Brave New Psychiatry: Culture of Empathy and Mental Health for All.

Psychiatry has the historical opportunity to shape the future of mental health care, medicine, and society. The term New Brave Psychiatry refers to challenges to psychiatry in our volatile, uncertain, complex and ambiguous (VUCA) world. The present and the future of psychiatry lie on the recognizing these challenges and resolving them. Transdisciplinary multiperspective integrative view on psychiatry (TIP) involving creative, person-centered narrative psychopharmacotherapy (CP-CNP) and empathization-based cognitive-emotional-behavioral therapy (EB-CEBT) as an art and practice of the empathic learning organization are presented in this article as well as the culture of empathy as a cornerstone of good clinical practice and mental health. We should all be driven by the vision of psychiatry and other mental health disciplines for a better world and promotion of mental health for all as a part of the Global Enlightenment 2.0 for Sustainability of the Earth System.

Rare copy number variation in posttraumatic stress disorder.

Posttraumatic stress disorder (PTSD) is a heritable (h2 = 24-71%) psychiatric illness. Copy number variation (CNV) is a form of rare genetic variation that has been implicated in the etiology of psychiatric disorders, but no large-scale investigation of CNV in PTSD has been performed. We present an association study of CNV burden and PTSD symptoms in a sample of 114,383 participants (13,036 cases and 101,347 controls) of European ancestry. CNVs were called using two calling algorithms and intersected to a consensus set. Quality control was performed to remove strong outlier samples. CNVs were examined for association with PTSD within each cohort using linear or logistic regression analysis adjusted for population structure and CNV quality metrics, then inverse variance weighted meta-analyzed across cohorts. We examined the genome-wide total span of CNVs, enrichment of CNVs within specified gene-sets, and CNVs overlapping individual genes and implicated neurodevelopmental regions. The total distance covered by deletions crossing over known neurodevelopmental CNV regions was significant (beta = 0.029, SE = 0.005, P = 6.3 × 10-8). The genome-wide neurodevelopmental CNV burden identified explains 0.034% of the variation in PTSD symptoms. The 15q11.2 BP1-BP2 microdeletion region was significantly associated with PTSD (beta = 0.0206, SE = 0.0056, P = 0.0002). No individual significant genes interrupted by CNV were identified. 22 gene pathways related to the function of the nervous system and brain were significant in pathway analysis (FDR q < 0.05), but these associations were not significant once NDD regions were removed. A larger sample size, better detection methods, and annotated resources of CNV are needed to explore this relationship further.

GLOBAL MENTAL HEALTH ENLIGTENMENT2.0 IN ACTIONFOR GLOBAL SUSTAINABILITY, PEACE AND EMPATHIC CIVILIZATION.

Mental health as a crucial global public good requires action of all scientific, political, social and cultural disciplines and sectors in our VUCA (volatile, uncertain, complex, ambiguous) world. Empathy based on love as life philosophy and a way of being in the world is the most essential and basic core element in human communications which leads to healthy, creative, flourishing, and well-functioning families, communities, nations, societies, and civilizations. Culture of empathy is an essential part of the new 2.0 Enlightenment which is a mental, social, spiritual and political movement that inspires aspiration towards global human spirit, collective mind and humanistic self, public and global mental health, cosmopolitism and empathic civilization.

SUICIDE ATTEMPTS ARE ASSOCIATED WITH PERSONALITY DIMENSIONS IN CROATIAN WAR VETERANS WITH POSTTRAUMATIC STRESS DISORDER.

BACKGROUND: Patients with combat-related posttraumatic stress disorder (PTSD) have an increased frequency of suicide ideations, but also a higher risk of suicide attempts. Of all the known predisposing risk factors of suicide attempts in this population, personality dimensions are one of the least investigated. The main aim of this study was to examine if personality traits, namely temperament and character dimensions and trait impulsivity, are associated with suicide attempts in war veterans with PTSD. SUBJECTS AND METHODS: his sample included 178 Croatian male war veterans (mean age 49.20 years) treated for PTSD at the Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb. These patients were assessed with the M.I.N.I. diagnostic interview and they filled out several self-report scales: the Beck Depression Inventory-Second Edition (BDI-II), the Temperament and Character Inventory-Revised (TCI-R), the Barratt Impulsiveness Scale-11 (BIS-11), and the Satisfaction with Life Scale (SWLS). RESULTS: It was found that 42 (24%) Croatian war veterans with PTSD had a previous suicide attempt. Comparison between the two groups (participants with vs. those without history of suicide attempts) revealed that patients with previous suicide attempts are less educated and more often unemployed, have a longer duration of psychiatric treatment and more psychiatric hospitalizations, and exhibit higher levels of depression and lower life satisfaction. In multivariate logistic regression analyses, temperament dimension Harm Avoidance and character dimension Self-transcendence were unique predictors of suicide attempts, above the influence of age, education level and length of treatment. CONCLUSIONS: Croatian war veterans with PTSD have a substantial risk of suicide attempts. In addition to the role of some sociodemographic and clinical factors, it seems that certain personality dimensions are uniquely associated with suicide behaviours among these individuals.

Association of polygenic risk scores, traumatic life events and coping strategies with war-related PTSD diagnosis and symptom severity in the South Eastern Europe (SEE)-PTSD cohort.

OBJECTIVES: Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental events and characterized by high emotional distress, re-experiencing of trauma, avoidance and hypervigilance. The present study uses polygenic risk scores (PRS) derived from the UK Biobank (UKBB) mega-cohort analysis as part of the PGC PTSD GWAS effort to determine the heritable basis of PTSD in the South Eastern Europe (SEE)-PTSD cohort. We further analyzed the relation between PRS and additional disease-related variables, such as number and intensity of life events, coping, sex and age at war on PTSD and CAPS as outcome variables. METHODS: Association of PRS, number and intensity of life events, coping, sex and age on PTSD were calculated using logistic regression in a total of 321 subjects with current and remitted PTSD and 337 controls previously subjected to traumatic events but not having PTSD. In addition, PRS and other disease-related variables were tested for association with PTSD symptom severity, measured by the Clinician Administrated PTSD Scale (CAPS) by liner regression. To assess the relationship between the main outcomes PTSD diagnosis and symptom severity, each of the examined variables was adjusted for all other PTSD related variables. RESULTS: The categorical analysis showed significant polygenic risk in patients with remitted PTSD and the total sample, whereas no effects were found on symptom severity. Intensity of life events as well as the individual coping style were significantly associated with PTSD diagnosis in both current and remitted cases. The dimensional analyses showed as association of war-related frequency of trauma with symptom severity, whereas the intensity of trauma yielded significant results independently of trauma timing in current PTSD. CONCLUSIONS: The present PRS application in the SEE-PTSD cohort confirms modest but significant polygenic risk for PTSD diagnosis. Environmental factors, mainly the intensity of traumatic life events and negative coping strategies, yielded associations with PTSD both categorically and dimensionally with more significant p-values. This suggests that, at least in the present cohort of war-related trauma, the association of environmental factors and current individual coping strategies with PTSD psychopathology was stronger than the polygenic risk.

Creative, Person-Centered Narrative Psychopharmacotherapy of Depression.

Depression as a multifactorial, polygenic mental disorder with thousands faces, poorly defined endophenotypes and characterized with high rate of morbidity, comorbidity, disability, mortality, and treatment failures, remains a relentless illness with heavy burden on patients, their families, and society. Therapeutic outcome of depression needs to be significantly improved and overcome the 65% barrier. The best treatments are those that utilize and integrate multiple modalities. The time is ripe for psychiatry to find its transdisciplinary integrative soul and increase treatment effectiveness. Creation and fostering hope, meaning, personal responsibility, spirit of optimism, and commitment can significantly contribute to overall positive response to pharmacotherapy, but in the other way round drug treatment can also contribute to creation and fostering hope, meaning, personal responsibility, spirit of optimism, and commitment. This chapter addresses the concept of creative person-centered narrative psychopharmacotherapy (CP-CNP) as a transdisciplinary integrative strategy for improvement of the therapeutic effectiveness in patients with depression.

Creative, Person Centered Narrative Psychopharmacotherapy (CP-CNP): From Theory to Clinical Practice.

Modern psychopharmacotherapy is a hot and controversial topic, glorified by some and vilified by others within the field of psychiatry that is by itself deeply divided and stigmatized. Mental disorders are multifactorial and polygenic phenomena with polymorphic clinical manifestations and poorly defined endophenotypes. They are characterized with high rate of morbidity, comorbidity, disability, mortality, and treatment failures. These relentless and commonly tragic disorders represent heavy burden on patients, their families and society and there is an urgent need to improve treatment successfulness in psychiatry. The best treatments are those that utilize and integrate multiple modalities. The time is ripe for psychiatry to find its transdisciplinary integrative soul and increase treatment effectiveness. Creation and fostering hope, meaning, personal responsibility, spirit of optimism and commitment can significantly contribute to overall positive response to pharmacotherapy, but in the other way round drug treatment can contribute to creation and fostering hope, meaning, personal responsibility, spirit of optimism and commitment. This paper addresses the concept of creative person-centered narrative psychopharmacotherapy (CP-CNP) as a transdisciplinary integrative strategy for improvement of the therapeutic effectiveness in patients with mental disorders. CP-NCP represents a set of tools that can allow higher effectiveness and efficiency in treatment of major mental disorders in a systemic way.

Psychiatria Danubina and Challenges of the COVID-19 Pandemic: The Answer Is in the Knowledge, Empathy, Coherence and Global Ethics.

The COVID-19 pandemic crisis is cruel but crucial lesson for the future of humankind. This crisis involves very complex events, complex in its origin, its spread, its effects and its consequences at multiple levels and fields with a big impact on people's mental health. On the other side, the quality of our individual, collective and public mental health is very important for successful fighting against the COVID-19 pandemic and infodemic. For a better public and global mental health we need a common background, common values and virtues on which we agree and follow them. Knowledge, ethics, empathy, coherence, solidarity, cooperation and unity are the key factors to long-term survival and flourishing of humankind. COVID-19 pandemic and infodemic can be effectively overcome only in spirit of common ethic and mutual empathy, respect, trust and public/global cooperation sowing the seeds for humanistic self, compassionate society and empathic civilization, rather than blaming, scapegoating and xenophobia. The Psychiatria Danubina focus is on expanding the world's collective knowledge and promoting mental health through the culture of empathy and global ethics.

SCIENCES, ARTS AND RELIGIONS: THE TRIAD IN ACTION FOR EMPATHIC CIVILIZATION IN BOSNIA AND HERZEGOVINA.

From historical or traditional perspective sciences at one side and arts and religions on the other side are strictly divided epistemology fields with no much mutual engagement and understanding. Digital revolution is changing significantly all fields of science, art and religion changing regimes and methods of knowledge and values production, communication and relationships. Big Data approach promises to provide the scientific Holy Grail, a single overarching theory or multiple theories and models that unify all the scientific disciplines from biology snd neuroscience to music and spirituality. Brain is place where biological, psychological, social and spiritual mechanisms meet each other and interact. Global empathic civilization seems to be a key to the very survival of humankind and life on our planet. Spiritually integrated sciences, arts and religions in creative dialogues and synergy as allies can significantly contribute to the healing of our broken world and promoting compassionate society and empathic civilization.

MUSIC, RELIGION AND HEALTH; A SCIENTIFIC PERSPECTIVE ON THE ORIGIN OF OUR RELATIONSHIP TO MUSIC.

Why do we react emotionally to music? Does music appreciation have an adaptive value? What is the role of music in spiritual and healing practices? Music is a fascinating area of research for evolutionary theory, psychological development, and emotional perception and elicitation. It is a highly valued feature of all known living cultures and societies, pervading many aspects of daily and devotional life and playing many roles. The question that still lingers among music researchers however is why is this so. This paper will discuss the influence of music on our emotional life, psychological wellbeing, spiritual practices and finally on physiological processes present in our body. The aim is to examine the origin of our relationship to music through the mentioned perspectives and to attempt to link the various theoretical perspectives on this subject across two major domains; health and spirituality.

MEDICINE AND PSYCHOLOGY OF IBN SINA (AVICENNA) - A UNIQUE SCIENTIFIC AND RELIGIOUS APPROACH.

Ibn Sina (Avicenna) is primarily known for his philosophy and medicine, but there is almost no scientific discipline in which this great man didn't leave a significant mark. This paper gives a brief overview of his contribution to medicine and psychology through which his unique scientific and religious approach to the study of the phenomena of human being can be best seen. Medical works of Ibn Sina represent a pinnacle of most important medical achievements of his time. These works contain synthesis of all Greek, Indian and Iranian medical schools, but also new breakthroughs achieved by Muslim scholars through their own experimentation and practice. Although he wrote many medical works, his most important one is El-Kanun fit-tib, which can be translated as The Canon of Medicine. It's made out of five books which systematically show everything known in the area of medicine up until that point in time. In it, Ibn Sina discusses, among other things, the structure of psychological apparatus of human being and the connection of psychological functions with the brain. He considered psychology to be very important for medicine, so in his psychological works he discusses, in great detail, the essence of human soul, consciousness, intellect and other psychological functions. He observed a man in his entirety, taking into consideration all aspects of his existence, paying special attention to spiritual knowledge and spiritual perfection, religiosity, and methods of achieving inner peace and well-being.

Meaning and the Sense of Meaning in Life from a Health Perspective.

A personalized and holistic approach to therapy is increasingly demanding answers to questions related to the meaning of life. Over the years, research has shown a direct link between the presence of meaning in life, health and recovery. It becomes impossible to ignore this connection as well as the issues of spirituality and religiosity that are immersed in the meaning of life. The article presents different definitions of meaning, the relationship of meaning in life and parts of meaning to quality of life, allostasis, stress, pathological conditions and recovery, and finally connecting the points between creative psychopharmacotherapy and meaning. A complementary approach to the meaning of life implies a desire for a clear, reliable understanding of three related but different dimensions: continuity (as opposed to fragmentation), purpose (as opposed to pointlessness), and value (as opposed to worthlessness). Creating personal meaning in life structures can provide a context for understanding and integrating stressful situations. Finding meaning means connecting, meaning are the expected connections and associations that human beings see in their world. In this aspect, the construction of meaning is a dimension that we impose on the world. Each person's ability is to decide what makes their life meaningful. The meaning of life is a changing cognitive-emotional framework, directly accessible to subjective assessment based on one's own needs and values. The art of living is to discover in though and painful life situations their true meaning, values and meaning of life, and thus health and disease. Creative psychopharmacotherapy can be used to help patients discover and explore the sensation of meaning, create a new meaning in life, a new life story, manifest their potential through recovery. Mental disorders present a chance to break with misplaced life goals and values and turn to authentic values through new forms of thinking, experiencing, behaving, and creating a successful life.

Mentalization and Change of Perception in the Context of Creative Psychopharmacotherapy Focused on People.

The concept of mentalization is relatively new in modern psychiatry, whose utilization is expanding daily in working with clients suffering from mental illness. Mentalization enables the incorporation of several different theoretical models and therapeutic techniques into a single whole, which encourages a holistic and integrative approach to treating patients. This theoretical model looks at different spheres of mental states, both the client seeking medical help and the doctor himself in the therapeutic process. Consequently, providing an adequate basis for the creation of a therapeutic/working alliance, which is imposed in the age of modern psychiatry, as a "condition without which it is impossible" to achieve the desired therapeutic response. Therefore, it is necessary to creatively implement treatments while creating a "therapeutic/working alliance" between the patient and the doctor in order to improve the therapeutic response and change the patient's perception.

Possible Consequences of Cannabis Legalization - What Do Research Show?

BACKGROUND: Indian hemp (lat. Cannabis sativa subs. Indica) has been used as a source of industrial fiber, seed oil, food, medicine for some somatic diseases, and it is also used as a psychoactive substance. Cannabis can be used by smoking, evaporation, as a food ingredient, or as an extract. Acute and chronic cannabis use has been shown to be detrimental to several aspects of psychological and physical health and many experimental studies done on healthy people indicate the potential of Δ9- tetra hydro cannabinoid (THC) in inducing transient, dose-dependent psychotic symptoms, but also affective, behavioral, cognitive, neurovegetative, and psychophysical symptoms. Cannabis is the most commonly used illegal drug globally. In many communities, cannabis is perceived as a low-risk drug, leading to political lobbying to decriminalize its use. The wave of laws and initiatives to liberalize cannabis use continues to spread across the United States and the rest of the world, and there seems to be a political debate in the background about the potential risks and benefits of cannabis use. Aim is to present the possible consequences that the legalization of cannabis would have from the aspect of mental health and mental disorders. METHODS: Authors reviewed the literature using PubMed resources on the effects of cannabis using the keywords: cannabis use, cannabis use and psychoticism, cannabis use and depression, cannabis use and anxiety, cannabis use and cognition, cannabis use and insomnia, legalization of cannabis. RESULTS: Authors examined the effects of cannabis use on psychiatric disorders and the review of the legal status of cannabis use in the world was also made. The possible consequences of cannabis legalization on the public health system were also considered, based on experiences from countries where legalization has already been done. The evidence cited in this article suggests that strong claims about the need to legalize cannabis are still questionable, and may, even in the long run, remain mixed, inconclusive, or even contradictory. Political interference in this issue can trigger a wide range of unintended but profound and lasting consequences for the health system and the health of the individual. CONCLUSION: We recommend further research on this topic and data collection with an emphasis on the effects and consequences of cannabis use on mental health, and in particular the benefits and harmful effects of medical cannabis use.

The Significance of Understanding Body Language in Depressed Patients within the Context of Creative Psychopharmacotherapy.

Since it is generally known that the human body is the best image of the human soul, this paper aims to explain how important body language is when diagnosing psychiatric diagnosis "depression". It is important to point out the importance of other alternative approaches in the treatment of depression when standard psychopharmacotherapy is not enough. Body language is a powerful form of non-verbal communication that provides important traces of intentions, emotions, and motivations in other people. In everyday life, we collect information about what people think and feel by their body posture, manners, and gestures. Evaluations of clinical depression are traditionally based on verbal information. However, non-verbal expressive behavior, related to reflexive feedback of a person, may reveal negative emotional or social processes that are not fully controlled by patients therapy, along with other artistic therapies (art therapy, drama therapy, and music therapy are other artistic therapies that are applied in Great Britain) offers an attractive opportunity for patients because it enables them to work on those issues that are placed on non-verbal and pre-verbal level. Creative psychofarmacotherapy is the concept that involves creativity as its main means. In this context, the importance of physical activity and body movements will be emphasized in the treatment of depression, when regular psychopharmacotherapy is not sufficient. To conclude, the patient has the right to actively take part in creating a therapeutic relationship and responsibly contributes to overcoming psychopathology. The importance of physical activities and body movements is emphasized in the treatment of depressive people. Studies have shown that the anti-depressive effect of physical activity is increased with simultaneous use of antidepressants, as well as that movement therapy and music therapy, together with regular pharmacotherapeutic methods, help with fast recovery and that they can be used in a creative approach to problem-solving.

Emotional Contamination in the Context of Creative Psychopharmacotherapy.

It is well known that emotions have always attracted the special attention of both laymen and scientists because life without emotions is unthinkable. Emotions prepare us for all life circumstances regardless of their qualities and intensities. Reviewing the available literature, the authors described the phenomenon of emotional contamination and its importance in interpersonal relationships with a focus on "infecting" other people's emotions. Research has shown that individuals mimic facial expressions as well as other emotional reactions of others by emotional contamination in interaction with another person manifesting emotional behavior, and in such situations mimic model reactions, with the perception of their own reactions eliciting an appropriate emotional state. They stressed the importance of patient's perceptions of the emotions of the physicians treating them and the caring attitude that is crucial to contributing to treatment outcomes in clinical practice. Specific expectations between the patient and his physician, when they meet and achieve a physician-patient relationship, reduce uncertainty, and play a useful and crucial role in healing. A caring emotional practitioner who can effectively connect with patients is a huge boon to health. The connection of emotional contamination with creative psychopharmacotherapy and with several therapeutic options is especially described, determined in different ways either through narrative psychopharmacotherapy, through assertive and positive communication, creating a favorable and positive therapeutic relationship whereby a partnership is created, which together leads to the main goal, which is the successful treatment of the patient to the mutual satisfaction. It is useful for patients to have a doctor who spends more time with them and listens carefully and, with adequate emotions, strongly and effectively facilitates treatment. They conclude that emotional contamination is a phenomenon that happens every day in life, especially in specific situations, and that it is up to professionals to use this type of therapeutic opportunity and assistance in the right way to help their patients and be creative in a psychopharmacotherapeutic sense.

Acceptance and Change as Dialectic of Recovery: Examples of Storytelling, Fairy Tale and Psychopharmacotherapy as Therapeutic Modalities.

"Narative medicine" promotes theraputic healing and recovery using fairy tales and traditional folk stories. Individuals are capable of shaping their lives through various narrative strategies and re-authoring alternative stories that are concerned with different aspects of acceptance and change. Psychotherapy through the eyes of stories and fairy tales can have two perspectives. Firstly, fairy tale acts like a weft around which the very story/script of the patient is formed, which in itself becomes the basis for interpreting the occurrence of a mental disorder. The second perspective is the perspective of healing or getting out of a "fairytale" story/script by changing an incoherent life narrative into an alternative coherent narrative (reframing). The aim of this pilot case studies approach was to use a narrative approach based on stories and fairy tales in order to promote psychological growth, meaning in life, resilience, self-realization and improved well-being and highlight the dialectic of recovery, an interplay of acceptance and change (reframing). With properly applied personalized narrative psychopharmacotherapy, the patient is capable of changing their beliefs in order to reach a new meaning of life, and thus to facilitate the lowering of symptomatology, its dissaperance and possibly even a cure, whatever that may mean for an individual. Considering its promising results, clinical implications and possible further applications are discussed.

Psychopharmacotherapy and the Hero's Journey: Mental Health Medicines and Script Change.

The concept of a script in Transactional Analysis (TA) can be considered as the basis for the occurrence and duration of mental disorders. As such, a script change can be the solution leading to improved mental health and well-being. In addition to redecision therapy, offered by TA, there are other techniques for changing the script. One of them is the psychotherapeutic technique, The Hero's Journey, by Robert Dilts, developed from Joseph Campbell's idea of a single myth; i.e. a monomyth, which is in fact the narrative of all narratives. It is this model of all myths that is actually a story about the meaning of life, which is exactly what gives the patient the power to achieve the goal. This goal is also the cornerstone of all existential psychotherapeutic modalities. Life can be viewed as a journey in which each chooses their own path by choosing their own goals, in any sphere of life; private, professional, or other. Misalignment of goals or failure to achieve them can cause mental disorders, leading to a loss of the meaning of life and with this loss, one's goals. When illness appears on the journey, the treatment itself becomes the journey. By applying personalized psychopharmacotherapy and removing the symptoms of the disease, further treatment aims to help the patient enter stabilization and socialization. In this phase of treatment, the hero's journey becomes a therapeutic journey. Through setting new goals and thus changing the meaning of life, the patient is introduced to the last phase of disease prevention, where health becomes a life goal through metaphors of achieving various personal goals. The synergy of both approaches can bring the patient into a state of remission that becomes a permanent state as the patient has established their own goals, felt fulfilled and found their own meaning and purpose in life using motivation, creativity and their forgotten or neglected resources and potentials.

Creative Person-Centered Psychopharmacotherapy in the Context of Prenatal Psychiatry - Dilemmas and Challenges.

The authors presented a psychopharmacotherapeutic approach to the treatment of women in the prenatal period that requires a personalized, person-centered treatment plan. Treatment should include care for the mental health of women of childbearing age, pregnancy planning, during the prenatal period, and then during the postpartum period. The authors highlighted creative psychopharmacotherapy which is the foundation of holistic and integrative treatment of mental disorders. They emphasize the significant role of the mother in the emotional development of the child, which begins while the child is still in the womb. Mothers who stop taking psychotropic drugs during pregnancy have an increased risk of recurrence of the mental disorder after childbirth because the mother's psychiatric illness is not a benign event and can cause significant morbidity for both the mother and her child, therefore, discontinuation or denial of medication during pregnancy is not always the safest option. For more serious disorders, such as schizophrenia, bipolar disorder, and severe depression, medications may be needed during pregnancy and lactation, despite complex evidence based on the effects of psychotropic medications on the fetus and newborn. Perinatal mental health has become a significant focus of interest in recent years. The randomized controlled examinations provide evidence of the effectiveness of psychological and psychosocial interventions at the individual level. It is necessary to make a new conceptual shift in the approach to maintaining the mental health of pregnant women and newborns, and that is to optimize the mental health of pregnant women, and not simply reduce the symptoms of mental disorders from which they suffer before conception, during pregnancy and after childbirth. Dilemmas and challenges of psychopharmacotherapeutic treatment in the prenatal period are intensified by the knowledge that the psychological difficulties of mothers can significantly affect the integrity of the safe relationship between mother and child, which is essential for the emotional, cognitive, and behavioral development of the child. Often, these problems existed before pregnancy or occurred during pregnancy, and they are often the deterioration of the mental state due to discontinuation of pharmacotherapy during this period. The quality of the biopsychosocial milieu in the fetal period and childhood during the early neuroplastic development phase is one of the determinants of risk for diseases during the life cycle. For this reason, the mental health of pregnant women and mothers must be optimized. For many of these women, health is optimized with pharmacotherapy.

Gambling Disorder as an Addictive Disorder and Creative Psychopharmacotherapy.

Addiction does not mean "addiction to substances" only. At the core of the definition of substance dependence is the loss of control. Gambling addiction belongs to non-substance / non-chemical addictions or behavioral/behavioral addictions. The concept of behavioral addictions is new and revolutionary in psychiatry. Gambling addiction, formerly pathological or problematic gambling occurs due to loss of control over gambling. There is growing evidence to suggest that behavioral addictions resemble substance addictions in many domains, including phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment. Behavioral addiction has been proposed as a new class in the Diagnostic Statistical Manual Fifth Revision (DSM-5), but the only category included is gambling addiction. The prevalence of gambling disorders in adolescence is very high and for certain disorders (especially related to the use of the Internet) it becomes more pronounced over time. In this paper, we presented a comprehensive overview of gambling disorders from definition, epidemiology, manifestations, comorbidities, assessment, treatment options, and existing forms of treatment. Given the complexity of the approach to the treatment of gamblers, a creative individualized integrative approach is necessary, which is the basis of creative psychopharmacotherapy. Due to the possibility of the emergence of problem gambling and other impulse-control deficits we need to be very careful when commencing a patient on dopamine replacement therapy or therapy with aripiprazole.