Psychological and somatic health problems in Bosnian refugees: a three year follow-up.

BACKGROUND: Aim of this study was to explore association between psychiatric disorders (PTSD and depression) and chronic medical illnesses in a group of Bosnian refugees followed up for three years (1996-1999). SUBJECTS AND METHODS: Study was conducted in refugee camps in Varazdin, Nbaseline=534, Nendpoint=376 (70.4%). The interviews were conducted in Bosnian, data on depression and PTSD were collected using the Hopkins Symptom Checklist-25 and Harvard Trauma Questionnaire, respectively. Medical conditions were self-reported. RESULTS: Most important findings: 1) Half of the sample at both study points reported no psychiatric problems (N=294, 55% vs. N=225, 59%), others suffered from depression (N=99, 18.5% at both times), PTSD (N=30, 5.6% vs. N=15, 4%), and depression + PTSD (N=129, 24.2% vs. N=114, 30.3%); 2) A total of 15 medical conditions were identified, and most frequently present were high blood pressure (N=201, 37.6%) and heart disease (N=167, 31.3%); 3) Occurrence of medical conditions was related to the clinical group - they were more frequent in subjects diagnosed with depression and depression + PTSD, than in those who were asymptomatic or suffering from PTSD only. CONCLUSIONS: Our data indicate the persistence of both psychological and somatic health problems in Bosnian refugees involved in this study over time. Holistic approach and avoiding of mind-body dualism might be beneficial for the care and long-term prognosis of these people.

Family and child with central nervous system lesion.

The aim of the study was to assess if mothers of children with severe forms of cerebral motor impairment perceive their family strength differently than mothers of children with moderate forms of this disorder, as compared.The study included 135 children with cerebral motor impairment. Children were divided into two groups according to the clinical picture severity and their development was followed-up over a one-year period. The course of rehabilitation was assessed by the method of locomotor system functional evaluation. After 12-month rehabilitation, the method of targeted structured interview with the mothers was used. The mothers filled out a questionnaire on family strength, which consisted of 12 questions on their perception of family strength. The present study confirmed the need and efficacy of rehabilitation treatment in children with motor development abnormalities. Study results showed no significant differences in the values obtained by the family strength questionnaire, indicating that there was no statistically significant difference between the two groups in their coping with stressors. It is postulated that the family crisis induced by the birth of a child with risk symptoms must have brought the parents closer and reinforced the family as a whole, irrespective of the severity of the child's clinical picture.

Biological aspects of the development and self-concept in adolescents living in single-parent families.

In this study we investigate whether there are differences between adolescents who grow up in single-parent families and those who grow up in nucleus families. We have decided that there are no differences in the physical development between the adolescents who are growing up in single parent families and those growing up in nucleus families. There is no difference in the self-concept between these two groups, except in the ethical and moral self-image of adolescents living with one parent. Adolescents living in single-parent families have a weaker moral self-image. It can thus be concluded that physical development and positive self-concept (a favorable image of oneself) in adolescents do not depend on whether an adolescent is growing up in a single-parent or a nucleus family, but on the different characteristics of parents and their relationship with children, whether they are married or not. For the children development the best is healthy marriage of their parents.

Longitudinal studies of IQ stability in children with childhood autism - literature survey.

BACKGROUND: In this paper we present a survey of the literature dealing with IQ stability in children with childhood autism (CA) over the last ten years. Nowadays there is no clear evidence on this topic. SUBJECTS AND METHODS: We used the online "PubMed" database. By inputting the following key words: (autism and IQ and child) and (stability or outcome or follow-up) we obtained a total of 78 references. Out of those 78 references, some papers were left out in line with the exclusion criteria, so this survey includes 23 papers altogether. RESULTS: The average initial IQ point is in the range from borderline intelligence to mild mental retardation. Out of a total of 23 studies, the majority, 19 of them, generally state that there are no changes in IQ, 8 studies mention increased IQ, while 3 studies demonstrate a decrease in IQ. Some studies register different results in the same study. At an individual level, single studies show a similar trend to the general results. CONCLUSION: The majority of studies state that the IQ points will remain the same. Today the generally accepted belief is that therapy should be started intensely and early. Some children with good progress may attend regular school.

Family as a factor in cerebral palsy prevention.

The aim of the study was to assess maternal perception of family impact on the course and outcome of rehabilitation in children with cerebral motor impairment. The study included 135 children with cerebral motor impairment. Their motor development was followed-up over a one-year period by use of structured interview with the children's mothers after 12-month rehabilitation. The course of rehabilitation was assessed by the method of locomotor system functional evaluation. The improvement achieved in motor development was significantly better in the group of children whose mothers found their relationships with extended family excellent than in those whose mothers considered it good or poor. The study showed that mothers to children with cerebral motor impairment frequently feel the lack of extended family support, being it real or perceived as such by the mothers due to their emotional sensitivity, suggesting the need of additional studies of the reasons for this. These findings indicate that greater attention should be paid by health professionals to the psychological support offered to these mothers.

The mental health of children upon their return home after a long displacement period.

The aim of this study was to determine the different levels of depression, hopelessness and post-traumatic stress disorder between two groups of adolescents, those who returned to Baranja and those from Osijek. The first group consisted of 57 adolescents (32 female and 25 male) with the mean age of 17.36, who were grammar school students in Beli Manastir (Gimnazija, Beli Manastir). The mean duration of displacement period was 7 years. The second group consisted of 58 adolescents of grammar school students in Osijek (III. gimnazija, Osijek) (32 female and 26 male) with the mean age of 17.28. All examinees filled in the Croatian version of the Children's Depression Inventory (CDI), the Hopelessness Scale for Children (HSC) and Children's Post-Traumatic Stress Disorder (PTSD) Inventory. The analysis of the results did not show any statistically significant difference between these two groups regarding levels of depression, hopelessness and post-traumatic stress disorder. The results point out rather good psychosocial adjustment of adolescents upon their return home after 4 years.

Anxiety and defense styles in eating disorders.

This study investigates anxiety and defense styles in eating disorders. Seventy eating disorder (ED) patients and fifty-one female matched control subjects completed State and Trait Anxiety Inventory (STAI) and 88-items Defense Style Questionnaire (DSQ). ED patients were more anxious in actual situations and more anxiety prone in general. They relied on maladaptive action and Image distorting defense style. Bulimic anorexic (BAN) patients and bulimia nervosa (BN) patients differed in defense styles from restrictive anorexic (RAN) patients who displayed no significant difference in either state and trait anxiety or in defense styles when compared to healthy patients. Different levels of anxiety and ego defense maturity are present in ED patients. The almost normal ego functioning of RAN patients could be explained by pseudomaturity, tendency to control external and internal environment and the unconscious efforts to imitate normality to avoid conflicts.