Mirjana Graovac

1917 – Childhood trauma and developmental processes

Introduction Children can experience traumas in family, school and society, as well as participants in natural disasters, terrorism, war and civilian casualties. Their reactions depend on age, sex, individual ego strength, coping strategies, but also on the reactions of childs surrounding. Objectives Clinical entities associated with the traumatic experience in children are common in psychiatric practice. Frequent manifestations of these experiences are classical clinical picture of PTSD, as well as depression, anxiety, somatization, behavior disorder, dissociative reactions, etc. Aims The childs perception of the traumatic event, and subsequent developing psychiatric symptoms were the aims of this case report. Methods We present difficulties in growing a 9 years old girl, whose father, after being stricken at the front and had been treated for PTSD, attempted suicide. Results Faced with the traumatic situation, the patient used a self-protective mechanism suppressing negative emotions and memories to combat the negative effects of traumatic experience. Ways of coping were associated with the low degree of reliance with mother, brother and siblings. During adolescence she manifested symptoms intensified anxiety and depresion, guilt to encourage a sense of protection. Conclusions Secure attachment is the first line of defense against psychopathology launched traumatic experience. In terms of traumatic events in the child unless objective factors related to the traumatic event affects a childs perception of danger / threat, and perceptions of care required and provided by others. In that space shape the emotional experience of the child, which includes a sense of helplessness, irretrievable loss, anger and betrayal.

P-757 - Oral and oropharinegeal cancer and defence mechanisms

Biological mechanisms of tumor development are largely known, however influence of psychological factors in alcoholics with malignant tumor of the oral cavity and the oropharynx are mostly unexplored. The aim of the research was to examine early family relations and investigate differences in the use of defense mechanisms in alcohol dependent patients suffering from malignant tumor of the oral cavity and oropharynx compared to alcohol dependent persons without malignant tumors and healthy controls. The research included 51 alcohol dependent patients treated for malignant tumor of the oral cavity and oropharynx at the University Hospital Center Rijeka from 2005 to 2009. The control groups corresponded to the experimental group in age, sex and education level. The research used a general demographic questionnaire, the Mini International Neuropsychiatric Interview and the Revised Questionnaire of Life Style and Defense Mechanisms.The research groups showed significant differences in difficult childhood (p

P01-291 - Arachnoid cyst and psychosis in an adolescent

Introduction Arachnoid cysts are rare, benign space-occupying lesions formed by an arachnoid membrane containing cerebrospinal fluid (CSF). They are often discovered as incidental findings found on imaging. Occasionally they may produce symptoms because of expansion or bleeding. Objectives The coexistence of arachnoid cysts with psychiatric disturbances in adolescents had not been closely covered in the literature. Recent descriptions of aphasia and attention-deficit disorders associated with these cysts indicate that we do not fully understand this entity. There is also no acceptable explanation for the male preponderance and increased incidence on the left side. Aims The appearance of some references that focus on a possible link between arachnoid cysts and psychotic symptoms in adolescents has increased the interest in this subject. Methods and results This case report describes the treatment of a 17-year old male adolescent, characterized by “negative” psychotic symptoms, reduced affect, unfunctioning behavior, headaches and vision problems. An arachnoid cyst was found on the temporobasilaris left brain side on magnetic resonance image. His psychotic symptoms were suspected to be induced by the arachnoid cyst. The patient was treated with an outpatient antipsychotic therapy (olanzapin) during one year and shown improvement, but without a complete remission of the psychotic symptoms. Conclusions It is difficult to discus whether the lesion had influence on the patient’s psychiatric symptoms or not, but clinical features and treatment modalities points this possibility. However, the co morbidity of neurological and psychiatric symptoms in adolescence raises problems when it comes to choosing the therapeutic guidelines.