Showing papers in "Alcoholism and psychiatry research in 2015"

Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Abstract: Title: Diagnostic and statistical manual of mental disorders (DSM-5) Author: American Psychiatric Association Editors of Croatian Edition: Vlado Jukic, Goran Arbanas ISBN: 978-953-191-787-2 Publisher: Naklada Slap, Jastrebarsko, Croatia Number of pages: 936Diagnostic and statistical manual of mental disorders is a national classification, but since its third edition it became a worldwide used manual. [1] It has been published by the American Psychiatric Association and two years ago the fifth edition was released. [2] Croatian was among the first languages this book was translated to. [3] DSM-5 was translated by psychiatrists and psychologists, mainly from the University psychiatric hospital Vrapce and published by the Naklada Slap publisher.DSM has always been more publicly debated than the other main classification - the International Classification of Diseases (ICD). [4] The same happened with this fifth edition. Even before it was released, numerous individuals, organizations, groups and associations were publicly speaking about the classification, new diagnostic entities and changing criteria. [5]Although there is a tendency of authors of both DSM and ICD to synchronize these two classifications and to make them more harmonized with each new edition, there are several differences among them. While ICD covers all the diseases, disorders and reasons for making a contact with the health system, DSM covers "only" mental disorders. Other disorders (medical conditions, as they are named in DSM-5) are not included, except in situations when they lead to a development of a mental disorder. The other main difference is that DSM is more operational zed, and gives criteria for each of the disorders, listing how many criteria have to be met to make a diagnosis of a particular disorder, and what excluding criteria are.Due to the fact that it is used all around the globe and since it has become the most used psychiatric manual, it is sometimes said that DSM is a "psychiatric Bible". [6]Some critics of DSM say that it stigmatizes people and that in each edition it includes more diagnostic entities. It is true that in each edition of DSM there are more disorders listed, but this is due to the fact that medicine is a developing area and new insights are made every year, so some disorders are separated into different subtypes or subgroups and different new diagnoses, giving the impression more behaviour are being pathologized. The intention of the authors was to make more homogenous groups. But, the truth is that, compared with ICD, it is more difficult to get a diagnosis in DSM, than in ICD, with the same clinical presentation. [7] DSM requires functional impairment or distress to pathologize behaviour, while in ICD this criterion is not present in every case.During the process of developing DSM-5 there was an open public discussion. [2] For over a year any person was able to participate in the discussion about future criteria, inclusion or exclusion of diagnostic entities from DSM. More than 21000 letters was sent to the authors. This was the unprecedented way of developing a classification that ICD now tries to follow in preparation of its 11th edition.As a direct consequence of such an open and wide discussion, some new disorders were included (e.g. hoarding disorder), some were excluded even though they were included during the proposal period (e.g. hypersexual disorders), some were heavily debated (e.g. narcissistic personality disorder). [8-10]As previously mentioned, DSM and ICD systems try to harmonize more. There were more non-American authors included in DSM-5 than ever before and some of the experts in the field were in the task force of DSM-5 and ICD-11. [2, 11]What is new in DSM-5, compared to DSM-IV. The organization of the chapters has been changed, so now the flow of the disorders follow life cycle. The book starts with neurodevelopmental disorders, followed by schizophrenia, bipolar and depressive disorders, and closing with neurocognitive disorders. …

Child Abuse and Neglect: Croatian Dental Practitioners’ Experience and Knowledge

Abstract: The aim of this study was to assess the experience and knowledge regarding child abuse and neglect (CAN) amongst the Croatian dental practitioners. Self-administered, structured questionnaire was posted to 500 Croatian dental... Language: en

Serotonin Transporter Polymorphism in Relation to Depression

Abstract: IntroductionMuch has been written about serotonin, its physiology and effects through the course of time but we still cannot claim to know everything about this neurotransmitter. Serotonin is regarded as one of the most important factors in modern psychiatry and therefore is no wonder that many studies deal with serotonin in one way or another. Research regarding serotonin transporter is no exception and this article will try to pro vide a closer and more concise report of research conducted thus far.5-hydroxytryptamine, or just serotonin, plays an important role in neurodevelopment and functioning of the brain. It is involved in regulation of a wide variety of functions and behaviors such as appetite, sleep, mood, motor activity, emotions and altered neuroendocrine function [1]. Serotonin functions as a short-range neurotransmitter, a paracrine neuronal modulator at a number of different receptors and as a long-range signaling modulator. Its effects are multiple and spread throughout the organism via plasma, platelet, neuroendocrine, gut, adrenal and other peripheral systems across many species [2].The serotonin transporter (5-HTT) is a monoamine transporter protein with a crucial role in serotoninergic function. It terminates synaptic actions of 5-HT and transports it from synaptic spaces into presynaptic neurons, effectively recycling it into the neurotransmitter pool [3]. 5-HTT also has a major role in regulation of the homeostasis of spatial distribution and intensity of 5-HT signals with 5-HT receptors [4-6]. Serotonin transporter is encoded by the gene termed SLC6A4 that maps to chromosome 17q11.2. It is composed of 15 exons spanning about 40 kb. The sequence of the transcript predicts a protein comprised of 630 amino acids with 12 transmembrane domains. Alternative promoters, differential splicing involving exons 1A, B, and C, and 30-untranslated-region variability result in multiple mRNA species, as well as specific polymorphisms, that are likely to regulate gene expression SLC6A4 in humans. Best studied is the promoter region polymorphism, 5-HTTLPR, which together with two intrinsic single nucleotide polymorphisms (SNP's) [rs25531 and rs25532], all located upstream of the transcription start site, modulate the transcriptional activity of SLC6A4 [2,7-9]. Additional variants at the SLC6A4 locus include a functional variable number of tandem repeats (VNTR) polymorphism in intron 2 and a number of other coding region SNP's that change the structure or function of the transporter protein, such as I425V and G56A [2,8,1013]. Most of these SNP's are rare [7,14].As mentioned, best studied polymorphisms of the serotonin system are linked with the 5-HTT gene-linked polymorphic region (5-HTTLPR), a repetitive element of varying length located in the promoter region of SLC6A4. It modulates the transcriptional activity of human 5-HTT. Alleles of the serotonin transporter polymorphism are most commonly composed of either fourteen (short or S allele) or sixteen (long or L allele) repeated elements which affect transporter expression and function [15]. However, other alleles have also been identified at low frequency, including 15-, 18-, 19-, 20-, and 22-repeat alleles, with various additional SNPs distinguishing some repeats [16]. More recently, 5-HTTLPR polymorphisms have been researched from a newer viewpoint. Specifically, an A/G nucleotide substitution in the L allele renders the 5-HTTLPR tri-allelic with the functional variants of the L allele designated as LA and LG [17]. Similar was observed for the S allele and it was subdivided into SA and SG18. It was observed that the A variant - LA produces high levels of mRNA and that the G variant - LG is equivalent to the S allele [7,19,20].Other polymorphisms in this gene that have been reported include: functional VNTR polymorphism comprised of 9, 10, or 12 copies of a 16/17 bp element located in intron 2 of the serotonin transporter gene, termed Stin2 VNTR and a single nucleotide polymorphism (SNP) in the 30 untranslated region (UTR) [4,21-23]. …

Differences in the knowledge and attitudes between students of technical and nursing studies towards alcohol and alcoholism

Abstract: IntroductionAlcoholism is the most common type of addictive behaviour. In many parts of the world, consumption of alcoholic beverages is a common feature of social gatherings. However, consumption of alcoholic beverages carries with it the risk of adverse health and social consequences associated with the toxic effects of alcohol intoxication and dependence, which it can cause. [1] As the previous sentence suggests, alcohol consumption in today's world is considered quite normal, moreover, a part of the tradition. But tradition has long been out of control and created one of important problems of today - excessive alcohol consumption, which affects not only the elderly, but also the young population. Every year, the age limit is pushed lower and ever more young people reach for alcohol. The problem of excessive drinking and alcoholism in Croatia is one of the leading problems in public health. It is considered that the main generator of drinking in our society is family - with all its customs that are generationally transmitted and society with high tolerance towards drinking - socially acceptable alcohol consumption. Drinking starts very early, at the age of 14-16 years and the number of alcoholics in the population of women is increased. Data of the Republic registry of alcoholics in Croatia indicates that 3.5-4% of the population suffers from alcoholism. [2]The definition of adolescence suggests that this is a vulnerable period in life of every person, during which the individual assumes the role of an adult. Due to the efforts, fears, pressures of the environment, high expectations and crises, that are characteristic phenomena of adolescent years - a tendency toward alcohol consumption occurs, as a form of escape from life's realities. [3] Consumption of alcohol in adolescence is considered an attempt of creating the individual's identity. European research (ESPAD) on the use of drugs, cigarettes and alcohol from 2011 places Croatia above European average in consumption of alcohol among adolescents, especially in excessive drinking (the way of alcohol consumption in which alcohol is used - as a large number of drinks during a single occasion). Results indicate a higher amount of alcohol consumption in the range of 30 days, as well as a higher amount consumed on the most common day of drinking. The proportion of students who reported that they had engaged in excessive drinking in the past 30 days is also above average. [4] the young drink from the puberty and some of them even before that. Although they drink less often than the adults, they almost always drink with the tendency to get drunk. They do it to identify with their peers, especially those in whose families alcohol consumption is excessive and frequent, and those who come from backgrounds where there is no good education. [5] However, the main problem associated with alcohol consumption among younger age groups is not alcohol addiction, but rather the consequences of its misuse that are manifested in individual behavior, behavior in traffic, poor school achievement, delinquent behavior, aggression, frequent abuse of other addictive substances and traffic accidents. [6] Alcohol abuse leads to unwanted, often violent behavior, injuries, fights, trouble with the law, setbacks in school, study or work, conflicts with family and health consequences. It is not just a consumer that is damaged, but its surroundings as well.Aims of the research conducted on a sample of students of the Technical college in Bjelovar were to explore drinking habits, knowledge and attitudes towards alcohol and alcoholism and to investigate possible differences between the health students and students of the technical field of science.Subject and methodsDuring February and March 2014, 141 (N = 141) students of the Technical college in Bjelovar in Croatia had been examined. 65 of them were mechatronics students and 76 of them were nursing students from all three years of professional study. …

The effect of beverage type on fatal accidents rate in Russia

Abstract: (ProQuest: ... denotes formulae omitted.)IntroductionIt is widely recognized that acute alcohol intoxication is associated with an increased risk for almost all categories of accidents and injuries. [1,2] In many countries alcohol plays a significant role in accidental falls, accidents caused by fire, accidental drowning. [3] A causal link between alcohol and injuries has been established from both individual and population level studies. [4,5] A systematic review of emergency department studies, published between 1995 and 2005, revealed that injured patients were more likely to be positive for BAC at the time they were admitted and to report drinking within six hours prior to the injury event compared with those who had not reported any injuries. [5,6] Of all alcohol-attributable deaths globally, WHO identified 12% as being a result of intentional injuries and 29.6% as being a result of unintentional injuries. [7] There is a dose-response relationship between alcohol and injury, with risk increasing with the increasing amount of alcohol consumed. [3] Alcohol-related accidents and injuries are more closely related to pattern of drinking than to the overall volume consumed. [4,7] There are several studies indicating that binge drinking is associated with high risk of trauma. [8,9] Savola and coauthors [10] reported that binge drinking is a major risk factor for head trauma among trauma patients and that the relative risk for head injury markedly increases with the increasing blood alcohol level. A study from Finland showed an excess of head traumas during weekends and this excess was associated with heavy episodic drinking. [11] Similar weekly variations of head trauma have been reported in other countries where heavy episodic drinking is also the prevailing drinking pattern. [9]The strong support for a causal role of alcohol in accident mortality comes from the aggregate-level studies. Both longitudinal and cross-sectional aggregate-level studies have reported elsewhere a significant temporal co-variation between per capita alcohol consumption and accident mortality rates. [12] An analysis of time-series data for Canada covering the period 1950-1998 revealed a statistically significant association between per capita alcohol consumption and overall fatal accidents rate. [13] Nevertheless, the crosscountry comparisons demonstrate heterogeneity with respect to strength of association between population drinking and accidental mortality. [12] In countries where high level of intoxication is an integral part of the drinking culture, the etiological significance of alcohol seems to be larger. A time series analysis, based on the data for the period from 1950-95 covering 14 European Union countries suggests that an increase in population drinking had the largest impact on accident mortality in northern Europe than in mid-Europe and southern Europe. [6] These findings provided support for the hypothesis, that the effect of alcohol on accident mortality rate is stronger in the northern European spirits countries characterized by a low per capita consumption with the bulk of consumption concentrated on a few occasions (binge drinking pattern), or "dry" drinking cultures, than in the southern European wine countries with a high average consumption which is more evenly distributed throughout the week, or "wet" drinking cultures. Similarly, the results of recent study suggest that changes in per capita consumption have a significant impact on injury mortality in 6 eastern European countries, but the strength of the association tends to be stronger in countries where intoxicationoriented drinking pattern prevails. [14]There is common belief that high level of alcohol consumption in conjunction with binge drinking pattern is a major determinant of accident mortality crisis in Russia. [15] The findings suggest that population drinking and accidental deaths rate are positively related at the population level in Russia. …

Anxieties and Depression Disorders in Composers

Abstract: IntroductionFrom the biographies of more than ten thousand composers and over a thousand pathographies it appears that in the last five hundred years the average lifespan of com-posers was more than sixty years. Composers presented in this work were sorted chronologically by the year of their birth. [1-7] Some pathographies were more deeply elaborated, and all pathographies with diagnoses were shown chronologically in the additional list of composers affected by anxiety and depression. [8-11].Rolande (Orlando) de Lassus (C 1532-1594)Flemish - renaissance conductor and composer. In 1586 his mental and physical health worsened so he withdrew to the countryside, which helped him a lot. In approximately 1590 he became more and more depressed, paranoid, amnesic, leading to dementia. He had a stroke, which resulted in a speech disturbance.Carlo Gesualdo (1560-1613)Italian composer. He married his cousin for dynastic purposes, his wife was a daughter of the marquis of Pescara. She was not a very sincere and faithful wife. So he punished her by killing her. This act forced him to withdraw from the public life and he spent the rest of his life in his castle. Later he mar- ried a niece of the duke and this was another mistake. His marriage failed for the second time, there were conversations that he also killed his younger, maybe illegitimate daughter. All these circumstances caused a severe mental crisis to the point of the break down. A social misfit inclined to masochism, he let himself be whipped. Strangely enough, this was the only way he could empty his body properly. He died three weeks after the death of his only son Emanuel who was born from marriage with Carla, his first wife. He died deeply depressed, probably from the consequences of asthmatic problems when he was 53.Claudio Monteverdi (1567-1643)Italian composer and violinist. There was a tragedy in his family when he was 40, his wife died and left him with two underage children. This resulted with depression and illness and consequently, he became less active. His later activities are tied with Venice. When he was 65, there was another period of depression and illness. It was the time of plague epidemic which eliminated all social activities, therefore orders for musical pieces as well. Whenever there was a hard time for him, he used to return to his family in Cremona, so did he just before his death. He had a need to see his family, hometown and Lombardia in general, since he was most appreciated there. All this was too tense for him, he returned home to Venice already ill and died in fever at the age of 76.Arcangelo Corelli (1653-1713)Italian composer and violinist. He was known as a humble, mild and moral man. Due to frail health he receded from public life, probably after prolonged hardship. It is believed that he suffered from depression, anxiety and melancholy. After he had turned sixty, he died in just three weeks. from a feverish acute illness.George Frideric Handel (1685-1759)German composer, organist and conductor. He was qualified as a man of a big appetite, a trencherman, and it was even said he was apt to drink and change his mood. Thus, in the cases of overworking or failure in his business dealings, and probably due to his picnic constitution and cyclothymia, he was prone to shorter or longer depressive conditions which always ended with decreased activities. His frankness, extrovert nature, cheerfulness up to hypomania were rarely interrupted by deeper depressions, particularly in the years 1729, 1734, 1737, 1742, 1743, 1745, (strokes?, embolisms?, alcohol abuse?). When he was about seventy years old, he was especially down, due to his blindness and impossibility to lead further dynamic life of a performer and composer. He was often sitting "in the dark", feeling bad. If he had lived in modern times of alienation but also of professional developed improvement, he would probably go to see a psychiatrist, more probably because of the expressed disturbances than because of a severe manic-depressive disorder. …

Karl T. Jaspers and Viktor E. Frankl: Compared Thoughts of Two Psychiatrist

Abstract: IntroductionThe topic addressed in this article presents both psychological and philosophical concepts. Both Karl Theodor Jaspers and Viktor Emil Frankl have in fact left a legacy of deep thought which can currently also be valid in many respects and some scientific work [1-3] have already compared specific topics which bring them together. Primarily in the case of the writings by Frankl there are diverse similarities with the concepts comprised in the thoughts presented by Jaspers, which accounts for the idea behind our research.Karl. T. Jaspers (1883-1969), was initially a psychiatrist and subsequently a philosophy professor in Heidelberg and in Basel, in his work he claims that man is capable of making decisions about himself. Man is a postulate, but he is able to shape his own life, since, facing the extreme situations with his eyes wide open, he passes continuously from a possible existence to a real existence. A man is in fact much more than he can know about himself.Viktor E. Frankl (1905-1997), a logotherapist and an existential analyst, the founder of the third school of psychotherapy in Vienna, writes on his having found the meaning of life in helping the others to find the meaning of their life. Through his inexhaustible work he is trying to find the way to help man who, yearning for the meaning and pushed by the will to find a meaning, is looking for an answer to fundamental questions in his life to be able to dedicate it to somtehing or someone.We commence by saying that due to the fact that Jaspers and Frankl were mutually aware of each other's opinions, Frankl had been influenced by Jaspers. He confirmed it personally in his first letter to Jaspers. Moreover, he had been influenced also by other philosophers with whom he shares several aspects of his thoughts (most of them being existentialists).We will especially consider the following: explanation of existence and existential analysis, the perception of meaning according to Jaspers and Frankl, the spiritual aspect and the spirit, the limit situations and the tragic triad, the concept of psychotherapy. Towards the end of this article, before presenting the correspondence between Frankl and Jaspers, we will attempt to highlight, in a systematic way, both the common points and the divergences present in the thought of the two authors. Through presentation of their correspondence, we will also present a comment on a letter by Frankl and on a letter by Jaspers, in order to provide a more comprehensive insight into their content, against the backdrop of all the topics addressed in this article.In order to be able to compare Jaspers' thought and Frankl's thought, we primarily focused on the readings of original texts by the two authors and we also considered the secondary sources, especially the book by Anette Suzanne Fintz entitled Die Kunst der Beratung , Jaspers's Philosophie in Sinn-oreintierter Beratung. In some cases the common points and the divergences between Jaspers and Frankl are evident, yet in others a major effort is required to reveal and compare them.Acquaintance Between Viktor E. Frankl and Karl T. JaspersIn addition to the letters by Frankl and Jaspers, the fact that Frankl and his wife visited Jaspers in Basel in spring of 1961 has also been confirmed. Hence, Frankl reminded in a paragraph "When I paid him a visit in Basel, Karl Jaspers stated: "Mr Frankl, I know all your books, yet the one on concentration camps (and he showed it to me in his librar y) is one of the few great books of mankind"[4]. Consequently, Jaspers was acquainted with the books by Frankl which in turn were influenced by Japers' thought, as had been stated by Frankl in his letter.The events that occurred in the life of both Jaspers and Frankl had a huge impact on their thoughts. Both had worked in psychiatric clinics from their youth, where they faced the reality which reached the depths of human experience - pain, guilt, death, etc. …

Cytochrome p4502D6 and Serotonin Transporter Polymorphism in Patient with Bipolar Disorder Type II

Abstract: IntroductionBipolar disorder (BD) is a complex psychiatric entity, which represents a diagnostic as well as a therapeutic challenge in clinical practice. The very definition and classification of BD is determined by a range of possible clinical presentations, which are sometimes difficult to distinguish from other psychiatric entities by means of a differential diagnosis, for example acute schizophrenic episode, schizoaffective disorder or psychotic depression. Furthermore, BD is frequently comorbid with other psychiatric disorders, especially substance abuse disorders, but also personality disorders or eating disorders, [1-4] which complicate the diagnosis and treatment further.BD can manifest itself for years with recurring depressive episodes before the first manic, hypomanic or mixed episode occurs. The depressive episode of the BD thus frequently remains unrecognised and misdiagnosed as a major depressive disorder (MDD), and therefore inadequately treated with antidepressant monotherapy. According to the current psychiatric classification DSM-V, BD is not diagnosed before an occurrence of a manic or hypomanic episode, while ICD-10 describes, besides a manic and hypomanic episode, a mixed episode in BD as well. [5,6] However, a clinician can consider bipolar depression based on clinical characteristic of depressive episodes. Disease onset before the age of 20, recurrent depressive episodes, which cause the person to be ill most of the time, failure to respond to antidepressants, severe psychomotor retardation, hypersomnia, increased appetite, presence of psychotic symptoms or suicidal ideations are frequently present in patients with bipolar depression. [7,8]Data on prevalence of mood disorders is significantly changing in the last decade. According to past epidemiological data, BD I is responsible for about 2% of prevalence among mood disorders, in the same percentage as BD II. MDD has been diagnosed in 86% of all patients with mood disorders, and non-specific mood disorder in 10% of the patients. Today, we believe that MDD represents 50 % of all mood disorders, BD I about 2%, BD II 15%, while 33% of mood disorders belong to a heterogeneous group of disorders from the bipolar spectrum. [9] Accordingly, it is necessary to adjust the pharmaco-therapeutic approach and introduce mood stabilizers to the treatment if BD or a disorder from the bipolar spectrum is suspected. Special attention should be paid to symptoms of the depressive episode, and all medical history data on patients with depression should be carefully analyzed for evidence of possible episodes of elevated mood in the past.Clinical research has shown that the individual therapeutic response to psychotropic drugs considerably varies, from tendency to develop side effects to therapeutic resistance. In the treatment of a depressive episode, about one third of the patients show no therapeutic response after an adequate therapeutic trial. [8] It is a well known fact the therapeutic response can be affected by different factors, such as the age of the patient, liver or kidney dysfunction, diet, smoking or excessive alcohol use. Recent research shows the lack of response to antidepressant treatment is associated with bipolar disorder, [10] and the association of other psychopathological phenomena with the lack of therapeutic response is also being investigated. However, it is believed that the genetic basis is of key importance for the variability of response to antidepressants. [11,12] Pharmacogenetics studies the influence of specific gene polymorphisms, which are responsible for the function of enzymes important in pharmacokinetics and pharmacodynamics.Biotransformation of most psychotropic drugs in the liver occurs via cytochrome P450 (CYP P450) superfamily, which consists of more than 50 different enzymes. CYP2D6 has an important role in biotransformation of a large number of antidepressants. [13,14] The gene that encodes the CYP2D6 is located at the locus 22q13. …

A comparison of persons with Posttraumatic stress disorder and the normative sample with the Trauma Symptom Inventory

Abstract: IntroductionThe Trauma Symptom Inventory [1] (TSI) consists of 100 items and serves for the evaluation of acute and chronic trauma symptoms which include, but are not limited to, the consequences of rape, spousal abuse, physical assaults, serious accidents and natural disasters, permanent consequences of abuse in childhood as well as other early traumatic experiences. The TSI includes 10 clinical scales and 3 validity scales. The various scales of the TSI assess a wide range of psychological impacts, and five of the ten clinical scales measure symptoms closely related to the Diagnostic and Statistical Manual of Mental Disorders [2] (DSM-IV-TR) symptoms of posttraumatic stress disorder. Clinical scales include not only symptoms typically associated with Posttraumatic Stress Disorder (PTSD), but also those for the Acute Stress Disorder (ASD), and intra- and interpersonal difficul ties often associated with more chronic psychological trauma.In this research we wanted to evaluate the TSI, based on whether it is a good diagnostic instrument for diagnosing PTSD. The TSI does not generate DSM-V diagnoses; instead, it is intended to evaluate the relative level of various forms of posttraumatic distress. In 2014, the American Psychiatric Association revised the PTSD diagnostic criteria in the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders. [2] Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/ numbing symptoms, and hyper-arousal symptoms. Fifth criterion concerns duration of symptoms and a sixth assesses functioning. It is estimated that the prevalence of PTSD in general population is between 1 and 7% (depending on the diagnostic criteria), while in Vietnam veterans, firemen, rape victims, and persons who have been exposed to extreme stressful situations, frequency of PTSD is somewhere in between 20 and 40%. [3-7]In validation studies done by Briere, [8] all of the clinical scales were higher in samples of PTSD group, compared to the normative non-PTSD sample. In the research done by McDevitt-Murphy, Weathers and Adkins, [9] PTSD and non-PTSD groups differed on seven TSI clinical scales and one validity scale, with Cohen's d ranging from 0.26 to 0.53. In that research, the largest effect sizes and best diagnostic utility were found on two clinical scales: Defensive Avoidance and Anxious Arousal scale. We wanted to further investigate, whether the same scales are equally important in Croatian PTSD sample. It is confirmed that there is a substantial evidence of the cross-cultural validity of PTSD. [10] However, evidence of cross-cultural variability in certain areas suggests the need for further research. Also we were interested whether the symptoms stated in the DSM-V for PTSD is also valid and do they have similar frequency in Croatian.The aim of this study was to examine whether the scales are related to PTSD symptoms, and which scales would best predict the diagnosis of PTSD.Subjects and MethodsSubjectsIn this research we gathered the data for 235 participants, of which all of them were males (average age: 33 years) from the community. All of the participants gave their written consent for the participation in this research.The clinical sample consisted of 51 males, between 38 and 61 years of age (average age: 48.5 years). The participants were hospitalized based on a diagnosis of PTSD. All of those patients developed PTSD during the war, as they were Croatian soldiers in the Croatian War of Independence (1991 - 1995).All of the participants completed the Croatian version of TSI. [1]MeasurementThe TSI has a total of 100 items and contains 10 clinical scales. In the manual1 for the TSI are stated the reliabilities for the scales: Anxious Arousal (AA; 8 items, alpha = 0,81), Depression (D; 8 items, alpha = 0,79), Anger/Irritability (AI; 9 items, alpha = 0,87), Intrusive Experiences (IE; 8 items, alpha = 0,84), Defensive Avoidance (DA; 8 items, alpha = 0,87), Dissociation (DIS; 9 items, alpha = 0,78), Sexual Concerns (SC; 9 items, alpha = 0,78), Dysfunctional Sexual Behavior (DSB; 9 items, alpha = 0,81), Impaired Self- Reference (ISR; 9 items, alpha = 0,84), and Tension Reduction Behavior (TRB; 8 items, alpha = 0,54). …

Violent deaths among composers (accidents, drownings and murders)

Abstract: AccidentsAmong the examined pathographies of over 1000 composers, we emphasized the importance of accidents as the cause of death of several composers. Some of the accidents occurred in wars, but the majority of them occurred during peacetime. [1,2] Pathographies are listed according to the chronological order of their occurrence, which points partly to the contemporariness of their etiology. The majority of these composers had died early and consequently. their creative work was suddenly interrupted. [3-7]In the period from 1600-2000 we analyzed pathographies of famous composers/musicians who died in accidents. We emphasize especially pathographies of Alkan, Chausson, Porter, Miller, Kenton. We mentioned pathographies of other composers in table 1. which shows the most important characteristics of composers and types of accidents.Charles Valentin Alkan (1813 - 1888), a French composer and pianist of Jewish origin. At the height of his fame in the 1830s and 1840s he was, among the leading virtuoso pianists in Paris. At the age of seventy-five, he was killed in an accident. Namely, the full bookcase fell on him, while he was trying to reach the copy of Talmud. Alkan died in Paris on 29th March 1888 at the age of 74. [1-9]Ernest Chausson (1855 - 1899), a French romantic composer. [1-6] His orchestral output was small, but significant and included his singular Symphony in B Flat Major, completed in 1890. When only 44 years old, Chausson died while staying at one of his country retreats, the Château de Mioussets, in Limay, Yvelines. Riding his bicycle downhill, Chausson hit a brick wall and died instantly. [9] The exact circumstances remain unclear; although apparently a freak accident, there has been the suggestion of suicide, as Chausson had been suffering from depression for some time. We can conclude that he was killed in bicycle-accident, from which he suffered a serious cranio-cerebral injury. He died relatively young and never reached his creative peak. [10,11]Cole Porter (1891 - 1964) an American composer and songwriter. [1,3,5-7,11] After a serious horseback riding accident in 1937 in Long Island, while he was under the influence of alcohol, Porter was left disabled and felt constant pain, but he continued to work. In this accident he broke both legs. [12] Afterwards he suffered from chronic ulcer and was in chronic pains. Porter's mother died in 1952, and his wife died from emphysema in 1954. By 1958, Porter's injuries caused a series of ulcers on his right leg. After 34 operations, the leg had to be amputated and replaced with an artificial limb. He tried to heal his fears with ethanol and analgesics, which were very damaging to his health. [13,14]Alton Glenn Miller (1904 -1944) an American big band musician, arranger, composer, and bandleader in the swing era. [1,3,5,6] He died in an airplane accident during the flight from London to Paris. There are many controversies surrounding his death. [15] There are four theories about Miller's death in the airplane accident: crash due to bad weather, bombed by English heavy bombers returning from Germany; other sources state that he died from lung cancer in an American hospital, while others mention that Miller died in a French brothel from a heart attack. A 2014 article in the Chicago Tribune reported that, despite many theories which had been proposed, Miller's plane crashed because it had a faulty carburetor. The plane's engine had a type of carburetor that was known to be defective in cold weather and had a history of causing crashes in other aircraft by icing up. The theory that the plane was hit by a bomb jettisoned by Allied planes returning from an aborted bombing raid on Germany is impugned by the log of a plane-spotter which implies that the plane was heading in a direction which would avoid the zone where such bombs were jettisoned. [16,17]Stan Kenton (1911 - 1979), a famous American jazz musician. Stanley Newcomb "Stan" Kenton (1911 - 1979) was a pianist, composer and arranger who led an innovative, influential, and often controversial American jazz orchestra. …

Experience with Hysterical Paralysis of the Legs in Abstaining Alcoholic

Abstract: IntroductionTreatment of persons with alcohol-related problems is neither easy nor simple. A common problem in the treatment of alcoholism is the lack of motivation for change that is often attributed to personality traits and defense mechanisms of alcoholics, but also to the difficulties and challenges in psychotherapeutic treatment [1,2].It is almost the easiest part to achieve abstinence, but the change of lifestyle and quality of life requires re-socialization and rehabilitation with individual and group psychotherapy and family support in self-protection and self-help groups [3]. As alcohol addiction is a systemic disorder, the whole family needs to be involved in the treatment in order to achieve family homeostasis, and also support from colleagues at work, friends and other people close to the patient should be provided for [4,5].I decided to present a case study of an abstaining alcoholic with hysterical paralysis of the legs. At the time when I was studying hypnotherapy and was beginning to believe that it was a discovery of a new way of communication, I was faced with the case of hysterical paralysis of the legs. The case of the abstaining alcoholic is instructive and it taught me again, how important it is to listen to what the patient says, no matter what you think that should be done with the patient according to the opinion of experts.Case StudyA 39-year-old patient, a tailor by profession, married with two children and who had been abstaining from alcohol for some time, was brought to neurological clinic with leg paralysis that had occurred during a phone call. It was not clear what had been going on during the telephone conversation and whether it was only after he had completed the call that he found out that he could not get up. He lived about 30 km from our hospital and four of his workmates carried him to the car and then to the clinic. It was all very dramatic. A neurologist from the clinic called me and told me what had happened to the patient. She thought the case was for me because the neurological examination was NAD. I was surprised that she expressed doubts about the possibilities of psychotherapy. I was not sure whether she was joking or perhaps mocking me. It is easy to practice and imagine what you can do, but what to do with the living man? I said, "Don't send him to me, I don't have a magic wand." But she hung up and sent me the patient. What now? I had to receive the patient. The same four men that had taken him to the hospital brought him to my office and sat him in an armchair. Two other armchairs were occupied by our hospital psychologist who often used to practice hypnotherapy with me and a nurse who was dealing with hospital lists.Not knowing how to begin, I asked the patient: "How are you?" and he pointed with his hand to his chest. "I feel a pressure here." "What kind of pressure?" I asked. He pointed to his chest in the form of two bands, one wider, and the other narrower. "How heavy are those bands?" I continued. "This wider one is around 30 kg, and this narrower one around 10 kg". Now I was already feeling that the patient was leading me somewhere. However, he did not mention his legs at all. I decided not to mention them either. I continued to follow the patient and said aloud "Thirty plus ten is forty. What might be 40 kg heavy?" I asked, and the patient answered "Poles for beans." I was wondering what the "poles" could mean and remembered The Story of Magic Beans - it might be it. I turned to the patient "What happened to the poles for the beans?"He said: "Yesterday I wanted to make some, but I didn't manage ... they called me home ...". The patient was calm and as if in a timeless space. He was in a spontaneous hypnotic trance. "Now what?" I thought, but calmly as we do in a trance continued "I will ask you to imagine that you are now finishing the poles and tell me when you're done." It is hard to say how many seconds passed, but it was all very quickly. …