Ljubomir Hotujac - Academia.edu (original) (raw)
Papers by Ljubomir Hotujac
The recognition, diagnosis and treatment of bipolar disorders (BD) is a major task for public hea... more The recognition, diagnosis and treatment of bipolar disorders (BD) is a major task for public health and for mental health authorities. Bipolar disorders are among the most common mental disorders with a prevalence estimated at 1.5% of the adult population. When the whole spectrum of bipolar disorders including their sub-threshold forms are taken into consideration, the rate of BD has been estimated by some authors to be as high as 6%. The fact that BDs are recurrent makes the provision of eff ective and well-tolerated treatment to those suff ering from these disorders even more important.
Collegium antropologicum
The aims of this study were to assess prevalence and symptom profile of premenstrual dysphoric di... more The aims of this study were to assess prevalence and symptom profile of premenstrual dysphoric disorder (PMDD) in a sample of Croatian students and young university graduates. We obtained data for 87 healthy women, aged 18-30, at their regular gynecologic outpatient visits over the period of 2003 to 2004. The severity of premenstrual symptoms were assessed daily, during two cycles, with the Daily Record of Severity of Problems (DRSP) and criteria for PMDD according to DSM-IV were applied. Fifteen out of 87 women fulfilled PMDD criteria and reported statistically significantly higher prevalence of co morbid disorders in their medical history compared to non-PMDD group. The most common symptoms in the PMDD group were psychological, while in non-PMDD group were vegetative. Overall, relatively high prevalence of PMDD in studied group indicates the need to continue the study.
Neuro endocrinology letters, 2008
Treatment-resistant depression is one of the major challenges in clinical psychiatry, considering... more Treatment-resistant depression is one of the major challenges in clinical psychiatry, considering that its current treatments are far from optimal. Although known for decades, in the last few years vagus nerve stimulation (VNS) has become increasingly popular as a novel method of treatment of pharmacoresistant depression. In spite of an emerging body of literature concerning the effectiveness and potential mechanisms of action of VNS, some crucial questions regarding those issues remain to be answered. We review the pre-clinical and clinical literature relating to VNS, with the impact of studies of efficacy and safety in treatment of pharmacoresistant depression and also in other clinical applications in the field of psychiatric disorders. We conclude that in light of emerging reports, VNS warrants more controlled studies for the treatment of other forms of depression, including depression in a younger population, and also of other psychiatric disorders. Because of its safety, VNS c...
Collegium antropologicum, 2007
The aims of this study were to assess prevalence and symptom profile of premenstrual dysphoric di... more The aims of this study were to assess prevalence and symptom profile of premenstrual dysphoric disorder (PMDD) in a sample of Croatian students and young university graduates. We obtained data for 87 healthy women, aged 18-30, at their regular gynecologic outpatient visits over the period of 2003 to 2004. The severity of premenstrual symptoms were assessed daily, during two cycles, with the Daily Record of Severity of Problems (DRSP) and criteria for PMDD according to DSM-IV were applied. Fifteen out of 87 women fulfilled PMDD criteria and reported statistically significantly higher prevalence of co morbid disorders in their medical history compared to non-PMDD group. The most common symptoms in the PMDD group were psychological, while in non-PMDD group were vegetative. Overall, relatively high prevalence of PMDD in studied group indicates the need to continue the study.
International Journal of Psychiatry in Clinical Practice, 2002
While efficacy in treatment of the acute phase of schizophrenia is well established for so-called... more While efficacy in treatment of the acute phase of schizophrenia is well established for so-called atypical antipsychotics, more data regarding long-term treatment are needed. In a naturalistic, open-label study, 32 patients were included in order to investigate the efficacy and safety of risperidone over 3 years of treatment; 26 of them were treatment-resistant to the previously used antipsychotic drugs (except clozapine). At the end of the first year, 20 of these 26 patients showed at least partial improvement. At the end of the third year, 17 patients were still being treated with risperidone. While eight patients were lost to follow-up, six relapsed in spite of good compliance. All the adverse events which occurred during treatment were strictly dose-dependent and disappeared when the dose was lowered to 4 mg daily. Within the limits of naturalistic studies, it can be concluded that risperidone seemed to be an effective and safe drug for long-term treatment in the majority of our patients. (Int J Psych Clin Pract 2002; 6: 193-197 ).
European Neuropsychopharmacology, 1994
One of the most frequent objections to electroconvulsive treatment (ECT), by both laymen and medi... more One of the most frequent objections to electroconvulsive treatment (ECT), by both laymen and medical professionals, is that ECT impairs the cognitive functions of the brain. This paper is a study of the effects of ECT on the cognitive function of patients in whom such therapy was indicated due to the nature of their illness. The study included 11 female patients: six with mood disorder and five with schizophrenic psychosis (diagnostic criteria of DSM-IIIR). Bilateral electroshocks were given three times a week, by means of a Siemens apparatus, type 622, applying an electric current of 600 mA for 2.5 s under anesthesia.
Socijalna Psihijatrija, Jul 15, 2013
Prema vremenu pojavljivanja simptoma bolest se može podijeliti u dvije skupine: OPP s ranim pojav... more Prema vremenu pojavljivanja simptoma bolest se može podijeliti u dvije skupine: OPP s ranim pojavljivanjem i OPP s kasnim pojavljivanjem. Prosječna dob pojavljiva-Soc. psihijat., 41 (2013) 123 -127 Pregled oBuZeto-PrISILnI PoreMeĆaj MARTINA BOJANIĆ, ILARIA ČULO, ANA IVANIŠ, ANJA MARAVIĆ, JELENA TOPIĆ i LJUBOMIR HOTUJAC Klinika za psihijatriju Vrapče, Zagreb i Opća bolnica Vukovar, Odjel za psihijatriju, Vukovar, Hrvatska U radu su prikazane najnovije spoznaje o epidemiologiji, dijagnostici i liječenje obuzeto-prisilnog poremećaja (OPP). Prikazani rezultati pokazuju da je OPP znatno češći no što se ranije mislilo, a dijagnostika je obogaćena nizom novih neuroslikovnih istraživanja što pobuđuju nadu u bolje poznavanje etiologije poremećaja. Dat je pregled genetskih istraživanja, kao i načini liječenja poremećaja, kako psihofarmakološki, psihoterapijski tako i transkranijskom magnetskom stimulacijom, dubokom stimulacijom mozga i neurokirurškim metodama. Ključne riječi: obuzeto-prisilni poremećaj, transkranijska magnetska stimulacija, neurokirurške metode liječenja Adresa za dopisivanje: Ilaria Čulo, dr. med. Klinika za psihijatriju Vrapče Bolnička 32 10000 Zagreb, Hrvatska UVOD SUMMARY
Acta Medica Croatica C̆asopis Hravatske Akademije Medicinskih Znanosti, Oct 1, 2006
Epidemiological and clinical studies provide evidence that veterans with chronic PTSD can be at r... more Epidemiological and clinical studies provide evidence that veterans with chronic PTSD can be at risk of relapse with respect to a number of high-risk behaviors, including attempted suicide, violence, and misuse of alcohol and drugs. The aim of our study was to assess the prevalence of psychiatric comorbidity in veterans with chronic PTSD treated at Center for Crisis Intervention, Zagreb University Hospital Center, for 4 years. The diagnosis of PTSD and comorbid psychiatric diagnosis were confirmed according to DSM-IV criteria. Study results showed PTSD without comorbid psychiatric diagnosis to persist in 25.3%, and PTSD with comorbid psychiatric diagnosis in 74.7% of study subjects. The most common psychiatric disorders were depression, personality disorders, and alcoholism. It is important to recognize other comorbid disorders because of the increased risk of suicidal behavior. Accordingly, therapeutic intervention should be adjusted to each individual case.
Psychiatry Research, Sep 30, 2008
- The influence of 5-HT(2C) and MDR1 genetic polymorphisms on antipsychotic-induced weight ga... more 2008) The influence of 5-HT(2C) and MDR1 genetic polymorphisms on antipsychotic-induced weight gain in female schizophrenic patients. Psychiatry
Eur Neuropsychopharmacol, 1995
Collegium Antropologicum, Mar 1, 2009
Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumati... more Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumatic event or experience. Lifetime prevalence rate in the European population is 1.9 % and it is higher for women (2.9%) then for men (0.9 %). The aim of this study was to examine rates and sociodemographic and clinical characteristics of women with PTSD who were hospitalized at the Psychiatric clinic of University Hospital Center in Croatia over the years 1990-2007. Data were gathered retrospectively from the medical charts. We found that 67 women were diagnosed with PTSD which is 0.58% of all admissions over these years. Majority suffered from comorbid depression (N=51) and various somatic conditions, especially malignant gynecological tumors (N=23). No significant differences were found in distribution of PTSD symptoms in relation to the combat vs. civilian trauma. We found that patients with combat trauma often suffer from comorbid depression, while those with civilian traumas more often reported somatic conditions, especially malignant gynecological tumors. Our institution is a speciality clinic at a tertiary care medical center which tends to accumulate patients with serious forms of the disorder, and therefore our results can not be generalized to other settings involved in working with women with PTSD. Our results indicate that psychiatrists' assessment of female patients should inevitably include lifetime traumatic experiences, and among those with PTSD, special attention should be paid to comorbid depression and malignant tumors.
Neuro endocrinology letters
Neuro endocrinology letters, 2008
Electroconvulsive therapy (ECT) is largely historical but is still in use. Modern psychiatry requ... more Electroconvulsive therapy (ECT) is largely historical but is still in use. Modern psychiatry requires careful selection of patients in whom ECT will be performed. The indications for ECT treatment are limited, and the selection criteria should be strictly followed. The advantages and the disadvantages of the methods are discussed here. Despite the limitations, ECT seems to have real value in selected mental conditions in which it can even be considered a life-saving procedure.
Lijec̆nic̆ki vjesnik
Integration of the psychiatry in primary care is beneficial for the early detection of mental dis... more Integration of the psychiatry in primary care is beneficial for the early detection of mental disorder, better outcome of mental disorder and reduction of stigma. Psychiatry is a leading profession in organisation of mental health services. General practitioners (GPs) in Europe deal with mental disorders in their everyday practice, so the same is expected in Croatia. Graduate and postgraduate education of our GPs is insufficient for this new role. The paper compares actual situation in Croatia with forthcoming needs. The paper suggests that community psychiatry, anti-stigma program, continuing medical education of GPs and network of consultant psychiatrists give the best results in the early detection and treatment of mental disorder.
Collegium antropologicum, 2009
Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumati... more Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumatic event or experience. Lifetime prevalence rate in the European population is 1.9 % and it is higher for women (2.9%) then for men (0.9 %). The aim of this study was to examine rates and sociodemographic and clinical characteristics of women with PTSD who were hospitalized at the Psychiatric clinic of University Hospital Center in Croatia over the years 1990-2007. Data were gathered retrospectively from the medical charts. We found that 67 women were diagnosed with PTSD which is 0.58% of all admissions over these years. Majority suffered from comorbid depression (N = 51) and various somatic conditions, especially malignant gynecological tumors (N = 23). No significant differences were found in distribution of PTSD symptoms in relation to the combat vs. civilian trauma. We found that patients with combat trauma often suffer from comorbid depression, while those with civilian traumas more ...
Croatian medical journal, 2006
To explore the short- and long-term psychological consequences of rape on women victims of rape d... more To explore the short- and long-term psychological consequences of rape on women victims of rape during the 1992-1995 war against Croatia and Bosnia and Herzegovina. The study included 68 women victims of rape and was conducted at the Medical Center for Human Rights, Zagreb, Croatia, from 1992 to 1995. Testimony method and a questionnaire were used to retrospectively obtain the description of rapes and symptoms women suffered immediately after rape and at the time of the study, ie, 11.9-/+2.4 after the trauma. Structured clinical interviews were conducted to diagnose psychiatric disorders that were present at the time of study, according to the third edition of Diagnostic and Statistical Manual of Mental Disorders. The raped women were Croatian and Muslim (Bosniak) women, residents of Croatia and Bosnia and Herzegovina. Forty-four of them were raped more than once, 21 were raped every day during their captivity, and 18 were forced to witness rapes. Most of the rapes (n=65) were accom...
Collegium antropologicum, 2003
The aim of this research was to investigate the opinions and attitudes of medical staff towards s... more The aim of this research was to investigate the opinions and attitudes of medical staff towards schizophrenic patients. The research included three groups of examinees, 200 physicians of various specialties, 200 nurses and technicians working in Zagreb city hospitals, and 200 3rd and 4th year students of the School of Medicine in Zagreb. Previously validated anti-stigma questionnaire was used, consisting of 25 questions divided into three thematic groups, structured and adapted to the specific requirements of this study. The results were mutually compared and statistically analyzed by applying the chi 2-test. Significant difference (p < 0.01) between the answers of physicians and those of medical students was found in questions 2, 4, 5, 6, 11, 13, 15, 16, 18, 22, 23, 25, and between physicians and nurses/technicians in answers to questions 4, 15, 22, 23. Significant difference (p < 0.01) between the answers given by nurses/technicians and medical students was found in question...
Collegium antropologicum, 2003
Introduction of the antipsychotics of the second generation (SGA) into the therapy of schizophren... more Introduction of the antipsychotics of the second generation (SGA) into the therapy of schizophrenia roused expectations that, finally, the cognitive dysfunction in schizophrenia could be eliminated by psychopharmacological therapy. The purpose of the study was to verify the effect of atypical antipsychotic risperidone on cognitive functions in schizophrenic patients. The study was carried out upon 48 male schizophrenic patients aged 21-47 years who were switched from the antipsychotics of the first generation (FGA) to the antipsychotic risperidone, due to intolerance, during the treatment. Intelligence, abstract and concrete thinking and mental speed, attention, and short-term non-verbal memory prior to the switch, one month after the switch, and three months after the switch to risperidone, were evaluated. One month after the switch the number of subjects with severe impairment of intellectual abilities decreased significantly from 62% to 15% and after three months the number was e...
Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti, 2006
Epidemiological and clinical studies provide evidence that veterans with chronic PTSD can be at r... more Epidemiological and clinical studies provide evidence that veterans with chronic PTSD can be at risk of relapse with respect to a number of high-risk behaviors, including attempted suicide, violence, and misuse of alcohol and drugs. The aim of our study was to assess the prevalence of psychiatric comorbidity in veterans with chronic PTSD treated at Center for Crisis Intervention, Zagreb University Hospital Center, for 4 years. The diagnosis of PTSD and comorbid psychiatric diagnosis were confirmed according to DSM-IV criteria. Study results showed PTSD without comorbid psychiatric diagnosis to persist in 25.3%, and PTSD with comorbid psychiatric diagnosis in 74.7% of study subjects. The most common psychiatric disorders were depression, personality disorders, and alcoholism. It is important to recognize other comorbid disorders because of the increased risk of suicidal behavior. Accordingly, therapeutic intervention should be adjusted to each individual case.
Integration of the psychiatry in primary care is beneficial for tlie early detection of mental di... more Integration of the psychiatry in primary care is beneficial for tlie early detection of mental disorder, better outcome of mental disorder and reduction of stigma. Psychiatry is a leading profession in organisation of mental health services. General practitioners (GPs) in Europe deal with mental disorders in their everyday practice, so the same is expected in Croatia. Graduate and postgraduate education of our GPs is insufficient for this new role. The paper compares actual situation in Croatia with forthcoming needs. The paper suggests that community psychiatry, anti-stigma program, continuing medical education of GPs and network of consultant psychiatrists give the best results in the early detection and treatment of mental disorder.
The recognition, diagnosis and treatment of bipolar disorders (BD) is a major task for public hea... more The recognition, diagnosis and treatment of bipolar disorders (BD) is a major task for public health and for mental health authorities. Bipolar disorders are among the most common mental disorders with a prevalence estimated at 1.5% of the adult population. When the whole spectrum of bipolar disorders including their sub-threshold forms are taken into consideration, the rate of BD has been estimated by some authors to be as high as 6%. The fact that BDs are recurrent makes the provision of eff ective and well-tolerated treatment to those suff ering from these disorders even more important.
Collegium antropologicum
The aims of this study were to assess prevalence and symptom profile of premenstrual dysphoric di... more The aims of this study were to assess prevalence and symptom profile of premenstrual dysphoric disorder (PMDD) in a sample of Croatian students and young university graduates. We obtained data for 87 healthy women, aged 18-30, at their regular gynecologic outpatient visits over the period of 2003 to 2004. The severity of premenstrual symptoms were assessed daily, during two cycles, with the Daily Record of Severity of Problems (DRSP) and criteria for PMDD according to DSM-IV were applied. Fifteen out of 87 women fulfilled PMDD criteria and reported statistically significantly higher prevalence of co morbid disorders in their medical history compared to non-PMDD group. The most common symptoms in the PMDD group were psychological, while in non-PMDD group were vegetative. Overall, relatively high prevalence of PMDD in studied group indicates the need to continue the study.
Neuro endocrinology letters, 2008
Treatment-resistant depression is one of the major challenges in clinical psychiatry, considering... more Treatment-resistant depression is one of the major challenges in clinical psychiatry, considering that its current treatments are far from optimal. Although known for decades, in the last few years vagus nerve stimulation (VNS) has become increasingly popular as a novel method of treatment of pharmacoresistant depression. In spite of an emerging body of literature concerning the effectiveness and potential mechanisms of action of VNS, some crucial questions regarding those issues remain to be answered. We review the pre-clinical and clinical literature relating to VNS, with the impact of studies of efficacy and safety in treatment of pharmacoresistant depression and also in other clinical applications in the field of psychiatric disorders. We conclude that in light of emerging reports, VNS warrants more controlled studies for the treatment of other forms of depression, including depression in a younger population, and also of other psychiatric disorders. Because of its safety, VNS c...
Collegium antropologicum, 2007
The aims of this study were to assess prevalence and symptom profile of premenstrual dysphoric di... more The aims of this study were to assess prevalence and symptom profile of premenstrual dysphoric disorder (PMDD) in a sample of Croatian students and young university graduates. We obtained data for 87 healthy women, aged 18-30, at their regular gynecologic outpatient visits over the period of 2003 to 2004. The severity of premenstrual symptoms were assessed daily, during two cycles, with the Daily Record of Severity of Problems (DRSP) and criteria for PMDD according to DSM-IV were applied. Fifteen out of 87 women fulfilled PMDD criteria and reported statistically significantly higher prevalence of co morbid disorders in their medical history compared to non-PMDD group. The most common symptoms in the PMDD group were psychological, while in non-PMDD group were vegetative. Overall, relatively high prevalence of PMDD in studied group indicates the need to continue the study.
International Journal of Psychiatry in Clinical Practice, 2002
While efficacy in treatment of the acute phase of schizophrenia is well established for so-called... more While efficacy in treatment of the acute phase of schizophrenia is well established for so-called atypical antipsychotics, more data regarding long-term treatment are needed. In a naturalistic, open-label study, 32 patients were included in order to investigate the efficacy and safety of risperidone over 3 years of treatment; 26 of them were treatment-resistant to the previously used antipsychotic drugs (except clozapine). At the end of the first year, 20 of these 26 patients showed at least partial improvement. At the end of the third year, 17 patients were still being treated with risperidone. While eight patients were lost to follow-up, six relapsed in spite of good compliance. All the adverse events which occurred during treatment were strictly dose-dependent and disappeared when the dose was lowered to 4 mg daily. Within the limits of naturalistic studies, it can be concluded that risperidone seemed to be an effective and safe drug for long-term treatment in the majority of our patients. (Int J Psych Clin Pract 2002; 6: 193-197 ).
European Neuropsychopharmacology, 1994
One of the most frequent objections to electroconvulsive treatment (ECT), by both laymen and medi... more One of the most frequent objections to electroconvulsive treatment (ECT), by both laymen and medical professionals, is that ECT impairs the cognitive functions of the brain. This paper is a study of the effects of ECT on the cognitive function of patients in whom such therapy was indicated due to the nature of their illness. The study included 11 female patients: six with mood disorder and five with schizophrenic psychosis (diagnostic criteria of DSM-IIIR). Bilateral electroshocks were given three times a week, by means of a Siemens apparatus, type 622, applying an electric current of 600 mA for 2.5 s under anesthesia.
Socijalna Psihijatrija, Jul 15, 2013
Prema vremenu pojavljivanja simptoma bolest se može podijeliti u dvije skupine: OPP s ranim pojav... more Prema vremenu pojavljivanja simptoma bolest se može podijeliti u dvije skupine: OPP s ranim pojavljivanjem i OPP s kasnim pojavljivanjem. Prosječna dob pojavljiva-Soc. psihijat., 41 (2013) 123 -127 Pregled oBuZeto-PrISILnI PoreMeĆaj MARTINA BOJANIĆ, ILARIA ČULO, ANA IVANIŠ, ANJA MARAVIĆ, JELENA TOPIĆ i LJUBOMIR HOTUJAC Klinika za psihijatriju Vrapče, Zagreb i Opća bolnica Vukovar, Odjel za psihijatriju, Vukovar, Hrvatska U radu su prikazane najnovije spoznaje o epidemiologiji, dijagnostici i liječenje obuzeto-prisilnog poremećaja (OPP). Prikazani rezultati pokazuju da je OPP znatno češći no što se ranije mislilo, a dijagnostika je obogaćena nizom novih neuroslikovnih istraživanja što pobuđuju nadu u bolje poznavanje etiologije poremećaja. Dat je pregled genetskih istraživanja, kao i načini liječenja poremećaja, kako psihofarmakološki, psihoterapijski tako i transkranijskom magnetskom stimulacijom, dubokom stimulacijom mozga i neurokirurškim metodama. Ključne riječi: obuzeto-prisilni poremećaj, transkranijska magnetska stimulacija, neurokirurške metode liječenja Adresa za dopisivanje: Ilaria Čulo, dr. med. Klinika za psihijatriju Vrapče Bolnička 32 10000 Zagreb, Hrvatska UVOD SUMMARY
Acta Medica Croatica C̆asopis Hravatske Akademije Medicinskih Znanosti, Oct 1, 2006
Epidemiological and clinical studies provide evidence that veterans with chronic PTSD can be at r... more Epidemiological and clinical studies provide evidence that veterans with chronic PTSD can be at risk of relapse with respect to a number of high-risk behaviors, including attempted suicide, violence, and misuse of alcohol and drugs. The aim of our study was to assess the prevalence of psychiatric comorbidity in veterans with chronic PTSD treated at Center for Crisis Intervention, Zagreb University Hospital Center, for 4 years. The diagnosis of PTSD and comorbid psychiatric diagnosis were confirmed according to DSM-IV criteria. Study results showed PTSD without comorbid psychiatric diagnosis to persist in 25.3%, and PTSD with comorbid psychiatric diagnosis in 74.7% of study subjects. The most common psychiatric disorders were depression, personality disorders, and alcoholism. It is important to recognize other comorbid disorders because of the increased risk of suicidal behavior. Accordingly, therapeutic intervention should be adjusted to each individual case.
Psychiatry Research, Sep 30, 2008
- The influence of 5-HT(2C) and MDR1 genetic polymorphisms on antipsychotic-induced weight ga... more 2008) The influence of 5-HT(2C) and MDR1 genetic polymorphisms on antipsychotic-induced weight gain in female schizophrenic patients. Psychiatry
Eur Neuropsychopharmacol, 1995
Collegium Antropologicum, Mar 1, 2009
Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumati... more Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumatic event or experience. Lifetime prevalence rate in the European population is 1.9 % and it is higher for women (2.9%) then for men (0.9 %). The aim of this study was to examine rates and sociodemographic and clinical characteristics of women with PTSD who were hospitalized at the Psychiatric clinic of University Hospital Center in Croatia over the years 1990-2007. Data were gathered retrospectively from the medical charts. We found that 67 women were diagnosed with PTSD which is 0.58% of all admissions over these years. Majority suffered from comorbid depression (N=51) and various somatic conditions, especially malignant gynecological tumors (N=23). No significant differences were found in distribution of PTSD symptoms in relation to the combat vs. civilian trauma. We found that patients with combat trauma often suffer from comorbid depression, while those with civilian traumas more often reported somatic conditions, especially malignant gynecological tumors. Our institution is a speciality clinic at a tertiary care medical center which tends to accumulate patients with serious forms of the disorder, and therefore our results can not be generalized to other settings involved in working with women with PTSD. Our results indicate that psychiatrists' assessment of female patients should inevitably include lifetime traumatic experiences, and among those with PTSD, special attention should be paid to comorbid depression and malignant tumors.
Neuro endocrinology letters
Neuro endocrinology letters, 2008
Electroconvulsive therapy (ECT) is largely historical but is still in use. Modern psychiatry requ... more Electroconvulsive therapy (ECT) is largely historical but is still in use. Modern psychiatry requires careful selection of patients in whom ECT will be performed. The indications for ECT treatment are limited, and the selection criteria should be strictly followed. The advantages and the disadvantages of the methods are discussed here. Despite the limitations, ECT seems to have real value in selected mental conditions in which it can even be considered a life-saving procedure.
Lijec̆nic̆ki vjesnik
Integration of the psychiatry in primary care is beneficial for the early detection of mental dis... more Integration of the psychiatry in primary care is beneficial for the early detection of mental disorder, better outcome of mental disorder and reduction of stigma. Psychiatry is a leading profession in organisation of mental health services. General practitioners (GPs) in Europe deal with mental disorders in their everyday practice, so the same is expected in Croatia. Graduate and postgraduate education of our GPs is insufficient for this new role. The paper compares actual situation in Croatia with forthcoming needs. The paper suggests that community psychiatry, anti-stigma program, continuing medical education of GPs and network of consultant psychiatrists give the best results in the early detection and treatment of mental disorder.
Collegium antropologicum, 2009
Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumati... more Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumatic event or experience. Lifetime prevalence rate in the European population is 1.9 % and it is higher for women (2.9%) then for men (0.9 %). The aim of this study was to examine rates and sociodemographic and clinical characteristics of women with PTSD who were hospitalized at the Psychiatric clinic of University Hospital Center in Croatia over the years 1990-2007. Data were gathered retrospectively from the medical charts. We found that 67 women were diagnosed with PTSD which is 0.58% of all admissions over these years. Majority suffered from comorbid depression (N = 51) and various somatic conditions, especially malignant gynecological tumors (N = 23). No significant differences were found in distribution of PTSD symptoms in relation to the combat vs. civilian trauma. We found that patients with combat trauma often suffer from comorbid depression, while those with civilian traumas more ...
Croatian medical journal, 2006
To explore the short- and long-term psychological consequences of rape on women victims of rape d... more To explore the short- and long-term psychological consequences of rape on women victims of rape during the 1992-1995 war against Croatia and Bosnia and Herzegovina. The study included 68 women victims of rape and was conducted at the Medical Center for Human Rights, Zagreb, Croatia, from 1992 to 1995. Testimony method and a questionnaire were used to retrospectively obtain the description of rapes and symptoms women suffered immediately after rape and at the time of the study, ie, 11.9-/+2.4 after the trauma. Structured clinical interviews were conducted to diagnose psychiatric disorders that were present at the time of study, according to the third edition of Diagnostic and Statistical Manual of Mental Disorders. The raped women were Croatian and Muslim (Bosniak) women, residents of Croatia and Bosnia and Herzegovina. Forty-four of them were raped more than once, 21 were raped every day during their captivity, and 18 were forced to witness rapes. Most of the rapes (n=65) were accom...
Collegium antropologicum, 2003
The aim of this research was to investigate the opinions and attitudes of medical staff towards s... more The aim of this research was to investigate the opinions and attitudes of medical staff towards schizophrenic patients. The research included three groups of examinees, 200 physicians of various specialties, 200 nurses and technicians working in Zagreb city hospitals, and 200 3rd and 4th year students of the School of Medicine in Zagreb. Previously validated anti-stigma questionnaire was used, consisting of 25 questions divided into three thematic groups, structured and adapted to the specific requirements of this study. The results were mutually compared and statistically analyzed by applying the chi 2-test. Significant difference (p < 0.01) between the answers of physicians and those of medical students was found in questions 2, 4, 5, 6, 11, 13, 15, 16, 18, 22, 23, 25, and between physicians and nurses/technicians in answers to questions 4, 15, 22, 23. Significant difference (p < 0.01) between the answers given by nurses/technicians and medical students was found in question...
Collegium antropologicum, 2003
Introduction of the antipsychotics of the second generation (SGA) into the therapy of schizophren... more Introduction of the antipsychotics of the second generation (SGA) into the therapy of schizophrenia roused expectations that, finally, the cognitive dysfunction in schizophrenia could be eliminated by psychopharmacological therapy. The purpose of the study was to verify the effect of atypical antipsychotic risperidone on cognitive functions in schizophrenic patients. The study was carried out upon 48 male schizophrenic patients aged 21-47 years who were switched from the antipsychotics of the first generation (FGA) to the antipsychotic risperidone, due to intolerance, during the treatment. Intelligence, abstract and concrete thinking and mental speed, attention, and short-term non-verbal memory prior to the switch, one month after the switch, and three months after the switch to risperidone, were evaluated. One month after the switch the number of subjects with severe impairment of intellectual abilities decreased significantly from 62% to 15% and after three months the number was e...
Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti, 2006
Epidemiological and clinical studies provide evidence that veterans with chronic PTSD can be at r... more Epidemiological and clinical studies provide evidence that veterans with chronic PTSD can be at risk of relapse with respect to a number of high-risk behaviors, including attempted suicide, violence, and misuse of alcohol and drugs. The aim of our study was to assess the prevalence of psychiatric comorbidity in veterans with chronic PTSD treated at Center for Crisis Intervention, Zagreb University Hospital Center, for 4 years. The diagnosis of PTSD and comorbid psychiatric diagnosis were confirmed according to DSM-IV criteria. Study results showed PTSD without comorbid psychiatric diagnosis to persist in 25.3%, and PTSD with comorbid psychiatric diagnosis in 74.7% of study subjects. The most common psychiatric disorders were depression, personality disorders, and alcoholism. It is important to recognize other comorbid disorders because of the increased risk of suicidal behavior. Accordingly, therapeutic intervention should be adjusted to each individual case.
Integration of the psychiatry in primary care is beneficial for tlie early detection of mental di... more Integration of the psychiatry in primary care is beneficial for tlie early detection of mental disorder, better outcome of mental disorder and reduction of stigma. Psychiatry is a leading profession in organisation of mental health services. General practitioners (GPs) in Europe deal with mental disorders in their everyday practice, so the same is expected in Croatia. Graduate and postgraduate education of our GPs is insufficient for this new role. The paper compares actual situation in Croatia with forthcoming needs. The paper suggests that community psychiatry, anti-stigma program, continuing medical education of GPs and network of consultant psychiatrists give the best results in the early detection and treatment of mental disorder.