Family home and institutions for children without parental care represent the rearing-environments where, from the early years, whole human development goes on. It's known today that despite the recognized importance of inborn traits, the influence of child-rearing environments dominates current models of development. The aim of the study was to investigate the satisfaction with the rearing-environment of school-aged institutionalized children, their dominating feeling and if institutionalization affects life optimism for now and for the future. The study was conducted in two institutions in Bosnia and Herzegovina who share the same care model imitating the traditional Bosnian families where the older children care for the younger siblings. We took as a sample 30 institutionalized children aged 8-12, and for the control group 60 children matched by age and sex. Parents, children and teachers who gave their informed consent answered the questionnaires. It was confirmed that children without parental care are vulnerable group and in a great risk who need urgent help of professional multidisciplinary team of their close and broad environment. Lack of social support cause the withdrawing and suffering and can lead soon or later to problematic behaviour.
Cerebral palsy is a pathological state characterized primarily with the damage to the motoric functioning which can be accompanied by the other disorders such as: problems with sight and hearing, intellectual deficit, emotional problems, conduct disorders, speech disorders, epileptic seizures etc. Martin Bax defines this entity as a disorder of movements and postural balance due to defect or damage of the young brain (Gavrankapetanović I. at all., 2001). Study of the influence of prenatal ethiological factors on learning difficulties of children and adolescents with cerebral palsy in Canton Sarajevo is cohort, epidemiologicaly based and retrospectively prospective. In this study a Structural interview for the parents of children and adolescents with cerebral palsy was used. Sample was consisted of 80 respondents, children and adolescents with cerebral palsy of Canton Sarajevo, age from 6 up to 20 years, mean age was 13.94 years, 47 male 858.75%) and 33 (41.25%) female. In the group of respondents with illnesses during pregnancy 16 (53.3%) have epilepsy, and 14 (46.7%) does not. In the group withaut illnesses during pregnancy 17 (34%) have epilepsy, and 33 (66%) does not. Risk ration is 1.59 which means that these respondents whose mothers had illnesses during pregnancy have 1.6 times larger probability of developing epilepsy.
In this paper we have presented historical overview of development of psychiatric services in Bosnia and Herzegovina. Special attention was given to the recent war destruction (l992-l995), as well as to the reconstruction and reform of mental health services within a frame of newly introduced mental health strategy.
People have abused drugs from the moment they found out about them. Abuse of substances increased during crises (war, displacement, catastrophes, different stress-induced circumstances, fear for existence, absence of prospects and hope). Benzodiazepines are most frequently abused psychopharmaceuticals due to their easy accessibility. The war and aggression on Bosnia and Herzegovina have made unforeseeable consequences, they have caused great migration of population, deaths, wounding, separation of families, unemployment and social poverty. All these factors have had influence on mental health of people. The most frequent psychological consequence of war and displacement is PTSP. The survey has shown that there is a difference in drugs abuse between the interviewees in collective centres and local population. A great percentage of interviewees who are accommodated in collective centres are traumatised (63%) and they mostly misused benzodiazepines to alleviate fear, nervousness, mood disorder and pain. Due to a long-term and uncontrolled use of benzodiazepamines, 50% of interviewees who abused benzodiazepamines have become addicted to them.
Antipsychotic drugs produce a wide spectrum of physiological actions. Some of these effects differ among the various classes of antipsychotics. This medications have indications in the treatment of acute psychotic disorders. The main goal of this investigation was to determine the incidence and prevalence of the neuroleptic therapy acute side effects. The reason for this epidemiological investigation performing was the lack of knowledge of the exact neuroleptic therapy side effects incidence. Qualitative study on this problem has not been performed yet. Antipsychotic therapy side effects prevalence rate according to the literature data is ranging from 24% to 74%. Different prevalence rate is a consequence of different antipsychotic drug usage, different drug administration method and different side effects identification. On account of all these facts, we put the hypothesis on the correlation between the antipsychotic therapy and occurred side effects. Our experiment included all patients hospitalised from December 31st 1999 to January 31st 2000 in Intensive Care Unit of Biological Psychiatry Department of Psychiatric Clinic in Sarajevo. All patients were divided in three groups according to the applied therapy. All of them met ICD-10 criteria for schizophrenia (F20-29). During our study the following examinations were performed: psychiatric interview, BRPS, scale of side effects, psychophysiological tests, general clinical impression, scale of appetite, carbon hydrate needs scale. Psychiatric and statistical evaluations were done as well. The evaluation of our examination is showing successful results in all groups of patients. The improvement of psychopathological symptoms was insignificant. Reported side effects were minimal with low incidence rate and relatively high prevalence rate. Statistical tests were calculated from the obtained data after what the null hypothesis was rejected. Consequently, an alternative hypothesis was confirmed and it indicated that the acute side effects incidence and prevalence were within the range of expectation. Intensity of the recorded side effects was moderate to mild. On the basis of the obtained data, it has been concluded that applied antipsychotic agents did not induce more psychophysiological function impairments in the treated patients. Psychophysiological functions remained in physiological range limits and their changes were not significant. Neuroleptic therapy side effects were minimal, meaning no toxic signs or therapy discontinuations were recorded.
Depression is among the most common of chronic health problems. WHO report predicts that depression will be the leading cause of disability in the industrial world by the year 2020. To be successful, treatment for the patients suffering from depression must be continued until complete recovery, but most patients do not stay on their antidepressant medication long enough. One of the most frequent reasons for break down is appearance of unpleasant side effects. In this study we followed up dynamics of the characteristic side effects of antidepressant therapy, with the major goal to assess their frequency and characteristics. The sample was all female patients taking antidepressant drugs in the Department of Psychiatry of Clinical Centre of University in Sarajevo. The treatment with antidepressants was efficient in most of the patients. A major advantage of SSRI over TCA was less pronounced side effects. The most intensive side effects of TCA (amitriptyline) were dry mouth, tremor and tachycardia while the most frequent side effects included blurred vision, tachycardia, dry mouth, tremor and sedation. Side effects of SSRI (fluoxetine/fluvoxamine) were mild, and the most frequent were nausea, tachycardia, swelling, dry mouth.
1 Two studies were carried out on acutely psychotic patients receiving chlorpromazine (100 mg) 8-hourly. 2 In the pilot study on five patients, plasma chlorpromazine concentrations fell over the course of 3 weeks of treatment and parallel changes were noted in the plasma half-life of antipyrine, salivation rate and handwriting length. 3 In the main study involving twelve patients treated for 15 weeks, the above findings were confirmed and were interpreted as indicating that chlorpromazine accelerated its own metabolism by inducing liver microsomal oxidising enzymes. No metabolites of chlorpromazine were detected in plasma. 4 The addition of phenobarbitone (50 mg) 8-hourly for 3 weeks, or orphenadrine (100 mg) 8-hourly for 3 weeks, resulted in a lowering of plasma chlorpromazine concentrations together with a further shortening of plasma antipyrine half-life. 5 Physiological effects of the additional treatments suggested that phenobarbitone lessens the effects of chlorpromazine by lowering body concentrations. However, orphenadrine acts more by virtue of its anticholinergic effects. 6 It was concluded that phenobarbitone and orphenadrine should not be prescribed routinely in patients receiving major tranquillisers. The need for the addition of orphenadrine should be assessed in each individual case.
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