Super-ego in patients with coronary artery disease [Super-ego oboljelih od bolesti koronarnih arterija srca]

In this paper, we explored the super-ego of patients with coronary artery disease. Research results have confirmed the initial hypothesis that a significant number of patients with coronary artery disease has rigorous super-ego. Among patients with coronary artery disease (N=50), and control group (N=50), we have found significant differences in the quality of super-ego and ego attitude towards the demands of the super-ego. The results of this research contribute to understanding the impact of psychological factors in coronary artery disease

Uloga biologijskih faktora u suicidalnom ponašanju (The Role of Biological Factors in the Suicidal Behavior)

Suicid je jedan od najvećih problema u suvremenoj medicini, a podaci o njegovoj učestalosti variraju, ovisno o studiji. Suicid također predstavlja i veliki javno zdravstveni problem.Tradicionalno, faktori rizika za suicidalno ponašanje promatrani su odvojeno, u zasebnim kategorijama, od biologijskih do psiholoških i socijalnih. S razvojem znanosti, pokazalo se kako ova formalna podjela na odvojene kategorije ne daje zadovoljavajuća objašnjenja ovog kompleksnog fenomena.  Novi  modeli (Mann, 1999) idu u smjeru razumijevanja suicidalnosti kao rastućeg procesa (u rasponu od blažih do težih oblika) koji se razvija i na koji utječu dvije grupe faktora: faktori predispozicije (dijateze) i faktori okidači (stresori). Istraživanja idu u smjeru boljeg razumijevanja faktora predispozicije kao i stresogenih faktora, koji mogu potaknuti suicidalno ponašanje.    Među faktorima predispozicije, najviše se istražuju biologijski pokazatelji, sa sve više istraživanja koja su na genetskoj razini

PSYCHODYNAMICS AND PSYCHOPHARMACOTHERAPY IN THE TREATMENT OF DIFFICULT PATIENTS WITH PERSONALITY AND EATING DISORDERS

The complex inter-relationship between external and internal reality, a source of interest and controversy in psychiatry, has come to the foreground more prominently in the context of more integrative understanding of psychopharmacotherapy. This paper discusses the meaning and clinical applications of the psychodynamic related to psychopharmacotherapy for difficult personality and eating disorders patients. The one of the psychodynamic explanations for patients’being difficult is related to their perceived lack of mentalizing (reflective) capacities. Lack of mentalizing capacity implies disturbed view of psychopharmacotherapy. Therapeutic relationship and optimal alliance offers the frame for acceptance of psychiatric drugs as positive and useful for personality and eating disorder patients. Mentalization and intersubjectivity theories have direct implications for clinical practice, and that the notion of the third is particularly useful in understanding what happens in the patient-doctor relationship

BORDERLINE PERSONALITY DISORDER AND BIPOLAR DISORDER COMORBIDITY IN SUICIDAL PATIENTS: DIAGNOSTIC AND THERAPEUTIC CHALLENGES

Suicidality is one of the great challenges in contemporary psychiatry. Suicidal patients are often misdiagnosed in clinical practice. It is very important to evaluate possible comorbidity in diagnostic assessment of suicidal patients. The high prevalence of comorbid bipolar (BD) and borderline personality disorders (BPD) presents both a diagnostic and a therapeutic challenge. Although the primary treatment for patients with BPD is psychotherapy, pharmacotherapy is a core component for the treatment of comorbid conditions such as bipolar disorder. Because of heterogeneity of the BPD, pharmacologic treatment has evolved to some particular dimensions of BPD rather than the disorder in its entirety. The dimensions include affective instability, impulsive aggression and identity disturbance. Effective medication management reduces the overall suffering of the patient and enables to make greater use of psychotherapeutic interventions which is very important for BPD patients with BD comorbidity