BACKGROUND The 1992-1995 war in Bosnia and Herzegovina (BH) has had a tremendous impact on civilians; thousands of inhabitants were left with numerous traumatic experiences. Many children suffered or witnessed horrifying acts of violence and aggression. Although young trauma victims are often resilient, many experience mental health difficulties, including PTSD. The aim of the study was to estimate whether psychosocial support given by the School Project of Humanitarian Association of " Prijateljice" reduced posttraumatic consequences in students in primary and secondary schools in Bosnia and Herzegovina after 1992-1995 war. SUBJECTS AND METHODS A stratified sample of 336 students in primary and secondary schools located in two entities of North-East Bosnia and Herzegovina, involved in psychosocial support, was compared with 72 voluntarily selected same-age students from the same schools who were not involved in this project. Data were collected on two occasions, beginning of December 2005 and end of May 2006, by using a self-evaluation survey method for measuring symptoms of posttraumatic stress disorder (PTSD) according to DSM IV. The Index of Children Post-traumatic reactions were used. RESULTS The severity of PTSD symptoms among students involved in the School Project decreased from (mean+/-standard deviation=35.3+/-10.2 to 26.7+/-8.7) (t=13.1, P<0.001, Paired sample test), whereas in the group with no psychosocial assistance this reduction was from (29.7+/-10.9 to 28.1+/-11.8) (t=0.9, P=0.396, Paired sample test). CONCLUSION This study suggests that work with students by giving them psychosocial support within the School Project resulted in significant reduction of PTSD symptoms' severity.
Bosnia and Herzegovina (BH) is located on the western part of the Balkan Peninsula. It has an area of 51 210 km2 and a population of 3 972 000. According to the Dayton Agreement of November 1995, which ended the 1992–95 war, BH comprises two ‘entities’ – the Federation of Bosnia and Herzegovina (FBH) and the Republic of Srpska (RS) – and the District of Brcko. The administrative arrangements for the management and financing of mental health services reflect this. The FBH, with 2 325 018 residents, is a federation of 10 cantons, which have equal rights and responsibilities. The RS has 1 487 785 residents and, in contrast, a centralised administration. Brcko District has just under 80 000 residents.
Background: Majority of Bosnia-Herzegovina (BH) residents were exposed to cumulative traumatic events during and after the (1992-1995) war, which demanded emergency organizing of psychosocial support as well as psychiatric-psychological treatment of psychotraumatized individuals. Objectives: To describe organizing of psychosocial help during and after the BH war, institutional treatment of psychotraumatized in the frame of mental health service reform program with an overview on the model of psychosocial support and psychiatry-psychological treatment of psychotraumatized persons of Tuzla Canton region. Subjects and methods: The retrospective analysis of functioning in the Department for traumatic stress disorders on the Psychiatry Clinic in Tuzla for the 1999-2003 period has been described in regard of number, gender, age and trauma related mental disorders of referred patients. Results: In the observed period, 8.329 of patients in the outpatient care program were included, 617 of inpatients were treated in the Clinic, while 301 of patients in the Partial hospitalization program were included. Mean ± standard deviation of patients’ age was 45±8.06 years. More psychotraumatized women (60.8%) were encompassed in the partial hospitalization program than in inpatients (23.9%) or outpatients (18.3%) care programs. In regard of trauma related mental disorders, majority outpatients had Posttraumatic stress disorder (PTSD) in co morbidity with other mental disorders (72.5%), PTSD was presented amongst the majority of inpatients (64.5%) and in partial hospitalization program there were (47.5%) patients with PTSD. Conclusions: In the treatment of psychotraumatized persons, in the organizing of health care system schema in postwar Bosnia and Herzegovina, meaningful obstacles are presented still today on the both, social and political level, despite mental health service reform performed in Bosnia-Herzegovina. The stigmatization of mental health issues is an important problem in treatment of traumatized individuals especially among war veterans. The lack a single Center for psychotrauma in postwar BH shows absence of political will in BH to resolve the problem of war veterans with trauma related psychological disorders.
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