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D. Babic, M. Martinac, Vedran Bjelanović, R. Babić, A. Sutović, O. Sinanović

For thousands of years it has been known that aggression as a symptom appears in numerous psychiatric disorders and diseases. During the last decade the appearance of the aggressive behavior related to the posttraumatic stress disorder (PTSD) has been frequently investigated, often associated with war trauma. The goal of this study is to analyze the impact of alcoholism on a way war veterans suffering from chronic PTSD express and control aggression. The sample included 240 war veterans with chronic PTSD. The subjects were divided in two groups. PTSD group (n=147) and controlled group composed of those suffering from alcoholism in addition to PTSD (n=93). In this study, the following psychological instruments were used: The Harvard trauma questionnaire for PTSD diagnosis (HTQ); the questionnaire for self-evaluation of aggression (STAXI); The Profile Index Emotion (PIE); questionnaire for auto-diagnosis of alcoholism (CAGE). The obtained results indicate that subjects who have PTSD with co-morbid alcoholism are more deprived, aggressive (p < 0.001) and oppositional (p < 0.05) in comparison to subjects whose PTSD is not combined with alcoholism (PIE). The aggression is statistically more expressed in subjects with PTSD who have also been diagnosed with alcoholism on all subscales in comparison to subjects with PTDS who have not been diagnosed with alcoholism: the current state of aggression, the general state of aggression, aggression towards an unfair treatment, aggression directed inwards and outwards (p < 0.001); aggression towards nonspecific provocation and a general way of expressing aggression (p < 0.05) (STAXI). Subjects that had PTSD combined with alcoholism show a higher degree of aggression in comparison to subjects with PTDS who are not diagnosed with alcoholism.

OBJECTIVE The aim of the study was to assess the impact of the family socioeconomic status (SES) on health related quality of life (HRQoL) in children operated on for congenital heart defects. PATIENTS AND METHODS The study included 114 children aged 1.6-18 (mean = 10.2 +/- 4.2) years (46.5% male and 53.5% female), followed up at University Department of Pediatrics in Tuzla after cardiac surgery, and one of their parents or caretakers. Of 114 children with congenital heart defects, 54.4% had anomalies with left-right shunt, 18.4% obstructive type anomalies and 27.2% complex anomalies. Control group consisted of 127 healthy age-matched subjects (age range 1.5-18, mean = 11.2 +/- 4.2 years; 49.6% male and 50.4% female). In this prospective study, we used PedsQL 4.0 Generic Core Scale to assess HRQoL of children operated on for congenital heart defects. This measurement includes both the parent proxy and child reports. The family SES was assessed by use of Hollingshead two factor index of social position. Statistical significance of differences between respondents and control group was determined by use of t-test and ANOVA with Bonferroni test. RESULTS The reports of children operated on for congenital heart defects yielded no statistically significant difference in their HRQoL according to family SES. Parental proxy reports showed medium scores for physical health and activity to be significantly lower in children from low SES families as compared with those from medium SES families. Scores on school activities also differed significantly between patients with low and higher family SES. Parental reports revealed statistically significantly poorer HRQoL in children from low SES families in terms of physical health and activity, psychosocial and emotional health and social activities scores, as compared with the control group with low SES. Children operated on for congenital heart defects from medium and high SES families also had statistically lower school activities in comparison to control group of children from medium or high SES families. CONCLUSION The results of HRQoL according to parental proxy report indicated low SES to influence various aspects of HRQoL in children operated on for congenital heart defects. This could be explained by the fact that the risk factors associated with low SES may directly or indirectly affect not only family HRQoL but also HRQoL of children operated on for congenital heart defects. Therefore, it appears necessary for the low SES families with a child suffering from chronic disease to receive help from wider community to solve the above mentioned problem.

detoxification of alcoholics. The alcohol history was assessed through a structured questionnaire. Reliable data on the history of medical disorders (liver diseases, pancreatitis, gastritis, gastric or duodenal ulcer, pneumonia, diabetes, hypertension, heart disease or brain trauma) were available for 43 patients. Results: Of the study 71.7% had current somatic problems or disorders. The most often are gastrointestinal disease pathology consisted of cardio-vascular diseases (stage II–III hypertension, ischemic heart disease, autonomic vascular dystonia), more cerebral degeneration, liver disease or alcoholic polyneuropathies. In our sample 36.7% are divorced; and 40% have heredity. Conclusions: Alcoholism is a major contributor to the physical ill-health. Treatment or rehabilitation of addictive behavior should be of major concern for adequate service planning or provision.

Bosnia and Herzegovina (BH) is located on the western part of the Balkan Peninsula. It has an area of 51 210 km2 and a population of 3 972 000. According to the Dayton Agreement of November 1995, which ended the 1992–95 war, BH comprises two ‘entities’ – the Federation of Bosnia and Herzegovina (FBH) and the Republic of Srpska (RS) – and the District of Brcko. The administrative arrangements for the management and financing of mental health services reflect this. The FBH, with 2 325 018 residents, is a federation of 10 cantons, which have equal rights and responsibilities. The RS has 1 487 785 residents and, in contrast, a centralised administration. Brcko District has just under 80 000 residents.

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