Dražen Begić

Electroencephalographic comparison of veterans with combat-related post-traumatic stress disorder and healthy subjects

Various investigations prove the biological basis for post-traumatic stress disorder (PTSD). There are only a few quantitative electroencephalographic (qEEG) studies of patients with PTSD. The aim of this investigation is to find out whether there are differences in qEEG parameters between PTSD patients and healthy subjects. The experimental group was comprised of 18 veterans with PTSD, and 20 healthy non-veterans were included in the control group. After informed consent was obtained, they were investigated by qEEG recordings. The artifact-free EEG epoch was analyzed by fast Fourier transformation (FFT). Power values of particular frequency bands (delta, theta, alpha 1, alpha 2, beta 1, beta 2) were observed on the regions: Fp I, Fp2, F3, F4, F7, F8, C3, C4, T3, T4, T5, T6, P3, P4, O1 and O2. PTSD patients had increased theta activity over central regions, and increased beta activity. Beta 1 activity increased over frontal, central and left occipital regions; beta 2 activity increased over frontal regions. No significant differences were noted between the PTSD and control group in delta and alpha activity. These results suggest a neurobiological basis for PTSD. Increased theta activity may help to explain changes in hippocampal volume. Various explanations (cortical hyperexcitability, prolonged wakefulness, or attention disturbances) have been offered for the beta activity increase observed in PTSD subjects.

Quantitative electroencephalogram (qEEG) in combat veterans with post-traumatic stress disorder (PTSD)

Only a small number of studies have used quantitative electroencephalography (qEEG) in research of the post-traumatic stress disorder (PTSD). The results are not consistent. The aim of the present investigation was to compare qEEG in combat veterans with and without PTSD. The hypothesis is that differences among qEEG characteristics will be found regarding the presence/absence of PTSD. Seventy-nine combat veterans with PTSD comprised the experimental group and 37 veterans without PTSD were included as controls. After the informed consent, they were investigated by the resting EEG recordings. The results demonstrate that PTSD veterans had decreased alpha power and increased beta power. These results suggest an altered neurobiology in PTSD. Various explanations have been offered for alpha activity decrease observed in PTSD veterans. Increased beta rhythm may play a role as a potential marker in differentiating subtypes of PTSD.

Quantitative EEG in "positive" and "negative" schizophrenia

Begić D, Hotujac Lj, Jokić‐Begić N. Quantitative EEG in ‘positive’ and ‘negative’ schizophrenia.

Quantitative EEG in schizophrenic patients before and during pharmacotherapy

The aim of the study was to determine the possible differences in quantitative EEG parameters of schizophrenic patients before and during therapy with neuroleptics. First EEG recordings were obtained from schizophrenic patients (n = 50) who had not been taking any medicaments during the preceding 2 months. Second EEG recordings were obtained during the administration of neuroleptic therapy. Amplitude values of particular spectral segment, i.e. delta, theta, alpha 1, alpha 2, beta 1 and beta 2 (after fast Fourier transformation) were analyzed. The F3, F4, C3, C4, T3, T4, P3, P4, O1 and O2 regions were observed. The effect of pharmacotherapy manifested as a decrease in delta and beta 2 activities. The alterations of the delta spectrum were recorded in each patient subgroup (regardless of the neuroleptic used). The changes in beta 2 activity were registered in patients on haloperidol and fluphenazine.

Violent behaviour and post-traumatic stress disorder

Purpose of review There is a dual connection between violent behaviour and post-traumatic stress disorder. On one hand, exposure to violence leads to post-traumatic stress disorder symptoms, and on the other hand some of the symptoms of post-traumatic stress disorder are violent behaviour and aggression. In other words, violence creates post-traumatic stress disorder, and post-traumatic stress disorder contains violence. The frequency of violent behaviour as a background for the development of post-traumatic stress disorder is increasing. Exposure to violence, criminal and terrorist attacks, sexual (especially in early childhood) and physical abuse lead to anxiety, aggression, depression and post-traumatic stress disorder symptoms. Recent findings Different types of violence and their psychological and psychiatric consequences are now being researched to determine whether there are any differences in exposure to violence and its consequences with regard to age, sex, ethnicity, and sociodemographic characteristics. Apart from the individual and his/her family, the effects of violence on the wider community are being examined. In contrast, the well-described post-traumatic stress disorder, within the frame of increased alertness, can contain violence, aggression, anger, and impulsivity, which are a big problem for the patient and his/her family. These are the most common reasons for requesting psychiatric treatment. Summary Future research into violent behaviour and post-traumatic stress disorder will reveal the risk factors for this disorder, and try to explain what it is that, after exposing an individual to psychological trauma, leads to post-traumatic stress disorder. Possible protective factors and mechanisms to prevent the occurrence of post-traumatic stress disorder will be described.

Prediction of posttraumatic stress disorder symptomatology after childbirth – A Croatian longitudinal study

BACKGROUND Following childbirth, a vast number of women experience some degree of mood swings, while some experience symptoms of postpartum posttraumatic stress disorder. AIM Using a biopsychosocial model, the primary aim of this study was to identify predictors of posttraumatic stress disorder and its symptomatology following childbirth. METHODS This observational, longitudinal study included 372 postpartum women. In order to explore biopsychosocial predictors, participants completed several questionnaires 3-5 days after childbirth: the Impact of Events Scale Revised, the Big Five Inventory, The Edinburgh Postnatal Depression Scale, breastfeeding practice and social and demographic factors. Six to nine weeks after childbirth, participants re-completed the questionnaires regarding psychiatric symptomatology and breastfeeding practice. FINDINGS Using a multivariate level of analysis, the predictors that increased the likelihood of postpartum posttraumatic stress disorder symptomatology at the first study phase were: emergency caesarean section (odds ratio 2.48; confidence interval 1.13-5.43) and neuroticism personality trait (odds ratio 1.12; confidence interval 1.05-1.20). The predictor that increased the likelihood of posttraumatic stress disorder symptomatology at the second study phase was the baseline Impact of Events Scale Revised score (odds ratio 12.55; confidence interval 4.06-38.81). Predictors that decreased the likelihood of symptomatology at the second study phase were life in a nuclear family (odds ratio 0.27; confidence interval 0.09-0.77) and life in a city (odds ratio 0.29; confidence interval 0.09-0.94). CONCLUSION Biopsychosocial theory is applicable to postpartum psychiatric disorders. In addition to screening for depression amongst postpartum women, there is a need to include other postpartum psychiatric symptomatology screenings in routine practice.

Croatia Needs a Gender Incongruence Diagnosis for Prepubertal Children

First of all, we want to emphasize that we completely understand arguments given against the diagnosis, especially clinical ones (prepubertal individuals need psychological space, support, and information, not medical treatment and diagnosis). We also agree and support all efforts against the pathologization and stigmatization of gender variant persons. The shift in expert opinion, in which mere gender non-conformity is seen as a variation rather than a disorder, as can be seen in the Standards of Care for transgender persons of the WPATH 2011 and in the DSM-5, no doubt contributes to the psychological welfare of gender variant people. However, even in the countries representing benchmarks of good practice in the care of individuals with GI, not all health experts adopt the same approach toward supporting transgender people, and trans-healthcare providers have differing attitudes according to Gender Incongruence of Adolescence and Adulthood (GIAA) and Gender Incongruence in Childhood (GIC) diagnosis (Winter, De Cuypere, Green, Kane, & Knudson, 2016).