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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 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 PTSD symptom severity, measured by the Clinician Administrated PTSD Scale (CAPS) by liner regression. To assess the relationship between the main outcomes PTSD diagnosis and symptom severity, each of the examined variables was adjusted for all other PTSD related variables. Results The categorical analysis showed significant polygenic risk in patients with remitted PTSD and the total sample, whereas no effects were found on symptom severity. Intensity of life events as well as the individual coping style were significantly associated with PTSD diagnosis in both current and remitted cases. The dimensional analyses showed as association of war-related frequency of trauma with symptom severity, whereas the intensity of trauma yielded significant results independently of trauma timing in current PTSD. Conclusions The present PRS application in the SEE-PTSD cohort confirms modest but significant polygenic risk for PTSD diagnosis. Environmental factors, mainly the intensity of traumatic life events and negative coping strategies, yielded associations with PTSD both categorically and dimensionally with more significant p-values. This suggests that, at least in the present cohort of war-related trauma, the association of environmental factors and current individual coping strategies with PTSD psychopathology was stronger than the polygenic risk.

Objectives This study aims to assess the possible relationship between 99mTc-pertechnetate hand perfusion scintigraphy (HPS) and nailfold capillaroscopy (NC) in systemic sclerosis (SSc) patients. Patients and methods The study group consisted of 25 SSc patients (6 males; 19 females; mean age 54.2±9.7 years; range, 32 to 67 years), 18 female patients with primary Raynaud's phenomenon (PRP) (mean age 47.1±9.5 years; range, 34 to 65 years) and 10 healthy individuals (3 males, 7 females; mean age 52.7±12.6 years; range, 37 to 73 years). NC and 99mTc-pertechnetate HPS were performed in all examinees. The capillaroscopic findings were classified as normal or scleroderma pattern ("early", "active", or "late"). The fingers-to-palm ratios were calculated for both blood flow (BF) and blood pool (BP) phases of the 99mTc-pertechnetate HPS. Results Systemic sclerosis patients showed a significantly lower BP ratio than PRP patients and healthy subjects (p=0.004). No statistically significant difference was observed between the SSc and PRP patients in respect to BF ratio. A gradual decrease of BF and BP with the severity of NC microangiopathy pattern ("early", "active" or "late") was found in SSc patients, while the differences were not statistically significant. Patients with diffuse SSc showed lower BF and higher BP than those with limited SSc, while these differences were without statistical significance. There was no significant correlation between BF or BP values and type of SSc (limited or diffuse) (p=0.77 versus p=0.54, respectively) as well as three microangiopathy patterns (p=0.22 versus p=0.54, respectively). Conclusion 99mTc-pertechnetate HPS improves the evaluation of vascular damage in SSc patients. There is no direct relationship between NC and 99mTc-pertechnetate HPS; however, the two methods complement each other in the assessment of microcirculation in SSc.

Funding Information: This work was supported by the National Institute of Mental Health / U.S. Army Medical Research and Development Command (Grant No. R01MH106595 [to CMN, IL, MBS, KJRe, and KCK], National Institutes of Health (Grant No. 5U01MH109539 to the Psychiatric Genomics Consortium ), and Brain & Behavior Research Foundation (Young Investigator Grant [to KWC]). Genotyping of samples was provided in part through the Stanley Center for Psychiatric Genetics at the Broad Institute supported by Cohen Veterans Bioscience . Statistical analyses were carried out on the LISA/Genetic Cluster Computer ( https://userinfo.surfsara.nl/systems/lisa ) hosted by SURFsara. This research has been conducted using the UK Biobank resource (Application No. 41209). This work would have not been possible without the financial support provided by Cohen Veterans Bioscience, the Stanley Center for Psychiatric Genetics at the Broad Institute, and One Mind. Funding Information: MBS has in the past 3 years received consulting income from Actelion, Acadia Pharmaceuticals, Aptinyx, Bionomics, BioXcel Therapeutics, Clexio, EmpowerPharm, GW Pharmaceuticals, Janssen, Jazz Pharmaceuticals, and Roche/Genentech and has stock options in Oxeia Biopharmaceuticals and Epivario. In the past 3 years, NPD has held a part-time paid position at Cohen Veterans Bioscience, has been a consultant for Sunovion Pharmaceuticals, and is on the scientific advisory board for Sentio Solutions for unrelated work. In the past 3 years, KJRe has been a consultant for Datastat, Inc., RallyPoint Networks, Inc., Sage Pharmaceuticals, and Takeda. JLM-K has received funding and a speaking fee from COMPASS Pathways. MU has been a consultant for System Analytic. HRK is a member of the Dicerna scientific advisory board and a member of the American Society of Clinical Psychopharmacology Alcohol Clinical Trials Initiative, which during the past 3 years was supported by Alkermes, Amygdala Neurosciences, Arbor Pharmaceuticals, Dicerna, Ethypharm, Indivior, Lundbeck, Mitsubishi, and Otsuka. HRK and JG are named as inventors on Patent Cooperative Treaty patent application number 15/878,640, entitled “Genotype-guided dosing of opioid agonists,” filed January 24, 2018. RP and JG are paid for their editorial work on the journal Complex Psychiatry. OAA is a consultant to HealthLytix. All other authors report no biomedical financial interests or potential conflicts of interest. Funding Information: This work was supported by the National Institute of Mental Health/ U.S. Army Medical Research and Development Command (Grant No. R01MH106595 [to CMN, IL, MBS, KJRe, and KCK], National Institutes of Health (Grant No. 5U01MH109539 to the Psychiatric Genomics Consortium), and Brain & Behavior Research Foundation (Young Investigator Grant [to KWC]). Genotyping of samples was provided in part through the Stanley Center for Psychiatric Genetics at the Broad Institute supported by Cohen Veterans Bioscience. Statistical analyses were carried out on the LISA/Genetic Cluster Computer (https://userinfo.surfsara.nl/systems/lisa) hosted by SURFsara. This research has been conducted using the UK Biobank resource (Application No. 41209). This work would have not been possible without the financial support provided by Cohen Veterans Bioscience, the Stanley Center for Psychiatric Genetics at the Broad Institute, and One Mind. This material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting true views of the U.S. Department of the Army or the Department of Defense. We thank the investigators who comprise the PGC-PTSD working group and especially the more than 206,000 research participants worldwide who shared their life experiences and biological samples with PGC-PTSD investigators. We thank Mark Zervas for his critical input. Full acknowledgments are in Supplement 1. MBS has in the past 3 years received consulting income from Actelion, Acadia Pharmaceuticals, Aptinyx, Bionomics, BioXcel Therapeutics, Clexio, EmpowerPharm, GW Pharmaceuticals, Janssen, Jazz Pharmaceuticals, and Roche/Genentech and has stock options in Oxeia Biopharmaceuticals and Epivario. In the past 3 years, NPD has held a part-time paid position at Cohen Veterans Bioscience, has been a consultant for Sunovion Pharmaceuticals, and is on the scientific advisory board for Sentio Solutions for unrelated work. In the past 3 years, KJRe has been a consultant for Datastat, Inc. RallyPoint Networks, Inc. Sage Pharmaceuticals, and Takeda. JLM-K has received funding and a speaking fee from COMPASS Pathways. MU has been a consultant for System Analytic. HRK is a member of the Dicerna scientific advisory board and a member of the American Society of Clinical Psychopharmacology Alcohol Clinical Trials Initiative, which during the past 3 years was supported by Alkermes, Amygdala Neurosciences, Arbor Pharmaceuticals, Dicerna, Ethypharm, Indivior, Lundbeck, Mitsubishi, and Otsuka. HRK and JG are named as inventors on Patent Cooperative Treaty patent application number 15/878,640, entitled ?Genotype-guided dosing of opioid agonists,? filed January 24, 2018. RP and JG are paid for their editorial work on the journal Complex Psychiatry. OAA is a consultant to HealthLytix. All other authors report no biomedical financial interests or potential conflicts of interest. Publisher Copyright: © 2021 Society of Biological Psychiatry Background: Posttraumatic stress disorder (PTSD) is heritable and a potential consequence of exposure to traumatic stress. Evidence suggests that a quantitative approach to PTSD phenotype measurement and incorporation of lifetime trauma exposure (LTE) information could enhance the discovery power of PTSD genome-wide association studies (GWASs). Methods: A GWAS on PTSD symptoms was performed in 51 cohorts followed by a fixed-effects meta-analysis (N = 182,199 European ancestry participants). A GWAS of LTE burden was performed in the UK Biobank cohort (N = 132,988). Genetic correlations were evaluated with linkage disequilibrium score regression. Multivariate analysis was performed using Multi-Trait Analysis of GWAS. Functional mapping and annotation of leading loci was performed with FUMA. Replication was evaluated using the Million Veteran Program GWAS of PTSD total symptoms. Results: GWASs of PTSD symptoms and LTE burden identified 5 and 6 independent genome-wide significant loci, respectively. There was a 72% genetic correlation between PTSD and LTE. PTSD and LTE showed largely similar patterns of genetic correlation with other traits, albeit with some distinctions. Adjusting PTSD for LTE reduced PTSD heritability by 31%. Multivariate analysis of PTSD and LTE increased the effective sample size of the PTSD GWAS by 20% and identified 4 additional loci. Four of these 9 PTSD loci were independently replicated in the Million Veteran Program. Conclusions: Through using a quantitative trait measure of PTSD, we identified novel risk loci not previously identified using prior case-control analyses. PTSD and LTE have a high genetic overlap that can be leveraged to increase discovery power through multivariate methods. publishersversion published

Colon cancer is one of the most common malignancies. Numerous studies suggest an association between resilience and quality of life in colon cancer patients. The aim of this study was to explore the association between resilience and quality of life in people with colon cancer.A cross-sectional study was conducted on a sample of 200 subjects at the Oncology Clinic of the University Clinical Hospital Mostar. Data were collected in the period between April 2019 and June 2021. A socio-demographic questionnaire specifically designed for this study, a CD-RISC-25 scale for assessing resilience, and a WHOQOL-BREF questionnaire for assessing quality of life were used for collecting data.A statistically significant positive association of resilience with all domains of quality of life was found. The mental health domain contributed the most statistically significantly positively to the level of resilience. Patients who were not married had a statistically significantly higher level of resilience compared to married, divorced and widowed patients. No statistically significant difference was found in resilience levels relative to other socio-demographic factors and cancer stage. Patients treated with a combination of surgery and chemotherapy had a statistically significantly higher level of resilience compared to patients treated with other therapeutic methods.Higher level of resilience statistically significantly contributes to a higher level of quality of life in people with colon cancer.

Uvod: Onkološki bolesnici mogu se ubrojiti u rizičnu skupinu smanjene kvalitete života s obzirom na specifične zdravstvene tegobe, nuspojave liječenja ali i promijenjene životne okolnosti koje sa sobom nosi sama bolest. Mnogi stručnjaci smatraju da se kroz multidisciplinarni pristup liječenju onkoloških bolesnika može poboljšati njihova rezilijencija i kvaliteta života. Cilj: Ispitati povezanost rezilijencije i kvalitete života u onkoloških bolesnika. Ispitanici i metode: Istraživački uzorak predstavljali su onkološki bolesnici koji se liječe na Klinici za onkologiju Sveučilišne kliničke bolnice (SKB) Mostar (N=50). Za prikupljanje podataka korišteni su: sociodemografski upitnik namjenski sačinjen za ovo istraživanje, WHOQOL-BREF upitnik za procjenu kvalitete života i CD-RISC-25 upitnik psihološke rezilijencije. Rezultati: Nađena je pozitivna statistički značajna korelacija između svih domena kvalitete života i rezilijencije. Najsnažnija korelacija pronađena je između domene psihološkog zdravlja i rezilijencije. Ispitanici koji su bili u stadiju IV bolesti imali su najlošiji rezultat na skali tjelesnog zdravlja. Nije bilo statistički značajnih razlika u drugim domenama kvalitete života i rezilijenciji među ispitanicima u odnosu na stadij bolesti. Nije bilo statistički značajnih razlika u rezilijenciji i kvaliteti života među ispitanicima u odnosu na dužinu liječenja. Zaključak: Onkološki bolesnici s višom razinom rezilijencije su imali višu razinu kvalitete života.

Neke psihijatrijske bolesti i stanja zahtijevaju postupke i prisilnu hospitalizaciju radi zaštite tj. primjene prisilnog smještaja i prisilnog zadržavanja kako bi se zaštitilo duševne bolesnike i njima bliske osobe koje su u opasnosti zbog njihove duševne bolesti. Protiv tih osoba se nerijetko vodi kazneni i prekršajni postupak. Neubrojiva je ili je smanjeno ubrojiva osoba zbog opasnosti za sebe ili društvo koju mogu prouzročiti takvi duševni bolesnici. U radu se detaljno razlaže o potonjem analizirajući zakonske odredbe Bosanskohercegovačkog i Hrvatskog zakonodavstva. Prisilna hospitalizacija se sprovodi kod osoba koje su zbog ozbiljno narušenog duševnog zdravlja ozbiljno opasne za svoj ili tuđi život. Najčešći sudski procesuirani pacijenti iz ove skupine su iz skupine psihotičnih poremećaja, pod radnom dijagnozom iz skupine shizofrenije, poremećaja sličnih shizofreniji i sumanutih stanja, a drugi su iz skupine mentalnih poremećaja i poremećaja ponašanja nastalih upotrebom psihoaktivnih tvari te osobe s poremećajem ličnosti u fazi psihotične dekompenzacije. Cilj ovog rada je objasniti zakonsku regulativu zahvata u tjelesnu slobodu radi zaštite osoba s duševnim smetnjama u Federaciji Bosne i Hercegovine i Republike Hrvatske – sličnosti i razlike te sudsko procesuiranje radi prisilnog smještaja. Jedan od ciljeva je dokazati da sinergija pacijent tj. osoba s duševnom smetnjom, liječnika i zajednice se pospješuje dragovoljna hospitalizacija, a sve u svrhu pomoći i zaštiti duševno oboljele osobe.

U ovom radu je predstavljen povijesni razvoj stigmatizirajućih stavova prema osobama sa psihičkim smetnjama, negativni učinci koje taj problem nosi sa sobom te mogući načini prevazilaženja ovog problema. Razvoj psihijatrije seže u daleku prošlost. Smatra se da su primitivna plemena na psihičku bolest gledala kao na višu silu, koju nije bilo moguće promijeniti, a izolacija psihički oboljelih osoba bila je popularna i u to daleko doba. Na psihijatrijske se pacijente oduvijek gledalo kao na opasne i kriminalce. U prilog tome govori i činjenica da su ovakve osobe bivale mučene po raznim logorima, omalovažavane i etiketirane. Psihijatrijske su ustanove uvijek smještane izvan gradova, na planine, daleko od ostalih ljudi. To se može vidjeti još i danas. Svi ovi faktori pridonijeli su stvaranju stigmatizacije ne samo među općom populacijom već i među zdravstvenih djelatnicima. Tek se u 18. stoljeću nazire svijetla točka u psihijatriji, skidanjem okova i lanaca s oboljelih. Bez obzira na napore koji su uloženi u smanjenje stigmatizacije, među općom populacijom još je i danas prisutan strah i oprez prilikom kontakta sa psihijatrijskim pacijentima. Ono što nas veseli je činjenica da se zbog sve većeg broja psihičkih oboljenja žele izraditi programi za borbu protiv stigmatizacije. Ovakvi programi imaju za cilj vraćanje dostojanstva oboljelim osobama, ali i ustanova u kojima one borave. Stigmatizaciji značajno doprinosi nedostatak znanja i razumijevanja psihičke bolesti. Stoga je iznimno važna edukacija bolesnika, njihovih obitelji, ali i šire javnosti. Sve ovo ima isti cilj, a on je bolje razumijevnje psihički oboljelih osoba i smanjenje stigmatizacije. Cilj ovog rada je prikazati što sve utječe na stvaranje stigmatizirajućih stavova prema psihički oboljelim osobama, do kojih negativnih posljedica dovode takvi stavovi te koji su mogući načini njihovog prevazilaženja.

Uvod: Rak dojke najčešći je rak koji se dijagnosticira kod žena. Psihološke reakcije na spoznaju bolesti najčešće se izražavaju u obliku depresije i anksioznosti. Mnoge studije ukazuju na povezanost depresivnosti i kvalitete života u žena oboljelih od raka dojke. Cilj: Istražiti povezanost stupnja depresivnosti i kvalitete života u žena oboljelih od raka dojke. Ispitanici i metode: Rad je urađen primjenom anketnog istraživanja na uzorku od 50 ispitanika na Klinici za onkologiju Sveučilišne kliničke bolnice (SKB) Mostar. U istraživanju su korišteni sociodemografski upitnik namjenski sačinjen za ovo istraživanje, Beckova skala depresivnosti i WHOQOL-BREF upitnik kvalitete života. Rezultati: Pronađena je negativna povezanost između razine depresivnosti i kvalitete života u žena oboljelih od raka dojke, međutim povezanost nije statistički značajna. Ispitanice koje imaju djecu, viši ekonomski status, su samostalno pokretne i ne uzimaju lijekove iskazale su višu razinu kvalitete života. Nije pronađena statistički značajna razlika u razini ispitanika u odnosu na njihove sociodemografske podatke. Zaključak: Kvaliteta života je negativno povezana s depresivnošću u žena oboljelih od raka dojke, ali povezanost nije statistički značajna.

Breast cancer is the most common malignancy in women. Modern research attempts to investigate the relationship between psychoemotional parameters and the length of survival of breast cancer patients. Understanding the factors which affect a higher level of resilience can have important clinical implications and can represent a guiding principle for designing psychological interventions that would accelerate recovery and improve the quality of life of cancer patients. To explore the relationship between resilience and quality of life of women with breast cancer.The study was conducted at the Clinic of Oncology of the University Clinical Hospital Mostar, which included 60 subjects. Objective realization was achieved through using the socio-demographic questionnaire purposely made for this research, the quality of life questionnaire WHQOL-BREF and the psychological resilience questionnaire CD-RISC-25.Subjects treated with radiotherapy achieved statistically significantly higher scores on subscales of the quality of life: mental health, social relations, and the environment. No statistically significant correlations were found between the level of resilience and results in the domains of quality of life.There is not a statistically significant association between resilience levels and quality of life in patients with breast cancer.

Anxiety is a state of feeling helpless and insecure, a state of anticipation and concern that something bad will happen. Fear of pain and the unknown, as well as fear of screening results can increase anxiety. Severe anxiety during magnetic resonance imaging (MRI)can cause patient's movement, leading to poorer imaging and reduction in the quality of the diagnostic test. To determine the anxiety of patients before and after magnetic resonance imaging and to investigate the relationship between the tested anxiety and the socio-demographic characteristics of the patients.The study was conducted at the Department of Radiology of the University Clinical Hospital Mostar in the period from February 1A statistically significantly higher degree of anxiety was determined after MRI screening (p0.001). Male subjects achieved a statistically significantly higher degree of anxiety before (p=0.019) and after (p=0.034) MRI screening. There were no statistically significant correlations between the age of the subjects and the results achieved on the anxiety tests before and after the MRI screening.Subjects who were prescribed an MRI screening have a statistically significantly higher degree of anxiety after the screening. Male subjects had a statistically significantly higher degree of anxiety on MRI screening.

Background: Posttraumatic stress disorder (PTSD) is a disorder that occurs in some people who have experienced a severe traumatic event. Several genetic studies suggest that gene encoding proteins of catechol O-methyl-transferase (COMT) may be relevant for the pathogenesis of PTSD. Some researchers suggested that the elevation of interleukin-6 (IL6) correlates with major depression and PTSD. The aim of this study was to investigate whether the single nucleotide polymorphisms COMT rs4680 (Val158Met) and IL6 rs1800795 are associated with PTSD and contribute to the severity of PTSD symptoms. Subjects and methods: This study comprised 747 participants that experienced war between 1991 and 1999 in the South Eastern Europe conflicts. COMT rs4680 (Val158Met) and IL6 rs1800795 genotypes were determined in 719 participants (369 with and 350 without PTSD). The Mini International Neuropsychiatric Interview (M.I.N.I.), the Clinician Administrated PTSD Scale (CAPS) questionnaire and the Brief Symptom Inventory (BSI) were used for data collection. Results: Regarding the COMT gene polymorphism, the results of the regression analyses for BSI total score were significant in the lifetime PTSD group in the dominant (P=0.031) and the additive allelic model (P=0.047). Regarding the IL6 gene, a significant difference was found for the recessive model predicting CAPS total score in the lifetime PTSD group (P=0.048), and indicated an association between the C allele and higher CAPS scores. n the allelic, genotypic and rezessive model, the results for BSI total score were significant in the lifetime PTSD group (P=0.033, P=0.028 and P=0.009), suggesting a correlation of the C allele with higher BSI scores Conclusion: Although our nominally significant results did not withstand correction for multiple tests they may support a relevance of the COMT (Val158Met) and IL6 rs1800795 polymorphism for aspects of PTSD in war traumatized individuals.

Objective: The aim of the study was to estimate the seroprevalence of HIV infection among TB patients, knowledge, self-perceived risks and testing practices related to HIV. Methods: We performed cross-sectional study from 10 May to 15 July 2011. Cluster sampling method was used to select 27 hospitals where 289 TB patients were consecutively recruited. Descriptive statistics and multivariable logistic regression methods were used to identify the factors associated with correct comprehensive knowledge of HIV/AIDS. Results: HIV prevalence among TB patients was 0.3%. Only 25.2% of the respondents presented comprehensive correct knowledge of HIV/AIDS. The percentage of correct answers to all questions related to knowledge about HIV/AIDS increases with educational status (χ2 = 5.42; p 0.05). The independent predictors of correct comprehensive knowledge were living without partner (OR = 4.45; CI = 1.59-12.95) and self-awareness of HIV risk (OR = 4.43; CI = 1.20-16.52). Conclusion: HIV prevalence among TB patients is higher than among general population in Serbia. The level of comprehensive correct knowledge of HIV/AIDS is low. There is a need for continuous implementation of public health strategy to successfully manage HIV and HIV/TB co-infection in Serbia.

Maloljetnička delinkvencija upućuje na postojanje nepovoljnih socijalnih okolnosti u kojima djeca odrastaju što traži vrlo kompleksnu intervenciju usmjerenu prema brojnim faktorima koji uzrokuju takvu pojavu. Zbog nedovoljne izgrađenosti i osjetljivosti u fazi odrastanja, razvoj mlade osobe može biti usmjeren u asocijalnom ili antisocijalnom pravcu, sve do kriminalnog oblika ponašanja. Maloljetni eksperimentator predstavlja osobu koja prije nego li počne uzimati sredstvo ovisnosti već dugo nije zadovoljna svojim životom. Uzroci mogu biti različiti: od osamljenosti, zatvorenosti u sebe, nepostignutih ciljeva, dosade, frustriranosti zbog razočarenja, neprihvaćenosti u društvu. Osim toga ljudi koji ulaze u svijet ovisnosti obično nemaju obitelj u pravom smislu riječi. Često nije lako prepoznati razliku između «normalnih», uobičajenih promjena u adolescenciji, kao što su promjene raspoloženja i prkošenje roditeljima i nastavnicima i znakova zlouporabe sredstava ovisnosti. Postoji niz znakova zlouporabe sredstava ovisnosti kod mladih, a najvažniji od njih je promjena, odnosno važno je obratiti pažnju na bilo kakve značajne promjene u fizičkom izgledu, ličnosti, stavovima ili ponašanju. Terapijske zajednice tijekom zadnjih desetljeća pokušavaju dati odgovor na pojave i problematiku vezanu uz zlouporabu sredstava ovisnosti. Kod svih korisnika terapijske zajednice prisutni su problemi u ponašanju različitih oblika i intenziteta te određeni stupanj odgojno-obrazovne zapuštenosti. Svrha terapijske zajednice je psihoterapijska i rehabilitacijska. Bez adekvatne psihoterapije i socioterapije maloljetni korisnici bi postali učestali korisnici zdravstvenih službi.

Systematic and continuous physical exercise of certain intensity and volume is irreplaceable in the stages of growth and development and in preventing impairments of the biological, functional and health state of the human organism.Many studies show that physical exercise contributes to development and reinforcement of mental health and increases self-esteem. Examine mental health and self-esteem of active athletes.The subjects of the study are active athletes from Herzegovina and students of the Faculty of Health Studies in Mostar. Mental health and self-esteem were measured by a sociodemographic questionnaire, The Symptom Checklist-90 and the Satisfaction With Life Scale.There is a statistically significant difference in the frequency of exercise, active athletes have the highest percentage (100%) and state that they exercise often (almost every day) while university students have a significantly lower percentage (20%).Students scored significantly higher on the subscales for somatization, obsessive - compulsive symptoms, interpersonal vulnerability, depression, anxiety, aggression, phobia, and paranoia than active athletes. Active athletes have statistically higher scores for almost all the claims of the subjective assessment of life satisfaction.Active athletes showed significantly less psychological symptoms and better mental health, greater life satisfaction and higher self-esteem than students of the Faculty of Health Studies in Mostar.

The different personalities of alcoholics are expressed in the way they manifest certain traits of their personality. In addition to knowing the general and common characteristics of alcoholics, it is even more important for clinical practice to know the differences between them, thus allowing a personalized approach to each patient, as a unique personality. The division of the personalities of alcoholics may be viewed through the prism of seven perspectives: the disease perspective, the dimensional perspective, the cognitive-anxiety perspective, the behavioral perspective, the spiritual/transcendent perspective, the narrative and the systemic perspective. Each of these perspectives more clearly represents part of the personality of the alcoholic; together they give a clearer picture of the problem and accordingly offer different treatment options.

Researches to date had indicated that socioeconomic status is a strong predictor of health behavior but also it has two-way effect with alcohol use disorder. This study examines social factors and their impact on alcohol use disorder and places individual alcohol use in the context of the status and conditions in which people live. To determine the distribution and characteristics of social factor in patients with alcohol use disorder (AUD) in the area of the Tuzla Canton (TC) in the period 01.01.2011 - 31.12.2015, in relation to: age, sex, marital status, level of education, municipality of residence, home ownership status, family structure, employment status, and monthly monetary income.Retrospective research was conducted using a systematic sample of 1863 patients with AUD, using documentation from the Psychiatry clinic of the University Clinical Centre (UCC) and the protocols of Health Centres.The sample was composed 1808 (97.05%) men and 55 (2.95%) women; the ratio of men to women was 33:1. the ages of the patients in the sample were 54.4±9.79 years - men 54.49±9.74 years; women 51.45±10.94 years. Most of the men in the sample were married (71.1%) and most of the women were widowed (54.5%). The largest number of patients had elementary school education (66.5%), were unemployed (56.8%), with a monthly monetary income less than 300 convertible marks (KM) (62.2%), owned their own home (78.2%), and 36.1% of them lived with a partner or their own children.There are significantly more men being treated for AUD; most of them are married, and most of the women are widowed. The largest number of patients treated for AUD have elementary school education, are unemployed, have monthly monetary income less than 300 km, own their own house, and a little more than one third of them lived with their partner or their own children.

The mental health of the human being and a higher level of the self-esteem have the positive effects on the peace surrounding, stability, success and the personal satisfaction of any individual. The fundamental opinion is that the dance has the affect on the body and the psychical health of the people. To explore if the dancers have their less-expressed psychical symptoms and higher self-esteem.The examination was performed on the sample of 310 examinees, mostly of the young life age and who identified themselves as the dancers or non-dancers. For the requirements of the investigation there were used the socio-demographic question-form, the psychical symptoms estimation scale (RCL-90-R) and the Rosenberg self-esteem scale (RSES).The dancers show the smaller appearance of the psychical symptoms and that almost in all sub-scales, but their difference is not statistically significant. The statistically significant difference among the men and the women was recorded in the subscales of the somatisations, then the interpersonal vulnerability, the depression, the anxiety and the phobias. The dancers possess their higher self-esteem then the non-dancers, but statistically their difference is not significant. Comparing the results against the sex, the persons of the female sex possess the higher self-respect than the persons of the male sex.The dancers possess less of the psychical symptoms and their higher self-esteem than the non-dancers, but the difference within the results is not significant statistically.

Stress at work is a specific type of stress arising from the work environment. Stress of the medical staff has been investigated in recent years by the medical institutions of different countries. The aim of this study was to examine the stress levels in medical staff of Department of Cardiac Surgery and Center of emergency medicine (CEM) in the Clinical settings, and to compare them.We conducted a cross-sectional study which included 55 patients between 21 and 50 years of age. The study group consisted of 30 employees from the Department of Cardiac Surgery of Mostar University Clinical Hospital, while the control group comprised 25 employees from the CEM. Research instruments were the Occupational Stress Questionnaire for Hospital Health Care Workers (OSQ-HHCW), General Health Questionnaire (GHQ 28) and a Stress MGMT-TEST A.The subjects from the control group had significantly higher stress experience in "bombing" with new information (p=0.028), unavailability of literature (p=0.039), poor communication with superiors (p0.001), conflicts with patients (p=0.042) and inappropriate public criticism (p=0.007). The highest stress level showed F1 group of stressors, concerning the organization of work and funding. CEM employees had statistically significantly higher level of stress on public criticism and lawsuits compared to the study group (p=0.013), as well as higher score on the anxiety/insomnia subscale (p0.001), social dysfunction scale (p=0.002) and on the depression subscale (p0.001).Stressors from the group of organizational factors have proven to be the most common stressors in both groups. However, in some areas within the impact of workplace stress, CEM employees had significantly greater vulnerability compared to employees of the Department of cardiac surgery. Further studies are needed to establish the frequency and intensity of stress among health professionals, and to clearly determine the risk factors for its development.

Objective: To investigate the association of high baseline serum levels of metalloproteinases-3 (MMP-3) with structural damage to hand and feet joints, assessed by ultrasonography (US), in patients with early, treatment-naïve rheumatoid arthritis (RA), without initial X-ray-visible erosions, during 24 months follow-up. Methods: Sixty-three early RA (European League Against Rheumatism/American College of Rheumatology 2010), disease-modifying anti-rheumatic drugs/glucocorticoid naïve patients (mean age 53.4 ± 14.1) with symptom duration ≤12 months, had baseline serum levels of MMP-3 tested. OMERACT US group definition was used to detect the presence, as well as longitudinal diameter of erosions by US at study entry and after 24 months, at the level of wrists, metacarpophalangeal (MCP2/MCP5) joints of both hands, and fifth metatarsophalangeal joints. Results: Complete data were collected from 52 out of 63 patients. High baseline serum levels of MMP-3 (MMP-3-positive) were found in 46/63 patients. 122 bone erosions in total (1.9 bone erosions/patients) were detected by US at baseline visit and 213 erosions (4.3/patients) after 24 months. MMP-3 positive patients had significantly higher total number of erosions than MMP-3-negative (p = 0.039) and higher increase in size of bone erosions in the feet but not in the hand joints after follow-up (OR 4.82 [1.23–18.9], p = 0.024; OR 1.17 [0.320–4.26], p = 0.816 respectively). Conclusion: After 2 years of follow-up, US assessment showed a higher number of new bone erosions in MMP-3-positive compared to MMP-3-negative patients with early RA and no visible initial radiographic changes. High baseline levels of MMP-3 predict significantly higher structural damage progression at the level of feet, but not at the level of hand joints.

Background: Epilepsy is a neurological disease that is often associated with psychiatric comorbidities. Subjects and methods: The aim of the study was to examine the frequency of psychic symptoms and their association with different types of epilepsy in the adolescent population. The study involved 100 adolescents with epilepsy and 100 healthy adolescents of both sexes at the age of 13–19. The examinees completed a standardized Symptom Checklist-90-R (SCL-90-R) questionnaire, concerning self- assessment of psychological disorders in the previous week. The value system of ​​nine dimensions and three global indexes of SCL-90-R scales were analyzed. Results: Our results suggest that adolescents with epilepsy have more than one psychic disorder compared to a healthy group of respondents. Somatic symptoms are more common in non-epileptic subjects, while obsessive- compulsive, depressive and phobic symptoms, as well as anxiety, aggressiveness, interpersonal vulnerability and paranoia, are more common in adolescents with epilepsy. Due to the type of epilepsy, obsessive compulsive symptoms are more common in adolescents with focal epilepsy, while the symptoms of phobia are more present in those withgeneralized epilepsy. The depth and intensity of psychological stress is higher in the group of adolescents with epilepsy compared to the healthy group of respondents. Conclusions: Psychiatric comorbidity is very common in epileptic patients and depending on the type of diagnosed epilepsy, various symptoms are expressed. Furthermore, psychological stress is more observable in adolescents with epilepsy. For patients with epilepsy, mental health care and seizure control is extremely important in the prevention of serious mental disabilities.

Uvod: Uporabom psihoaktivnih tvari mogu se izazvati oštećenja zdravlja ili na drugi način ugroziti ljudski integritet u fizičkom, psihičkom i socijalnom smislu. Sve je više dokaza za uporabu psihoaktivnih tvari među mladeži. Cilj: Ispitati pojavnost uporabe psihoaktivnih tvari studenata Fakulteta zdravstvenih studija Sveučilišta u Mostaru. Ispitanici i metode: Ispitivanje je obuhvatilo ispitnu skupinu (N=100) studenata Fakulteta zdravstvenih studija u Mostaru i kontrolnu skupinu (N=60) učenika Srednje elektrotehničke škole Ruđer Bošković u Mostaru. U istraživanju je korišten standardizirani upitnik Europsko istraživanje u školama o pušenju, pijenju i uzimanju „droga“ (ESPAD). Rezultati: Najveći postotak studenata Fakulteta zdravstvenih studija je probalo prvu cigaretu u dobi od 16 godina i više, u odnosu srednjoškolce među kojima većina nikad nisu probali cigaretu, a što je predstavljalo statistički značajnu razliku. Najveći postotak ispitanika u skupini FZS je počeo svakodnevno pušiti u dobi od 16 godina i više, značajno viši udio srednjoškolaca nikad nije probao cigaretu, a što je predstavljalo statistički značajnu razliku. U odnosu na studente učenici srednje škole su u statistički značajno većem postotku koristili ljepila i druga otapala. U uporabi ostalih psihoaktivnih tvari nije bilo značajni statističkih razlika među ispitanim skupinama. Zaključak: Studenti statistički značajno više puše cigarete od učenika, a učenici su statistički značajno više udisali ljepila i ostala otapala od studenata.

Koronavirusna bolest je vrlo teška zarazna bolest uzrokovana teškim akutnim respiratornim koronavirusom 2 koji se neumoljivo širi od čovjeka do čovjeka u cijelom svijetu. Svjetska zdravstvena organizacija je u ožujku 2020.g. dala procjenu da se COVID-19 može okarakterizirati kao pandemija. Pandemija koronavirusom za veliku većinu ljudi predstavlja stresnu situaciju razine velikog stresnog doživljaja u kojoj može biti ugroženo zdravlje čitave populacije. Pandemija COVID-19 može izazvati snažne stresogene reakcije za sve osobe, a neke osobe mogu razviti izraženije reakcije. Reakcija na stres mogu biti različite, a najčešči simptomi su: emocionalne, kognitivne i tjelesne prirode, poteškoće sa spavanjem, pogoršanje kroničnih duševnih i tjelesnih bolesti te povećana uporaba alkoholnih pića i drugih psihoaktivnih tvari. Da bismo se sačuvali od stresa vrlo je važno ispravno koristiti svoju pamet i nedopustiti da nas negativne emocije vode u preveliki strah i paniku. Važno je znati da su znaci stresa normalna reakcija u ovakvim situacijama i veća je vjerovatnoća da će biti izraženiji u osoba koje prekomjerno slušaju, gledaju i čitaju nove vijesti o ovoj bolesti, poglavito ako su izvori nesigurni i neprovjereni i ako ne dolaze od ovlaštenih stručnih organizacija. Za vrijeme izolacije uvjetovane pandemijom Korona virusa vrlo je važno upražnjavati prikladnu tjelovježbu, pozitivno misliti, raditi vježbe dubokog disanja, meditaciju, molitvu i sl. Potrebno je zdravo se hraniti, jesti uravnotežene obroke, piti dovoljno vode, izbjegavati prekomjerno pijenje alkoholnih pića i drugih sredstva ovisnosti (duhan, kava…), osigurati dovoljno sna i odmora. Cilj ovog rada je pojasniti kako se sačuvati od stresa za vrijeme pndemije Korona virusom.

Background: Posttraumatic stress disorder (PTSD) is a complex stress related disorder, that follows a severe traumatic experience, characterized with an intense sense of terror, fear, and helplessness. The aim of this study is to identify associations of genetic variations within candidate genes DRD2 and DRD4 with various PTSD related phenotypes. PTSD lifetime and PTSD current subjects were analyzed separately, each of them were analyzed in a Case/Control design, as well as regarding BSI and CAPS within cases only. Subjects and methods: 719 (487 male, 232 female) participants who had experienced war-related trauma between 1991 and 1999 in Bosnia and Hercegovina, Kosovo and Croatia were included in the study. Sociodemographic questionnaire, Clinician Administered PTSD Scale (CAPS) and the Brief Symptom Inventory (BSI) were used to collect clinical data. Results: The DRD2 rs1800497 variant and a variable number tandem repeat (VNTR) located in exon three of DRD4 were investigated for association with PTSD. In case control analyses we did not identify any significant associations. Within the PTSD current patients, we identified an association of DRD2 rs1800497 with BSI in the genotypic and the recessive model with the T allele as the risk allele. Conclusion: Our findings suggest that rs1800497 of DRD2 gene is involved in pathogenesis of PTSD.

Background: Exposure to life-threatening events is common and everyone will most likely experience this type of trauma during their ifetime. Reactions to these events are highly heterogeneous and seems to be influenced by genes as well. Some individuals will develop posttraumatic stress disorder (PTSD), while others will not. In this study, our aim was to analyze the correlation between single nucleotide polymorphisms (SNPs) within the oxytocin receptor (OXTR) gene (rs53576 and rs2254298), the RAR-related orphan receptor A (RORA) gene (rs8042149) and the cannabinoid receptor 1 (CNR1) gene (rs1049353) and PTSD. All candidate genes have been previously associated with stress related disorders and the reaction to traumatic events. Subjects and methods: Participants (N=719) have been exposed to war-related trauma during the war in South-Eastern Europe (Bosnia and Herzegovina, Croatia and Kosovo). We correlated the presence and absence of current and lifetime PTSD as well as PTSD severity (Clinician Administered PTSD scale (CAPS)) and current psychopathology (Brief Symptom Inventory (BSI) score) with the mentioned SNPs. DNA was isolated from whole blood and genotyped for OXTR rs2254298 and rs53576 following previously published protocols, for RORA rs8042149 via PCR-RFLP and CNR1 rs1049353 via KASP. Results: Nominally significant results were found for OXTR rs53576 in connection with the CAPS and BSI scores within lifetime PTSD patients. The additive allelic model indicated that G allele carriers achieved lower CAPS (p=0.0090) and BSI (p=0.0408) scores than participants carrying one or two copies of the A allele. These results did not withstand correction for multiple tests. No significant results were observed for OXTR rs2254298, RORA rs8042149 and CNR1 rs1049353 although the results for RORA showed a slight tendency that rs8042149 may influence the level of BSI scores in current PTSD patients. Conclusions: This study points to a role of the OXTR gene in PTSD and the related psychopathology following war related trauma.