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.

The study examined the psychological health of war-traumatized adolescents in rural and urban areas of Bosnia and determined its correlation with poverty and hopelessness. The study was carried out in Teocak and Tuzla, Bosnia and Herzegovina in March 2007. PTSD prevalence was significantly higher amongst rural than urban adolescents. Depression was present with no statistical difference between the rural and urban groups. All adolescents reported high hopelessness scores with again no difference between groups. Prevalence of PTSD was positively correlated with the prevalence of depression. Life in poor material conditions worsened psychological war consequences and academic achievement. Academic achievements were negatively associated with age, severity of PTSD, depression, suicidal thoughts, hopelessness and with the mean number of trauma experiences.

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.

BACKGROUND The traumatic events experienced in Bosnia and Herzegovina during the 1992-1995 conflict may have a lasting effect on the mental health of the citizens, characterized by high rates of post-traumatic stress disorder (PTSD), depression, and anxiety. A diagnosis of PTSD, depression, and anxiety among family physician residents could affect their ability to diagnose and treat patients for depression, anxiety and PTSD. OBJECTIVES To assess PTSD, depression and anxiety symptoms and prevalence amongst family medicine residents (FMR) who were general practitioners (GP) in different war engagements and compare them with FMR who were medical students, 9 years after the 1992-1995 war in Bosnia-Herzegovina (BH). SUBJECTS AND METHODS We applied the Bosnia-Herzegovina versions of both the Harvard Trauma Questionnaire (HTQ) for PTSD symptoms, and Hopkins Symptom Checklist - 25 (HSCL-25) for anxiety and depression symptoms to 78 residents (age 30-45 years, 84.6% females), who lived in BH during the conflict years. RESULTS PTSD prevalence of 10.3% and depression and anxiety prevalence of 21.8%, was found. The anxiety symptoms score was significantly higher amongst FMR who were GPs (1.69+/-0.66) than medical students (1.40+/-0.41, t-test=2.219, P=0.029) during the war.

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.

AIM The aim of this paper is to determine the influence of religious moral beliefs on the stability of adolescents' mental health. METHODS The sample consists of 240 mentally and physically healthy male and female adolescents attending a high school, who are divided into groups equalized by gender (male and female), age (younger 15, older 18 years); school achievement (very good, average student); behaviour (excellent, average); family structure (complete family with satisfactory family relations), and level of exposure to psycho-social stress (they were not exposed to specific traumatizing events). Subjects were assessed with regard to the level of belief in some basic ethical principles that arise from religious moral values. The score of religious moral belief index was used to compare two groups of subjects. For sample selection the measuring instruments were used to assess the religious, moral and social profile of subject. For the assessment of personality structure a standardized test battery (Freiburg's Personality Questionnaire/ Das Freiburger Personlichkeitsinventar - FPI, Profile Index of Emotions - PIE, Life Style Questionnaire - OM) was used to assess personality profile, emotional profile and subject's defence orientation. RESULTS The score of the moral belief index was negatively correlated to neuroticism and depressiveness (Pearson's r=-0.242, P<0.001; r=-0.311, P<0.001, respectively). Spontaneous and reactive aggressiveness and irritability were negatively correlated with the score of moral belief index (Pearson's r=-0.197, P=0.002; r=-0.147, P=0.023; r=-0.350, P<0.001, respectively). Emotional instability is negatively associated with the moral belief index of the investigated adolescents (Pearson's r=-0.324, P<0.001). The moral belief index was highly negatively correlated with repression (r=-0.206, P=0.001), regression (r=-0.325, P<0.001), compensation (r=-0.186, P=0.004), transfer (r=-0.290, P<0.001) and defensive orientation (r=-0.129, P=0.046). Verified intellectualisation and reactive formation are in positive correlation with the moral belief index among our investigated adolescents (Pearson's r=0.168, P=0.009; r=0.356; P<0.001, respectively). CONCLUSIONS A higher index of religious moral beliefs in adolescents enables better control of impulses, providing better mental health stability. It enables neurotic conflicts typical for adolescence to be more easily overcome. It also causes healthier reactions to external stimuli. A higher index of religious moral beliefs of young people provides a healthier and more efficient mechanism of anger control and aggression control. It enables transformation of that psychical energy into neutral energy which supports the growth and development of personality, which is expressed through socially acceptable behaviour. In this way, it helps growth, development and socialization of the personality, leading to the improvement in mental health.

AIM To assess the frequency of silent brain infarcts and cerebral cortical atrophy in psychiatric patients with cognitive dysfunction. METHODS One hundred and ninety four patients with cognitive dysfunction determined by the use of the Benton Visual Retention Test and Wechsler Memory Scale were analyzed according to age, gender, education, duration of psychiatric treatment, presence of mental disorders, neurological findings, and CT scan of neurocranium. The results were analyzed using descriptive statistics. RESULTS Average age of the group of patients studied was 48+/-9.7 years, and average duration of psychiatric treatment was 6+/-7.3 years. Regarding mental disorders, patients suffered from posttraumatic stress disorder (PTSD) in comorbidity with depression (21.1%), depressive disorder (14.4%), Complex PTSD (13.9%), PTSD (11.3%), and post-concussion syndrome (7.7%). Cerebral cortical atrophy was determined in 47.4%, silent brain infarct in 3.6%, whereas the combination of cerebral cortical atrophy and silent brain infarct was found in 26.3% of patients. In 22.6% of patients with cognitive dysfunction on the Benton Visual Retention Test and Wechsler Memory Scale CT scan findings were completely normal. Cerebral cortical atrophy was more frequent in patients with PTSD in comorbidity with depression (43%), PTSD (39.0%), Complex PTSD (26%), depression (25%), whereas the silent brain infarct was more frequent in patients with post-concussion syndrome (53.3%) and depression (42.8%). CONCLUSION Cerebral cortical atrophy and silent brain infarct are frequent findings in computerized tomography of the brain in psychiatric patients with cognitive dysfunction. Cerebral atrophy is frequent in patients with PTSD, whereas in patients with depression, besides cerebral atrophy, silent brain infarct is also frequently present.