CORRELATION OF ALEXITHYMIA AND TEMPERAMENTAL TRAITS WITH SEROTONIN TRANSPORTER GENE POLYMORPHISM

U istraživanjima se 5-HTTLPR polimorfizam pokušavao povezati s osobinama ličnosti, s obzirom da je rano bilo uočeno da su lijekovi koji djeluju preko serotoninskog transportera efikasni u liječenju anksioznih i depresivnih poremećaja. Dosadašnja istraživanja bila su usmjerena na povezanost 5-HTTLPR polimorfizma i osobina ličnosti te na povezanost aleksitimije i osobina ličnosti, ali u populaciji Kokeza niti jedno istraživanje o povezanosti 5-HTTLPR polimorfizma i aleksitimije. Ciljevi ovog rada bili su ispitati ispitati frekvenciju pojedinih alela 5-HTTLPR, ispitati povezanost 5-HTTLPR polimorfizma i aleksitimije, povezanost 5-HTTLPR polimorfizma i dimenzija temperamenta i karaktera mjereno upitnikom TCI i povezanost 5-HTTLPR polimorfizma i osobina temperamenta mjereno upitnikom TEMPS-A-SV te ispitati povezanost aleksitimije i određenih osobina temperamenta i karaktera. Istraživanje je provedeno na 96 ispitanika, oba spola, dobnog raspona od 18-60 godina, tjelesno i psihički zdravih (medicinsko i nemedicinsko osoblje KBC Sestre milosrdnice i OB Zabok, studenti Sveučilišta u Zagrebu i djelatnici MUP-a). Primijenjeni su upitnici: TAS-26, TCI i TEMPS-A, SV. Genotipizacija serotoninskog transportera provedena je metodama PCR i RFLP. Sukladno ciljevima, utvrđene su sljedeće frekvencije alela: 65,1 % l alela i 34,9 % s alela. Uočena je pozitivna povezanost s alela i jače izraženog stupnja aleksitimije. Utvrđena je statistički značajna razlika između genotipa l/l i s/s u dimenziji izbjegavanja štete (HA) i između genotipova l/l i l/s u dimenziji samo-transcedencije (ST), a pozitivna povezanost nalazi se kod s alela i dimenzije samo-transcedencije (ST) i ciklotimnog temperamenta.Utvrđena je pozitivna povezanost aleksitimije i dimenzija izbjegavanja štete (HA) i samo-transcedencije (ST). Uočena je pozitivna povezanost samo za anksiozni temperament.Background of research: This research has an attempt to establish a correlation between 5-HTTLPR polymorphism and personality traits in view of the fact that earlier researches have already established that medication via serotonin transporters are efficient in the treatment of anxiety and depression disorders. Researches to date have been focused on the correlation between 5-HTTLPR polymorphism and personality traits, but no research has been conducted among Caucasian population concerning the correlation between 5-HTTLPR polymorphism and alexithymia. Aim of the study: The purpose and aims of this work was to conduct research into the frequency of individual 5-HTTLPR allele, the correlation between 5-HTTLPR polymorphism and alexithymia, the correlation between 5-HTTLPR polymorphism and the dimensions of temperament and character evaluated by TCI Questionnaire and correlation between 5-HTTLPR polymorphism and temperament traits evaluated by a TEMPS-A-SV Questionnaire, as well as to explore the correlation between alexithymia and certain temperament traits and specific character. Methodology: The sample included 96 examinees of both sexes, at the age of 18-60 years, physically and mentally healthy individuals (medical and non-medical staff at the Clinical Hospital Centre Sestre Milosrdnice, the General Hospital Zabok, students at the Zagreb University and the employees of the Police Force). Questionnaires which were applied were as follows: TAS-26, TCI and TEMPS-A, SV. Genotypisation of serotonin transporters was conducted through PCR and RFLP methods. Results: In view of the aims, the following allele frequencies were established : 65,1 % l allele and 34,9 % s allele. A positive correlation was found between s allele and a higher degree of alexithymia. A statistically significant difference between genotype l/l was established in the dimension of harm avoidance (HA), between genotype l/l and l/s in self-transcedence (ST), and a positive correlation between s allele and self-transcedence (ST) and cyclothymic temperament. In addition a positive correlation was found between alexithymia and harm avoidance and self-transcedence (ST). A positive correlation was only found for anxiety temperament

Validacija Torontske ljestvice aleksitimije (TAS-26) u hrvatskoj populaciji

The aim of this study was to validate the Croatian translation of the Toronto Alexithymia Scale (TAS-26). For this purpose, 194 volunteers from the general population, both genders, aged between 18 and 60, were tested on this scale after it had undergone a repeated backtranslation procedure by an independent bilingual translator. The mean total score on TAS-26 (mean ± SD) was 72.9±8.4. Cronbach’s α-coefficient for the entire scale was 0.71, indicating the scale to be sufficiently reliable. When analyzing the α-coefficient of reliability for the entire scale, it was found that upon removal of one of the factors, only 3 factors (‘I have physical sensations that even doctors don’t understand’; ‘When I’m upset, I don’t know if I’m sad, frightened, or angry’; and ‘I have feelings that I can’t quite identify’) would determine the α-coefficient of the entire scale amounting to less than 0.67, which would indicate insufficient reliability of the scale. The aforementioned factors belong to the group of F1 facet factors, the facet around which most items are grouped (n=12) and therefore the scale would be reliable enough even without the three factors. The results of factor analysis in our study confirmed the four-factor structure wherein most items are saturated by the first factor (n=12), and it denotes the alexithymia facet F1 (difficulty identifying feelings). Five items are saturated by the second factor and it denotes the alexithymia facet F2 (difficulty describing feelings), and the third factor which denotes facet F3 (reduced daydreaming) also saturated five items, whereas the fourth factor which denotes facet F4 (externally oriented thinking) saturated four items. The four listed facets explain 47.2% of variance wherein the highest percentage (20.1%) is attributed to facet F1, with facet F2 accounting for 12.1%, facet F3 for 7.5%, and facet F4 for 6.6% of variance.Cilj ove studije bio je validacija hrvatskoga prijevoda torontske ljestvice aleksitimije (Toronto Alexithymia Scale, TAS-26). U tu svrhu na uzorku od 194 ispitanika dobrovoljaca iz opće populacije oba spola, dobnog raspona od 18-60 godina, primijenjena je navedena ljestvica nakon što je prošla postupak povratnog prijevoda (back-translation) s nezavisnim dvojezičnim prevoditeljem. Srednja vrijednost (±SD) ukupnog zbira na TAS-26 bila je 72,9±8,4. Cronbachov α-koeficijent za cijelu ljestvicu iznosio je 0,71, prema kojem se ova ljestvica može smatrati dovoljno pouzdanom. Analizirajući α-koeficijent pouzdanosti čitave ljestvice ako se pojedina čestica ukloni zaključuje se da samo 3 čestice (Imam tjelesne osjećaje koje ni liječnici ne razumiju; Kada sam uzrujan(a), ne znam jesam li ljut(a), prestrašen(a) ili tužan/tužna; Imam osjećaje koje ne mogu u potpunosti odrediti) određuju α-koeficijent čitave ljestvice manji od 0,67 koji bi ukazivao na nedovoljnu pouzdanost ljestvice. Navedene čestice pripadaju skupini čestica facete F1 oko koje se grupira najviše čestica (n=12), stoga bi ljestvica i bez navedene tri bila dovoljno pouzdana. Rezultati faktorske analize u našem ispitivanju potvrđuju četvero-faktorsku strukturu, pri čemu je prvim faktorom zasićeno najviše čestica (n=12), a označava facetu aleksitimije F1 (poteškoće u identificiranju i opisivanju emocija). Drugim faktorom je zasićeno pet čestica i on označava facetu aleksitimije F2 (poteškoće u razlikovanju između emocija i tjelesnih senzacija uslijed emocionalnog pobuđenja), trećim faktorom koji označava facetu F3 (manjak fantazija) je zasićeno također pet čestica, a četvrtim koji označava facetu F4 (označava preokupaciju detaljima vanjskih zbivanja, uz značajno smanjen misaoni sadržaj vezan za osjećaje i fantazije) su zasićene 4 čestice. Četiri navedene facete objašnjavaju 47,2% varijance, pri čemu najviši postotak (20,1%) pripada faceti F1, faceti F2 12,1%, faceti F3 7,5% i faceti F4 6,6% varijance

HOW TO SQUARE A CIRCLE?

Psychodynamic group psychotherapy in Daily Hospital for non-psychotic disorders was held through Hangouts program during CoViD-19 pandemic lockdown. In our pilot study we compared patients\u27 impressions and their satisfaction with online program vs. usual, in-person setting program. We analyzed the impressions of group therapists as well. Our conclusion is that according to our patients\u27 impressions and satisfaction, online psychodynamic group psychotherapy is good enough option in extreme situations such as infectious disease pandemic, although it cannot completely replace all the aspects of usual "live" setting

The Insight of Patients and Their Parents Differ in the Early Phase of Psychosis

The aim of this cross-sectional study was to investigate whether the insight of patients and their parents differ in the early phase of psychosis. Target population were the patients hospitalized with the diagnosis of the psychotic spectrum (F20- F29; ICD- 10th; disease duration ≤ 5 years), both sexes, with average age M = 25.4 (SD = 3.56, C = 25, min = 18, max = 32) and their parents. Insight into illness in patients was assessed using the Scale to assess Unawareness of mental Disorder (SUMD) abbreviated version. Parents’ insight into illness was assessed with a modified version of the SUMD with question rephrased to probe parents’ understanding of patients’ illness. The expression, structure and severity of psychotic symptoms was assessed by The Positive and Negative Syndrome Scale of Schizophrenia (PANSS- Five factor models) and Clinical global impression scale (CGI- s). The results indicated a statistically significant (Z = 2.99; p < 0.01) higher mean value on General Awareness of patients (M = 6.1, SD = 3.26) compared to parents (M = 5.0, SD = 2.99. A significant difference was obtained by the sex of parents too (z = -2.07, p < 0.05): fathers had better insight (M = 2.0, SD = 1.15) than mothers (M = 1.5, SD = 0.89). The results call for necessity to develop innovative and comprehensive program for early family interventions

Temporomandibular Joint Disorder Therapy by Occlusal Splint: A Case Report

Temporomandibularni poremećaji obuhvaćaju sve funkcijske poremećaje čeljusnih (temporomandibularnih) zglobova i žvačnih mišića. U radu se opisuje jedan od najčešćih - pomak zglobne pločice u anteriorni položaj, tzv. dislokacija. Ona se povezuje s nekoliko čimbenika - najčešće je to makrotrauma, na primjer udarac u čeljust, ili mikrotrauma povezana s kroničnom mišićnom hiperaktivnošću ili okluzijskom nestabilnošću. Magnetskom rezonancijom, neinvazivnom metodom za analizu tkiva, koristili smo se kako bismo snimili temporomandibularni zglob te meka tkiva. Iako se u liječenju temporomandibularnih poremećaja preporučuju i ireverzibilna terapijska sredstva, najčešći stomatološki oblik liječenja reverzibilan je i neinvazivan, što znači da se izrađuje stabilizacijska okluzijska udlaga. U radu je predstavljen slučaj pacijentice s anteriornim pomakom zglobne pločice lijevog temporomandibularnog zgloba te liječenje stabilizacijskom udlagom kako bi se postigla funkcionalna učinkovitost njezina mastikatornog sustava.Temporomandibular disorder is the term that includes all functional disturbances of temporomandibular joint and masticatory muscles. This paper deals with one of the most common types of temporomandibular disorders that is articular disc displacement into an anterior position or so called articular disc dislocation. The most common risk factor related to this disorder is trauma. This can be a macrotrauma, such as an impact into the jaw, or microtrauma, which is related to chronic muscle hyperactivity or the occlusal instability. Magnetic resonance imaging is used for noninvasive evaluation of temporomandibular joints and soft tissues. Although irreversible therapeutic means are recommended for temporomandibular disorder treatment, the most common dental treatment is reversible and noninvasive which implies occlusal stabilization splint fabrication. This paper reports a case of a female patient with anterior articular disc displacement of her left temporomandibular joint and the treatment by a stabilization splint in order to obtain functional effi ciency of her masticatory system

ALCOHOL ABUSE IN THE DENTAL PATIENT AND TEMPOROMANDIBULAR DISORDER CAUSED BY TRAUMA

The aim of the paper was to describe the multidimensional character of alcoholism and its effects on oral health, with a review of the relation between the traumatogenic factor of temporomandibular disorders (TMDs) and bruxism development. The difference between moderate drinking and the development of alcohol addiction which leads to alcoholism-related medical, social, legal and economic issues is not always clear. Alcoholism is often hidden within the private and wider social framework of a patient. Oral diseases are easy to notice in recorded alcoholics as well as in, for example, smokers. TMDs consist of a disorder of masticatory muscles and/or a disorder of temporomandibular joint (TMJ). Since the traumatogenic factor of individuals under the influence of alcohol is clearly evident, it can potentially become an initializing factor of TMJ disorder\u27s clinical signs and symptoms development. A modern approach to the etiopathogenesis is to include the multifactorial model, that is, combinations of potential factors with various individual importances. In everyday dental practice, co-morbidities of oral diseases and alcoholism are expected more often, as well as oral diseases with their etiopathogenesis partially related to alcohol use

Initial treatment of temporomandibular joint osteoarthritis

Opisana je dijagnostika i inicijalna terapija pacijentice koja boluje od temporomandibularnog poremećaja. Klinički i pomoću magnetske rezonancije dijagnosticiran je osteoartritis te diskopatija oba čeljusna zgloba. Anksioznost je potvrđena psihološkim mjernim instrumentom State-Trait Anxiety Inventory. Inicijalnom terapijom pomoću okluzijske udlage uklonjeni su bolovi u čeljusnim zglobovima te stvoreni preduvjeti provedbe definitivne okluzijske terapije.The diagnostic procedure and the initial treatment of a female patient suffering from temporomandibular disorder is described. Osteoarthritis and the discopathy of the temporomandibular joint were diagnosed both clinically and by magnetic resonance imaging. Anxiety was confirmed by measuring instrument State-Trait Anxiety Inventory. Pains in temporomandibular joints were removed after the initial treatment in which the occlusion splint had been used so that conditions for carrying out the definite occlusal treatment were fulfilled

Orofacijalna bol: dijagnostički i terapijski izazovi

The concept of diagnostics and therapy of musculoskeletal and neuropathic diseases of the stomatognathic system, which are the subject of this paper, has been developing for decades. It can be said that in order to avoid misunderstanding, the orofacial pain as a clinical problem, in the narrower sense, involves non-odontogenic and non-malignant causes of orofacial region. In this study, the results of clinical diagnosis of the population of 557 consecutive patients with orofacial pain based on multidisciplinary diagnostics were evaluated. 15.6% of patients have given up on the participation in the study. It has been shown that the patients who dropped out of the study were significantly older (p=0.0411) than those who agreed to participate, but there was no difference in gender ratio (p=0.185) since the proportion of female patients prevailed. In an analysis of 84.4% of patients participating in the study, the elevated anxiety values were established (mean value on STAI 1 was 39.2 and STAI 2 was 41.1) and statistical significance was found in correlation between elevated anxiety and intensity of pain as shown on visual analogue scale on open mouth (p<0.0001). Compared to the age, the statistical significance was for STAI 1 (p=0.0097) but not for STAI 2 (p=0.5599). The most common form of therapy is Michigan stabilization splint: for disc displacement of temporomandibular joint (TMJ) in 38.9% of patients and in combination with physiotherapy in 18.7% of patients; for osteoarthritis of TMJ in 28.4% and in combination with physiotherapy in 26.4% of patients. The treatment with anticonvulsant drugs for trigeminal neuralgia predominates in 54.3% of patients, which is combined with acupuncture in 25.7% of patients and only acupuncture in 17.1% of patients. In this study, a multidisciplinary co-operation in initial diagnostics and differential was designed to develop subspecialist knowledge on orofacial pain.Već desetljećima se razvija koncepcija dijagnostike i terapije muskuloskeletalnih i neuropatskih bolesti stomatognatskog sustava, što je predmet ovog članka. Kako bi se izbjegle nedoumice može se reći da orofacijalni bolovi kao klinički problem obuhvaćaju u užem smislu ne-odontogene i ne-maligne uzroke bolova orofacijalne regije. U ovom članku evaluirani su rezultati kliničke dijagnostike populacije od 557 konsekutivnih pacijenata s orofacijalnim bolovima temeljem multidisciplinarne dijagnostike. Od sudjelovanja u studiji odustalo je 15,6% pacijenata. Za pacijente koji su odustali od istraživanja pokazalo se da su bili značajnije stariji (p=0,0411) od onih koji su pristali sudjelovati, ali nije bilo razlike u omjeru spola (p=0,185), jer je prevladavao udio ženskih pacijenata. U analizi 84,4% pacijenata koji su sudjelovali u studiji utvrđene su povišene vrijednosti anksioznosti (prosjek STAI 1 je bio 39,2, a na STAI 2 je bio 41,1), te se je pokazala statistička značajnost u ovisnosti povišene anksioznosti s intenzitetom bolova na vizualno-analognoj skali pri otvorenim ustima (p<0,0001). U odnosu na dob statistička značajnost bilo je za STAI 1 (p=0,0097) ali ne i za STAI 2 (p=0,5599). Najčešći oblik terapije je michiganska stabilizacijska udlaga: za pomak diska temporomandibularnog zgloba (TMZ) kod 38,9% i u kombinaciji s fizioterapijom kod 18,7% pacijenata; za osteoartritis TMZ-a kod 28,4% i u kombinaciji sa fizioterapijom kod 26,4% pacijenata. Za trigeminalnu neuralgiju prevladava kod 54,3% liječenje sa antikonvulzivima, u kombinaciji s akupunkturom 25,7% te samo akupunktura kod 17,1% pacijenata. Multidisciplinarna suradnja u inicijalnoj dijagnostici i diferencijalnoj dijagnostici u ovoj studiji osmišljena je u svrhu razvijanja subspecijalističkog znanja o orofacijalnim bolovima