Nermina Kravic | University Clinica Center Tuzla (original) (raw)

Papers by Nermina Kravic

Research paper thumbnail of Post-traumatic stress disorder and coping styles of war veterans twenty years after the war from Tuzla Canton

PubMed, Feb 1, 2018

Aim To analyse symptoms of posttraumatic stress disorder and coping strategies of war veterans in... more Aim To analyse symptoms of posttraumatic stress disorder and coping strategies of war veterans in Tuzla Canton twenty years after the war in Bosnia and Herzegovina (BiH). Methods The study analysed a group of 120 war veterans from the Tuzla Canton who had experience of the war in BiH. For assessment of posttraumatic stress disorder Harvard Trauma Questionnaire was used, a version for Bosnia and Herzegovina and for assessment of coping styles Life Style Index was used. Results Concerning number of traumatic experiences of war veterans, it was found that they suffered 12 traumatic experiences. Most often traumatic experience was the participation in fighting and shelling (90.0%), knowledge of injuries in combat or landmine injuries of family members or friends (75.8%), exposure to snipers (74.2%). The most important were the symptoms of numbnessemotional numbness (2.62%), the symptoms of intrusion (2.58%) and the severity of the symptoms of PTSD (2.39%). The most common strategy of dealing with veterans of war was a projection (68.31%) and intellectualisation (56.20%). Conclusion War veterans have experienced polytraumatic experiences in war and show increased expression of symptoms of posttraumatic stress disorder, emphasised psychosocial problems with a common defence mechanism in the form of projections twenty years after the war. War veterans are in need of continuous treatment in order to reduce long-term consequences of war trauma.

Research paper thumbnail of Psychopharmacotherapy characteristics of alcoholics treated on psychiatry department tuzla from 01.01.2005. to 31.12.2009. with brain comuterized tomography

European Psychiatry, Mar 1, 2011

IntroductionTreatment of alcoholics is complex and difficult, very often it demands complex psych... more IntroductionTreatment of alcoholics is complex and difficult, very often it demands complex psychopharmacotherapy.AimTo investigate characteristics of psychopharmacotherapy of inpatients alcoholics with brain computerized tomography (CT) during hospitalization on Psychiatry Department in Tuzla.MethodologyWe investigated 86 record files of inpatients that were treated from 01.01.2005 to 31.12.2009 year on Psychiatry Department, who had dismissed diagnosis Alcohol dependency F 10.2 according ICD-10, to whom computerized tomography of brain has been done durin hospitalization. Targeted variables were: age, marital status, working status, involvement in war fighting's, CT diagnosis, psychological findings, laboratory findings and characteristics of psychopharmacotherapy.ResultsThe mean age of observed patients was 50.1 ± 6.6 years. Age of inpatients was in positive correlation with duration of work, presence of silent ischemic stroke and brain cortex atrophy. Presence of PTSD was in positive correlation with involvement in the combatants, with cognitive disturbances, with depressiveness and somatic complains. Brain cortex atrophy positively correlated with silent stroke and glucose blood level.There were 72 (83.7%) inpatients that treated with antidepressants, 45 (52.3%) with sedating antipsychotic drugs, 10 (11.7%) atypical antipsychotics 12 (13.0%) with typical antipsychotics, 53 (61.6%) with hypnotics, 37 (43.0%) tranquilizers, 23 (26.7%) vitamin B. There was the most frequent combinations of antidepressants SSRI with promazine in 41 (47.7%), with diazepam 25 (29.1%), with zolpidem 20 (23.3%) and nitrazepam in 17 (19.8%) patients.ConclusionSSRI antidepressants were the most frequent used psychopharmacotherapy drugs, then sedating neuroleptics and hypnotics. The most frequent drug combinations were antidepressants, sedating neuroleptic or tranquillisers and hypnotics.

Research paper thumbnail of Moral conflict and first sexual experience - case presentation

European Psychiatry, Mar 1, 2011

ObjectivesIn our mind as well as in our body and nature nothing is happened accidentally, we can ... more ObjectivesIn our mind as well as in our body and nature nothing is happened accidentally, we can often see that there is mutual connection between them. There is a case presentation of young man age 29 with obsessive thoughts for getting fatal disease if step on junky needles which he had seen in his neighbor. It thoughts influence his all life he is avoiding to go out of his apartment, poorly sleep, he insisted to be admitted to in patient treatment because he „would probably kill himself if he had to stay there jet…” His first difficulties appeared when he was 20, after his first sexual experience which he has had with prostitute, after his friend’s birthday party. Then he obsessively started to think about getting AIDS, getting died… Four years ago he really have got malignant testicular tumor and in his 24he had passed through exhausting surgery and chemotherapy. As a child he was growing up during the war time, experienced snake bite, often tonsil infections.Now he has no job, live with parents and one year older brother, no girlfriend or other relationship. Treated with antidepressant venlafaxin, and atypical narcoleptic risperidon, with additionally used EMDR, he showed good recovery and getting into every day activities.ConclusionMoral conflict and unsolved guilty feelings lead to real illness and constant fear of fatal disease as a punishment for him.

Research paper thumbnail of Edukacija stručnjaka za mentalno zdravlje u grupnoj analizi u BiH nakon rata 1992.-1995

Psihijatrija između fenomenologije i neuroznanosti, knjiga sažetaka, 2012

Research paper thumbnail of Online Counseling “The World Without a Label”

International Perspectives in Values-Based Mental Health Practice, 2020

The online platform is a platform of the future, both in the world and in Bosnia and Herzegovina.... more The online platform is a platform of the future, both in the world and in Bosnia and Herzegovina. “The World Without a Label” is the first counseling center of this kind in BiH, because it brings together experts from behavioral, psychological, and psychiatric problems in one place. As a special problem of sociopolitical context is victims of sexual violence, war rape crimes. A case study shows a young boy is accompanied by a parent due to behavioral problems manifested by extremely bad social interaction with peers and for spending most of his free time on his computer playing video games. The boy’s mother had previously been treated in a psychiatric clinic’s day hospital, where she shared her own trauma of rape in group psychotherapy and the painful problems she faced in her early 20s, where Republika Srpska Army soldiers systematically raped captured Bosniaks. The father is a former member of the Bosnian army, and he himself had lot of war traumas. Experience in working in the Co...

Research paper thumbnail of Transdisciplinary Research in Bosnia and Herzegovina on Juvenile Delinquency – Experiences and Challenges

Over the past few decades, there are evidences that scientific paradigm is changed from disciplin... more Over the past few decades, there are evidences that scientific paradigm is changed from disciplinary to transdisciplinary approaches. The question of sustainability science, novel ways for production and coproduction of knowledge and a matter of accomplishment for real world problems represent a big challenge for scientific and academic community. Transdisciplinary team-based research, integration of knowledge from different disciplines and a view into complex societal problems from different perspectives can make a contribution for production of new, practice-oriented knowledge, applied for social problems solution. Going to the transdisciplinary approach is especially valuable in social sciences, where collaborative practice became a necessary normative.In this paper authors, first in the context of theoretical considerations describe possible applications of transdisciplinary research in Bosnia and Herzegovina, as post-conflict, transitional community. The second part of article ...

Research paper thumbnail of Training Bosnia-Herzegovina mental health workers in group analysis resulted in founding of Bosnia- Herzegovina group analysis association and continual training of new generation from local educators

European Psychiatry, 2016

Background Zagreb Institute for Group Analysis Training Programme took place in Tuzla University ... more Background Zagreb Institute for Group Analysis Training Programme took place in Tuzla University Clinical Centre, Department of Psychiatry, in Bosnia-Herzegovina (BH) in response to 1992–1995 war, in helping to train mental health workers in GA to enable them to treat psychological trauma symptoms of war survivors. Objectives The primary objective focused on educational process in Group Analysis (GA) in post-war BH which resulted with building capacities to continue education of new generation of Group Analysis trainees from national educators. Method Authors described realization of educational process considering the two Diploma courses and process of supervision, which was provided from the Institute for GA (IGA) Zagreb, Croatia. Results Internationally approved IGA trainers provided completed training for trainees: neuropsychiatrists, neurosurgeon, residents, nurses, psychologists, social workers, special educators, paediatrician, and gynaecologist from several different institu...

Research paper thumbnail of Association of polygenic risk scores, traumatic life events and coping strategies with war-related PTSD diagnosis and symptom severity in the South Eastern Europe (SEE)-PTSD cohort

Journal of Neural Transmission, 2021

Objectives Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental... more Objectives Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental events and characterized by high emotional distress, re-experiencing of trauma, avoidance and hypervigilance. The present study uses polygenic risk scores (PRS) derived from the UK Biobank (UKBB) mega-cohort analysis as part of the PGC PTSD GWAS effort to determine the heritable basis of PTSD in the South Eastern Europe (SEE)-PTSD cohort. We further analyzed the relation between PRS and additional disease-related variables, such as number and intensity of life events, coping, sex and age at war on PTSD and CAPS as outcome variables. Methods Association of PRS, number and intensity of life events, coping, sex and age on PTSD were calculated using logistic regression in a total of 321 subjects with current and remitted PTSD and 337 controls previously subjected to traumatic events but not having PTSD. In addition, PRS and other disease-related variables were tested for association with PT...

Research paper thumbnail of Hypermethylation of the monoamine oxidase A gene – a new epigenetic marker for posttraumatic stress disorder?

European Neuropsychopharmacology, 2018

ANOVA (probe test and immunohistochemistry) followed by post hoc Fisher LSD test. In vitro: one-w... more ANOVA (probe test and immunohistochemistry) followed by post hoc Fisher LSD test. In vitro: one-way ANOVA followed by post hoc Tukey test. Results: Ts were severely impaired in various learning and memory parameters (po0.01) and had fewer new neurons (DCX + cells/100 mm) in the DG (-37%; po0.05) in comparison with Eu. Treatment with tideglusib did not improve either memory or neurogenesis. Similarly to adults, tideglusib-treated Ts pups underwent no neurogenesis increase, indicating that the lack of effects of tideglusib on neurogenesis is not age-dependent. Interestingly, vehicle alone (corn oil) improved behavior in adults and neurogenesis both in adults (+39%; po0.05) and pups (+ 26%; po0.001). The absence of these effects in Ts that received vehicle + tideglusib suggests that tideglusib counteracts the positive effects of the vehicle. In vitro experiments showed that i) a wide range of tideglusib concentrations (0.1-10.0mM) was unable to enhance neurogenesis of Ts NPCs; ii) exposure to OA or LA, the main components of corn oil, enhanced proliferation (+ 40-65%; po0.001); iii) the effect of OA and LA was abrogated by co-exposure to tideglusib. Conclusion: The finding that tideglusib does not improve neurogenesis and behavior indicates that it is not a suitable treatment for DS. The finding that the fatty acids present in the vehicle (OA and LA) have a pro-neurogenic effect suggests that agonists of fatty acid receptors may represent a good strategy to ameliorate brain development in individuals with DS.

Research paper thumbnail of The Role of Taqi DRD2 (RS1800497) and DRD4 VNTR Polymorphisms in Posttraumatic Stress Disorder (PTSD)

Psychiatria Danubina, 2019

Background: Posttraumatic stress disorder (PTSD) is a complex stress related disorder, that follo... more Background: Posttraumatic stress disorder (PTSD) is a complex stress related disorder, that follows a severe traumatic experience, characterized with an intense sense of terror, fear, and helplessness. The aim of this study is to identify associations of genetic variations within candidate genes DRD2 and DRD4 with various PTSD related phenotypes. PTSD lifetime and PTSD current subjects were analyzed separately, each of them were analyzed in a Case/Control design, as well as regarding BSI and CAPS within cases only. Subjects and methods: 719 (487 male, 232 female) participants who had experienced war-related trauma between 1991 and 1999 in Bosnia and Hercegovina, Kosovo and Croatia were included in the study. Sociodemographic questionnaire, Clinician Administered PTSD Scale (CAPS) and the Brief Symptom Inventory (BSI) were used to collect clinical data. Results: The DRD2 rs1800497 variant and a variable number tandem repeat (VNTR) located in exon three of DRD4 were investigated for association with PTSD. In case control analyses we did not identify any significant associations. Within the PTSD current patients, we identified an association of DRD2 rs1800497 with BSI in the genotypic and the recessive model with the T allele as the risk allele. Conclusion: Our findings suggest that rs1800497 of DRD2 gene is involved in pathogenesis of PTSD.

Research paper thumbnail of Associations of Gene Variations in Neuropeptide y and Brain Derived Neurotrophic Factor Genes with Posttraumatic Stress Disorder

Psychiatria Danubina, 2019

Background: Individuals who are exposed to traumatic events are at an increased risk of developin... more Background: Individuals who are exposed to traumatic events are at an increased risk of developing posttraumatic stress disorder (PTSD), a condition during which an individual's ability to function is impaired by emotional responses to memories of those events. The gene coding for neuropeptide Y (NPY) and the gene coding for brain-derived neurotrophic factor (BDNF) are among the number of candidate gene variants that have been identified as potential contributors to PTSD. The aim of this study was to investigate the association between NPY and BDNF and PTSD in individuals who experienced war-related trauma in the South Eastern Europe (SEE) conflicts (1991-1999). Subjects and methods: This study included participants with current and remitted PTSD and healthy volunteers (N=719, 232 females, 487 males), who were recruited between 2013 and 2015 within the framework of the South Eastern Europe (SEE)-PTSD Study. Psychometric methods comprised the Mini International Neuropsychiatric Interview (M.I.N.I.), the Clinician Administered PTSD Scale (CAPS), and the Brief Symptom Inventory (BSI). DNA was isolated from whole blood and genotyped for NPY rs5574 via PCR-RFLP and NPY rs16147 and BDNF rs6265 using the KASP assay. Results: Tests for deviation from Hardy-Weinberg equilibrium showed no significant results. Analyses at the categorical level yielded no associations between the affected individuals and all three SNPs when compared to controls. Within lifetime PTSD patients, the major alleles of both NPY variants showed a nominally significant association with higher CAPS scores (p=0.007 and p=0.02, respectively). Also, the major allele of rs5574C>T was associated with higher BSI scores with a nominal significance among current PTSD patients (p=0.047). The results did not withstand a Bonferroni adjustment (=0.002). Conclusion: Nominally significant associations between NPY polymorphisms and PTSD susceptibility were found that did not withstand Bonferroni correction.

Research paper thumbnail of Role of the Allelic Variation in the 5-HYDROXYTRYPTAMINE Receptor 1A (HTR1A) and the Tryptophan Hydroxylase 2 (TPH2) Genes in the Development of PTSD

Psychiatria Danubina, 2019

Research paper thumbnail of Association of Neuropeptide S Receptor 1 and Glutamate Decarboxylase 1 Gene Polymorphisms with Posttraumatic Stress Disorder

Psychiatria Danubina, 2019

Research paper thumbnail of Associations Between Polymorphisms in the Solute Carrier Family 6 Member 3 and the Myelin Basic Protein Gene and Posttraumatic Stress Disorder

Psychiatria Danubina, 2019

Background: Previous research showed inconsistent results concerning a possible association betwe... more Background: Previous research showed inconsistent results concerning a possible association between solute carrier family 6 member 3 (SLC6A3) gene polymorphisms and dopamine symptoms of posttraumatic stress disorder (PTSD). Several studies also indicate that the myelin basic protein (MBP) gene is of importance in the etiology of several psychiatric disorders. The aim of this study was to investigate the relation of distinct SLC6A3 and MBP gene polymorphisms with PTSD and whether SLC6A3 and MBP genotypes contribute to PTSD symptom severity. Subjects and methods: The study included 719 individuals who had experienced war trauma in the South Eastern Europe (SEE). Genotypes of variable number tandem repeat (VNTR) polymorphism within the SLC6A3 gene were assessed in 696 participants, and the single nucleotide polymorphism (SNP) rs12458282 located within the MBP gene region was genotyped in a total of 703 subjects. The Mini International Neuropsychiatric Interview, the Clinical Administrated PTSD Scale (CAPS) and Brief Symptom Inventory (BSI), were used for data collection. Results: No significant differences concerning the investigated SLC6A3 and MBP polymorphisms was identifiable between PTSD and non PTSD participants. Also we could not detect significant influence of these distinct SLC6A3 and MBP alleles on the severity of PTSD symptoms (CAPS) or BSI scores. However, the results of MBP rs12458282 within the patients with lifetime PTSD may point to a possible correlation of the major allele (T) with elevated CAPS scores. Conclusions: Our results do not support an association of the analysed SLC6A3 and MBP gene polymorphisms with PTSD in war traumatized individuals. We found that there is a possibility for a correlation of the T allele rs12458282 within the MBP gene with higher CAPS scores in lifetime PTSD patients which would need to be tested in a sample providing more statistical power.

Research paper thumbnail of Association Analysis of Maoa and SLC6A4 Gene Variation in South East European War Related Posttraumatic Stress Disorder

Psychiatria Danubina, 2019

Background: The aim of this study is to investigate the association of gene variations of the mon... more Background: The aim of this study is to investigate the association of gene variations of the monoamine oxidase A (MAOA) and the serotonin transporter solute carrier family 6 member 4 (SLC6A4) gene with posttraumatic stress disorder (PTSD) severity and coping strategies in patients with war related PTSD. Subjects and methods: The study included 747 individuals who had experienced war trauma in the South Eastern Europe conflicts between 1991 and 1999. Genotyping of the MAOA VNTR and SLC6A4 tandem repeat polymorphism in combination with rs25531 was done in 719 participants: 232 females and 487 males. Among them, 369 have had current or lifetime PTSD and 350 have had no PTSD symptoms. For psychometric approach we used the Clinician Administrated PTSD Scale (CAPS), the Brief Symptom Inventory (BSI), the adapted Hoffman-Lazarus Coping scale and a basic socio-demographic data questionnaire. Results: There were no significant intergroup (PTSD versus non PTSD) differences in the genotype distribution of MAOA and SLC6A4 gene polymorphisms. The primary finding of our study was that the MAOA short allele (MAOA-S) was nominally significantly associated with the severity of PTSD symptoms in the total subgroup of participants with lifetime PTSD; males for symptoms of hyperarrousal and females with symptoms of re-experience and hyperarousal. In our research the male subsample with current PTSD and MAOA-S genotype had nominally significantly higher scores for some positive coping strategies compared to those carrying the long allele genotype (MAOA-L). There was no significant association between the severity of PTSD symptoms, BSI phenotype, coping scores and the SLC6A4 genotype. Conclusion: The present results support the notion that MAOA VNTR gene variation modulates development and recovery of posttraumatic stress disorder in a war traumatised population, but did not support a connection between SLC6A4 gene variations and war related PTSD.

Research paper thumbnail of Post-traumatic stress disorder and coping styles of war veterans twenty years after the war from Tuzla Canton

Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina, 2018

Aim To analyse symptoms of posttraumatic stress disorder and coping strategies of war veterans in... more Aim To analyse symptoms of posttraumatic stress disorder and coping strategies of war veterans in Tuzla Canton twenty years after the war in Bosnia and Herzegovina (BiH). Methods The study analysed a group of 120 war veterans from the Tuzla Canton who had experience of the war in BiH. For assessment of posttraumatic stress disorder Harvard Trauma Questionnaire was used, a version for Bosnia and Herzegovina and for assessment of coping styles Life Style Index was used. Results Concerning number of traumatic experiences of war veterans, it was found that they suffered 12 traumatic experiences. Most often traumatic experience was the participation in fighting and shelling (90.0%), knowledge of injuries in combat or landmine injuries of family members or friends (75.8%), exposure to snipers (74.2%). The most important were the symptoms of numbnessemotional numbness (2.62%), the symptoms of intrusion (2.58%) and the severity of the symptoms of PTSD (2.39%). The most common strategy of de...

Research paper thumbnail of Monoamine oxidase A gene methylation and its role in Posttraumatic Stress Disorder - First evidence from the South Eastern Europe (SEE)-PTSD study

The international journal of neuropsychopharmacology, Jan 23, 2017

Posttraumatic Stress Disorder (PTSD) is characterized by an overactive noradrenergic system confe... more Posttraumatic Stress Disorder (PTSD) is characterized by an overactive noradrenergic system conferring core PTSD symptoms such as hyperarousal and re-experiencing. Monoamine oxidase A (MAO-A) is one of the key enzymes mediating the turnover of noradrenaline. Here, DNA methylation of the MAOA gene exonI/intronI region was investigated for the first time in regards to its role in PTSD risk and severity. MAOA methylation was analyzed via direct sequencing of sodium bisulfite treated DNA extracted from blood cells in a total sample of N=652 (m=441) patients with current PTSD, patients with remitted PTSD and healthy probands (comparison group) recruited at five centres in Bosnia-Herzegovina, Croatia, and the Republic of Kosovo. PTSD severity was measured by means of the Clinician-Administered PTSD Scale (CAPS) and its respective subscores representing distinct symptom clusters. In the male, but not the female sample, patients with current PTSD displayed hypermethylation of three CpGs (Cp...

Research paper thumbnail of Molecular Mechanisms of Posttraumatic Stress Disorder (PTSD) as a Basis for Individualized and Personalized Therapy: Rationale, Design and Methods of the South Eastern Europe (SEE)-PTSD study

Psychiatria Danubina, 2016

Posttraumatic Stress Disorder (PTSD) is a major health problem in South Eastern Europe (SEE). Ava... more Posttraumatic Stress Disorder (PTSD) is a major health problem in South Eastern Europe (SEE). Available treatment options are not efficient enough and the course is often chronic. Little is known about molecular mediators and moderators of pathogenesis and therapy. Genetic and epigenetic variation may be one central molecular mechanism. We therefore established a consortium combining clinical expertise on PTSD from SEE countries Bosnia-Herzegovina (Sarajevo, Tuzla and Mostar), Kosovo (Prishtina) and Croatia (Zagreb) with genetic and epigenetic competence from Germany (Würzburg) in 2011 within the framework of the DAAD (Deutscher Akademischer Austauschdienst)-funded Stability Pact for South Eastern Europe. After obtaining ethical votes and performing rater trainings as well as training in DNA extraction from EDTA blood between 2011 and 2013, we recruited 747 individuals who had experienced war-related trauma in the SEE conflicts between 1991 and 1999. 236 participants had current PTS...

Research paper thumbnail of 1285 – Training of bosnia-herzegovina mental health professionals in group analysis as the factor of development of culture of dialogue in the aftermath ofthe 1992–1995 war

European Psychiatry, 2013

Aim The primary objective will focus the first of all on Group Analysis (GA) as the psychotherapy... more Aim The primary objective will focus the first of all on Group Analysis (GA) as the psychotherapy method and theory of group analysis applied particularly in post-war environments. It outlines in particular a Zagreb Institute for GA Training Programme that took place in Tuzla University Clinical Centre, Department of Psychiatry, in Bosnia-Herzegovina (BH) in response to 1992–1995 war, in helping to train mental health workers in GA to enable them to treat psychological trauma symptoms of war survivors. Method In the GA education in the period of 16 years mental health professionals employed in mental health services were involved as well as other care employees as General Practitioners, Family physicians, pediatricians, gynecologists and neurosurgeons, psychologists and special educators. Results Trainees in education were from greater part of BH, and from several towns from neighborhoods countries. In this way a new room for mutual exchanges of experiences and establishing of cooperation was created. Idea of group analytic treatment of persons with mental health problems spread out on the whole region of BH through this model of education. The future of GA application as a psychotherapy model in BH confirmed through established models of education which are employed inowadays in Tuzla, Sarajevo and Mostar. The future of GA is provided in activities focused on foundations of the Institute for Analysis in Tuzla. Conclusion Training of Bosnia-Herzegovina mental health workers to effectively use GA with enthusiastic help of GA trainers from Institute for GA Zagreb will develop dialogue culture in postwar BH.

Research paper thumbnail of P02-331 - Characteristics of brain comuterized tomography diagnoses and comorbid conditions of alcohol dependant males treated on psychiatry department Tuzla during 2005–2009

European Psychiatry, 2011

IntroductionConsequences of alcohol dependence may be complex, and difficult for treatment, thus ... more IntroductionConsequences of alcohol dependence may be complex, and difficult for treatment, thus complex diagnostic procedures are needed.AimTo assess the prevalence of silent brain strokes and cortical cerebral atrophy amongst male inpatient alcoholics.MethodologyWe analyzed 86 file records of males treated from 01 January 2005 to 31 December 2009 year on Tuzla Psychiatry Department, who had dismissed diagnosis Alcohol dependency (F 10.2) according ICD-10, with computerized tomography (CT) of brain, related to age, war engagement, brain trauma, employment, smoking, psychological findings and presence of silent stroke and cortical brain atrophy according CT diagnosis.ResultsThe mean age of observed patients was 50.1 ± 6.6 years. Amongst them (70.9%) were active soldiers in Bosnia-Herzegovina Army during 1992–1995 war. There were 71 (72.6%) with atrophy of brain cortex, 27 (31.4%) had ischemic silent stroke. In the sample, 61 (70.9%) of inpatients met criteria for PTSD according ICD-...

Research paper thumbnail of Post-traumatic stress disorder and coping styles of war veterans twenty years after the war from Tuzla Canton

PubMed, Feb 1, 2018

Aim To analyse symptoms of posttraumatic stress disorder and coping strategies of war veterans in... more Aim To analyse symptoms of posttraumatic stress disorder and coping strategies of war veterans in Tuzla Canton twenty years after the war in Bosnia and Herzegovina (BiH). Methods The study analysed a group of 120 war veterans from the Tuzla Canton who had experience of the war in BiH. For assessment of posttraumatic stress disorder Harvard Trauma Questionnaire was used, a version for Bosnia and Herzegovina and for assessment of coping styles Life Style Index was used. Results Concerning number of traumatic experiences of war veterans, it was found that they suffered 12 traumatic experiences. Most often traumatic experience was the participation in fighting and shelling (90.0%), knowledge of injuries in combat or landmine injuries of family members or friends (75.8%), exposure to snipers (74.2%). The most important were the symptoms of numbnessemotional numbness (2.62%), the symptoms of intrusion (2.58%) and the severity of the symptoms of PTSD (2.39%). The most common strategy of dealing with veterans of war was a projection (68.31%) and intellectualisation (56.20%). Conclusion War veterans have experienced polytraumatic experiences in war and show increased expression of symptoms of posttraumatic stress disorder, emphasised psychosocial problems with a common defence mechanism in the form of projections twenty years after the war. War veterans are in need of continuous treatment in order to reduce long-term consequences of war trauma.

Research paper thumbnail of Psychopharmacotherapy characteristics of alcoholics treated on psychiatry department tuzla from 01.01.2005. to 31.12.2009. with brain comuterized tomography

European Psychiatry, Mar 1, 2011

IntroductionTreatment of alcoholics is complex and difficult, very often it demands complex psych... more IntroductionTreatment of alcoholics is complex and difficult, very often it demands complex psychopharmacotherapy.AimTo investigate characteristics of psychopharmacotherapy of inpatients alcoholics with brain computerized tomography (CT) during hospitalization on Psychiatry Department in Tuzla.MethodologyWe investigated 86 record files of inpatients that were treated from 01.01.2005 to 31.12.2009 year on Psychiatry Department, who had dismissed diagnosis Alcohol dependency F 10.2 according ICD-10, to whom computerized tomography of brain has been done durin hospitalization. Targeted variables were: age, marital status, working status, involvement in war fighting's, CT diagnosis, psychological findings, laboratory findings and characteristics of psychopharmacotherapy.ResultsThe mean age of observed patients was 50.1 ± 6.6 years. Age of inpatients was in positive correlation with duration of work, presence of silent ischemic stroke and brain cortex atrophy. Presence of PTSD was in positive correlation with involvement in the combatants, with cognitive disturbances, with depressiveness and somatic complains. Brain cortex atrophy positively correlated with silent stroke and glucose blood level.There were 72 (83.7%) inpatients that treated with antidepressants, 45 (52.3%) with sedating antipsychotic drugs, 10 (11.7%) atypical antipsychotics 12 (13.0%) with typical antipsychotics, 53 (61.6%) with hypnotics, 37 (43.0%) tranquilizers, 23 (26.7%) vitamin B. There was the most frequent combinations of antidepressants SSRI with promazine in 41 (47.7%), with diazepam 25 (29.1%), with zolpidem 20 (23.3%) and nitrazepam in 17 (19.8%) patients.ConclusionSSRI antidepressants were the most frequent used psychopharmacotherapy drugs, then sedating neuroleptics and hypnotics. The most frequent drug combinations were antidepressants, sedating neuroleptic or tranquillisers and hypnotics.

Research paper thumbnail of Moral conflict and first sexual experience - case presentation

European Psychiatry, Mar 1, 2011

ObjectivesIn our mind as well as in our body and nature nothing is happened accidentally, we can ... more ObjectivesIn our mind as well as in our body and nature nothing is happened accidentally, we can often see that there is mutual connection between them. There is a case presentation of young man age 29 with obsessive thoughts for getting fatal disease if step on junky needles which he had seen in his neighbor. It thoughts influence his all life he is avoiding to go out of his apartment, poorly sleep, he insisted to be admitted to in patient treatment because he „would probably kill himself if he had to stay there jet…” His first difficulties appeared when he was 20, after his first sexual experience which he has had with prostitute, after his friend’s birthday party. Then he obsessively started to think about getting AIDS, getting died… Four years ago he really have got malignant testicular tumor and in his 24he had passed through exhausting surgery and chemotherapy. As a child he was growing up during the war time, experienced snake bite, often tonsil infections.Now he has no job, live with parents and one year older brother, no girlfriend or other relationship. Treated with antidepressant venlafaxin, and atypical narcoleptic risperidon, with additionally used EMDR, he showed good recovery and getting into every day activities.ConclusionMoral conflict and unsolved guilty feelings lead to real illness and constant fear of fatal disease as a punishment for him.

Research paper thumbnail of Edukacija stručnjaka za mentalno zdravlje u grupnoj analizi u BiH nakon rata 1992.-1995

Psihijatrija između fenomenologije i neuroznanosti, knjiga sažetaka, 2012

Research paper thumbnail of Online Counseling “The World Without a Label”

International Perspectives in Values-Based Mental Health Practice, 2020

The online platform is a platform of the future, both in the world and in Bosnia and Herzegovina.... more The online platform is a platform of the future, both in the world and in Bosnia and Herzegovina. “The World Without a Label” is the first counseling center of this kind in BiH, because it brings together experts from behavioral, psychological, and psychiatric problems in one place. As a special problem of sociopolitical context is victims of sexual violence, war rape crimes. A case study shows a young boy is accompanied by a parent due to behavioral problems manifested by extremely bad social interaction with peers and for spending most of his free time on his computer playing video games. The boy’s mother had previously been treated in a psychiatric clinic’s day hospital, where she shared her own trauma of rape in group psychotherapy and the painful problems she faced in her early 20s, where Republika Srpska Army soldiers systematically raped captured Bosniaks. The father is a former member of the Bosnian army, and he himself had lot of war traumas. Experience in working in the Co...

Research paper thumbnail of Transdisciplinary Research in Bosnia and Herzegovina on Juvenile Delinquency – Experiences and Challenges

Over the past few decades, there are evidences that scientific paradigm is changed from disciplin... more Over the past few decades, there are evidences that scientific paradigm is changed from disciplinary to transdisciplinary approaches. The question of sustainability science, novel ways for production and coproduction of knowledge and a matter of accomplishment for real world problems represent a big challenge for scientific and academic community. Transdisciplinary team-based research, integration of knowledge from different disciplines and a view into complex societal problems from different perspectives can make a contribution for production of new, practice-oriented knowledge, applied for social problems solution. Going to the transdisciplinary approach is especially valuable in social sciences, where collaborative practice became a necessary normative.In this paper authors, first in the context of theoretical considerations describe possible applications of transdisciplinary research in Bosnia and Herzegovina, as post-conflict, transitional community. The second part of article ...

Research paper thumbnail of Training Bosnia-Herzegovina mental health workers in group analysis resulted in founding of Bosnia- Herzegovina group analysis association and continual training of new generation from local educators

European Psychiatry, 2016

Background Zagreb Institute for Group Analysis Training Programme took place in Tuzla University ... more Background Zagreb Institute for Group Analysis Training Programme took place in Tuzla University Clinical Centre, Department of Psychiatry, in Bosnia-Herzegovina (BH) in response to 1992–1995 war, in helping to train mental health workers in GA to enable them to treat psychological trauma symptoms of war survivors. Objectives The primary objective focused on educational process in Group Analysis (GA) in post-war BH which resulted with building capacities to continue education of new generation of Group Analysis trainees from national educators. Method Authors described realization of educational process considering the two Diploma courses and process of supervision, which was provided from the Institute for GA (IGA) Zagreb, Croatia. Results Internationally approved IGA trainers provided completed training for trainees: neuropsychiatrists, neurosurgeon, residents, nurses, psychologists, social workers, special educators, paediatrician, and gynaecologist from several different institu...

Research paper thumbnail of Association of polygenic risk scores, traumatic life events and coping strategies with war-related PTSD diagnosis and symptom severity in the South Eastern Europe (SEE)-PTSD cohort

Journal of Neural Transmission, 2021

Objectives Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental... more Objectives Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental events and characterized by high emotional distress, re-experiencing of trauma, avoidance and hypervigilance. The present study uses polygenic risk scores (PRS) derived from the UK Biobank (UKBB) mega-cohort analysis as part of the PGC PTSD GWAS effort to determine the heritable basis of PTSD in the South Eastern Europe (SEE)-PTSD cohort. We further analyzed the relation between PRS and additional disease-related variables, such as number and intensity of life events, coping, sex and age at war on PTSD and CAPS as outcome variables. Methods Association of PRS, number and intensity of life events, coping, sex and age on PTSD were calculated using logistic regression in a total of 321 subjects with current and remitted PTSD and 337 controls previously subjected to traumatic events but not having PTSD. In addition, PRS and other disease-related variables were tested for association with PT...

Research paper thumbnail of Hypermethylation of the monoamine oxidase A gene – a new epigenetic marker for posttraumatic stress disorder?

European Neuropsychopharmacology, 2018

ANOVA (probe test and immunohistochemistry) followed by post hoc Fisher LSD test. In vitro: one-w... more ANOVA (probe test and immunohistochemistry) followed by post hoc Fisher LSD test. In vitro: one-way ANOVA followed by post hoc Tukey test. Results: Ts were severely impaired in various learning and memory parameters (po0.01) and had fewer new neurons (DCX + cells/100 mm) in the DG (-37%; po0.05) in comparison with Eu. Treatment with tideglusib did not improve either memory or neurogenesis. Similarly to adults, tideglusib-treated Ts pups underwent no neurogenesis increase, indicating that the lack of effects of tideglusib on neurogenesis is not age-dependent. Interestingly, vehicle alone (corn oil) improved behavior in adults and neurogenesis both in adults (+39%; po0.05) and pups (+ 26%; po0.001). The absence of these effects in Ts that received vehicle + tideglusib suggests that tideglusib counteracts the positive effects of the vehicle. In vitro experiments showed that i) a wide range of tideglusib concentrations (0.1-10.0mM) was unable to enhance neurogenesis of Ts NPCs; ii) exposure to OA or LA, the main components of corn oil, enhanced proliferation (+ 40-65%; po0.001); iii) the effect of OA and LA was abrogated by co-exposure to tideglusib. Conclusion: The finding that tideglusib does not improve neurogenesis and behavior indicates that it is not a suitable treatment for DS. The finding that the fatty acids present in the vehicle (OA and LA) have a pro-neurogenic effect suggests that agonists of fatty acid receptors may represent a good strategy to ameliorate brain development in individuals with DS.

Research paper thumbnail of The Role of Taqi DRD2 (RS1800497) and DRD4 VNTR Polymorphisms in Posttraumatic Stress Disorder (PTSD)

Psychiatria Danubina, 2019

Background: Posttraumatic stress disorder (PTSD) is a complex stress related disorder, that follo... more Background: Posttraumatic stress disorder (PTSD) is a complex stress related disorder, that follows a severe traumatic experience, characterized with an intense sense of terror, fear, and helplessness. The aim of this study is to identify associations of genetic variations within candidate genes DRD2 and DRD4 with various PTSD related phenotypes. PTSD lifetime and PTSD current subjects were analyzed separately, each of them were analyzed in a Case/Control design, as well as regarding BSI and CAPS within cases only. Subjects and methods: 719 (487 male, 232 female) participants who had experienced war-related trauma between 1991 and 1999 in Bosnia and Hercegovina, Kosovo and Croatia were included in the study. Sociodemographic questionnaire, Clinician Administered PTSD Scale (CAPS) and the Brief Symptom Inventory (BSI) were used to collect clinical data. Results: The DRD2 rs1800497 variant and a variable number tandem repeat (VNTR) located in exon three of DRD4 were investigated for association with PTSD. In case control analyses we did not identify any significant associations. Within the PTSD current patients, we identified an association of DRD2 rs1800497 with BSI in the genotypic and the recessive model with the T allele as the risk allele. Conclusion: Our findings suggest that rs1800497 of DRD2 gene is involved in pathogenesis of PTSD.

Research paper thumbnail of Associations of Gene Variations in Neuropeptide y and Brain Derived Neurotrophic Factor Genes with Posttraumatic Stress Disorder

Psychiatria Danubina, 2019

Background: Individuals who are exposed to traumatic events are at an increased risk of developin... more Background: Individuals who are exposed to traumatic events are at an increased risk of developing posttraumatic stress disorder (PTSD), a condition during which an individual's ability to function is impaired by emotional responses to memories of those events. The gene coding for neuropeptide Y (NPY) and the gene coding for brain-derived neurotrophic factor (BDNF) are among the number of candidate gene variants that have been identified as potential contributors to PTSD. The aim of this study was to investigate the association between NPY and BDNF and PTSD in individuals who experienced war-related trauma in the South Eastern Europe (SEE) conflicts (1991-1999). Subjects and methods: This study included participants with current and remitted PTSD and healthy volunteers (N=719, 232 females, 487 males), who were recruited between 2013 and 2015 within the framework of the South Eastern Europe (SEE)-PTSD Study. Psychometric methods comprised the Mini International Neuropsychiatric Interview (M.I.N.I.), the Clinician Administered PTSD Scale (CAPS), and the Brief Symptom Inventory (BSI). DNA was isolated from whole blood and genotyped for NPY rs5574 via PCR-RFLP and NPY rs16147 and BDNF rs6265 using the KASP assay. Results: Tests for deviation from Hardy-Weinberg equilibrium showed no significant results. Analyses at the categorical level yielded no associations between the affected individuals and all three SNPs when compared to controls. Within lifetime PTSD patients, the major alleles of both NPY variants showed a nominally significant association with higher CAPS scores (p=0.007 and p=0.02, respectively). Also, the major allele of rs5574C>T was associated with higher BSI scores with a nominal significance among current PTSD patients (p=0.047). The results did not withstand a Bonferroni adjustment (=0.002). Conclusion: Nominally significant associations between NPY polymorphisms and PTSD susceptibility were found that did not withstand Bonferroni correction.

Research paper thumbnail of Role of the Allelic Variation in the 5-HYDROXYTRYPTAMINE Receptor 1A (HTR1A) and the Tryptophan Hydroxylase 2 (TPH2) Genes in the Development of PTSD

Psychiatria Danubina, 2019

Research paper thumbnail of Association of Neuropeptide S Receptor 1 and Glutamate Decarboxylase 1 Gene Polymorphisms with Posttraumatic Stress Disorder

Psychiatria Danubina, 2019

Research paper thumbnail of Associations Between Polymorphisms in the Solute Carrier Family 6 Member 3 and the Myelin Basic Protein Gene and Posttraumatic Stress Disorder

Psychiatria Danubina, 2019

Background: Previous research showed inconsistent results concerning a possible association betwe... more Background: Previous research showed inconsistent results concerning a possible association between solute carrier family 6 member 3 (SLC6A3) gene polymorphisms and dopamine symptoms of posttraumatic stress disorder (PTSD). Several studies also indicate that the myelin basic protein (MBP) gene is of importance in the etiology of several psychiatric disorders. The aim of this study was to investigate the relation of distinct SLC6A3 and MBP gene polymorphisms with PTSD and whether SLC6A3 and MBP genotypes contribute to PTSD symptom severity. Subjects and methods: The study included 719 individuals who had experienced war trauma in the South Eastern Europe (SEE). Genotypes of variable number tandem repeat (VNTR) polymorphism within the SLC6A3 gene were assessed in 696 participants, and the single nucleotide polymorphism (SNP) rs12458282 located within the MBP gene region was genotyped in a total of 703 subjects. The Mini International Neuropsychiatric Interview, the Clinical Administrated PTSD Scale (CAPS) and Brief Symptom Inventory (BSI), were used for data collection. Results: No significant differences concerning the investigated SLC6A3 and MBP polymorphisms was identifiable between PTSD and non PTSD participants. Also we could not detect significant influence of these distinct SLC6A3 and MBP alleles on the severity of PTSD symptoms (CAPS) or BSI scores. However, the results of MBP rs12458282 within the patients with lifetime PTSD may point to a possible correlation of the major allele (T) with elevated CAPS scores. Conclusions: Our results do not support an association of the analysed SLC6A3 and MBP gene polymorphisms with PTSD in war traumatized individuals. We found that there is a possibility for a correlation of the T allele rs12458282 within the MBP gene with higher CAPS scores in lifetime PTSD patients which would need to be tested in a sample providing more statistical power.

Research paper thumbnail of Association Analysis of Maoa and SLC6A4 Gene Variation in South East European War Related Posttraumatic Stress Disorder

Psychiatria Danubina, 2019

Background: The aim of this study is to investigate the association of gene variations of the mon... more Background: The aim of this study is to investigate the association of gene variations of the monoamine oxidase A (MAOA) and the serotonin transporter solute carrier family 6 member 4 (SLC6A4) gene with posttraumatic stress disorder (PTSD) severity and coping strategies in patients with war related PTSD. Subjects and methods: The study included 747 individuals who had experienced war trauma in the South Eastern Europe conflicts between 1991 and 1999. Genotyping of the MAOA VNTR and SLC6A4 tandem repeat polymorphism in combination with rs25531 was done in 719 participants: 232 females and 487 males. Among them, 369 have had current or lifetime PTSD and 350 have had no PTSD symptoms. For psychometric approach we used the Clinician Administrated PTSD Scale (CAPS), the Brief Symptom Inventory (BSI), the adapted Hoffman-Lazarus Coping scale and a basic socio-demographic data questionnaire. Results: There were no significant intergroup (PTSD versus non PTSD) differences in the genotype distribution of MAOA and SLC6A4 gene polymorphisms. The primary finding of our study was that the MAOA short allele (MAOA-S) was nominally significantly associated with the severity of PTSD symptoms in the total subgroup of participants with lifetime PTSD; males for symptoms of hyperarrousal and females with symptoms of re-experience and hyperarousal. In our research the male subsample with current PTSD and MAOA-S genotype had nominally significantly higher scores for some positive coping strategies compared to those carrying the long allele genotype (MAOA-L). There was no significant association between the severity of PTSD symptoms, BSI phenotype, coping scores and the SLC6A4 genotype. Conclusion: The present results support the notion that MAOA VNTR gene variation modulates development and recovery of posttraumatic stress disorder in a war traumatised population, but did not support a connection between SLC6A4 gene variations and war related PTSD.

Research paper thumbnail of Post-traumatic stress disorder and coping styles of war veterans twenty years after the war from Tuzla Canton

Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina, 2018

Aim To analyse symptoms of posttraumatic stress disorder and coping strategies of war veterans in... more Aim To analyse symptoms of posttraumatic stress disorder and coping strategies of war veterans in Tuzla Canton twenty years after the war in Bosnia and Herzegovina (BiH). Methods The study analysed a group of 120 war veterans from the Tuzla Canton who had experience of the war in BiH. For assessment of posttraumatic stress disorder Harvard Trauma Questionnaire was used, a version for Bosnia and Herzegovina and for assessment of coping styles Life Style Index was used. Results Concerning number of traumatic experiences of war veterans, it was found that they suffered 12 traumatic experiences. Most often traumatic experience was the participation in fighting and shelling (90.0%), knowledge of injuries in combat or landmine injuries of family members or friends (75.8%), exposure to snipers (74.2%). The most important were the symptoms of numbnessemotional numbness (2.62%), the symptoms of intrusion (2.58%) and the severity of the symptoms of PTSD (2.39%). The most common strategy of de...

Research paper thumbnail of Monoamine oxidase A gene methylation and its role in Posttraumatic Stress Disorder - First evidence from the South Eastern Europe (SEE)-PTSD study

The international journal of neuropsychopharmacology, Jan 23, 2017

Posttraumatic Stress Disorder (PTSD) is characterized by an overactive noradrenergic system confe... more Posttraumatic Stress Disorder (PTSD) is characterized by an overactive noradrenergic system conferring core PTSD symptoms such as hyperarousal and re-experiencing. Monoamine oxidase A (MAO-A) is one of the key enzymes mediating the turnover of noradrenaline. Here, DNA methylation of the MAOA gene exonI/intronI region was investigated for the first time in regards to its role in PTSD risk and severity. MAOA methylation was analyzed via direct sequencing of sodium bisulfite treated DNA extracted from blood cells in a total sample of N=652 (m=441) patients with current PTSD, patients with remitted PTSD and healthy probands (comparison group) recruited at five centres in Bosnia-Herzegovina, Croatia, and the Republic of Kosovo. PTSD severity was measured by means of the Clinician-Administered PTSD Scale (CAPS) and its respective subscores representing distinct symptom clusters. In the male, but not the female sample, patients with current PTSD displayed hypermethylation of three CpGs (Cp...

Research paper thumbnail of Molecular Mechanisms of Posttraumatic Stress Disorder (PTSD) as a Basis for Individualized and Personalized Therapy: Rationale, Design and Methods of the South Eastern Europe (SEE)-PTSD study

Psychiatria Danubina, 2016

Posttraumatic Stress Disorder (PTSD) is a major health problem in South Eastern Europe (SEE). Ava... more Posttraumatic Stress Disorder (PTSD) is a major health problem in South Eastern Europe (SEE). Available treatment options are not efficient enough and the course is often chronic. Little is known about molecular mediators and moderators of pathogenesis and therapy. Genetic and epigenetic variation may be one central molecular mechanism. We therefore established a consortium combining clinical expertise on PTSD from SEE countries Bosnia-Herzegovina (Sarajevo, Tuzla and Mostar), Kosovo (Prishtina) and Croatia (Zagreb) with genetic and epigenetic competence from Germany (Würzburg) in 2011 within the framework of the DAAD (Deutscher Akademischer Austauschdienst)-funded Stability Pact for South Eastern Europe. After obtaining ethical votes and performing rater trainings as well as training in DNA extraction from EDTA blood between 2011 and 2013, we recruited 747 individuals who had experienced war-related trauma in the SEE conflicts between 1991 and 1999. 236 participants had current PTS...

Research paper thumbnail of 1285 – Training of bosnia-herzegovina mental health professionals in group analysis as the factor of development of culture of dialogue in the aftermath ofthe 1992–1995 war

European Psychiatry, 2013

Aim The primary objective will focus the first of all on Group Analysis (GA) as the psychotherapy... more Aim The primary objective will focus the first of all on Group Analysis (GA) as the psychotherapy method and theory of group analysis applied particularly in post-war environments. It outlines in particular a Zagreb Institute for GA Training Programme that took place in Tuzla University Clinical Centre, Department of Psychiatry, in Bosnia-Herzegovina (BH) in response to 1992–1995 war, in helping to train mental health workers in GA to enable them to treat psychological trauma symptoms of war survivors. Method In the GA education in the period of 16 years mental health professionals employed in mental health services were involved as well as other care employees as General Practitioners, Family physicians, pediatricians, gynecologists and neurosurgeons, psychologists and special educators. Results Trainees in education were from greater part of BH, and from several towns from neighborhoods countries. In this way a new room for mutual exchanges of experiences and establishing of cooperation was created. Idea of group analytic treatment of persons with mental health problems spread out on the whole region of BH through this model of education. The future of GA application as a psychotherapy model in BH confirmed through established models of education which are employed inowadays in Tuzla, Sarajevo and Mostar. The future of GA is provided in activities focused on foundations of the Institute for Analysis in Tuzla. Conclusion Training of Bosnia-Herzegovina mental health workers to effectively use GA with enthusiastic help of GA trainers from Institute for GA Zagreb will develop dialogue culture in postwar BH.

Research paper thumbnail of P02-331 - Characteristics of brain comuterized tomography diagnoses and comorbid conditions of alcohol dependant males treated on psychiatry department Tuzla during 2005–2009

European Psychiatry, 2011

IntroductionConsequences of alcohol dependence may be complex, and difficult for treatment, thus ... more IntroductionConsequences of alcohol dependence may be complex, and difficult for treatment, thus complex diagnostic procedures are needed.AimTo assess the prevalence of silent brain strokes and cortical cerebral atrophy amongst male inpatient alcoholics.MethodologyWe analyzed 86 file records of males treated from 01 January 2005 to 31 December 2009 year on Tuzla Psychiatry Department, who had dismissed diagnosis Alcohol dependency (F 10.2) according ICD-10, with computerized tomography (CT) of brain, related to age, war engagement, brain trauma, employment, smoking, psychological findings and presence of silent stroke and cortical brain atrophy according CT diagnosis.ResultsThe mean age of observed patients was 50.1 ± 6.6 years. Amongst them (70.9%) were active soldiers in Bosnia-Herzegovina Army during 1992–1995 war. There were 71 (72.6%) with atrophy of brain cortex, 27 (31.4%) had ischemic silent stroke. In the sample, 61 (70.9%) of inpatients met criteria for PTSD according ICD-...