Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries.

BACKGROUND: Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD). METHODS: The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148). RESULTS: About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines. CONCLUSIONS: Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.

Psychophysical and Social Functioning of Patients with Chronic Obstructive Lung Disease and Depression.

The relationship between depression and chronic obstructive pulmonary disease (COPD) is not fully understood. The comorbidity rate ranges from 18 to 84%, and depression is closely related to chronic inflammation, which affects how patients and the people around them perceive their condition. This study aims to examine the relationship between the psychophysical and social functioning of COPD patients who have been diagnosed with depression and the therapeutic benefits of selective serotonin reuptake inhibitors (SSRIs). This prospective study enrolled primary care patients diagnosed with COPD and depression. The entire period of this research was 3 years. The research was conducted at the Primary Health Center, Kragujevac, Serbia, in 87 patients for 8 weeks. The Hamilton Depression Scale (HAM-D) and Questionnaire for Quality of Life and Life Satisfaction Short Form (Q-LES-Q-SF) were used for psychiatric assessment. A positive correlation was found between the psychophysical and social functioning of the participants after 8 weeks of treatment with SSRIs. Based on the value of the phi correlation coefficient (phi = 0.5) obtained using the χ2 test, a large influence was observed in terms of life satisfaction and physical health (p < 0.05). In terms of physical functioning by gender, based on the value of the Pearson's coefficient (r) obtained with the χ2 test, it was shown that physical functioning was superior in the female respondents (p < 0.05). Treatment was found to improve depression in COPD after 8 weeks of therapy.

COPD and Depression Analysis in Regard to Obstructive Pulmonary Levels.

Depression symptoms take place recurrently in patients suffering from COPD. This study aims to assess the effects of antidepressant therapy in patients with COPD and a depressive disorder in relation to COPD levels. The study population consisted of N = 87 patients diagnosed with COPD, according to the GOLD criteria, and a depressive disorder. All of the patients were subjected to clinical and psychiatric exploration according to psychiatric assessment instruments, which was followed by SSRI therapy for the duration of 8 weeks. The main methods used were descriptive statistics and analysis of variance. The results showed a different distribution of depressive symptoms at a different stage of COPD by FEV1 (χ2 = 30.47, df = 6, p < 0.01) and by mMRC (χ2 = 34.6, df = 6, p < 0.01). After the application of SSRIs, there was a significant improvement in HDRS scores in all stages of COPD by FEV1 (χ2 = 251.62, df = 9, p < 0.01) and by mMRC (χ2 = 919.17, df = 9, p < 0.01). This study contributes to the improvement in the quality of life of patients by the targeted application of SSRI therapy and, therefore, more precise and better overall treatment results.

Clinical decision-making style preferences of European psychiatrists: Results from the Ambassadors survey in 38 countries.

BACKGROUND: While shared clinical decision-making (SDM) is the preferred approach to decision-making in mental health care, its implementation in everyday clinical practice is still insufficient. The European Psychiatric Association undertook a study aiming to gather data on the clinical decision-making style preferences of psychiatrists working in Europe. METHODS: We conducted a cross-sectional online survey involving a sample of 751 psychiatrists and psychiatry specialist trainees from 38 European countries in 2021, using the Clinical Decision-Making Style - Staff questionnaire and a set of questions regarding clinicians' expertise, training, and practice. RESULTS: SDM was the preferred decision-making style across all European regions ([central and eastern Europe, CEE], northern and western Europe [NWE], and southern Europe [SE]), with an average of 73% of clinical decisions being rated as SDM. However, we found significant differences in non-SDM decision-making styles: participants working in NWE countries more often prefer shared and active decision-making styles rather than passive styles when compared to other European regions, especially to the CEE. Additionally, psychiatry specialist trainees (compared to psychiatrists), those working mainly with outpatients (compared to those working mainly with inpatients) and those working in community mental health services/public services (compared to mixed and private settings) have a significantly lower preference for passive decision-making style. CONCLUSIONS: The preferences for SDM styles among European psychiatrists are generally similar. However, the identified differences in the preferences for non-SDM styles across the regions call for more dialogue and educational efforts to harmonize practice across Europe.

Hopelessness and Fighting Spirit Relation with Illness Perception in Breast Cancer Patients / Relación de la Desesperanza y el Espíritu de Lucha con la Percepción de Enfermedad en Pacientes con Cáncer de Mama

Objective: Breast cancer is related to numerous psychological challenges, so the way of coping with the illness and its consequences may influence the outcome of treatment. Also, while confronting the diagnosis individuals will use their own illness perception in order to evaluate the possibility of healing and that can affect different areas of their functioning. The aim was to examine the degree to which women with breast cancer perceived their illness as threatening, as well as to examine potential predictive power of illness perception on strategies of coping with illness (hopelessness and fighting spirit). Method: 102 patients (Mage = 58.64, SDage = 10.143), who were hospitalized at the Center for Oncology and Radiology, for treatment of previously diagnosed breast cancer (Mmonths= 19.07, SDmonths = 23.49), were included in the study. The instruments included sociodemographic questionnaire, medical records, Brief Illness Perception Questionnaire and the Mini-Mental Adjustment to Cancer scale. Results: Patients declared to use fighting spirit more than hopeless style of coping the illness. Model that included Illness perception, Metastasis and Treatment length predicted 16% of Fighting Spirit variance. Model that included Illness perception and Age predicted 39% of Hopelessness variance. Conclusion: Illness perception can predict the tendency to resort to hopelessness and there is a correlation between certain sociodemographic and clinical characteristics with hopelessness and fighting spirit coping styles (AU)

Objetivo: El cáncer de mama se asocia a una serie de cambios psicológicos, el modo de afrontamiento la enfermedad y sus consecuencias puede influir en el resultado del tratamiento. Además, al afrontar el diagnóstico las personas utilizarán su propia percepción de la enfermedad para evaluar la posibilidad de curación, lo que puede afectar diferentes aspectos de su funcionamiento. El objetivo del presente estudio es examinar el nivel en el que las mujeres con cáncer de mama perciben su enfermedad como amenaza, además de examinar el posible valor predictivo de la percepción de la enfermedad en las estrategias del afrontamiento con la enfermedad (desesperanza y espíritu de lucha). Método:102 pacientes (Medad = 58,64; SDedad= 10,143) incluídos en la investigación, todos internados en el Centros de Oncología y Radioradio, para tratamiento (Mmonths = 19,07, SDmonths = 23,49) del cáncer mamario previamente diagnosticado. Los instrumentos incluyeron un cuestionario sociográfico, registros médicos, El Cuestionario Breve de Percepción de la Enfermedad y La Escala-Mini de Ajuste Mental al Cáncer. Resultados: Las pacientes afirmaron que utilizan más el espíritu combativo que la desesperación para afrontar la enfermedad. El modelo que incluía la percepción de la enfermedad, metástasis y duración del tratamiento pronosticó 16% de la divergencia del Espíritu Combativo. El modelo que incluía la percepción de la enfermedad y la edad pronosticó 39% de la divergencia de la desesperación. Conclusión:La percepción de la enfermedad puede pronosticar la tendencia hacia la desesperación; además, existe la relación entre ciertas características sociodemográficas y clínicas y ciertos mecanismos de afrontar la enfermedad, como son la desesperación o el espíritu combativo (AU)

Association between Vitamin D and Cognitive Deficiency in Alcohol Dependence.

There are still not enough findings to elucidate how exactly alcohol use impairs cognitive abilities. Some studies have shown that there is a link between alcohol intake and vitamin D levels, but these findings are inconsistent so further research is needed. The aim of this study was to investigate the association between serum vitamin D levels and cognitive impairment in alcohol-dependent individuals. A case-control study was carried out including a total of N = 132 respondents with a medical history of alcoholism, and healthy volunteers. The Montreal Cognitive Assessment (MoCa) and Addenbrooke's Cognitive Examination-Revised (ACE-R) screening tools were used for cognitive status assessment and serum vitamin D levels analysis (blood samples of respondents). Significant difference (p = 0.022), was found in vitamin D levels in the alcohol-dependent group with cognitive deficiency 13.7 ± 9.4 (ng/mL), alcohol-dependent group without cognitive deficiency 19.5 ± 11.2 (ng/mL) and healthy controls 19.9 ± 11.1 (ng/mL), respectively. Furthermore, vitamin D levels were significantly different across all groups based on MoCa (p = 0.016) and ACE-R (p = 0.004) scores. All three groups exhibited vitamin D deficiency. A significant correlation was found between vitamin D deficiency and cognitive impairment, but it yielded no significant difference in alcohol-dependent individuals.

Mental health services during the first wave of the COVID-19 pandemic in Europe: Results from the EPA Ambassadors Survey and implications for clinical practice.

BACKGROUND: The COVID-19 pandemic caused an unprecedented worldwide crisis affecting several sectors, including health, social care, economy and society at large. The World Health Organisation has emphasized that mental health care should be considered as one of the core sectors within the overall COVID-19 health response. By March 2020, recommendations for the organization of mental health services across Europe have been developed by several national and international mental health professional associations. METHODS: The European Psychiatric Association (EPA) surveyed a large European sample of psychiatrists, namely the "EPA Ambassadors", on their clinical experience of the impact of COVID-19 pandemic on the treatment of psychiatric patients during the month of April 2020 in order to: a) identify and report the views and experiences of European psychiatrists; and b) represent and share these results with mental health policy makers at European level. Based on the recommendations issued by national psychiatric associations and on the results of our survey, we identified important organisational aspects of mental health care during the peak of the first wave of the COVID-19. RESULTS: While most of the recommendations followed the same principles, significant differences between countries emerged in service delivery, mainly relating to referrals to outpatients and for inpatient admission, assessments and treatment for people with mental disorders. Compared to previous months, the mean number of patients treated by psychiatrists in outpatient settings halved in April 2020. In the same period, the number of mentally ill patients tested for, or developing, COVID-19 was low. In most of countries, traditional face-to-face visits were replaced by online remote consultations. CONCLUSIONS: Based on our findings we recommend: 1) to implement professional guidelines into practice and harmonize psychiatric clinical practice across Europe; 2) to monitor the treatment outcomes of patients with COVID-19 and pre-existing mental disorders; 3) to keep psychiatric services active by using all available options (for example telepsychiatry); 4) to increase communication and cooperation between different health care providers.

Internet use during coronavirus disease of 2019 pandemic: Psychiatric history and sociodemographics as predictors.

Coronavirus disease of 2019 (COVID-19) pandemic and related containment measures have grossly affected the daily living and created a need for alternative ways of social communication and entertainment. The aim of this study was to explore the use of various Internet contents depending on sociodemographics and on psychiatric history of participants. This cross-sectional, population-based study is a part of a wider international multicenter study. A total of 1275 participants across Serbia (71.1% of females; average age = 41.81 ± 12.52 years) were recruited using two-level chain-referral sampling method. The participants filled in an anonymous online questionnaire that included questions on sociodemographic data, psychiatric history, and various aspects of increased Internet use since the pandemic. The data were analyzed using a series of multiple logistic regressions. About two-thirds of the sample reported using Internet more during the pandemic. All of the tested regression models, apart from models predicting browsing religion and travel/tourism, were significant, explaining from about 2% (for the contents specific for COVID-19) up to 34.4% (for the sexual content) of variance of use. Reporting a previously diagnosed psychiatric disorder was a significant predictor of greater Instagram use and browsing sexual and sport-related content since the pandemic. To the best of our knowledge, the study is the first to report on the relationship between Internet using and mental health, during COVID-19 pandemic, in the Balkan region. The findings showed various patterns of the increased use of Internet contents since the pandemic referring to both potentially positive and negative Internet influences.

The Impact of Immunological Factors on Depression Treatment - Relation Between Antidepressants and Immunomodulation Agents.

It is determined that 30% of patients with depression are resistant to antidepressant medication. The increased concentration of inflammation factors, such as C-reactive protein, and pro-inflammatory cytokines, have been detected in serum in these patients. It is necessary to establish new therapeutic possibilities and protocols that are created to overcome the difficulties caused by increased concentration of inflammatory biomarkers in depressive patients. The Selective Serotonin Reuptake Inhibitors (SSRIs) are considered to be the most powerful antidepressants, increasing the level of serotonin in endogenous depression, as well as in that caused by immunological mechanisms. It is believed that agents that influence cytokines, immunological signal pathways and cytokine syntheses, like the inhibitors of cyclooxygenase enzyme and other non-steroidal anti-inflammatory drugs (NSAIDs), are very important in the potential treatment of residual symptoms of depression. Treatment with cytokine antagonists is one of the potential adjuvant therapies, along with antidepressants. Signal pathways blockers, such as the inhibitors of cyclooxygenase and other NSAIDs, are in the phase of research, in terms of their antidepressant effects. Also, it has been shown that the inhibition of indolamin-2,3 deoxygenase (IDO) and kynurenine (KYN) signal pathways in the synthesis of neurotransmitters, by application of IDO antagonists, are leading to suppression of pro-inflammatory cytokine effects. Antidepressants may have anti-inflammatory effects, depending on dose and type, and they achieve this effect through the decrease of pro-inflammatory cytokine production and increase of anti-inflammatory cytokines. Also, antidepressants modulate the humoral and cellular immune system. This work aims to summarise certain neurobiological and neuroimmunological specificities that have been observed in patients with depression, antidepressants and immunomodulation agents. The understanding of complex and heterogenic pathophysiology of depression through the prism of the altered immune system, is of major importance, in terms of better optimisation of pharmacotherapy, and options for a personalised approach in depressive disorder treatment.

The prevalence and socioeconomic correlates of depressive and anxiety symptoms in a group of 1,940 Serbian university students.

UNLABELLED: BACKGROUND/AIM. Mental health of university students is under increasing concern worldwide, because they face challenges which predisposes them to depression and anxiety. The aim of this study was to identify demographic and socioeconomic variables associated with depressive and anxiety symptoms among university students. METHODS: This cross-sectional study on 1,940 university students was performed using a questionnaire including demographic and socioeconomic variables, Beck Depression Inventory and Beck Anxiety Inventory. RESULTS: The prevalence of depressive symptoms in students was 23.6%, while the prevalence of anxiety symptoms was 33.5%. The depressive symptoms were significantly related to the study year (p = 0.002), type of faculty (p = 0.014), satisfaction with college major choice (p < 0.001), satisfaction with grade point average (p < 0.001). Female students (odds ratio--OR = 1.791, 95% confidence interval--CI = 1.351-2.374), older students (OR = 1.110, 95% CI = 1.051-1.172), students who reported low family economic situation (OR = 2.091, 95% CI = 1.383-3.162), not owning the room (OR = 1.512, 95%CI = 1.103-2.074), dissatisfaction with graduate education (OR = 1.537, 95% CI = 1.165-2.027) were more likely toshow depressive symptoms. The anxiety symptoms were significantly related to study year (p = 0.034), type of faculty(p < 0.001), family economic situation (p = 0.011), college residence (p = 0.001) satisfaction with the college major choice (p = 0.001), and satisfaction with graduate education(p < 0.001). Female students (OR = 1.901, 95% CI =1.490-2.425), and students who reported parents high expectations of academic success (OR = 1.290, 95% CI =1.022-1.630) were more likely to show anxiety symptoms. CONCLUSION: This is one of the largest study examining mental disorders in a sample of university students in Serbia. These findings underscore the importance of early detections of mental problems and prevention interventions in university students.

Modulation of spin accumulation by nanoscale confinement using electromigration in a metallic lateral spin valve.

We study spin transport in lateral spin valves with constricted channels. Using electromigration, we modulate the spin accumulation by continuously varying the width of the non-magnetic (NM) channel at a single location. By fitting the non-local spin signal data as a function of the NM channel resistance, we extract all the relevant parameters regarding spin transport from a single device. Simulations show that constricting the channel blocks the diffusion of the accumulated spins rather than causing spin flipping. This result could be used to improve the design of future spintronic devices devoted to information processing.

The effect of antipsychotic drugs on nonspecific inflammation markers in the first episode of schizophrenia.

BACKGROUND/AIM: Immune system disorder, including inflammation, takes a significant place when considering still unclear etiology of schizophrenia. The aim of this study was to determine the blood levels of nonspecific inflammation markers in the first episode of schizophrenia and their relation to the therapy response. METHODS: In this study we determined the blood levels of nonspecific inflammation markers: white blood cells count (WBC), C-reactive protein (CRP), erythrocytes sedimentation rate (ESR) and the elements of differential white blood cell counts (or the leukocyte formula): granulocytes (Gra), lymphocytes (Lym) and monocytes (Mon), in the first episode of schizofrenia, in 78 patients hospitalized at the Clinic for Psychiatric Disorders "Dr Laza Lazarevic" in Belgrade. The levels were measured at admission to the clinic, as well as after 4 weeks of antipsychotic treatment. The Positive and negative syndrome scale for schizophrenia (PANSS) was applied to measure the severity of psychopathology and response to the treatment. RESULTS: During the first episode of schizophrenia, before initiation of antipsychotic treatment, the frequency of abnormal values was high (≥ 25% of the patients) for the following non-specific inflammation markers: WBC, CRP, ESR and Gra, in the leukocyte formula, but dropped after 4 weeks of antipsychotic treatment at the level of high statistical significance for WBC and Gra (p < 0.001). The ESR remained unchanged in as many as 50% of the patients even after 4-week antipsychotic treatment, at the level of statistical significance in the non-responders compared to the responders (p = 0.045). CONCLUSION: The obtained results indicate that in the first episode of schizophrenia the blood levels of non-specific inflammation markers (WBS, CRP, ESR and Gra from the leukocyte formula) were high in the subpopulation of patients with the tendency towards normalization of inflammation parameters after a 4-week antipsychotic treatment.

Surgical treatment of intradiploic epidermoid cyst treated as depression.

INTRODUCTION: Extradural intradiploic epidermoid cysts are rare, representing less than 0.25% of all primary intracranial tumors. They can be neurologically silent and can only present psychiatric symptoms like depression, cognitive or personality changes. CASE OUTLINE: A 68-year-old male with two year long history of depressive mood, lack of motivation, helplessness, hopelessness and poor response to antidepressive drug therapy was described. CT scan showed a well-defined mass in the parietal scalp with destruction of the scull. He underwent intracranial tumor resection. Surgical resection and cranioplasty were performed. Pathology confirmed intradiploic epidermoid cyst. CONCLUSION: Total removal of these cysts and repeated washing of the cavity with 0.9% saline may prevent recurrence and aseptic meningitis and may improve mental state of the patient. We also emphasize the need for neuroimaging studies in a patient with atypical changes in mental status, even without neurological signs or symptoms.

Ca(2+)-regulatory function of the inhibitory peptide region of cardiac troponin I is aided by the C-terminus of cardiac troponin T: Effects of familial hypertrophic cardiomyopathy mutations cTnI R145G and cTnT R278C, alone and in combination, on filament sliding.

Investigations of cardiomyopathy mutations in Ca(2+) regulatory proteins troponin and tropomyosin provide crucial information about cardiac disease mechanisms, and also provide insights into functional domains in the affected polypeptides. Hypertrophic cardiomyopathy-associated mutations TnI R145G, located within the inhibitory peptide (Ip) of human cardiac troponin I (hcTnI), and TnT R278C, located immediately C-terminal to the IT arm in human cardiac troponin T (hcTnT), share some remarkable features: structurally, biochemically, and pathologically. Using bioinformatics, we find compelling evidence that TnI and TnT, and more specifically the affected regions of hcTnI and hcTnT, may be related not just structurally but also evolutionarily. To test for functional interactions of these mutations on Ca(2+)-regulation, we generated and characterized Tn complexes containing either mutation alone, or both mutations simultaneously. The most important results from in vitro motility assays (varying [Ca(2+)], temperature or HMM density) show that the TnT mutant "rescued" some deleterious effects of the TnI mutant at high Ca(2+), but exacerbated the loss of function, i.e., switching off the actomyosin interaction, at low Ca(2+). Taken together, our experimental results suggest that the C-terminus of cTnT aids Ca(2+)-regulatory function of cTnI Ip within the troponin complex.

Magnetic field dependence of non-local lateral spin-valve signals beyond the Hanle effect.

We present a theoretical model of spin transport in metallic lateral valves that takes into account spin scattering on magnetic impurities. We show that the model agrees with recent experimental findings of increasing non-local spin signals by in-plane magnetic field, which is parallel to the injected spins. The increase arises due to reduction of conduction electron spin flips on magnetic impurities present at the metal-ferromagnet interfaces as they freeze out under application of the magnetic field.

Micromechanical thermal assays of Ca2+-regulated thin-filament function and modulation by hypertrophic cardiomyopathy mutants of human cardiac troponin.

Microfabricated thermoelectric controllers can be employed to investigate mechanisms underlying myosin-driven sliding of Ca(2+)-regulated actin and disease-associated mutations in myofilament proteins. Specifically, we examined actin filament sliding-with or without human cardiac troponin (Tn) and α-tropomyosin (Tm)-propelled by rabbit skeletal heavy meromyosin, when temperature was varied continuously over a wide range (~20-63°C). At the upper end of this temperature range, reversible dysregulation of thin filaments occurred at pCa 9 and 5; actomyosin function was unaffected. Tn-Tm enhanced sliding speed at pCa 5 and increased a transition temperature (T(t)) between a high activation energy (E(a)) but low temperature regime and a low E(a) but high temperature regime. This was modulated by factors that alter cross-bridge number and kinetics. Three familial hypertrophic cardiomyopathy (FHC) mutations, cTnI R145G, cTnI K206Q, and cTnT R278C, cause dysregulation at temperatures ~5-8°C lower; the latter two increased speed at pCa 5 at all temperatures.

Facilitated cross-bridge interactions with thin filaments by familial hypertrophic cardiomyopathy mutations in α-tropomyosin.

Familial hypertrophic cardiomyopathy (FHC) is a disease of cardiac sarcomeres. To identify molecular mechanisms underlying FHC pathology, functional and structural differences in three FHC-related mutations in recombinant α-Tm (V95A, D175N, and E180G) were characterized using both conventional and modified in vitro motility assays and circular dichroism spectroscopy. Mutant Tm's exhibited reduced α-helical structure and increased unordered structure. When thin filaments were fully occupied by regulatory proteins, little or no motion was detected at pCa 9, and maximum speed (pCa 5) was similar for all tropomyosins. Ca(2+)-responsiveness of filament sliding speed was increased either by increased pCa(50) (V95A), reduced cooperativity n (D175N), or both (E180G). When temperature was increased, thin filaments with E180G exhibited dysregulation at temperatures ~10°C lower, and much closer to body temperature, than WT. When HMM density was reduced, thin filaments with D175N required fewer motors to initiate sliding or achieve maximum sliding speed.

[Pharmacotherapeutical possibilities in mental disorders: current status in Serbia].

The new therapeutical approaches have direct implications on living in order to accomplish remission, stop further progression of illnesses or improve the quality of life. The life expectancy has been increased up to 10 years in the last 55 years, probably owing to the innovative drugs. The innovative drugs application in our everyday clinical practice should be analyzed, related to economical aspects and to the transitional status of a country, but also in the context of fears and misconceptions of therapists. The cost of therapy is not equal to the cost of prescribed drugs, however it also includes direct and indirect costs and medical and nonmedical burden. Countries in our region spend 4-7.3% of the total budget for antipsychotic drugs, while the costs in Serbia are about 1.5%. The new antipsychotics and the new formulations of the available antipsychotics in the treatment of schizophrenia are pharmacoeconomically justified. On the other side, the substance abuse needs other strategies, including new substitution treatments. In our country only methadone maintenance therapy is available. It is necessary to provide adequate legislation to improve the process of drug registration. In the European Union it takes from 0 to 400 days for a drug to be registered, but in Serbia the process last longerthan 3 years. Important laws approved in 2006 and 2009, are only a part of the destigmatiazation of patients with mental disorders. Treatment guidelines also help in resolving these issues. Taking all of the above into consideration, the treatment of mental disorders with innovative drugs is financially justified, but still unreachable for patients in Serbia. The voice of the professionals should be heard in these matters in order to provide the adequate treatment of people with mental health problems.

Quality of life of schizophrenic patients treated with haloperidol depot and injection preparation of long-lasting risperidone.

INTRODUCTION: In the last decades psychiatric patients' quality of life attracts great attention of researchers. Improving the quality of life of schizophrenic patients is increasingly becoming an imperative in pharmacological therapy. OBJECTIVE: Analysis of certain aspects of quality of life in patients with schizophrenia treated with depot formulations of a typical antipsychotic (haloperidol) and injection preparation of a long-acting atypical antipsychotic (risperidone). METHODS: Research was conducted as a cross-sectional study that included 60 patients of both genders. Examinees diagnosed with schizophrenia (ICD-10, F20.0-F20.9) were divided into two groups: the group of patients that received haloperidol depot (n = 30) and the group of patients that received injection preparation of long-acting risperidone (n = 30). In order to assess the quality of life, social functioning scale (SFS), satisfaction with life scale (SWLS), and short version of World Health Organization quality of life scale (WHO-QoL-Brief) were applied. RESULTS: Results showed statistically significant differences when it comes to social activity and satisfaction with life in favour of patients treated with injection preparation of long-acting risperidone. Examinees from this group were much more satisfied with themselves, their health and sleep compared to those on haloperidol depot. There was no statistically significant difference found on the quality of life scale. CONCLUSIONS: Applying the scales for the assessment of the quality of life of schizophrenic patients in terms of psychosocial functioning, statistically significant difference between groups was found. Results showed higher scores in the group of patients treated with injection preparation of long-acting risperidone concerning social activities and life satisfaction.

Differentiation between opiate addicts in relation to judicial problems.

INTRODUCTION: Some research results point to significant benefit in the use of methadone substitution treatment in reduction of criminogenic activities in opiate addicts, as in positive affect on their somatic and mental state. OBJECTIVE: The objective of the study was to indicate factors which lead to criminogenic activities in addicts with judicial problems before entering substitute, methadone program. METHODS: Addicts were divided into two groups: addicts who had judicial problems before they entered substitution methadone program (group A-46 addicts) and addicts withoutjudicial problems (group B-20 addicts). A questionnaire containing basic data about the addicts in the treatment program (Pompidou questionnaire) was for questioning. RESULTS: A statistically significant difference was recorded related to the way of taking PAS. The largest number of examinees from the group A took primal PAS intravenously (41; 89.1%), while from the group B 11 took it intravenously (55.0%). The majority of examinees in the group A committed the first criminal act before taking PAS (psychoactive substances) (19; 41.3%), then after taking so-called harder PAS (16; 34.8%), and finally after taking the so-called lighter PAS (11; 23.9%). In somewhat over half of the examinees in the group A (24; 52.2%) the measure of juvenile court was imposed. A suspended sentence was passed upon 19 (41.3%) examinee, then prison sentence in 16 (34.8%), multiple prison sentences in 6 (13.0%) and misdemeanour in 4 (8.7%). CONCLUSION: Future research at our centre should show the efficiency of methadone program in a decrease of risky behaviour, degree of criminogenic activity and judicial problems, improvement of life quality, as well as show the ways for preventive acting.