Browsing by Author "Vuković, Olivera (14044368800)"

Background/Aim. In spite of the growing body of evidence in the field of personality disorders, these disorders still retain the lowest diagnostic reliability of any major category of mental disorders. The aim of this study was to investigate the differences of personality profiles in patients diagnosed with personality disorder in comparison with the group of healthy control subjects, as well as to establish to what extent the five-factor personality model domains determine the specific clusters of personality disorders. Methods. The study group comprised 97 patients diagnosed as personality disorders (according to the Diagnostic and Statistical Manual of Mental Disorders - DSM-IV criteria), aged between 18 and 65 years [mean = 35.78 years, standard deviation (SD) = 13.72 years], 67% were female. Control group included 58 healthy subjects (student population) aged between 20 to 35 years (mean = 22.48 years, SD = 2.56 years), 56% were female. The assessment was carried out by the new version of the NEO Personality Inventory-Revised (NEO-PIR), form S, and the Structured Clinical Interview (SCID II) for DSM-IV disorders. Results. The three clusters were found by the use of regression analysis: Cluster A - eccentrics (low scores in agreeableness), cluster B - dramatics (high score in extroversion, low score in agreeableness, and cluster C - anxious (low score in extroversion). The findings showed that the high level of neuroticism was a non-specific predictor of all three clusters, while dimension openness to experience had no predictive power for any of the three clusters. Conclusion. Our findings support the meta-analysis which suggests consistently high level of neuroticism and low level of agreeableness in most personality disorders. The study showed that it is possible to conceptualize personality disorders by using five-factor personality model of normal personality. Integrating the psychiatric classification with the dimensional model of general personality structure could enable the uncovering of essential parameters for setting the diagnosis. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

More than half a century ago, Delay and colleagues have discovered, quite accidentally, that antihistamine (chlorpromazine) relieves psychotic symptoms. This discovery prompted further investigation through a series of performed experiments aimed to elucidate the antipsychotic mechanism of action. Initial results have shown that antipsychotic drugs in experimental animals lead to "neuroleptic effect" (indifference). However, not until the end of 1960s, it becomes clear that all previously known antipsychotics, block dopamine receptors, particularly postsynaptic D2 receptors. The next three decades marked the development and application of these so-called classic neuroleptics in the treatment ofpsychotic patients. During the nineteen nineties, as a result of ongoing efforts to achieve greater efficiency and reduce the scope of side effects, novel antipsychotics were synthesized (second generation antipsychotics - SGA). As a result the notion of serotonin-dopamine antagonist (SDA) was formulated. According to one of the hypothesis, "new", so called atypical antipsychotic drugs strongly block the serotonin (5-HT]), and weakly block the dopamine (DJ receptors. Yet, there is still a debate as to the molecular basis of atypicality, whether it is in dopaminergic and serotonergic antagonism of neurotransmission or it lays exclusively in the modulation of dopaminergic system and dissociation rate at the level of D2 receptors in specific brain regions. Although the synthesis and use of antipsychotics in clinical practice have radically changed not only the basic approach to the patient, but also the quality of life of millions ofpeople, the question remains whether this is just "old wine in new glasses © Medicinska naklada-Zagreb, Croatia.

Background: Quality of life (QoL) is known to be indicative of the level of social functioning in mental health patients. However, the research on QoL, in the field of psychiatry, is not as comprehensive as it is in other domains of medicine. The aim of this study was to review the research evidence on QoL in psychiatric patients, published in Serbian medical journals during the last decade. Material and methods: The research data from studies on quality of life in psychiatric patients, published in Serbian medical journals from 2000 to 2009, were obtained by searching the databases Kobson and Medline. Results: We found eight studies on QoL in psychiatric patients published in Serbian medical journals from 2000 to 2009. The reviewed articles were focused on the comparison of QoL between psychiatric patients and healthy controls, or somatic patients, the research on the relationship of QoL and general psychopathology, and the research on QoL and medical treatment. Conclusions: QoL in patients suffering from mental disorders, as the outcome variable, is of a paramount interest in the follow-up treatment studies in psychiatry targeting critical issues of mental illness management strategies. QoL of psychiatric patients in Serbia is still under-researched, and it would be important to measure QoL from both a patient's and observer's (i.e. family members, friends, nursing staff, mental health professionals, etc.) perspective, in the context of social, economic, and cultural background of the patient. In the future, the studies on QoL in psychiatric patients in Serbia should also rely on "disease specific" assessment scales, which would consider particular aspects of psychopathology, and eventually follow up longitudinal course of mental illness, treatment outcome, and recovery. © Medicinska naklada.

Objective: To prospectively evaluate depressive symptoms and risk factors for depression in patients with chronic hepatitis C (CHC) treated with pegylated interferon alpha therapy combined with oral ribavirin (PEG-IFN-α+RBV) and to analyze self-rating scale for depression in comparison to observer-based scale in the given population. Subjects and methods: The Hamilton Depression Rating Scale and Zung Self Rating Depression Scale were used to screen for depressive symptoms in 74 subjects with CHC before PEG- IFN-α (mean dose 152.6±25.6 mcg), and in the follow-up visits (4, 12 and 24 week). Results: Incidence of depressive symptoms in patients (mean age 39.9±13.4 years; equal sex distribution p=0.225) treated by PEG- IFN-α was the highest on 12th week of the treatment, when more than a 20% of our sample had moderate/severe symptoms of depression, and about 30% had minor depressive symptoms. For the screening of depression during PEG- IFN-α self-assessment scale was equally reliable as observer-based assesment of depressive symptoms. Common clinical parameters- subject related risk factors (age (p=0.955 ), sex (p=0.008), lifetime psychiatric disorder (p=0.656)), illness related risk factors (duration of CHC (p=0.267), i.v drug aplication as way of transmission (p=0.292)) and therapy-related risk factors (recommended duration of PEG-IFN-α (p=0.993) and dose of PEG-IFN-α (p=0.841)) were not significantly associated with depressive symptoms on PEG-IFN-α. Conclusions: Liason-consultation services should collaborate with hepatologists in creating screening programmes, supplemented by objective criteria and guidelines, for early recognition and treatment of interferon-induced depression. © Medicinska naklada.

Objective: Trazodone is an effective antidepressant. The present study was designed as a non-interventional open-label, multi-centre, post-marketing study. The aim of the study was to evaluate the therapeutic effectiveness and tolerability of trazodone retard formulation (Trittico® retard) in everyday clinical practice. Methods: Two hundred and forty-two patients with depressive disorder from 19 different centres were included in the study. The antidepressant and anxyolitic effects were assessed using Hamilton anxiety rating scale 14 items version, Hamilton depression rating scale 14 items version and Clinical Global Impression Severity scale. Results: After only two weeks of therapy, a statistically significant improvement in the HAM-D score, was observed. This observation was maintained over the whole study period, up to the day 56. Conclusions: Our study points toward clinical effectiveness of the prolonged-release formulation of trazodone in the treatment of unselected depressed patients in real-world practice. © 2016 Informa UK Limited, trading as Taylor & Francis Group.

Background: Tianeptine, a new generation antidepressant, possesses a unique mechanism of antidepressive action and has a specific pharmacokinetic profile. The aim of this study was to determine the efficacy, tolerability and safety of tianeptine in a "fragile" population of depressive patients: (1) a group of elderly patients and (2) a group with comorbid alcohol addiction. Subjects and methods: This was an open multicentric eight-week study of tianeptine efficacy, tolerability and safety including patients with mild to moderate depression (DSM-IV), age ≥55 years (group 1; n=45) or with comorbid alcohol addiction (group 2; n=32). Assessments was made with the following rating scales; MADRS, HAM-A and CGI for efficacy and DESS for tolerability. Results: After eight-week tianeptine therapy, remission (MADRS ≤12) was established in 51.1% and 84.4%patients, respectively. On day 7, the therapy led to a significant decrease of MADRS. On endpoint, there were significant differences on HAM-A, CGI-I and CGI-S scores (p<0.01). No adverse effects with frequency ≥ 10%, were registered. A lower tolerability of tianeptine was registered in a group of elderly (nausea 4.5%, leg fatigue 4.4%, irritability 2.2%, bursts of crying and sadness 2.2%), while only 3.1% depressive patients with comorbid alcohol addiction had dizziness. Conclusion: This is the first clinical study to evaluate tolerability, efficacy and safety of tianeptine in a special population of depressive patients in the region. The study showed that tianeptine had good efficacy in treatment of mild to moderate forms of depression in special populations of depressive patients (elderly population and patients with comorbid alcohol addiction). The drug was well tolerated. © Medicinska naklada.

Background: The purpose of the study was to research gender differences in suicides committed in Podgorica between 2000 and 2006, including sociodemographic variables (e.g. age, marital status, education etc.), methods of and motives for committing suicide. Data were taken from the Police Directorate of Montenegro. Subjects and methods: We used data on 220 males and 83 females who committed suicide. Statistical analysis was done by using the crude specific rate. Significance between two independent crude rates is constructed around their 95% confidence intervals and it utilizes the difference between the two rates (D) to determine significance. Results: The incidence of suicide in males was found to be higher than infernales (the male to female suicide ratio is 2.6 to 1). Females were older than males. Females had completed elementary education more frequently, and they were single or divorced or widows. Males had completed secondary education more frequently and they were married. The most frequent employment status of both gender groups implied pensioner and unemployment statuses. There was a significant difference in suicide rates between the genders during the reporting period. Suicide rates increase with age in both genders. Males chose firearms, hanging, strangulation and suffocation and jumping. Females chose hanging, strangulation and suffocation, jumping and drowning as the most frequent methods of suicide. The most frequent motive for suicide in both gender groups was physical illness. The second most frequent motive was mental illness. Emotional and financial difficulties were motives which were more common in males, whereas family problems appeared to be motives two times more frequent infernales. Conclusions: The complex multifactorial etiology of suicide suggests the need to consider gender differences when developing effective strategies for the therapy and the prevention of suicide. © Medicinska naklada.

Introduction The COVID-19 pandemic is likely to have a prolonged impact on mental health (MH); however, the long-term MH effects of the COVID-19 pandemic remain unknown. The Serbian national survey-CoV2Soul.RS-was launched to document the MH status of the Serbian population following the COVID-19 pandemic and to contribute to an international evidence base about MH prevalence rates during different phases of the pandemic. Methods and analysis This cross-sectional study was designed to collect a nationally representative sample (N=1200; age 18-65 years; estimated start/end-June/November 2021) using multistage probabilistic household sampling. Trained staff will conduct in-person diagnostic interviews. A battery of self-report instruments will be administered to assess the quality of life (QoL), general distress and associated protective and harmful psychological and societal factors. Analyses will be conducted to delineate the prevalence rates of MH disorders, how MH conditions and QoL vary with respect to sociodemographic variables, personality, health status and traumatic events during the COVID-19 pandemic, and to test how these relations depend on geographical region. Moreover, this study was designed to explore mechanisms linking personality and the perception of pandemic consequences and associated distress. Prevalence rates of MH disorders will be calculated using descriptive statistics. For additional analyses, we will use correlations, analysis of variance and regression analyses. The hierarchical structure of the data will be explored using multilevel random coefficient modelling. Structural equation modelling will be used to investigate the indirect effects of personality on distress through relevant variables. Ethics and dissemination Ethical Committees of the Faculty of Medicine (1322-VII/31) and Faculty of Philosophy in Belgrade (02-33/273) and Faculty of Philosophy in Novi Sad (05-27, br.893/1) approved the protocol. Only respondents able to provide informed consent will participate in the study. Research reports will be submitted to peer-reviewed journals and the results will be placed on the website www.cov2soul.rs to be available to funders, researchers, policy-makers and interested laypeople, and will be advertised through social media. Trial registration number NCT04896983. ©

Aim: To compare patient's attitudes, demographic, clinical characteristics, psychopathology, insight and type of antipsychotic therapy in compliant and non-compliant outpatients with schizophrenia; to explore correlations between patient's attitudes and related variables. Methods: A sample of 44 outpatients of both genders (> 60 years), with a diagnosis of ICD-10 Schizophrenia (F20) was included into the study. All the patients were on maintenance treatment with different classes of antipsychotics (oral, depot or both), for at least 6 months from the latest hospitalisation. The exclusion criteria were determined. The BPRS and the PANSS were used to assess psychopathology and insight (G12 item). The self-report questionnaire MARS was used to assess patient's attitudes. Results: Compliant patients (N=37) showed the following significant differences compared to non-compliant patients (N=7): higher the MARS (p<0.001), lower the PANSS (Positive sub score) (p<0.01) G12 scores (p<0.01) (the Student t test) and percentage of patients with previous non-compliance (p<0.05) (χ2 test). Considerable correlation between the MARS and the BPRS (p<0.001), the PANSS (Positive, General psychopathology) (p<0.001; p<0.01), G12 scores (p<0.05) (negative) and current compliance (p<0.001) was also found (The Spearman's correlation). Conclusions: Our results suggest that special attention should be paid to attitudes, severity of psychopathology, insight and history of non-compliance in compliance evaluation of outpatients with schizophrenia. © Medicinska naklada - Zagreb, Croatia.