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.

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.

Students' mental health during the pandemic: results of the observational cross-sectional COVID-19 MEntal health inTernational for university Students (COMET-S) study.

Introduction: The aim of the study was to search rates of depression and mental health in university students, during the COVID-19 pandemic. Materials and methods: This is an observational cross-sectional study. A protocol gathering sociodemographic variables as well as depression, anxiety and suicidality and conspiracism was assembled, and data were collected anonymously and online from April 2020 through March 2021. The sample included 12,488 subjects from 11 countries, of whom 9,026 were females (72.2%; aged 21.11 ± 2.53), 3,329 males (26.65%; aged 21.61 ± 2.81) and 133 "non-binary gender" (1.06%; aged 21.02 ± 2.98). The analysis included chi-square tests, correlation analysis, ANCOVA, multiple forward stepwise linear regression analysis and Relative Risk ratios. Results: Dysphoria was present in 15.66% and probable depression in 25.81% of the total study sample. More than half reported increase in anxiety and depression and 6.34% in suicidality, while lifestyle changes were significant. The model developed explained 18.4% of the development of depression. Believing in conspiracy theories manifested a complex effect. Close to 25% was believing that the vaccines include a chip and almost 40% suggested that facemask wearing could be a method of socio-political control. Conspiracism was related to current depression but not to history of mental disorders. Discussion: The current study reports that students are at high risk for depression during the COVID-19 pandemic and identified specific risk factors. It also suggested a role of believing in conspiracy theories. Further research is important, as it is targeted intervention in students' groups that are vulnerable both concerning mental health and conspiracism.

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.

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.

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.

Comorbidities and Syndemics in the COVID-19 Age: Challenges and Opportunities for Bringing Separated Branches of Medicine Closer to Each Other.

The Corona Virus Disease 2019 (COVID-19) as a unique disaster has stressed the extreme importance of the three issues for medicine, society and humanity in general: comorbidity, pandemic and syndemic. There are many reasons why the study of comorbidities and syndemics of COVID-19 is of great importance for researchers, clinicians and health policy makers who are responsible for health care organization and funding in a bid to develop more effective and efficient prevention and treatment. Thinking about COVID-19 through a syndemics concept and taking biological, psychological, social and spiritual dimensions into account, physicians could be more effective in clinical practice and community-based interventions. The outcome of SARS-CoV-2 infection is determined by the virus-host interaction, with pathogenicity of SARS-CoV-2 being related to the presence of comorbid diseases. The risk for severe COVID-19 clinical manifestations and death increases with age of patients and comorbidity. General mechanisms of multi-system dysfunction and multi-organ damage reported in COVID-19 are probably related to ubiquitous expression of ACE2 in many tissues and its important role in the renin-angiotensin-aldosterone system (RAAS) functioning. Physicians all over the world should be aware of COVID-19 related comorbidities, multisystem disorders and syndemics, as well as treatment and preventive strategies. COVID-19 age is a right time to reconsider the state of science and practice in comorbidity medicine field from the both epistemological and treatment perspective. Comorbidities and multimorbidities are indifferent to medical specializations, so the integrative and complementary medicine is an imperative in the both education and practice. Shifting the paradigm from vertical and mono-morbid interventions to comorbidity, multimorbidity and multi-system disease approaches enhances effectiveness and efficiency of human resources utilization. The aim of this review is to summarize the theoretical concepts and clinical experience and research regarding comorbidity in general, and specifically related to the COVID-19 pandemic, syndemics and infodemic.

Gambling from Seven Perspectives.

In recent decades, it has been recognized that certain behaviors resemble addictions to alcohol and other psychoactive substances (PAS). Based on the results of research for such behaviors, many authors have found that it is justified to consider them addictions not related to PAS or "behavioral" addictions and that in the classifications of mental disorders should be in the same group with addictions related to PAS. Compulsive activities that may include gambling, Internet use, playing video games, sex, eating, and shopping based on epidemiological and neurobiological characteristics have similarities to PAS addictions. Recognition of clinical and neurobiological similarities between the described behaviors and behaviors related to PAS use resulted in the inclusion of gambling disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and online gaming disorders are classified as conditions for further research. In the 11th revision of the International Classification of Diseases, gambling and gaming disorders are involved in behavioral addictions. Authors presented problem of gambling through sevne perspectives.

Healthy Aging in the Time of Corona Pandemic.

BACKGROUND: The key considerations for healthy aging are diversity and inequity. Diversity means that there is no typical older person. Policy should be framed to improve the functional ability of all older people, whether they are robust, care dependent or in between. OBJECTIVE: The aim of this article is to describe negative influence of Corona pandemic (COVID-19) for realization of the WHO project about Healthy Aging global strategy proposed in the targets "Health for all". METHODS: Authors used descriptive model for this cross-sectional study based on facts in analyzed scientific literature deposited in on-line databases about healthy aging concept of the prevention and treatment of the people who will come or already came to the "third trimester of the life". RESULTS AND DISCUSSION: Some 80-year-olds have levels of physical and mental capacity that compare favorably with 30-year-olds. Others of the same age may require extensive care and support for basic activities like dressing and eating. Policy should be framed to improve the functional ability of all older people, whether they are robust, care dependent or in between. Inequity reflects a large proportion (approximately 75%) of the diversity in capacity and circumstance observed in older age is the result of the cumulative impact of advantage and disadvantage across people's lives. Importantly, the relationships we have with our environments are shaped by factors such as the family we were born into, our sex, ethnicity, level of education and financial resources. CONCLUSION: COVID-19 pandemic "celebrated" one year of existing in almost all countries in the world with very difficult consequences for whole population. But in the first risk group are old people who have in average 6 to 7 co-morbidities. WHO recommended some measures to improve prevention and treatment this category of population, but COVID-19 pandemic stopped full realization of Decade of Healthy Aging project.

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.

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.

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.

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.

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.