Synthesis of Di(s-triazinyl) Sulphides and Disulphides. The-Promoting Effect of Oxidants on the Cleavage of the Thioether Bond

Synthesis of a number of di(s-triazinyl) sulphides and disu1phides is described. The behaviour of these compounds on oxidative attack has been examined. It has been found that instead of the expected sulphoxide and/or sulphone formation upon oxidation, a simple scission of the thioether linkage takes place, yielding a hydroxytriazine and the corresponding disulphide

Synthesis of Di(s-triazinyl) Sulphides and Disulphides. The-Promoting Effect of Oxidants on the Cleavage of the Thioether Bond

Synthesis of a number of di(s-triazinyl) sulphides and disu1phides is described. The behaviour of these compounds on oxidative attack has been examined. It has been found that instead of the expected sulphoxide and/or sulphone formation upon oxidation, a simple scission of the thioether linkage takes place, yielding a hydroxytriazine and the corresponding disulphide

DIFFERENTIAL DIAGNOSIS OF PSYCHOTROPIC SIDE EFFECTS AND SYMPTOMS AND SIGNS OF PSYCHIATRIC DISORDERS

Diagnostic recognition and distinguishing of psychotropic side effects which are phenomenological Identical/similar to symptoms and/or signs of psychiatric disorders undergoing psychotropic treatment, is an integral element within the general diagnostic procedure. Unrecognising and undistinguishing of psychotropicinduced side effects from psychopathological phenomena and/or physical signs which are, according to relevant classification criteria, standard parts of psychiatric disorders, most frequently can cause increase the dose of the psychotropic medication, assigning of the unwarranted diagnoses, and/or addition of unnecessary medications. Some of the most frequent side effects that can be caused by the diagnostic difficulties and/or misjudgements of the phenomenological recognition and differentiating side effects from psychiatric symptoms and signs are: druginduced akathisia, intensive anticholinergic pharmacodynamic effects including delirium, neuroleptic induced Parkinsonism, paradoxically antidepressants-induced worsening or re-emerging depression, acute dystonia and tardive dyskinesia and others. In conclusion, differential diagnosis of these side effects requires careful evaluation based on clinical experience and knowledge

Comparative Study on Dermatoglyphics in Patients with PTSD

The factors situated at the bases of the genesis and development of PTSD are divided in: biological, psychological and social factors. Primary factor is a stressful event of extremely dangerous and threatening nature. The sort and the intensity of the stressful event too play an important role, followed by the personality structure, the relation with the environment and the genetic constitution. The study was thought to determine the quantitative dermatoglyphic properties of the digito-palmar complex in patients with PTSD aiming to establish whether there are biological, that is, genetic bases for PTSD, in what measure they determine the clinical manifestation of the disorder, and whether there is a dermatoglyphic marker, characteristic for people with PTSD. We analyzed the quantitative properties of the digito-palmer complex on a group of 100 male examinees over 18 years of age with PTSD, no psychiatric comorbidity, and who were two or more times cured at the Psychiatric Hospital »Sveti Ivan«, comparing them with the quantitative dermatoglyphic properties of a group of 100 phenotypically healthy male examinees over 18 years of age. Using the method of descriptive statistics, we found no statistically significant differences among the results of the examined groups. With the T-test we evaluated the heterogeneity of the groups, and the results showed the existence of statistically significant differences among the comparison group and the group of patients with PTSD on three variables. We calculated the Fluctuating Asymmetry (FA) measure, which illustrates the compatibility, that is, the symmetry of the observed property on the right and on the left side of the body, indicating a difference on one variable. The outcome did not confirm the existence of a connection between a particular dermatoglyphic result and the genesis of PTSD. This is, however, in line with the hypothesis that, in patients with PTSD and other psychiatric disorders, there is a multiple effect of several micro-abnormalities in different genes, along with the inevitable and essential influence of environmental and/or physical and/or psychosocial stressogenic factors

SUICIDALITY AND SIDE EFFECTS OF ANTIDEPRESSANTS AND ANTIPSYCHOTICS

Antidepressants and antipsychotics can cause side effects in various organs and organic systems, and some (and) in the central nervous system, which can also be clinically manifested by suicidal behavior as well. Tricyclic antidepressants particularly of imipramine and clomipramine can have pro-suicidal effect, which is believed to be the consequence of their own hypothetic asynchronous cognitive-psychomotor pharmacodynamic action. Antidepressants from the group of selective serotonin reuptake inhibitors can at the beginning of administration as monotherapy also have pro-suicidal effects in patients with hints of suicidality or suicidal behavior, by increasing the intensity of already present suicidal predictors, such as dysphoria, anxiety, impulsiveness, agitation etc. Antipsychotics can act stimulatingly upon predictors of suicidal behavior, that is, pro-suicidal in an indirect way through side effects they cause indirect pro-suicidal neurological and consecutive psychological impact, as it is called. It is particularly valid for classic antipsychotics causing primarily neurological, i.e. extrapyramidal side effects, along which consecutive psychological side effects can occur as well. However, new antipsychotics in comparison to classic ones, have less pronounced neurological, extrapyramidal symptoms and signs but more somatic-metabolic side effects, and thereby their action can be mostly manifested as indirect pro-suicidal neurological and somatic-metabolic as well as consecutive psychological activity

SUICIDALITY AND SIDE EFFECTS OF ANTIDEPRESSANTS AND ANTIPSYCHOTICS

Antidepressants and antipsychotics can cause side effects in various organs and organic systems, and some (and) in the central nervous system, which can also be clinically manifested by suicidal behavior as well. Tricyclic antidepressants particularly of imipramine and clomipramine can have pro-suicidal effect, which is believed to be the consequence of their own hypothetic asynchronous cognitive-psychomotor pharmacodynamic action. Antidepressants from the group of selective serotonin reuptake inhibitors can at the beginning of administration as monotherapy also have pro-suicidal effects in patients with hints of suicidality or suicidal behavior, by increasing the intensity of already present suicidal predictors, such as dysphoria, anxiety, impulsiveness, agitation etc. Antipsychotics can act stimulatingly upon predictors of suicidal behavior, that is, pro-suicidal in an indirect way through side effects they cause indirect pro-suicidal neurological and consecutive psychological impact, as it is called. It is particularly valid for classic antipsychotics causing primarily neurological, i.e. extrapyramidal side effects, along which consecutive psychological side effects can occur as well. However, new antipsychotics in comparison to classic ones, have less pronounced neurological, extrapyramidal symptoms and signs but more somatic-metabolic side effects, and thereby their action can be mostly manifested as indirect pro-suicidal neurological and somatic-metabolic as well as consecutive psychological activity

DREAMS AND FANTASIES IN PSYCHODYNAMIC GROUP PSYCHOTHERAPY OF PSYCHOTIC PATIENTS

Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness

DREAMS AND FANTASIES IN PSYCHODYNAMIC GROUP PSYCHOTHERAPY OF PSYCHOTIC PATIENTS

Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness

The change in perception of illness monitored by group psychotherapy of family members of patients with psychotic disorder

Cilj: Opisati promjene odnosa prema bolesti kroz četverogodišnji rad grupne psihoterapije članova obitelji. U sklopu Programa rane intervencije kod prvih epizoda psihotičnih poremećaja (RIPEPP) roditelji bolesnika oboljelih od psihotičnih poremećaja uključeni su, uz psihoedukacijske radionice, i u psihodinamsku grupnu psihoterapiju. Metode: Praćenje protokola seansi koje se bilježe po sjećanju nakon održanih grupa. Rezultati: Tijekom četverogodišnjeg rada s članovima obitelji opazili smo da je postupno došlo do promjene stava prema bolesti. U početku grupnog rada uočeno je neprihvaćanje bolesti, negacija te pomak problema prema van (npr. uzimanje droga). U drugoj fazi prorađuju se osjećaji srama (bolest kao narcistička povreda) i krivnje (bolest kao kazna) te teškoće suočavanja s ozbiljnošću i dugotrajnošću bolesti. Prepoznata je i treća faza rada u kojoj članovi grupe (roditelji) fokus pomiču s djece i njihovih poteškoća na sebe (počinje prorada tugovanja). Zaključak: Grupna klima koja se tijekom četverogodišnjeg rada u grupi stvorila pridonijela je postupnom prihvaćanju bolesti te time i promjeni odnosa prema djeci. Bolja uspostava granica stvara uvjete za separaciju najprije od grupe, a kasnije i od oboljelog člana.Aim: This paper gives the description of changes in the perception of illness during the four-year involvement of the patients’ family members in group psychotherapy. Within the program of early intervention in the first episodes of psychotic disorder, parents of patients with psychotic disorder take part in psycho-educational workshops as well as in psychodynamic group psychotherapy. Methods: The method of work is based on the monitoring of session protocols noted from memory after the group therapies have been finished. Results: Unacceptance of illness, denials and outer transfer of the problem (such as drug abuse) were noticed in the beginning of the group work. In the second phase, the feelings of shame were dealt with (illness as a narcissistic injury) and guilt (illness as punishment) as well as difficulties in facing the severity and long duration of illness. The third phase was also recognized in which we noticed that the group members (parents) focused their attention from their children’s difficulties to themselves (the period of grieving process started). Conclusion: The group atmosphere which developed during the four- year period of work in the group contributed to the gradual acceptance of illness and so changed the relationship with children. Better setting of boundaries allowed separation, first from the group, and also from the inflicted family member later on

Serotonin and Cortisol as Suicidogenic Factors in Patients with PTSD

Post-traumatic Stress Disorder (PTSD) frequently occurs in commorbidity with different mental disorders, including suicidal behaviour. Group of biological factors, including serotonergic system, HPA axis and some genetic factors, are being studied as potential markers, able to differentiate suicidal and non-suicidal behaviour across the group of PTSD patients. This study is examining statistical relation between platelet serotonine concentration and serum cortisole concentration, within the group of PTSD patients with and without attempted suicide, treated at »Sveti Ivan« Psychiatric Hospital in Zagreb. The hypothesis of this study is that periferal biochemical markers are different accross the groups of PTSD patients with and without attempted suicide and the group of healthy controls. Our results have shown significantly lower platelet serotonine concentration in PTSD patients with and without suicide behaviour, compared to healthy controls. There are no statisticaly significant differences of the serum cortisole concentration accross observed groups. Our results correspond with those reported by other authors in this area of research, suggesting that platelet serotonine level might be used as potential periferal marker to detect risk of suicidal behaviour in PTSD patients