PSYCHIATRIA DANUBINA AND CHALLENGES OF THE COVID-19 PANDEMIC: THE ANSWER IS IN THE KNOWLEDGE, EMPATHY, COHERENCE AND GLOBAL ETHICS

The COVID-19 pandemic crisis is cruel but crucial lesson for the future of humankind. This crisis involves very complex events, complex in its origin, its spread, its effects and its consequences at multiple levels and fields with health. On the other side, the quality of our individual, collective and public mental health is very important for successful fighting against the COVID-19 pandemic and infodemic. For a better public and global mental health we need a common background, common values and virtues on which we agree and follow them. Knowledge, ethics, empathy, coherence, solidarity, cooperation and unity are the key factors to long-term survival and flourishing of humankind. COVID-19 pandemic and infodemic can be effectively overcome only in spirit of common ethic and mutual empathy, respect, trust and public/global cooperation sowing the seeds for humanistic self, compassionate society and empathic civilization, rather than blaming, scapegoating and xenophobia

IN SEARCH FOR BIOMARKERS, ENDOPHENOTYPES OR BIOSIGNATURES OF PTSD: WHAT HAVE WE LEARNED FROM THE SOUTH EAST EUROPEAN STUDY

Posttraumatic stress disorder (PTSD) is a complex mental disorder whose neurobiology, including epi/genetics, is still elusive. The South East European (SEE)-PTSD study has conducted an impressive amount of research on molecular mechanisms of PTSD. The results of the study make obvious the need of coordinated pluralism and transdisciplinary integrative approach in research on molecular mechanisms of PTSD and other stress-related disorders. The development of PTSD is influenced by a tangled and complicated interaction of inborn or acquired predisposition or vulnerability and environmental adversity which alters gene regulation producing effects on neurons and brain systems and inducing changes in cognition, emotion and behavior. There are still no identified objective biomarkers or tests which could confirm the trauma exposure or identify the real presence of PTSD. The puzzle how brain function enables the resilience to adversity and how brain dysfunctions lead to vulnerability to stress and development of PTSD and other stress-related disorders is still awaiting reliable explanation. Discovery of PTSD associated epi/genetic factors might provide reliable markers for pathogenesis, what could result in getting novel therapeutics and/or objective stratifying patients for research

PERSON-CENTRED PSYCHOPHARMACOTHERAPY: WHAT IS IT? Each patient is a unique, responsive and responsible subject

Modern psychopharmacotherapy is currently in contention both outside and within the field of psychiatry. Conventional psychopharmacology paradigms focusing just on a disease perspective, biological narrative and a “one fits all” treatment are often regarded as inadequate and disjunctive. A significant proportion of psychiatric patients achieve no improvement or only partial improvement in their symptoms, while many of them suffer adverse and even toxic effects of medications. Psychopharmacotherapy as a sole form of treatment may carry the wrong message that patients don’t have to change their life style and don’t have to learn any new skills, they just have to receive their medication on time because the only problem is in brain chemistry. Evidence-based psychopharmacotherapy and person-centered narrative psychopharmacotherapy are not competitors but a complementuary duality, as intimately connected as brain and soul. Narrative preserves individuality, distinctivenesss and therapeutic context, whereas quantitative methods and evidence-based guidelines offer a solid foundation for what is reliably and generally correct. The purpose of person-centered psychopharmacotherapy is to empower the patients to control their disease, to re-author their problematic life story, to obtain full personal recovery and to regain control over their life