Panic disorder (PD) is an acute psychobiologic reaction manifested by intense anxiety and panic attacks, that occur unpredictably with subjective sense of intense apprehension or terror, accompanied by temporary loss of the ability to plan, think, or reason and the intense desire to escape or flee the situation. Panic attacks may last from a few seconds to an hour or longer. Symptoms typically include, among others, palpitations, tachycardia, hypertension, chest pain, dyspnoea, and fear of loosing control or going crazy and vague feeling of imminent doom or death. Since pharmacotherapy of PD includes the administration of selective serotonin reuptake inhibitors and tricyclic antidepressants, the objective of this study was to perform a pilot double blind clinical trial designed to compare the effects of two studied drugs in the treatment of PD. A total number of 40 patients with a history of panic disorder were randomly assigned into two groups of 20 patients each. Hamilton anxiety rating scale and Standard Psychiatric Interview were methods for PD assessment. One group was treated with clomipramine hydrochloride (ANAFRANIL) 75 mg/day and the other with fluoxetine (OXETIN) 60 mg/day. Both drugs were administrated by mouth (PO) two times-a-day in equally divided doses for 6 weeks. Both studied agents produced similar antipanic effectiveness. Favourable response was achieved in 95% of patients treated with fluoxetine and 90% of patients treated with clomipramine. The onset of antipanic effects was quicker in all clomipramine treated patients, while fluoxetine produced more-favourable response in male patients. The duration of treatment with both antidepressants studied should be at least 10 weeks, instead of 6 weeks.

Posttraumatic stress disorder (PTSD) is a psychiatric disorder characterised by an acute emotional response to a traumatic event or situation involving severe environmental stress (natural disasters, wars, epidemics, rape, assaults, physical torture, catastrophic illness or accident), which may be identified in cognitive, affective or sensory motor activities. The objective was to perform a pilot clinical trial designed to compare the effects of older (tricyclic) and newer "second-generation" (selective inhibitors of serotonin uptake) antidepressants in the treatment of PTSD. A total of 20 hospitalised chronic military combat Bosnian veterans with PTSD symptoms were randomly assigned into two groups of 10 patients each. One group was treated with amitriptyline hydrochloride (AMYZOL) 75 mg/day as a representative of older antidepressants and the other with fluoxetine hydrochloride 60 mg/day (OXETIN) as a representative of newer antidepressants. Those drugs were administered by mouth two or three times-a-day in equally divided doses for at least 8 weeks. Favourable response was achieved in 70% of patients treated with amitriptyline hydrochloride and 60% of patients treated with fluoxetine hydrochloride. Amitriptyline hydrochloride was more effective in the treatment of acute PTSD symptoms (emotional numbing, startle reaction, nightmares, flashbacks, intrusive thoughts, vulnerability, poor impulse control or irritability and explosiveness). Fluoxetine hydrochloride showed a greater efficacy in the treatment of chronic PTSD symptoms (avoidance and numbing symptoms, hyperarousal, nightmares and a feeling of guilt).

Although the drug abuse has been evidenced in every age of the human life, it seems that its occurrence is crucial during adolescence period with its well-known consequences on the further personality development. Adolescents like to experiment with risky lifestyles without adequate knowledge about their possible harmful effects and consequences. International experiences have represented that early onset of the risky behaviour predisposes young persons for serious problems in social, psychological and physical future lives. It has been noticed that adolescents like to combine different psychoactive substances. Therefore the aim of this study was to present the most important and the most actual substances abused by young adolescents together with the substance characteristics. This research included 600 adolescents with the same prevalence regarding age, sex and living zone (rural-urban). Our research showed that simultaneous abuse of various harmful psychoactive substances (polydrug abuse) is the most common (tobacco smoking and cannabis consumption in 75% of cases, alcohol consumption and cannabis consumption in 80% of cases).

Psychoactive drug misuse, as bad habit, is local ethiologic factor of periodontal diseases, and it represents the significant socio-medical problem. The aim of study is: to establish the values of plaque and gingival index in psychoactive drug addicts. The study has been carried out in 42 patients. Experimental group consists of psychoactive drug addicts, and control group consists of patients who have not used psychoactive drugs. The plaque and gingival index show significant difference between experimental and control group. Psychoactive drug misuse has the influence to increased adherence of dental plaque and gingival inflammation, and therapeutic approach is at multidisciplinary level.

The enquiry of suicide is of particular importance. According to WHO statistics suicide in people aged from 15 to 24 years has shown the greatest increase of relative mortality. In the group of suicidal adolescents, depression, behavioural disorders, abuse of different substances and personality deviations are frequent factors in presence. The aim of our investigation was to determine the correlation between psychoactive substance abuse and the occurrence of suicidal thoughts in adolescents. The specific "Q 2000" test was used to question 600 adolescents, from Tuzla and Sarajevo Cantons, with the same gender and age distribution and rural-urban ambient. The more prevailing suicidal idea occurrence was observed in cannabis abusers (50.0%) and alcohol abusers (36.6%) in comparison to non-abusers regardless gender and/or living ambient (settlement types) (19.5% and 17.6% per each, x2 = 17.184 p = 0.00001). The augmentation in number of suicidal ideas was not observed in tobacco smokers.

Posttraumatic Stress Disorder (PTSD) very often occurs accompanied with other psychiatric disorders such as: Alcohol and Drug abuse, Personality Disorder, General Anxiety Disorder, Obsessive Compulsive Disorder, Schizophrenia etc. Sometimes it might be a problem for clinicians to differ PTSD symptoms from symptoms of coexisting psychic disorders. The aim of this study was to present the most common PTSD coexisting psycho-disorders. This research was conducted during the period from April 1998 to October 1999. Participants were divided in two groups each containing 30 examinees. The first group consisted of 30 participants with symptoms of PTSD only while the second group included participants who suffered from both PTSD and other psychic disorders (co-morbidity). Both groups were quite similar regarding participants gender and age. The scientific tools used in the research were: Standard Psychiatric Interview, Harvard Trauma Questionnaire (HTQ), Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Drug and Alcohol Abuse Checklist. Our research results are indicating that PTSD symptoms are most common in middle-aged persons, regardless of their gender and age. We have found following coexisting psychic disorders: personality disorder 46.6% (from which 13.3% is permanent personality disorder after the traumatic experience); depression 29.9% (depression without psychotic symptoms 23.3% and depression with coexisting psychotic symptoms 6.6%); drug abuse 13.3; alcohol abuse 6.7% and dissociative (conversion) disorder 3.3%. The results of our work are suggesting that co-morbid psychic symptoms have significant regressive influence on PTSD course and prognosis.

It is well known that drug abuse is common in early adolescence with almost the same epidemiological characteristics in economical developed and undeveloped countries. Aim of this study is to compare drug abuse among adolescents in the urban and rural areas. Research covers 600 adolescents equal gender and age distribution. Distribution of participants regarding to the rural and urban type of areas, was equal, as well. It was used Q 2000 questionnaires, which was comprehensive tool for all aspects of adolescents life. Results shows that drug abuse is much more common in urban areas (alcohol 62.4%; and cannabis 70.0%; in rural areas alcohol 37.6%; and cannabis 30.0%). Regarding to age, drug abuse is the most common among adolescents aged 15-17. Alcohol is much more related to boys, but regarding to cannabis there is almost no differences.

The last few decades have seen a sharp increase in research into the psychological, psychiatric and social consequences of war. However the bulk of this research relates to male veterans and refugees. There is a serious dearth of literature on female civilians, particularly where the research is being performed in the country of trauma origin. This study aims to explore the psychosocial effects of war on women. One hundred and fifty female civilians participated in this study, conducted in the city of Sarajevo and surrounding refugee settlements in Bosnia. The subjects were divided into three groups: domestic women residing in Sarajevo during and after the war, displaced: women forced to leave their homes, and staying in refugee settlements, returness: women who have returned to Sarajevo from exile. Each woman was interviewed extensively by local psychiatrists. This interview contained the Harvard Trauma Scale for the screening of PTSD and Social Functioning, and the Hopkins Checklist for Anxiety and Depression. Both these tests have been revised, translated and validated for the Bosnian population. The Rosenberg Self-Esteem Scale and the Lazarus Coping scale examine psychological aspects of self-esteem and coping. A questionnaire containing demographic information was devised for the purposes of this study.

War in Bosnia and Herzegovina has caused many psychic and social breakdowns. The consequences on mental health of the war which caused stress are of importance, as well as influences on psychic functioning of individuals are caused by changes in social structure of population and economic potential of the society. Project "Psycho-social aspects of war in BiH" carried out within the frame of the Academy of Sciences and Arts of Bosnia and Herzegovina and the Department of Psychiatry of Clinical Center of Sarajevo University. In this article are given the results of the Project, but only partially. The investigations showed that the number of patients visiting hospitals during the war was greatly increased in the field of stress reactions and reactive psychoses. But incidence and prevalence of alcohol psychoses decreased. Findings are the same for out patient clinics. The field investigation on the free territories of Sarajevo s communities shows enormous increase of mental disorders among the citizens: neurotic over 40%, psychotic about 20% and that is, together, more than 60% of the population of the town Sarajevo were disturbed at that time. Among the children and adolescents there was an increase of neurotic and psychotic disorders in the very beginning of the first year of the war, and decrease of the same diagnoses during the second year. This might be explained by particular adaptation of the youngsters to war conditions. When we are talking about invalidity of neurological and psychiatric disorders, the investigations showed that illness is the mostly caused by invalidity (85.1%) among the global invalidity during the war in Sarajevo. Injuries before the war were at 3%, during the war are 11% of cases. But, all those shows temporary, because war caused invalidity more and we are expecting to registration later. Our investigation among the refugee camps and population in Sarajevo shows that "life equipment" among the displaced persons was lower than domestic people. That shows that after the phase of surviving this part of the population was at risk of many psycho-social problems. Also, our investigation shows that very low socio-economical level of inhabitants of Sarajevo leads to the potential of absolutely poverty. The indicators of this trend are: low level of education, very low life standard, unemployment, bad health conditions etc. Among refugees all those indicators are worse. Criminality in Sarajevo during the war has been increased, particularly among adolescents. One fifth of contents of daily newspaper "Oslobodenje" has been during the war oriented to the health system problems.