No abstract

Hepatitis E has become an emerging infection in many European countries. We analysed the prevalence of hepatitis E virus (HEV) infection in selected population groups in Croatia. Overall HEV IgG seropositivity was 5.6%, while 1.9% participants showed IgM antibodies suggestive of recent infection. No IgM-positive sample was positive for HEV RNA. HEV IgG antibodies were most prevalent in alcohol abusers (8.9%) and war veterans (8.6%), compared with 6.1% among injecting drug users and 2.7% in healthcare professionals. No individual with high-risk sexual behaviour tested HEV seropositive. HEV IgG positivity increased significantly with age from 1.8% to 2.3% in individuals younger than 40 years to 11.3% in individuals older than 50 years (P = 0.023). The mean age of HEV-positive participants was significantly higher than that of HEV-negative participants (50.9 ± 11.8 years versus 41.2 ± 11.8 years, P = 0.008). Seroprevalence rates were significantly higher in residents of suburban and rural areas compared with residents of urban areas (14.5% versus 2.5%, P = 0.003). Additionally, an increasing prevalence of HEV IgG antibodies was observed from 1.8% in participants living in families with two household members to 12.1% in those living with more than four members (P = 0.046). Gender, marital status, educational level, sexual orientation, source of drinking water, history of blood transfusions, surgical procedures, tattooing and travelling were not associated with HEV seroprevalence. Logistic regression showed that living in suburban/rural areas was the main risk factor for HEV seropositivity (OR = 6.67; 95%CI = 1.89-25.0; AOR = 7.14, 95%CI = 1.89-25.0).

U radu je istraživana povezanost obrambenih mehanizama i drugih parametara ovisnosti (dob, spol, bračni i radni status, vrsta ovisnosti, te duljina i težina ovisnosti). Rezultati istraživanja su pokazali da su dominantni obrambeni mehanizmi kod ovisnika: apatično povlačenje, devaluacija, negacija, potiskivanje, projekcija, projektivna identifikacija i racionalizacija. Rezultati su također pokazali da postoje razlike u svim navedenim ispitivanim elementima. Kod žena se ovisnost razvija znatno rjeđe nego kod muškaraca, ali kada se ovisnost razvije tada ima teži oblik (češće prisutni nezreli obrambeni mehanizmi). Ovisnost o alkoholu i kockanju je više povezana s potiskivanjem, racionalizacijom, negacijom i projekcijom, a ovisnost o drogama i internetu s apatičnim povlačenjem, devaluacijom i projektivnom identifikacijom. Daljnja istraživanja obrambenih mehanizama ovisnika značajno će doprinijeti daljnjem napretku u dijagnostičkim i terapijskim postupcima. / This paper investigates the correlation between defence mechanisms and other parameters of addiction (age, gender, marital and work status, type of addiction, and length and severity of addiction). Research findings have shown thatdominant defence mechanisms in addicts are apathetic withdrawal, devaluation, denial, repression, projection, project identification and rationalization. These results also showed that there are differences in all of the above-mentioned parameters. In women, addiction develops considerably less often than in men, but when addiction develops it has a heavier form (more often, immature defence mechanisms are present). Alcohol and gambling addictions are more associated with repression, rationalization, denial and projection, and addiction to drugs and the internet with apathetic withdrawal, devaluation and projective identification. Further research on defence mechanisms in addicts will significantly contribute to further progress in diagnostic and therapeutic procedures.

Narcizam se u novije vrijeme sve češće razmatra u psihijatrijskoj literaturi, prije svega jer se nalazimo u dobu kada je izrazito raširen te se često se vidi kod osoba na vodećim funkcijama tako da za neke postaje model poželjnog ponašanja. Patologija narcizma se počinje intenzivnije proučavati početkom 20. stoljeća te kulminira radovima Kohuta i Kernberga. Prema mnogim istraživanjima prevalencija narcističkog poremećaja ličnosti u općoj populaciji iznosi 1 % što je veliki broj, no s druge strane dijagnoza narcističnog poremećaja u kliničkoj praksi rijetko se postavlja. Dijagnoza je iznimno složena, te je teško povući granicu između normalnog i patološkog narcizma, a dodatne komplikacije izaziva nedovoljan naglasak u stručnoj literaturi na dva tipa ovog poremećaja: vulnerabilni i grandiozni. Liječenje poremećaja iznimno je dugotrajno i zahtjevno prije svega zbog izostanka uvida pacijenta kao i zbog njegove usmjerenosti na međuljudske odnose. Terapijski izbor kojim bi se moglo pomoći ovim osobama da osvijeste svoje stanje te ga kontroliraju kako bi im se omogućilo stvaranje zdravih međuljudskih odnosa je psihoterapija, što individualna, što grupna. U ovom je radu naglašen grupni rad koji bi narcističnim pacijentima empatijom koja se stvara u grupama i kohezijom koja je esencijalna za integraciju narcističnog pacijenta pomoglo izgraditi manjkave intrapersonalne strukture, a dinamikom grupnog rada i povratnom vezom (feedback) pokazati kako svojim ponašanjem utječe na druge. / Narcissism has been discussed in the literature with increasing frequency, primarily because we are living in an age when it is widespread and is often seen in people holding leadership positions, so that for some it has become a model of desirable behaviour. Pathological narcissism began to be more intensively studied in the early 20th century, which culminated in the works of Kohut and Kernberg. According to many studies, the prevalence of narcissistic personality disorders in the general population is 1%, which is a large number, but on the other hand its diagnosis in clinical practice is rarely described. Diagnosis is extremely complex, and it is difficult to distinguish the boundary between normal and pathological narcissism, while additional complications result in insufficient emphasis in the professional literature on the two types of this disorder: vulnerable and grandiose. Treatment of the disorder is extremely long-lasting and demanding, primarily because of the patient's lack of insight and its focus on interpersonal relationships. Psychotherapy, either individual or in a group, is emphasized as a therapeutic choice that could help patients revitalize their condition, control it and enable them to create healthy interpersonal relationships. In this paper, we discuss the group work, that could help narcissistic patients to build upon a lack of intrapersonal structures through group empathy and cohesion that is essential for the integration of a narcissistic patient through the dynamics of group work and based on feedback about how th...