Experiencing trauma during armed robbery: patient overview through drawing analysis

Crtež predstavlja isključivo ljudsku djelatnost, služi kao sredstvo komunikacije i dopunjuje govor i pismo. Razvoj likovnog oblikovanja kod svih se ljudi odvija na isti način i odgovara određenim stupnjevima razvoja čovjeka, a odstupanja od tih normi mogu biti dokaz psihičkih smetnji. Tijekom 2005. godine u Hrvatskoj se dogodilo 30 oružanih pljački pošte. Jedna od njih, koja je imala izrazito dramatičan završetak, zbila se 6. prosinca 2005. godine, u zagrebačkom naselju Botinec. Nakon izvršene pljačke, u energičnoj policijskoj potjeri ubijena su oba pljačkaša. Rad prikazuje rezultate liječenja i dijagnostičke obrade triju službenica dotične pošte kroz razdoblje od 6 mjeseci. Sve tri ispitanice liječene su ambulantno i u sklopu Dnevne bolnice. Tijekom spomenutog vremenskog razdoblja, u dva navrata bile su psihologijski testirane (na početku liječenja, te nakon 6 mjeseci) putem EPQ; LASC-01; STA1 X-1, STA1 X-2, PIE te crtež po WARTEGG-u, te CAPS DX testova. Pristup u praćenju terapijskog pomaka, sastojao se u individualnom crtežu u kojem su pacijentice u tri navrata prikazale svoj doživljaj pljačke (na početku, nakon tri mjeseca i nakon šest mjeseci). Iako su se sve tri pacijentice nalazile u isto vrijeme na mjestu pljačke, dobiveni rezultati ukazuju na bitne razlike u emotivnom proživljavanju istog doživljaja. Usporedbom rezultata i crteža vidljivo je da kod sve tri pacijentice postoje međusobne razlike. Nažalost, evaluacija pomoću crteža je vrlo kompleksan dijagnostički instrument, pa ovaj prikaz treba promatrati kao početak za neka druga i opsežnija istraživanja uloge crteža kao pomoćnog sredstva u terapijskom pomaku.The drawing exclusively represents human activity, serves as a means of communication and supplements speaking and writing. The development of artistic form in all people took place in the same manner corresponding to determined degrees of human development, and deviation from those standards may be evidence of psychic disorders. During the year 2005, there were 30 armed post office robberies in Croatia. One of them had a particularly dramatic ending. It happened on December 6, 2005, in the Zagreb suburb of Botinec. After the robbery, both robbers were killed in a vigorous police pursuit. This work shows the results of treatment and diagnostic evaluation of three female clerks of the mentioned post office in a period of 6 months. All three examinees were treated as outpatients within the daily hospital. During the aforementioned period, they were tested psychologically (at the beginning of the treatment and after 6 months) with EPQ; LASC-01; STA1 X-1, STA1 X-2, PIE and drawings according to WARTEGG, and CAPS DX tests. Access to therapy progress follow up consisted of individual drawings where patients showed their experience of the robbery on three occasions (at the beginning, after three months and after six months). Regardless of the fact that all three patients had been in the same place at the time of the robbery, the acquired results indicated essential differences in the emotional experience of the same event. In comparing the results and drawings, it was evident that there were differences with all three patients. Unfortunately, evaluation assisted by drawings is a very complex diagnostic instrument and this should be observed as the beginning of some other more extensive research on the role of drawings as means of assistance in therapy progress

INFLUENCE OF BIOLOGICAL THERAPEUTICS ON PATIENT-REPORTED QUALITY-OF-LIFE OUTCOMES (WHOQOL-BREF), FUNCTIONAL SCORES AND DISEASE ACTIVITY AMONG CROATIAN PATIENTS WITH RHEUMATOID ARTHRITIS: OUR EXPERIENCE

Background: Rheumatoid arthritis (RA) is a chronic and disabling disease with a great impact on the quality of life (QOL). The aim of this study was to assess QOL and health in RA patients treated with biological disease-modifying drugs (bDMARDs) as opposed to those treated with conventional synthetic DMARDs (csDMARDs). We analysed four domains of QOL: physical health (D1), mental health (D2), social relationships (D3) and one\u27s surroundings (D4); as well as general quality of life (W1), general state of health (W2), and disease activity and physical disability. Subjects and methods: Seventy-seven RA patients (group A=29 on bDMARDs, group B= 48 on csDMARDs) were enrolled in the study. QOL was evaluated using WHO questionnaire (WHOQOL-BREF), disease activity using Disease ActivityScore28C-reactive protein (DAS28CRP) and functional status using Health Assessment Questionnaire (HAQ). Results: There was no statistically significant difference of mean values in the four domains of QOL, nor in the general QOL, between groups A and B. There was also no statistically significant difference regarding RA activity (3.51 vrs 3.54, p=0.56). However, we have found that the variable of the general state of health domain was statistically significantly higher in group B (2.66 vrs 2.89, p=0.001), while HAQ was statistically significantly higher in group A (1.19 vrs 1.07, p=0.018), as well as the duration of RA (6.25vrs 3.75 years, p=0.0006). Statistically significant correlation was found between HAQ and W2, disease duration and D3 in group A and DAS28CRP and D1, D2, W2 and HAQ and D1 and D2 in group B. Conclusion: These findings suggest that the inclusion of bDMARDs in the treatment regimen was overdue, with RA already advancing with developed functional disability, which prevented the achievement of the primary goals of treatment: low disease activity or remission and the improvement of patient\u27s QOL