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S. Pavlović, M. Hasanovic, Nera Kravić Prelić

INTRODUCTION The previous neuropsychological studies have pointed to a significant understanding of the neurobiological correlates of Post Traumatic Stress Disorder with deficits in the functions of the intellect. AIM To establish the existence of intellectual changes in war veterans with developed PTSD and their relationship to PTSD. METHODS War veterans are divided into two groups: Group A, war veterans with PTSD and "B" groups, veterans without PTSD. Were used: Wechsler's Adult Intelligence Scale (WB-F2); Trauma Questionnaire (UT-PTSD); Questionnaire-socio-biographical data RESULTS The severity of stress and severity of post-traumatic stress disorder is directly associated with the intellectual functions. War veterans, who had more severe traumatic experience, with a strong and destructive PTSD compared to veterans without PTSD had significantly lower ratio of general, verbal and non-verbal intelligence quotient of mental efficiency, a high level of mental deterioration with significantly pronounced oscillations in intratest and insidetest variability. Veterans with PTSD showed significantly lower scores in the immediate memory capacity, efficient attention, concentration under conditions of mental activity, visual perceptual skills predicted exactly bit of trivial things, of associative elasticity of thinking and short-term learning abilities. CONCLUSIONS These results suggest that deficits in the intellect, are not primarily the result of low intelligence, of premorbid states, but it occurs under the devastating impact of PTSD, which influencing changes in certain centers in the brain and changes in intellectual functioning.

M. Hasanovic, I. Pajević, A. Kuldija, A. Delić

AIM To present medically assisted treatment for opiate addiction with substitution medicament Suboxone and prevention of social exclusion of young opiate addicts in Bosnia and Herzegovina. GENERAL OVERVIEW Until recently there was no solution for long-term and comprehensive treatment of young persons who suffer from opiate addiction. This is not an illness that impairs only psychological and physical health of addicts with possible fatal aftermaths, but serious societal problem due to its consequences such as delinquency, crimes and violence that lead young people to social exclusion. There are no capacities within the existing health facilities for long-term stationary treatment, which is necessary for drug addiction. In addition, far less adequate solution is placement of young addicts into penal and correctional institutions, which are stigmatizing and contribute to their exclusion from normal social life. Hence, the latest medically assisted method of substitution treatment with a combination of buprenorphine and naloxone (Suboxone) is introduced. This medicament, with its characteristics, offers possibility for outpatient treatment, and prompt and effective results of detoxification and weaning of opiates is to be achieved. Opiate addicts that undergo this treatment benefit from "clear mind" and capability for occupational and social activities, which significantly improves the quality of their family and social relations. With Suboxone substitution method, the institutional (inpatient) treatment is to be avoided and social exclusion of young addicts treated with Suboxone prevented. CONCLUSION Medically assisted treatment for opiate addiction with Suboxone is conducted in outpatient setting with the involvement of close relatives who are not addicted. It brings back "clear mind" to previous addicts, does not stigmatize but contribute to re-socialization and prevention of social exclusion of young opiate addicts.

Objective – To estimate neuroticism and its relationship with psychological trauma and posttraumatic stress disorder (PTSD) among Bosnia-Herzegovina (BH) refugee and internally displaced adolescents after the 1992-1995 war.  Subjects and methods – A sample of 217 pupils (108 females and 109 males) aged 15.1±2.1 years was divided into three groups from the north-eastern BH regions: Srebrenica (n=69), Zvornik (n=79), and Bijeljina (n=69), who were exposed to the trauma of the 1992-1995 war and became refugees or internally displaced persons for the duration of the whole war and after it were evaluated for assessment of war trauma, the presence of PTSD, neuroticism, and its associations. Data collection took place in June 1999 in the classrooms of the adolescents’ schools, with the written permission of the Tuzla Canton Ministry for Culture, Sport and Education.  Results  – Srebrenica pupils were significantly more introverted. The prevalence of PTSD differed statistically significantly between the groups: Srebrenica (73.9%), Zvornik (60.8%) and Bijeljina (47.6%)(Chi-square=9.854, df=2, p=0.007). The PTSD prevalence, PTSD symptoms and social dysfunction were the most severe in Srebrenica, then in Zvornik and finally in the Bijeljina group. In the Srebrenica group neuroticism was significantly associated with PTSD cluster symptoms and problems in social functioning. Adolescents with PTSD, in all three groups and in the whole sample, were more neurotic. Loss of father significantly increased introversion of the adolescents in all three groups, and decreased the adolescents’ sociability in Zvornik and Bijeljina.  Conclusions – Refugee and internally displaced adolescents from Bosnia-Herzegovina suffered very frequently from PTSD 3.5 years after war. The PTSD prevalence is highly reported and differed significantly between groups. PTSD associated positively with neuroticism and introversion. Loss of father significantly increased the adolescents’ introversion in all three groups, and it decreased the adolescents’ sociability in Zvornik and Bijeljina.

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