RELATIONSHIP BETWEEN EARLY PSYCHOTRAUMATISATION WITH THE ONSET AND THE COURSE OF PSYCHOTIC DISORDERS

Connections between specific types of altered brain functioning and some mental disorders are still not fully clarified. However, there is a large number of evidence that indicates mental disorders are results of complex interactions of biological and environmental factors. When it comes to environmental factors, the main focus in the scientific literature has been particularly focused on early psychotraumatisation. Early psychotraumatisation is a multi-layered construct that essentially involves sexual, emotional and psychical neglect in childhood and emotional and psychical negligence, with about one-fourth of children experience a traumatic event before the age of 18. Although most children are resilient after traumatic exposure, some develop significant and potentially long-lasting psychiatric disorders. In addition, the high prevalence of trauma and neglect has been found in all types of psychiatric disorders. While early psychotraumatisation in patients with psychotic disorders was recently diminished or denied altogether, there is now strong evidence that the prevalence of childhood adversities in this population is exceptionally high. Regarding this, there is an increasing number of sophisticated studies that point out the fact that early psychotraumatisation has an important impact on development and clinical course of psychosis in adults. It seems that this relation is causal, especially when considering severity, frequency, and number of traumatic events. In addition, psychotic patients who experience psychotraumatisation at an earlier age along with their first psychotic episode are known to be hospitalized more often with their psychotic episodes lasting longer; further, they commit suicide more often and have more dissociative symptoms. These patients’ is poorer such as their quality of life in comparison with patients without the experience of early psychotraumatisation. Moreover, this type of traumatic experience is very often an important determinant of henomenology of psychotic disorder

RELATIONSHIP BETWEEN EARLY PSYCHOTRAUMATISATION WITH THE ONSET AND THE COURSE OF PSYCHOTIC DISORDERS

Connections between specific types of altered brain functioning and some mental disorders are still not fully clarified. However, there is a large number of evidence that indicates mental disorders are results of complex interactions of biological and environmental factors. When it comes to environmental factors, the main focus in the scientific literature has been particularly focused on early psychotraumatisation. Early psychotraumatisation is a multi-layered construct that essentially involves sexual, emotional and psychical neglect in childhood and emotional and psychical negligence, with about one-fourth of children experience a traumatic event before the age of 18. Although most children are resilient after traumatic exposure, some develop significant and potentially long-lasting psychiatric disorders. In addition, the high prevalence of trauma and neglect has been found in all types of psychiatric disorders. While early psychotraumatisation in patients with psychotic disorders was recently diminished or denied altogether, there is now strong evidence that the prevalence of childhood adversities in this population is exceptionally high. Regarding this, there is an increasing number of sophisticated studies that point out the fact that early psychotraumatisation has an important impact on development and clinical course of psychosis in adults. It seems that this relation is causal, especially when considering severity, frequency, and number of traumatic events. In addition, psychotic patients who experience psychotraumatisation at an earlier age along with their first psychotic episode are known to be hospitalized more often with their psychotic episodes lasting longer; further, they commit suicide more often and have more dissociative symptoms. These patients’ is poorer such as their quality of life in comparison with patients without the experience of early psychotraumatisation. Moreover, this type of traumatic experience is very often an important determinant of henomenology of psychotic disorder

METHODS TO FIGHT MENTAL ILLNESS STIGMA

Mental illness stigma is still widely spread and present in all the cultures and nations. Even more, during the last half of century there hasn\u27t been much change in the perception of mentally ill persons as "incurable and dangerous individuals incapable of living on their own". The significance of mental illness stigma is determined by the size of its negative effect on mentally ill individuals, their family members, and the psychiatric service as well as on the society as a whole. In order to reduce the negative effects of stigma on the life of mentally ill individuals as well as to provide equal lifestyle in the community, at the beginning of the 1990s the World Health Organization recommended a global and decisive fight against the mental health stigma and discrimination. Since then three effective methods proliferated in fighting the mental illness stigma. These methods consist of combining education, contact with stigmatized group representatives and protest. To achieve better efficiency of anti-stigma program, the fight should be led by citizens of all age groups, especially younger people, the media, health care providers involved in treating the patients, but also the patients themselves as well as their family members

METHODS TO FIGHT MENTAL ILLNESS STIGMA

Mental illness stigma is still widely spread and present in all the cultures and nations. Even more, during the last half of century there hasn\u27t been much change in the perception of mentally ill persons as "incurable and dangerous individuals incapable of living on their own". The significance of mental illness stigma is determined by the size of its negative effect on mentally ill individuals, their family members, and the psychiatric service as well as on the society as a whole. In order to reduce the negative effects of stigma on the life of mentally ill individuals as well as to provide equal lifestyle in the community, at the beginning of the 1990s the World Health Organization recommended a global and decisive fight against the mental health stigma and discrimination. Since then three effective methods proliferated in fighting the mental illness stigma. These methods consist of combining education, contact with stigmatized group representatives and protest. To achieve better efficiency of anti-stigma program, the fight should be led by citizens of all age groups, especially younger people, the media, health care providers involved in treating the patients, but also the patients themselves as well as their family members

INAPPROPRIATE USE OF TOPICAL CORTICOSTEROIDES IN THE DERMATOLOGY OUTPATIENT

Introduction: Topical corticosteroids are group of drugs which have anti-immuno-suppressive, anti-proliferative and vasoconstrictive effects and are among the most commonly prescribed medication, important and efficacious for management of various dermatological disorders. Strict implementation of the existing regulations is the need of the hour to prevent their widespread abuse. Aim of the study was to investigate the usage of topical corticosteroids therapy with the recipe of a doctor and without it. Subjects and methods: The subjects were patients who visited Pharmacies in Mostar from April to July 2020 and were buying topical corticosteroids with or without a recipe or medical report from the doctor. 80 subjects completed a questionnaire themselves included: the way of buying a topical corticosteroids, the information about using topical corticosteroids earlier, the information about subject\u27s visits to the doctor; the length of time using topical corticosteroids, the type of topical corticosteroids used, the part of body the topical corticosteroids was applied on. Results: A total of 80 subjects were treated in the observed period, 58.8% were female. 72.5% subjects had already used local corticosteroids, 62.50% purchased the drug at the recommendation of the pharmacist, 66.30% had no recent diagnosis or no diagnosed disease at all, 21.25% used the drug for more than a month, the most often purchased one was moderate potent local corticosteroid Betamethasone diproprionate 0.05 %. Most commonly subjects applied local corticosteroids on arms (50%). Conclusion: Strict regulations regarding only prescription-based dispensing of local corticosteroids must be put into practice. This will hopefully bring down both the extremes of ever increasing cases of steroid-induced dermatoses in everyday dermatology practise on one hand and the irrational fears of using TCs in well justified indications on the other

INAPPROPRIATE USE OF TOPICAL CORTICOSTEROIDES IN THE DERMATOLOGY OUTPATIENT

Introduction: Topical corticosteroids are group of drugs which have anti-immuno-suppressive, anti-proliferative and vasoconstrictive effects and are among the most commonly prescribed medication, important and efficacious for management of various dermatological disorders. Strict implementation of the existing regulations is the need of the hour to prevent their widespread abuse. Aim of the study was to investigate the usage of topical corticosteroids therapy with the recipe of a doctor and without it. Subjects and methods: The subjects were patients who visited Pharmacies in Mostar from April to July 2020 and were buying topical corticosteroids with or without a recipe or medical report from the doctor. 80 subjects completed a questionnaire themselves included: the way of buying a topical corticosteroids, the information about using topical corticosteroids earlier, the information about subject\u27s visits to the doctor; the length of time using topical corticosteroids, the type of topical corticosteroids used, the part of body the topical corticosteroids was applied on. Results: A total of 80 subjects were treated in the observed period, 58.8% were female. 72.5% subjects had already used local corticosteroids, 62.50% purchased the drug at the recommendation of the pharmacist, 66.30% had no recent diagnosis or no diagnosed disease at all, 21.25% used the drug for more than a month, the most often purchased one was moderate potent local corticosteroid Betamethasone diproprionate 0.05 %. Most commonly subjects applied local corticosteroids on arms (50%). Conclusion: Strict regulations regarding only prescription-based dispensing of local corticosteroids must be put into practice. This will hopefully bring down both the extremes of ever increasing cases of steroid-induced dermatoses in everyday dermatology practise on one hand and the irrational fears of using TCs in well justified indications on the other

Metabolički čimbenici rizika, suočavanje sa stresom i psihološko zdravlje u bolesnika sa senilnom makularnom degeneracijom

The aim of this study was to determine the relationship between the risk factors (age, obesity, hypertension, hyperlipidemia, smoking, consumption of alchohol and drugs, positive family history, and exposure to sunlight), coping with stress, psychological well-being and age-related macular degeneration (ARMD). Forty patients with ARMD (case group) and 63 presbyopes (control group) participated in the study. Patient data were collected through general information questionnaire including patient habits, the COPE questionnaire that showed the way the patients handling stress, and the GHQ that analyzed the psychological aspects of their quality of life. These questionnaires were administered to the patients during ophthalmologic examination. The study involved 46 (44.66%) men and 57 (55.33%) women. Statistical analysis showed that the major risks for the development of ARMD were elevated cholesterol, triglycerides and LDL cholesterol in plasma. A significantly higher number of ARMD patients had a positive family history when compared with presbyopes. This study showed presbyopes to cope with emotional problems significantly better and to have a lower level of social dysfunction when compared with ARMD patients. However, it is necessary to conduct further studies in a large number of patients to determine more accurately the pathophysiological mechanisms of metabolic factors as well as the impact of the disease on the quality of life in patients with ARMD.Cilj ovoga istraživanja bio je utvrditi povezanost između rizičnih čimbenika (dob, pretilost, hipertenzija, hiperlipidemija, pušenje, konzumacija alkohola i lijekova, pozitivna obiteljska anamneza, izloženost sunčevom zračenju), suočavanja sa stresom, psihološkog aspekta kvalitete života i senilne makularne degeneracije (SMD). U istraživanje su bili uključeni bolesnici oboljeli od SMD (n=40) koji su činili ispitivanu skupinu i prezbiopi (n=63) koji su činili kontrolnu skupinu. Podatci su se prikupili ispunjavanjem upitnika kojim su se dobili opći podatci i opisale navike bolesnika, upitnika COPE kojim su se ispitali načini reagiranja na stres te upitnika GHQ kojim se analizirao psihološki aspekt kvalitete života. Navedeni upitnici bili su osobno uručeni ispitanicima prilikom oftalmološkog pregleda. U istraživanje je bilo uključeno 46 (44,66%) muškaraca i 57 (55,33%) žena. Statistička obradba pokazala je da najveći rizik za obolijevanje od SMD predstavljaju povišene razine kolesterola, triglicerida i LDL kolesterola u krvi. Značajno veći broj bolesnika u ispitivanoj skupini imao je pozitivnu obiteljsku anamnezu u odnosu na kontrolnu skupinu. Ovo istraživanje pokazalo je da prezbiopi značajno bolje reagiraju u osjećajima usmjerenom suočavanju te da imaju niži stupanj socijalne disfunkcije u odnosu na bolesnike oboljele od SMD. Međutim, potrebno je provesti daljnja istraživanja na velikom broju bolesnika kako bi se točnije utvrdili patofiziološki mehanizmi metaboličkih čimbenika, kao i utjecaj bolesti na kvalitetu života u bolesnika sa SMD