Aim: To describe the treatment of opiate addicts who had to spend certain period in prison, after introduced in outpatient administering of substitution medicament Buprenorphine/Naloxon in Bosnia-Herzegovina. Methodology: We assessed 10 male opiate addicts aged 24.8±4.7 years. With presentation of clinical vignettes, authors described how opiate dependants with criminal past imprisoned in jail because of aging penalties avoided discontinuation of treatment after they were included in the Buprenorphine/Naloxon maintenance treatment program. This practice has been implemented in cooperation of Department of Psychiatry in Tuzla and Tuzla prison from 27 July 2009. Results: All opiate dependants described with clinical vignettes showed surprised with positive effects on overall outcomes of Buprenorphine/Naloxon after implementation of continual treatment in prison in cooperation with jail officers (nurse and guards). Also they were very satisfied with life quality during treatment in prison. Also jail officers, family members of dependant person showed satisfaction with achieved efficacy of Buprenorphine/Naloxon eider during aging penalties. Conclusion: Medically assisted treatment of opiate dependence with Buprenorphine/Naloxon for imprisoned addicts implemented as outpatient treatment with involvement of jail officers who were instructed in Buprenorphine/Naloxon daily administration, improved quality of life of treated opiate dependants, and quality of their relations in prison with others.

Introduction: Consequences of alcohol dependence may be complex, and difficult for treatment, thus complex diagnostic procedures are needed.Aim: To assess the prevalence of silent brain strokes and cortical cerebral atrophy amongst male inpatient alcoholics.Methodology: We analyzed 86 file records of males treated from 01 January 2005 to 31 December 2009 year on Tuzla Psychiatry Department, who had dismissed diagnosis Alcohol dependency (F 10.2) according ICD-10, with computerized tomography (CT) of brain, related to age, war engagement, brain trauma, employment, smoking, psychological findings and presence of silent stroke and cortical brain atrophy according CT diagnosis.Results: The mean age of observed patients was 50.1±6.6 years. Amongst them (70.9%) were active soldiers in Bosnia-Herzegovina Army during 1992-1995 war. There were 71 (72.6%) with atrophy of brain cortex, 27 (31.4%) had ischemic silent stroke. In the sample, 61 (70.9%) of inpatients met criteria for PTSD according ICD-10, 53 (61.6%) had cognitive disturbances, 29 (33.7%) had psychotic symptoms, 50 (58.1%) of them had clinically manifested depression, 47 (54.7%) had difficulties in social contacts, 23 (26.7%) had somatic disorders. Age of inpatients was in positive correlation with duration of work, presence of silent ischemic stroke and brain cortex atrophy. Presence of PTSD was in positive correlation with involvement in the combatants, with cognitive disturbances, with depressiveness and somatic complains. Atrophy of brain cortex positively correlated with silent stroke and glucose blood level. Conclusion: Brain cortical atrophy and silent brain stroke were frequent CT findings amongst male alcohol dependants clinically treated in Psychiatry department.

Aim To assess the frequency of some epidemiological characteristics amongst heroin dependant psychiatric patients in post war Bosnia and Herzegovina. Methods We analyzed sixty heroin addicts (47 males; χ²-test=19.3, P<0.001) who were treated in the Department of Psychiatry Tuzla, during the period 1 st July 2007- 30 th Jun 2008, and were tested with Pompidou questionnaire. Results Average age of the group of patients studied was 27.3±5.6 years (min. 20- max. 44 years), the age of the first intake of heroin was 19.9±4.3 year and average duration of heroin addiction was 6.4±4.2 years. 43/60 started treatment following own decision, 48/60 coming from town’s environments, 46/60 were unemployed, 15/60 finished elementary school and 45/60 finished secondary school. 34/60 own driver’s licenses, males significantly more frequently 31/47 than females 3/13 (χ²-test=7.6, P=0.006). 39/60 had no marriage experience. 15/60 had own children (1-3 kids). 12/60 had experience of parents’ divorce, 13/60 had lost one parent and 2/60 lost both parents. Material status of parents was below average for 21/60, and average for 36/60. 24/60 had parent(s) who suffered from certain psychiatric disorder(s). Two thirds had judicial proceedings, and 33/60 were imprisoned. Hepatitis “C” virus infections were reported from 18/60 heroin addicts. Conclusion Majority of heroin addicts who were treated in Psychiatry Clinic in Tuzla were males, from towns, unemployed, not married, with finished secondary schools, owners of driver licenses, had average material status of parents. Majority of them had judicial proceedings with imprisonment. Hepatitis “C” infection was highly presented.

Aim To examine how the experience of genocide in Srebrenica in the early childhood (ages 1-5) influences the psychological health in adolescence. Methods This study included 100 school-attending adolescents, age 15-16 (born in 1990-91) who were divided in two groups according to the place of residence from 1992-1995: the Srebrenica group – adolescents who lived in Srebrenica during the siege and the non-Srebrenica group who lived in the “free territory,” were not wounded, and experienced no losses. We used the socio-demographic questionnaire created for the purposes of our study and the War Trauma Questionnaire, Posttraumatic Stress Reactions Questionnaire, Self-report Depressive Scale (Zung), Freiburg Personality Inventory, and the Lifestyle Questionnaire. Results Srebrenica adolescents experienced significantly more traumatic experiences (14.26 ± 3.11 vs 4.86 ± 3.16, P < 0.001). Although there was no significant difference in the total score of posttraumatic stress reactions and intensity of depression between the two groups, significantly higher scores of posttraumatic stress reaction were noticed for several specific questions. The most prominent defense mechanisms in both groups were projection, intellectualization, and reactive formation. Srebrenica adolescents had higher sociability levels (34.7% vs 16.0%, χ2 = 7.231, P = 0.020). Conclusion Srebrenica adolescents reported significantly more severe PTSD symptoms and significantly greater sociability. Our findings could be used for planning treatment and improving communication and overcoming traumas in war-affected areas.