Prevention of bullying is paramount to creating a positive and welcoming school environment. This study compared the following characteristics reported by students who had perpetrated bullying in ...Croatian schools and those who did not: gender, type of school, family wealth, negative emotionality, behaviors that may compromise health, and endorsement of traditional masculinity. Within the framework of the “Croatian Adolescent Masculinity Study,” second and third grade students of secondary schools (equivalent to tenth and eleventh grade in the United States) in the city of Zagreb (N = 4,072) completed a cross-sectional, paper-and-pencil survey. Descriptive and logistic regression analyses were conducted separately for males and females to identify constructs associated with bullying perpetration. More males (12.7%) than females (5.8%) perpetrated bullying. Compared to students who did not report bullying others, significantly more students, who perpetrated bullying reported feeling sad or hopeless, having suicidal ideation, carrying a weapon, missing school because of feeling unsafe, drinking alcohol, getting inebriated, being victims of bullying, and endorsing traditional masculinity norms. The proportion of males reporting bullying others did not vary by type of school; females were more likely to perpetrate bullying in predominantly male and mixed-gender vocational schools. Bullying prevention interventions should address the complexity of problems associated with bullying others. Students who reported bullying others were more likely to participate in other harmful behaviors and have emotional problems. Endorsement of traditional masculinity norms should be further researched in other cultures and included in investigations of bullying perpetration, given its association with increased bullying among male and female students.
The concept of masculinity is particularly challenging to measure across cultures, given the lack of scales in languages other than English. This study describes the adaptation for Croatian ...adolescents of the MRNI-A-r scale, which measures the endorsement of traditional masculinity. We organized the process into two segments. Segment 1 described the step-by-step adaptation process showing evidence of face and content validity. Segment 2 examined the factorial structure, internal consistency, and construct and criterion-related validity of the scores of the Croatian version in a large sample of adolescents (n = 4116) attending schools in Zagreb. As hypothesized, higher scores were associated with lower support for gender equality, males reported higher scores than females, and the internal consistency of the scores was good. The development of scales in the language of the priority population with a demonstrated cultural equivalence of terms is a fundamental step toward understanding the impact of masculinity in a global context.
To assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) with an H1 coil as a treatment for hopelessness in patients with major depressive disorder (MDD).
We conducted a ...randomised controlled trial in a tertiary psychiatric institution in Croatia, including patients diagnosed with MDD without psychotic symptoms and with clinically relevant hopelessness. High-frequency (18 Hz) rTMS with an H1 coil was administered over four weeks on the left dorsolateral prefrontal cortex. We examined changes in the Beck Hopelessness Scale (BHS) scores.
We randomly assigned 51 participants to the intervention group (rTMS plus standard therapy) and 52 to the control group (standard therapy). The mean (
) ages were 50 (12.3) and 50 (10.4) years, and 47% and 52% of the participants were females in the intervention and control groups, respectively. Following treatment, the BHS scores decreased (unadjusted bivariate analysis,
= 0.043; false discovery rate (FDR) >5%). Multivariate analysis revealed that the BHS score was reduced by 10.8% (95% confidence interval (CI: -17.8% to -3.9%) in the rTMS group and 0.7% (95% CI: 7.5% -6.1%) in the control group (
= 0.037; FDR < 5%).
rTMS with an H1 coil improved the symptoms of hopelessness in patients with MDD.
Accelerated repetitive transcranial magnetic stimulation (rTMS) protocols are being increasingly studied because of their potential to provide quicker and enhanced treatment efficacy. However, there ...is a lack of accelerated deep TMS with H1-coil (adTMS) treatment research. This randomized pilot study investigated the efficacy and safety of adTMS protocols. Twenty-eight TRD patients received 20-min sessions twice daily for 10 or 15 days. Primary outcomes were changes in Hamilton Depression Rating Scale (HDRS) scores and discontinuation because of adverse events (AE). Secondary outcomes were response, remission, daily changes in Beck Depression Inventory-II (BDI-II) scores, and AE incidence. HDRS scores decreased by 13 (95% CI 11–17; 59%, 95% CI 45–73%) and 13 (95% CI 11–14; 62%, 95% CI 54–69%) points in the 10- and 15-day protocols, respectively. The adjusted difference between the two protocols was not significant or clinically relevant. Remission was achieved by 38% and 42% after 10-day and 15-day protocols, respectively. The intervention was discontinued because of AEs in 3/33 (9%) patients. The BDI-II decreases were significant and clinically relevant during the first 8 days. Twice-daily adTMS for 10 days seems to be safe and effective, with rapid clinical benefits during the first week of treatment. These promising results warrant further investigation in larger randomized clinical trials comparing adTMS with the standard dTMS protocol.
Risky traffic behaviors among youth potentially lead to serious consequences, injuries or deaths. Young men are particularly at risk.Growing body of research indicates that the endorsement of ...traditional masculinity is at the root of the causes of deviant behavior of boys. With National program for road safety due to expire in 2020, there is a need for evidence on the present state of behaviors of youth in traffic in Croatia, using indicators that take into the account the differences between boys and girls and the influence of the prevalent gender norms on these groups.The goal of the research was to analyze the health risk behaviors in traffic for high school students from Zagreb by sex as well as to test the association between the endorsement of traditional masculinity and risky traffic behaviors among adolescent boys.Study and included 4094 high school students in the City of Zagreb. Two of the most prevalent risky traffic behaviors were analyzed: the use of seat belts while riding in the front seat of a vehicle and the use of helmets while riding a bike. To compare scores between participants who reported risky traffic behavior and those who did not, we used chi-square test for sex and independent samples t-test for masculinity scale.Students engage in multiple health risk behaviors while participating in the traffic. Over half of the students report inconsistent seat belt use when riding in the front seat of the car and only 7.5% report ever using a helmet when riding a bike. A significant association was found between sex and inconsistent seat belt use, with male adolescents reporting significantly more risky behavior than their female counterparts. Stronger endorsement of traditional masculinity norms among boys was correlated with less consistent use of seat belts (p<0.001). The difference between male and female students in carrying a helmet when riding a bike was less significant, with results suggesting that the lack of protection when riding may be a part of the general youth culture.The results in general highlight the prevalent harmful risky traffic behaviors of adolescents. The study highlights the need to further investigate the causes of risky traffic behaviors among youth and intervene at the level of youth culture. The results further suggest the need to design experimental gender-transformative interventions for boys specifically, as a group at a higher risk.
Hyperprolactinemia is associated with side effect of antipsychotics in people suffering from psychotic disorders. However, increased prolactin levels (mlU/L) were found in patients suffering from the ...first psychotic episode who were not receiving antipsychotic therapy. The assumption of this study is that the abnormality in the level of prolactin is associated with the effect and influence of the disease, not the therapy that is carried out.
Study involved 54 female patients hospitalized in Psychiatric hospital "Sveti Ivan", whose average age was 33.9 years. All patients had been diagnosed with a psychotic disorder (according to MKB-10, F20-F29). 18 patients had their first psychotic episode, while 36 patients had relapses of psychotic disorder. The methods used were: PANSS scale and measurement of prolactin concentration (Immunoanalyzer ACCESS 2, CLIA method). Arithmetic mean, standard deviations, correlation coefficient, Mann Whitney U test and the chi-squared test were used.
75.5% of patients had prolactin values above the reference values (min 121, max 4192 ml/L). In a sample of patients with first psychotic episode, 77.8% had elevated prolactin levels, while among re-hospitalized patients, elevated levels had 74.2%. Statistically significant results were obtained: patients with higher pronounced symptoms had higher prolactin values, especially particles on PANSS: P1 (delusions), N4 (Apathy), G15 (preoccupation) and G16 (active avoidance).
Elevated prolactin in patients has been demonstrated regardless of antipsychotic therapy, therefore the question of etiology of hyperprolactinemia in psychotic disorders is questionable. The association of hyperprolactinemia with the severity of the clinical picture has also been demonstrated, higher prolactin values indicating a stronger clinical picture, which calls into question the protective role of prolactin in psychotic disorders.
This article reviews the history, evolution, and current status of repetitive transcranial magnetic stimulation (rTMS) in Croatia. University Psychiatric Hospital Sveti Ivan experts performed the ...first rTMS in 2015 as a first treatment and research group in Croatia. In addition to being a leading center for rTMS in clinical trials and in treating depression, University Psychiatric Clinic Sveti Ivan TMS center continues to research rTMS for depression and other neuropsychiatric disorders and conditions, exploring novel stimulation parameters and individualized treatment protocols. Since 2017 rTMS treatment for MDD in Croatia has been reimbursed by the National Insurance Fund and has been available to hospital and ambulatory patients by indication, and now is widely used in other health centers in Croatia, to treat depression and other neuropsychiatric disorders and conditions, especially when drugs are ineffective or produce harmful side effects.
The influence of cannabis use on the occurrence, clinical course and the treatment of the first psychotic episode (FEP) is well documented. However, the exact link is still not clearly established. ...The aim of this article is to review and report the noticed increase in the number of hospitalizations of young people with a clinical appearance of severe psychotic decompensation following cannabis consumption and to show the clinical challenges in treatment of the FEP. The case study describes the clinical course of a five selected patients with a diagnosis of the FEP and positive tetrahydrocannabinol (THC) urine test who were hospitalized in a similar pattern of events. They all have a history of cannabis consumption for at least 6 years in continuity and were presented with severe psychomotor agitation, disorganisation, confusion and aggression at admission. Although the chosen drug to treat all patients was atypical antipsychotic and benzodiazepines, the course of the disorder and the clinical response to therapy were noticeably different in each patient. The clinical presentation of FEP in cannabis users can be atypical and highly unpredictable from mild psychotic symptoms to severe substance intoxication delirium. In clinical practice clinicians treating new onset psychosis need to be watchful for cannabis and synthetic cannabinoids induced psychosis. Pharmacotherapeutic interventions include prompt and adequate use of the benzodiazepine, second-generation antipsychotic, and mood-stabilizers. Further research in the pharmacotherapy of cannabis-induced psychosis is required.
There is a growing body of evidence suggesting that early and effective management in the critical early years of schizophrenia can improve long-term outcomes. The objective of this study was to ...evaluate time to relapse of the patients with early-phase psychosis treated in the Centre for integrative psychiatry (CIP).
We performed a retrospective cohort study on the sample of 373 early-phase psychosis patients admitted to Psychiatric Hospital "Sveti Ivan", Zagreb Croatia: from January 1, 2015 to December 31, 2017. The primary outcome was time to relapse.
Patients who were admitted to group psychotherapeutic program after the end of acute treatment had 70% lower hazard for relapse (HR=0.30; 95% CI 0.16-0.58). Patients who were included first in the psychotherapeutic program and then treated and controlled in the daily hospital had 74% lower hazard for relapse (HR=0.26; 95% CI 0.10-0.67).
In early-phase psychosis, integrative early intervention service has relevant beneficial effects compare to treatment as usual. These results justified the implementation of multimodal early intervention services in treatment of patients with early-phase psychosis.
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