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Publikacije (172)

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Ivana Trlin, M. Hasanovic

Eye movement desensitization and reprocessing (EMDR) is an integrative psychotherapy that has been extensively evaluated in its approach to trauma and posttraumatic stress disorder (PTSD). In brief, the AIP model is based on the idea that the neurobiological system naturally attempts to process current perceptions in a manner that promotes associations to relevant stored information, to facilitate learning, and to relieve emotional distress. The resulting transfer of information from implicit to explicit memory systems (Shapiro 2001) allows disturbing thoughts, emotions, and bodily sensations to be resolved by facilitating access to the stored material and linking it with more adaptive information. However, the intense effect and subsequent dissociation that accompany trauma may interfere with this process, causing the information (e.g., images, thoughts, emotions, and sensations) to be dysfunctionally stored within the memory network. Because the event is isolated within the network, preventing associations with adaptive information, the unresolved material is easily triggered during similar encounters, often leading to intrusive thoughts, emotions, and somatic responses. The consequent habitual response patterns can manifest in characterological difficulties, psychopathology, and the avoidance behaviors associated with phobias and panic disorders (Shapiro 2001, 2002). EMDR s ability to access and target an etiological conditioning event is appreciated and it is also possible to address past, present, and future symptoms in the absence of a known etiological event. Thus, EMDR has the ability to address panic and phobia regardless of the method by which the symptoms, or fear, were acquired. Once the appropriate targets are chosen, the EMDR protocol addresses all experiential components (images, thoughts, emotions, bodily sensations) to stimulate the information processing system as explained by the AIP model (Shapiro 2001, 2002). EMDR was introduced in Bosnia and Herzegovina (BH), in 1998 just three years after the war (19921995). The first training was organized in 2009, and in 2014 Association of EMDR Therapists in Bosnia and Herzegovina was established (Hasanovi et al. 2018). So the mental health workers who were properly educated started to use EMDR therapies in everyday helping to BH citizens in need (Trlin & Hasanovi 2018, Hasanovi et al. 2021). The aim of the following case to present how EMDR treatment was used to successfully address panic disorder with agoraphobia.

Elvira Ališahović-Gelo, M. Hasanovic

Car accident victims can suffer from an acute stress reaction and post-traumatic stress disorder. In the therapeutic method of desensitization and reprocessing with eye movements (Eye Movements Desensitizing Reprocessing EMDR), trauma with a large "T" includes events that a person perceives as a life-threatening. These events are so saturated, stressful, that they can overcome our usual capacity to fight (Herman 1992). They result in intense fear, extreme feelings of helplessness, and complete loss of control. Symptoms of post-traumatic stress disorder (PTSD) manifest in two types of simultaneous and diametrically opposed behaviors. In one type, the traumatized person cannot escape their trauma, they are forced to get rid of the original event through intrusive symptoms such as flashback episodes, nightmares, panic attacks, and obsessive thoughts. In the second, they, again, must not approach trauma: they are completely isolated from the recollection of trauma by avoiding symptoms and anything that can be associated with the event, such as social isolation, emotional stiffness, and substance dependence. Victims of trauma also have physiological reactions such as insomnia, hypervigilance, and a tendency to be easily intimidated by any recollection of an event, such as a single sound or touch (Shapiro 1997). In the approach to the treatment of PTSD, physicians most often opt for psychopharmacotherapy by combining antidepressants such as selective serotonin reuptake inhibitors, anxiolytics, mood stabilizers, hypnotics, and atypical antipsychotics (Hasanovi et al. 2011, 2013). The relative short-term efficacy and long-term benefits of pharmacological and psychotherapeutic interventions have rarely been studied for posttraumatic stress disorder (PTSD). Different types of psychological therapy have been proposed in the treatment of trauma, including exposure therapy, cognitive therapy, psychodynamic therapy, and EMDR. EMDR is currently an effective psychological treatment, recognized and recommended as the first line of trauma treatment in a number of international guides (Boccia et al. 2015). In Bosnia and Herzegovina, education for mental health workers EMDR was organized in 2009, and in 2014 Association of EMDR Therapists in Bosnia and Herzegovina was established (Hasanovi et al. 2018, 2021). Accordingly, our capacities to use EMDR in everyday treatment of traumatized patients became a reality (Ališahovi -Gelo & Hasanovi 2018, Hrvi & Hasanovi 2018, Imširovi & Hasanovi 2018, Kokanovi & Hasanovi 2018, Pašali & Hasanovi 2018, Omeragi & Hasanovi 2018, Smaji -Hodži & Hasanovi 2018, Siru i & Hasanovi 2018). The aim is to show the case of a patient who responded favorably to EMDR therapy but did not respond favorably to pharmacotherapy and superficial supportive treatment

Modern psychiatric treatment is largely dictated by national and international guidelines rested on evidence-based data, including psychopharmacotherapy and psychotherapy. An alternative to the rigid application of official guidelines and criterion for the standards of treatment in psychiatric practice is the concept of creative psychopharmacotherapy. It is a concept based on the integration of different approaches to a person as whole, mental disorders and their treatment into person-centered clinical practice. In this sense, group psychotherapy and creative psychopharmacotherapy today are part of the overall integrative efforts in psychiatry. Neuroscientific discoveries suggest that they share similar neural pathways that lead to changes in brain function and symptoms relief. Various integrative elements make group psychotherapy and psychopharmacotherapy in combination more effective and efficient. The integration of the concept of creative psychopharmacotherapy and group psychotherapy into everyday clinical practice can improve treatment options as well as clinical practice by creating opportunities for research and development of new modalities of overall treatment.

Z. Selimbašić, M. Hasanovic

Resilience is a complex multidimensional psychobiological concept that researchers define differently depending on the context of their research and theoretical orientation. Resilience indicates the ability of a child or adolescent (person) to adequately deal with problems, to continue to improve, grow and develop, and to successfully adapt to a new situation, regardless of the threats and challenges that characterize the environment. Salutogenesis is a sociomedical concept that focuses on factors that support human health and feelings of satisfaction, rather than on factors that cause disease. Through the salutogenic model, through the sense of coherence as a basic concept and a central resource, through generalized and specific resources of resilience, a person manages to preserve his physical and mental health even in the most difficult life circumstances. Promoting salutogenesis and the search for health factors, not diseases, in the study of children and young people and the importance of the salutogenic health model in times of wars, economic crises, social change, major changes on the planet can be a significant goal of treatment.

A good/beautiful word in creative psychopharmacotherapy offers: an environment for purposeful activities, such as creative work, structured work, enjoying the nature of essence and existence; and a feeling of security and safety, according to which it is necessary to act with respect and dignity, and permit the development of a feeling of belonging, value and trust; it is necessary to have time to express one's feelings to other members with sympathy, and active listening; the opportunity and encouragement for developing feelings and drawing conclusions from experience, including illness and its treatment; receiving permission and encouragement to develop a relationship with God or the Absolute; enable people to experience holiness, regardless of the time, place and privacy for prayer and worship; spiritual education, encouragement in faith, a feeling of universal connection and forgiveness.

M. Hasanovic, I. Pajević, Muhammed Hasanović

The paper gives an approximate significance of religion in the mental health of believers. Islamic views of the soul are presented, as a basic principle of human life. The correct, beneficial effects in the attitudes and behavior of individuals towards their souls are also shown. It is also shown what can negatively affect the soul, which creates a basis for the disruption of mental well-being, which causes a mental disorder or mental illness. The paper focused on Islam, as a complete worldview based on the theory of the Revelation of the Qur'an and the practices of God's Messenger, Muhammad, peace be upon him (p.b.u.h.) through which the Revelation was given to all mankind. The basic Islamic theoretical and practical principles and their beneficial protective and healing effect on the mental, psychosocial and psychosomatic well-being of the individual and the community are enumerated and briefly explained when the daily routine of Islamic living is properly applied. The paper presents the basic Islamic principles that help people who suffer sudden, short-term or long-term troubles and catastrophes, because of which psychological trauma and its acute and chronic consequences are formed, which makes the treatment of traumatized faster, and more efficient.

Ahmed Pajević, I. Pajević, M. Jakovljevič, M. Hasanovic, N. Kravić, N. Žigić

Ibn Sina (Avicenna) is primarily known for his philosophy and medicine, but there is almost no scientific discipline in which this great man didn't leave a significant mark. This paper gives a brief review of his contributions to medicine, especially to psychiatry. Medical works of Ibn Sina represent a pinnacle of most important medical achievements of his time. These works contain synthesis of all Greek, Indian and Iranian medical schools, but also new breakthroughs achieved by Muslim scholars through their own experimentation and practice. Although he wrote many medical works, his most important one is El-Kanun fit-tib, which can be translated as The Canon of Medicine. It's made out of five books which systematically show everything known in the area of medicine up until that point in time. In it, Ibn Sina discusses, among other things, the structure of psychological apparatus of human being and the connection of psychological functions with the brain as well as the role of psyche in etiology of somatic diseases. He also describes certain psychiatric diseases along with the explanation of their etiology and recommended therapy. He considered psychology to be very important for medicine, so in his psychological works he discusses, in great detail, the essence of human soul, consciousness, intellect and other psychological functions.

M. Hasanovic, A. Kuldija, I. Pajević, M. Jakovljevič, Muhammed Hasanović

Addiction does not mean "addiction to substances" only. At the core of the definition of substance dependence is the loss of control. Gambling addiction belongs to non-substance / non-chemical addictions or behavioral/behavioral addictions. The concept of behavioral addictions is new and revolutionary in psychiatry. Gambling addiction, formerly pathological or problematic gambling occurs due to loss of control over gambling. There is growing evidence to suggest that behavioral addictions resemble substance addictions in many domains, including phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment. Behavioral addiction has been proposed as a new class in the Diagnostic Statistical Manual Fifth Revision (DSM-5), but the only category included is gambling addiction. The prevalence of gambling disorders in adolescence is very high and for certain disorders (especially related to the use of the Internet) it becomes more pronounced over time. In this paper, we presented a comprehensive overview of gambling disorders from definition, epidemiology, manifestations, comorbidities, assessment, treatment options, and existing forms of treatment. Given the complexity of the approach to the treatment of gamblers, a creative individualized integrative approach is necessary, which is the basis of creative psychopharmacotherapy. Due to the possibility of the emergence of problem gambling and other impulse-control deficits we need to be very careful when commencing a patient on dopamine replacement therapy or therapy with aripiprazole.

N. Žigić, M. Hasanovic, I. Pajević, M. Jakovljevič

BACKGROUND Indian hemp (lat. Cannabis sativa subs. Indica) has been used as a source of industrial fiber, seed oil, food, medicine for some somatic diseases, and it is also used as a psychoactive substance. Cannabis can be used by smoking, evaporation, as a food ingredient, or as an extract. Acute and chronic cannabis use has been shown to be detrimental to several aspects of psychological and physical health and many experimental studies done on healthy people indicate the potential of Δ9- tetra hydro cannabinoid (THC) in inducing transient, dose-dependent psychotic symptoms, but also affective, behavioral, cognitive, neurovegetative, and psychophysical symptoms. Cannabis is the most commonly used illegal drug globally. In many communities, cannabis is perceived as a low-risk drug, leading to political lobbying to decriminalize its use. The wave of laws and initiatives to liberalize cannabis use continues to spread across the United States and the rest of the world, and there seems to be a political debate in the background about the potential risks and benefits of cannabis use. Aim is to present the possible consequences that the legalization of cannabis would have from the aspect of mental health and mental disorders. METHODS Authors reviewed the literature using PubMed resources on the effects of cannabis using the keywords: cannabis use, cannabis use and psychoticism, cannabis use and depression, cannabis use and anxiety, cannabis use and cognition, cannabis use and insomnia, legalization of cannabis. RESULTS Authors examined the effects of cannabis use on psychiatric disorders and the review of the legal status of cannabis use in the world was also made. The possible consequences of cannabis legalization on the public health system were also considered, based on experiences from countries where legalization has already been done. The evidence cited in this article suggests that strong claims about the need to legalize cannabis are still questionable, and may, even in the long run, remain mixed, inconclusive, or even contradictory. Political interference in this issue can trigger a wide range of unintended but profound and lasting consequences for the health system and the health of the individual. CONCLUSION We recommend further research on this topic and data collection with an emphasis on the effects and consequences of cannabis use on mental health, and in particular the benefits and harmful effects of medical cannabis use.

J. Hamidović, M. Hasanovic, I. Pajević, L. Dostović Hamidović, M. Jakovljevič

It is well known that emotions have always attracted the special attention of both laymen and scientists because life without emotions is unthinkable. Emotions prepare us for all life circumstances regardless of their qualities and intensities. Reviewing the available literature, the authors described the phenomenon of emotional contamination and its importance in interpersonal relationships with a focus on "infecting" other people's emotions. Research has shown that individuals mimic facial expressions as well as other emotional reactions of others by emotional contamination in interaction with another person manifesting emotional behavior, and in such situations mimic model reactions, with the perception of their own reactions eliciting an appropriate emotional state. They stressed the importance of patient's perceptions of the emotions of the physicians treating them and the caring attitude that is crucial to contributing to treatment outcomes in clinical practice. Specific expectations between the patient and his physician, when they meet and achieve a physician-patient relationship, reduce uncertainty, and play a useful and crucial role in healing. A caring emotional practitioner who can effectively connect with patients is a huge boon to health. The connection of emotional contamination with creative psychopharmacotherapy and with several therapeutic options is especially described, determined in different ways either through narrative psychopharmacotherapy, through assertive and positive communication, creating a favorable and positive therapeutic relationship whereby a partnership is created, which together leads to the main goal, which is the successful treatment of the patient to the mutual satisfaction. It is useful for patients to have a doctor who spends more time with them and listens carefully and, with adequate emotions, strongly and effectively facilitates treatment. They conclude that emotional contamination is a phenomenon that happens every day in life, especially in specific situations, and that it is up to professionals to use this type of therapeutic opportunity and assistance in the right way to help their patients and be creative in a psychopharmacotherapeutic sense.

I. Pajević, M. Hasanovic, N. Žigić, Ahmed Pajević, L. Avdić

BACKGROUNDS Written historical evidence reveals that Cannabis sativa has been used medically, recreationally and spiritually for more than five centuries in many cultures. It is considered the most-used plant-based psychoactive substance with millions of different usages across the world. To review what the studies, conducted over the past two decades, indicate about effects of the cannabis on physical and mental health as well as the impact on social functioning. METHODS We selected literature review using PubMed resources, to summarize the findings of the existing publications on cannabis and cannabinoids and their possible psychopharmacological therapeutic effects only. RESULTS Research supports cannabis' clear acute effect on neurocognition, while non-acute effects for prolonged use of marijuana are unclear and still insufficiently explored. Due to cannabidiol's (CBD) safety and tolerability, the absence of psychoactive or cognitive effects, the existence of clinical trials with positive results and its broad pharmacological spectrum, CBD is a cannabinoid whose initial results will likely lead to implementation into clinical practice. The fact that the results of previous studies establish the claim of CBD as an antipsychotic and anxiolytic, makes the above developments even more likely. However, long-term, double-blind, placebo studies with samples of patients with different psychotic and anxiety disorders are still necessary. Likewise, due to CBD's biphasic effects, determining an adequate therapeutic dose remains a challenge to conclude, the cannabinoid system represents a promising target for new therapeutic interventions in psychiatry. CONCLUSION Further controlled studies are essential to determine the precise mechanisms of action of cannabinoids on various neuropsychiatric disorders as well as the safety of their use are needed. Never just the use of 'smoking cannabis in an unlicenced way'. The use of simple 'smoked cannabis' remains dangerous because of the effects on inducing psychosis which the article itself refers to, and needs to remain illegal.

M. Mešanović, I. Pajević, M. Hasanovic

INTRODUCTION Previous research has shown the simultaneous presence of health diseases and alcohol use disorder (AUD). This research emphasizes the importance of individual diseases, the simultaneous presence and connection of different diseases, which creates the conditions for more adequate treatment of patients with AUD. Determine somatic, neurological and psychiatric diseases in patients with AUD in the Tuzla Canton (TK) in the period from 01.01.2011. to 31.12.2015. SUBJECTS AND METHODS A retrospective study on the systematic cause of 1,863 patients with AUD recorded in the TK health system. RESULTS Among 1004 (53.9%) patients with AUD, somatic diseases were present; in men: arterial hypertension 573 (31.7%), alcoholic liver disease 269 (14.9%), diabetes mellitus 211 (11.7%); and in women: arterial hypertension 27 (49.1%), diabetes mellitus 27 (49.1%), elevated lipoproteins 3 (5.5%); alcoholic liver disease 1 (1.8%) and anemia 1 (1.8%). Among 1196 (64,2%) patients with AUD, neurological diseases were present; in men: cognitive impairment 627 (34.7%), post-stroke condition 418 (23.1%), polyneuropathy 269 (14.9%); and in women, post stroke condition 28 (50.9%). Psychiatric comorbidity was determined in 1619 (86.9%) patients with AUD; in men: depressive disorder 806 (44.6%), personality disorder 660 (36.5%), while nicotine addiction 27 (1.5%) and dementia 13 (0.7%) were least present; in women: personality disorder 33 (60.0%), neurotic disorder 27 (49.1%), depressive disorder 22 (40.0%). The largest number of patients with somatic (787 or 42.25%), neurological (939 or 50.40%) and psychiatric comorbidity (939 or 50.40%) belonged to the age group 55-64.9 years. CONCLUSION Slightly more than half of the patients with AUD were diagnosed with somatic diseases, almost two thirds were diagnosed with neurological diseases and with more than four fifths of patients were diagnosed with psychiatric diseases. Of the somatic diseases the most common ones were, arterial hypertension, diabetes mellitus, and alcoholic liver disease; from neurological diseases: cognitive impairment, post-stroke condition and polyneuropathy; and the most common of psychiatric illnesses were depressive disorder and personality disorder. The largest number of patients are in the ages of 55-64.9.

Anel Brigić, M. Hasanovic, I. Pajević, N. Aljukić, J. Hamidović, M. Jakovljevič

In this paper authors described some of the principles and theses of Hippocratic medicine. They emphasized that regardless existing controversial opinions as to whether Hippocrates stated some theses or not, and controversial views on some of his principles, he is often called the "father" of medicine, who laid the foundations in medicine as a science. Hippocrates gave recommendations on the doctor's behavior towards the patient, which is relevant up today. His holistic approach to medicine is becoming more and more relevant in the modern medicine. The application of the Hippocratic Oath today depends on the legislation of individual states, related to how legal solutions in some states are pro or contra to it. Authors opened and discussed his attitudes that mental illnesses are a sign of a diseased brain, his consideration the food as medicine and that the disease came from the intestines. Also issue of prognosis of the disease was opened and discussed as well as and Hippocrates's consideration of work and physical activity as the most appropriate medicine. Furthermore, authors considered importance of Hippocratic medicine related to Creative psychopharmacotherapy based on therapeutic communication and the creative satisfaction of needs in the therapeutic relationship with patients and in the recovery itself. Finally, an example of creatively use of the principle of Hippocratic medicine: "work as the most appropriate medicine" in therapeutic communication with patients through an ecological approach called "Ecopsychiatry", under the slogan presented in the media to the general public: "Cleansing nature improves your mental health" was described.

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