Smiljka Popović-Deušić

Facets of the childhood anxiety sensitivity index among Serbian youth.

Data from factor analytic studies using the Child Anxiety Sensitivity Index (CASI) suggest that global anxiety sensitivity (AS) is best represented by three or four underlying factors or facets. The aim of this study was to identify facets best representing the CASI structure in its Serbian version. Confirmatory factor analysis was used on data collected from 456 non-referred children in Serbia. A 13-item version of the CASI provided a better fit to the data than the original 18-item version. The four-factor model of the CASI-13 with disease, unsteady, mental incapacitation, and social concerns facets provided the best fits for the data and it was found to be fully invariant (configural, metric, and scalar invariance) across gender and age. Among Serbian children, hierarchical structure was found for a 13-item CASI version with a single higher-order factor of global AS represented by four underlying facets. Future research will consider these AS facets and their role in the development, maintenance, and exacerbation of anxiety symptoms in children.

Sexual dimorphism and specificities of psychopharmacological treatment in women

The scope of gender related differences observed in mentally ill persons provides a major source of inference about the role of gonadal steroids in brain function and behavior. Reported gender dimorphism in psychiatry includes the following: prevalence of certain mental disorders specific to female gender, phenomenology and treatment characteristics, i.e. response to the applied psychopharmacotherapy. Structural and functional relationship between the hormonal system and central nervous system is closely correlated with vulnerability to various psychopathological disturbances in biologically different stages in women. It has been observed, for instance, that the association of gonadal steroid activity with serotonin is relevant to mood change in premenstrual and postpartum mood disturbances. Gender related hormonal fluctuations may cause or be correlated with the development of several gender-related psychopathological disturbances. The aim of this article is to review the literature concerning gender-related specificities of psychopharmacological treatment of some of the most important mental disorders in women, such as affective disorder in menopause, premenstrual syndrome and postpartum mood disorders.

[Adjustment disorders in hospital treated adolescents: a follow-up study].

INTRODUCTION Adjustment disorders represent a frequent diagnostic entity especially among adolescents. They involve a wide spectrum of various emotional and behaviour problems. OBJECTIVE The aim was to investigate characteristics of diagnostic category known as adjustment disorders among hospital treated adolescents for the first time at the Clinical Department for Children and Adolescents of the Institute of Mental Health in Belgrade, during five consecutive years, as well as to investigate the outcome of the disorder in follow-up period. METHODS We conducted a retrospective investigation of the first time hospital treated adolescents from Belgrade with discharge diagnosis of adjustment disorders during 2000-2004. The follow up was conducted 5-10 years after a first discharge from the hospital. RESULTS During the investigated period 75 adolescents from Belgrade were hospitalized for the first time with diagnosis adjustment disorder. From the studied patients the main sample was formed that included 24 (32%) males and 51 (68%) females. After 5-10 years a follow-up of 52 patients was conducted (sample at follow-up) which included 16 (30.77%) males and 36 (69.23%) females. Of the main sample, 70% of the patients were under follow-up. After the first hospitalization 58% of adolescents continued with further psychiatric treatment, either as rehospitalized or out-of-hospital patients. CONCLUSION Our findings showed that 38% of adolescents under follow-up for 5-10 years after the first discharge from hospital with the diagnosis adjustment disorders had multiple hospitalizations. The outcome of the disorder among these patients was the worst, because three-quarters of the patients were rediagnosed in the follow-up period with a new psychiatric disorder, often from psychotic spectrum.

[DiGeorge syndrome: a case report].

INTRODUCTION DiGeorge syndrome is a genetic disorder caused by deletion of chromosome 22. The main features are congenital heart disease, absence or hypoplasia ofthymus (with consecutive immunodeficiency and infections), hypoparathyroidism with consecutive hypocalcaemia, gastrointestinal problems, Delayed psychomotor development, abnormalities of head and face, tendency to develop seizures and psychiatric disorders. Syndrome can be detected prenatally, or during early development, which is of great importance for preventive and therapeutic measures. Death rate is high during the first year of life, mostly because of congenital heart disease. With prompt diagnosis and treatment most of the children can survive to adulthood, but they are children with special needs requiring continual care and supervision (because of metal retardation, seizures, neurological and psychiatric disorders). CASE OUTLINE A seven-year-old boy underwent surgical correction of congenital heart disease soon after the birth. Since the age of four years he developed seizures, partially controlled by antiepileptic therapy. Entering the seventh year of age he displayed severe auto and heteroaggressive behaviour. His condition has improved by the introduction of intensive psychiatric and defectological treatment, and daily counselling with his mother the child improved in the sense of calming down, better social communication and acquiring some self-help specific skills. CONCLUSION Symptoms of DiGeorge syndrome can be detected soon afterthe birth, especially that concerning congenital hearth disease. A prompt diagnosis and surgical intervention can save the childs life. Because of many other symptoms, many diagnostic procedures focused on this syndrome are to be performed, followed by long lasting stimulative treatment and treatment of seizures and psychiatric disorders.