Recurrent nonmelanoma skin cancer is a chronic, mutilating disease with great potential to leave cosmetic, functional, and emotional consequences. Aims: To examine the correlation between psychological symptoms, quality of life and resilience in people with recurrent nonmelanoma skin cancer. Methods: A clinical retrospective study was conducted at the Clinic for Otorhinolaryngology and Maxillofacial Surgery of the University Hospital Mostar in the period from February 2025 to April 2026. The study sample consisted of 160 patients who underwent surgery for nonmelanoma facial skin carcinoma. Data were collected with a sociodemographic questionnaire, the Symptom Checklist-90-R (SCL-90-R), the Connor Davidson Resilience scale 25 (CD-RISC-25) and World Health Organization Quality of Life Scale (WHQOL-BREF). Results: Correlation analysis showed significant associations between psychological symptoms, quality of life and resilience. All dimensions of psychological symptoms were statistically significantly negatively related to quality of life. Resilience measured by the CD-RISC scale showed a weak but statistically significant negative correlation with non-specific psychological symptoms. Patients with reccurent NMSC had significantly more psychological symptoms (F = 21.961, p < 0.001), lower quality of life (F = 12.788, p < 0.001), and lower levels of resilience (F = 4.174, p = 0.043). Conclusions: Psychological factors play an important role in patients with nonmelanoma skin cancer. An integrated biopsychosocial approach, which includes the assessment of psychological symptoms and resilience, may contribute to a better understanding of patients' needs and improve the quality of treatment.

Introduction: Post-traumatic embitterment syndrome is a pathological reaction to drastic life events and doesnot have the tendency to end. This syndrome also occurs relatively frequently in patients with post-traumatic stress disorder (PTSD).Aim: To investigate post-traumatic embitterment syndrome in patients with post-traumatic stress disorder.Subjects and methods: A cross-sectional study was conducted on a sample of 200 subjects who were participants in the past war. The research group consists of 100 subjects who participated in the war and have a diagnosis of PTSD, and the control group consists of 100 healthy volunteers who were in the war but were not previously diagnosed with PTSD.The study used a sociodemographic questionnaire, a self-assessment questionnaire for post-traumatic embitterment syndrome, and a clinical questionnaire for post-traumatic stress disorder.Results: Subjects with PTSD show a statistically significantly higher level of post-traumatic embitterment syndrome compared to subjects without PTSD. There were no statistically significant differences between the groups that actively and passively participated in the war, between genders, and between the groups with current PTSD and lifetime PTSD.Conclusion: Subjects with PTSD show a statistically significantly higher level of post-traumatic embitterment syndrome compared to subjects without PTSD.

The aim of this research was to investigate the impact of COVID-19 on the mental health of primary health care workers. This prospective research included 107 medical (51.5%) and non-medical (48.5%) employees of Health Center (HC) Mostar. Data were gathered using a questionnaire that contained the depression, anxiety and stress scale (DASS-21) and a validated short questionnaire of human mental health (MHI-5) during the COVID-19 pandemic. Most respondents were < 45 years of age. There was no statistically significant difference between medical and non-medical staff on both the DASS-21 and MHI-5 scales. Also, no statistically significant difference was found in the subcategorization of medical staff. The prevalence of stress in the subjects was 30%, anxiety 54% and depression 31%. A multivariate logistic regression model found that age > 45 years (OR = 0.509; P = 0.016) and opiate use (OR = 0.203; P = 0.023) were positively associated with depression (P = 0.042). The overall crisis related to the COVID-19 pandemic has led to various psychological difficulties in the general population, but also in a significant percentage of healthcare workers at all levels of healthcare. Therefore, new approaches are necessary in the treatment of the mentioned mental health problems.

Objectives: To examine the mental health of patients with inflammatory bowel disease (IBD) treated with biological therapy.Methods: A cross-sectional study was conducted among patients with Crohn’s disease. Two groups were included: an experimental and a control group. The experimental group consisted of 100 patients with Crohn’s disease, of whom 50 were on biological therapy and 50 were not, all treated at the Department of Gastroenterology. Participants completed instruments adapted for the research: a sociodemographic questionnaire and the Symptom Checklist 90 (SCL-90), a tool designed to assess various aspects of mental health and personality.Results: The highest proportion of women was recorded among healthy participants (71.0%), while men were most represented in the group receiving biological therapy (58.0%). A significant difference was found between genders among healthy and diseased individuals. Participants receiving biological therapy achieved significantly higher scores in the domains of Obsessive–Compulsive Symptoms, Depression, and Psychoticism compared to the other groups. Conclusion: These findings are consistent with research highlighting the connection between mental health and disease activity, suggesting the need for a holistic approach in the diagnosis and treatment of IBD.

Introduction: Mental health and quality of life are key aspects of students’ daily functioning, and circumstances such as living conditions can significantly influence them. Given the increasing number of young people facing psychological difficulties during their studies, researching the relationship between lifestyle and mental health is of great importance. Objective: To examine the mental health and quality of life of students at the Faculty of Health Studies, University of Mostar. Subjects and Methods: A cross-sectional study was conducted. The research included 150 participants: 84 students living as tenants (study group) and 66 students living with their parents (control group). Data were collected using a sociodemographic questionnaire specifically designed for this study, the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, and the Symptom Checklist-90-R (SCL-90-R) self- assessment questionnaire for psychological symptoms. Results: A statistically significant difference was found between students living as tenants and those living with their parents in the psychological symptom self-assessment scale Tenants scored significantly higher (p<0.001) in the domains of Somatization, Obsessive Compulsive Disorder, Interpersonal Sensitivity, Depression, Anxiety, Hostility/Aggression, Phobic Anxiety, and Paranoid Ideation. There was no statistically significant difference in quality of life between students living with their parents and those living as tenants (p<0.005). Conclusion: Students living as tenants exhibit higher levels of psychological symptoms. However, there is no statistically significant difference in quality of life between students living as tenants and those living with their parents, regardless of the domain. Keywords: Mental health, quality of life, students

BACKGROUND:We aimed to identify therapeutic approaches for managing schizophrenia in different phases and clinical situations - the prodromal phase, first-episode psychosis, cognitive and negative symptoms, pregnancy, treatment resistance, and antipsychotic-induced metabolic side effects - while assessing clinicians' adherence to guidelines. METHODS:A cross-sectional online survey was conducted in 2023 as part of the Ambassador project among psychiatrists and trainees from 35 European countries, based on a questionnaire that included six clinical vignettes (cases A-F). Additionally, a review of multiple guidelines/guidance papers was performed. RESULTS:The final analysis included 454 participants. Our findings revealed a moderate to high level of agreement among European psychiatrists regarding pharmacological treatment preferences for first-episode psychosis and cognitive and negative symptoms, prodromal symptoms and pregnancy, with moderate adherence to clinical guidelines. There was substantial similarity in treatment preferences for antipsychotic-induced metabolic side effects and treatment resistance; however, adherence to guidelines in these areas was only partial. Despite guideline recommendations, non-pharmacological treatments, including psychotherapy and recovery-oriented care, were generally underutilized, except for psychoeducation and lifestyle recommendations, and cognitive behavioural therapy for treatment of the prodromal phase. Contrary to guidelines, cognitive remediation and physical exercise for cognitive symptoms were significantly neglected. CONCLUSIONS:These discrepancies highlight the need for effective implementation strategies to bridge the gap between research evidence, clinical guidelines/guidance papers, and real-world clinical practice. Clinicians' unique combination of knowledge and experience positions them to shape future guidelines, especially where real-world practice diverges from recommendations, reinforcing the need to integrate both research evidence and clinical consensus.

BACKGROUND:Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD). METHODS:The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148). RESULTS:About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines. CONCLUSIONS:Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.

Introduction: The use of psychoactive substances is a serious and difficult problem in many countries of the world, and is taking on epidemic proportions, especially in the youth population. Disorders caused by the psychoactive substance useinclude a wide range of disorders. Experts are finding it increasingly difficult to monitor the possible consequences that drugs can cause in the human body.Aim: To examine the prevalence of the psychoactive substance useamong high school students in Županja. Respondents and methods: A cross-sectional survey was conducted during May 2023. The first group of respondents consisted of 115 students of the third and fourth grades of the Županja Grammar School, while the second group consisted of 100 students of the third and fourth grades of the Županja Vocational School. The research instrument was a standardised internationally agreed questionnaire "European Research in Schools on Smoking, Drinking and Drug Use among Pupils" (2011). European School Survey Project on Alcohol and Other Drugs (ESPAD). Results: A statistically significant number of respondents has never used cigarettes, alcoholic beverages, adhesives and other solvents. Respondents fromthe Vocational School used cigarettes on a larger scale daily, while Grammar school students started smoking at an older age. In the last 12 months, when compared to the Vocational School students, a higher percentage of Grammar School students have used adhesives and other solvents. Grammar School students experimented with"drugs" in a higher proportion due to curiosity. Conclusion: The prevalence of the psychoactive substance use among high school youth in Županja is at a satisfactory low level.Keywords:psychoactive substances, students, secondary school

Post-traumatic stress disorder (PTSD) genetics are characterized by lower discoverability than most other psychiatric disorders. The contribution to biological understanding from previous genetic studies has thus been limited. We performed a multi-ancestry meta-analysis of genome-wide association studies across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases). We identified 95 genome-wide significant loci (80 new). Convergent multi-omic approaches identified 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators (for example, GRIA1, GRM8 and CACNA1E), developmental, axon guidance and transcription factors (for example, FOXP2, EFNA5 and DCC), synaptic structure and function genes (for example, PCLO, NCAM1 and PDE4B) and endocrine or immune regulators (for example, ESR1, TRAF3 and TANK). Additional top genes influence stress, immune, fear and threat-related processes, previously hypothesized to underlie PTSD neurobiology. These findings strengthen our understanding of neurobiological systems relevant to PTSD pathophysiology, while also opening new areas for investigation. Multi-ancestry genome-wide analyses identify 95 loci associated with post-traumatic stress disorder and implicate candidate genes, pathways and neurobiological systems underlying its pathophysiology.

In recent decades, conventional medicine has begun to include natural remedies and spiritual therapy in the treatment of people with mental disorders, and in recent years, physicians and healthcare professionals more often refer to alternative and complementary methods in the treatment of mental disorders. Alternative medicine includes “other treatments” and a more suitable term would be complementary medicine which supplements the definition of conventional medicine accepted by the World Health Organization. After the rise of pharmaceutical industry in the second half of the 20th century and significant advancement in the treatment of mental disorders, comes a period of disappointment and acceptance of the fact that synthetic drugs are not omnipotent and may have serious and unpleasant side-effects. Due to this fact, there is a growing interest in the treatment of mental disorders with the use of complementary methods. It is important to note that these methods are not a substitute for standard treatment procedures and their appropriate application does not diminish the importance of classical treatment of psychiatric disorders. Numerous patients refuse classical therapy and seek the help of complementary medicine methods. It is therefore important for physicians and healthcare professionals to have knowledge of complementary medicine which is science based and advises on treatment methods provided they are scientifically justified. Key words: complementary medicine, psychiatry

Severe acute respiratory infections (SARI) are estimated to be the cause of death in about 19% of all children younger than 5 years globally. The outbreak of coronaviral disease (COVID-19) caused by SARS-CoV-2, increased considerably the burden of SARI worldwide. We used data from a vaccine effectiveness study to identify the factors associated with SARS CoV-2 infection among hospitalized SARI patients. We recruited SARI patients at 3 hospitals in Serbia from 7 April 2022-1 May 2023. We collected demographic and clinical data from patients using a structured questionnaire, and all SARI patients were tested for SARS-CoV-2 by RT-PCR. We conducted an unmatched test negative case-control study. SARS-CoV-2 infected SARI patients were considered cases, while SARS CoV-2 negative SARI patients were controls. We conducted bivariate and multivariable logistic regression analysis in order to identify variables associated with SARS-CoV-2 infection. We included 110 SARI patients: 74 were cases and 36 controls. We identified 5 factors associated with SARS-CoV-2 positivity, age (OR = 1.04; 95% CI = 1.01-1.07), having received primary COVID-19 vaccine series (OR = 0.28; 95% CI = 0.09-0.88), current smoking (OR = 8.64; 95% CI = 2.43-30.72), previous SARS CoV-2 infection (OR = 3.48; 95% CI = 1.50-8.11) and number of days before seeking medical help (OR = 0.81; 95% CI = 0.64-1.02). In Serbia during a period of Omicron circulation, we found that older age, unvaccinated, hospitalized SARI patients, previously infected with SARS CoV-2 virus and those who smoked, were more likely to be SARS-CoV-2-positive; these patient populations should be prioritized for COVID vaccination.

Introduction: Inflammatory bowel disease (IBD) refers to two main diseases: ulcerative colitis and Crohn's disease. In terms of structure and process, it has been postulated that IBD treatment requires a multidisciplinary approach in which physicians, nurses, nutritionists, and social workers interact to achieve goals. The role of doctors in treatment is clearly defined, but it is useful to define the role of nurses in the care of patients with IBD. Objective: Clarify the influence of nurses on the quality of care in the treatment of patients with inflammatory bowel diseases.Methods: An electronic search of the PubMed, MEDLINE, EMBASE databases was conducted and the Cochrane database. The search was performed using keywords. This paperincludes studies which examines contributions within 10 years of nurses in the quality of care for patients with IBD.Results: The number of hospital visits decreased from 1,377 to 853 (38 % decrease) in institutions that had a specialized IBD nurse. Patient satisfaction has been improved inkey areas, particularly in IBD information approaches and conservation health advice. The number of patients in remission increased from 63 % to 69 %. Recognized IBD nurse releasedthe doctor's resources, and better contacts with patients were achieved, and thus a smaller number of hospitalization.Conclusion: It is important to recognize the role of specialized nurses who are dedicated to the care and observation of patients with inflammatory bowel diseases in the management of specialist nursing interventions to improve the care and observation of patients, the disease itself, access to treatment, discharge, morbidity and quality of life. Nurse education is an important part of care for patients suffering from inflammatory bowel diseases, because the nurse is the first person from whom patients will ask for cooperation after diagnosing the disease. Keywords: inflammatory bowel disease, nurse, IBD specializations

Personalized healthcare, tailored to individual characteristics, has gained prominence in the modern healthcare systems. This comprehensive review explores the various aspects of personalized healthcare and its impact on patient resilience.The review incorporates a synthesis of literature from multiple disciplines, including genetics, psychology, nutrition, and environmental factors. It analyzes the role of personalized health care in enhancing patient resilience, considering genetic predisposition, psychological aspects, nutrition, environmental influences, individualized treatment plans, treatment outcomes, challenges, and future directions.Genetic analysis is crucial for identifying patients' predispositions and making personalized treatment decisions. Psychological factors significantly influence patient resilience, with adaptable therapeutic approaches to enhance psychological resilience. Personalized dietary recommendations, based on individual needs and genetic factors, improve overall health. Environmental factors, such as air quality and stress, impact patient well-being, and personalized care involves monitoring and reducing these risks. Integrating these aspects into individualized treatment plans leads to improved outcomes and quality of life. Real-world examples confirm the effectiveness of personalized healthcare in strengthening patient resilience.Personalized health care plays a vital role in enhancing patient resilience. It offers tailored treatment plans that address individual characteristics, resulting in improved treatment outcomes and quality of life. Keywords:personalized health care, indicator, resilience, patient

Greater insight into patient's quality of life can help researchers and clinicianstouse quality of life as a measure fortreatment outcomes.Breast cancer is a stressful and causes extremely difficult physical, emotional and social challenges. In addition to concerns about whether breast cancer will metastaize and the impact of treatment side effects on daily life, breast cancer patients are more likely to experience depression than patients with other types of cancer. Surgery, chemotherapy, radiation therapy, and other forms of treatment can cause changes in a patient's physical apperance, leading to anxiety, pain, depression, and low self-esteem.Self-esteem is determined by positive or negative feelings as well assatisfaction and confidence in oneself. It also refers to the belief that one is capable of coping with life's challenges and is worthy of happiness. One study found that self-esteem is a key factor in the growth andreturn to normal life in breast cancer patients. Low self-esteem has been found to be strongly associated with depression and other psychological problems.The diagnosis and treatment of breast cancer encompasses a critical period in a woman's life duringwhich she suffers from anxiety ofthe cancer spreading to other parts of the body, uncertainty about the future, anxiety and depression, anger, frustration, pain, changes in self-image, fear of losing femininity and changed confidence. Advances in the diagnosis and treatment of breast cancer, pathological differences between this disease and other chronic diseases, changes in self-esteem, the development of negative emotions, the experience of everyday problems at work and in interpersonal relationships, and the development of anxiety can lead to changes in the quality of life of patients with breast cancer.The objectiveof this studyis to explain the connection between the quality of life and self-esteem of breast cancer patients.Keywords: connection, quality of life, self-esteem, cancer, breast

One full century after the assassination in Sarajevo, Gavrilo Princip continues to capture a lot of attention, both for his character and the symbolic potential of his act that changed the course of history. That is why his appearance in modern comic books does not come as a sur- prise, and this paper is going to focus on two titles – Linije fronta, a nine-book collection by var- ious artists published between 2014 and 2020, as well as Atentat – s one strane patnje, a graphic novel written by Boris Stanić and Guido van Hengel. The nature of these two pieces, as well as numerous differences that set them apart – technical, organizational, stylistic, poetic, ideologi- cal, and thematic – cause a different representation of the First World War and the assassination in Sarajevo, on the one hand, and the character of Gavrilo Princip, on the other. These similari- ties and differences will be a part of the analysis, and by emphasizing them, we will try to reach a more detailed view of the position of Gavrilo Princip in the world of modern comic books.

Posttraumatic stress disorder (PTSD) genetics are characterized by lower discoverability than most other psychiatric disorders. The contribution to biological understanding from previous genetic studies has thus been limited. We performed a multi-ancestry meta-analysis of genome-wide association studies across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases). We identified 95 genome-wide significant loci (80 novel). Convergent multi-omic approaches identified 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators (e.g., GRIA1, GRM8, CACNA1E ), developmental, axon guidance, and transcription factors (e.g., FOXP2, EFNA5, DCC ), synaptic structure and function genes (e.g., PCLO, NCAM1, PDE4B ), and endocrine or immune regulators (e.g., ESR1, TRAF3, TANK ). Additional top genes influence stress, immune, fear, and threat-related processes, previously hypothesized to underlie PTSD neurobiology. These findings strengthen our understanding of neurobiological systems relevant to PTSD pathophysiology, while also opening new areas for investigation.

One full century after the assassination in Sarajevo, Gavrilo Princip continues to capture a lot of attention, both for his character and the symbolic potential of his act that changed the course of history. That is why his appearance in modern comic books does not come as a surprise, and this paper is going to focus on two titles - Linije fronta, a nine-book collection by various artists published between 2014 and 2020, as well as Atentat - s one strane patnje, a graphic novel written by Boris Stanic and Guido van Hengel. The nature of these two pieces, as well as numerous differences that set them apart - technical, organizational, stylistic, poetic, ideological, and thematic - cause a different representation of the First World War and the assassination in Sarajevo, on the one hand, and the character of Gavrilo Princip, on the other. These similarities and differences will be a part of the analysis, and by emphasizing them, we will try to reach a more detailed view of the position of Gavrilo Princip in the world of modern comic books.

Introduction: Addiction is a mental state or physical condition that results from the continued use of a substance or performance of a particular activity.Dual diagnosis is the co-occurrence in the same individual of severe mental problems and addiction disease.Objective: To test the frequency of co-occurring disorders among the users of psychosocial services in the therapeutic communities in the Republic of Croatia.Subjects and methods: A cross-sectional study on a sample of 648 members of therapeutic communities was carried out.The data were collected by means of a modified international Pompidou Group's questionnaire consisting of general sociodemographic data and the data on treatment, risky behaviour and legal problems.Results: More than a half of the total number of subjects had dual diagnosis.The most frequent diagnoses co-occurring with addiction were disorders of adult personality and behaviour and schizophrenia, schizophrenia-like disorders and delusional disorders.Co-occurring disorders were more frequent in women than in men.In the Pope John XXIII Community, the main addiction substance among people of young age was amphetamine, and this change in trends of psychoactive substance abuse should be additionally explored.Conclusion: Somewhat more than a half of users of psychosocial services in the therapeutic communities in the Republic of Croatia had dual diagnosis.

Resilience can be changed and modified over time, it is affected by many different situations and difficulties that a person overcomes during life. Resilience is a newer concept, which should be applied to the patient from the beginning of life with cancer. Clinicians should invest more time and effort in creating interventions that enable patients to foster their resilience. The term resilience or the ability to recover refers to the process of overcoming adverse events, including stress, trauma and illness. Considering the ability to recover as a personality trait imposes the assumption that the ability to recover represents a constellation of personal characteristics that enable individuals to adapt to different circumstances they encounter. Resilience as a complex phenomenon changes over time and circumstances. Understanding resilience as a complex, multidimensional and dynamic process is very important for understanding therapeutic mechanisms and healing mechanisms. Psychological factors are the most important factors that contribute to the development of resilience. It is necessary to work on the development of psychosocial interventions that will target the psychological resilience of cancer patients. Breast cancer is the most common malignant disease in women. In women with breast cancer who manage to develop the ability to resist and accept life's crisis, greater resilience and personal growth is created, thereby reducing the negative impact associated with the disease. The aim of this work is to explain the relationship between resilience and breast cancer. Key words: connection, resilience, cancer, breast