The evolution of the female sexual response concept: Treatment implications

Sexual dysfunctions have been the most prevalent group of sexual disorders and include a large number of populations of both sexes. The research of sexual behavior and treatment of women with sexual distress arises many questions related to differences in sexual response of men and women. The conceptualization of this response in modern sexology has changed over time. The objective of our paper was to present the changes and evolution of the female’s sexual response concept in a summarized and integrated way, to analyze the expanded and revised definitions of the female sexual response as well as implications and recommendations of new approaches to diagnostics and treatment according to the established changes. The lack of adequate empirical basis of the female sexual response model is a critical question in the literature dealing with this issue. Some articles report that linear models demonstrate more correctly and precisely the sexual response of women with normal sexual functions in relation to women with sexual dysfunction. Modification of this model later resulted in a circular model which more adequately presented the sexual response of women with sexual function disorder than of women with normal sexual function. The nonlinear model of female sexual response constructed by Basson incorporates the value of emotional intimacy, sexual stimulus and satisfaction with the relationship. Female functioning is significantly affected by multiple psychosocial factors such as satisfaction with the relationship, self-image, earlier negative sexual experience, etc. Newly revised, expanded definitions of female sexual dysfunction try to contribute to new knowledge about a highly contextual nature of woman’s sexuality so as to enhance clinical treatment of dysfunctions. The definitions emphasize the evaluation of the context of women’s problematic sexual experiences

PSYCHIATRY AND MOVIES

As one of the most potent and substantial form of mass communication, film exercises a very significant influence upon the perceptions of the audience, especially in relation to mental illness issues, and that perception is very much blurred with populists’ misinterpretation and lack of awareness regarding problems faced by persons suffering from mental disorders. Movies such as “Psycho”, “One Flew Over Cuckoo’s Nest”, “Exorcist”, despite being valuable in an artistic sense, corroborated and encouraged confusion and undermined the clarity and certainty concerning the fine line separating mental health from mental illness. Modern film makers and movie theoreticians try to overcome these limitations which are often generated by exploitation of stereotypes and myths referring to mentally ill people. This paper defines and discusses the most frequent thematic stereotypes seen in movies which are perpetuating stigmatization of mentally ill people. They are: freespirited rebel, maniac on a killing spree, seducer, enlightened member of society, narcissistic parasite, beastly person (stereotype of animal sort). Psychiatry and cinematography are linked inseparably not only because they creatively complement each other, but also as an opportunity of mutual influences blending into didactical categories and professional driving forces, benefiting both the filmmakers’ and the psychiatrists’ professions

LAMOTRIGINE VERSUS LITHIUM AUGMENTATION OF ANTIDEPRESSANT THERAPY IN TREATMENT-RESISTANT DEPRESSION: EFFICACY AND TOLERABILITY

Background: Mood stabilizer augmentation of standard antidepressant drugs has been shown to be effective in treatment-resistant depression. Despite the reported high overall efficacy, lithium has been relatively underused in recent years. Lamotrigine, a novel anticonvulsant recently recognized as a mood stabilizer, seems to have putative antidepressive properties. The aim of the study was to investigate lamotrigine efficacy and tolerability as antidepressant augmentation for unipolar treatment-resistant depression compared to lithium. Subjects and methods: 88 patients suffering from treatment-resistant Major depressive disorder, having acute recurrent depressive episodes according to DSMIV criteria, were enrolled in the study. This was an open-label trial with a flexible dosing regimen. All patients, received antidepressants in full therapeutic doses. They were divided into two augmentation groups: 46 patients received 50-200 mg/day lamotrigine, and 42 patients received 600-1200 mg/day lithium. The Hamilton Rating Scale for Depression (HAM-D) and The Clinical Global Impression scale (CGI) were used to monitor therapeutic efficacy. Patients were evaluated weekly for an 8 week treatment period. Results: The HAM-D total score was significantly reduced in both treatment groups at the study endpoint, without any difference between the groups. However, significant clinical improvement was reached within the second treatment week in the lamotrigine group compared to the lithium group (p=0.01 vs. lithium). Lamotrigine showed significant efficacy on the HAM-D item 1(depressed mood; p=0.01), item 7 (work and interest; p=0.01) and CGI-Improvement scale (p=0.02). The drop-out rate due to treatment failure was lower in the lamotrigine group (n=1) compared to the lithium (n=4) group. Also, the incidence of side effects did not differ between the groups. Conclusions: Our results suggest that lamotrigine could be useful as augmentation of antidepressants for treatment-resistant unipolar depression. Also, lamotrigine may accelerate the onset of antidepressant action, and therefore might be useful in treatment of major depression in general

The Life and Work of Ksenija Atanasijević (1894-1981) - Psychology and Anthropology as the Inevitability and Necessity of Philosophy

Ksenija Atanasijević (1894-1981) was the first woman in Serbia to obtain a Ph. D. in philosophy. Going through numerous psychological metamorphoses in her lifetime and confronted with numerous challenges, Ksenija Atanasijević developed a specific philosophical-psychological system of consolation prominently featuring the concepts of happiness, bliss, moderation, courage and wisdom. Modifying the original teachings of Democritus and Epicurus, Ksenija Atanasijević developed a distinctive anthropology based on confrontation with but equally the overcoming of obstacles, both internal (spiritual) as well as external ones. The philosopheress developed a reflexive and indeed metaphysical defensive psychotherapeutical skill at the root of which was cleansing the soul, as well as dedication to the realm of fancy, fantasy and imagination. Ksenija Atanasijević also had precious literary talent which was best expressed in her analyses of the poetry and prose of great Serbian writers (Pandurović, Njegoš, Nastasijević, etc.). It is quite certain that this, with Anica Savić-Rebac, definitely greatest Serbian philosopheress, through personal suffering, creative solitude and shrouded desperation built an utterly authentic and harmonious system of philosophical comfort

The Life and Work of Ksenija Atanasijević (1894-1981) - Psychology and Anthropology as the Inevitability and Necessity of Philosophy

Ksenija Atanasijević (1894-1981) was the first woman in Serbia to obtain a Ph. D. in philosophy. Going through numerous psychological metamorphoses in her lifetime and confronted with numerous challenges, Ksenija Atanasijević developed a specific philosophical-psychological system of consolation prominently featuring the concepts of happiness, bliss, moderation, courage and wisdom. Modifying the original teachings of Democritus and Epicurus, Ksenija Atanasijević developed a distinctive anthropology based on confrontation with but equally the overcoming of obstacles, both internal (spiritual) as well as external ones. The philosopheress developed a reflexive and indeed metaphysical defensive psychotherapeutical skill at the root of which was cleansing the soul, as well as dedication to the realm of fancy, fantasy and imagination. Ksenija Atanasijević also had precious literary talent which was best expressed in her analyses of the poetry and prose of great Serbian writers (Pandurović, Njegoš, Nastasijević, etc.). It is quite certain that this, with Anica Savić-Rebac, definitely greatest Serbian philosopheress, through personal suffering, creative solitude and shrouded desperation built an utterly authentic and harmonious system of philosophical comfort

Kliničko terapijske specifičnosti shizofrenije s prodromima i ranim početkom - model rizičnog mentalnog stanja i shizofrene vulnerabilnosti

Shizofreniji, kao i drugim psihotičnim oboljenjima, često prethode prodromalne izmjene u ponašanju, koje mogu trajati od nekoliko dana do nekoliko godina, nagovještavajući početak psihoze. Ako bolest počne u ranijem uzrastu, posebno u adolescenciji, prodromalna faza je nespecifična i teža za prepoznavanje i intervencije. Postoji veći broj operacionalnih instrumenata kojima se klinički procjenjuju i kvantificiraju prodromalni simptomi i “rizično mentalno stanje“, kao i prediktivni potencijal za psihozu. U radu je opisana prodromalna faza u razvoju shizofrene psihoze s ranim početkom, s naglaskom na postupnom, višemjesečnom obogaćivanju psihopatologije i evolucijom nespecifičnih i atenuiranih (subklinički) prodromalnih simptoma u floridne shizofrene simptome. Također se ukazuje na optimalne mogućnosti terapijskog tretmana psihoze s ranim početkom u svrhu prevencije težih simptoma i razvijene kliničke slike shizofrenije

Predicting violence in veterans with posttraumatic stress disorder

Background/Aim. Frequent expression of negative affects, hostility and violent behavior in individuals suffering from posttraumatic stress disorder (PTSD) were recognized long ago, and have been retrospectively well documented in war veterans with PTSD who were shown to have an elevated risk for violent behavior when compared to both veterans without PTSD and other psychiatric patients. The aim of this study was to evaluate the accuracy of clinical prediction of violence in combat veterans suffering from PTSD. Methods. The subjects of this study, 104 male combat veterans with PTSD were assessed with the Historical, Clinical and Risk Management 20 (HCR-20), a 20-item clinicianrated instrument for assessing the risks for violence, and their acts of violence during one-year follow-up period were registered based on bimonthly check-up interviews. Results. Our findings showed that the HCR-20, as an actuarial measure, had good internal consistency reliability (α = 0.82), excellent interrater reliability (Interaclass Correlation ICC = 0.85), as well as excellent predictive validity for acts of any violence, non-physical violence or physical violence in the follow-up period (AUC = 0.82-0.86). The HCR-20 also had good interrater reliability (Cohen's kappa = 0.74), and acceptable predictive accuracy for each outcome criterion (AUC = 0.73-0.79). Conclusion. The results of this research confirm that the HCR-20 may also be applied in prediction of violent behavior in the population of patients suffering from PTSD with reliability and validity comparable with the results of previous studies where this instrument was administered to other populations of psychiatric patients

The annulling of the sudden appearance of an unbalance in rotary machines by using active magnetic bearings

The application of magnetic bearings has become more frequent during the last 20 years and represents a significant aspect of improvements in the construction of machines with rotary motion. With the advancement of technology, the number of applications in which magnetic bearings have found their application is increasing. In this paper, it is shown how the effect of magnetic forces can annul the negative influence of unbalance, which suddenly appeared in a rotor supported in active magnetic bearings. Such cases may occur in operation due to breakage and rotor parts falling off (e.g., fan blades), which will lead to a sudden change in the mass balance of the rotor system and dislocation of the centre of mass in relation to the geometric centre of the rotor. In the paper, a mathematical model of the dynamic behaviour of a rigid rotor in active magnetic bearings was developed. The model is nonlinear and has five degrees of freedom and can only be solved numerically. The Newmark beta method and the Newton-Raphson method were used to solve the system of nonlinear differential equations. The results of the simulation showed the advantages of using active magnetic bearings for annulling sudden occurrences of unbalance in rotary machines

THE HISTORICAL DEVELOPMENT OF PSYCHIATRY IN SERBIA

The authors present the development of the concept of mental disease and treatment in Serbian medicine. Serbian medieval medicine did not acknowledge fortune telling, sorcery, the use of amulets and magical rituals and formulas. These progressive concepts were confirmed by the Church and the Serbian state in what is known as Dušan’s Code. The Historical data on the establishment of the first psychiatric hospital in the Balkans “Home for the Unsound of Mind” at Guberevac, Belgrade, in 1861 and its founders is reviewed. After World War I, in 1923, the Faculty of Medicine was established in Belgrade to which the coryphaei of Serbian medicine educated in Europe, mostly in France and Germany, flocked and that same year the Psychiatry Clinic of the Faculty of Medicine in Belgrade was set up. Its first seat was on the premises of the Mental Hospital in Belgrade, and it became a training base and laid the foundations of the future Neuropsychiatry Clinic in Belgrade, which in time evolved into the nursery of psychiatric professionals for all of Serbia. The most important data on the further development of psychiatry up to date are presented

Impact of downtime pattern on mining machinery efficiency

In this paper, problem of mining machinery efficiency is considered through impact of different types of downtimes. New methodology is suggested based on comparison impact of mechanical and technological mining machinery time in fault (M-t, T-t) and mechanical and technological mining machinery downtime frequencies (M-f, T-f) on machine work done (W). Benchmarking analysis is conducted by pairing variables M-t-W, T-t-W, M-f-W and T-f-W, and determining relationships between observed variables. By comparing the increment of the cumulative downtime curve with the cumulative curve of the machine's operating volume, it can be assessed whether the observed downtime develops a concave or convex character of the operating volume cumulative curve, in respect to significant losses. Results indicate that the relationship between cumulative downtime curve and cumulative work done curve can successfully serve as a parameter for evaluating the impact of specific downtime on the efficiency of the machine. A multi-criteria analysis, namely, an analysis of the criteria - frequency and time spent in downtime for each of the observed causes of downtime, clearly determines the critical pattern of downtime on the efficiency of the observed machine