Introduction: Globally, the most common mental disorders in the elderly include dementia (5% - 8%), depression (7%), anxiety disorder (4%), and substance abuse (1%). Moreover, 25% of suicide deaths occur among the elderly. Whether the prevalence rate of psychiatric disorders increases in later life is currently debated in the literature. During the previous two decades of their lives, older adults in Bosnia and Herzegovina have experienced many specific psychosocial circumstances. The experience of war aggression on our country, and the post-war period with a very complex socioeconomic environment of the current socio-political climate, were accompanied by special challenges for the mental health of this population. Motivated by a large number of questions and dilemmas related to the state of mental health of this population, we conducted research at the Department of Psychiatry at the University Clinical Center Tuzla.Objective: Our objective was to investigate psychiatric morbidity and comorbidity in people over 55 years of age.Methods: The research sample consisted of all patients older than 55 years treated at the Department for Psychiatry during 2018 (N=281), divided into four age categories. To obtain data, we used medical documentation, i.e., medical records, and we constructed a special questionnaire for research purposes.Results: Diagnoses by ICD-10 groups: 33.4% of patients in the entire sample had affective disorders (F30.0-F39.0): "young" (39.2%), "middle" (43.3%), "older "(75%) (p<0.001); women had significantly more affective disorders (61.8%) than men (26.8%) (p<0.001). Men had significantly more organic mental disorders (F00.0-F09.0) (63.3%) than women (22.6%) (p<0.001).Hypertensio arterialis was the most common comorbid dg. of the entire sample, without significant differences according to age groups and sex (p>0.05). Diabetes mellitus was the second comorbid dg. By frequency in the total sample (19.6%) without significant differences according to age groups and according to sex (p>0.05).Conclusion: In the entire sample, the most common diagnoses are from the affective disorders group; the most common somatic comorbidities are hypertensio arterialis and diabetes mellitus.

Introduction This paper aims to examine the frequency and significance of diagnostic comorbidity of psychiatric disorders and somatic diseases in a sample of patients with depression as well as present current psychopharmacological treatment of the patients in the sample. Methods The subjects in this study sample were 489 patients from the four Western Balkan countries with current primary diagnosis of major depression according to ICD 10. Comorbid psychiatric disorders and non-psychiatric illnesses were noted according to ICD 10 criteria during the diagnostic interview and analysed later. Additionally, the pharmacological treatment (existing and newly introduced) for each patient was noted and analysed later. Results At least one comorbid psychiatric disorder was present in 72.5% of patients. The most frequent were anxiety disorders (53.6%), specifically generalized anxiety disorder (20.2%); non-organic sleep disorders (50.7%), specifically insomnia (48.4%); and sexual dysfunctions (21.4%), specifically lack of sexual desire (20.2%). Comorbidity with any non-psychiatric illness was present in 80.3% of patients. The most frequent were circulatory system diseases (55.9%), specifically hypertension (45.9%); endocrine, nutritional and metabolic disorders (51.3%), specifically hyperlipidaemia (24.0%); and other non-psychiatric disorders (60.7%), specifically low back pain (22.7%). All patients received pharmacological treatment with different medications. Most patients received monotherapy or combination therapy of antidepressants, anxiolytics, antipsychotics and antiepileptics. The most frequently used antidepressants were escitalopram, sertraline, and duloxetine. The most frequently used anxiolytics were alprazolam and diazepam, the most used antiepileptic was pregabalin, and the most used antipsychotics were olanzapine, quetiapine, and aripiprazole. Conclusion The results of the study confirm the results of previous research studies about the high prevalence of psychiatric and non-psychiatric comorbidities in patients with depression that were conducted in the past. It would be important if future studies could prove the importance of those comorbidities on clinical severity, choice of treatment, and its outcome in patients with depression.

Abstract More research on the medium- and long-term effects of childhood exposure to war, including orphanhood, is needed. We compared 50 orphans1 who lost their father during the war in Bosnia and Herzegovina (1992–1995) and 50 age- and sex-matched adolescents from two-parent families during 2011–2012 in terms of sociodemographic characteristics, behavioral/emotional problems, depression, resilience, maternal mental health, and perceived social support. The two groups differed on sociodemographic factors, that is, number of children, family composition, income, school grades, and refugeehood. Paternal war orphans did not differ in terms of adolescent mental health and resilience from their nonorphaned peers, controlling for sociodemographic variables. The mothers of orphans had comparably more posttraumatic psychopathology. As for perceived resources for social support, orphans identified those comparably more often among distant relatives and in the community, that is, religious officials and mental health professionals, and less often among siblings, paternal grandparents, paternal and maternal uncles/aunts, school friends and teachers. Our findings suggest that contextual factors may play an important role in orphans' postwar mental health.

Introduction Posttraumatic stress disorder in the paediatric population has clinical features. The Clinician-Administered PTSD Scale for DSM-5,child and adolescent version (CAPS-CA-5) is the gold standard for the positive diagnosis. Objectives The objectives of our work were to translate the CAPS-CA-5 into Tunisian dialectal Arabic and to validate it in our Tunisian sociocultural context. Methods This is a descriptive cross-sectional study conducted in the child psychiatry department of Mongi Slim Hospital and the forensic medicine department of Charles-Nicolle Hospital (Tunisia), among children older than seven years who were exposed to a potentially traumatic event at least one month before. We validated the tool through translation, content, construct validity and reliability. The statistical processing for this data was carried out using SPSS 26 software. Results We conducted our study with 150 patients. The validation was made on 146 records after the exclusion of 4 incompleted assessments. We initially translated the CAPS-CA-5 into Tunisian dialect. We validated the content through pre-test and scientific committee evaluation. Afterwards, we validated the construction. We calculated the Bartlett’s sphericity test (p<0.001) .The KMO index that was 0.766. Concerning the reliability study, we found a Cronbach’s alpha coefficient equal to 0.92. We studied also the inter-raters reliability; we found an intra-class coefficient between 0.8 and 1 Conclusions We validated the first Tunisian diagnostic tool for PTSD in children according to the DSM-5 criteria with satisfactory psychometric qualities. Disclosure of Interest None Declared

Background: Globally, life expectancy is increasing, leading to an equal proportion of elderly and young individuals, which carries extensive implications. In Bosnia and Herzegovina (BiH), the average age at death in 2021 was 77 years, positioning BiH in the middle of the global list of average life expectancy. Current studiesinvestigate whether the prevalence of psychiatric disorders increases or decreases with age, but results are inconsistent regarding the role of age.There is no prior research on mental disorders in the elderly population in BiH. The experience of the previous war in BiH and the post-war complex “transitional period” have been associated with specific challenges to the mental health of this population, inspiring our research topic. Objective: The aim of this study was to investigate the psychiatric morbidity in hospitalized individuals aged≥55 years. Methods: The sample consisted of all patients over age 55 treated at the Department of Psychiatry in Tuzla between January 2018 and December 2020 (N=637), divided into four age categories. Data were obtained from medical records, and for research purposes, a specific questionnaire was constructed. Results: The predominant psychiatric morbidity stemmed from the category of affective disorders, most common within the “55-64 years” age group, while organic mental disorders were more prevalent in other age groups.Substance use disorders were present in patients aged “55-64 years”, with a sharp decline in their prevalence in older age. Female participants had a significantly higher prevalence of affective, psychotic, neurotic, and stress-related disorders, whereas male participants exhibited an increased prevalence of organic mental and substance use disorders. Conclusion: In total sample, the most prevalent diagnoses belong to the category of affective disorders. Female were most frequently diagnosed with affective disorders, whereas organic mental disorders and substance use disorders prevail in male.

s have we learned about the consequences of the COVID-19 16. Javed A: Mental health challenges during COVID-19 pandemic. Book of abstracts of the International Scientific Symponces of the COVID17. & : Mental health challenges during COVID-19 pandemic. tracts of the learned about the consequences of the COVID-19 18. Kes P: Acute kidney injury in patients with COVID-19. In: a have we learned about the consequences of the COVID-19 19. Kurjak A: Is the COVID-19 pandemic the end of happy globalization what was the scientific response? In: abstracts of the have we learned about the consequences of the COVID-19s of the have we learned about the consequences of the COVID-19 20. Leonardi F: The Definition of Health: Towards New Perspectives. Int J Health Serv 2018; 48:735-748 21. -Dinar S: Postcovid-19 in children evaluation of immunological and coronary artery status. In: abstracts of the Internation have we learned about the consequences of the COVID-19 pandemi 22. Mesihovic-Dinarevic S & : Post-coronavirus disease 2019 children in Sarajevo-Lessons learnt? J Health Sciences 2021; 11:93 97 23. Muf : Post-COVID-19 syndrome rehabilitation. In: s). Book of have we learned about the consequences of the COVID-19 24. Niki M: The COVID-19 pandemic call to conversion and return to God: a view from the perspective of Catholic theology. Book of abstracts of the International Scientific Symposium consequences of the COVID25. Radmanovi : COVID-19 pandemic shepherd challenges for Orthodox church. I & : "WHAT HAVE WE LEARNED ABOUT THE CONSEQUENCES OF THE COVID-19 PANDEMIC?" INTERNATIONAL SCIENTIFIC SYMPOSIUM ORGANIZED IN TUZLA IN BOSNIA-HERZEGOVINA Psychiatria Danubina, 2021; Vol. 33, No. 3, pp 427-437 437 we learned about the consequences of the COVID-19 rajevo, 2021 26. Sinano O: Long-term neuropsychiatric consequences of SARS-CoV infections. Psychiatr Danub 2021; 33(Suppl 3):S309-S317 27. : Association of sense of smell and taste disorders with SARS-CoV-2 infection. of abstracts of the learned about the consequences of the COVID-19 28. & : Covid-19 pandemia: neuropsychiatric comorbidity and consequences. Psychiatr Danub 2020; 32:236-244 29. & Pajev I: The Book of What have we learned about the consequences of the COVID-19 pandemic? IANUBIH: Sarajevo, 2021. https://ianubih.ba/2021/10/22/medjunarodni-naucnisimpozij-sta-smo-naucili-o-posljedicama-covid-19pandemije-knjiga-sa/ 30. Seljubac S: COVID-19 pandemics: a test or punishment Islamic perspective. nal consequences of the COVIDSarajevo, 2021 31. : COVID-19: respiratory disorders. In: Sinan O, Hasano International Scien learned about the consequences of the COVID-19 32. : Mother and newborn during the COVID-19 pandemic: between Sci k of abstracts of the e learned about the consequences of the COVID-19 33. Trkanjec Z: COVID-19 and Parkins In: a have we learned about the consequences of the COVID-19 34. Umakanthan S, Sahu P, Ranade AV, Bukelo MM, Rao JS, Abrahao-Machado LF, Dahal S, Kumar H & Kv D: Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad Med J 2020; 96:753-758. doi:10.1136/postgradmedj-2020138234. Epub 2020 Jun 20. PMID: 32563999

Abstract Background The COVID-19 pandemic caused an unprecedented worldwide crisis affecting several sectors, including health, social care, economy and society at large. The World Health Organisation has emphasized that mental health care should be considered as one of the core sectors within the overall COVID-19 health response. By March 2020, recommendations for the organization of mental health services across Europe have been developed by several national and international mental health professional associations. Methods The European Psychiatric Association (EPA) surveyed a large European sample of psychiatrists, namely the “EPA Ambassadors”, on their clinical experience of the impact of COVID-19 pandemic on the treatment of psychiatric patients during the month of April 2020 in order to: a) identify and report the views and experiences of European psychiatrists; and b) represent and share these results with mental health policy makers at European level. Based on the recommendations issued by national psychiatric associations and on the results of our survey, we identified important organisational aspects of mental health care during the peak of the first wave of the COVID-19. Results While most of the recommendations followed the same principles, significant differences between countries emerged in service delivery, mainly relating to referrals to outpatients and for inpatient admission, assessments and treatment for people with mental disorders. Compared to previous months, the mean number of patients treated by psychiatrists in outpatient settings halved in April 2020. In the same period, the number of mentally ill patients tested for, or developing, COVID-19 was low. In most of countries, traditional face-to-face visits were replaced by online remote consultations. Conclusions Based on our findings we recommend: 1) to implement professional guidelines into practice and harmonize psychiatric clinical practice across Europe; 2) to monitor the treatment outcomes of patients with COVID-19 and pre-existing mental disorders; 3) to keep psychiatric services active by using all available options (for example telepsychiatry); 4) to increase communication and cooperation between different health care providers.

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 overview of his contribution to medicine and psychology through which his unique scientific and religious approach to the study of the phenomena of human being can be best seen. 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. 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. He observed a man in his entirety, taking into consideration all aspects of his existence, paying special attention to spiritual knowledge and spiritual perfection, religiosity, and methods of achieving inner peace and well-being.

INTRODUCTION Paediatric psychopharmacology involves the application of psychotropic agents to the treatment of children and adolescents with mental disorders and gathered knowledge from child and adolescent psychiatry (CAP), neurology, paediatrics and pharmacology. Defining elements of this discipline are: the metabolism of drugs is different in children than in adults (pharmacokinetics), the developing brain reacts specifically to the drug (pharmaco dynamics), and psychopathology itself is not differentiated yet. To make and overview of specifics in psychopharmacological use in CAP and emphasize some experiences from Bosnia and Herzegovina in that field. METHODS Through insight in current literature, we presented comprehensive findings and compare it with situation in Bosnia and Herzegovina. RESULTS The most common conditions in which psycho pharmaceuticals are used in CAP were attention deficit hyperactivity disorders (ADHD), depressive and bipolar disorder, obsessive compulsive disorder and the treatment of early psychosis. Psycho pharmaceuticals were also used to treat agitated conditions in various causes. We made an overview of psycho pharmaceuticals use in Bosnia and Herzegovina CAP and emphasized the fact that psycho stimulants are not approved for the use yet, although they are mostly prescribed medicament in CAP over the world. That limits us in the effectiveness of the treatment in ADHD and put us in the situations to use other medicaments instead (anxiolytics, antipsychotics, mood stabilizers) which are not approved for that condition. CONCLUSION The use of psycho pharmacotherapy in CAP is justified in cases where it is necessary to reduce the suffering of children and to improve their functionality at the time when cognitive, social and emotional advancement is most pronounced. Further research and clinical monitoring of efficacy and safety in the use of psycho pharmaceuticals in youngsters are necessary.

A personalized and holistic approach to therapy is increasingly demanding answers to questions related to the meaning of life. Over the years, research has shown a direct link between the presence of meaning in life, health and recovery. It becomes impossible to ignore this connection as well as the issues of spirituality and religiosity that are immersed in the meaning of life. The article presents different definitions of meaning, the relationship of meaning in life and parts of meaning to quality of life, allostasis, stress, pathological conditions and recovery, and finally connecting the points between creative psychopharmacotherapy and meaning. A complementary approach to the meaning of life implies a desire for a clear, reliable understanding of three related but different dimensions: continuity (as opposed to fragmentation), purpose (as opposed to pointlessness), and value (as opposed to worthlessness). Creating personal meaning in life structures can provide a context for understanding and integrating stressful situations. Finding meaning means connecting, meaning are the expected connections and associations that human beings see in their world. In this aspect, the construction of meaning is a dimension that we impose on the world. Each person's ability is to decide what makes their life meaningful. The meaning of life is a changing cognitive-emotional framework, directly accessible to subjective assessment based on one's own needs and values. The art of living is to discover in though and painful life situations their true meaning, values and meaning of life, and thus health and disease. Creative psychopharmacotherapy can be used to help patients discover and explore the sensation of meaning, create a new meaning in life, a new life story, manifest their potential through recovery. Mental disorders present a chance to break with misplaced life goals and values and turn to authentic values through new forms of thinking, experiencing, behaving, and creating a successful life.

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. Background: To assess the psychoemotional and neurovegetative disorders in postmenopausal women depending on therapy. carried out after 30 days of treatment. Results: There was a significant difference between 1 st and 2 nd groups. KI’s neurovegetative component (hot flashes, sweating, palpitations, headaches, dizziness) in the 2nd group decreased to 10.0±1.8 points, in the 1st group - 18.4±2.0 (p<0.02). According to HADS, in the 2nd group, anxiety stopped and amounted to 6.7±0.3 points, while in the 1st group, subclinical 10.1±0.2 points remained (p (cid:0) 0.05). The average level of depression was reduced to normal - 6.5±0.3 - only in the 2nd group, in the 1st group - 9.7±0.3 (p<0.05). The average value of the indicator «Physical health» of the questionnaire SF-36 in the 1st group was 36.3±2.5 points, in the 2nd group 65.4±2.8 points (p (cid:0) 0.05); the indicator «Mental health» in the 1st group - 25.6±2.5 points, in the 2nd - 59.4±2.8 points (p (cid:0) 0.05). Conclusions: In postmenopausal women, the therapeutic correction of psychoemotional and neurovegetative disorders was associated with taking «Femo- (cid:409) lim». Adequate therapy in this category of patients contributed to the improvement of indicators of quality of life in general. using PubMed resources on the effects of cannabis using the 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. Background: Anxiolytics such as benzodiazepines are widely used in the treatment of anxiety disorders, although they are no longer recommended as first-line therapy for these conditions due to

Since it is generally known that the human body is the best image of the human soul, this paper aims to explain how important body language is when diagnosing psychiatric diagnosis "depression". It is important to point out the importance of other alternative approaches in the treatment of depression when standard psychopharmacotherapy is not enough. Body language is a powerful form of non-verbal communication that provides important traces of intentions, emotions, and motivations in other people. In everyday life, we collect information about what people think and feel by their body posture, manners, and gestures. Evaluations of clinical depression are traditionally based on verbal information. However, non-verbal expressive behavior, related to reflexive feedback of a person, may reveal negative emotional or social processes that are not fully controlled by patients therapy, along with other artistic therapies (art therapy, drama therapy, and music therapy are other artistic therapies that are applied in Great Britain) offers an attractive opportunity for patients because it enables them to work on those issues that are placed on non-verbal and pre-verbal level. Creative psychofarmacotherapy is the concept that involves creativity as its main means. In this context, the importance of physical activity and body movements will be emphasized in the treatment of depression, when regular psychopharmacotherapy is not sufficient. To conclude, the patient has the right to actively take part in creating a therapeutic relationship and responsibly contributes to overcoming psychopathology. The importance of physical activities and body movements is emphasized in the treatment of depressive people. Studies have shown that the anti-depressive effect of physical activity is increased with simultaneous use of antidepressants, as well as that movement therapy and music therapy, together with regular pharmacotherapeutic methods, help with fast recovery and that they can be used in a creative approach to problem-solving.

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.

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.