Background: The objective of this study was to assess the complex relationship between the multiple determinants of the caregiving process, the caregiver burden, and depression during the COVID-19 pandemic in Serbia. Methods: A cross-sectional study was conducted on a nationally representative sample (n = 798) during the COVID-19 pandemic in Serbia from March to September 2020. A nine-section questionnaire designed for this study included the characteristics of caregivers, characteristics of care and care recipients, COVID-19 related questions, and the following standardized instruments: 12-Item Short-Form Health Survey, Fatigue Severity Scale, Activities of Daily Living Scale and Instrumental Activities of Daily Living Scale, Zarit Caregiver Burden Scale, and Beck Depression Inventory. Path analysis was used for the simultaneous assessment of the direct and indirect relationships of all determinants. Results: More than two thirds (71.9%) of informal caregivers experienced a burden, and more than one quarter (27.1%) had depression symptomatology. Self-rated physical health, need for psychosocial support, and caregiver burden were the main direct predictors of depression. Multiple determinants of the caregiving process had indirect effects on depressive symptomatology via the caregiver burden as a mediating factor. Conclusions: The subjective burden presented a significant risk factor for depressive symptoms in caregivers during the COVID-19 pandemic. The provision of psychosocial support was identified as an important opportunity to reduce depressive risk in informal caregivers.

Background/Aim. Adherence to the guidelines of Good Clinical Practice (GCP) during the treatment of specific disorders is considered a guarantee of the implementation of a uniform, evidence-based clinical practice in psychiatry. The aim of this study was to analyze the concordance of prescribing patterns of antipsychotic drugs with the recom

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A cardiovascular comorbidity (CVC) in psychiatric patients represents a simultaneous occurrence of a cardiovascular and a mental illness in the same patient regardless of the order of occurrence or of the cause and effect relationship that conjoins them. The objective was to determine the frequency and sort of the CVC in previously hospitalized patients with diagnoses of schizophrenic and affective disorders along with the differences in distribution of said disorders between the two groups of patients. Design-wise this is a retrospective study of intersections. It is based on the analytics of medical data (the history of disease along with the internal medicine consultant reviews) of the hospitalized patients in the Clinic for psychiatric disorders "Dr. Laza Lazarević" in Belgrade during the period between November 2014 and February 2015. Patients who were involved were older than 18 and they had diagnoses of schizophrenic disorders (F20-F29) and affective disorders (F30-F39), according to diagnostic criteria in the International classification of diseases 10 (ICD-10). CVC which were previously diagnosed or registered during the examination we separated into the following groups according to ICD-10: hypertension (HTA) I10, cardiac arrhythmia (CA) I47-I49, chronic cardiomyopathy (CMP) I42-I43 and ischemic heart disease (IHD) 120-125. The two groups of patients were analyzed according with socio-demographic characteristics (gender and age range) and CVC diagnosed according to MKB-10 classification. CVC were registered in 66% of the patients diagnosed with schizophrenia and 34% of the patients with affective disorders. Hypertension was most common in both groups of patients following with cardiac arrhythmia. Cardiac arrhythmias were statistically significantly more common in patients diagnosed with schizophrenic disorders (p<0.001) compared to patients with affective disorders. The frequency of hypertension, ischemic heart disease and chronic cardiomyopathy rises with age in both groups of patients. The results of this research confirm a high degree of CVC in hospitalized patients with diagnoses of schizophrenic and affective disorders (especially cardiac arrhythmia and hypertension). A multidisciplinary team is the key for diagnosing and monitoring patients with schizophrenic and affective diseases in both primary and secondary preventions.

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Rett syndrome is a neurodevelopmental disorder caused by mutation in the gene MECP2 on the X chromosome. The main clinical characteristics are breathing disorders, epileptic seizures, scoliosis, walking disability and constipation with frequent growth failure and malnutrition. Our transversal study included 29 female patients with Rett syndrome treated in the Institute for Mother and Child Health Care ''Dr Vukan Čupić'' in Belgrade. The patients were anthropometrically measured by their height and weight and caluculating body mass index. The degree of scolisios, the frequency of epileptic seizures, walking ability and grade of respiratory dysfunction were assessed based on the clinical scales for disease severity estimation. The statistical data analysis was done in the software package PASW Statistics 18. The average age of the patients was 145.5±90.1 months. The average height was 125.2±22.1cm, the average weight 27.6±12.3kg, and the average body mass index was 16.6±3.5kg/m 2. The average z scores for height, weight and BMI-for-age were statistically significantly lower in comparison to general population, which is given with negative z scores. There was the statistically significant negative coorelation between the age of patients and the average z scores for height-for-age (r=-0.464 p=0.011), weight-for-age (r=-0.433 p=0.019) and BMI-for-age (r=-0.433 p=0.019). The statistically significant negative coorelation was found between the degree of scoliosis and the average z scores for height and weight-for-age, but not with the average z score for BMI-for-age.The growth failure and malnutrition represent significant problems which are found in Rett syndrome. The detection of factors affecting the growth and nutrition in patients with Rett syndrome could greatly contribute to the improvement of the quality of life in the patients with Rett syndrome and perhaps lead to the correction of the approach of symptomatic and supportive therapy.

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Delirium is connected to bad short-term (the increase in hospital mortality rate and hospital days) and long-term outcomes (disfunctionality, institutionalisation, cognitive damage and post hospital-release dementia). The objective of this study is to determine whether there are possible incompatibilities of treatment of delirium with the recommendations in the guides of good clinical practice from developed countries. The grounded method was used in the study. The so called principal sampling of 17 psychiatrists, anesthesiologists and registered nurses was conducted. Afterwards, the unstructured interviews with the selectees were conducted, transcribed and analyzed immediately through coding, category and concept detection. Having completed this, the theoretical sampling of new interview examinees was conducted. Their analysis enabled the concepts to be linked into a working theory and graphically displayed. The new sampling, the new interviews and their analysis were then continued interactively until the saturation of the working theory was achieved and the final version of the theory was formulated based on the findings reached through the interviews. Having completed the principal sampling and coding of the transcripts led the researches to the saturation of the theory through the separation of eight categories: A -Delirium as a sign of system infection, B -Therapy -Anaesthesiologists administer benzodiazepines, whereas psychiatrists administer antipsychotics, C -An inconspicuous onset of delirium is overlooked, D -Bleeding as the cause of delirium, E -Anticholinergics as a cause of delirium, F -Misunderstanding the nature of delirium by anaesthesiologists, G -Being aware that the patient is vitally endangered, and H -The nurses apply enhanced health care measures. Delirium is a syndrome which can be prevented in 30-40% of cases (50). An etiological treatment would help avoid complicating delirium's clinical picture and would very much prevent poor outcomes, such as institutionalisation, cognitive damage and delirious patients' high mortality rate.