Many research has indicated that, during the COVID-19 pandemic, health care workers are under greatly increased pressure and at increased risk for the development of mental health problems. ...Furthermore, previous research has indicated that psychiatrists are exposed to a number of unique stressors that may increase their risk for poor mental health. The aims of the present study were to assess the level of COVID-19 related concerns, psychological distress and life satisfaction among psychiatrists and other physicians during the first period of the pandemic and to examine whether individual differences in COVID-19 concerns, psychological flexibility, psychological resilience and coping behaviors account for differences in mental health indicators.
The sample consisted of N=725 physicians, among whom 22.8% were psychiatrists. This study was conducted online during the first lockdown in Croatia and collected data regarding COVID-19 related concerns, coping behaviors and mental health indicators (Psychological Distress and Life Satisfaction).
Physicians of other specialties had higher scores on a measure of COVID-19 anxiety than psychiatrists (p=0.012). In addition, a number of differences in coping behaviors are evident. Specifically, psychiatrists were less likely than physicians of other specializations to believe that being informed about COVID-19 is an effective coping strategy (p=0.013), but more prone to using sedatives and drugs as a coping strategy (p=0.002; p=0.037).
Psychiatrists are at special risk for substance abuse. Younger age, psychological inflexibility, low resilience and greater COVID-19 concerns might act as specific risk factors for distress. Our findings highlight the need for promoting a healthy lifestyle and psychological flexibility as universal protective factors.
Cilj istraživanja: Cilj provedenog istraživanja jest usporedba zdravstvenih briga i ponašanja pripadnika opće populacije i liječnika, kao i indikatora njihovoga mentalnog zdravlja tijekom pandemije ...COVID-19 u Hrvatskoj. Ispitanici i metode: Istraživanje je provedeno u ožujku i travnju 2020. na dva uzorka. Uzorak liječnika sastojao se od 725 sudionika, od kojih su većina žene (71,9%) u dobi između 26 i 81 godine (M=48,3; SD=11,26). U uzorku iz opće populacije sudjelovalo je 780 sudionika, također većinom žene (72,7%); raspon dobi kretao se
od 19 do 77 godina (M=40,2; SD=12,27). Sudionici su ispunili Upitnik ponašanja vezanih uz COVID-19, Ljestvicu COVID-19 briga, Ljestvicu briga vezanih uz pandemiju, a kao indikatori mentalnog zdravlja korišteni su CORE-YP i procjena kvalitete života. Rezultati: Liječnici, u odnosu na opću populaciju, imaju izraženije brige vezane za COVID-19 i brige vezane za funkcioniranje zdravstvenog sustava. Manje su zabrinuti za vlastito mentalno zdravlje, nisu psihološki uznemireniji niti imaju lošiju kvalitetu života u odnosu na opću populaciju. Međutim, imaju
izraženije teškoće sa spavanjem, bili su manje zainteresirani za razgovor o svojim teškoćama, ali su imali dojam adekvatne socijalne podrške i samoefikasnosti. Iako nema razlike između liječnika i opće populacije u općoj razini psihološkog distresa, u objema skupinama ta je razina značajno viša nego u razdoblju prije pandemije. Zaključci: Pandemija je izazvala situacijske specifične zabrinutosti kod liječnika, no njihov stupanj opće uznemirenosti i razina procijenjene kvalitete života jednaki su kao i u općoj populaciji. Iako se prema dosadašnjim stranim istraživanjima očekivalo narušeno psihičko zdravlje liječnika u pandemiji, naši rezultati to nisu potvrdili. Jedan je od mogućih razloga povoljna epidemiološka situacija u Hrvatskoj, koja je pokazivala linearni porast oboljelih od COVID-19.
A network of healthcare professionals specializing in transgender care was established in Croatia in 2011, and legal advancements were subsequently made in 2014. Both achievements made gender ...transition more transparent and thus more attainable in Croatia. This observational study was conducted to assess the number of transgender individuals initiating gender-affirming hormone treatment (GAHT) in Croatia and describes trends in age and sex assigned at birth. Between 2011 and 2022, a total of 111 transgender individuals initiated GAHT. Within the cohort, 52 were assigned male at birth (AMAB) and 59 were assigned female at birth (AFAB). The overall annual incidence rate of transgender individuals initiating GAHT was 0.52 per 100,000 age-adjusted individuals. There was a statistically significant increase (
p
< 0.01) in transgender individuals commencing GAHT before the COVID-19 pandemic. Furthermore, a rising trend toward masculinizing rather than feminizing treatment was identified (
p
< 0.05), particularly among younger transgender individuals. The COVID-19 pandemic disrupted these trends in 2020, except for the trend of initiating therapy at a younger age (
p
< 0.01). The annual incidence and age distribution trends of transgender individuals initiating GAHT in Croatia closely mirrored those in other European countries, with a higher prevalence of individuals assigned female at birth. The study underscores a significant rise in the number of individuals initiating gender-affirming hormone treatment, emphasizing the need for proper legal regulation and healthcare system response.
Following childbirth, a vast number of women experience some degree of mood swings, while some experience symptoms of postpartum posttraumatic stress disorder.
Using a biopsychosocial model, the ...primary aim of this study was to identify predictors of posttraumatic stress disorder and its symptomatology following childbirth.
This observational, longitudinal study included 372 postpartum women. In order to explore biopsychosocial predictors, participants completed several questionnaires 3–5 days after childbirth: the Impact of Events Scale Revised, the Big Five Inventory, The Edinburgh Postnatal Depression Scale, breastfeeding practice and social and demographic factors. Six to nine weeks after childbirth, participants re-completed the questionnaires regarding psychiatric symptomatology and breastfeeding practice.
Using a multivariate level of analysis, the predictors that increased the likelihood of postpartum posttraumatic stress disorder symptomatology at the first study phase were: emergency caesarean section (odds ratio 2.48; confidence interval 1.13–5.43) and neuroticism personality trait (odds ratio 1.12; confidence interval 1.05–1.20). The predictor that increased the likelihood of posttraumatic stress disorder symptomatology at the second study phase was the baseline Impact of Events Scale Revised score (odds ratio 12.55; confidence interval 4.06–38.81). Predictors that decreased the likelihood of symptomatology at the second study phase were life in a nuclear family (odds ratio 0.27; confidence interval 0.09–0.77) and life in a city (odds ratio 0.29; confidence interval 0.09–0.94).
Biopsychosocial theory is applicable to postpartum psychiatric disorders. In addition to screening for depression amongst postpartum women, there is a need to include other postpartum psychiatric symptomatology screenings in routine practice.
Funkcionalne vrtoglavice ističu se svojom učestalošću i drugi su najčešći uzrok vrtoglavica u općoj populaciji, dok su u dobnoj skupini od 30 do 50 godina i najčešći. Klasični dijagnostički proces ...usmjeren je na pronalaženje medicinske ili kirurške dijagnoze, a ako se ona ne pronađe, obično kažemo da je uzrok bolesti „psihogen“. Posljednjih desetljeća, napuštanjem uvriježenoga dihotomnoga dijagnostičkog pristupa i primjenom novog, integrativnog načina dijagnostičkog razmišljanja došlo se do spoznaje o postojanju funkcionalnih vestibularnih poremećaja. Oni su uvijek posljedica loše readaptacije posturalnog sustava na neku vestibularnu, neurološku, strukturnu ili psihijatrijsku bolest. Uzrok tomu leži u uskoj povezanosti živčanih projekcija u mozgu odgovornih za kontrolu pokreta i položaja tijela u prostoru s onima odgovornima za opasnost i strah. Odbor za klasifikaciju vestibularnih poremećaja Bárányjeva društva nedavno je utemeljio dijagnostičke kriterije za perzistentnu posturalno-percepcijsku vrtoglavicu (PPPD). Riječ je o najčešćem funkcionalnom vestibularnom poremećaju, koji obuhvaća prije uspostavljene entitete: fobičnu posturalnu vrtoglavicu, vizualnu i kroničnu subjektivnu vrtoglavicu. Dominantni simptomi PPPD-a jesu: vrtoglavica koja kontinuirano traje najmanje 3 mjeseca i uvijek je povezana s držanjem tijela, a nije kružnog tipa. Javljaju se preosjetljivost na pokretne podražaje, uključujući i vlastite pokrete, ali i kretanje velikih vizualnih objekata ili kompleksnih vizualnih podražaja u širokome vidnom polju, kao i teškoće pri izvođenju preciznih vizualnih radnja. Kod blažih i umjerenih smetnja poželjno je provesti vestibularnu rehabilitaciju, jer većina pacijenata ima provokativne čimbenike vezane uz vid i kretanje. Indicirano je i farmakoterapijsko liječenje selektivnim inhibitorima ponovne pohrane serotonina i noradrenalina. Dobri rezultati postižu se i primjenom kognitivno-bihevioralne psihoterapije, mijenjanjem negativnih automatskih misli, refokusiranjem pažnje, reatribucijom, sustavnim i postupnim izlaganjem ili, pak, izlaganjem odjedanput i dr. Prognoza bolesti znatno je bolja kod pacijenata bez komorbiditeta u odnosu prema onima s njime.
The aim of this research was to investigate the opinions and attitudes of medical staff towards schizophrenic patients. The research included three groups of examinees, 200 physicians of various ...specialties, 200 nurses and technicians working in Zagreb city hospitals, and 200 3rd and 4th year students of the School of Medicine in Zagreb. Previously validated anti-stigma questionnaire was used, consisting of 25 questions divided into three thematic groups, structured and adapted to the specific requirements of this study. The results were mutually compared and statistically analyzed by applying the chi 2-test. Significant difference (p < 0.01) between the answers of physicians and those of medical students was found in questions 2, 4, 5, 6, 11, 13, 15, 16, 18, 22, 23, 25, and between physicians and nurses/technicians in answers to questions 4, 15, 22, 23. Significant difference (p < 0.01) between the answers given by nurses/technicians and medical students was found in questions 10, 13, 22, 23. The results point to the existence of prejudices and stigmatizing attitudes in all three investigated groups. The most frequent reasons for stigmatizing attitude of students are based on fear and insufficient knowledge about mental patients and schizophrenia as a disease, while there are a high percentage of positive answers to the questions on rehabilitation and resocialization. The nurses/technicians also show a high degree of mistrust towards schizophrenic patients and mostly answer with "I don't know", thus presenting insufficiently formed attitudes about the mentioned problems. The physicians in their answers confirm fear, mistrust and stigmatizing attitudes towards schizophrenic patients found in general population in Croatia. The consequences of such attitudes are the low quality of life of schizophrenic patients, and slow, often incomplete, resocialization.
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