Papers by branka restek-petrovic
Archives of psychiatry research, Jun 15, 2023
The aim of this cross-sectional study was to investigate whether the insight of patients and thei... more The aim of this cross-sectional study was to investigate whether the insight of patients and their parents differ in the early phase of psychosis. Target population were the patients hospitalized with the diagnosis of the psychotic spectrum (F20 -F29; ICD -10th; disease duration ≤ 5 years), both sexes, with average age M = 25.4 (SD = 3.56, C = 25, min = 18, max = 32) and their parents. Insight into illness in patients was assessed using the Scale to assess Unawareness of mental Disorder (SUMD) abbreviated version. Parents' insight into illness was assessed with a modified version of the SUMD with question rephrased to probe parents' understanding of patients' illness. The expression, structure and severity of psychotic symptoms was assessed by The Positive and Negative Syndrome Scale of Schizophrenia (PANSS -Five factor models) and Clinical global impression scale (CGI -s). The results indicated a statistically significant (Z = 2.99; p < 0.01) higher mean value on General Awareness of patients (M = 6.1, SD = 3.26) compared to parents (M = 5.0, SD = 2.99. A significant difference was obtained by the sex of parents too (z = -2.07, p < 0.05): fathers had better insight (M = 2.0, SD = 1.15) than mothers (M = 1.5, SD = 0.89). The results call for necessity to develop innovative and comprehensive program for early family interventions.
Socijalna psihijatrija =, May 4, 2022
Istraživanja u području starenja danas više nisu usmjerena samo na kronične bolesti i funkcionaln... more Istraživanja u području starenja danas više nisu usmjerena samo na kronične bolesti i funkcionalne gubitke, već uključuju i pozitivne aspekte starosti kao što su očuvanje i razvijanje potencijala i sposobnosti te kvalitete života u kasnijim godinama. Populacija osoba starije dobi vrlo je heterogena pa postoje prijedlozi da ih je potrebno razlikovati prema obrazovanju, spolu, dobi, funkcionalnoj sposobnosti i drugim obilježjima. Osnovni cilj ovoga rada bio je provjeriti postoje li dobne, spolne i obrazovne razlike u uspješnom starenju i nekim njegovim korelatima kao što su zdravlje i psihološka dobrobit, te je provedeno istraživanje na uzorku od 329 sudionika. Rezultati analiza pokazali su da muškarci (neovisno o dobi) procjenjuju svoje tjelesno zdravlje značajno boljim nego žene. Starije stare osobe su zadovoljnije financijama od mlađih starih, a mlađi su otvoreniji prema novim životnim iskustvima od starijih samo u ženskom poduzorku. Mlađe stare žene procjenjuju svoj proces starenja uspješnijim te se smatraju generativnijima nego mlađi stari muškarci, no stariji stari muškarci su uspješniji i imaju veći osjećaj generativnosti nego starije stare žene. Značajne razlike potvrđene su i među osobama različitog obrazovnog statusa. Ovakvi nalazi ukazuju da se u starosti osobe ne bi trebale tretirati kao homogena populacija, te potvrđuju važnost i potrebu razmatranja starih osoba kao heterogenih podskupina. / Contemporary research in the field of aging no longer focuses only on chronic diseases and loss of function, but also encompasses positive aspects of aging, such as the maintenance and development of potential and abilities and the quality of life in later years. The population of older people is very heterogeneous and there are proposals to differentiate the group according to education, gender, age, functional abilities, and other characteristics. The main objective of this paper was to investigate whether there are age-, gender-, and education-specific differences in successful aging together with some of its correlates, such as health and psychological well-being. The study was conducted on a sample of 329 participants. The results of the analysis show that men (regardless of age) rate their physical health significantly higher than women. Older elders are more satisfied with their finances than younger elders, and younger elders are more open to new life experiences than older elders in the female subsample only. Younger old women rate their aging process as more successful and are more generative than younger old men, but older old men are more successful and have a greater sense of generativity than older old women. Significant differences were also found between people with different educational status. These findings suggest that people in old age should not be treated as a homogeneous population and confirm the importance and need to consider older people as heterogeneous subgroups.
Medicina-buenos Aires, 2010
Aim: This paper gives the description of changes in the perception of illness during the four-yea... more Aim: This paper gives the description of changes in the perception of illness during the four-year involvement of the patients' family members in group psychotherapy. Within the program of early intervention in the first episodes of psychotic disorder, parents of patients with psychotic disorder take part in psycho-educational workshops as well as in psychodynamic group psychotherapy. Methods: The method of work is based on the monitoring of session protocols noted from memory after the group therapies have been finished. Results: Unacceptance of illness, denials and outer transfer of the problem (such as drug abuse) were noticed in the beginning of the group work. In the second phase, the feelings of shame were dealt with (illness as a narcissistic injury) and guilt (illness as punishment) as well as difficulties in facing the severity and long duration of illness. The third phase was also recognized in which we noticed that the group members (parents) focused their attention f...
Sažetak. Cilj: Opisati promjene odnosa prema bolesti kroz četverogodišnji rad grupne psihoterapij... more Sažetak. Cilj: Opisati promjene odnosa prema bolesti kroz četverogodišnji rad grupne psihoterapije članova obitelji. U sklopu Programa rane intervencije kod prvih epizoda psihotičnih poremećaja (RIPEPP) roditelji bolesnika oboljelih od psihotičnih poremećaja uključeni su, uz psihoedukacijske radionice, i u psihodinamsku grupnu psihoterapiju. Metode: Praćenje protokola seansi koje se bilježe po sjećanju nakon održanih grupa. Rezultati: Tijekom četverogodišnjeg rada s članovima obitelji opazili smo da je postupno došlo do promjene stava prema bolesti. U početku grupnog rada uočeno je neprihvaćanje bolesti, negacija te pomak problema prema van (npr. uzimanje droga). U drugoj fazi prorađuju se osjećaji srama (bolest kao narcistička povreda) i krivnje (bolest kao kazna) te teškoće suočavanja s ozbiljnošću i dugotrajnošću bolesti. Prepoznata je i treća faza rada u kojoj članovi grupe (roditelji) fokus pomiču s djece i njihovih poteškoća na sebe (počinje prorada tugovanja). Zaključak: Grupna klima koja se tijekom četverogodišnjeg rada u grupi stvorila pridonijela je postupnom prihvaćanju bolesti te time i promjeni odnosa prema djeci. Bolja uspostava granica stvara uvjete za separaciju najprije od grupe, a kasnije i od oboljelog člana. Ključne riječi: odnos prema bolesti, psihodinamska grupna psihoterapija članova obitelji Abstract. Aim: This paper gives the description of changes in the perception of illness during the four-year involvement of the patients' family members in group psychotherapy. Within the program of early intervention in the first episodes of psychotic disorder, parents of patients with psychotic disorder take part in psycho-educational workshops as well as in psychodynamic group psychotherapy. Methods: The method of work is based on the monitoring of session protocols noted from memory after the group therapies have been finished. Results: Unacceptance of illness, denials and outer transfer of the problem (such as drug abuse) were noticed in the beginning of the group work. In the second phase, the feelings of shame were dealt with (illness as a narcissistic injury) and guilt (illness as punishment) as well as difficulties in facing the severity and long duration of illness. The third phase was also recognized in which we noticed that the group members (parents) focused their attention from their children's difficulties to themselves (the period of grieving process started). Conclusion: The group atmosphere which developed during the four-year period of work in the group contributed to the gradual acceptance of illness and so changed the relationship with children. Better setting of boundaries allowed separation, first from the group, and also from the inflicted family member later on.
Grupni psihoterapijski rad s psihotičnim pacijentima počeo se razvijati 30-tih godina dvadesetog ... more Grupni psihoterapijski rad s psihotičnim pacijentima počeo se razvijati 30-tih godina dvadesetog stoljeća na osnovi primjene psihodinamskih teorijskih saznanja i tehničkih postupaka proizašlih iz individualnog psihoanalitičkog rada s neurozama (1). Slijedile su decenije prikupljanja iskustava u grupnom radu s psihotičnim pacijentima, prvo u bolničkim a kasnije i u ambulantnim uvjetima, širenje razumijevanja psihotičnih komunikacija kao i adaptacija klasičnih tehnika proizašlih iz psihoanalize potrebama pacijenata s psihotičnim poremećajima i grupnom setting-u (2). Učinkovitost grupne psihoterapije kod psihotičnih pacijenata u kombinaciji s antipsihotičnom psihofarmakoterapijom pokazana je nizom različitih meta-analiza (26). Pokazalo se da dugotrajna grupna psihoterapija ima kratkoročne i dugoročne utjecaje na kvalitetu života, suradljivost u liječenju, socijalno funkcioniranje i redukciju stigmatizacije kod psihotičnih pacijenata, tako da je danas važan dio mnogih bolničkih i izvanb...
Psychiatria …, 2010
Antidepressants and antipsychotics can cause side effects in various organs and organic systems, ... more Antidepressants and antipsychotics can cause side effects in various organs and organic systems, and some (and) in the central nervous system, which can also be clinically manifested by suicidal behavior as well. Tricyclic antidepressants particularly of imipramine and clomipramine can have pro-suicidal effect, which is believed to be the consequence of their own hypothetic asynchronous cognitive-psychomotor pharmacodynamic action. Antidepressants from the group of selective serotonin reuptake inhibitors can at the beginning of administration as monotherapy also have pro-suicidal effects in patients with hints of suicidality or suicidal behavior, by increasing the intensity of already present suicidal predictors, such as dysphoria, anxiety, impulsiveness, agitation etc. Antipsychotics can act stimulatingly upon predictors of suicidal behavior, that is, pro-suicidal in an indirect way through side effects they cause indirect pro-suicidal neurological and consecutive psychological impact, as it is called. It is particularly valid for classic antipsychotics causing primarily neurological, i.e. extrapyramidal side effects, along which consecutive psychological side effects can occur as well. However, new antipsychotics in comparison to classic ones, have less pronounced neurological, extrapyramidal symptoms and signs but more somatic-metabolic side effects, and thereby their action can be mostly manifested as indirect pro-suicidal neurological and somatic-metabolic as well as consecutive psychological activity.
Psychiatria Danubina
Work with dreams in the group analysis represents an important part of the analytical work, with ... more Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness.
Socijalna psihijatrija
Značajan doprinos psihoanalitičkih teorijskih koncepata i znanja u liječenju shizofrenih bolesnik... more Značajan doprinos psihoanalitičkih teorijskih koncepata i znanja u liječenju shizofrenih bolesnika je u razumijevanju značenja simptoma u kontekstu individualnih životnih događaja. Iako se shizofreni bolesnici međusobno značajno razlikuju, njihovi se simptomi najčešće mogu razumjeti kao obrana od nepodnošljivih iskustava. Svjesna i nesvjesna značenja iskustava derivat su unutarnjeg svijeta individuuma, koji isto tako biva formiran od životnih iskustava, najviše onih iz ranog djetinjstva kada se počinje razvijati osjećaj selfa i identiteta. Mogućnost razumijevanja simptoma i ponašanja shizofrenih bolesnika koju daje primjena psihodinamskih teorija i znanja kao i participacija u psihoterapijskom procesu pružaju kliničarima platformu za cjeloviti uvid u psihodinamiku i funkcioniranje ličnosti pacijenta oboljelog od shizofrenije, a time i adekvatno planiranje terapijskih intervencija i procesa liječenja u cjelini. Rad sadrži prikaz dugogodišnjeg grupnog procesa s kroničnim shizofrenim bolesnicima te razvoj razumijevanja psihotičnih simptoma jednog od članova grupe. / Understanding the meaning of symptoms in the context of individual life events would be a significant contribution to psychoanalytic theoretical concepts and knowledge in treating schizophrenic patients. Although schizophrenic patients differ significantly, their symptoms can usually be understood as a defence from unbearable experiences. Conscious and unconscious meanings of experience are a derivative of the inner world of the individual, which is also formed of life experiences; most of them come from the early childhood when the feeling of self and identity begins to develop. The ability to understand the symptoms and behaviour of schizophrenic patients by applying psychodynamic theories and knowledge as well as participation in the psychotherapeutic process provides clinicians with a platform for a complete insight into psychodynamics and functioning of a person suffering from schizophrenia and also contributes to adequate planning of therapeutic interventions and treatment process as a whole. This paper presents a long-term group process with chronic schizophrenic patients and the development of understanding of the psychotic symptoms in one member.
Psychiatria Danubina
Background: Psychiatric hospital "Sveti Ivan" in Zagreb, Croatia, offers an outpatient Early inte... more Background: Psychiatric hospital "Sveti Ivan" in Zagreb, Croatia, offers an outpatient Early intervention programme for patients with psychotic disorders (RIPEPP), consisting of psychoeducational workshops and group psychodynamic psychotherapy. The aim of this study was to describe sociodemographic and baseline characteristics of the participants, in order to provide better understanding of this population, and to assist with the development of more effective therapeutic approaches. Subjects and methods: Since 2008, a total of 245 patients with first episodes of psychosis and their family members participated in the programme. They filled out several questionnaires within the framework of the programme evaluation, but for the purposes of this study, only data collected on sociodemographic questionnaire and the Health of the Nation Outcome Scales (HoNOS) are presented. Results: Majority of the participants were male (66%), at the average age of 28 (SD=6.6), living with their parents (73.5%). Most of them finished secondary school (45.7%) but almost a quarter of the sample (23.7%) is currently studying at university. The average duration of untreated period was 101.60 days, with a median of 30 days. According to results of HONOS questionnaire, upon entry into the programme, the patients most often listed cognitive functioning (attention, concentration, memory) and professional issues (performance of work tasks and activities tied to work) as the most problematic areas. Conclusion: The findings of this study provide more detailed description of the beneficiaries of the RIPEPP programme, which can contribute to forming future programmes for the prevention of psychotic disorders.
Psychiatria Danubina, 2013
Work with dreams in the group analysis represents an important part of the analytical work, with ... more Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened ...
Collegium antropologicum, 2010
Post-traumatic stress disorder (PTSD) frequently occurs in commorbidity with different mental dis... more Post-traumatic stress disorder (PTSD) frequently occurs in commorbidity with different mental disorders, including suicidal behaviour. Group of biological factors, including serotonergic system, HPA axis and some genetic factors, are being studied as potential markers, able to differentiate suicidal and non-suicidal behaviour across the group of PTSD patients. This study is examining statistical relation between platelet serotonine concentration and serum cortisole concentration, within the group of PTSD patients with and without attempted suicide, treated at "Sveti Ivan" Psychiatric Hospital in Zagreb. The hypothesis of this study is that periferal biochemical markers are different across the groups of PTSD patients with and without attempted suicide and the group of healthy controls. Our results have shown significantly lower platelet serotonine concentration in PTSD patients with and without suicide behaviour, compared to healthy controls. There are no statistically sig...
Collegium antropologicum, 2009
The factors situated at the bases of the genesis and development of PTSD are divided in: biologic... more The factors situated at the bases of the genesis and development of PTSD are divided in: biological, psychological and social factors. Primary factor is a stressful event of extremely dangerous and threatening nature. The sort and the intensity of the stressful event too play an important role, followed by the personality structure, the relation with the environment and the genetic constitution. The study was thought to determine the quantitative dermatoglyphic properties of the digito-palmar complex in patients with PTSD aiming to establish whether there are biological, that is, genetic bases for PTSD, in what measure they determine the clinical manifestation of the disorder, and whether there is a dermatoglyphic marker, characteristic for people with PTSD. We analyzed the quantitative properties of the digito-palmer complex on a group of 100 male examinees over 18 years of age with PTSD, no psychiatric comorbidity, and who were two or more times cured at the Psychiatric Hospital &...
Psychiatria Danubina, 2009
Diagnostic recognition and distinguishing of psychotropic side effects which are phenomenological... more Diagnostic recognition and distinguishing of psychotropic side effects which are phenomenological Identical/similar to symptoms and/or signs of psychiatric disorders undergoing psychotropic treatment, is an integral element within the general diagnostic procedure. Unrecognising and undistinguishing of psychotropic-induced side effects from psychopathological phenomena and/or physical signs which are, according to relevant classification criteria, standard parts of psychiatric disorders, most frequently can cause increase the dose of the psychotropic medication, assigning of the unwarranted diagnoses, and/or addition of unnecessary medications. Some of the most frequent side effects that can be caused by the diagnostic difficulties and/or misjudgements of the phenomenological recognition and differentiating side effects from psychiatric symptoms and signs are: drug-induced akathisia, intensive anticholinergic pharmacodynamic effects including delirium, neuroleptic induced Parkinsonis...
Collegium antropologicum, 2004
Schizophrenia and other psychotic disorders as well as the delirium caused by abstinence from alc... more Schizophrenia and other psychotic disorders as well as the delirium caused by abstinence from alcohol and accute state of drunkenness appear at the very top of the list of factors, which are positively correlated with involuntary hospitalization of patients. This is at the same time a confirmation of the data found in literature considering psychosis an essential factor of involuntary hospitalization; the same referring to the male sex was not, however, confirmed by the results obtained in the first and second research period. Regarding the positive correlation between schizophrenia and other psychotic disturbances, dementia, delirium and other cognitive impairments including the delirium caused by abstinence from alcohol and an accute state of drunkenness on the one side and the high rate of involuntary hospitalization on the other, there is no statistically significant difference between the period preceding and the period following the alterations and amendments to the Law on the...
Collegium antropologicum, 2003
The effects of cisapride (10 mg three times daily) on the stool evacuation characteristics, laxat... more The effects of cisapride (10 mg three times daily) on the stool evacuation characteristics, laxative consumption (symptom diary) and motility pattern (rectoanal manometry) were assessed in patients with chronic idiopathic constipation who fulfilled Rome II criteria. After a 14-day basal period on a diet rich in fiber (phase I), patients were treated with placebo (n = 20) or cisapride (n = 19) (phase II). Anorectal manometry was performed at the end of each phase. The study was controlled, randomized and double blind. Side effects related to the use of cisapride were noted and found to be mild. Cisapride and placebo increased stool frequency from 4 (1-11) to 7 (14-12) (p < 0.001) and from 4 (2-10) to 6 (2-11) (p < 0.05) per week, respectively. Straining was decreased from 69.0% to 39.7% in the cisapride (p < 0.0001) group, and from 79% to 35% (p < 0.0001) in the placebo group. Both cisapride and placebo decreased the feeling of incomplete evacuation from 91.7% to 37.5% (p...
Collegium antropologicum, 2002
This epidemiological study of irritable bowel syndrome (IBS) was the first one of the type in Cro... more This epidemiological study of irritable bowel syndrome (IBS) was the first one of the type in Croatia. The aim of the study was to determine prevalence and association between IBS and gender, age, education and urban/rural living. Study design included a questionnaire based on Rome criteria, which was send to 500 study subjects by post. Study population matched the adult population of Croatia according last census. Study result showed a high prevalence of IBS: i.e. 28% (10% of males and 18% of females). Age, education and urban/rural type of living were not related to the prevalence of IBS. Logistic regression gave gender-body mass index (BMI) model for IBS determination: the relative risk for getting IBS in females was by 165% higher than in males and BMI increase of 5 kg/m2 increased the risk of IBS by 36%. BMI was indicated as a possible new factor of IBS prevalence.
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Papers by branka restek-petrovic