Trauma and suicidality in war affected communities.

PURPOSE: The aim was to assess whether experiences of war trauma remain directly associated with suicidality in war affected communities when other risk factors are considered. MATERIALS AND METHODS: In the main sample 3313 participants from former Yugoslavia who experienced war trauma were recruited using a random sampling in five Balkan countries. In the second sample 854 refugees from former Yugoslavia recruited through registers and networking in three Western European countries. Sociodemographic and data on trauma exposure, psychiatric diagnoses and level of suicidality were assessed. RESULTS: In the main sample 113 participants (3.4%) had high suicidality, which was associated with number of potentially traumatic war experiences (odds ratio 1.1) and war related imprisonment (odds ratio 3) once all measured risk factors were considered. These associations were confirmed in the refugee sample with a higher suicidality rate (10.2%). DISCUSSION AND CONCLUSIONS: Number of potentially traumatic war experiences, in particular imprisonment, may be considered as a relevant risk factor for suicidality in people affected by war.

Course of post-traumatic stress disorder following war in the Balkans: 1-year follow-up study.

BACKGROUND: Prevalence rates of post-traumatic stress disorder (PTSD) following the experience of war have been shown to be high. However, little is known about the course of the disorder in people who remained in the area of conflict and in refugees. Method We studied a representative sample of 522 adults with war-related PTSD in five Balkan countries and 215 compatriot refugees in three Western European countries. They were assessed on average 8 years after the war and reinterviewed 1 year later. We established change in PTSD symptoms, measured on the Impact of Events Scale - Revised (IES-R), and factors associated with more or less favourable outcomes. RESULTS: During the 1-year period, symptoms decreased substantially in both Balkan residents and in refugees. The differences were significant for IES-R total scores and for the three subscales of intrusions, avoidance and hyperarousal. In multivariable regressions adjusting for the level of baseline symptoms, co-morbidity with depression predicted less favourable symptom change in Balkan residents. More pre-war traumatic events and the use of mental health services within the follow-up period were associated with less improvement in refugees. CONCLUSIONS: Several years after the war, people with PTSD reported significant symptom improvement that might indicate a fluctuating course over time. Co-morbid depression may have to be targeted in the treatment of people who remained in the post-conflict regions whereas the use of mental health services seems to be linked to the persistence of symptoms among refugees.

[The role of Islam in the therapeutic rehabilitation process in raped women]. / Mjesto i uloga islama u terapijsko-rehabilitacijskom procesu silovanih zena.

This paper is based on the author's experience from the psychotherapy group of raped women. The paper will present the flow of psychotherapeutic process of the group of women who were the victims of the massive rape during the aggression on Bosnia and Herzegovina. The rape of the women in B&H by the aggressor was a part of the strategy of the genocidal war that occurred recently. The role of Islam in our tradition is seen through the whole psychotherapeutic process. The Islam was the strongest therapeutic factor in the process of reintegration of the raped women's personalities.

[Torture as a cause of onset of psychopathologic disorders and treatment results]. / Tortura kao uzrok nastanka psihopatoloskih poremecaja i rezultati tretmana.

This research has been performed over the torture victims during the aggression against Bosnia and Herzegovina, who because of being under psychotic and somatic symptoms asked for aid in the Center for Torture Victims in Sarajevo. Psychotic and somatic symptoms have been registered in the beginning and at the end of treatment by valid scales and questionnaires. These symptoms clearly indicated psychopathological profile of each subject. The combined treatment with psycho and pharmaco therapy lasted for the three month period and after that the evaluation of the results was done.