Croatia is a European country with one of the highest prevalence of domestic violence (DV) against women and without a strategy related to male victims. DV against men is a problem often overlooked ...and associated with numerous stereotypes. This study examines gender differences of DV help-seekers and specificities related to men. Data were derived through structured face to face interviews specifically designed for this study which based on DV literature that included 3296 help-seeking interviewees who personally visited the Counseling Center for Domestic Violence Victims, Zagreb, Croatia. Mental health professionals collected data on gender differences of help-seekers, socio-demographic characteristics, types, and duration of violence, perpetrators, and types of interventions. Important predictors of the gender of DV help-seekers were age, educational level, marital status, and DV types, duration and reporting. Women were more commonly abused by current partners and men by parents. Female victims were more likely to seek help after years of sustaining DV while male victims would seek help after up to 6 months of abuse. Women were more often victims of physical, financial, and multiple-type abuse, and men were more likely to suffer psychological abuse. Men were less likely to report abuse to the police, and misdemeanor or felony courts, but they sought legal counseling. 25% of DV help-seekers were men. Gender differences between victims of DV were in the socio-demographic characteristics, types and duration of violence, and perpetrators. Men underreported DV to institutions but they sought legal counseling. Additional practice and research implications are discussed.
Psychoactive substance-induced delirium is delirium which occurs during or immediate after psychoactive substance intoxication, withdrawal or during the use of specific psychoactive substance. It is ...characterized by sudden onset of disturbed consciousness, disorientation, hallucinations, changed psychomotor activity, insomnia, acute memory impairment, violent, and bizarre behaviour. The most commonly abused psychoactive substances which may induce delirium are those acting on the major inhibitory neurotransmitter gamma aminobutyric acid (alcohol, anxiolytics, sedatives, hypnotics, and gammahydroxybutyrate- GHB. Psychoactive substance-induced delirium may have hyperactive, hypoactive or mixed clinical presentation. Treatment of delirium induced by psychoactive substances is carried out with antipsychotics, anxiolytics, and sedatives, but each of the listed abused psychoactive substances has its own treatment peculiarities. This narrative literature review describes the epidemiology, pathophysiology, clinical presentation, and treatment of delirium induced by intoxication and withdrawal from GABAergic psychoactive substances. The paper summarizes well-known knowledge with the latest research in psychoactive substances-induced delirium.
Aim: To determine the effect of COVID-19 pandemic and earthquakes on the overall Internet usage (IU) and Internet-specific activities (ISA) among adult Croatian population and their relation with ...sociodemographic factors. Subjects and Methods: A total of 1,118 participants (220 men and 898 women; mean age: 35.14 ± 12.31 years; range 18 - 78) participated in an online self-report survey providing sociodemographic data and replying to questions on COVID-19 and earthquake-related stress factors and overall IU and ISA before and during the period of the first three pandemic waves and earthquakes. Results: Overall IU (p < 0.001), online gaming (OG) (p < 0.001), pornography viewing (PV) (p < 0.001), social media use (SM) (p < 0.001), and online shopping (OS) (p < 0.001) during the pandemic and earthquakes were significantly increased in the group that used the Internet before this prolonged stress experiences. Furthermore, overall IU increased in women (p < 0.001), less educated (p = 0.001), and single participants (p = 0.027). OG was associated with younger age (p = 0.001), lower education (p < 0.001), single status (p = 0.006), child-free status (P = 0.001), and urban residence (p = 0.032). Increased PV was associated with younger age (p < 0.001), male sex (p < 0.001), lower education (p < 0.001), single status (p = 0.001) and child-free status (p < 0.001). Increased SM was associated with female sex (p < 0.001) and lower education (p < 0.001). Conclusion: To reduce the negative impacts of prolonged stress, clinicians and public health authorities should take into consideration sociodemographic risk factors associated with IU and ISA.
Alcohol dependence has a strong impact on quality of life (QoL) and OoL assessment is considered as a valid measure in evaluating the success of the treatment of patients with alcohol dependence. The ...goal of the study was to investigate QoL and some sociodemographic characteristics of patients with alcohol dependence in comparison with healthy individuals. Cross-sectional study (which is part of larger study) included 312 patients with alcohol dependence and 329 healthy individuals of both sexes. Structured interview for sociodemographic and alcohol related data, the Croatian version of the 5.00 Mini International Neuropsychiatric Interview (MINI), and the short version of the World Health Organization Quality of Life (WHOQoLBREF) were used. The results have shown that alcohol dependent patients were significantly more frequently uneducated (p=0.006) and primary education (p<0.001), while healthy individuals were significantly more likely to have secondary (p=0.003) and tertiary education (p=0.013). Patients with alcohol dependence were significantly more likely to be single (p=0.005), divorced (p<0.001), and living as married (p=0.008) compared to healthy people, while healthy populations were more often married (p<0.001) in comparison to alcohol addicts. Alcohol dependent persons were more often unemployed (p<0.001) and retired (p=0.005). Patients with alcohol dependence were more likely to have a perceived a sense of illness (p<0.001) than healthy subjects. There were significant differences in all domains of QoL: general, physical, psychological, social, and environment between patients with dependence and healthy individuals (p<0.001). To conclude, alcohol dependence has been shown to be negatively correlated with overall QoL and domains of QoL: physical, psychological, social, and environmental. Education of patients with alcohol dependence was lower than in healthy people, who were more likely to live in marriage and were employed.
ABSTRACT
Introduction
Sociodemographic factors can sometimes be more contributory in relation to war-related stress-induced disorder treatment and compensation-seeking than health-related factors. ...However, their impact is often overlooked. This study explores a relationship between sociodemographic factors and diagnoses of combat-related stress-induced disorders in combat compensation seekers for delayed-onset PTSD (DOPTSD).
Materials and Methods
Between June 2002 and August 2004, at the Regional Centre for Psychotrauma Zagreb, University Hospital Dubrava, the expert team evaluated subjects to diagnose DOPTSD and other comorbid illnesses. The study included 831 war veterans who experienced combat stress during the 1991-1995 Croatian war. They were subjects of psychiatric treatments before applying for compensation. The researchers derived results from data collected during the expert evaluation for compensation seeking, which included a structured diagnostic procedure. The diagnostic procedure included structured clinical interviews that also provided sociodemographic (age, sex, education, employment, marital status, number of children, and place of residence) and other data (heredity, medical history of physical and mental disorders, history of social functioning, combat-related and post-traumatic experiences, symptoms, their duration, intensity, and treatment). After the interview, the Clinical Global Impression Scale, the Clinician-Administrated PTSD Scale, and the Mississippi Scale for Combat-Related PTSD were applied. Final diagnoses of a lifetime or current PTSD and stress-related disorders according to the ICD-10 were established after fulfilling psychiatric and psychometric criteria. Multiple logistic regression determined independent contributions of sociodemographic characteristics (e.g., age, gender, education, employment and marital status, and parental status), war (duty duration and physical disabilities from combat injuries), and post-war experiences (outpatient treatment duration and the number of hospitalizations) in predicting compensation eligibility.
Results
Better-educated combat compensation seekers were 2.23 times more likely to have eligible psychiatric diagnoses. Furthermore, married veterans were 2.22 times more likely to have eligible diagnoses than single compensation seekers. Likewise, hospitalization status was a risk factor concerning post-war experiences for eligible psychiatric diagnoses.
Conclusion
Marriage and higher education are accounted for longer DOPTSD in the group of combat compensation seekers with diagnoses eligible for compensation as a protective factor. A higher number of hospitalizations was also predictive because of more severe PTSD symptomatology as a risk factor. Higher education, marriage, and the higher number of the hospitalizations contributing to war-related DOPTSD diagnoses eligible for compensation.
Neuroimaging research reflects the complexity of post-traumatic stress disorder and shares some common difficulties of post-traumatic stress disorder research, such as the different classifications ...of the disorder over time, changes in diagnostic criteria, and extensive comorbidities, as well as precisely delineated and prevailing genetic and environmental determinants in the development of the disorder and its clinical manifestations. Synthesis of neuroimaging findings in an effort to clarify causes, clinical manifestations, and consequences of the disorder is complicated by a variety of applied technical approaches in different brain regions, differences in symptom dimensions in a study population, and typically small sample sizes, with the interplay of all of these consequently bringing about divergent results. Furthermore, combinations of the aforementioned issues serve to weaken any comprehensive meta-analytic approach.
In this review, we focus on recent neuroimaging studies and those performed on larger samples, with particular emphasis on research concerning the amygdala, hippocampus, and prefrontal cortex, as these are the brain regions postulated by the core research to play a prominent role in the pathophysiology of post-traumatic stress disorder. Additionally, we review the guidelines for future research and list a number of new intersectional and cross-sectional approaches in the area of neuroimaging. We conclude that future neuroimaging research in post-traumatic stress disorder will certainly benefit from a higher integration with genetic research, better profiling of control groups, and a greater involvement of the neuroimaging genetics approach and from larger collaborative studies.
•Variety of methods impede comprehensive systematic evaluation of neuroimaging of PTSD.•Increased amygdala activation and smaller amygdala volumes are most consistently reported.•Smaller hippocampal volume commonly appear repeatedly, results on changes in hippocampal activation are not consistent.•The decrease in frontal cortex volumes and activation appear recurrently.•Larger collaborative efforts are prerequisite to identification of reliable neuroimaging markers of the disorder.
Increased prevalence and severity of both substance and behavioral addictions are among the most harmful consequences of the COVID-19 outbreak.
To determine the sociodemographic characteristics, ...COVID-19-related stressors, and stress, anxiety, and depression symptoms that may predict the use and changes in the use of psychoactive substances (PS) during the first three COVID-19 waves in Croatia.
The cross-sectional online survey included 1,118 adult participants (220 men and 898 women; mean age: 35.1 SD = 12.3 years; age range: 18-78) from general adult population. Sociodemographic data were collected, and ad-hoc developed questionnaires on COVID-19-related stressors, PS use before and during the pandemic, CAGE Alcohol Questionnaire, Impact of Event Scale, and Hospital Anxiety Depression Scale were applied.
The PS use increased in 31% of participants. The use of tobacco, caffeine, alcohol, cannabinoids, and anxiolytics showed the greatest increase in the last year (tobacco 7.1%; caffeine 5.8%; alcohol 6.4%; cannabinoids 2.5%; and anxiolytics 3.9%). Alcohol consumption during the pandemic increased in 16.8% of participants who consumed alcohol before the pandemic, with 4.5% of them reporting problematic alcohol use (PAU). The tested model demonstrated relatively good model-data fit and significantly predicted 11.8% increase in the use of PS and 9.8% of PAU.
Being married or in a relationship and severe anxiety and depression symptoms predicted increased use of PS and PAU, while higher education level and ever being diagnosed with COVID-19 predicted only increased use of PS.
The prolonged stress experience caused by the COVID-19 pandemic and two earthquakes led to increased alcohol and psychoactive substance use (PSU) accompanied by a decrease in mental wellbeing and ...quality of life (QoL) in the Croatian population. Our aim was to determine the relationship between alcohol and PSU and mental health outcomes including anxiety and depression, and QoL.
A cross-sectional online survey conducted from September 30 to October 27, 2021, included 1,118 Croatian adults (220 men and 898 women; mean age, 35.1 ± 12.3 years) recruited through non-probabilistic convenience sampling. The survey consisted of a self-reported questionnaire on PSU, the CAGE Alcohol Questionnaire, the Hospital Anxiety Depression Scale, and the World Health Organization Quality of Life (WHOQoL)-BREF. Structural equation modeling was used to evaluate the association between PSU, problematic alcohol use (PAU), mental health outcomes, and QoL.
The model demonstrated a good fit and indicated that PSU increase, PAU, and anxiety and depression symptoms significantly explained all QoL domains (
< 0.001 for all). Both PSU increase and PAU during prolonged stress were directly associated with decreased QoL. These relationships were also indirectly mediated through increased anxiety and depression symptoms.
These results showed the need to direct public health interventions and treatment interventions during and after long-term stress (pandemics and earthquakes) to reduce the negative impact on substance use and QoL by reducing depression and anxiety, which ultimately may contribute to better wellbeing and rapid recovery of individuals affected by prolonged stress.
Background
During the COVID-19 pandemic and concomitant earthquakes in Croatia in 2020, increased Internet use (IU) and Internet-based addictive behaviors were associated with decreasing mental ...well-being. We determined the changes in IU, problematic IU (PIU), and problematic specific Internet activities in young adults during the prolonged stress caused by the pandemic and earthquakes, age differences in PIU and differences in perceived source of stress (pandemic or earthquakes), and association between PIU and increase in specific Internet activities and stress, anxiety, and depression symptoms in young adults.
Methods
A cross-sectional online survey conducted from September 30, 2021 to October 17, 2021 included 353 young adults aged 22.6 ± 2.1 years, 382 early adults aged 32.1 ± 4.4 years, and 371 middle-aged adults aged 49.0 ± 6.5 years. Data on sociodemographic characteristics, stressors (without perceived stressors, only pandemic-related stressor, only earthquake-related stressor, and both pandemic and earthquake-related stressors), PIU and IU were collected with a self-report questionnaire. The Impact of Event Scale and the Hospital Anxiety Depression Scale were used to evaluate mental symptoms. PIU and problematic specific Internet activities were assessed using Tao et al.’s criteria. Data were anaylzed with paired-sample Wilcoxon test, McNemar’s and Pearson’s chi-square tests, and structural equation modeling.
Results
In 17% of young adults, we found increased PIU (OR = 5.15, 95% CI 2.82, 10.18), problematic social media use (OR = 2.77, 95% CI 1.56, 5.14), and uncontrolled online shopping (OR = 5.75, 95% CI 1.97, 22.87) (
p
< 0.001 for all). PIU and problematic social media use were more common among young adults (60.8%), as well as problematic online gaming (25.9%). Problematic social media use was more frequent among young adults reporting pandemic stress than among those without perceived stress (69.9% vs. 43.2%). Increased online gaming predicted more severe avoidance symptoms (
p
= 0.041), increased social media use predicted more severe depression symptoms (
p
= 0.017), increased online shopping predicted more severe intrusion (
p
= 0.013) and anxiety symptoms (
p
= 0.001). PIU predicted more severe intrusion (
p
= 0.008), avoidance (
p
= 0.01), anxiety (
p
< 0.001), and depression (
p
= 0.012) symptoms.
Conclusion
Different effects of the pandemic and earthquakes on IU could reflect a different effect of various stressors on Internet behavior of young adults. Type of problematic Internet behavior may predict for the type of mental health problem.
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