Since 1970, a relationship between cardiovascular morbi-mortality and anxiety disorders has been studied. Endothelial dysfunction is one of the possible mechanisms and has been studied in mental stress. The aim of this study is to compare the levels of two of the best known endothelial damage markers (von Willebrand Factor –vWF- and E-selectin) in patients and controls and its evolution after the treatment.

We recruited a sample of patients with recent onset panic disorder from the Panic Disorder Unit of Cantabria (University Hospital Marques de Valdecilla, Santander, Spain). Data were analyzed with the statistical package SPSS 12.0 and parametric test were used to compare the means (T test for paired and for independent samples).

We obtained measures in 54 cases and 43 age, sex and BMI matched controls. Mean age was 31.3 and 63% were women. Median duration of panic disorder was 7 months. Mean values of the markers were higher in patients than controls (vWF= 78.7 vs. 75.5; p=0.4, and E-selectin= 64.7 vs. 57.8; p=0.3) but did not reach statistical significance. When we analyzed evolution of markers in patients we observed a decrease in both (vWF= 78.7 → 74.6; p=0,058, E-selectin= 62.1 → 57.8; p=0,1) but again without reaching statistical significance.

These results could support our hypothesis of a relationship between the endothelial damage and panic disorder. The lack of statistical significance could be explained because of our small sample; therefore larger samples are needed to confirm our results.

The war in Bosnia and Hercegovina caused a massive psychotraumatisation in female civilian population.In addition the postwar transitional processes are cousing unemplointment,social insecurity, poverty and the disruption of family ties. In that situation the social support, especialy that from family members could play the major role in preventing posttraumatic simptoms.

To find out what are the long term psychological consequences of war psihotraumatisation and how social support influence the psychological outcome in female population in Mostar, BiH wich was exposed to extreme war devastation and postwar etnic division.

Target group was 187 randomly selected females living in Mostar who were exposed to whole spectrum of war traumatic events.The control group were 180 females living in county close to Mostar area wich was not directly exposed to war destruction.A batery of psychological tests were applied to mesure traumatic exposure,psychological symptoms, social support and demografic data.

Femals in target group shows significantly more traumatic experiences (10,3:3,27) and PTSD prevalence(28,3%:4,4%).They experienced more stresfull life events after war,are more often widows or devorced and have lower quality of life.Predictors of PTSD symptoms were level of traumatisation and low support from colegues and friends in target group and low family support and quality of life in controls.

Dissociation is a disruption of the usually integrated functions of consciousness, memory or perception of the environment. Many individuals with PTSD reported dissociative experiences.

In this case-control study, 130 of veterans with chronic PTSD and 130 matched individuals from normal population who had not involved in war were selected. First patients' demographic data were recorded, and then some suggested contributing factors were evaluated.Dissociative symptoms were evaluated via dissociative experience scale (DES). In this scale, score above 30 shows significant dissociation. Respondents were also evaluated by dissociative disorder interview schedule (DDIS) which is a semi-structural interview to discover presence of any dissociative disorder

The mean age±SD of veterans was 41.46±5.09 years. The mean score of DES in case group was 26.01±12.31 and was 9.58±7.23 in control group (F=1.171, P<0.0001). In case group, 74 (56.48%) received diagnosis of dissociative amnesia, 9 (6.87%) had diagnosis of dissociative fugue and 5(3.81%) had diagnosis of depersonalization disorder. Non of control group received additional diagnosis of dissociative disorder. Positive history of self cutting (c2 = 26.35, P<0.001) opioid dependence (c2 = 16.28, P<0.001) were more prevalent in case group.

Additional diagnosis of dissociative amnesia was the most prevalent of dissociative disorders in veterans. It is suggested that many complaint of veterans with chronic PTSD could be rather due to their dissociative symptoms rather than PTSD per se. Similar mechanism which could result in PTSD, in veterans, can prone them to dissociative disorders.

Spirituality - Group psychotherapy - Psycho-traumatized - Bosnia and Herzegovina

To determine the influence of religiosity on mental stability of war veterans after stress situations in Bosnia-Herzegovina war (1992-95).

The sample consists of 98 healthy males aged 20-40 years, with equable educational level. The religiosity level of participants measured with frequency of daily prayers performing, and with inner motivation toward religion. The sample divided in: group of subjects that are highly religious (n=48) who perform prayers every day five times, and another group of subjects who are lowly religious (n=50), who do not practice any daily prayer. For sample selection the measuring instruments were used to assess spiritual, religious, and social profile of subject. For assessment of personality structure were used standardized psychometric tests (Minnesota Multiphase Personal Inventory – MMPI, Profile Index of Emotions – PIE, Life Style Questionnaire - OM) to assess personality profile, emotional profile, and subject's defense orientation.

Regarding MMPI scores: highly religious war veterans presented significantly lower levels for depression (P=0.021), hysteria (P=0.048), psychopathic (P=0.004), and paranoid (P=0.005) than war veterans who were low religious. According the OM scores: highly religious war veterans expressed significantly lower levels for: regression (P<0.001), compensation (P=0.002), transfer (P<0.001), and reactive formation (P<0.001) than low religious ones. In PIE scores highly religious subjects had significantly higher levels for: incorporation (P=0.008) and self-protection (P<0.001), but lower levels for no-controlling (P<0.001), oppositionality (P<0.001), and aggressiveness (P=0.001).

Highly religious war veterans presented better ability to deal with stress and to keep mental balance than their peers who were lowly religious.

To estimate prevalence of Posttraumatic Stress Disorder (PTSD), depression, anxiety and substance misuse among university students after the 1992-1995 war in Bosnia-Herzegovina (BH).

The sample of 372 students from University of Tuzla (234 females) aged of 21.9±2.4 years, divided in medical (n=108) and philosophy students group (n=264), were evaluated for prevalence of PTSD, depression, anxiety and substance misuse. The Harvard Trauma Questionnaire, Beck Depression Inventory, and Sheehan Patient-Rated Anxiety Scale were used.

In the sample PTSD prevalence was 20.7%; groups did not significantly differed (Chi-square=0.895; df=1; P=0.344). Girls presented significantly more PTSD (24.4%) than boys (14.2%) (Chi-square=5.424, df=1, P=0.020). The prevalence of depression and anxiety in the sample was 30.1% and 35.5% respectively, with no significant differences between groups (Chi-square=1.265; df=1; P=0.261; Chi-square=2.278; df=1; P=0.131, respectively). Gender had no influence on the prevalence of depression and anxiety.

Prevalence of cigarette smoking and alcohol drinking in whole sample was 35.2% and 41.4% respectively with no significant differ between groups. Significantly, more boys were drinking alcohol (57.3%) than girls (32.3%) (Chi-square=21.362; df=1; P<0.001). Prevalence of marijuana and heroin misuse in whole sample was 15.3% and 5.0% respectively; significantly, more boys misused marijuana (20.6%) than girls (12.2%) (Chi-square=4.525; df=1; P=0.033).

The prevalence of PTSD, depression, anxiety, and substance misuse between groups of medical and philosophy university students in BH seven years after the war quitted did not significantly differ. Girls presented significantly more PTSD prevalence than boys. Boys significantly more frequently were drinking alcohol and misused marijuana than girls.

To estimate the frequency, type, and severity of psychological trauma among displaced adolescents from three different municipalities with different exposure to war conditions after the 1992-1995 war in Bosnia-Herzegovina (BH).

The sample of 212 adolescents from northeast region of BH (102 girls) aged of 15.1±2.1 years, divided in three groups. Srebrenica group (n=69), Zvornik group (n=74) and Bijeljina group (n=69), were assessed for war traumatic events and presence of post-traumatic stress disorder (PTSD). The Harvard Trauma Questionnaire (HTQ) version for Bosnia and Herzegovina was used.

Among tested adolescents 82.1% left homes, 77.8% of them were separated from family, 76.4% were forcedly expelled from homes, 50% lived in collective settlements. In the sample 11.6% of adolescents lost father: Srebrenica (43.5%), Zvornik (29.7%) and in Bijeljina group (5.8%)(Chi-Pearson=25.844, df=2, P<0.001). The PTSD prevalence was 61.3% in the sample; Srebrenica (73.9%), Zvornik (62.1%), and Bijeljina group (47.8%) (Chi-square=9.933; df=1; P=0.007). Among adolescents who lost father in the sample 82.1% presented PTSD: Srebrenica (80.0%), Zvornik (90.9%) and Bijeljina (50.0%)(Chi -square=16.769, df=2, P<0.001). In Srebrenica and Zvornik groups gender had no influence on PTSD prevalence but in Bijeljina group girls presented significantly more PTSD (59.6%) than boys (34.4%)(Chi-square=4.327, df=1, P=0.038).

The prevalence of PTSD was very frequent among Bosnian displaced adolescents 3.5 years after the war ended. Adolescents from Srebrenica had the highest rate of father loss and PTSD prevalence. Father loss influenced significantly on the prevalence of PTSD, while girls presented significantly more PTSD only in Bijeljina group.

Stress and mental health problems is common among medical students, but we lack studies of intervention programmes during medical school.

The students participated in one of two group session programmes during their third year at medical school. One option was a self-development programme delivered by trained group therapists. Alternatively the students chose a programme focusing on themes of special relevance to doctors. The format was one and a half hours' group sessions, once weekly, altogether 12 times. The baseline data were gathered before the intervention (T1).We studied the effect 3 months post intervention (T2), in this first follow-up paper. One class (N= 128) of medical students were given the group intervention programmes. The next year class (comparison group) received no intervention (N= 152). The main outcome of this study was Perceived Medical School Stress (PMSS), which has been linked to anxiety and depression, as well as need for treatment. We used multilevel linear model (repeated measures) to test for differences over time.

Both the intervention and the comparison groups showed a decline in PMSS from T1 to T2. There was an interaction between time and the intervention, and this indicates a significant effect (P=0.01) of the intervention. We found this effect due to the participation in the self-development groups (P=0.009). All effects were controlled for age and gender.

The self-development groups have a beneficial effect on stress among the students in a three months follow-up.

We examined 56 patients, who were operated on oncological pathology of thyroid (operation was performed from 1 to 10 years ago). The patients took the course of radioiodine therapy and obtained life-time substitutional therapy with L-thyroxin.

To assess the quality of life during the after operation period we used the Russian language version of the questionnaire SF (36 (Medical Outcomes Study Short Form) (Ware J.E., 1993).

The quality of life in case of cancer of thyroid gland, as compared to the sample group, appeared to be significantly decreased in all the scales of the questionnaire SF-36. With reliability of P<0,05, as compared to the sample group, the following indices decreased: physical functioning (69,1±2,8 и 92,1±2,4); the role of physical problems in the restriction of vital activity (22,3±4,0 и 70,2±6,8); social functioning (42,0±1,6 и 52,8±2,3); the role of emotional problems in the restriction of vital activity (19,6±5,4 и 73,1±8,9).

These data indicate to the prolonged effect of the psychotraumatic experience and the changes of subjective perception of one's social status. The data obtained show the significant influence of psychological aspects of the perception of the case of cancer of thyroid gland on the level of subjective assessment of vital activity and, as a result, social adaptation.

Investigating the indexes of alexithymia and psychopathology, as well as their relation to each other, in patients with type II diabetes.

The study was conducted on a random sample of 60 patients with type II diabetes (Group 1), who were outpatients in two Diabetes Centers of Northern Greece, and in 30 healthy controls (Group 2) We used the translated and validated versions of: 1) the international neuropsychiatric interview questionnaire (M.I.N.I. screen/ DSM-IV), 2) the M.M.S.E., 3) the TAS-20 questionnaire for alexithymia, 4) the SCL-90-R symptoms auto-questionnaire, 5) the Beck Depression Inventory (BDI) and 6) a protocol of demographic data.

The statistical analysis of the data has yielded the following results: 1) in Group 1, there seems to be a high or very high statistical correlation between the rates of all 4 factors of alexithymia and all 11 sub-scales of SCL-90-R, 2) where alexithymia is concerned, in both Groups 1 and 2, the findings in all 4 factors are as follows: Total score z(78)=-5.132, p<0.001/ Factor 1 z(78)=-5.553, p<0.001/ Factor 2 z(78)=-3.857, p<0.001/ Factor 3 t(78)=-3.825, p<0.001.

The indexes of alexithymia in chronic patients with type II diabetes have a statistically significant higher frequency compared to healthy controls. The factors of alexithymia, as defined in the TAS-20 questionnaire, correlate in various ways with certain psychopathological conditions, as defined in the SCL-90-R questionnaire

The etiology of selective mutism (SM), a relatively rare psychiatric disorder of childhood characterized by consistent failure to speak in specific social situations despite having appropriate language skills has not been clarified. Although, number of biological and environmental factors have been identified as risk factors based on case studies or studies with small sample size, there were only few investigations with a case-control design. Our aim was to explore the role of several early developmental and psychosocial factors in the development of the disease by comparing patients with SM to a control group.

37 children hospitalized due to SM between 1995 and 2005 were compared to 45 community controls in the same age range and similar sex ratio. Patients were evaluated by a comprehensive diagnostic assessment including an interview focusing on developmental history. In case of controls we used a self-rating version of the General Information Sheet a fully structured interview about the developmental history.

Among the cases there were 24 (64.9%) girls and 13 (35.1%) boys. The mean age of the patients was 8.24 years. Among the 21 variables in 8 domains we found significant differences between the two groups in terms of speech development, frequency of divorce and moving, and education level of the parents.

Our case-control investigation with considerably large sample of children with SM confirmed those earlier findings that early neurodevelopmental problems along with environmental factors could render children vulnerable to development of SM.

critical care units are the most sensitive professional units of hospital, and one of the stressors in nursing profession is working in these units. Observing dying patients, doing more work, communicational problems and other environmental factors are the main stressors of these nurses. This study was performed to determine stressors of nurses working in critical care units of Ardabil hospitals.

This is a descriptive study. The study population was the all of nurses working in critical units of Ardabil hospitals, contains 48 nurses and all of them were selected for the sample. The mean for collecting data was questionnaire.

in this study 46% of nurses mentioned that new experiences in profession is the first stressors and being not to able for decision-making about living and dying of patients is the second stressor.

of course knowing the stressors of nurses working directly with patient can decrease potential problems and increase quality and quantity of nursing care.

critical care unit, nurses, stressor

A comparison between Pyridoxine (vitamin B6) and a placebo for the treatment of premenstrual syndrome (PMS).

A double blind randomized clinical trial was performed on 160 university students who were suffering from PMS (according to the retrospective diagnostic criteria which had been recorded during the last 3 menstrual cycles). Then the patients were randomly assigned into two groups, and finally 94 patients who had finished the study were statistically analyzed.

In the Pyridoxine group (46 patients) vitamin B6 was prescribed at a dose of 40 mg twice daily (total 80 mg), and in the placebo group (48 patients) a tablet similar to vitamin B6 tablets in size, smell, shape and taste was prescribed 1 tablet twice daily. In both groups the tablets were started from the first day of the fourth menstrual cycle and continued for the next two cycles, and during these two cycles the symptoms were recorded.

The severity of PMS in the second cycle of the treatment (in both groups) showed a statistically significant decrease (p <0.05, Pair T test) and the comparison between the two groups showed that the severity of PMS in the Pyridoxine group decreased more than the placebo group, which was statistically significant (p < 0.05, Student T Test) and this was because of the reduction in the psychiatric rather than somatic symptoms of PMS.

Regarding the effect of Pyridoxine in reducing the severity of PMS, it can be suggested as a treatment for PMS.

A comparison between Pyridoxine (vitamin B6) and a placebo for the treatment of premenstrual syndrome (PMS).

A double blind randomized clinical trial was performed on 160 university students who were suffering from PMS (according to the retrospective diagnostic criteria which had been recorded during the last 3 menstrual cycles). Then the patients were randomly assigned into two groups, and finally 94 patients who had finished the study were statistically analyzed.

In the Pyridoxine group (46 patients) vitamin B6 was prescribed at a dose of 40 mg twice daily (total 80 mg), and in the placebo group (48 patients) a tablet similar to vitamin B6 tablets in size, smell, shape and taste was prescribed 1 tablet twice daily. In both groups the tablets were started from the first day of the fourth menstrual cycle and continued for the next two cycles, and during these two cycles the symptoms were recorded.

The severity of PMS in the second cycle of the treatment (in both groups) showed a statistically significant decrease (p <0.05, Pair T test) and the comparison between the two groups showed that the severity of PMS in the Pyridoxine group decreased more than the placebo group, which was statistically significant (p < 0.05, Student T Test) and this was because of the reduction in the psychiatric rather than somatic symptoms of PMS.

Regarding the effect of Pyridoxine in reducing the severity of PMS, it can be suggested as a treatment for PMS.