Trauma and Anxiety Disorders throughout lifespan: Fear and anxiety from normality to disorder.

Anxiety disorders are among the most common mental disorders. Anxiety disorders and neurotic fear cause significant disruption of the psychosocial functioning of the individual. In generalized anxiety disorder, neurotic fear appears in the form of fears, expectations, tension, with nothing specifically uncomprehendingly crying anticipation, worry, poor concentration, psychic and physical fatigue, irritability, restlessness, insomnia, sense of near accident etc. Traumatic events in the life of the individual are often referred to as potential relevant factors in the occurrence of psychological disorders. Exposure to long-lasting traumatic experiences in childhood leads to the prolongation and fixation of the emotional state of fear and sadness and the emphasized use of certain defense mechanisms that contribute to the structuring of specific clinical images of anxiety states.

Psychiatrists' treatment preferences for generalized anxiety disorder.

OBJECTIVE: The objective of this study is to ascertain psychiatrists' treatment preferences for generalized anxiety disorder (GAD) and compare them to the same psychiatrists' treatment preferences in the hypothetical scenario that treatment is to be administered to themselves as patients. METHODS: A questionnaire was completed by 221 psychiatrists from 3 Balkan countries. They were asked to indicate their treatment preferences for patients with GAD and for themselves as patients. RESULTS: A large majority of psychiatrists chose selective serotonin reuptake inhibitors/serotonin and norepinephrine reuptake inhibitors as preferred treatment option for GAD patients. Fewer psychiatrists selected benzodiazepines and pregabalin and about one third chose psychotherapy. The majority of psychiatrists chose the same treatments for their patients and for themselves, with main differences being in terms of pharmacotherapy (especially benzodiazepines) being less frequently recommended and psychotherapy being more frequently recommended as preferred treatment option for psychiatrists as patients. CONCLUSIONS: Treatment preferences for GAD by psychiatrists in the 3 West Balkan countries were mostly in accordance with treatment guidelines and treatment preferences for patients and for psychiatrists as patients were mostly concordant. However, some psychiatrists were more likely to choose pharmacotherapy for patients and psychotherapy for themselves as patients. These findings have implications for education of psychiatrists and for efforts to improve treatment guidelines and mental health services.

Validation of the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) Among Patients with Schizophrenia.

BACKGROUND: The main goal of psychiatric care is not to be focused only on reducing psychopathological symptoms, but on improvement of the patient's quality of life. AIM: To examine validation and reliability SQLS-R4 among patients with schizophrenia. METHODS: The sample consisted of 61 outpatients with schizophrenia attending the Psychiatry Hospital "Skopje". nclusion criteria for subject selection were: 1) age more than 18 years, 2) clinically stable (not acutely ill or has not been recently hospitalized at least for the past 3 months). They completed SQLS-R4 and SF36 questioners. RESULTS: The internal consistency reliability was satisfactory for both the psychosocial and vitality domains (Cronbach's α = 0.928, 0.83). Most of the items were significantly correlated with own scale score (from 0.189 to 0.687). The average of the score for the psychosocial quality life was 39.9 ± 8.6 (sometimes), for the cognition and vitality was 26.5 ± 6.1 (sometimes) (SQLS-R4). There was moderate correlation between SF 36-energy with SQOLS - motivation and energy; SF 36-mental health correlation with SQOLS-psychosocial. CONCLUSION: SQLS-R4 appears to offer excellent potential as an easily administered and patient acceptable assessment and monitoring measure of quality of life (QoL). However, a principle psychometric criterion crucial to the use and validity of the instrument concerns the underlying factor structure.

[Child abuse in panic disorder].

INTRODUCTION: Numerous authors associate child abuse with serious long-term consequences to the general and psychological well-being in particular. Clinical research to date reveals strong correlation between childhood abuse and neglect and anxiety disorders, especially panic disorder. MATERIAL AND METHODS: This study was conducted in order to assess the level of emotional, physical and sexual childhood abuse as well as the physical and emotional childhood neglect in 40 adult patients suffering from panic disorder, diagnosed in accordance with the 10th International Classification of Disorders diagnostic criteria, compared with the control group of 40 healthy test subjects without a history of psychiatric disorders, using the Childhood Trauma Questionnaire. The severity of the clinical manifestation in patients with panic disorder was assessed using the Panic Disorder Severity Scale. RESULTS AND DISCUSSION: There were no significant differences between the groups as to the level of sexual abuse and physical neglect, whereas in the group of patients with panic disorder, the level of physical and emotional abuse was significantly higher, with emphasis on emotional neglect. With regards to the correlation between the severity of the clinical manifestation in patients with panic disorder and the severity of suffered abuse and neglect in childhood age, significant correlation was found in the physical and emotional abuse as well as emotional neglect. There was no significant correlation in the aspect of the physical neglect and sexual abuse. CONCLUSION: Our research underlines the importance of childhood physical abuse, and especially emotional abuse and emotional neglect in the occurrence of panic disorder later in life.

Cross-cultural comparisons of child-reported emotional and physical abuse: rates, risk factors and psychosocial symptoms.

OBJECTIVES: This study was designed to assess the incidence of child emotional and physical abuse, associated risk factors and psychosocial symptoms in a cross-cultural comparison between post-communist bloc countries. METHOD: One-thousand one-hundred forty-five children ages 10-14 from Latvia (N = 297), Lithuania ( N = 300), Macedonia (N = 302), and Moldova (N = 246) participated in the study. They completed questionnaires assessing their experience of emotional or physical abuse, and provided information about family risk-factors and psychosocial symptoms, including PTSD-related symptoms. RESULTS: Incidence rates of maltreatment differed by country, as did levels of reported psychosocial symptoms. Incidence of emotional and physical abuse differed by region, with higher levels of abuse reported in the rural regions. In all four countries, a similar association between emotional/physical abuse and psychosocial symptoms was found, with the uniformly largest correlation between emotional abuse and anger. When examining the combined scores of emotional and physcial abuse, even higher correlation's were found, particularly in relation to anger and depression. In all four countries, parental overuse of alcohol was associated with emotional and/or physical abuse. CONCLUSIONS: Findings show differences by country in child-reported levels of emotional and physical abuse, but similar patterns of correlation with psychosocial symptoms and the risk factors of parental alcohol overuse and living in a rural area.