Repetitive suicide attempts by poisoning in Vojvodina, Serbia - Psychotropic drugs as main causes.

OBJECTIVE: Repetitive acute self-poisoning takes great part of all admissions at the Emergency Department including self-harm as one of the main reasons. The aim of this study is to analyze the characteristics of the patients treated for repetitive self-poisoning with suicidal intent (RSP-SI) in Vojvodina (Serbia), in order to propose preventative strategy and better management of the issue. PATIENTS AND METHODS: The retrospective study included data regarding patients treated for RSP-SI during a 5-year period in Vojvodina, Serbia. RESULTS: Repetitive self-poisoning was determined in 485 patients, of whom 35.05% reported suicidal intention. Mean number of RSP-SI per patient was 3.61±3.08. The mean period between two RSP-SI in group of females and males was 9.69±13.60 and 6.95±11.02 months, respectively. Almost two thirds (65.29%) of them were unemployed. Most of the patients had mental and behavioral disorders due to psychoactive substance use (ICD F10-19; 51.18%) and anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (ICD F40-48; 33.53%). The sole etiological agent was identified in 39.15% attempts. In 58.08% of the attempts more than one substance was detected (2.50±0.73 per attempt). The co-ingestion of alcohol and benzodiazepines was the most common combination (19.41%). Psychiatry intervention was needed in 70.31% of the patients. Five of all patients with RSP-SI (2.94%) committed suicide. CONCLUSIONS: The recognition and the treatment of mental disorders as well as the control of psychiatric medications prescribing could represent one of the most important preventive strategies for repetitive suicidal behavior.

Shared psychotic disorder - a case study of folie à famille.

BACKGROUND: Folie à famille is a rare form of shared psychotic disorder. It is defined as the transfer of delusions from one person to another. CASE REPORT: This paper presents a case of shared psychotic disorder in two brothers, aged 16 and 17 and their mother who were admitted on the same day at the Clinic for psychiatry. The inducer was a mother, suffering from schizophrenia. She transferred her delusions to her sons. Both boys produced mostly the same paranoid delusions, that the others have been recording and monitoring them since their father died. After few days, the older boy, who had more severe psychotic symptoms, was treated with aripiprazole, while both received anxiolytics in low dosage. RESULTS: We observed a withdrawal of psychotic psychopathology in both kids. Genetic burden, social isolation and strong emotional connection of family members are factors that have contributed to the development of shared psychotic disorder in this case. CONCLUSIONS: The new approach of treatment for induced psychosis includes not only separation from the primary case, but also specific pharmacotherapy. It is necessary to think about this clinical entity, because this delusional disorder needs specific treatment, with better prognostic outcomes.

FAMILIAL CIRCUMSTANCES AND PSYCHOLOGICAL CHALLENGES IN ADOLOSCENTS WITH HISTORY OF CHILDHOOD ABUSE.

Violence, child abuse and neglect, which can lead to physical, psychological and social impairment and cause serious long-term consequences, are widespread throughout the world. The aim of our study is to examine the characteristics of the family and the emotional-behavioral difficulties of adolescents who were abused in childhood, compared with those who did not experience abuse. Sixty participants of both genders aged 12 to 18 years were divided into two groups (abused adolescents and the control group). The medical documentation and the self-report questionnaire for youth (SRQY) were used for data collection.The data were analyzed by JASP 0.8.5.1 by ANOVA. 46.67% of adolescents reported that they experienced neglect, 10% physical abuse, 3.33% emotional abuse, and 40% have suffered from several types of abuse. Usually, they are abused by both parents. In abusive families, the average number of siblings, divorced and single parents is higher than in non-abusive families and the level of parents' education is lower compared with the control group.The adolescents with abusive experience have more somatic disturbances, delinquency, and aggressive behavior (p<0.01) than controls.Adolescents with childhood neglect and abuse develop multiple psychopathological difficulties that require psychological and psychiatric intervention to prevent the negative consequences in adulthood.