Purpose: The basic research goal of the current study was to determine the relationship between stressful life events and the appearance and course of psoriasis under the extreme conditions of war. Patients and Methods: A prospective study was made encompassing 181 patients with psoriasis. One half of the patients were soldiers in active duty under war conditions, the other half consisted of civilians who were living in an area that was frequently subject to shelling from across the nearby frontline. Diagnosis was based on clinical picture, patient history, and auxiliary diagnostic methods. The study has been carried out at the University Clinical Center of Tuzla, as a result of the cooperation between the Departments of Dermatology and Psychiatry. Although numerous measurement instruments were used, the present article concentrates on the analysis of stressful life events with standardized instruments such as ‘Five-Stage Rating Scale’, and ‘Social Readjustment Rating Scale’. Severity of the clinical picture was estimated according to the PASI score, a standardized measurement instrument. Results: Stress levels were observed to be very high: 75% of the soldiers scored above 300 points, with 34% even above 500 points. Civilians scored significant lower, but 51% still had scores above 300 points. Stress was found to be strongly correlated to severity of the disease with correlations of 0.862 and 0.773 (Kendall’s tau-b, p < 0.0001) for soldiers and civilians, respectively. Conclusions: In the past, many authors reported correlations between stress and severity of psoriasis. Our findings demonstrate that under extreme circumstances the correlation between severity of psoriasis and the experience of stress is also extremely strong.
The primary objective will focus the first of all on Group Analysis (GA) as the psychotherapy method and theory of group analysis applied particularly in postwar environments. It outlines in particular a Zagreb Institute for GA Training Programme that took place in Tuzla University Clinical Centre, Department of Psychiatry, in Bosnia-Herzegovina (BH) in response to 1992-1995 war, in helping to train mental health workers in GA to enable them to treat psychological trauma symptoms of war survivors. Method: Authors described educational process considering the history of idea and its realization through training levels and process of supervision which was provided from the Institute for GA,
AimThe primary objective will focus the first of all on Group Analysis (GA) as the psychotherapy method and theory of group analysis applied particularly in post-war environments. It outlines in particular a Zagreb Institute for GA Training Programme that took place in Tuzla University Clinical Centre, Department of Psychiatry, in Bosnia-Herzegovina (BH) in response to 1992–1995 war, in helping to train mental health workers in GA to enable them to treat psychological trauma symptoms of war survivors.MethodIn the GA education in the period of 16 years mental health professionals employed in mental health services were involved as well as other care employees as General Practitioners, Family physicians, pediatricians, gynecologists and neurosurgeons, psychologists and special educators.ResultsTrainees in education were from greater part of BH, and from several towns from neighborhoods countries. In this way a new room for mutual exchanges of experiences and establishing of cooperation was created. Idea of group analytic treatment of persons with mental health problems spread out on the whole region of BH through this model of education. The future of GA application as a psychotherapy model in BH confirmed through established models of education which are employed inowadays in Tuzla, Sarajevo and Mostar. The future of GA is provided in activities focused on foundations of the Institute for Analysis in Tuzla.ConclusionTraining of Bosnia-Herzegovina mental health workers to effectively use GA with enthusiastic help of GA trainers from Institute for GA Zagreb will develop dialogue culture in postwar BH.
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