Papers by Dusica Lecic-Tosevski
Current Opinion in Psychiatry, 2006
This review summarizes the findings of recent researches from selected empirical and nonempirical... more This review summarizes the findings of recent researches from selected empirical and nonempirical publications focused on stressful life events and physical health. The findings can be divided into biological, psychological, and social issues concerning the important relationship between stressful life events and physical health. Growing evidence in the field of psychoneuroimmunology contributes to the understanding of the mechanisms by which stressful events affect physical health. The interactions between behavior, central nervous system, and endocrine system that might cause immunosuppression is the most fascinating finding in modern medicine, and its implications are important for the prevention and treatment of somatic illnesses. Trauma, abuse, and stressful events have been studied extensively, especially among vulnerable groups such as children, women, caregivers, and combatants. Risk factors and resilience were the focus of attention of some authors as well as the behavioral intervention for coping with stressful events. The findings support old observations and case reports of a close link between stressful life events and physical health and emphasize the necessity of early recognition and timely management of stress-induced illnesses. Psychosomatic approach, multidimensional diagnostics, and treatment should be sine qua non in the integrated care of affected people and should improve their quality of life.
International Journal of Geriatric Psychiatry, 2019
The aim of the present study was to characterize the clinical pathways that people with dementia ... more The aim of the present study was to characterize the clinical pathways that people with dementia (PwD) in different countries follow to reach specialized dementia care.
Journal of Personality Disorders, 2003
There is an ongoing debate on which risk factors for developing posttraumatic stress symptoms are... more There is an ongoing debate on which risk factors for developing posttraumatic stress symptoms are more important-personality traits reflecting vulnerability, previous stressful experiences or characteristics of the traumatic event. In this study, posttraumatic stress symptoms and their relationship with personality traits, previous stressful experiences and exposure to stressful events during air attacks in Yugoslavia were investigated. The Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983), Impact of Events Scale (IES; Horowitz, Wilner, & Alvarez, 1979), Life Stressor Checklist Revised (LSCL-R; Wolfe & Kimerling, 1997), and List of Stressors were administered to a homogeneous group of medical students 1 year after the attacks. In multiple regression analyses, compulsive and passive-aggressive personality traits and a higher level of exposure to stressors during air attacks independently predicted the degree of intrusion symptoms. Avoidance symptoms were predicted by avoidant personality traits and a higher exposure to stressors both previously in life and during the attacks. In the next step, we tested in analyses of variance whether personality traits, previous stressful experiences, and stressful events during attacks as independent variables interact in predicting intrusion and avoidance symptoms. For this, students were clustered into three groups depending on their predominant personality traits. In addition to direct predictive effects, there were significant interaction effects in predicting both intrusion and avoidance. The findings suggest that each of the tested factors, i.e., personality traits, previous stressful experiences, and exposure to traumatic events may have an independent and direct influence on developing posttraumatic stress. However, the effect of these factors cannot just be added up. Rather, the factors interact in their impact on posttraumatic stress symptoms. Bigger samples and longitudinal designs will be required to understand precisely how different personality traits influence response to stressful events.
The Journal of Nervous and Mental Disease, 2016
Our study was intended to test whether there are any differences in the way defense mechanisms ar... more Our study was intended to test whether there are any differences in the way defense mechanisms are used by patients suffering from pure anxiety and those with pure depressive disorders. The sample size was as follows: depressive disorders without psychotic symptoms 30, anxiety disorders 30, and the healthy control group 30. The assessment of defense mechanisms was made using the DSQ-40 questionnaire. Our findings show that "pure" anxiety disorders differ from "pure" depressive disorders only in the use of immature defense mechanisms. The group with depressive disorders was significantly more prone to use immature defense mechanisms than the group with anxiety disorders (p = 0.005), primarily projection (p = 0.001) and devaluation (p = 0.003). These defense mechanisms may therefore be used both to differentiate between anxiety and depressive disorders and also to determine which symptoms (anxiety or depressive disorders) are dominant at any given stage of treatment.
Scientific Reports, 2016
Although severe gynaecological pathology during delivery and negative outcome have been shown to ... more Although severe gynaecological pathology during delivery and negative outcome have been shown to be related with posttraumatic stress disorder (PTSD) little is known about traumatic experiences following regular delivery, at the expected time and with a healthy child. The objective of our study was to determine the prevalence of PTSD during postpartum period after vaginal delivery and its risk factors. The sample included 126 primiparous women. Monthly, for the next three months, the women were assessed for PTSD using the gold standard interview for PTSD, Clinician-Administered PTSD Scale (CAPS). Risk factors were assessed including sociodemographic variables, personal medical history and clinical variables. After the first month, 2.4% women had acute full PTSD and another 9.5% had clinically significant level of PTSD symptoms. Following the second and the third month, partial PTSD was found in 5.9% and 1.3% of the women, respectively, and none of participants had full PTSD. Obstetrical interventions were the only significant risk factor for the development of PTSD. Symptoms of postpartum PTSD are not rare after a traumatic delivery, and associated with specific obstetrical risk factors. Awareness of these risk factors may stimulate interventions to prevent this important and neglected postpartum disorder.
Human brain mapping, Jan 9, 2016
In major depressive disorder (MDD), the need to study multiple-gene effect on brain structure is ... more In major depressive disorder (MDD), the need to study multiple-gene effect on brain structure is emerging. Our aim was to assess the effect of accumulation of specific SERT, BDNF and COMT gene functional polymorphisms on brain structure in MDD patients. Seventy-seven MDD patients and 66 controls underwent a clinical assessment, genetic testing and MRI scan. Compared with controls, patients were more BDNF-Val homozygotes, COMT-Met carriers and SERT-L' carriers. Thus, subjects were split into three groups: 1. High-frequency susceptibility polymorphism group (hfSP, subjects with all three SPs); 2. Intermediate-frequency SP group (ifSP, two SPs); and 3. Low-frequency SP group (lfSP, one/none SP). Cortical thickness, volumetry of hippocampus, amygdala and subcortical structures, and white matter (WM) tract integrity were assessed. Compared to controls, hfSP patients showed thinning of the middle frontal cortex bilaterally, left frontal pole, and right lateral occipital cortex, and sm...
European Journal of Echocardiography, 2003
Psychiatria Danubina, 2014
During the past decade studies have shown that Type D personality is associated with increased ri... more During the past decade studies have shown that Type D personality is associated with increased risk of cardiac events, mortality and poor quality of life. Some authors suggested that depression and Type D personality have substantial phenomenological overlap. The sample consisted of non-consecutive case series of seventy nine patients with clinically stable and angiographically confirmed coronary artery disease (CAD), who had been admitted to the Clinic of Cardiology, University Clinical Centre, from May 2006 to September 2008. The patients were assessed by the Type-D scale (DS14), The Beck Depression Inventory (BDI), and provided demographic information. Risk factors for CAD were obtained from cardiologists. The findings of our study have shown that 34.2% patients with CAD could be classified as Type D personality. The univariate analysis has shown that the prevalence of Type D personality was significantly higher in individuals with unstable angina pectoris and myocardial infarcti...
World psychiatry : official journal of the World Psychiatric Association (WPA), 2011
Journal of neurology, Jan 21, 2015
An overlap frequently occurs between major depression disorder (MDD) and generalized anxiety diso... more An overlap frequently occurs between major depression disorder (MDD) and generalized anxiety disorder (GAD). Aim of this study was to assess cortical and white matter (WM) alterations in MDD patients with or without GAD comorbidity. Seventy-one MDD patients and 71 controls were recruited. All subjects underwent T1-weighted and diffusion tensor (DT)/MRI. MRI metrics of cortical thickness and WM integrity were obtained from atlas-based cortical regions and the interhemispheric and major long association WM tracts. Between-group MRI comparisons and multiple regressions with clinical scale scores were performed. Compared to controls, both MDD and MDD-GAD patients showed a cortical thinning of the middle frontal cortex bilaterally, left medial frontal gyrus and frontal pole. Compared to controls and MDD patients, MDD-GAD cases also showed a thinning of the right medial orbitofrontal and fusiform gyri, and left temporal pole and lateral occipital cortices. Compared to controls, MDD patien...
Case reports in medicine, 2014
An increasing number of findings confirm the significance of cerebellum in affecting regulation a... more An increasing number of findings confirm the significance of cerebellum in affecting regulation and early learning. Most consistent findings refer to association of congenital vermis anomalies with deficits in nonmotor functions of cerebellum. In this paper we presented a young woman who was treated since sixteen years of age for polysubstance abuse, affective instability, and self-harming who was later diagnosed with borderline personality disorder. Since the neurological and neuropsychological reports pointed to signs of cerebellar dysfunction and dysexecutive syndrome, we performed magnetic resonance imaging of brain which demonstrated partially developed vermis and rhombencephalosynapsis. These findings match the description of cerebellar cognitive affective syndrome and show an overlap with clinical manifestations of borderline personality disorder.
Epidemiologia e psichiatria sociale
Srpski arhiv za celokupno lekarstvo, 2005
Medicinski pregled, 2008
Hipertiroidizam je poremecaj koji predstavlja hipermetabolicko stanje, nastalo sekundarno usled e... more Hipertiroidizam je poremecaj koji predstavlja hipermetabolicko stanje, nastalo sekundarno usled efekta hipersekrecije tiroidnih hormona na periferna tkiva, i manifestuje se nizom somatskih i psihickih simptoma. Najcesca klinicka prezentacijaje Gravesova bolest koju odlikuju hipertiroidizam, difuzna struma, infiltrativna oftalmopatija i infiltrativna dermopatija, Smatra se da je bolest autoimunoloskog porekJa [1] iako jos nije do kraja ustanovljena etiologija. Hipertiroidizam se ukljucuje u grupu psihosomatskih porernecaja s obzirom na multifaktorsku interakciju psiholoskih faktora, kao sto je vulnerabilnost na stres [2,3], genetskih cinilaca (cesee se javlja u odredenim porodicama), imunoloskih faktora [1] i moguce odredenih cinilaca u vezi sa po-10m (javlja se cesee kod zena, posebno u populaciji osoba starij ih od sezdeset godina) .
Srpski arhiv za celokupno lekarstvo, 2013
The scope of gender related differences observed in mentally ill persons provides a major source ... more The scope of gender related differences observed in mentally ill persons provides a major source of inference about the role of gonadal steroids in brain function and behavior. Reported gender dimorphism in psychiatry includes the following: prevalence of certain mental disorders specific to female gender, phenomenology and treatment characteristics, i.e. response to the applied psychopharmacotherapy. Structural and functional relationship between the hormonal system and central nervous system is closely correlated with vulnerability to various psychopathological disturbances in biologically different stages in women. It has been observed, for instance, that the association of gonadal steroid activity with serotonin is relevant to mood change in premenstrual and postpartum mood disturbances. Gender related hormonal fluctuations may cause or be correlated with the development of several gender-related psychopathological disturbances. The aim of this article is to review the literature concerning gender-related specificities of psychopharmacological treatment of some of the most important mental disorders in women, such as affective disorder in menopause, premenstrual syndrome and postpartum mood disorders.
Vojnosanitetski pregled, 2013
World psychiatry : official journal of the World Psychiatric Association (WPA), 2010
The treatment gap for people with mental disorders exceeds 50% in all countries of the world, app... more The treatment gap for people with mental disorders exceeds 50% in all countries of the world, approaching astonishingly high rates of 90% in the least resourced countries. We report the findings of the first systematic survey of leaders of psychiatry in nearly 60 countries on the strategies for reducing the treatment gap. We sought to elicit the views of these representatives on the roles of different human resources and health care settings in delivering care and on the importance of a range of strategies to increase the coverage of evidence-based treatments for priority mental disorders for each demographic stage (childhood, adolescence, adulthood and old age). Our findings clearly indicate three strategies for reducing the treatment gap: increasing the numbers of psychiatrists and other mental health professionals; increasing the involvement of a range of appropriately trained non-specialist providers; and the active involvement of people affected by mental disorders. This is tru...
The British journal of psychiatry : the journal of mental science, 2014
It is unclear whether there is a direct link between economic crises and changes in suicide rates... more It is unclear whether there is a direct link between economic crises and changes in suicide rates. The Lopez-Ibor Foundation launched an initiative to study the possible impact of the economic crisis on European suicide rates. Data was gathered and analysed from 29 European countries and included the number of deaths by suicide in men and women, the unemployment rate, the gross domestic product (GDP) per capita, the annual economic growth rate and inflation. There was a strong correlation between suicide rates and all economic indices except GPD per capita in men but only a correlation with unemployment in women. However, the increase in suicide rates occurred several months before the economic crisis emerged. Overall, this study confirms a general relationship between the economic environment and suicide rates; however, it does not support there being a clear causal relationship between the current economic crisis and an increase in the suicide rate.
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2010
Objective: Despite clozapine's unique effectiveness in patients with schizophrenia, a number of a... more Objective: Despite clozapine's unique effectiveness in patients with schizophrenia, a number of adverse effects have been recognised including abnormalities in lipid and glucose metabolisms. A high clozapine level in red blood cells (RBCs) and disturbed anti-oxidant enzyme activities in blood from schizophrenic patients prompted us to investigate lipid status and anti-oxidant enzyme defence in the blood of chronic schizophrenic patients on long-term clozapine therapy. Methods: Plasma lipids, RBC anti-oxidant enzyme activities and haemoglobin (Hb) content were measured using established procedures in a group of eighteen chronically-medicated (average 630 days of therapy) schizophrenic patients receiving clozapine (average dose of 295 mg/day) and data were compared with those from a group of eighteen well-matched normal controls. Results: Significantly higher levels of plasma triglycerides (by 47%, pb 0.01) and total cholesterol and phospholipids (by 8% and 11%, respectively pb 0.05) in patients were found. CuZn-superoxide dismutase (SOD1) activity was markedly higher (by 35%, p b 0.001) while selenium-dependent glutathione peroxidase (GSH-Px1) activity was markedly lower (by 41%, pb 0.001) in patients. In addition, metHb and HbA1c levels in patients were significantly higher (by 58% and 25%, respectively pb 0.001). SOD1 activity was negatively correlated (p b 0.001) to GSH-Px1 activity in patients.
Personality and Mental Health, 2011
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Papers by Dusica Lecic-Tosevski