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Nera Žigić

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M. Fazlovic, N. Žigić

Introduction Autistic spectrum disorders belong to the group of neurodevelopmental disorders, where the manifestations of the disorder differ depending on the severity of the autistic condition. These disorders are often associated with intellectual impairments and structural language disorders. In his patients, Asperger described cases with above-average intelligence as well as cases with low language and intellectual abilities. What they had in common was that they had significant disorders in social and affective communication. The diagnosis of autism spectrum disorders is usually made in childhood, but there are also cases where the diagnosis is made at an older age due to the later manifestation of symptoms. Objectives To present a case report of 18 years old girl who was diagnosed with moderate intellectual disability in childhood, while later established with symptoms of Asperger’s syndrome and mild intellectual disability. Methods Psychiatric interview, medical history, psychological testing Results An 18-year-old girl, accompanied by her mother, presented herself to psychiatrist for the first time due to affective disorders that manifested in the form of increased nervousness and outbursts of anger. Early psychomotor development was slow, she started walking at the age of 1.5 years and spoke at the age of two. From early childhood, stereotypies in movements and hypervigilant attention were observed, along with very poor social interactions. Due to difficulties at school, she was categorized at the age of 12 as having moderate intellectual insufficiency and IQ of 35. She underwent long-term speech therapy treatment and finished elementary and high school with the help of teaching assistant. Somewhere in high school, the patient’s pronounced talent for drawing was noticed. Observation during the psychiatric examination reveals emotional immaturity, stereotypes and rigidity in social interactions. The patient is referred again for psychological testing, results show IQ of 88 with a lag in emotional development and development of basic social skills. The patient is referred to another psychiatrist for an additional opinion, who agrees with diagnose of Asperger’s syndrome. Low dose of lamotrigine was included in therapy, after which affective state stabilized. The patient is referred again for categorization. Conclusions This case report that a diagnosis established in childhood period does not have to be definitive and that revision of diagnosis is necessary over time and as necessary, initially due to increase of patient’s IQ, as well as due to the later presentation of symptoms characteristic of certain disorder. Disclosure of Interest None Declared

Introduction Posttraumatic stress disorder in the paediatric population has clinical features. The Clinician-Administered PTSD Scale for DSM-5,child and adolescent version (CAPS-CA-5) is the gold standard for the positive diagnosis. Objectives The objectives of our work were to translate the CAPS-CA-5 into Tunisian dialectal Arabic and to validate it in our Tunisian sociocultural context. Methods This is a descriptive cross-sectional study conducted in the child psychiatry department of Mongi Slim Hospital and the forensic medicine department of Charles-Nicolle Hospital (Tunisia), among children older than seven years who were exposed to a potentially traumatic event at least one month before. We validated the tool through translation, content, construct validity and reliability. The statistical processing for this data was carried out using SPSS 26 software. Results We conducted our study with 150 patients. The validation was made on 146 records after the exclusion of 4 incompleted assessments. We initially translated the CAPS-CA-5 into Tunisian dialect. We validated the content through pre-test and scientific committee evaluation. Afterwards, we validated the construction. We calculated the Bartlett’s sphericity test (p<0.001) .The KMO index that was 0.766. Concerning the reliability study, we found a Cronbach’s alpha coefficient equal to 0.92. We studied also the inter-raters reliability; we found an intra-class coefficient between 0.8 and 1 Conclusions We validated the first Tunisian diagnostic tool for PTSD in children according to the DSM-5 criteria with satisfactory psychometric qualities. Disclosure of Interest None Declared

N. Žigić, E. Becirovic, M. Mirković-Hajdukov, N. Aljukić, H. Löffler‐Stastka

Introduction Developmental predisposition to schizophrenia can be a consequence of early experienced traumas. Transgenerational trauma is process in which traumatic experience of one generation is passed on to the next generation. Objectives To show connection between transgenerational transmission of trauma and development of schizophrenia. Methods Psychiatric interview, psychological testing. Results Patient G.E. age 29, admitted to Psychiatry Clinic due to altered behavior, aggressiveness and presence of delusions and hallucinations. First mental problems in form of a catatonic stupor appeared 6 years ago. Patient has history of earlier abuse of psychoactive substances. A drug test performed at admission was negative. Patient was born in Srebrenica in 1993, he escaped to Tuzla with his mother in July 1995, while father survived escaping on foot. Patient is a first child from his father’s second marriage. The father’s first wife and two minor children were shot by Bosnian Serbs in early 1992. Patient was born a year and a half after death of his siblings and was named after his half-sister. Patient’s father consumed alcohol after the war and was aggressive towards children. In the last two years, patient had frequent hallucinations, he told his parents that voices were telling him to kill his mother and told his father that his children were still alive. Diagnostic processing was performed and diagnosis of schizophrenia was stated. During hospitalization, patient was treated with olanzapine and low doses of haloperidol, along with haloperidol decanoate, which resulted in significant reduction of productive psychotic symptoms. A partial remission is achieved, negative schizophrenic symptoms and cognitive impairments verified by psychological instruments remain. Conclusions Case report emphasize transgenerational transmission of trauma: father‘s untreated trauma, alcohol dependency and abuse of the patient in childhood. These findings are important for treatment and therapeutic considerations. Mentalizing is a possible mediator between childhood abuse and negative symptoms. Parental bonding was explored within high expressed emotions theory as a risk factor for relapse to psychosis, especially the “affectionless control” in the parental (mainly father‘s) bonding style. Studies also stated that psychotic patients often show insecure attachment representations. Possible pathway for further analysis could be discussed: a cold parental bonding style leading to experienced emotional neglect and attachment avoidance might be reflected in lower capacity to mentalize. To improve the mentalization capacity, it would be essential to establish a sustainable therapeutic treatment frame. Disclosure of Interest None Declared

I. Martinčević, N. Žigić, Igor Mraz, Nikola Sedlar

The aim of this research was to examine the connection of body mass index of eighth grade students and their results in motor abilities test, with the purpose of gaining insight in which tests is that connection more or less expressed, or there isn’t any. The sample of subjects consisted of 66 male and 64 female students from four elementary schools from the Varaždin city area, who attended eighth grade in the school year of 2018/2019 For data analysis, the results of the final testing of motor abilities were used. The sample of variables consisted of six motor tests and two anthropometrical measures, student’s age and their body mass index. For all 10 variables the basic descriptive parameters were calculated (arithmetic mean, standard deviation, minimum and maximum), both for female and male students. Further data processing was done by linear regression analysis – 6 x regression analysis for each motor ability. The results of the regression analysis in male students showed statistically significant connection of body mass index and four variables (standing long jump, shuttle run with carrying objects, sit and reach and pull-up hold), while in female students the connection was significant only in two variables (standing long jump and pull-up hold). Overweight and obesity of children and adolescents is a growing phenomenon all over the world. Motor abilities are an important indicator of physical activity and one of the possible indicators of the level of fitness. Overweight and obesity, as well as underweight, negatively influence the condition and development of motor abilities, and the role of Physical education classes are of great importance in prevention and promotion of healthy living habits of students.

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