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C. Ziegler, C. Wolf, M. Schiele, E. F. Bojić, S. Kučukalić, E. S. Dzananovic, A. Uka, B. Hoxha et al.

Z. Selimbašić, M. Brkić, N. Kravić, J. Hamidović, Mirna Selimbašić

Aim To analyse symptoms of posttraumatic stress disorder and coping strategies of war veterans in Tuzla Canton twenty years after the war in Bosnia and Herzegovina (BiH). Methods The study analysed a group of 120 war veterans from the Tuzla Canton who had experience of the war in BiH. For assessment of posttraumatic stress disorder Harvard Trauma Questionnaire was used, a version for Bosnia and Herzegovina and for assessment of coping styles Life Style Index was used. Results Concerning number of traumatic experiences of war veterans, it was found that they suffered 12 traumatic experiences. Most often traumatic experience was the participation in fighting and shelling (90.0%), knowledge of injuries in combat or landmine injuries of family members or friends (75.8%), exposure to snipers (74.2%). The most important were the symptoms of numbnessemotional numbness (2.62%), the symptoms of intrusion (2.58%) and the severity of the symptoms of PTSD (2.39%). The most common strategy of dealing with veterans of war was a projection (68.31%) and intellectualisation (56.20%). Conclusion War veterans have experienced polytraumatic experiences in war and show increased expression of symptoms of posttraumatic stress disorder, emphasised psychosocial problems with a common defence mechanism in the form of projections twenty years after the war. War veterans are in need of continuous treatment in order to reduce long-term consequences of war trauma.

C. Ziegler, C. Wolf, M. Schiele, Elma Ferić Bojić, S. Kučukalić, Emina Šabić Džananović, Aferdita Goci Uka, B. Hoxha et al.

Abstract Background Posttraumatic stress disorder is characterized by an overactive noradrenergic system conferring core posttraumatic stress disorder symptoms such as hyperarousal and reexperiencing. Monoamine oxidase A is one of the key enzymes mediating the turnover of noradrenaline. Here, DNA methylation of the monoamine oxidase A gene exonI/intronI region was investigated for the first time regarding its role in posttraumatic stress disorder risk and severity. Methods Monoamine oxidase A methylation was analyzed via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells in a total sample of N=652 (441 male) patients with current posttraumatic stress disorder, patients with remitted posttraumatic stress disorder, and healthy probands (comparison group) recruited at 5 centers in Bosnia-Herzegovina, Croatia, and the Republic of Kosovo. Posttraumatic stress disorder severity was measured by means of the Clinician-Administered Posttraumatic Stress Disorder Scale and its respective subscores representing distinct symptom clusters. Results In the male, but not the female sample, patients with current posttraumatic stress disorder displayed hypermethylation of 3 CpGs (CpG3=43656362; CpG12=43656514; CpG13=43656553, GRCh38.p2 Assembly) as compared with remitted Posttraumatic Stress Disorder patients and healthy probands. Symptom severity (Clinician-Administered Posttraumatic Stress Disorder Scale scores) in male patients with current posttraumatic stress disorder significantly correlated with monoamine oxidase A methylation. This applied particularly to symptom clusters related to reexperiencing of trauma (cluster B) and hyperarousal (cluster D). Conclusions The present findings suggest monoamine oxidase A gene hypermethylation, potentially resulting in enhanced noradrenergic signalling, as a disease status and severity marker of current posttraumatic stress disorder in males. If replicated, monoamine oxidase A hypermethylation might serve as a surrogate marker of a hyperadrenergic subtype of posttraumatic stress disorder guiding personalized treatment decisions on the use of antiadrenergic agents.

Suada Selimović, N. Kravić, M. Bijedić, Lejla Kuralić-Čišić, R. Kovačević, Edin Muftić, E. Lučić, A. Arnautović et al.

Over the past few decades, there are evidences that scientific paradigm is changed from disciplinary to transdisciplinary approaches. The question of sustainability science, novel ways for production and coproduction of knowledge and a matter of accomplishment for real world problems represent a big challenge for scientific and academic community. Transdisciplinary team-based research, integration of knowledge from different disciplines and a view into complex societal problems from different perspectives can make a contribution for production of new, practice-oriented knowledge, applied for social problems solution. Going to the transdisciplinary approach is especially valuable in social sciences, where collaborative practice became a necessary normative.In this paper authors, first in the context of theoretical considerations describe possible applications of transdisciplinary research in Bosnia and Herzegovina, as post-conflict, transitional community. The second part of article there is emphasized transdisciplinary approach to the problem of juvenile delinquency in Tuzla Canton through research project: „Influence of different contexts of socialisation on the development of juvenile delinquency in post-war Bosnia and Herzegovina – Recommendations for prevention and intervention“ which is realised in four years from 2010 to 2014. Analysing of challenges and problems which this interdisciplinary research team was faced with, authors tried to explain that the way of transdisciplinarity is the way for bridging of different discipline perspectives and through research process finding out solutions applicable in practice. Looking for applicable and practical solutions and maintenance of sustainable strategies for socially relevant and real life problems in post-conflict communities is one of the priorities and challenges for universities, academic communities, government institutions and whole society.

A. Kulenović, F. Agani, E. Avdibegović, M. Jakovljevič, D. Babic, A. Kučukalić, S. Kučukalić, E. S. Dzananovic et al.

Posttraumatic Stress Disorder (PTSD) is a major health problem in South Eastern Europe (SEE). Available treatment options are not efficient enough and the course is often chronic. Little is known about molecular mediators and moderators of pathogenesis and therapy. Genetic and epigenetic variation may be one central molecular mechanism. We therefore established a consortium combining clinical expertise on PTSD from SEE countries Bosnia-Herzegovina (Sarajevo, Tuzla and Mostar), Kosovo (Prishtina) and Croatia (Zagreb) with genetic and epigenetic competence from Germany (Würzburg) in 2011 within the framework of the DAAD (Deutscher Akademischer Austauschdienst)-funded Stability Pact for South Eastern Europe. After obtaining ethical votes and performing rater trainings as well as training in DNA extraction from EDTA blood between 2011 and 2013, we recruited 747 individuals who had experienced war-related trauma in the SEE conflicts between 1991 and 1999. 236 participants had current PTSD, 161 lifetime PTSD and 350 did not have and never had PTSD. Demographic and clinical data are currently merged together with genetic and epigenetic data in a single database to allow for a comprehensive analysis of the role of genetic and epigenetic variation in the pathogenesis and therapy of PTSD. Analyses will be done to a great degree by PhD students from participating SEE centers who in addition to participation in the project had an opportunity to take part in spring and summer schools of the DFG (Deutsche Forschungsgemeinschaft) funded Research Training Group (RTG) 1253 and thus meet PhD students from Germany and other countries We are confident that our project will not only contribute to a better understanding of genetic and epigenetic mechanisms of PTSD as a basis for future individualized and personalized therapies, but also to the academic development of South Eastern Europe.

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 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.

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