THE STIGMA OF MENTAL ILLNESS AND RECOVERY

Stigma and recovery “from” and “in” mental illness are associated in many various ways. While recovery gives opportunities, makes person stronger, gives purpose and meaning to their lives and leads to social inclusion, in the same time stigma reduces opportunities, reduces self-esteem and self-efficacy, reduces the belief in own abilities and contributes to social exclusion through discrimination. The recovery of a person with mental illness means to get and keep hope, to understand their own possibilities and impossibilities, active living, to be autonomous, to have a social identity and to give meaning and purpose of our own lives. The care system, recovery-oriented, provides help and support to people with mental disorders in his/her recovery, which contributes to reduction of self-stigma, to the elimination of stigmatizing attitudes and beliefs in mental health services which consequently may have a positive reflection in reducing the stigma of mental illness in the community. It is important to look at the stigma and recovery from the perspective of individual experience of each person with a mental illness in the process of recovery. A support to the recovery concept and the development of a recovery-oriented system of care should be one of the key segments of any strategy to combat the stigma of mental illness. Also, the cultural and the social stigma aspects of stigma would be taken into account in the developing of the recovery concept and on the recovery-oriented care system

THE STIGMA OF MENTAL ILLNESS AND RECOVERY

Stigma and recovery “from” and “in” mental illness are associated in many various ways. While recovery gives opportunities, makes person stronger, gives purpose and meaning to their lives and leads to social inclusion, in the same time stigma reduces opportunities, reduces self-esteem and self-efficacy, reduces the belief in own abilities and contributes to social exclusion through discrimination. The recovery of a person with mental illness means to get and keep hope, to understand their own possibilities and impossibilities, active living, to be autonomous, to have a social identity and to give meaning and purpose of our own lives. The care system, recovery-oriented, provides help and support to people with mental disorders in his/her recovery, which contributes to reduction of self-stigma, to the elimination of stigmatizing attitudes and beliefs in mental health services which consequently may have a positive reflection in reducing the stigma of mental illness in the community. It is important to look at the stigma and recovery from the perspective of individual experience of each person with a mental illness in the process of recovery. A support to the recovery concept and the development of a recovery-oriented system of care should be one of the key segments of any strategy to combat the stigma of mental illness. Also, the cultural and the social stigma aspects of stigma would be taken into account in the developing of the recovery concept and on the recovery-oriented care system

ICD-11 CLASSIFICATION OF MENTAL DISORDERS – THE CHALLENGE OF INTEGRATING A PSYCHODYNAMIC APPROACH

Danas je razvijeno nekoliko dijagnostičko-klasifikacijskih sustava duševnih poremećaja, Međunarodna klasifikacija bolesti i srodnih stanja (MKB) Svjetske zdravstvene organizacije se smatra ključnom klasifikacijom zbog njene globalne primjenjivosti. U posljednjoj, jedanaestoj MKB reviziji (MKB-11) uvedene su značajne opće promjene i promjene vezano za dijagnozu i klasifikaciju duševnih poremećaja. One su sadržane u strukturi poglavlja koje se bavi duševnim poremećajima, uvođenju novih dijagnostičkih kategorija, djelomičnoj integraciji dimenzionalnog pristupa u dijagnostičke kategorije, te revidiranim kliničkim opisima i dijagnostičkim smjernicama. Cilj ovog rada je prikazati najistaknutije promjene uvedene u klasifikaciju duševnih poremećaja s posebnim osvrtom na poremećaje ličnosti i poremećaje koji su u MKB-10 svrstani u skupinu neurotskih, sa stresom povezanih i somatoformnih poremećaja kroz prizmu mogućnosti integracije psihodinamičkog pristupa.Multiple systems for the diagnosis and classification of mental disorders have been developed today and the International Statistical Classification of Diseases and Related Health Problems (ICD) is considered to be the key classification due to its global applicability. The latest, eleventh ICD revision (ICD-11) included significant general changes and changes relating to the diagnosis and classification of mental disorders. These are listed in the chapter describing mental disorders, the introduction of new diagnostic categories, partial integration of the dimensional approach into diagnostic categories, and the revised clinical descriptions and diagnostic guidelines. The aim of this paper is to address the most prominent changes introduced into the classification of mental disorders, with a specific review of personality disorders and disorders that were classified in the ICD-10 as neurotic, stress-related disorders and somatoform disorders, through the prism of a possible integration of the psychodynamic approach

Consequences of Domestic Violence on Women’s Mental Health in Bosnia and Herzegovina

Aim: To assess psychological consequences of domestic violence, and determine the frequency and forms of domestic violence against women in Bosnia and Herzegovina. Methods: The study was carried out in the Tuzla Canton region in the period from 2000 to 2002, and included 283 women aged 43 ± 9.6 years. Out of 283 women, 104 received psychiatric treatment at the Department for Psychiatry of the University Clinical Center Tuzla, 50 women were refugees; and 129 were domicile inhabitants of the Tuzla Canton. Domestic Violence Inventory, Cornell Index, Symptom Checklist-90-Revised, PTSD Checklist Version for Civilians, and Beck Depression Inventory were used for data collection. Basic sociodemographic data and information from the medical documentation of the Department for Psychiatry of the University Clinical Center Tuzla was also collected. Results: Out of 283 women, 215 (75.9%) were physically, psychologically, and sexually abused by their husbands. Among the abused, 107 (50.7%) experienced a combination of various forms of domestic violence. The frequency of domestic violence was high among psychiatric patients (78.3%). Victims of domestic violence had a significantly higher rate of general neuroticism, depression, somatization, sensitivity, obsessive-compulsive symptoms, anxiety, and paranoid tendency than women who were not abused. The prevalence of posttraumatic stress disorder (PTSD) symptoms according to the type of trauma was higher in women with the history of childhood abuse (8/11) and domestic violence (53/67) than in women who experienced war trauma (26/57) and the loss of loved ones (24/83). The majority of 104 psychiatric patients suffered from PTSD in comorbidity with depression (n = 45), followed by depression (n = 17), dissociative disorder (n = 13), psychotic disorder (n = 7), and borderline personality disorder with depression (n = 7). The intensity of psychological symptoms, depression, and Global Severity Index for Psychological Symptoms (GSI) were in significant positive correlation with the frequency of psychological (r = 0.45, P<0.001), physical (r = 0.43, P<0.001), and sexual abuse (r = 0.37, P<0.001). Conclusion: Domestic violence in various forms had long-term consequences on mental health of women. This should be taken into account when treating women with war-related trauma

INTEGRATING THE CONCEPT OF CREATIVE PSYCHOPHARMACOTHERAPY AND GROUP PSYCHOTHERAPY IN CLINICAL PRACTICE

Modern psychiatric treatment is largely dictated by national and international guidelines rested on evidence-based data, including psychopharmacotherapy and psychotherapy. An alternative to the rigid application of official guidelines and criterion for the standards of treatment in psychiatric practice is the concept of creative psychopharmacotherapy. It is a concept based on the integration of different approaches to a person as whole, mental disorders and their treatment into person-centered clinical practice. In this sense, group psychotherapy and creative psychopharmacotherapy today are part of the overall integrative efforts in psychiatry. Neuroscientific discoveries suggest that they share similar neural pathways that lead to changes in brain function and symptoms relief. Various integrative elements make group psychotherapy and psychopharmacotherapy in combination more effective and efficient. The integration of the concept of creative psychopharmacotherapy and group psychotherapy into everyday clinical practice can improve treatment options as well as clinical practice by creating opportunities for research and development of new modalities of overall treatment