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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]

Introduction. Psychoactive drug addiction causes serious consequences in many countries, not only for the health of the nation, but also for the emergence of various social problems, such as high crime rates, delinquency and unemployment. Material and Methods. A retrospective-prospective study included data of 100 criminal offenders, drug addicts, gathered from forensic psychiatric records in the context of criminal offences committed by those persons. Results. Out of all the drug addicts who committed criminal offences, 98% were males and the average age was 30.44. Most of the offenders were unemployed and had a lower level of education. A total of 56% were previously convicted. The majority of them previously committed one felony. Compared to previous offences, new criminal offenses were against life and body in 70%. Comorbid mental disorders were diagnosed among 84% of examinees at the moment of committing a crime, and 60% had personality disorders. The largest number of subjects with alcohol addiction primarily make offenses against life and body, while those with substance addiction usually commit offenses against human health. Conclusion. In drug addicts who have committed criminal offences, it has been confirmed that gender, age, employment, history of committing criminal acts and comorbid mental disorders are criminogenic factors that are significant for the prediction of general criminality. The continuity in researching predictive factors, as well as crime prevention within the population with mental disorders is and needs to remain a priority. [ABSTRACT FROM AUTHOR]

Introduction. Binge eating disorder, as a fairly new disorder, has recently been added to the Diagnostic and Statistical Manual of Mental Disorders 5, and it is characterized by recurrent and frequent episodes of eating large quantities of food in a short time frame. The aim of this study was to associate binge eating disorder with obsessive-compulsive disorder and food addiction, which is crucial for understanding and appropriate treatment of patients. Material and Methods. We reviewed the literature from PubMED database from January 2000 to May 2021 using the keywords: binge eating disorder, binge eating disorder and obsessive-compulsive disorder, binge eating disorder and food addiction, and food addiction, in both English and German language. Results. Binge eating disorder, as part of the cycle of obsessive-compulsive disorder, may be considered obsessive thinking about weight, appearance or bad mood, where hunger and satiation is replaced by compulsion and loss of control, ritual eating, and secret eating. Furthermore, binge eating disorder may cause food addiction and this paper shows that addiction to high sugar and high fat products can lead to addiction behavior by habituation of certain points in the dorsal nucleus. This division is of major importance to establish proper treatment protocols. Conclusion. Binge eating disorder is closely related to obsessive-compulsive disorder and addiction to behavior and substances. Further research should focus on identifying the largest subtypes and classifications of binge eating disorder. [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]

Introduction. It is known that it is possible to improve healthcare by paying more attention to psychological aspects of diagnosis and treatment of physical and mental conditions. The study and practice of such factors is called psychological medicine. The aim of this paper was to provide contemporary aspects of psychological medicine and to emphasize its contributions to clinical practice. Material and Methods. A review of the literature on psychological and psychosomatic medicine was performed using Medline and manual search. Results. The main goals of psychological medicine are comprehensive assessment of psychological factors affecting the etiology, course and outcome of illness, biopsychosocial consideration of patient care, as well as integration of specific interventions in prevention, treatment and rehabilitation of patients. We need to emphasize that due to clinical limitations, in terms of current separation of mental and physical healthcare, the treatment of many health conditions in which psychological factors are significant, is still insufficient. Conclusion. Because of its importance to patients’ well-being, psychological and psychosomatic medicine should to be an integral part of clinicians’ knowledge across all specialties. [ABSTRACT FROM AUTHOR]

Pathological gambling is the most widespread and severe form of non-chemical addiction. It is challenging to categorize pathological gambling into just one category, ie. into a disorder characterized by impulsivity or into behavioral addiction, since there are obvious overlaps. With the above in mind, the changes within the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the eleventh revision of the International Classification of Diseases (ICD-11) are not surprising. Although not listed in the diagnostic criteria, impulsivity and neuropsychological deficits are an integral part of gambling disorder. For this reason, they are essential for a more complete understanding of the profile of pathological gamblers. The strongest arguments in favor of the reclassification of pathological gambling under the category of addiction are: similarities with the diagnostic characteristics of addiction to psychoactive substances (PAS); high degree of comorbidity between these two disorders; their common features including aspects related to the reward system; findings that the same brain structures are involved in both disorders. There are similarities in the way gambling disorders are reclassified within DSM-5 and ICD-11. As in DSM-5, pathological gambling is recognized as a form of addiction. In ICD-11, it was renamed gambling disorder and classified as behavioral addictions. The latest revisions of both classifications (DSM and ICD) have the same development path and essentially the same foundations, and a change in the perception of gambling within diagnostics is clearly visible. Pathological gambling is a very complex disease that is accompanied by neuropsychological deficits and impulsive behavior, both characteristic of addicts and people with impulse control disorders. Reclassification is significant for several reasons. First, there are similarities with the diagnostic characteristics of chemical addiction. Second, there is a high degree of comorbidity between impulse control disorders and addiction. Third, both involve the reward system and activate the same parts of the brain. It is assumed that these similarities led to the reclassification in both DSM-5 and ICD-11. It is still not entirely clear how this change in the perception of gambling within diagnostics will affect the actual treatment of pathological gambling. [ABSTRACT FROM AUTHOR]

Introduction. Atypical antipsychotics are the gold standard in the treatment of psychotic and other mental disorders due to their efficacy and tolerability. However, the relatively frequent occurrence of antipsychotic-induced metabolic syndrome has encouraged research into possible solutions to this problem, including the adjunctive use of metformin. The aim of this review article is to present a concise, comprehensive and critical overview of the aforementioned issue based on the analysis of available experimental research. Material and Methods. PubMed and Google Scholar databases were searched for relevant literature published in a fifteen-year period between 2008 and 2022. The following terms were used in the search: atypical antipsychotics, metformin, and weight gain. Only double-blind, placebo-controlled, randomized, and cohort studies were taken into consideration. Results. A total of 145 papers were analyzed, of which 10 papers with 852 subjects met the inclusion criteria. All the reviewed studies concluded that the adjunctive administration of metformin at a daily dose of 500 mg to 2,000 mg has significantly reduced atypical antipsychotic-induced weight gain, with a favorable effect on other metabolic parameters that were examined in the analyzed papers. Conclusion. Taking into account the increased cardiovascular morbidity and the consequent mortality among those who have been using atypical antipsychotics in the long term, it is necessary to assess the risks and benefits of introducing adjunctive metformin in every patient who is at risk of developing metabolic syndrome. In order to recommend the routine use of metformin in such indications, studies that would include a larger sample and a longer period of treatment are needed. [ABSTRACT FROM AUTHOR]