnih identiteta. U posljednje vrijeme dolazi do znatnog napretka u prihvaćanju seksualnih različitosti i na društvenom planu i na planu grupne terapije. Bez obzira na koji način se pristupa pitanjima seksualnih različitosti u terapijskoj grupi, seksualne različitosti prisutne su i utječu na većinu aspekata grupnog procesa. Zadaća grupnih terapeuta jest suočiti se s promjenama na planu seksualnih različitosti i prilagoditi vlastita moralna načela kako bi grupa postigla koheziju i kako bi svaki član grupe bio u prilici izraziti želje „ovdje i sada“, uključujući i one seksualne prirode, bez obzira na seksualne različitosti., Desire includes a subjective aspect and a motivational force which, apart from the sexual, pervades all spheres of human life. When it comes to expressing a desire in a group, this cannot be merely brought down to sexual desire. Sexual identity, or gender identity, in a group will affect the way the desire is expressed, and especially so when diverse sexualities are involved. The degree to which the members of a group will be able to express their desires in the group depends on a number of factors that may concern either the members, the conductor, or the group itself. Similar factors determine who the object of the desire will be: another member, the conductor, or the group as a whole.Topics pertaining to sexuality, especially when sexual differences are in question, are difficult to approach in a group process since sexuality is considered to be a personal thing, often accompanied by feelings of guilt or shame. Healthy discussions on the topic are often not held, especially concerning sexual differences. This way, a path opens towards prejudice and unnecessary stigma or pathologization of certain sexual features that are oftentimes just variations of some of sexual or gender identities. In recent times, we have seen a significant development in acceptance of sexual differences, as in society so in group therapy. Irrespective of the approach to the issues of sexual differences in a therapy group, sexual differences are present and affect most aspects of the group process. The task of group therapists is to face the changes concerning sexual differences and to adjust their own moral principles in order for the group to attain cohesion. Consequently, every member of the group would have the opportunity to express their desires “here and now”, including those of sexual nature, regardless of sexual differences.

By learning cooperation strategies in social skills training within the socio-therapeutic group, the patient's functioning was clearly improved, alcohol abstinence was achieved with complete symptomatic remission. Respect for and adequate treatment of comorbidities significantly contributes to the quality and success of patient treatment and to the improvement of prognosis.

The paper discuss the connection and consequences between the immune system and psychological trauma and PTSD.

Generalized anxiety disorder has high risk rate of psychiatric comorbidity, mostly psychoactive substance use.

Setting a diagnosis and starting a treatment in the earliest stage of a malignant disease is of great significance for successful treatment and surviving these diseases. Despite intensive preventive measures and educational efforts, a large number of patients are still seeking help too late. To illustrate this problem, a case of a 51 year old patient with breast cancer who delayed doctor visitation for 3 years will be presented.

Personality takes its form from late adolescence or early adulthood and although its features persist for longer periods of life, some can be weakened and some can be changed.We present a 43 y old female patient with a disorder of emotionaly unstable state and antisocial tendencies ; she spent three years in psychiatric treatment for anxiety disorders and many years alcocholic syndrome.During psychotherapy treatm, ent there werer more and more evident behavioural patterns that support the existance of personality disorder.We discuss the possibilites of psychotherapy and pharmacotherapy treatment with respect to the character specificities.

The rates of sexual dysfunctions among patients with PTSD are much higher than in the general population. An increasing body of scientific research has confirmed clinically relevant sexual problems (Letourneau et al. 1997, Kotler et al. 2000, Hossain et al. 2013, Yehuda et al. 2015, Tran et al. 2015), among which erectile dysfunction (ED) and premature ejaculation (PE) were the most frequent (Letourneau et al. 1997). It is important to underline that patients, particularly military veterans with PTSD, have an increased risk of sexual dysfunction independent of the use of psychiatric medications (Benjamin et al. 2014). Considering the utilization of pharmacotherapy, data indicate that over 80% of the veterans treated for PTSD in the USA have been receiving at least one of the psychotropic medications (Bernardy et al. 2012). A drug utilization study conducted in Croatia revealed that the annual frequency of drug use among pharmacologically treated PTSD patients was the highest for anxiolytics (75.83% patients), antidepressants (61.36%), hypnotics (35.68%) and antipsychotics (30.21%) in 2012 (LeticaCrepulja et al. 2015). In this context, it is very important to highlight that a variety of psychotropic medications recommended for the treatment of PTSD can induce sexual function disorders (Clayton & Shen 1998, Labbate 2008). Most practice guidelines for the treatment of PTSD highlight antidepressants as the first-line pharmacotherapeutic agents, particularly selective serotonin reuptake inhibitors (SSRIs) (Ballenger et al. 2000, American Psychiatric Association 2004, National Institute for Clinical Excellence (NICE) 2005, Baldwin et al. 2005, Forbes et al. 2007) and serotonin-norepinephrine reuptake inhibitors (SNRIs) (Bandelow et al. 2008, Benedek et al. 2009, Stein et al. 2009, Department of Veterans Affairs 2010, World Health Organization 2013, Baldwin et al. 2014). Since the introduction of these medications, increasing attention has been given to the side effects, such as sexual dysfunction (Labbate 2008, Corona et al. 2009, Serretti & Chiesa 2011). SSRIs can negatively affect all domains of sexuality (desire-arousal-orgasm-resolution) (Corona et al. 2009). A study of sexual functioning in war veterans with posttraumatic stress disorder conducted in Croatia showed that these patients had less sexual activity, hypoactive sexual desire and more frequent ED compared with healthy volunteers. These problems might be associated with the antidepressant therapy (Anticevic & Britvic 2008). Another Croatian study revealed that the population exposed to traumatic event(s) had the same level of sexual functioning (or the same incidence of sexual dysfunction) regardless of the absence or presence of PTSD symptoms and their severity (Arbanas 2010). The aim of this report was to present a patient with PTSD and comorbid sexual dysfunctions.

Uvod: Pacijenti s posttraumatskim stresnim poremećajem (PTSP) imaju povećan rizik za neki od poremećaja seksualnog funkcioniranja. Oni su vezani za klinički tijek, ali i liječenje PTSP- a, a najzastupljeniji su erektilna disfunkcija i preuranjena ejakulacija. Cilj: Prikazati pacijenta oboljelog od PTSP-a s polimorfnim poremećajima seksualnog funkcioniranja u dugom kliničkom tijeku i liječenju. Prikaz slučaja: Dragovoljac Domovinskog rata, 47, pripadnik specijalnih postrojbi, sudionik svih redarstvenih akcija na zapadnoj bojišnici. Izložen je višestrukoj psihotraumatizaciji tijekom borbi i zarobljavanja. Traumatski događaj koji je imao najveći utjecaj na duševno zdravlje zbio se 1992. godine. S jednim od najbližih suboraca našao se na brisanom prostoru, metci su pljuštali oko njihovih glava, uspio se spasiti. Bespomoćno je, prestravljen gledao kako suborac krvari i umire ne mogavši mu pomoći. Osjetio je urgenciju za mokrenjem, stiskao sfinkter i kad više nije mogao izdržati, popustio je kako bi se pomokrio. Međutim, nije pomokrio ni kap. Nakon DR nastavlja raditi u interventnoj policiji, razdražljiv je, napet, ne spava dobro, sanja snove traumatskog sadržaja, budi se u znoju, muče ga ponovna proživljavanja, gotovo stalni nagon i druge poteškoće vezane za mokrenje, te preuranjena ejakulacija. U više navrata je učinjena konverzija terapije s ograničenim terapijskim učinkom. Poboljšanje u smislu produljenja seksualnog čina konačno je postignuto, međutim, uslijedile su poteškoće s erekcijom koje su progredirale do potpune nemogućnosti postizanja erekcije. Ponovno je učinjena konverzija terapije, te je uslijedilo poboljšanje. Nažalost, tijekom seksualnog čina, erekcija je bila produljena, nastao je edem glansa i parafimoza. Dijelom zbog srama, dijelom zbog blagdana nije se odmah javio liječniku. Nakon sedam dana je hitno operiran zbog izrazitog edema i početnih nekrotičnih promjena glansa penisa i prepucija. Nastavljeno je konzervativno liječenje, a kasnije učinjena cirkumcizija. Erektilna funkcija je uspostavljena i u daljnjem tijeku liječenja seksualna funkcija je bila zadovoljavajuća. Zaključak: Prikazom slučaja se ističe važnost uključivanja podataka o seksualnom funkcioniranju u svaki psihijatrijski intervju i tretman oboljelih od PTSP-a.

Objectives: The aim of this study was to examine the factors associated with referral to psychiatric treatment in the sample of war-survivors in Croatia. Methods: A cross-sectional survey was conducted with a sample of 333 war-survivors in Croatia. Clinical measures included the Structured Clinical Interview for DSM-IV (SCID-I/NP, version 2), the Clinician-Administered PTSD Scale (CAPS), the Beck Depression Inventory (BDI) and the Semi-Structured Interview for Survivors of War (SISOW). Results: In logistic regression analysis, in addition to some demographic and trauma variables, the critical factors in referring someone for psychiatric treatment are severity of depression and severity of disability due to PTSD symptoms. Severity of PTSD on the contrary, showed no significant predictive value for the referral to psychiatric treatment. Conclusion: Our findings of the critical predictors of referral to psychiatric treatment suggest the importance of further attempts to improve the clinical practice of GPs in recognition and management of PTSD. Early treatment of PTSD patients could prevent chronification and irreparable harm in global functioning due to PTSD.

Depression has been implicated as a possible risk factor for low bone mineral density (BMD). However, there is still no solid evidence that could connect these two different illnesses. This research examined the association between self-reported depression and low BMD in perimenopausal and postmenopausal women. This research screened 130 female patients who were 44 to 72 years old and registered at the densitometry clinic of KBC Rijeka during a three month period. Densitometry was performed in order to establish their BMD and according to the results two groups of participants were formed: normal BMD - 38 participants with normal BMD at hip and spine and reduced BMD - 75 participants with lower BMD at hip and spine. Depression was assessed using Beck depression inventory. Both groups of participants were compared regarding their depression scores. There were no significant differences between the groups with normal and reduced BMD regarding mean age, age of menopause, length of menopause and number of births (p = 0.001). Difference regarding depressiveness between the two groups was not significant (t = 0.73; p = 0.468). Also, there were no differences between the groups regarding the frequency of certain levels of depression. (chi2 = 2.27; p = 0.52). Results of this research suggest that self-reported depression is not associated with low BMD in perimenopausal and postmenopausal women.

Introduction: Cancer patienta are very vulnerable to neurocognitive dysfunction which may be caused by malignant tumoer per se (localisation in the CNS, damage of the neural tissue as a part of paraneoplastic syndrom), tumor therapy, infection, anemia, metabolic changes, nutritive deficits, combination of the above factors and many other causes. We present our experience measuring cognitive funkcions in various phases of malignant disease by computerised psychodiagnostic laboratory different from the standard set instruments.

Cognitive functions affect the quality of life of malignant disease victims. In research to date there has been a huge problem with objective measuring of cognitive abilities. Some very well-designed studies to date have not been conclusive and the authors themselves cited inadequate sensitivity of tests and equipment which were deficient in detecting minimal changes. The aim of research was to:1. assess to what extent malignant disease and anaemia are reflected on cognitive abilities of oncological-hemotological patients 2. define orientational norms for hematological-oncological patients, and 3. compare them with previously established norms for subjects with different educational levels and occupations using the state-of-the-art computerised equipment - a CRD instrument (Complex Reactiometer Drenovac). It is anticipated that the work will serve in designing future similar research. Subjects were chosen from a stratified sample of an adult patient population of both sexes who are under observation or being treated at Clinical Hospital Center, Rijeka, Croatia. A total of 400 patients divided in four commensurable groups (100 patients each) with or without malignant diseases and with or without anaemia were included in the study. The results of the psychological tests were analyzed through application of ANOVA statistical procedures. Through comparison of cognitive functions among groups, standard norms were made. Assignment indicators in the first testing (T1) and in the repeated testing (T2) after anaemia correction, checking differences in tests among the groups as well as testing the differences between the first and second testing, demonstrated that anaemia and malignant disease are significantly connected with loss of cognitive abilities. In all assignment indicators of cognitive tests, Group 1 (with malignant disease and anemia) demonstrated the worst results in comparison with all other groups (P

Anemia is commonly present in hematology and oncology patients and influence significantly their quality of life. The aim of this study was to evaluate the effect of anemia and malignant disease on cognitive functions in hematology- oncology patients. Four hundred patients were evaluated for cognitive functions and hemoglobin levels before and after correction of anemia in the Clinical Hospital Center of Rijeka, Croatia. The patients were divided in four groups (100 patients in each group): Experimental Group 1 – patients with malignancy plus anemia, and controls: Group 2 – patients with malignancy and without anemia, Group 3 – patients without malignancy but anemic and Group 4 – healthy controls without malignancy and without anemia. Cognitive functions were measured by Complex Reactiometer Drenovac (CRD) before and after therapy of anemia. Group 1 showed the worst cognitive achievement (p, Kognitivna disfunkcija uzorkovana anemijom vrlo je česta u onkoloških i hematoloških bolesnika te značajno utječe na njihovu kvalitetu života. Cilj ovog istraživanja bio je procijeniti u kolikoj se mjeri maligna bolest i anemija odražavaju na kognitivne sposobnosti onkološko-hematoloških bolesnika. Istraživanjem je obuhvaćen uzorak od 400 bolesnika liječenih u Kliničkom bolničkom centru Rijeka, koji su bili svrstani u 4 skupine izjednačene po spolu, dobi i stručnoj spremi (po 100 ispitanika u svakoj skupini). Skupina 1 bila je eksperimentalna (bolesnici sa zloćudnim tumorom koji pri postavljanju dijagnoze imaju i anemiju) dok su ostale skupine bile kontrolne: skupina 2 (bolesnici sa zloćudnim tumorom koji nemaju anemiju), skupina 3 (anemični bolesnici koji nemaju malignu bolest), skupina 4 (zdravi ispitanici koji nemaju ni malignu bolest niti anemiju). U svih bolesnika provedeno je psihometrijsko testiranje različitih kognitivnih funkcija pomoću kompjutoriziranih testova CRD-serije (Complex reactiometer Drenovac) prije i poslije liječenja anemije. U skupini 1 zabilježeni su lošiji rezultati na kognitivnim testovima (p

Anemia is commonly present in hematology and oncology patients and influence significantly their quality of life. The aim of this study was to evaluate the effect of anemia and malignant disease on cognitive functions in hematology-oncology patients. Four hundred patient were evaluated for cognitive functions and hemoglobin levels before and after correction of anemia in the Clinical Hospital Center of Rijeka, Croatia. The patient were divided in four groups (100 patients in each group): Experimental group 1 - patients with malignancy plus anemia, and controls: Group 2 - patients with malignancy and without anemia, Group 3 - patients without malignancy but anemic and Group 4 - healthy controls without anemia and without anemia. Cognitive functions were measured by Complex Reactiometer Drenovac (CRD) before and after therapy of anemia. group 1 showed the worst cognitive achievement (p

Introduction: Somatization (Greek, soma = body) is a disorder in which the psychological and emotional problems are expressed in physical symptoms. People prone to somatization tend to complain about the pain within the multiple organic systems although it cannot be find any organic cause. Objectives: Somatization as a separate diagnostic entity exists in the Somatoform disorder, but it occurs in a number of other psychopathological entities, such as mood disorders, panic disorder (in the attack), generalized anxiety disorder, delusions in schizophrenia, dependence on psychoactive substances, etc. Also, some personality disorders are more related to the expression of somatization. There is usually referred Histrionic, borderline, antisocial personality disorder etc. Aims: Because of possible multiple access to somatization as a symptom of psychopathological entity, the case of patient who expressed somatization was selected for presentation. Focus was on the course of hospitalization and differential diagnostic dilemmas with which we encountered in the diagnostic procedure according to DSM-IV. Methods: Psychiatric interview, mental status, EEG, Psychological Testing, SCID I DSM-IV. Results and conclusion: According to the used methods it was selected -Unspecific Somatoform disorder- as solution to the dilemma in our case.

Anemia is commonly present in hematology and oncology patients and influence significantly their quality of life. The aim of this study was to evaluate the effect of anemia and malignant disease on cognitive functions in hematology- oncology patients. Four hundred patients were evaluated for cognitive functions and hemoglobin levels before and after correction of anemia in the Clinical Hospital Center of Rijeka, Croatia. The patients were divided in four groups (100 patients in each group): Experimental Group 1 – patients with malignancy plus anemia, and controls: Group 2 – patients with malignancy and without anemia, Group 3 – patients without malignancy but anemic and Group 4 – healthy controls without malignancy and without anemia. Cognitive functions were measured by Complex Reactiometer Drenovac (CRD) before and after therapy of anemia. Group 1 showed the worst cognitive achievement (p, Kognitivna disfunkcija uzorkovana anemijom vrlo je česta u onkoloških i hematoloških bolesnika te značajno utječe na njihovu kvalitetu života. Cilj ovog istraživanja bio je procijeniti u kolikoj se mjeri maligna bolest i anemija odražavaju na kognitivne sposobnosti onkološko-hematoloških bolesnika. Istraživanjem je obuhvaćen uzorak od 400 bolesnika liječenih u Kliničkom bolničkom centru Rijeka, koji su bili svrstani u 4 skupine izjednačene po spolu, dobi i stručnoj spremi (po 100 ispitanika u svakoj skupini). Skupina 1 bila je eksperimentalna (bolesnici sa zloćudnim tumorom koji pri postavljanju dijagnoze imaju i anemiju) dok su ostale skupine bile kontrolne: skupina 2 (bolesnici sa zloćudnim tumorom koji nemaju anemiju), skupina 3 (anemični bolesnici koji nemaju malignu bolest), skupina 4 (zdravi ispitanici koji nemaju ni malignu bolest niti anemiju). U svih bolesnika provedeno je psihometrijsko testiranje različitih kognitivnih funkcija pomoću kompjutoriziranih testova CRD-serije (Complex reactiometer Drenovac) prije i poslije liječenja anemije. U skupini 1 zabilježeni su lošiji rezultati na kognitivnim testovima (p

Introduction: Delusional disorder is characterized in current classifications by the development of one delusional thought or set of related delusional ideas that are usually permanent. Body dysmorphic disorder is sick preoccupation with appearance of the whole body or focused on particular areas of body, when the patient is convinced that there is a change of shape, structure or function. Objectives: We will present 36-year old patient who was sent to a psychiatry recommended by the otorinolaringology specialist, where he was treated three years for sore throat. The patient was very focused and concerned about the problems of the target organ. Aim: Correct diagnosis is very important for choosing adequate therapy. Methods: clinical interview, psychologic testing, EEG egzam. Results: He was treated with different combinations of drugs, but the combined therapy showed that the most effective were quetiapin, venlafaksin and valproat acid. Conclusion: Individual access and knowledge of the pathophysiological background of patients with delusional body dysmorphic disorder is of great importance in choosing psycho pharmacotherapy.

New trends in medicine which are much more oriented towards pharmacoeconomy, are ever so common these days. There's an aim within the focus of the health system which is cutting down treatment expences, and that relates to psychiatry practice too. Prescription drugs issued by specialist doctors are allowed to be switched with cheaper ones of the same group of drugs by GP doctors, with an aim of cost reduction. „Instead of the medicament prescribed, a GP doctor is allowed to prescribe an alternative medicament of the same efficacy in the dosage of an adequate strenght“ (taken from the specialist medical report form). A 74 years old man is treated for psychotic depression. Exogenic environmental factors caused the symptoms manifestation due to which hospitalisation in a psychiatric ward occurred in two incidences. At the risperidone introduction soon after the second hospitalisation event, a long term remission was obtained which lasted for several years. Despite a stable medication dose, a new episode of the illness occurred. Researching the potential factors which lead towards the aggravation of the course of the illness disclosed that instead of the original risperidone, the pharmacist issued a generic in an equivalent dose.

Cilj rada bio je usporediti kvalitetu života osoba starije životne dobi koji žive u svom domu u odnosu na one koji su smješteni u domovima.Ispitano je 104 osobe smještene u u domovima za straije i nemoćmne te 124 njih koji žive u svojem domaćinstvu.Korištena je anketa za demografske podatke , Mansa upitnik te upitnik za depresiju.Rezultati pokazuju da su osobe koje žive u domaćinstvu zadovoljnije kvalitetom svojeg života dok su osobe u domu depresivnije posebno kada se moraju pridržavati nekog dijetnog režima.Nepokretni su nezadovoljniji bez obzira gdje su smješteni.

It shows observation of early cognitive disfunction which exlusevely lead to early diagnosis of malignant disease

In Clinical hospital Center of Rijeka, 200 pts with solid and hematologic malignancies were evaluated for cognitive abilities. The results are shown in these article.

Stressful and demanding life situations, such as those encountered during hospitalization because of coronary disease or surgery, are associated with a variety of psychic reactions and coping mechanisms, that both affect psychological and physical health status. The aim of the study was to assess the prevalence of distress, anxiety, depression and adaptive coping strategies in cardiac patients and consequently establish whether the type of the stressor - an unexpected, sudden cardiac event (heart atttack) or the expected intervention (open heart surgery) influenced and/or distinguish coping styles, psychic status and recovery of cardiac patients. Two groups of cardiac patients, first examined in coronary unit after myocardial infarction (N1=75), and second group examined in cardiosurgery unit after having open heart surgery ( N2=75), were given psychometric instruments to measure their stress perception (Stress Intensity Scale), anxiety (State and Trait Anxiety Inventory), depression (Beck Depression Inventory) and coping styles (COPE) during the first week of their recovery ; SPSS package of statistical analysis was applied ; Results Preliminary results show that older age (65 years and more) was significantly associated with poorer coping skills and higher scores on stress, depression and anxiety scales. Also, the difference in coping skills and psychic status between two groups based on type of the stressful event was not significantly supported. Older age could be the predictor for poorer coping skills in cardiac patients. Findings suggest that characteristics of the patients affected the recovery of the patient more than characteristics of the stressful event. Addressing such issues contributes to better understanding and designing treatment strategies contributing to recovery of cardiac patients.

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PTSD group treatment program has been modified and developed along last 10 years at our Center. For the last three years the program has been unique for all the patients and its form is: educative groups, sociotherapy groups, problem-solving groups and small, trauma groups. 90 PTSD patients have been followed up before the treatment and 12 months after the treatment. Measured dimensions were level of PTSD symptoms, DESNOS tendency, defence and cope mechanisms and level of anxiety and depression. The paper will show the basic changes in psychological functioning due to the treatment.

Torture represent exeptional traumatic experience in wich horror, helplesness and hopelesness are extreme. For this reasons it can be expected that depression and other trauma related disorders are present in higher percentage in torture victims than in other psychotraumatised population. To prove this we examined two groups of refugees, all of them living for five years in Rijeka region. First group N-30 had combat experience in addition. Second group N-50had combat experience but were inprisoned and tortured as well. By Hamilton scale, BDI scale and structured questionare we tried to see if those groups differ in level of depression according different level of traumatic experience and we try to examine caracteristics of depression as well. Our results prooved that troture victims had significant higher level of depression especially those of clinical relevance. That was interesting even more when knowing that only one quother of them were seeking some psychological help.

Reactive disorders as a response to the traumatic experience cover a spectre of disorders from acute reactions to the long lasting trauma consequences. A type of the response to the trauma depends on the character of the trauma, on the personal defences and coping mechanisms and on the level of social support. The more chronic the disorder appears, the trauma resaponse seems to be more determined by the basic structure of a person. This reflects on the therapeutic approach-thus the acute states, demand for different therapeutic interventions from chronic states that need therapeutic program with the accent on the family and social support. In the paper we described the ways of changing of our therapeutic concept during our work with psychotraumatized population, mostly veterans, the displaced persons and victims of torture from the beginning of the war in Croatia up to now. Now our therapeutic program in Center for Psychotrauma Rijeka, Croatia, includes a combination of pharmacotherapy and psychotherapy, individual, group and family. What will be the focus of the therapeutic process depends on disorder, its length and possible dual disorders.

There is lot of articles dealing with comorbidity of trauma related disorders and some kind of addiction to psychoactive drugs (coffee, cigarettes, alcohol, etc.) We studied two groups of patients: groups of war veterans who were prisoners of war. By structured interview and truma questionnaire we collected and compared information on psychoactive drugs abuse before and after traumatic experiences.

The need for evaluation the results of the psychotherapy is more and more frequent. We presented the long time effects of the PTSD treatment program in the Trauma Centre of the Psychiatric Clinic Rijeka - Croatia.The treatment programme is consisted of: Individual therapy, trauma focused group, sociotherapy group, educational-preventive group for the prevention of the addiction and therapeutic community. All our clients are war veterans. They have come to seek for two treatment, on or two year after traumatic experience. We tried to find out the consequences of a treatment programme one to four years after they have finished it. We have estimated levels of depression, anxiety level of PTSD symptoms and personality changes due to a traumatic experience. We used BECK, STAI, DSM-III-R and DESNOS questionnaire.

Group therapy of the patients with the Posttraumatic stress disorder caused by the war trauma, has its specifics dynamics as the traumatized persons in groups establish different relations towards cotherapeutic pair, group members, and a group as a whole. This necessarily influences the developmental phases of the group dynamics. On the material we got conducting and recording three cycles of 40 sessions-the period of duration of Posttraumatic stress disorder group on the Posttraumatic stress disorder department of Psychiatry Clinic Of Clinical Hospital Center Rijeka, we have tried to analyze group dynamic and developmental phases of the group processes.

In the very begining of the war in Croatia we could recognised several groups of psychotraumatised people.Level of their traumatisation differ according time, place and ingagement into the war situation.In the paper we presented various psychological problems opserved in refugee population settled in Rijeka region as well as the interventions apllied to prevent psychological consequences of their traumatisation.