Search

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. © 2021 Medicinska Naklada Zagreb. All rights reserved.

The presence of psychotic symptoms in post-traumatic stress disorder (PTSD) has already been recognized. Using the Structured Clinical Interview Diagnostic and Statistical Manual, we searched for and assessed psychotic symptoms in 91 males suffering from combat-related PTSD. Hallucinations and delusions were present in 20% of patients. We divided all patients into three groups: the group with hallucinations and delusions, the group without these symptoms, and the group with “subthreshold” psychotic symptoms. Using the Harvard Trauma Questionnaire, Clinician-Administered PTSD Scale, and Structured Clinical Interview Diagnostic and Statistical Manual, we investigated differences between groups in the intensity of traumatization, severity of PTSD symptoms, and the frequency of depression. There were no significant differences between groups; however, there was one exception: severity of hyperarousal symptoms was positively correlated with occurrence of psychotic symptoms.

Depressive disorders are among the five most frequent complaints seen in primary care settings and, in many cases, go unrecognised. The aim of this research was to examine the prevalence of depression in a Croatian primary care setting, and to investigate the proportion of depressive patients recognised and treated by either family physicians or psychiatrists respectively. Five hundred consecutive adult attenders at four general practices in Rijeka, Croatia were screened using the Beck Depression Inventory (BDI) and a proforma designed for this study. The results showed that 48.1% of investigated subjects had mild, moderate or severe depression on the BDI. Associations were found between depression and gender, age, marital status, parity and level of education. Detection of depression by primary care physicians was low: only 13.1% were recognised and treated within primary care or by psychiatrists. The Prevalence of depression among Croatian primary care attenders is high and recognition is low. This the first study of its kind from Croatia.

Akutna bolest jednog od članova obitelji predstavlja značajni stresni životni događaj ili situaciju unutar obitelji. Iznenadna bolest stvara previranja na koja obitelj često ne može adekvatno odgovoriti ili se nositi s promjenama u zahtjevima funkcioniranja. Bez obzira o kojoj akutnoj bolesti ili stradavanju se radi, primjerice srčanom udaru, moždanom udaru, prometnoj nesreći, iznenadnoj bolesti i sl., ono predstavlja akutni životni događaj vezan uz prekid uobičajenog tijeka života unutar svakodnevice obitelji (Holmes-Raheova ljestvica stresnih događaja stavlja povredu ili bolest na šesto mjesto bodovanja stresnosti). Stres zbog bolesti člana obitelji uvijek je nasljednik dotadašnjih iskustava obiteljskog života i njene povijesti funkcioniranja i pokretač je promjena, kako u strategijama suočavanja, tako i u značenju bolesti koje obitelj pridodaje stresnom zbivanju. Bolest mijenja aktualnu obiteljsku situaciju samom činjenicom da se jedan član obitelji razbolio. Ozbiljnija tjelesna bolest najčešće je komplicirana neugodnim emocijama svih članova obitelji – anksioznošću i depresijom, prilagodbenim teškoćama i nesnalaženjem u promjeni i preraspodjeli uloga koje se nameću i pojavljuju unutar obitelji nakon razbolijevanja jednog od članova. Radi se zapravo o seriji stresova koji mogu izazvati psihološke i fiziološke stresne odgovore unutar obitelji kao cjeline. Svaka obitelj reagira adaptirajući se koliko je god to moguće iz njenih resursa u teškoj situaciji. Strategije suočavanja mogu biti različite: od aktivnog suočavanja, distanciranja, traženja socijalne podrške i prihvaćanja odgovornosti do izbjegavanja i negiranja problema. Liječnici koji neposredno liječe bolesnika najvažniji su u pružanju informacija obitelji jer time znatno smanjuju stresnost akutnih zbivanja i omogućavaju prevladavanje nesigurne i uzdrmane obiteljske situacije., Acute illness of a family member represents an important stressful event for the whole family. Usually, the family confronted with a sudden illness, cannot adequatly cope with new demands for change in functioning. No matter which acute illness or injuries are involved – heart attack, stroke or traffic accident, sudden illness is an acute life event associated with the termination of the usual course of everyday life within the family (Holmes – Rahe Scale of stressfull events puts the injury or disease to sixth place scoring stressfulness). Stress due to illness of a family member always is the succesor of the previous family life experiences and its history of driving changes, as well as the meaning of illness which family adds to new stressors. The fact that one family member became ill, changes the whole current family situation. Serious physical illness is often complicated by unpleasent emotion of all family members – anxiety, depression, adaptive difficulties and disorientation, as well as with a change in redistribution of roles that occurs within the family. It is actually a series of stresses that can cause psychological and physiological responses in most family members. Each family will react according to their specific resources. Coping mechanisms are various – from active coping, distancing, getting social support and taking responsability to avoidance or denial of the problem. Doctors who treat patients directly, are the most important in providing information to family members, reducing their anxieties and in such way helping them to overcome the unsafe and shaken family situation.