BACKGROUND Suicidal behavior is an important worldwide health problem. Psychiatric disorders, especially mood disorders, are the main risk factors for suicidal behavior. Suicide is an important cause of death in patients with epilepsy. The aim of this study was to analyze the presence of suicidal ideation in patients with epilepsy. SUBJECTS AND METHODS The study included 50 epilepsy inpatients and outpatients of both genders, aged 18 years and older, treated at the Department of Neurology, Clinical Center University of Sarajevo in the period from 1(st) of April - October 1(st) 2007. The sample was selected randomly. Applied research instruments were general questionnaire, HAM-D-17, BHS and BSS. RESULTS Suicidal ideation and thoughts of death were present in 38% epilepsy patients. Symptoms of depression as well as feelings of hopelessness were found in half of the participants (52% and 48%), and were significantly more common in epilepsy patients with suicidal ideation. There was a significant relation of suicidal ideation with the presence of chronic pain (3.86; p=0.49), sexual/physical abuse history (5.95, p=0.015), level of hopelessness (20.7; p=0.000) and severity of depression (14.48; p=0.000) in epilepsy patients. Multiple logistic regression analysis showed that unemployment (Exp(B) 33.9; p=0.007) and the level of hopelessness (Exp(B) 14.9; p=0.001) were independently related to suicidal ideation in these patients. CONCLUSIONS The study has shown that the level of hopelessness and unemployment have a predictive value for appearance of suicidal ideation in epilepsy patients. In the prediction of suicidal ideation in this population of patients, there is no single variable that should be considered as specific and separate.

The aim of this study was to determine the relationship between the risk factors (age, obesity, hypertension, hyperlipidemia, smoking, consumption of alchohol and drugs, positive family history, and exposure to sunlight), coping with stress, psychological well-being and age-related macular degeneration (ARMD). Forty patients with ARMD (case group) and 63 presbyopes (control group) participated in the study. Patient data were collected through general information questionnaire including patient habits, the COPE questionnaire that showed the way the patients handling stress, and the GHQ that analyzed the psychological aspects of their quality of life. These questionnaires were administered to the patients during ophthalmologic examination. The study involved 46 (44.66%) men and 57 (55.33%) women. Statistical analysis showed that the major risks for the development of ARMD were elevated cholesterol, triglycerides and LDL cholesterol in plasma. A significantly higher number ofARMD patients had a positive family history when compared with presbyopes. This study showed presbyopes to cope with emotional problems significantly better and to have a lower level of social dysfunction when compared with ARMD patients. However, it is necessary to conduct further studies in a large number of patients to determine more accurately the pathophysiological mechanisms of metabolic factors as well as the impact of the disease on the quality of life in patients with ARMD.

This study presents new insights on the provenance, genesis, and post-depositional history of the Miocene pyroclastic tuffaceous layers (~18 and ~15 Ma) preserved in argillaceous sediments and interbedded within the lacustrine sedimentary succession of the Sinj Basin in central Dalmatia (Dinaride Lake System, Croatia). Analysed tuffs are classified as smectitic tuffs composed of three main lithotypes: (a) vitriclastic tuffs, (b) altered vitriclastic tuff, and (c) tuffaceous clays. The high field strength element (HFSE) contents of the tuffs, as well as the major- element chemistry of the vitric glass, suggests that parental magmas were high-K calc-alkaline trachyandesites. This is consistent with the distinctive heavy-mineral assemblages including clinopyroxene, zircon and apatite, identified in less evolved parental magmas, and biotite in more evolved ones. The regional geological data imply the placement of the parent volcano(es) outside the Dinaric Alps region, most probably in an area corresponding to the present-day southern margin of the Pannonian Basin where volcanic rock suites of analogous age and geochemistry are reported. Minor compaction and high permeability of coarse ash-sized pyroclastic material allowed for extensive in situ diagenetic clay mineral formation dominated by smectite. Following discrete smectite formation, the illite-smectite mixed-layering took place as a result of mica/illite alteration or surface illitization processes. On the basis of the very-low grade alteration of volcanic materials, it is suggested that diagenesis operated in an open hydrologic system of a lacustrine environment.

ABSTRACT Background. Although prescribing antipsychotics to patients with schizophrenia is advised by national and/or international evidence-based practice guidelines, the implementation of the guidelines in clinical practice is still matter of concern. Objective. The aim of our study was to estimate schizophrenia guideline adherence and identify eventual barriers to its implementation in Montenegro. Method. This study used focus group methodology. The focus group was composed of two psychiatrists, one psychologist, one pharmacist from a community pharmacy, one pharmacist from the State reimbursement fund, one pharmacist from a drug wholesaler and the chief investigator, a clinical pharmacologist. The focus group took place in Podgorica, Montenegro, in 2013. The analysis of recordings was performed using an iterative, qualitative technique and a constant comparison method. Results. The most important barriers to the implementation of evidence-based guidelines for the treatment of schizophrenia in Montenegro are non-adherence to medication, low level of psychiatrist-patient concordance, restrictive procedures for prescribing atypical antipsychotics, lack of availability of newer antipsychotics and some dosage forms, and mixing primary, secondary and tertiary care services within a tertiary care psychiatric institution. Conclusion. Addressing the barriers identified by this focus group and avoiding the consequences of poor adherence would be the first SAŽETAK Uvod. Mada je propisivanje antipsihotika pacijentima sa šizofrenijom regulisano nacionalnim i/ili međunarodnim smernicama dobre kliničke prakse, zasnovanim na dokazima, primena ovih smernica u praksi je daleko od željene. Cilj. Cilj naše studije je bio da proceni koliko se psihijatri u Crnoj Gori pridržavaju smernica prilikom propisivanja antipsihotika, i da identifi kuje eventualne prepreke za njihovu punu primenu. Metod. U studiji je korišćena matodologija fokus grupe. Fokus grupu su sačinjavali dva psihijatra, jedan psiholog, jedan farmaceut iz vanbolničke apoteke, jedan farmaceut iz Fonda zdravstvenog osiguranja, jedan farmaceut predstavnik veledrogerije i glavni istraživač, klinički farmakolog. Sastanak fokus grupe je održan u Podgorici, Crna Gora, tokom 2013. godine. Analiza fonografskih zapisa sa sastanka je rađena iterativnom kvalitativnom tehnikom i metodom stalnog poređenja. Rezultati. Najvažnije prepreke za punu primenu vodiča za lečenje šizofrenije su ne-pridržavanje propisanoj terapiji, nedovoljno učešće pacijenata u donošenju odluka o njihovom lečenju, komplikovana administrativna procedura za propisivanje atipičnih antipsihotika, nedostupnost novijih antipsihotika i nekih doznih formi, kao i pomešanost primarnih, sekundarnih i tercijernih zdravstvenih usluga u bolnicama namenjenim samo za tercijernu zaštitu. Conclusion. Obraćanje pažnje na prepreke za primenu smernica koje je identifi kovala focus grupa i popravljanje adherence pacijenata su prvi koraci ka boljem planiranju psihijatrijske zdravstvene zaštite u Crnoj Gori.