Hypochondria is a mental disorder characterized by a preoccupation with fears that a person may be ill or suffering from a serious illness, based on a misinterpretation of problems that cannot be eliminated by appropriate medical reassurance. A special type of hypochondriasis known as Medical Student Syndrome (MSS) refers to student's fears and beliefs that they are ill or may become ill with the illnesses they are learning while studying in pre-clinical and clinical subjects. A cross-sectional study was conducted during the winter semester of the 2019/2020 school year, with a sample of 90 students of the first, third, and sixth year of the Faculty of Medicine, sampled on a random basis. Subjects completed the Illness Attitude Scale (IAS). The aim of study was to investigate whether there is a difference in the incidence of hypochondrial tendencies and beliefs in the students of the Faculty of Medicine in relation to the year of study. The mean values on certain subscales were statistically significantly higher in students of third compared to students of first and sixth year of medicine. Students who have not renewed a year were found to have significantly higher average scores on the Disease Concerns and Pain Concerns subscale, as well as Disease phobia compared to those who renewed the year, while Hypochondrial beliefs were statistically significantly higher in subjects who renewed the year compared to students who had not renewed the year. The presented results support the hypothesis that health anxiety and all its components among the medical students at the preclinical level is most pronounced in the third year of study, and that it shows declining trend in the later stages of study.
Perinatal mental health disorders are defined as mental conditions developed during pregnancy or in a year following child delivery. Women are affected but it is possible partners can be too, as a new or additional mental health condition. The aim of perinatal psychiatry is preventing perinatal mental health problems, as well as timely and scientifically based diagnose and offer evidence-based treatment including psychosocial therapy or medications. Undiagnosed or untreated perinatal mental disorders during or after pregnancy can have significant and long-lasting effects on the wellbeing of the women and her overall health, child health and development, as well as partner relationships and society as whole.
Introduction: Congenital adrenal hyperplasia (CAH) is an inherited autosomal recessive disorder characterized by a defect in the synthesis of steroid hormones of the adrenal cortex. This defect results in elevated serum androgen levels. Androgens have been shown to have a significant effect on the developing brain during prenatal and postnatal period, which can lead to impaired neurocognitive functioning and contribute to the development of psychiatric disorders. The aim: In this paper, we will present a patient with CAH who developed serious psychiatric problems during adolescence. The aim of this case report is to discuss a possible connection between these two conditions and to consider possible diagnostic and therapeutic interventions. Case report: The patient was diagnosed with the classic form of CAH at birth. After months of corticosteroid substitution therapy, the patient was surgically treated at 7 months of age with vaginoplasty and clitoroplasty. The patient developed serious psychiatric problems from the depressive-anxiety spectrum in the early adolescent period, followed by impaired impulse control and aggression. This report illustrates the diagnostic and therapeutic interventions conducted at the Clinical Department for Children and Adolescents of the Institute of Mental Health. Conclusion: Given the abundant evidence on the impact of CAH on cognitive ability and psychosocial functioning, it is necessary to develop and implement complementary multidisciplinary diagnostic and therapeutic interventions in these patients. Such interventions would aim to prevent the onset of psychiatric comorbidities and consequently improve the quality of life and functionality of these patients.
No modern studies of the natural course of depression have been done since the nineteen fourties of the last century. A large number of depressive episodes spontaneously remit. Because of this, some psychiatrists call for more use of a therapeutic approach called watchful waiting, especially for milder forms of depression. At the Institute of mental health in Belgrade, from November 2019 until November 2021, a study in watchful waiting will be done. In this paper the methodology of the planned study is described.
Obesity is one of the leading problems in our society. The spread of obesity in developed societies is reaching pandemic lengths. In schizophrenic patients obesity raises an important issue. Patients suffering from schizophrenia have a shorter life span compared to the general population. Prevalence of obesity in schizophrenic patients is high. Obesity is the key factor in developing a metabolic syndrome. Metabolic syndrome is a frequent somatic complication in schizophrenia. Nowadays, it is clear that metabolic syndrome shortens the lifespan of people who developed an illness. Because of this, the treatment of obesity represents a major problem. Review of currently approved medications for treatment of obesity is the goal of this paper.
No specific cure has been found since the beginning of the COVID-19 pandemic. In the treatment of infection caused by SARS-CoV-2 virus, therapeutic protocols include drugs of different groups: antiviral drugs, antibodies, antibiotics, anti-inflammatory drugs, etc. It can be expected that a certain number of patients who are receiving therapy with psychopharmacotherapy will get sick from COVID-19, but we also know that the infection itself has certain psychological manifestations. Due to the above, the use of psychopharmacotherapy together with other drugs in the therapy of COVID-19 is sometimes unavoidable. Co-administering these drugs has to be with caution due to the potential prolongation of the QTc interval, drug interactions at the CYP enzyme level, and the associated potential for agranulocytosis.
The global pandemic caused by Corona Virus Disease 2019 (COVID-19) has led to major lifestyle changes in people living in the affected countries. Namely, most countries declared the state of emergency which included the implementation of different precautionary measures, such as restriction of movement, travel ban, isolation, social distancing and wearing protective equipment. The global fight with the unknown virus generated an abundance of different, often contradictory and inconsistent information. These new changes can have a potentially major impact on the physical and mental health of both children and adults. Children are a particularly vulnerable population in crisis situations. Although research shows that children and young people exhibit clinically significantly milder forms of COVID-19 compared to adults, their vulnerability is reflected in a greater susceptibility to develop serious psychological consequences. Mental problems of children most often develop due to the inability to adequately understand the new situation, fear, separation from peers, changes in the mental state of parents and greater susceptibility to abuse and neglect. Also, systematic changes in the country (closure of educational institutions, reduced workload or closure of health institutions or institutions of support and assistance to children and vulnerable individuals) contribute to the difficulty of overcoming the pandemic. These changes especially affect children with pre-existing mental disorders, neurodevelopmental difficulties, and children from vulnerable and minority groups who require more care and services from different support systems. In order to avoid harmful consequences for the health of children, we will present recommendations focused on children and parents, which are intended for the easier overcoming of crisis situations such as the current pandemic.
Despite national and international guidelines recommending inclusion of psychotherapy and psychosocial interventions as regular part of treatment for patients with psychosis spectrum disorders (PSD), outpatient psychiatric care in Southeastern Europe (SEE) is mostly limited to medication prescription. DIALOG+ is a recently developed technology-based, patient centered psychosocial intervention that provides an economically viable intervention for treatment and comprehensive evaluation of multiple life domains. Its effectiveness in a range of psychiatric disorders has been shown in several studies conducted in high-income countries. Before an ongoing study evaluating DIALOG+ implementation and effectiveness in developing SEE countries is completed, we aimed to explore general impressions of mental health clinicians towards such an intervention and to compare the duration of treatment as usual (TAU) with DIALOG+ enriched appointments of PSD outpatients. The attendees of the national professional educational symposium were presented with DIALOG+, after which they completed a short survey on their general impressions towards the intervention. To obtain the information regarding duration of psychiatric appointments for patients with PSD in Serbia, we used data from a currently ongoing randomized clinical trial where DIALOG+ is being tested for effectiveness. The impressions of the survey (n=110) from mostly psychiatrists and psychiatry residents towards the concept of this intervention were overwhelmingly positive. However, the question arose if TAU is being prolonged by DIALOG+ to the extent that might limit its implementation. Although significant difference in average session duration was observed between DIALOG+ and TAU (31.96±16.47 vs. 19.75±6.11 minutes, p<0.01), providing structured interventions and patient evaluation might be of additional benefit for long term care and quality of life of PSD patients. To the best of our knowledge, this was the first evaluation of the duration of psychiatric appointments for outpatients with PSD in Serbia. Present information could be useful for different stakeholders in education of MH workers and implementation of DIALOG+ in the local settings.
In the past few years the number of refugees, migrants and asylum seekers worldwide has increased dramatically. Serbia, as a mainly transit country currently hosts over 6,000 new asylum-seekers and refugees, over 26.200 refugees and 198.500 internally displaced persons from the ex-Yugoslavia region, and 1.950 persons at risk of statelessness. Migrants are often under acute and chronic stress. Many of them were traumatized in their homelands and during their journey , due to persecution, violence, and human right violations, and they are confronted with ongoing stressors in the exile countries. Extensive research has shown increased rates and substantial variability in the prevalence of short-term and long-term mental health problems among refugees, asylum seekers and migrants. The most prevalent psychiatric disorders are depression, anxiety, prolonged grief, somatoform disorders, psychosis, substance use disorders, and disorders specifically related to stress, particularly posttraumatic stress disorder. It's urgent to offer a systemic and sustainable solutions for mental health protection, in order to reduce trauma related mental health problems and prevent long-term consequences. Multisectoral, evidence-based and multidisciplinary approach is recognized as crucial in identifying needs of these populations and enabling proper protection of their mental health and psychosocial wellbeing.
Scales for assessment of patients with depression are in use for several decades. Among the most used are Hamilton's depression scale and the younger Patient Health Questionnaire. Even though both are heavily used in research and clinical practice they are still controversial and with questionable usefulness. This case report shows that the question whether a patient is better or worse can be diametrically opposite depending on the scale used (using these two most influential ones as examples) and what are the reasons for this.
The treatment of mental health patients in Serbia in the Middle ages was the same as in other European countries. Medicine of that time was based on science, the use of magic rituals and witchcraft was banned. Doctors from Serbia, Byzantium and the national doctors had been educated in Salerno and Montpellier, the most developed centers of medicine. They took the exam in front of the government Medical testimony. The development of medicine was followed in the Hodoloski code which was considered the oldest record of folk medicine and the Hilandar medical code which represented a collection of medieval scientific European medicine and Serbian medicine culture (XII-XV). The first Serbian hospital was established in Hilandar in 1199. The founder was Saint Sava who wrote the rules about the work of the hospital. Actually, it was the practice for all medical facilities that were opened later. We know about mental diseases and healing in Serbia from Lives of Saints in monasteries Zica (from 1207) and Decani (1327) and from the biography of Medieval ruler (king) Stephen of Decani. The illustrations of healing some patients with mental diseases were shown on frescoes and in the lives of saints. In Medieval Serbia, there were 49 foreign doctors working (15 in XIV, 30 in XV and 4 in XVI century) and until Turkish conquest Serbia took a very important place in Medieval Europe. Objective of this paper is to show where psychiatric patients were treated in Medieval Serbia, the way they were treated, who treated them, where the hospitals were and what kind of treatment wereapplied.
The main aim of this paper was to investigate levels of empathy in medical students as well as their attitudes toward people with mental disorders. We recruited 144 students from the School of Medicine in Podgorica (Montenegro), out of which 37.7% were males and 62.3% were females. The mean age of the sample was 21.85 (SD = 2.65). We designed Scale of attitudes toward mentally ill people (SAMIP), and principal component analysis revealed that this instrument could be divided into two subscales - Positive attitudes toward the mentally ill (PAMI, a= .903) and Stigmatization of the mentally ill (SMI, a= .875). These subscales had high levels of reliability (i.e. internal consistency). The second measure was Empathy Questionnaire which is a unidimensional tool with a very high level of internal consistency (a= .924). The results revealed a high positive correlation between empathy levels and positive attitudes towards people with mental illness, a low correlation of empathy with the year of study, a low negative correlation between stigmatizing the mentally ill and participants' age, as well as low positive correlations of proneness to stigma with students' GPA and expectations of their profession. Recommendations for further research in this field were listed as well.
The paper discusses the reasons why conspiracy theories emerge (the desire to belong, survive, be close with the members of the group, and maintain a positive image of ourselves and the community). Theories and results of research about psychological factors that are believed to influence the emergence of conspiracy theories are presented. The authors conclude that belief in conspiracy theories is highly dependent on epistemological, existential, and social motives. Research has not yet shown that these theories serve to satisfy these motives, and it is even possible to the contrary, that these theories do not strengthen social cohesion at all, do not lead to improvement of self-esteem and a more positive image of ourselves or the group we belong to. Important questions remain open and more research needs to be done about the consequences of believing in conspiracy theories, especially in vulnerable populations, which have been found to have the highest motivation to accept these theories. The tendency to believe in conspiracy theories is a phenomenon influenced by many factors. Some of these factors are belonging to a lower socio-economic background, a lower educational level, a tendency to outsource one's own responsibility for life's failures, or to neglect the genetic and educational factors that led to it. However, many other factors, such as mental health status, also determine this phenomenon. Poorly integrated, deeply insecure personalities who have not overcome the schizoid-paranoid position of development, tend to perceive the environment as perceptual and threatening, with the aim to protect their own self from deeper disintegration.
Introduction: The increase use of social networks among adolescents opens space for exploration of behavior on social networks and possible links with various aspects of mental health. Data from the literature suggest that people who present the authentic self on social networks have higher levels of positive affect, more social contacts and lower stress levels. The aim of our study was to investigate the prevalence of insincere information sharing and liking behavior on social networks in adolescents treated at the day care hospital, as well as to examine the difference in these two behaviors depending on the severity of depression and anxiety. Methods: 80 hospitalized patients of Day Hospital for Adolescents filled in the socio-demographic questionnaire, the questionnaire about behavior on social networks (Facebook, Instagram), designed for the purposes of this study, Beck Depression Inventory (BDI) and Generalized Anxiety Disorder 7-item Scale (GAD-7). Results: From the total sample, 90% of the subjects used social networks (Facebook or Instagram). In total, 20.8% of respondents in some form were insincere when they shared information on social networks, while 41.7% of respondents manifested dishonest liking behavior in order to be accepted by friends/followers on social networks. In this study, depression did not affect the presentation on the social networks in forms of sharing information and liking behavior, but the presence and severity of anxiety symptoms significantly made difference when it comes to sharing information insincere on social networks. Conclusion: The findings suggest a link between the online strategies of self-presentation on social networks and aspects of negative mental health offline, which may have practical implications in treating adolescents.
New technologies have always been intriguing, especially when considering their impact on children and young people. It seems that modern soceity is not ready to grasp the importance of social media which is why the attitudes towards the use of social media are usually negative. The usage of social media has become an integral part of the daily functioning of children and young people. The link between internet usage and mental wellbeing of children has been one of the main subjects of extensive research in the last two decades. However, there is still no clear scientific consensus on the impact of social media (or lifestyles based on screen use) on the mental health of children and adolescents. The purpose of this article is to present the possible positive impact of social media on children and young people. Among young people social media is usually used for fun, but also to improve social cohesion and to expand social relationships. Studies show multiple positive effects on wellbeing, social communication, social support and self-representation. Owing to the fact that thez are highly aveliable, media can be very useful way to commuicate about mental health, without prejudice and without stigma.
Research into the effect of video games on young people was done simultaneously with their rise in popularity. Two subjects have emerged as especially interesting and controversial: the effect on aggression and the potential for forming behavioral addiction. In this review we will take a look at the current situation in these two research fields and current conclusions from the knowledge so far accumulated.
Information technologies at the threshold of the third decade of the 21st century represent a significant factor in the psychosocial development of children and youth. The content presented by the media (using contemporary audio-visual effects) ranges from informative, through educational, entertainment, to sensational and shocking. Media content draws attention and leaves a strong impression on children, and often, provokes reactions of agitation. Children are trying to find ways to overcome this anxiety using a variety of strategies, and one of them is the need to talk about it. On the national child's line, a modern telephone and counseling support service for children and young people, there is a tendency for an increased number of calls from children that are presumed to be related to certain media events. This paper will present findings of research on the impact of disturbing media content on children as well as observations by children's counselors on calls related to sensationalist media content. The findings will be interpreted in relation to children's reactions and strategies for overcoming feelings of distress with calls during discussions with telephone counselors on the child's line.
Background: Social media has become an integral part of our daily lives, taking a primary place in communicating, networking and gathering information. In addition to numerous opportunities that the media has provided, the safety of young people in online worlds has always been an issue, especially since the paradigm of social network usage changes quickly. The aim: The aim of this study was to examine the opinions and attitudes of young people and their parents about media activity, as well as to compare their attitudes on this subject. Materials and Methods: This was a cross-sectional study that was conducted in randomly selected primary and secondary schools in Belgrade and Prijepolje. The survey was conducted between December 2018 and February 2019. The total number of participants was 330, ie. 165 students and 165 parents. We collected data using two questionnaires; Youth Self-Assessment and the Parents Report questionnaires. Results: According to our results, young people think that they spend the most time online communicating with peers, social networking and watching video content, mostly on weekends compared to weekdays (p <0.05). Our study found that older teens spend more time communicating, listening to music, and watching a video than younger individuals (p <0.001). Boys are significantly more likely to play games than girls (p <0.001). When comparing the differences in opinion of children and their parents, we found statistically significant differences in several questions. Parents, unlike children, do not consider children to receive mainly useful information through internet (p <0.05); they believe that children spend too much time online (p <0.05); and that they would spend more time in other activities and in organizations if they were not online (p <0.05). Conclusion: It is necessary to properly educate the child on proper social media usage from a young age. This should be a priority of every parent as well as professionals that work with children in order to avoid potentially serious consequences of unsafe internet usage.
Today, there are television channels that broadcast cartoons continuously, all day long. Watching cartoons can have both a positive and a negative effect on children's development and their behavior of both typical development and children with disabilities. For the past several decades, mothers spent more time in their homes, and children, surrounded by family, spending much more time outside. Nowadays, children stay more at home without the proper supervision of adults who are busy with their obligations, and the main entertainment is watching TV/cartoon films as well as consuming other types of media. Daily exposure to the content on TV and other "screens" (media) affects the development of behavior, language, cognition, and attention in children of typical development. The impact is even more profound in children who are already experiencing difficulties in communication and socialization. The research results show the negative effects of exposure to the contents on TV and other screens on the reciprocal mother-child interaction. Parents must pay attention to children's behavior, activities and cartoon content by creating a balance between watching cartoons and other social activities, although the materials available in cartoons can be used in the context of learning, especially learning social and self-help skills.
Introduction: Children spend on average 2.4 hours per day in front of a screen during a school week and 3 hours per day over the weekend. Regional surveys show that 79% of children under two years of age use a mobile phone, 6% of preschool children have a phone, 4.2% of whom have a phone before the age of four. According to research from the United States, about 72% of children under 6 years of age, know how to use a computer, about 30% do it on average an hour every day, while about 40% of children are introduced to an electronic device at the age of 3. This percentage is constantly increasing. The WHO warns that children under the age of two should not use electronic devices with screens. The question is at what age should children use modern technology and how? Aim: Using clinical examples from mental health practice the aim is to raise awareness about the dangers of the Internet and mobile phones to use at a young age and point to the lack of rules regarding their use in the family. Method: Case studies from the clinical practice showing the dangers of the Internet and mobile phone use at a young age, and pointing to the lack of rules for their use in the family. Conclusion: It is important to raise greater awareness about the dangers of internet use to minimize the exposure of young children and adolescents to asocial and inappropriate content which may be detrimental to their health and, in some instances, life-threatening. The technology and its applications are undeniably important in the education and development of young people, but the risks associated with their use must be pointed out, emphasizing family cohesion as a factor that may reduce exposure to hazardous situations. The negative impact can be prevented by carefully introducing digital technology to children, controlling the use and setting good examples of the appropriate use of these technologies by adults.
