Clinically significant depressive disorder in adolescence; cross-sectional study of two Croatian counties.

BACKGROUND: The aim of the study was to determine whether there is a difference in the intensity of depression, suicidality, and expression of clinical features among adolescents in two different regions of Krapina-Zagorje (KZ) and Split-Dalmatia (SD). SUBJECTS AND METHODS: The study was designed as a descriptive cross-sectional, the sample consisted of 200 adolescents, 100 from each region, aging 16-18 years, from various high schools. The research was conducted by psychiatrists in Split and Krapina, where school population of Split-Dalmatia County and Krapina-Zagorje County gravitates. For the assessment of depression, the Hamilton rating scale for depression with 21 items was used, which has proven in clinical practice. For the inclusion in the study, among other parameters, participants needed to satisfy the criterion that depression is clinically significant (19 or more points on the HAMD-21). RESULTS: The data obtained points out to statistically significant difference in the intensity of depression between the two regions (p<0.001). There was no difference in suicidal impulses. For the most part, the expression of clinical features between adolescents in these regions showed no significant difference, except that guilt (p=0.001), failing in the work plan and activities (p=0.000) and paranoid ideas (p=0.013) were significantly more expressed in adolescents of Krapina-Zagorje County and sleep disorders (p<0.001) in adolescents of Split-Dalmatia County. CONCLUSIONS: It can be concluded that depression, suicidality and much of the clinical features depend on the developmental age, i.e. the turbulent adolescent development, rather than on regional differences, although, to a lesser extent, the expression of clinical features can be influenced by milieu, lifestyle, family dynamics and educational procedures, which can partially affect the expression of clinical features.

Depression and auto-aggressiveness in adolescents in Zagreb.

BACKGROUND: The aim of the study was to explore the frequency of depression among the general population of adolescents who were high school students in the city of Zagreb. As depression is associated with increased suicidal risk we wanted to check to what extent depression, as an emotional problem among youth, is associated with auto-aggression in the general population of adolescents. SUBJECTS AND METHODS: The study was conducted on a sample of high school students in Zagreb and it included 701 students of both genders aged from 14-19 years of age. To test the depression a Beck Depression Inventory (BDI) was administered for youth between 11-18 years of age (Youth Self Report for ages 11-18). To test auto-aggression a Scale of Auto-destructiveness (SAD) was used. RESULTS: Results obtained by this study show that about 20.7% of high school students have mild and borderline depressive disorders while moderate or severe depression shows about 5% of them, whereby depression is statistically significant among girls who, on average, report more symptoms of depression. It has also been proven a significant impact of depression levels (F (2,423)=35.860, p<0.001) on auto-aggression in subjects of both genders. In both genders, moderately depressed show more auto destructiveness than those without depression symptoms (p<0.01). In the group of heavily depressed (n=30), significantly higher self-destructiveness is shown by girls (p<0.01). CONCLUSIONS: The data suggest the importance of early recognition, understanding and treatment of depressive symptoms in adolescents in order to reduce the risk of subsequent chronic psychosocial damage.

Family factors associated with auto-aggressiveness in adolescents in Croatia.

The aim of this research is to look into the roles of families' social situation and cohesion in adolescent auto-aggressiveness in Croatia. The research was conducted on a sample of Zagreb high school students which encompassed 701 pupils of both genders aged 14-19. The basic demographic data were obtained using the Structured Demographic and Family Data Questionnaire. Auto-aggressiveness was tested using a section of the Report on Youth Aged 11-18 and the Scale of Auto-destructiveness--SAD, whereas the family cohesion was tested with the Family Adaptability and Cohesion Evaluation Scales FACES III. The obtained results show differences according to the gender: girls are more prone to auto-aggressiveness than boys (t = -3.385, df = 565, p = 0.001) and girls more often show symptoms of destructiveness (t = -3.809, df = 637, p < 0.001) and anxiety (t = -6.562, df = 640, p < 0.001), while boys show pronounced aggressiveness (t = 2.655, df = 653, p = 0.008). Significant family factors associated with auto-aggressiveness are parents' marital status (chi2 = 18.039, df = 4, p = 0.001), their financial situation (F(2.548) = 4.604, p = 0.010), alcoholic father (chi2 = 9.270, df = 2, p = 0.010), mentally ill mother (t = 5.264, df = 541, p < 0.001), as well as mentally ill father (t = 4.744, df = 529, p < 0.001), and corporal punishment by mother (F(2.542) = 8.132, p < 0.001) or father (F(2.530) = 5.341, p = 0.005). Adolescents from split families show more auto-aggressiveness. Family cohesion appears to be considerably associated with auto-aggressiveness and the adolescents that see their families as less cohesive have more mental problems (chi2 = 29.98, df = 2, p < 0.001). There is a connection between auto-destructive behavior in adolescents and family factors. Knowledge of family's social situation and cohesion may help understand, prevent and treat auto-aggressiveness in adolescents.

Family Financial Situation, Parental Marital Status and Self-Harm amongst Adolescents in Croatia.

The aim of this study was to determine the level of self-harm behaviors among adolescents in the general population (students of secondary schools in Zagreb, Croatia), as well as to determine if the level of self-harm behaviors differed according to financial circumstances of the family and marital status of the parents. The study was conducted in 701 adolescents (male and female, age range 14 to 19 years). A specially designed questionnaire that included family and demographic data was used to determine the family financial circumstances. The Scale of Auto-Destructiveness measuring instrument was used to assess the level self-harm. Study results revealed that 87.3% of adolescents indicated average levels of self-harm, whereas above-average and high above-average self-harm was indicated in 12.7% of the adolescents. Results also showed that single-parent families significantly differentiated the level of self-harm among adolescents of both genders, whereas financial deprivation (perception of financial stress) partially differentiated these levels. Practical implications of this study emphasize the importance of social support to parents of adolescents grown up in single-parent and/or financially challenged families.

Effect of motor limitations on the expression of aggressiveness among adolescents.

This study examined how motor limitations in terms of reduced possibilities to move influence aggression, starting from the fact that motor skills and movement have an important place in the expression of aggression, as well as the tendency of adolescents to "body language". Adolescent with motor deficit is hindered in gaining experience of one's own body, which is reflected in the formation of complete experience of himself, or constitution of the self. In many of the functions of motor skills and movement aggression has a significant place that we wanted to determine without deeper analysis of whether the origin of aggression is instinctive or it is always just the result of frustration. The sample on which testing was performed consisted of 100 randomly selected subjects of both genders aged 16-18 years. Fifty subjects had motor limitations due to illness or injury, and another fifty subjects had intact motor functions. The study used three instruments: 1) A-87 questionnaire for aggressiveness examination; 2) structured interview; and 3) protocol for observation under natural conditions. Results of the analysis of data obtained in total score, as well as in all five subscales of the A-87 questionnaire for aggressiveness examination showed that the two groups were not significantly different. The results obtained by structured interview showed the adolescents with motor limitations to demonstrate greater verbal aggressiveness, then latent physical aggressiveness. A statistically significant between-group difference was obtained on the factor of self-destructiveness, which implies that adolescents with motor limitations are somewhat more self-destructive compared to those in control group. From the results obtained by the protocol for systematic observation in natural conditions, it was evident that there were significant differences on most of perceptual conducts between control and experimental group, whereby adolescents with motor limitations were more aggressive than control group subjects, especially in behaviors that apply to all forms of verbal aggressiveness. All examined adolescents in which some apparent forms of aggressive behavior were noticed in the observation protocol showed comparable expression of aggressiveness according to the results obtained on the subscales of the A-87 aggressiveness questionnaire, which connects these two measuring instruments and justifies their use in the study of aggressiveness regardless of the understanding of the origin of aggression.

The application of psychoanalytic principles to the study of "magic".

In this paper Freud's work on animism and magic is elaborated. Those two subjects are presented mainly in his work "Totem and Taboo" (1913). The true motives, which lead primitive man to practice magic are, according to Freud, human whishes and his immense belief in their power. Importance attached to wishes and to the will has been extended from them to all those psychical acts, which are subjected to will. A general overvaluation has thus come about of all mental processes. Things become less important than ideas of things. Relations, which hold between the ideas of things, are equally hold between the things. The principle of governing magic or the technique of animistic way of thinking is one of the 'omnipotence of thoughts'. The overvaluation of psychic acts could be brought into relation with narcissism and megalomania, a belief in the thaumaturgic force of words and a technique for dealing with the external world--'magic'--which appears to be a logical application of these grandiose premises. Recent psychoanalytic authors dealing with the problem of magic emphasize that magic survived culturally to the present days and even in adults who are otherwise intellectually and scientifically 'modern'. Their explanations for that derive from Ferenczi's and especially Róheim's work that pointed out that magic facilitates adaptive and realistically effective endeavors. Balter pointed out that magic employs ego functioning, and conversely ego functioning includes magic.