Background Impulsivity, affective instability, and neglect of oneself and other people's safety as symptoms of personality dysfunction are associated with risky behaviors regarding the transmission of infectious diseases either sexually or by intravenous drug abuse. Objective The aim of this study was to analyze the association between hepatitis C virus (HCV) infection and personality dysfunction in opiate addicts on opioid substitution treatment. Methods This was a cross-sectional, observational investigation of patients over 18 years of age who were actively participating in opioid substitution treatment at five centers in Bosnia and Herzegovina. The occurrence of HCV infection was the primary study outcome, and personality functioning, the main independent variable, was assessed using the Severity Indices of Personality Problems (SIPP−118) questionnaire. The association between scores of personality functioning domains items and HCV infection status was determined by binary logistic regression analysis. Results Patients on opioid substitution therapy with HCV infection more frequently had personality disorders (OR 2.168, 95% CI 1.161–4.05) and were treated longer than patients without HCV infection (OR 1.076, 95% CI 1.015–1.14). HCV infection was associated with lower self-respect (OR 0.946, 95% CI 0.906–0.988), decreased capacity to have enduring relationships with other people (OR 0.878, 95% CI 0.797–0.966), and lower capability to cooperate with others (OR 0.933, 95%CI 0.888–0.98). On the other hand, except for self-respect, other elements of the Identity Integration domain (enjoyment, purposefulness, stable self-image, and self-reflexive functioning), when more functional, increased the risk of HCV infection. Conclusions Our study demonstrates that opiate addicts on opioid substitution treatment have a higher risk of HCV infection if their personality is dysfunctional, especially in the aspects of self-respect, enduring relationships, and cooperativity. The risk is even higher in addicts who have an established diagnosis of any kind of personality disorder.

There are still not enough findings to elucidate how exactly alcohol use impairs cognitive abilities. Some studies have shown that there is a link between alcohol intake and vitamin D levels, but these findings are inconsistent so further research is needed. The aim of this study was to investigate the association between serum vitamin D levels and cognitive impairment in alcohol-dependent individuals. A case-control study was carried out including a total of N = 132 respondents with a medical history of alcoholism, and healthy volunteers. The Montreal Cognitive Assessment (MoCa) and Addenbrooke’s Cognitive Examination-Revised (ACE-R) screening tools were used for cognitive status assessment and serum vitamin D levels analysis (blood samples of respondents). Significant difference (p = 0.022), was found in vitamin D levels in the alcohol-dependent group with cognitive deficiency 13.7 ± 9.4 (ng/mL), alcohol-dependent group without cognitive deficiency 19.5 ± 11.2 (ng/mL) and healthy controls 19.9 ± 11.1 (ng/mL), respectively. Furthermore, vitamin D levels were significantly different across all groups based on MoCa (p = 0.016) and ACE-R (p = 0.004) scores. All three groups exhibited vitamin D deficiency. A significant correlation was found between vitamin D deficiency and cognitive impairment, but it yielded no significant difference in alcohol-dependent individuals.

Background: Coronavirus disease 2019 (COVID-19), like any other pandemic, has imposed an unprecedented threat to physical and mental health to all nations, worldwide. There is no enough evidence in the literature in this area. The present study has been done to explore the organization of psychiatric services in Bosnia and Herzegovina (BH) to meet mental health needs of BH citizens during the particular restrictive measures caused by COVID-19 pandemic. Materials and Methods: This online survey has been done for BH psychiatric institutions. Data were collected from psychiatric institutions in the mental health network of BH. A total of 38 complete responses have been received. Results: Of 38 study participants, three were the departments of psychiatry in university clinical centers, two were psychiatric hospitals, four were psychiatric wards in general hospitals, 27 were community mental health centers, and two were institutes for alcoholism and drug addiction. During the pandemic, all services functioned on a reduced scale, adhering to measures to protect and self-protect both staff and service users. Protective equipment was provided to staff in some institutions in a timely and complete manner and in some in an untimely and incomplete manner. Consultative psychiatric examinations were mainly performed through telephone and online, where it exists as a standard patient monitoring protocol. The application of long-acting antipsychotics was continuous with adherence to restricted and protective measures. In opiate addiction replacement therapy services, substitution therapy was provided for a longer period to reduce frequent contacts between staff and patients. Individual and group psychotherapy continued in reduced number using online technologies, although this type of service was not administratively regulated. An initiative has been given to regulate and administratively recognize telepsychiatry by health insurance funds in the country. A number of psychological problems associated with restrictive measures and fear of illness have been reported by patients as well as by the professionals in mental healthcare teams. There were no COVID-19-positive patients seeking help from institutions that responded to the questionnaire. In one center, infected people with COVID-19 from abroad sought help through the phone. Only one involuntary hospitalization was reported. The involvement of mental health professionals in the work of crisis headquarters during the design of the COVID-19 pandemic control measures varies from satisfactory to insufficient. Education of staff, patients, and citizens was regular with direct instructions through meetings, press, and electronic media. Conclusions: During the COVID-19 pandemic in BH, all psychiatric services functioned on a reduced scale, adhering to measures to protect and self-protect staff and service users. All patients who asked for help have been adequately treated in direct inpatient or outpatient mental healthcare or online, despite telepsychiatric services not being recognized in health system in BH. There were neither infected patients nor staff with COVID-19 in the psychiatric institutions who responded in this research. A large-scale, multicenter study needs to be performed to get a broader picture and to guide us for future better service planning and delivery.

INTRODUCTION Cloninger's psychological model of temperament and character confirms that the personality development is influenced by biological and psychological processes. The aim of this study is to examine personality dimensions and to determine which variable separates the healthy from the ill in the best way and could be a possible psychological marker for the presence of the illness. METHODS This research included 152 subjects, 76 patients with schizophrenia and 76 healthy controls, selected on the basis of medical interviews, random population sampling model from a wider social community using the independent T-Tests. The Temperament and Character Inventory (TCI), which compared personality traits of the patients with schizophrenia and the healthy control group, was used. Dependence of variables in these categories was assessed using the Chi-square and Fisher's tests, and the impact of variables on schizophrenia was tested using univariate and multivariate binary logistic regression. The same method was used for making the mathematical model. RESULTS Unlike the control group, patients with schizophrenia exhibited higher Harm avoidance (HA) and Self - transcendence (ST) scores as well as lower Self - directedness (SD) and Cooperativeness (C) scores. Multivariate binary logistic regression showed that Responsibility, Purposefulness, Resourcefulness, Cooperativeness and Compassion dimensions were significantly more present in the patients with schizophrenia. The new variable Model (area=0.896, p<0.0005) is composed of five TCI parameters. It proved to be a reliable marker for separation the healthy from the ill ones (area=0.896, p<0.0005). It has a good sensitivity (80%) and specificity (84%). CONCLUSIONS Research has emphasized variables in the temperament and character inventory, which are the best markers for distinguishing between the healthy and the ill, thus making the mathematical model.

Risperidone, as a potent antagonist of the serotonin 5-HT2 receptors, as well as of the dopamine D2 receptors, is presumed to have a major antipsychotic effect. Treatment of patients with acute psychosis most often includes the use of long-acting injectable risperidone. A number of placebo-controlled studies have shown that risperidone solution is well tolerated and that it has many advantages, including a rapid elimination of both positive and negative symptoms of schizophrenia, as well as a low risk of experiencing extrapyramidal symptoms, compared to therapies with classic antipsychotics such as Haloperidol (Yosimura 2005). However, Risperidone can block the D2 receptors in the pituitary gland resulting in hyperprolactinemia, which is dosedependent (Timotijevic 2008). Klinefelter syndrome belongs to a group of congenital primary hypogonadisms and it is a disorder which affects the development and structure of the testicles. It is the most common form of disorder of sexual differentiation which affects 1 in 500 men and is due to the presence of one or more extra copy of the X chromosomes in each cell, usually a karyotype is 47,XXY (classic shape) or 46,XY/47,XXY (mosaicism). Klinefelter syndrome is characterized by small, hard testicles, azoospermia, gynecomastia, a low level of testosterone (testosterone is the hormone that directs male sexual development before birth and during puberty and low level can lead to delayed or incomplete puberty), and a high level of gonadotropin in the plasma of males with two or more X chromosomes (Harrison et al. 2004). The clinical diagnosis of this syndrome is not easy to discern, which makes it hard to recognize children with Klinefelter syndrome symptoms at an early age. Often the first signs of the syndrome are noticed at puberty in form of insufficiently developed secondary sexual characteristics and gynecomastia. Sometimes it can be detected at an older age, during infertility testing. Children with this syndrome can have a low IQ or mild retardation, and they tend to be taller than their peers at this age (Stepanovic et al. 2001). The other characteristics entail psychosocial problems, a greater tendency towards malignant diseases and a high risk of cardiovascular diseases (Jaksic 2008). This case study reviews the dilemma the authors encountered during the treatment of psychotic disorder. Was hyperprolactinemia caused by long-active injectable risperidone or was it a symptom of Klinefelter syndrome?

Background: The current standard treatment of chronic hepatitis C in Bosnia and Herzegovina consists of pegylated interferon alpha in combination with ribavirin. Interferon therapy has many psychiatric side effects, with depressive symptomatology being most prominent. The aim of the study was to establish the frequency and severity of depression in patients with chronic hepatitis C during two months of the aforementioned therapy. Subjects and Methods: The overall sample consisted of 46 subjects, divided into three subgroups, aged 18 to 65. The study population consisted of subjects treated for chronic hepatitis C (n = 15), subjects infected but not treated for chronic hepatitis C (n = 15), and healthy controls (n = 16). The assessment and level of depression were based on the Structural clinical interview (SCID), Montgomery-Asberg Depression Rating Scale and Zung Self-Rating Depression Scale. The assessments were conducted before interferon therapy (on the day 0), after 4 and 8 weeks of therapy. Results: Regarding its frequency, MADRS scoring showed that the number of depressed subjects receiving therapy increased after 8 weeks (46.7%). There was statistical significance between the subgroups after 4 and 8 weeks. Likewise, the ZUNG scale showed that the number of depressed subjects receiving therapy increased after 8 weeks (73.3%). There was statistical significance between the subgroups on the day 0, after 4 and 8 weeks. Conclusions: Depression was significantly more frequent in chronic hepatitis C subjects treated with interferon alpha in combination with ribavirin than in subjects in the group without therapy. Mild depression was most prevalent.

The research was conducted at the Department of Addictions of the Psychiatry Clinic in BanjaLuka in 2011/2012. It included two groups of examinees.One group was Experimental N (50) which consisted of alcohol addicts who had committed crime and misdemeanor offenses and the second one was a control group N (50) which consisted of alcohol addicts who had not commited these acts. The perpetrators of domestic violence are often treated at the Psychiatry Clinic following the Court verdict. The aim of the research is to study personality characteristics of alcohol addicts from these stand points: 1) What are the personality characteristics of alcohol addicts. 2) What are the personality specificities of alcohol addicts who have commited criminal acts or offenses and alcohol addicts who have not committed criminal acts and offenses. 3) Can the personality characteristics of alcohol addicts be taken into account indrawing up treatment guidelines for the prevention of relapse of criminal behavior and suggesting possible ways of sanctioning through the legal system. The research was conducted at the Department of Addictions of the Psychiatry Clinic in BanjaLuka in 2011/2012. It included two groups of examinees.One group was Experimental N (50) which consisted of alcohol addicts who had committed crime and misdemeanor offenses and the second one was a control group N (50) which consisted of alcohol addicts who had not commited these acts. The perpetrators of domestic violence are often treated at the Psychiatry Clinic following the Court verdict. The results showed that the offenders differ from non-offenders in the fact that they start drinking earlier, and they have a statistically significant difference in many categories of sociopathic characteristics in terms of problems in school,conflicts with law, conflicts within the family, and more often show aggression. Analysis of the personality characteristics shows statistical significance at the subscale of psychopathic deviation forthe perpetrators. Category of offenders is significantly more impulsive than non-offenders under all three components of impulsiveness: cognitive, motor and dispersal of attention. Everything mentioned above indicates the need for early prevention of alcohol and work with high-risk populations. On the other hand, there should be a better secondary prevention where, besides treating alcohol dependence, a group of perpetrators has a need for psychosocial treatment of anger control.