Background: Coronavirus disease 2019 (COVID-19), like any other pandemic, has imposed an unprecedented threat to physical and mental health to all nations, worldwide. There is no enough evidence in the literature in this area. The present study has been done to explore the organization of psychiatric services in Bosnia and Herzegovina (BH) to meet mental health needs of BH citizens during the particular restrictive measures caused by COVID-19 pandemic. Materials and Methods: This online survey has been done for BH psychiatric institutions. Data were collected from psychiatric institutions in the mental health network of BH. A total of 38 complete responses have been received. Results: Of 38 study participants, three were the departments of psychiatry in university clinical centers, two were psychiatric hospitals, four were psychiatric wards in general hospitals, 27 were community mental health centers, and two were institutes for alcoholism and drug addiction. During the pandemic, all services functioned on a reduced scale, adhering to measures to protect and self-protect both staff and service users. Protective equipment was provided to staff in some institutions in a timely and complete manner and in some in an untimely and incomplete manner. Consultative psychiatric examinations were mainly performed through telephone and online, where it exists as a standard patient monitoring protocol. The application of long-acting antipsychotics was continuous with adherence to restricted and protective measures. In opiate addiction replacement therapy services, substitution therapy was provided for a longer period to reduce frequent contacts between staff and patients. Individual and group psychotherapy continued in reduced number using online technologies, although this type of service was not administratively regulated. An initiative has been given to regulate and administratively recognize telepsychiatry by health insurance funds in the country. A number of psychological problems associated with restrictive measures and fear of illness have been reported by patients as well as by the professionals in mental healthcare teams. There were no COVID-19-positive patients seeking help from institutions that responded to the questionnaire. In one center, infected people with COVID-19 from abroad sought help through the phone. Only one involuntary hospitalization was reported. The involvement of mental health professionals in the work of crisis headquarters during the design of the COVID-19 pandemic control measures varies from satisfactory to insufficient. Education of staff, patients, and citizens was regular with direct instructions through meetings, press, and electronic media. Conclusions: During the COVID-19 pandemic in BH, all psychiatric services functioned on a reduced scale, adhering to measures to protect and self-protect staff and service users. All patients who asked for help have been adequately treated in direct inpatient or outpatient mental healthcare or online, despite telepsychiatric services not being recognized in health system in BH. There were neither infected patients nor staff with COVID-19 in the psychiatric institutions who responded in this research. A large-scale, multicenter study needs to be performed to get a broader picture and to guide us for future better service planning and delivery.

The different personalities of alcoholics are expressed in the way they manifest certain traits of their personality. In addition to knowing the general and common characteristics of alcoholics, it is even more important for clinical practice to know the differences between them, thus allowing a personalized approach to each patient, as a unique personality. The division of the personalities of alcoholics may be viewed through the prism of seven perspectives: the disease perspective, the dimensional perspective, the cognitive-anxiety perspective, the behavioral perspective, the spiritual/transcendent perspective, the narrative and the systemic perspective. Each of these perspectives more clearly represents part of the personality of the alcoholic; together they give a clearer picture of the problem and accordingly offer different treatment options.

Presents case reports of two psychiatric patients who suddenly deteriorated and burned in a severe psychiatric condition due to the circumstances they faced due to the COVID-19 pandemic, which required urgent admission and intensive psychiatric treatment. In the first case report, pandemic and restrictive measures were the predisposing factors for suicide attempt of the patient who is the war veteran with diagnosed complex PTSD, while the precipitating factors for the suicide attempt were impaired physician-patient communication, fear of losing a job and existential issues. There is a need to raise awareness in society that rising unemployment is associated with an increased number of suicides, as well as responsible and balanced media coverage of the COVID-19 pandemic. In the second case report, our patient with bipolar disorder got into relapse of disease with psychotic symptoms during the pandemic of COVID-19 after changes the work structure and after she illegally visited her son who was self-isolated after returning to B&H from abroad, with no self-protected equipment. Overall, both case studies illustrate the psychological potential that the crisis caused by the COVID-19 pandemic has on at-risk groups of psychiatric patients. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

INTRODUCTION The needs for EMDR (eye movement desensitization and reprocessing) treatment of Bosnia-Herzegovina (BH) citizens, affected by 1992-1995 war, increased. The Trauma Aid UK (former Humanitarian Assistance Programs UK & Ireland) works in partnership with mental health professionals in BH. AIM We aim to build an environment in which qualified and experienced professionals trained in EMDR may establish and sustain complete EMDR education and to keep international standards of EMDR practice. METHOD Authors described the history of idea and its realization of EMDR education considering all needed phases that were provided from the Trauma Aid UK with non profit, humanitarian approach in sharing skills of EMDR to mental health therapists in BH. RESULTS The trainers from Trauma Aid UK completed five EMDR trainings in Bosnia-Herzegovina for recruited trainees from different cities and entities in BH. For continual professional development (CPD) all of these mental health professionals need to be active participants in professional and scientific meetings. Though, Association of Bosnia and Herzegovina EMDR Therapists, member of EMDR Europe, organized the First EMDR conference in Bosnia-Herzegovina sponsored by Trauma Aid UK under the patronage of EMDR Association of UK & Ireland. CONCLUSION Five training of Bosnia-Herzegovina mental health workers to effectively use EMDR with enthusiastic help of EMDR trainers from Trauma Aid UK resulted with European accredited EMDR practitioners, one European accredited EMDR consultant and the first EMDR conference in BH. This will keep national development of psychotherapy capacities in post-war BH.

BUPRENORPHINE/NALOXONE IN THE TREATMENT OF OPIATE DEPENDENCY DURING UNINTENTIONAL PREGNANCIES – BOSNIA-HERZEGOVINA EXPERIENCES Mevludin Hasanovi , Izet Pajevi , Abdurahman Kuldija, Amra Deli 1,3 & Dženita Hrvi 1 Department of Psychiatry, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina School of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany

The authors presents their perspectives on the relationship between antipsychiatry and the stigma of mental illness. The present paper aims to provide a short review of the basic principles of the antipsychiatric movement, and to discuss the atitudes of its most important theorists. The authors searched recent literature, as well as drawing upon some of the basic antipsychiatric texts. Antipsychiatry dates from 18th century, and as an international movement it emerged during the 1960s as part of the historic tumult of the period rather than as a result of the evolution of scientific ideas. During that period psychiatrists began to see heredity as the cause of mental illness, became pessimistic about restoring patients to sanity, and adopted essentially a custodial approach to care that included use of physical restraints. Radical attitudes of antipsychiatry gave a significant incentive to review psychiatric theory and practice, especially with protecting the rights of mental patients and giving importance not only to somatic, but mental, social and spiritual sides of human existence. But, at the same time, they led to unwarranted attacks on psychiatry as a medical discipline, encouraged different views of its stigmatization and in a certain measure affected the weakening of social awareness about the importance of medical and institutional care for the mentally ill persons. After the 1970s, the antipsychiatry movement became increasingly less influential, due in particular to the rejection of its politicized and reductionistic understanding of psychiatry.

It is known today that psycho-trauma and PTSD cause different levels of mental and social dysfunction. Human spirituality and capacity to meet further life diffi culties become severely damaged. There is wide accepted attitude today that in holistic approach in process of healing PTSD and psycho-trauma is necessary to include other professionals from community resource regarding needs of trauma victims. In Bosnia and Herzegovina after very severe war (1992-1995) as mental health professionals, we are faced with increasing number of different mental health disorders as result of severe trauma experiences. Regarding community based care orientation it is necessary to include and religion professionals. According national and religious background of majority of our population in Tuzla Canton that is Muslim, we meet spiritual needs of our clients as needs for Islamic explanation of life and death meaning. Our clients need to talk about spiritual issues in daily therapy and to practice daily religious rituals. Regarding that in this paper we tried to interface Islamic principles and it’s benefi cial toward psycho-trauma and PTSD, as well as Muslim perspectives in attempt to apply spiritual practice in therapeutic tools for better effi cacy in spiritual healing of mental dysfunction’s of believers who survived severe trauma, especially war trauma. Review Article Spiritual and religious Islamic perspectives of healing of posttraumatic stress disorder Mevludin Hasanović*, Izet Pajević and Osman Sinanović Department of Psychiatry, University Clinical Center Tuzla, School of Medicine, University Tuzla, 75 000 Tuzla, Bosnia and Herzegovina, Tuzla, Bosnia *Address for Correspondence: Mevludin Hasanović, Department of Psychiatry, University Clinical Center Tuzla, School of Medicine, University Tuzla, 75 000 Tuzla, Bosnia and Herzegovina, Tuzla, Email: hameaz@bih.net.ba Submitted: 12 September 2017 Approved: 22 September 2017 Published: 25 September 2017 Copyright: 2017 Hasanović M, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objectives: To describe the acculturation and repatriation problems and school behavior problems reported from teachers who were amidst Bosnia-Herzegovina (BH) repatriated school adolescents who were refugees after the 1992-1995 war, and to analyze possible differences between primary and secondary school students. Methods: The sample of 100 adolescents aged of 15.2 ± 2.4 years consisted from two groups: elementary and secondary school students (n=50, both equalized by gender), who survived the 1992-1995 war catastrophes, and were forced to spend certain refugee period in foreign country during and after this war. They were prevented to return to their original home places after repatriation because of no safety there. We used General questionnaire for personal information and trauma experiences, Personal questionnaire for acculturation and repatriation, and teacher’s version of the Children Behavior Check list, for (Achenbach CBCL). Results: Younger students reported lower adjustment and tendency to internalization. Older adolescents reported more intensive externalizing and other problems. Older adolescents reported significantly more often “thinking about his/her native place on arrival at the place of exile” and “thoughts about cousins”, while younger students reported more often “couldn’t play outside”. Teachers reported a number of behavioral disorders that returnees showed high maladjustment during repatriation. Returnees with greater acculturation problems showed increased functional and relational problems, however, with less psycho-emotional problems after repatriation. Conclusion: Younger students showed tendency to internalization and older adolescents showed significantly more intensive externalizing problems and other problems. Teachers have noticed a number of behavioral disorders that returnees showed as higher maladjustment during repatriation. Acculturation problems abroad were associated with functional and relational problems after returned at home. Correspondence to: Mevludin Hasanović, Department of Psychiatry, University Clinical Center Tuzla, Bosnia-Herzegovina, Tel: +387 35 267 111; E-mail: hameaz@bih.net.ba