Politički odgovor na demografske izazove

Populacioni izazovi su visoko rangirani na političkim agendama u XXI veku. Otuda postoji posebna potreba da se proučavaju karakteristike, determinišući faktori, posledice, zakonitosti u kretanju i očekivane promene u budućnosti svakog od izdvojenih populacionih izazova. To je zadatak demografa. Istovremeno se od istraživača nauke o stanovništvu očekuje da pomognu u pronalaženju odgovora na aktuelne dileme sa kojima se vlade suočavaju. To pretpostavlja postojanje dijaloga između demografa i donosilaca odluka. Ova vrsta dijaloga nije tako česta u Srbiji. Ona je bitna da bi populaciona politika bila zasnovana na činjenicama. No, zajedničko razmišljanje demografa i donosilaca odluka o odgovoru na demografske izazove izneto u radu je još značajniji korak od uspostavljanja dijaloga u ovoj sferi. Fokus u radu je na političkom odgovoru Srbije na nizak nivo rađanja, populaciono starenje i veće iseljavanje od useljavanja u zemlju. Pored ocene stanja političkog odgovora u ove tri sfere, iznesena su i očekivanja vezana za nadgradnju političkog odgovora Srbije na izdvojene demografske probleme, zasnovana na relevantnim teorijskim razmatranjima, rezultatima sprovedenih istraživanja, iskustvima drugih zemalja i preporukama međunarodnih organizacija

Defense mechanisms and quality of life in military personnel with a burnout syndrome

© 2019, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved. Background/Aim. Professional military personnel are exposed to a number of stressors during the war as well as in peacetime conditions that can cause some hidden or manifest disorders, especially anxiety and depression, but also the development of a burnout syndrome. The aim of our investigation was to determine the defense mechanisms and subjective assessment of quality of life and anxiety in professional military personnel of the Serbian Armed Forces with the burnout syndrome. Methods. The cross-sectional study included a total of 55 professional military personnel, from 25 to 55 years of age, without current mental problem. In the investigation, the Maslach Burnout Inventory (MBI), Defense Style Questionnaire (DSQ-40), World Health Organization Abbreviated Instrument for Quality of Life Assessment (WHOQOL-BREF) and Beck Anxiety Inventory were used. The statistical analysis included parametric and nonparametric descriptive statistics. Results. Emotional exhaustion and depersonalization were present in 10.9% of subjects and in 12.7% of subjects respectively, in moderate level, while personal accomplishment was present in 21.8% of subjects of high level. Humor was higher in the subjects with a moderate level of burnout on the personal accomplishment (PA) scale and altruism in the subjects with a low level of burnout on the depersonalization (DP) scale as well as acting-out and rationalization on the PA scale in the subjects with a moderate level of burnout. High level of anxiety was present in 14.5% of subjects. Conclusion. Professional military personnel with lower level of burnout were less anxious, use mature defense mechanisms and have a perception of better quality of life. When burnout is diagnosed, psychological interventions requires training through the adoption of mechanisms for overcoming everyday stress, which may affect the reduction of anxiety and the improvement of the quality of life. Professional assistance, including psychotherapy is required in severe cases

Prevalencija karijesa kod bolesnika hospitalizovanih zbog shizofrenije

Background/Aim. It is considered that over 450 million people worldwide suffer from some form of mental disorder. Previous studies in other countries have shown that schizophrenia is among the most frequent. Oral health is significant for general health and should not be separated from mental health. Studies in other countries have shown an increased incidence of carious and extracted teeth, and less incidence of filled teeth in this group of psychiatric patients. The aim of this study was to establish condition of the existing teeth, to determine the prevalence of caries and to consider possible risk factors that contribute to the current oral health status of hospitalized patients with schizophrenia. Methods. The study comprised 190 patients with schizophrenia, hospitalized at the Clinic for Psychiatric Disorders 'Dr. Laza Lazarević' in Belgrade, and 190 mentally healthy patients at the Clinic for Periodontology and Oral Medicine, Faculty of Dental Medicine in Belgrade. The decayed, missing, filled (DMF) index, sociodemographic and economic characteristics were registered in both groups, as well as characteristics of the primary disease of hospitalized patients with schizophrenia. Results. The value of DMF index (representing the sum of carious, extracted and filled teeth), in the hospitalized patients with schizophrenia was 18.57 ± 7.07 and 12.47 ± 5.64 in the healthy group (p = 0.000). The structure of the DMF index in the study group showed that caries and extracted teeth dominated with 88.1%; in the control group, filled teeth dominated with 55.6%, which was a statistically significant difference for all the three observed variables. Conclusion. Hospitalized patients with schizophrenia had twice as many caries and extracted teeth, and five time less filled teeth than healthy people. The patient's age and taking antiparkinsonics were established as predictors of the increased DMF index in hospitalized patients with schizophrenia.Uvod/Cilj. Smatra se da preko 450 miliona ljudi širom sveta pati od nekog oblika mentalnog poremećaja, a istraživanja sprovedena u drugim zemljama pokazala su da je shizofrenija među najzastupljenijima. Oralno zdravlje zauzima značajno mesto u celokupnom zdravlju čoveka i ne treba ga razdvajati od mentalnog zdravlja. Istraživanja sprovedena u drugim zemljama pokazala su povećanu zastupljenost karijesnih i izvađenih zuba, a manje plombiranih zuba kod ove grupe psihijatrijskih bolesnika. Cilj studije bio je da se istraži stanje prisutnih zuba, odredi prevalencija karijesa i ispitaju mogući faktori rizika koji doprinose postojećem stanju oralnog zdravlja kod bolesnika hospitalizovanih zbog shizofrenije. Metode. U istraživanju je učestvovalo 190 bolesnika sa shizofrenijom, hospitalizovanih na Klinici za psihijatrijske bolesti 'Dr Laza Lazarević' u Beogradu i 190 mentalno zdravih ispitanika, pacijenata Klinike za parodontologiju i oralnu medicinu Stomatološkog fakulteta u Beogradu. Ispitanicima obe grupe registrovane su vrednosti KEP indeksa, sociodemografske i ekonomske karakteristike, a bolesnicima hospitalizovanim zbog shizofrenije i karakteristike primarne bolesti. Rezultati. Vrednost KEP indeksa kod bolesnika hospitalizovanih zbog shizofrenije iznosila je 18,57 ± 7,07, a kod zdravih osoba 12,47 ± 5,64 (p = 0,000). U strukturi indeksa koji pokazuje zbir brojeva karioznih, ekstrahovanih i plombiranih zuba (KEP) kod bolesnika sa shizofrenijom, dominirali su karijesni i ekstrahovani zubi - 88,1%, a u kontrolnoj grupi plombirani zubi - 55,6%, što je bila statistički značajna razlika za sve tri posmatrane varijable. Zaključak. Bolesnici hospitalizovani zbog shizofrenije imali su dvostruko više karijesnih i izvađenih zuba, a pet puta manje plombiranih zuba od zdravih osoba. Kao prediktori povećanog KEP indeksa kod bolesnika hospitalizovanih zbog shizofrenije ustanovljeni su starost ispitanika i korišćenje antiparkinsonika

ALCOHOLIC AND POSTOPERATIVE DELIRIUM: A CASE-CONTROL STUDY

Background: Delirium is an urgent condition in psychiatry and it occurs after long-lasting alcohol abuse, in surgical procedures and other organic mental syndromes with deprivation of interpersonal and social stimulations. The aim was to evaluate of sociodemographical and psychopathological differences in delirium patients with alcoholand surgical genesis, studied in period from January 1st 2003 to December 31st 2012 in Bosnia and Herzegovina (B&H). Subjects and methods: Subjects were divided into two groups: alcoholics (N=75) and surgical patients (N=75) and multicentric, prospective study was performed in B&H. The following instruments have been used: list of general data (according to MCD-10 criteria), Eysenck Personality Questionnaire (EPQ), Becks test of anxiety (BAI), Hamilton Depressive Rating Scale (HDRS) and Mini Mental State Examination (MMSE). Descriptive and analytical statistical processing of patients has been performed (alpha level: 0.001). Results: Patients from alcohol group showed, with statistical significance p=0.001, the following: unemployment (OR=0.657, CI 0.540-670), ruined marriage (OR=0.570, CI 0.650-710), alcohol abuse (OR=0.179, CI 0.860-0.990), on represented expressed psychoticism, (OR=0.635, CI 0.550-0.715) in EPQ test, HDRS total was more frequent (OR=0.925, CI 0.870-1.120) and on MMSE test, total score was more frequent (OR=0.560, CI 0.570-810). Postoperative patients were older p=0.001 (OR= 1.120, CI 1.082- 1.159) with acutestress: (OR=0.735, CI 0.650-0.910) and showed neuroticism (OR=-0.660, CI 0.575-0.715). Discriminative function confirms the differences between alcohol and surgical groups of delirium patients: Canonical Fcn: r=0.771; Wilkin’s lambda

ALCOHOLIC AND POSTOPERATIVE DELIRIUM: A CASE-CONTROL STUDY

Background: Delirium is an urgent condition in psychiatry and it occurs after long-lasting alcohol abuse, in surgical procedures and other organic mental syndromes with deprivation of interpersonal and social stimulations. The aim was to evaluate of sociodemographical and psychopathological differences in delirium patients with alcoholand surgical genesis, studied in period from January 1st 2003 to December 31st 2012 in Bosnia and Herzegovina (B&H). Subjects and methods: Subjects were divided into two groups: alcoholics (N=75) and surgical patients (N=75) and multicentric, prospective study was performed in B&H. The following instruments have been used: list of general data (according to MCD-10 criteria), Eysenck Personality Questionnaire (EPQ), Becks test of anxiety (BAI), Hamilton Depressive Rating Scale (HDRS) and Mini Mental State Examination (MMSE). Descriptive and analytical statistical processing of patients has been performed (alpha level: 0.001). Results: Patients from alcohol group showed, with statistical significance p=0.001, the following: unemployment (OR=0.657, CI 0.540-670), ruined marriage (OR=0.570, CI 0.650-710), alcohol abuse (OR=0.179, CI 0.860-0.990), on represented expressed psychoticism, (OR=0.635, CI 0.550-0.715) in EPQ test, HDRS total was more frequent (OR=0.925, CI 0.870-1.120) and on MMSE test, total score was more frequent (OR=0.560, CI 0.570-810). Postoperative patients were older p=0.001 (OR= 1.120, CI 1.082- 1.159) with acutestress: (OR=0.735, CI 0.650-0.910) and showed neuroticism (OR=-0.660, CI 0.575-0.715). Discriminative function confirms the differences between alcohol and surgical groups of delirium patients: Canonical Fcn: r=0.771; Wilkin’s lambda

The effect of antipsychotic drugs on nonspecific inflammation markers in the first episode of schizophrenia

Background/Aim. Immune system disorder, including inflammation, takes a significant place when considering still unclear etiology of schizophrenia. The aim of this study was to determine the blood levels of nonspecific inflammation markers in the first episode of schizophrenia and their relation to the therapy response. Methods. In this study we determined the blood levels of nonspecific inflammation markers: white blood cells count (WBC), C-reactive protein (CRP), erythrocytes sedimentation rate (ESR) and the elements of differential white blood cell counts (or the leukocyte formula): granulocytes (Gra), lymphocytes (Lym) and monocytes (Mon), in the first episode of schizofrenia, in 78 patients hospitalized at the Clinic for Psychiatric Disorders “Dr Laza Lazarević” in Belgrade. The levels were measured at admission to the clinic, as well as after 4 weeks of antipsychotic treatment. The Positive and negative syndrome scale for schizophrenia (PANSS) was applied to measure the severity of psychopathology and response to the treatment. Results. During the first episode of schizophrenia, before initiation of antipsychotic treatment, the frequency of abnormal values was high (≥ 25% of the patients) for the following non-specific inflammation markers: WBC, CRP, ESR and Gra, in the leukocyte formula, but dropped after 4 weeks of antipsychotic treatment at the level of high statistical significance for WBC and Gra (p < 0.001). The ESR remained unchanged in as many as 50% of the patients even after 4-week antipsychotic treatment, at the level of statistical significance in the non-responders compared to the responders (p = 0.045). Conclusion. The obtained results indicate that in the first episode of schizophrenia the blood levels of non-specific inflammation markers (WBS, CRP, ESR and Gra from the leukocyte formula) were high in the subpopulation of patients with the tendency towards normalization of inflammation parameters after a 4-week antipsychotic treatment

COMPARATIVE ANALYSIS OF SOFT NEUROLOGICAL SIGNS IN POSITIVE AND NEGATIVE SUBTYPE OF SCHIZOPHRENIA

Background: The objective of the study was to investigate neurological deficit in schizophrenia and to compare soft neurological signs in positive and negative subtypes of schizophrenia. Subjects and methods: 66 patients with schizophrenia were evaluated with the Positive and Negative Syndrome Scale to classify the subtype of schizophrenia: positive subtype (36 patients) and negative subtype (30 patients), all of which were entering into remission. To examine the neurological soft signs we compared scores on the Neurological Evaluation Scale (NES) for positive and negative subtype. Results: The negative subtype of schizophrenia showed significantly higher neurological soft signs in comparison to the positive subtype, with reduced functioning in the sensory integration and motor coordination subscale as well as the other subscale. Conclusion: The main finding in this study indicates that patients with schizophrenia have neurological impairment, and that the negative subtype has significantly higher neurological impairment than the positive subtype. The results further support the significance of the soft neurological signs as a possible marker of different subtypes of schizophrenia

THE HISTORICAL DEVELOPMENT OF PSYCHIATRY IN SERBIA

The authors present the development of the concept of mental disease and treatment in Serbian medicine. Serbian medieval medicine did not acknowledge fortune telling, sorcery, the use of amulets and magical rituals and formulas. These progressive concepts were confirmed by the Church and the Serbian state in what is known as Dušan’s Code. The Historical data on the establishment of the first psychiatric hospital in the Balkans “Home for the Unsound of Mind” at Guberevac, Belgrade, in 1861 and its founders is reviewed. After World War I, in 1923, the Faculty of Medicine was established in Belgrade to which the coryphaei of Serbian medicine educated in Europe, mostly in France and Germany, flocked and that same year the Psychiatry Clinic of the Faculty of Medicine in Belgrade was set up. Its first seat was on the premises of the Mental Hospital in Belgrade, and it became a training base and laid the foundations of the future Neuropsychiatry Clinic in Belgrade, which in time evolved into the nursery of psychiatric professionals for all of Serbia. The most important data on the further development of psychiatry up to date are presented

THE HISTORICAL DEVELOPMENT OF PSYCHIATRY IN SERBIA

The authors present the development of the concept of mental disease and treatment in Serbian medicine. Serbian medieval medicine did not acknowledge fortune telling, sorcery, the use of amulets and magical rituals and formulas. These progressive concepts were confirmed by the Church and the Serbian state in what is known as Dušan’s Code. The Historical data on the establishment of the first psychiatric hospital in the Balkans “Home for the Unsound of Mind” at Guberevac, Belgrade, in 1861 and its founders is reviewed. After World War I, in 1923, the Faculty of Medicine was established in Belgrade to which the coryphaei of Serbian medicine educated in Europe, mostly in France and Germany, flocked and that same year the Psychiatry Clinic of the Faculty of Medicine in Belgrade was set up. Its first seat was on the premises of the Mental Hospital in Belgrade, and it became a training base and laid the foundations of the future Neuropsychiatry Clinic in Belgrade, which in time evolved into the nursery of psychiatric professionals for all of Serbia. The most important data on the further development of psychiatry up to date are presented