Psychological condition hormone levels in war trauma.

Psychological and hormonal responses to various degrees of war-related traumatic experience were analysed in 91 subjects. Their psychological responses (psychosomatic, personality traits, etc.) were evaluated by the COR-NEX2 test. Based on test results, the subjects were classified into three groups: G1 = normal, G2 = moderate, and G3 = severe response. The distribution of subjects in the three groups was related to the intensity and duration of stress that they had been exposed to. Serum levels of cortisol, prolactin, beta-endorphin, thyroxin and triiodothyronine were analysed in all subjects. The levels of cortisol and prolactin were significantly decreased in subjects expressing a severe psychological response, while the level of prolactin correlated with COR-NEX2 test scores. Although relations to other intervening variables are to be investigated, our results indicated that endocrine changes, following trauma, were not random, but rather related to stress-induced psychological responses, and not to trauma per se.

Assessment of post-traumatic stress disorder and comorbidity.

The symptoms of lifetime post-traumatic stress disorder (PTSD) and comorbid diagnoses were compared among 502 combat-experienced soldiers under examination for compensation-related purposes to confirm or deny the diagnosis of PTSD and 196 soldiers with combat experience without any psychiatric disorder. The two groups were matched with regard to duration of combat experience, time between combat experience and the study, age, marital status, and education. PTSD was diagnosed by psychiatrists with a structured clinical interview according to the research version of the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders. The psychologists applied the Mississippi Scale for Combat-Related PTSD, Watson's criteria for PTSD, the Minnesota Multiphasic Personality Inventory version 201, and the Trauma Questionnaire. Also, a very detailed heteroanemnestic questionnaire was completed by social workers. Medical documentation and data from the combat services were provided during the examination for compensation-related purposes. After psychiatric and psychological assessment, 20% of the combat-experienced soldiers under examination for compensation-related purposes were diagnosed with lifetime PTSD, 47% were diagnosed with PTSD and comorbid disorders, 6% were diagnosed with PTSD and enduring personality change, and 5% were diagnosed with adjustment disorder. Twelve percent did not fulfill any diagnostic psychiatric criteria, and 10% fulfilled diagnostic criteria for other psychiatric disorders, although they had previous medical documentation confirming PTSD diagnoses. Correlation coefficients between psychiatric and psychological assessment were significant, indicating their complementarity in reaching the final diagnosis. It is necessary to include many different assessment methods in the examination for forensic or compensation-related purposes to obtain a more objective assessment.

[Prenatal, perinatal and neonatal factors in infantile autism]. / Prenatalni, perinatalni i neonatalni faktori i infantilni autizam.

Analysing prenatal, perinatal, and neonatal complications in autistic children by a specially prepared questionnaire, the authors aimed at establishing whether there is a connection between prenatal, perinatal, and neonatal complications and autism in comparison with normal and mentally retarded children. The results have shown that there is a statistically significant connection of some of these factors with autism in relation to the control group of healthy children, while these differences proved less significant in relation to the group of mentally retarded children. The results obtained partly correspond to the results of similar investigations in the world, indicating a complex etiology of autism.

[The Croatian Society for Infant, Child and Adolescent Psychiatry: present state and proposals for improving the development of child and adolescent psychiatric services in Croatia]. / Hrvatska udruga za dojenacku, djecju i adolescentnu psihijatriju: sadasnje stanje i prijedlog za unapredenje razvoja sluzbe djecje i adolescentne psihijatrije u Republici Hrvatskoj.

The paper presents the current state of child and adolescent psychiatry in the Republic of Croatia. Thirty-seven psychiatrists practicing child and adolescent psychiatry in the entire Republic point to the lack of staff in this subspecialty profession. The subspecialty was approved by the Ministry of Health in 1994. The city of Zagreb satisfies the criteria of some European countries as regards the number of staff, but not as regards the organization of the service for child and adolescent psychiatry (e.g. lack of university hospital department as the base for medical teaching and further specialist training). In other and larger centers in the Republic the situation is well below the criteria achieved in this profession, particularly in the countries of the European Union and the USA. Still, psychiatric services in some towns tend to support the development of child and adolescent psychiatry in their environment by providing facilities and staff. There are still attempts, even in the health service itself, to overcome this lack of personnel and organization by transferring numerous cases from the domain of child and adolescent psychiatry to experts in other medical specialties or non-medical professionals, instead of improving the development of child and adolescent psychiatry. In some countries of the European Union and the USA it has already reached the monospecialty status, a tendency supported by the UEMS, which also makes efforts to coordinate programs of specialist training in the European countries. The described situation certainly has consequences in the of mental health care of children, adolescents and their families, because their treatment often begins only when a disorder has visibly developed. Its clinical manifestations can take very different forms.

[Contribution of anthropologic research to psychiatry]. / Doprinos antropoloskim istrazivanjima u psihijatriji.

Antropologic research comprises the analysis of numerous factors (geographic, lifestyle, model of family life, nutrition, etc.) which by their interaction have influence on human behaviour which is manifested not only in everyday life but having also characteristic forms in the disease and in attitudes toward pathologic changes. The military environment by its specific structure and regional involvement enables antropologic studies since soldiers in demanding military environment, which differs from their previous way of living, react, beside other, under effects of socio-cultural factors of the environment they are coming from. The pilot study of soldiers with psychic crises, hospitalized within 1986-1987 at the Psychiatric Department of the Zagreb Military Hospital has confirmed that soldiers with different socio-cultural characteristics react in the same military environment by different psychopathologic changes which is a challenge for further studies which would contribute to better understanding of some phenomena in behaviour, especially in some characteristic groups, e.g. adolescents, migrants, etc.

Immune, endocrine, and psychological responses in civilians displaced by war.

OBJECTIVES: The objectives of this study were to assess the influence of trauma caused by forced expulsion from home in a war-ravaged region on the psychological, hormonal, and immune responses in displaced persons and to analyze the relationships between psychometric, hormonal, and immunologic variables. METHODS: Participants were 20 displaced and 14 control women. Psychosomatic response was evaluated using the COR-NEX2 test. Serum concentrations of cortisol, prolactin, endorphin, thyroxine, and triiodothyronine were measured by radioimmunoassay. Immunophenotyping and lymphocyte proliferation were determined by flow cytometry, and phagocyte functions (i.e., ingestion and antibody-dependent cytotoxicity) against 51Cr-labeled sheep red blood cells were assessed through radioactivity uptake and release, respectively. RESULTS: In comparison with control women, displaced women had higher COR-NEX2 test scores; higher serum cortisol, prolactin, and endorphin levels; an increase in activated phenotype within all three measured cell populations (i.e., B, T, and natural killer cells); as well as an enhanced proportion of proliferating lymphocytes in freshly isolated samples. However, the phytohemagglutinin-stimulated proliferative response, estimated as the stimulation index, was lower in displaced women. A complex pattern of relations between psychological, hormonal, and immune responses was observed. CONCLUSIONS: Chronic psychological stress elicited multiple, predominantly stimulatory influences on immune functions.