War orphans have been reported to have unfavorable psychological outcomes; however, research on the impact of an orphan’s age at father loss on later mental health and resilience is scarce. In a sample of 50 orphans (mean age 18.9 SD ± 1.5 years, age range 16–21 years, 54

Introduction: Globally, the most common mental disorders in the elderly include dementia (5% - 8%), depression (7%), anxiety disorder (4%), and substance abuse (1%). Moreover, 25% of suicide deaths occur among the elderly. Whether the prevalence rate of psychiatric disorders increases in later life is currently debated in the literature. During the previous two decades of their lives, older adults in Bosnia and Herzegovina have experienced many specific psychosocial circumstances. The experience of war aggression on our country, and the post-war period with a very complex socioeconomic environment of the current socio-political climate, were accompanied by special challenges for the mental health of this population. Motivated by a large number of questions and dilemmas related to the state of mental health of this population, we conducted research at the Department of Psychiatry at the University Clinical Center Tuzla.Objective: Our objective was to investigate psychiatric morbidity and comorbidity in people over 55 years of age.Methods: The research sample consisted of all patients older than 55 years treated at the Department for Psychiatry during 2018 (N=281), divided into four age categories. To obtain data, we used medical documentation, i.e., medical records, and we constructed a special questionnaire for research purposes.Results: Diagnoses by ICD-10 groups: 33.4% of patients in the entire sample had affective disorders (F30.0-F39.0): "young" (39.2%), "middle" (43.3%), "older "(75%) (p<0.001); women had significantly more affective disorders (61.8%) than men (26.8%) (p<0.001). Men had significantly more organic mental disorders (F00.0-F09.0) (63.3%) than women (22.6%) (p<0.001).Hypertensio arterialis was the most common comorbid dg. of the entire sample, without significant differences according to age groups and sex (p>0.05). Diabetes mellitus was the second comorbid dg. By frequency in the total sample (19.6%) without significant differences according to age groups and according to sex (p>0.05).Conclusion: In the entire sample, the most common diagnoses are from the affective disorders group; the most common somatic comorbidities are hypertensio arterialis and diabetes mellitus.

Introduction The term “neurodevelopmental disorders” was first used in DSM-5. The ICD-11 retained this term, with some changes in the classification compared to DSM-5 and ICD-10. Objectives To identify changes on neurodevelopmental disorders in three classifications. Methods Review of neurodevelopmental disorders in ICD-10, DSM-5 and ICD-11. Results Neurodevelopmental disorders applie to a group of disorders with early onset that affect cognitive and social development. ICD-10 doesn’t have a dedicated group for neurodevelopmental disorders and uses different terminology for specific conditions. DMS-5 replaced term “Mental Retardation” with less stigmatizing “Intellectual Disability”, while ICD-11 proposes term “Disorders of intellectual development”. They continue to be defined on basis of significant limitations in intellectual functioning and adaptive behaviour. In recognition of lack of access to locally appropriate standardized measures and due to importance of determining severity for treatment planning, ICD‐11 provide a comprehensive set of behavioural indicator tables. Another big change is made with hyperkinetic disorder, that is classified among behavioural disorders in child and adolescent age in ICD-10. In DSM-5 and ICD-11 is among neurodevelopmental disorders, replaced with term “Attention deficit hyperactivity disorder”. Pervasive developmental disorders that is consisted of eight different subtypes in ICD-10, in DSM-5 and ICD-11 is replaced with “Autism spectrum disorders” category. Guidelines for autism spectrum disorder have been substantially updated to reflect the current literature. According to ICD-11, autism spectrum disorders and ADHD may coexist in an individual, which is useful since there is good evidence that children with this comorbidity can benefit from stimulant medications. Finally, tic disorders in ICD-11 are classified under the Diseases of the nervous system, while in DSM-5 they are placed within neurodevelopmental disorders. Conclusions ICD-11 doesn’t deviate significantly from DSM-5 when it comes to neurodevelopmental disorders, which is in accordance with the goal of WHO and APA to harmonize two psychiatric classifications. Disclosure of Interest None Declared

More research on the medium- and long-term effects of childhood exposure to war, including orphanhood, is needed. We compared 50 orphans 1 who lost their father during the war in Bosnia and Herzegovina (1992-1995) and 50 age- and sex-matched adolescents from two-parent families during 2011-2012 in terms of sociodemographic characteristics, behavioral/emotional problems, depression, resilience, maternal mental health, and perceived social support. The two groups differed on sociodemographic factors, that is, number of children, family composition, income, school grades, and refugeehood. Paternal war orphans did not differ in terms of adolescent mental health and resilience from their nonorphaned peers, controlling for sociodemographic variables. The mothers of orphans had comparably more posttraumatic psychopathology. As for perceived resources for social support, orphans identified those comparably more often among distant relatives and in the community, that is, religious officials and mental health professionals, and less often among siblings, paternal grandparents, paternal and maternal uncles/aunts, school friends and teachers. Our findings suggest that contextual factors may play an important role in orphans' postwar mental health.

Background:Globally, life expectancy is increasing, leading to an equal proportion of elderly and young individuals, which carries extensive implications. In Bosnia and Herzegovina (BiH), the average age at death in 2021 was 77 years, positioning BiH in the middle of the global list of average life expectancy. Current studiesinvestigate whether the prevalence of psychiatric disorders increases or decreases with age, but results are inconsistent regarding the role of age.There is no prior research on mental disorders in the elderly population in BiH. The experience of the previous war in BiH and the post-war complex "transitional period" have been associated with specific challenges to the mental health of this population, inspiring our research topic.Objective:The aim of this study was to investigate the psychiatric morbidity in hospitalized individuals aged≥55 years.Methods:The sample consisted of all patients over age 55 treated at the Department of Psychiatry in Tuzla between January 2018 and December 2020 (N=637), divided into four age categories. Data were obtained from medical records, and for research purposes, a specific questionnaire was constructed.Results:The predominant psychiatric morbidity stemmed from the category of affective disorders, most common within the "55-64 years" age group, while organic mental disorders were more prevalent in other age groups.Substance use disorders were present in patients aged "55-64 years", with a sharp decline in their prevalence in older age. Female participants had a significantly higher prevalence of affective, psychotic, neurotic, and stress-related disorders, whereas male participants exhibited an increased prevalence of organic mental and substance use disorders.Conclusion:In total sample, the most prevalent diagnoses belong to the category of affective disorders. Female were most frequently diagnosed with affective disorders, whereas organic mental disorders and substance use disorders prevail in male.

INTRODUCTIONPaediatric psychopharmacology involves the application of psychotropic agents to the treatment of children and adolescents with mental disorders and gathered knowledge from child and adolescent psychiatry (CAP), neurology, paediatrics and pharmacology. Defining elements of this discipline are: the metabolism of drugs is different in children than in adults (pharmacokinetics), the developing brain reacts specifically to the drug (pharmaco dynamics), and psychopathology itself is not differentiated yet. To make and overview of specifics in psychopharmacological use in CAP and emphasize some experiences from Bosnia and Herzegovina in that field.METHODSThrough insight in current literature, we presented comprehensive findings and compare it with situation in Bosnia and Herzegovina.RESULTSThe most common conditions in which psycho pharmaceuticals are used in CAP were attention deficit hyperactivity disorders (ADHD), depressive and bipolar disorder, obsessive compulsive disorder and the treatment of early psychosis. Psycho pharmaceuticals were also used to treat agitated conditions in various causes. We made an overview of psycho pharmaceuticals use in Bosnia and Herzegovina CAP and emphasized the fact that psycho stimulants are not approved for the use yet, although they are mostly prescribed medicament in CAP over the world. That limits us in the effectiveness of the treatment in ADHD and put us in the situations to use other medicaments instead (anxiolytics, antipsychotics, mood stabilizers) which are not approved for that condition.CONCLUSIONThe use of psycho pharmacotherapy in CAP is justified in cases where it is necessary to reduce the suffering of children and to improve their functionality at the time when cognitive, social and emotional advancement is most pronounced. Further research and clinical monitoring of efficacy and safety in the use of psycho pharmaceuticals in youngsters are necessary.

BackgroundImpulsivity, affective instability, and neglect of oneself and other people's safety as symptoms of personality dysfunction are associated with risky behaviors regarding the transmission of infectious diseases either sexually or by intravenous drug abuse.ObjectiveThe aim of this study was to analyze the association between hepatitis C virus (HCV) infection and personality dysfunction in opiate addicts on opioid substitution treatment.MethodsThis was a cross-sectional, observational investigation of patients over 18 years of age who were actively participating in opioid substitution treatment at five centers in Bosnia and Herzegovina. The occurrence of HCV infection was the primary study outcome, and personality functioning, the main independent variable, was assessed using the Severity Indices of Personality Problems (SIPP−118) questionnaire. The association between scores of personality functioning domains items and HCV infection status was determined by binary logistic regression analysis.ResultsPatients on opioid substitution therapy with HCV infection more frequently had personality disorders (OR 2.168, 95% CI 1.161–4.05) and were treated longer than patients without HCV infection (OR 1.076, 95% CI 1.015–1.14). HCV infection was associated with lower self-respect (OR 0.946, 95% CI 0.906–0.988), decreased capacity to have enduring relationships with other people (OR 0.878, 95% CI 0.797–0.966), and lower capability to cooperate with others (OR 0.933, 95%CI 0.888–0.98). On the other hand, except for self-respect, other elements of the Identity Integration domain (enjoyment, purposefulness, stable self-image, and self-reflexive functioning), when more functional, increased the risk of HCV infection.ConclusionsOur study demonstrates that opiate addicts on opioid substitution treatment have a higher risk of HCV infection if their personality is dysfunctional, especially in the aspects of self-respect, enduring relationships, and cooperativity. The risk is even higher in addicts who have an established diagnosis of any kind of personality disorder.

Although the question of death and the fear of it is one of the oldest questions man has dealt with, we have no discussions from ancient times about fear in an existential sense. The thematic approach to this phenomenon in Western philosophy and theology occurs in Hellenism and in the Christian religion, but it gains its full meaning only in the philosophies of existence. The famous Islamic philosopher and physician Ibn Sina, better known in the West as Avicenna (980-1037), wrote A Treatise on the Cure for the Fear of Death and the Treatment of Anxiety Caused by It more than nine centuries ago. Relying on Islamic teachings, Ibn Sina made a comprehensive analysis of this problem in the Treatise, giving precise instructions on how to deal with people who have mental impediments due to the fear of death, which in modern psychiatry are called anxiety and fear-related disorders. In this paper, a brief analysis of the Treatise is made in order to point out possible guidelines in the approach to the problem of fear of death, which in modern psychiatry, psychopathology and psychotherapy is obviously not given enough attention.

BACKGROUNDS Written historical evidence reveals that Cannabis sativa has been used medically, recreationally and spiritually for more than five centuries in many cultures. It is considered the most-used plant-based psychoactive substance with millions of different usages across the world. To review what the studies, conducted over the past two decades, indicate about effects of the cannabis on physical and mental health as well as the impact on social functioning. METHODS We selected literature review using PubMed resources, to summarize the findings of the existing publications on cannabis and cannabinoids and their possible psychopharmacological therapeutic effects only. RESULTS Research supports cannabis' clear acute effect on neurocognition, while non-acute effects for prolonged use of marijuana are unclear and still insufficiently explored. Due to cannabidiol's (CBD) safety and tolerability, the absence of psychoactive or cognitive effects, the existence of clinical trials with positive results and its broad pharmacological spectrum, CBD is a cannabinoid whose initial results will likely lead to implementation into clinical practice. The fact that the results of previous studies establish the claim of CBD as an antipsychotic and anxiolytic, makes the above developments even more likely. However, long-term, double-blind, placebo studies with samples of patients with different psychotic and anxiety disorders are still necessary. Likewise, due to CBD's biphasic effects, determining an adequate therapeutic dose remains a challenge to conclude, the cannabinoid system represents a promising target for new therapeutic interventions in psychiatry. CONCLUSION Further controlled studies are essential to determine the precise mechanisms of action of cannabinoids on various neuropsychiatric disorders as well as the safety of their use are needed. Never just the use of 'smoking cannabis in an unlicenced way'. The use of simple 'smoked cannabis' remains dangerous because of the effects on inducing psychosis which the article itself refers to, and needs to remain illegal.

Recent researches, following the pandemic, have shown in people, especially the youngest ones, an increase of suffering, articulated in tiredness and being worried, all feelings linked primarily to the national closure of schools and social meeting... Depressive and languishing mood seem to be the normal condition of everyday feeling of each of us, young and adult.

BackgroundNumbers of psychiatric beds (general, forensic, and residential) and prison populations have been considered to be indicators of institutionalisation of people with mental illnesses. The present study aimed to assess changes of those indicators across Central Eastern Europe and Central Asia (CEECA) over the last three decades to capture how care has developed during that historical period.MethodsWe retrospectively obtained data on numbers of psychiatric beds and prison populations from 30 countries in CEECA between 1990 and 2019. We calculated the median of the percent changes between the first and last available data points for all CEECA and for groups of countries based on former political alliances and income levels.FindingsPrimary national data were retrieved from 25 out of 30 countries. Data from international registries were used for the remaining five countries. For all of CEECA, the median decrease of the general psychiatric bed rates was 33•8% between 1990 and 2019. Median increases were observed for forensic psychiatric beds (24•7%), residential facility beds (12•0%), and for prison populations (36•0%). Greater reductions of rates of psychiatric beds were observed in countries with lower per capita income as well as in countries that were formerly part of the Soviet Union. Seventeen out of 30 countries showed inverse trends for general psychiatric beds and prison populations over time, indicating a possible shift of institutionalisation towards correctional settings.InterpretationMost countries had decreased rates of general psychiatric beds, while there was an increase of forensic capacities. There was an increase in incarceration rates in a majority of countries. The large variation of changes underlines the need for policies that are informed by data and by comparisons across countries.FundingAgencia Nacional de Investigación y Desarrollo in Chile, grant scheme FONDECYT Regular, grant number 1190613.

A personalized and holistic approach to therapy is increasingly demanding answers to questions related to the meaning of life. Over the years, research has shown a direct link between the presence of meaning in life, health and recovery. It becomes impossible to ignore this connection as well as the issues of spirituality and religiosity that are immersed in the meaning of life. The article presents different definitions of meaning, the relationship of meaning in life and parts of meaning to quality of life, allostasis, stress, pathological conditions and recovery, and finally connecting the points between creative psychopharmacotherapy and meaning. A complementary approach to the meaning of life implies a desire for a clear, reliable understanding of three related but different dimensions: continuity (as opposed to fragmentation), purpose (as opposed to pointlessness), and value (as opposed to worthlessness). Creating personal meaning in life structures can provide a context for understanding and integrating stressful situations. Finding meaning means connecting, meaning are the expected connections and associations that human beings see in their world. In this aspect, the construction of meaning is a dimension that we impose on the world. Each person's ability is to decide what makes their life meaningful. The meaning of life is a changing cognitive-emotional framework, directly accessible to subjective assessment based on one's own needs and values. The art of living is to discover in though and painful life situations their true meaning, values and meaning of life, and thus health and disease. Creative psychopharmacotherapy can be used to help patients discover and explore the sensation of meaning, create a new meaning in life, a new life story, manifest their potential through recovery. Mental disorders present a chance to break with misplaced life goals and values and turn to authentic values through new forms of thinking, experiencing, behaving, and creating a successful life.

In recent decades, it has been recognized that certain behaviors resemble addictions to alcohol and other psychoactive substances (PAS). Based on the results of research for such behaviors, many authors have found that it is justified to consider them addictions not related to PAS or "behavioral" addictions and that in the classifications of mental disorders should be in the same group with addictions related to PAS. Compulsive activities that may include gambling, Internet use, playing video games, sex, eating, and shopping based on epidemiological and neurobiological characteristics have similarities to PAS addictions. Recognition of clinical and neurobiological similarities between the described behaviors and behaviors related to PAS use resulted in the inclusion of gambling disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and online gaming disorders are classified as conditions for further research. In the 11th revision of the International Classification of Diseases, gambling and gaming disorders are involved in behavioral addictions. Authors presented problem of gambling through sevne perspectives.

Unresolved infectious psycho-neuro-endocrino-inflammation (PNEI) denotes an area of tragically accelerated interest because of SARS-CoV-2`s capacity to meddle with the immune responses in a stage-wise fashion. Its pandemic, interacting with antecedent further deteriorating health and living conditions, takes a direct toll of million human lives. In order to withstand the plethora of slowly or never easing ailments labeled Post-acute Sequelae of Covid-19 (PASC) a comprehensive understanding from the intrusions up to its emerging aftermaths is paramount. For the strained health professions these prospect care requirements of 1 in 5 for a non-convalescence overlapping also with other tedious long-hauling triggered disorders adjacent to psychiatry like chronic fatigue with orthostasis intolerance or intracranial hypertension (ME/CFS-OI; IIH). For the lattter two new pathophysiologies are proposed in order to inform a strong rehabilitative psychiatric liaison not referring sufferers to a psychiatric enigmo-somatic bin, but to an invigorated somato-psychic care e. g. for exertional malaise. Starting from early stimulation of escalating myeloid-derived suppressor cells the neglected mast cells show up (for now without their lymphatic partners) as ambivalent core participants. They interact or orchestrate or sequentially explode in etosis guarding or breaking sane barriers especially at cerebral arteries. In Covid-19 they seem unleashed at the blood-brain-barrier by the early virally invaded nasal ganglia, which plausibly mis-direct the quickest interstitial arterio-intramural outflow - thus a.) losing its ability to comply with pulsatile flow through varying the width of its sliding chambers causing ME/CFS-Orthostatic Intolerance and b.) inflaming and stiffening the brain's interstitium through a push-back outpacing the confuted inventive glymphatic-1.0 model. Mast cells - colonized or not - plausibly permeabilize the choroid plexus and venous or bony brain barriers co-causing the not so rare Idiopathic Intracranial Hypertension. Innate memory - as activated by short RNAs through BCG-vaccinations directed against the permanent TBC-pandemic leads to hopes for a hastening of resolutions through a combined medical, exertional, psychosocial, and psychiatric rehabilitation informed by a new PNEI - paving the way for amplified-BCG or future psychiatric vaccinations.

Ibn Sina (Avicenna) is primarily known for his philosophy and medicine, but there is almost no scientific discipline in which this great man didn't leave a significant mark. This paper gives a brief review of his contributions to medicine, especially to psychiatry. Medical works of Ibn Sina represent a pinnacle of most important medical achievements of his time. These works contain synthesis of all Greek, Indian and Iranian medical schools, but also new breakthroughs achieved by Muslim scholars through their own experimentation and practice. Although he wrote many medical works, his most important one is El-Kanun fit-tib, which can be translated as The Canon of Medicine. It's made out of five books which systematically show everything known in the area of medicine up until that point in time. In it, Ibn Sina discusses, among other things, the structure of psychological apparatus of human being and the connection of psychological functions with the brain as well as the role of psyche in etiology of somatic diseases. He also describes certain psychiatric diseases along with the explanation of their etiology and recommended therapy. He considered psychology to be very important for medicine, so in his psychological works he discusses, in great detail, the essence of human soul, consciousness, intellect and other psychological functions.

Eye Movement Desensitization and Reprocessing (EMDR) therapy is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma. EMDR is a set of standardized protocols that incorporates elements from many different treatment approaches. As EMDR is a mental health intervention, it should only be offered by properly trained and licensed mental health clinicians (Anonymous 2018). An EMDR International Association (EMDRIA) approved EMDR Training provides trained clinicians with the knowledge and skills to utilize EMDR therapy, a comprehensive understanding of case conceptualization and treatment planning, and the ability to integrate EMDR therapy into their clinical practice. Also, an EMDRIA approved EMDR Training provides, at a minimum, instruction in the current explanatory model, methodology, and underlying mechanisms of EMDR through lecture, practice, and integrated consultation. While the EMDRIA Approved EMDR Training Curriculum outlines the minimum requirements which need to be met, the developer of a specific curriculum can enhance or expand any portion as they see fit. This minimum training requirements include: 20 hours instruction material, 20 hours supervised practicum, and 10 hours consultation. Supervised Practicum which needs to be realized in 20 hours has the goal to facilitate the demonstration and practice of the EMDR therapy methodology by trainees (Ališahovi -Gelo 2017, 2018). One cohort consisted of three parts of EMDR training. The first level was realized through three days where trainees were introduced to basic principles of EMDR therapy in interactive lectures about the history of EMDR, eight phases of EMDR protocol, practicing in a small group, in couples and triads under the supervision of trainer and facilitators. The second part of training is intermediate level, and it consisted of practicing of eight phases of EMDR protocol, practicing in small groups, in couples and triads under the supervision of trainer and facilitators, additional theoretical learning, with supervision of case reports that trainees brought from their practice after the first level. Finally, the third part of EMDR training needs three days for realization where trainees were introduced to advanced principles of EMDR therapy and work with the complex medical conditions in interactive lectures following the eight phases of EMDR protocol, practicing in small groups, in couples and triads under supervision of trainer and facilitators, with group supervision of case reports that trainees brought from their practice after the intermediate level. For those who completed all three theoretical parts of EMDR training, they accomplished the condition for the process of supervision, whether in person or by Skype, for acquiring accreditations for European accredited EMDR practitioners, which lasts a minimum of two years under the supervision of accredited EMDR consultants, accredited from EMDR Europe (Hasanovi et al. 2017, 2018). The aim is to describe some personal impressions and self-experience gained during EMDR training and 18 implemented group supervision.