Search

Introduction. Traumatic brain injury and reactive psychiatric disorders are universal health problems, both individually and in comorbidity. Traffic accidents are the most common cause of traumatic head injury, followed by falls, violence, and sports injuries. Due to the fact that they are associated with rapid, stressful events, they clearly trigger or generate reactive psychiatric disorders. What makes them special in this area is their organic substrate. Almost all patients with severe head injuries, more than half with moderate, and one tenth with mild head injuries suffer neuropsychiatric sequelae. Discussion and Conclusion. Among the published papers on this topic, prospective epidemiological analytical studies are dominant. Most articles deal with injured soldiers, injured children or adolescents. Recent papers emphasize the need for a timely, multidisciplinary care for the affected people and the primary community. It is very important to initiate early rehabilitation and psychotherapy. Due to non-specific and limited pharmacotherapeutic options, especially evident in organ damage and pediatric population, special attention is given to occupational, psychological rehabilitation, and cognitive-behavioral psychotherapy, as well as psycho-pharmacological drugs in case of clear clinical indications. As potentially the most important for further research, are the results on the genetic predisposition of individuals for clinical outcomes of associated conditions, structural and functional visualization of brain regions associated with specific psychological symptoms, and psycho-protective role of morphine and amnesia. Involvement of the wider community in a range of activities that contribute to poor outcomes is of utmost importance. [ABSTRACT FROM AUTHOR]

Introduction. Recent studies have shown a growing correlation between violence and mental illness, but there is a higher risk of violent crimes only in certain cases of mental disorders. This study presents sociodemographic and psychiatric characteristics of homicide offenders in Serbia, in the Province of Vojvodina in a 10-year period (1996-2005). Material and Methods. The obtained data are based on performed forensic and psychiatric expert investigations of 154 homicide offenders in preceding period, considering sociodemographic data, personal history and current psychiatric status. Data were analyzed using the statistical John's Macintosh programe. Results. The male offenders were in the great majority (92%) as well as a low level of education (87%). A positive history of criminal acts was found in 24% of the subjects. Minority of subjects (21%) consumed alcohol on a daily basis. At the time of committing the crimes, 57% of homicide offenders were under the influence of alcohol, and just 2% of other psychoactive substances. Among the offenders who had previously received psychiatric treatment (31.2%), the most frequent diagnosis was alcohol addiction (25%) and anxiety disorders (22.9%). During the psychiatric examination 70.8% of the subjects were diagnosed with mental disorder: personality disorders (41%), alcohol addiction (84%), neurotic disorders (65%), schizophrenic psychosis (5.2%), affective disorders (3.2%), paranoid psychosis (2.6%), organic disorders (19%), psychoactive drug addiction (13%) and mental retardation (0.6%). Emotionally unstable personality disorder was dominant among personality disorders (55.6%). Diminished mental competency was established in 77.9% of subjects at the time of the homicide, being rather sever in most of them. All those diagnosed to have a psychotic disorder were mentally incompetent. Conclusion. Emotionally unstable disorders were the most common among the offenders who underwent forensic evaluation. A relatively low presence of psychotic disorders imposes the need for de-stigmatization particularly of the patients suffering from major mental illnesses. [ABSTRACT FROM AUTHOR]

Poremećaj pažnje s hiperaktivnošću (attention deficit hyperactivity disorder, u daljem nastavku teksta - ADHD) je najrasprostranjeniji neurorazvojni poremećaj kod dece i adolescenata, s procenjenom globalnom učestalošću između 5% i 12%. Učestalost ADHD-a zajedno s tikovima je značajno veća nego što bi se očekivalo. Deca koja su dijagnostikovana s ADHD-om znatno češće imaju i hronične tikove (chronic tic disoreder, u daljem nastavku teksta - CTD) u poređenju s onima koji nemaju ADHD. Kada se ADHD javlja zajedno s poremećajem tikova, lečenje može biti izazovno. Kroz ovaj prikaz, nadamo se osvetljavanju jedinstvenih izazova i potencijalnih strategija lečenja ove komorbidnosti. Devetogodišnji dečak primljen na Kliniku za psihijatariju zbog hiperaktivnosti, slabe koncentracije i pažnje, kao i motornih tikova u vidu izraženog treptanja, plaženja i klimanja glavom. Primljen radi dopunskih dijagnostičkih procedura i eventualnog uvođenja diferentne psihofarmakoterapije. Psihološkim testiranjem dobijeno da je globalno intelektualno postignuće u kategoriji proseka, međutim registrovan nesklad između verbalnih i manipulativnih sposobnosti. Tokom hospitalizacije na osnovu opservacije i psihološkog celokupnog testiranja, kao i korišćenjem testova (SNAP – IV granične vrednosti) nije semoglo direktno ukazati na postojanje hiperkinetskog poremećaja, te preporučeno šestomesečno praćenje i nastavak logopedsko-defektološkog tretmana. U međuvremenu praćen od strane nadležnog psihijatra tokom kojeg se na osnovu psihodijagnostičkih procena zaključuje da postoji deficit pažnje sa hiperaktivnošću. Po isključenju kontraindikacija, uvedena psihostimulativna terapija metilfenidatom u dozi od 18mg. Doza titrirana nakon dva meseca do 36mg kada se postiže zadovoljavajući terapijski odgovor. Uvođenje metilfenidata nije imalo značajnijeg uticaja na tikove, ali nije dolazilo ni do pogoršanja te vrste tegoba. Poremećaj ponašanja i funkcionalni poremećaji povezani s ADHD-om imaju negativne uticaje na akademske, socijalne i porodične aspekte. Za razliku od osoba koje se samo suočavaju sa Turetovim sindromom (TS), oni koji imaju i TS i ADHD imaju izraženije teškoće u oblastima poput planiranja, radne memorije, inhibicione funkcije i vizualne pažnje. Kliničari koji leče pacijente sa tikovima i ADHD-om mogu razmotriti korišćenje metilfenidata za rešavanje simptoma ADHD-a. Međutim, važno je da kliničari razgovaraju o ovom pitanju sa starateljima prilikom propisivanja leka i pažljivo prate pacijente zbog opreza navedenog u informacijama o leku. [ABSTRACT FROM AUTHOR]

The present study tested the possibility of distinguishing between different types of antisocial adolescents based on psychopathic characteristics, and the differences between antisocial adolescents of different ages and subtypes in relation to the Cloninger's personality dimension. The sample included 101 antisocial male adolescents, divided into two age groups (71 respondents in the 13-17 age group and 30 in the 18-25 age group). After conducting model-based cluster analyses, nonpsychopathic type (without pronounced signs of psychopathy) and psychopathic type (with pronounced antisocial, lifestyle and interpersonal facet) (Hare's model) were singled out in the whole sample. Within the psychopathic type, in comparison with juveniles, older adolescents showed a significantly lower expression of character dimensions of Self-directedness and Cooperativeness, which are key in determining all personality disorders. Within the group of juvenile offenders, members of the two subtypes did not differ significantly in temperament and character, which indicates that juveniles are in the process of personality development, especially when it comes to their character, so they are more susceptible to treatment and their outcomes are uncertain. The results suggest that the inflation of psychopathic scores may occur in juveniles due to the identification of developmental features of adolescence (impulsivity, immaturity) as psychopathic, which implies the need to apply basic personality models in the assessment of antisocial adolescent. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine the frequency of various forms of maltreatment in adolescents without parental care, their mental health problems and treatment needs. Sixty examinees of both genders, aged 12-18, were divided in two groups: abused group (adolescent without parental care in an institutional setting) and control group (general population). The presence/absence of registered abuse/neglect by official social services were the criterion for classifying respondents into groups. The general questionnaire, Childhood Trauma Questionnaire and Youth Self Report were used. 46.67% of adolescents were neglected, 40% of them suffered several types of abuse, 10% were physically abused, 3.33% were emotionally abused, and no adolescent was sexually abused. 16.6% of cases of sexual abuse in the abused group as well as milder forms of maltreatment in the control group were registered by self-reported retrospective measures, which are not part of official registers. Delinquency, aggressive behavior and somatic complaints are significantly more prominent in the abused group compared to the control group. 86% of adolescents used some form of support and counseling from professionals, 56.6% were included in psychiatric treatment, and only 36.6% in psychotherapy. Mental health problems in abused adolescents without parental care indicates the specific needs for psychotherapy and psychiatric treatment. [ABSTRACT FROM AUTHOR]

Introduction. The association between substance use and aggression derives from the fact that among violent crime offenders there is a large number of people with alcohol and drug abuse. The objective of the study was to determine the incidence of psychoactive substance addicts in the population of violent crime offenders, as well as to consider possible measures to reduce the crime rates in this population. Material and Methods. Forensic psychiatric reports were used to assess 94 violent offenders from 2001 to 2018. The expert reports were obtained from the Psychiatry Clinic in Novi Sad, Serbia, including court case files, medical records, and psychiatric and psychological records of all offenders. Results. We have found that of the total of 94 violent crime offenders, as many as 25% suffered from some form of mental disorder. More than half of those with mental disorders from this group suffered from disorders induced by psychoactive substances, which means that as many as 15% of all offenders had some form of addiction. On the other hand, as much as 50% of all the offenders were under the influence of psychoactive substances at the time of the offense, predominantly by alcohol. Conclusion. Further research is needed in order to develop specific programs for the prevention of violence in the population using psychoactive substances. [ABSTRACT FROM AUTHOR]