Dolores Britvić

Disorder of extreme stress not otherwise specified (DESNOS) in Croatian war veterans with posttraumatic stress disorder: case-control study

Aim To determine the presence of disorder of extreme stress not otherwise specified (DESNOS) in Croatian war veterans who suffer from combat-related posttraumatic stress disorder (PTSD). Methods The research included 247 veterans of the 1991-1995 war in Croatia who suffered from PTSD and were psychiatrically examined at four clinical centers in Croatia during a month in 2008. It was based on the following self-assessment instruments: The Harvard Trauma Questionnaire (HTQ): Croatian Version, the Structured Interview for Disorder of Extreme Stress (SIDES-SR), and the Mini International Neuropsychiatric Interview (MINI) Results Based on the SIDES-SR results, we formed two groups of participants: the group with PTSD (N = 140) and the group with both PTSD and DESNOS (N = 107). Forty three percent of participants met the criteria for DESNOS. There was a significant difference in the intensity of posttraumatic symptoms between the group with both PTSD and DESNOS and the group with PTSD only (U = 3733.5, P = 0.001). Respondents who suffered from both PTSD and DESNOS also reported a significantly larger number of comorbid mental disorders (U = 1123.5, P = 0.049) and twice more frequently reported comorbid depression with melancholic features (OR = 2.109, P = 0.043), social phobia (OR = 2.137, P = 0.036), or panic disorder (OR = 2.208, P = 0.015). Conclusion Our results demonstrate that PTSD and DESNOS can occur in comorbidity, which is in contrast with the ICD-10 criteria. A greater intensity of symptoms and a more frequent comorbidity with other psychiatric disorders, especially depression, panic disorder, and social phobia require additional therapy interventions in the treatment processes.

Comorbidities with Posttraumatic Stress Disorder (PTSD) among combat veterans: 15 years postwar analysis

The aim of this study was to investigate the differences in the prevalence of somatic diseases among combat veterans and their contemporaries who were not exposed to the traumatic experience at the battlefield, and to determine whether socio-demographic factors, exposure to war-time trauma and/or injury might predict individual somatic diseases. The study included 1,558 subjects living in south Croatia: 501 male combat veterans with Posttraumatic Stress Disorder (PTSD) and the corresponding control group of 825 men who were not exposed to combat experience. Veterans with PTSD, regardless of the length of time spent in war, suffered more often from cardiovascular, dermatological, musculoskeletal, pulmonary and metabolic diseases than corresponding control subjects who were not exposed to combat experience. The predictors of cardiovascular, musculoskeletal and malignant diseases in veterans were age, length of time spent in combat, having been wounded. A longer period in the combat zone was associated with arrhythmias in veterans with PTSD complicated with other psychiatric comorbidities. PTSD as a result of exposure to war trauma increases the possibility of developing somatic diseases.

Psychotherapeutic Treatment Program for Post-traumatic Stress Disorder: Prospective Study of 70 War Veterans

The aim of this study was to assess the effectiveness of the psychotherapeutic model of treatment of war veterans in Croatia with post-traumatic stress disorder (PTSD). The symptoms of PTSD are analysed and evaluated, together with associated neurotic symptoms, ways of coping with stress, and indicators of quality of life and depression.

Drug analysis in necrophagous flies and human tissues.

Drug Analysis in Necrophagous Flies and Human Tissues Necrophagous insects may provide useful information about the time, place and cause of death. In addition, they can serve as reliable alternative specimens for toxicological analysis in cases where human tissue and fluids, normally taken during autopsies, are not available, due to decomposition of the corpse. This paper reports the results of drug analysis of the larvae of two fly families, Calliphoridae and Sarcophagidae, collected from the body of a middle-aged man who had committed suicide approximately three weeks before his corpse was found. Multiple samples of decomposed human tissue, of the blowfly, and of the larval flesh were analysed using gas chromatography/mass spectrometry (GC/MS), and amphetamine was detected in all samples. While the screening results were beyond doubt, the quantitative analysis was less clear, and further research is needed in this area. Analiza Droga U Nekrofilnim Muhama I Ljudskim Tkivima Insekti strvinari mogu pružiti korisne informacije o vremenu, mjestu i uzroku smrti. Dodatno, oni mogu poslužiti kao pouzdani zamjenski uzorci za toksikološke analize u slučajevima kada ljudska tkiva i tekućine, koji se uobičajeno uzimaju tijekom obdukcije, ne postoje zbog raspadanja trupla. Ovaj rad prikazuje rezultate analize droga u uzorcima ličinki dviju porodica muha (Diptera: Calliphoridae i Sarcophagidae), prikupljenima s tijela muškarca srednje Životne dobi koji je počinio samoubojstvo otprilike 3 tjedna prije pronalaska njegova mrtvog tijela. Višestruki uzorci raspadajućeg ljudskog tkiva i ličinki muha analizirani su uporabom plinske kromatografije uz detekciju spektrometrijom masa (GC/MS) i u svima su otkriveni amfetamini. Dok su rezultati preliminarne kvalitativne analize bili izvan svake sumnje, kvantitativni su rezultati bili manje jasni te se preporučuje daljnje istraživanje u ovom području.

Long-Term Improvement in Coping Skills Following Multimodal Treatment in War Veterans with Chronic PTSD

Abstract Due to the long-lasting and resistant symptoms characteristic of chronic combat posttraumatic stress disorder (PTSD), its treatment is complex and often requires a tailored therapeutic approach incorporating both psychotherapy and pharmacotherapy. A multimodal approach of psychoeducative, sociotherapeutic, and dynamically oriented trauma-focused groups is described. We assessed the short- and long-term effectiveness of this therapeutic program by monitoring its impact on PTSD symptoms, depression, neurotic symptoms, coping skills, and quality of life for three years. The findings revealed short-term reduction in the symptoms of PTSD and depression, while the long-term results were manifested as the increased use of all coping mechanisms and a greater level of obsession.

Sexual self-concept, sexual satisfaction, and attachment among single and coupled individuals

The aim of this study was to examine the moderating role of attachment styles among single and coupled participants (N = 632) in the associations between sexual self-concept (sexual self-esteem, sexual depression, and sexual preoccupation) and sexual satisfaction. The results indicated lower sexual self-esteem and sexual satisfaction and higher sexual depression and avoidant attachment among singles, as compared to coupled participants. Furthermore, in coupled participants (securely, anxiously, and avoidantly attached), sexual self-esteem and sexual depression were predictors of sexual satisfaction. Among securely, fearfully, and avoidantly attached singles, sexual self-esteem was a predictor of sexual satisfaction. Sexual satisfaction was also predicted by sexual preoccupation among avoidantly attached singles. Finally, the only predictor of sexual satisfaction among anxiously attached singles was sexual depression.

Special Section: Group Supervision of Group Psychotherapy with Psychotic Patients: A Group-Analytic Approach

In this article the authors document their experiences in small and median groups of supervision of conductors and therapeutic teams who are engaged in group psychotherapy with psychotic patients within different institutional frameworks, and discuss dynamics, as well as the enlarging of therapeutic possibilities of group psychotherapy of group-analytic orientation for application in these settings. They propose the possibility that at times the group itself can become the supervisor, i.e. that the supervision might be effectuated by the group, under guidance of an experienced conductor.