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Biomedical subjects

N Mandić

Publications and source records attributed to N Mandić.

14 recordsLinked to original sources
PubMed2000

Posttraumatic stress disorder among Croatian veterans: a causal model.

The present study investigates the etiological roles of premilitary risk factors, military entry conditions, war zone experiences, dissociative reactions to war zone experiences and homecoming reception in the development of chronic posttraumatic stress disorder (PTSD) among Croatian veterans. A total of 150 Croatian war veterans with the diagnosis of chronic combat-related PTSD, who sought treatment at Psychiatric Clinic, Osijek, Croatia, in the period 1993-1998, and who provided complete data, were selected as the sample for the present study from the treatment-seeking group of the ex-soldier population. Structural equation modeling is used to develop an etiological model concerning the relationships of premilitary risk factors, military entry conditions, war zone experiences, dissociative reactions, and homecoming reception with current symptoms of PTSD. An etiological model with satisfactory fit and parsimony was developed. In terms of the magnitude of variables' total contributions to the development of PTSD, war zone experiences are the most influential contributor which is followed by dissociative reactions, homecoming reception, military entry conditions and premilitary risk factors. Statistical significant direct effects to the development of PTSD were found for dissociative reactions and low family postwar support. The etiology of combat-related PTSD among Croatian veterans remains largely unexplained. Partial explanations are omission of other etiological factors, retrospective nature of the data and small study sample. The results are the source of questions for further research.

Adult↗
PubMed2000

Osijek Health Center during the 1991-1992 war in Croatia.

To assess the effectiveness of health services in the city of Osijek during the 1991-1992 war in Croatia, we followed the changes in the utilization of health services, morbidity and mortality, and completion of a vaccination plan during the 2 years of the war. We used a retrospective analysis of data from the Osijek Health Center and the Osijek County Institute of Public Health. The organization of health care during the war followed the concept of integrated health care and the instructions of the Ministry of Health. Visits to primary health care physicians decreased considerably, with a concomitant increase in disease and mortality. The plan for mandatory vaccination was not completed because of the evacuation of preschool and school children. The war changed the mode of health care use, the disease and mortality structure, and the implementation of mandatory vaccination. However, timely education and preparation of the health services to the war situation resulted in an adequate provision of health care to the population.

Adult↗
PubMed1999

Symptom structure and psychiatric comorbidity of combat-related post-traumatic stress disorder.

The placement of the diagnostic category of post-traumatic stress disorder (PTSD) among anxiety disorders reflects the recognition that anxiety is a predominant reaction to trauma. Indeed, the symptoms of PTSD overlap considerably with those of other anxiety disorders. The nosological criteria render PTSD as quite a heterogeneous diagnosis. Two individuals with no common symptoms can be diagnosed as having PTSD. In this report we provide information on the phenomenology and psychiatric comorbidity in a sample of 33 patients with combat-related PTSD. The finding of clinical heterogeneity in subjects with combat-related PTSD and the therapy implications are discussed.

Adult↗
PubMed1998

Schizophrenic disorder and social functioning.

Social functioning is assessed according to 84 questioned subjects with schizophrenic disorder and their 84 key figures. Schizophrenic subjects showed significant dysfunction in all reviewed areas of behaviour and social roles. Key figures of all schizophrenic subjects most often showed a positive attitude in regard to the future of the schizophrenic members of their family. In relation to social functioning of the schizophrenic subject and the attitude of family key figures there is a statistically significant difference as well as a relationship. Results of assessment confirmed the impact of family life on social functioning of the schizophrenic patient and stresses the importance of active family support in rehabilitation programs.

Adult↗
PubMed1998

A current psychodynamic understanding of panic disorder.

While there has been burgeoning interest in the psychiatric literature about the phenomenology and biology of panic disorder, there is little new information about the psychodynamics of this condition. The reintroduction of a psychodynamic perspective could be useful in guiding research strategies to identify traits which predispose to panic and in designing treatments to address such traits. A psychodynamic model hypothesizes a relationship between current psychological functioning, early experiences, and ongoing psychological traits. Recent published reports about the nature of underlying psychodynamics and psychological characteristics of panic disorder are discussed.

Adult↗
PubMed1998

Homicides in war and peace in Croatia.

This work shows the interdisciplinary investigation of homicides in the Osijek area during the war and prewar periods. Similarities between the prewar and wartime perpetrators are related to social-demographic characteristics. Nevertheless, significant differences are found in the homicidal method of selection among victims and participation of victims involved. The major contributing factors in homicide genesis were acute alcohol intoxication and personality disorder among perpetrators. Besides these factors, the war stressors and access to firearms were significant factors during the war homicides. Prevention efforts should be directed toward consequential measures and further investigation suggests that the emphasis must be put on victimological aspects of the homicide problem. This work is a review of an interdisciplinary investigation of prewar and war homicides in the city of Osijek district. It provides confirmation of how the number of war homicides relate to the prewar number.

Alcoholism↗
PubMed1997

[Social phobias].

Social phobia is an anxiety disorder which can be found in general and specific subtype in general population from 2.4 to 16%. People who are suffering from social phobia don't have opportunities for optimal development and their quality of life and work productivity is ruined too. Authors showed definition, diagnosis and differential diagnosis, epidemiology, clinical features, quality of life, work and social disability of people with social phobia. Biology and therapy of social phobia are also presented. This paper is based on findings around the world. Authors recommend more attention to social phobia, its specific type which is very rare, as much as one in comorbidity because this disorder can make big economic costs, especially through work disability, which can be changed by early treatment.

Humans↗
PubMed1993

The immediate role of psychiatric staff in the resistance.

The psychiatric staff of the University Department of Psychiatry in Osijek University Hospital played an active and important role during the 1991/92 war. This grew out of the analytical approach to psycho-social relations in the undirectional spiritual state of mind under the communist system of Yugoslavia. The role of psychiatric staff in the resistance against the aggressor was determined by a spontaneous freedom of choice, an aspiration for permanent harmony of moral and legal system, mature interpersonal relations and an awareness of their place in the national community. Psychiatric staff investigate the psychology of a nation, its desires, anxieties and defense and they recognize their role. War makes therapeutical relationships more complex and demands almost daily supervision of the counter-transfer reactions towards the wounded, refugees and other patients who ask for or need psychiatric help. This study comments on the experiences of a group of staff members of the University Department of Psychiatry. In addition, the therapeutical phenomena in their relations with patients are also recognized.

Adaptation, Psychological↗
PubMed1990

Homicide-suicide by stabbing.

It is rare that an assailant kills someone and afterward commits suicide by stabbing himself on the scene. This report describes how a young soldier killed his young girlfriend and then killed himself.

Adult↗
PubMed1990

[Maprotiline and the heart rate].

The increased heart rate is a frequent, seldom clinically significant side-effect of antidepressants. There are different opinions about the Maprotiline influence on the heart rate, either about its very existence or the pathophysiological mechanism of its side-effect. The aim of this study was to test the Maprotiline influence on the heart rate of depressed patients and to compare the results with the results of other studies. The study was carried out in a group of 21 patients with a depressive involutional syndrome treated by fixed daily doses of 150 mg of Maprotiline. The heart rate was estimated in a small sample of examinees using the method of paired observations, as a part of the orthostatic cardiovascular tolerance testing by Schellong's method; this was done before the therapy and twice a week during four week of the application of Maprotiline. The increase in the heart rate in the basal reclining position was noticed in 20 patients. The average value was 16 beats per minute. The increase of the heart rate was not noticed immediately after the application of the first doses but after the latency of 8 days on average. While increasing in the basal reclining position, the orthostatic deviation of the heart rate did not significantly change during the therapy. At the end of the study the orthostatic deviation even showed a negative sign. The reclining of the patients at the end of Schellong's test discovered a frequent occurrence of the prolonged blood pressure return from higher to normal values. The results obtained confirm the thesis that the increased heart rate in the therapy with Maprotiline is due to its noradrenergic activity, in other words, to its ability to block the "reuptake" of noradrenalin in the synaptic cleft. The delay of the heart rate increase in the basal reclining position, a more frequent prolonged blood pressure return in the further phase of the study, and the therapeutic response delay in the treatment of depression are explained by the authors by the same mechanism: by the most probable existence of the pathological changes in the synapses.(ABSTRACT TRUNCATED AT 400 WORDS)

Blood Pressure↗
PubMedDate not supplied

[Post-traumatic stress disorder].

A traumatic experience outside the scope of the usual human experience (flood, earthquake, industrial disaster, fire, road accident, death camp, torture and bombing) results in a certain number of people in a traumatic disorder which was described for the first time in 1980. The third edition of the Diagnostic and Statistical Manual (DSM-III) of mental illnesses published by the American Psychiatric Society gave a definition of post-traumatic stress disorder which was amended in 1987 in the revised edition of the same manual. The same definition has been accepted by the International Classification of Diseases and Causes of Death (ICD-10). The disorder is observed in 30-80% of the survivors of catastrophic events, in 18-54% of the war veterans, in 17-67% of the prisoners of war, and the prevalence in the course of life is 9.2%. The symptoms include reliving the experience of the traumatic event, avoidance of stimuli related to the trauma, generally dulled reactions and a lack of alertness. PTSD etiology comprises the following: stressor (strength, duration and circumstances of occurrence), personality (age, personality traits, previous experience, genetic predisposition, and available social support) and organic factors (effects of autonomic nervous system and neurobiological changes in the brain). The etiology of the understanding of the disorder is supported by the psychoanalytical theories (primary and secondary gain, anxiety neurosis and conflict neurosis) together with the behavioural cognitive theories based on conditioning and the theory of learning.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMedDate not supplied

[Headache in displaced persons from east Slavonia].

The authors investigate the appearance of psychogenic headaches among 150 displaced persons of both sexes, average age 43 years with specific prepared questionnaire (Incidental Report Interview with questions important for the culture of examinees), neurological and psychiatric checkups. Diagnosis of headache was established according to the criteria of the Headache Classification Committee of the International Headache Society. In the group of 150 displaced persons the authors have found 106 (70%), 31 (30%) among males and 75 (70%) among females) psychogenic headaches. Psychogenic headache appeared in 53% of the male cases and was connected with psychoticism (1.7%), conversion (8.3%) and depression (43%), and in 81% of the female cases expression of conversion (4.3%) or a follower of anxiety (10.7%) and depression (66%). Headache is together with anxiety and depression most frequently found in the age groups 31-40 and 51-60 years, among married individuals (76%), and among those with secondary school education (86%). In the group of psychogenic headaches, 13 (42%) males and 23 (30%) females had elements of muscle contraction (tension) headaches, and 9 (29%) males and 8 (10%) females, mainly from the groups 31-40 and 51-60 years with lower educational level had elements of combined vascular and tension headaches. There was a positive correlation between the employment before exile, unemployment in exile, the loss of experience in changing the place of living, leaving home and country under pressure and in peril of death and appearance and intensity of psychogenic headaches.

Adolescent↗
PubMedDate not supplied

[Psychological status of Croatian refugees in Hungary].

This presentation addresses the capability of Croatian refugees from Baranja to acclimatize themselves in the Republic of Hungary. The authors assessed the mental health of 100 refugees through a psychiatric interview using a questionnaire, specifically designed for the purpose of this research. Their ages ranged from 10 to 82 years, average age 38 years. The assessment of mental health of the refugees was conducted 6 weeks following their placement in a camp (social institution) of a small town (Maria Jüd) in Hungary. The authors found that refugees fled their homes and homeland in front of barbarous combined forces of local Serbs whom they identified as terrorists and Yugoslav Federal Army. Leaving homes and country was sudden and unexpected, but by their own will. The departure was accompanied by fear, anxiety, disbelief, despair, anger and rarely by panic behaviour. Fear for children's safety was on the first place, than fear from exposure to violent injury--torture and crippling, while threat for ones own life and life of relatives as well as loss of property were of milder intensity. Among the most dominant feelings refugees manifested during an interview were: home--and homeland sickness and uncertainty about the future. In 61% of the examinees, these feelings prevailed. Forty-two per cent of the subjects experienced emotional and psychosomatic disorders, primarily Beard's "neurasthenic syndrome". Only 5% of the refugees needed psychiatric help, mainly those who had psychic problems before they fled their homes. The authors conclude that Croats from Baranja who took refuge in Hungary had acclimatizational problems even 6 weeks after displacement, which were manifested as emotional and psychosomatic reactions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗