No abstract

This analysis indicates that out of all the observed factors, the most important is appropriate selection of personnel.

The possibility for war veterans to obtain the right to disability and financial compensation due to a diagnosis of PTSD might interfere with the proper diagnostic assessment and thus the treatment outcome. During the procedures for the obtention of these rights, exaggeration or simulation of symptoms are common. The quality of the diagnostic assessment of PTSD can be improved by applying evidence based standardized procedures.

Background/Aim. The co-occurrence of depression and tobacco smoking among treated alcoholics is frequent, but understudied. Some findings suggest that there are some shared etiological factors, but a few clinical researches of personality dimensions among patients with these comorbidities were done. The personality dimensions, the pattern of cigarette use and depression and correlation of personality and depression among inpatient alcoholics were explored. Methods. One hundred primary male inpatient alcoholics were consecutively recruited. The eighty-six of them completed study and were compared with 30 age-matched, healthy male subjects. A semi-structured clinical interview related to sociodemographics, the pattern of cigarette and alcohol use and family history data was applied. According to cutoff on the Hamilton Depression Rating Scale (HDRS), the alcoholics were divided into depressive and non-depressive subgroups resulting in half of alcoholics in each subgroup. The Eysenck personality questionnaire (EPQ) was completed. Student's t-test for differences and Pearson's test for correlation were used. Results. There were no significant sociodemographic differences between groups. Alcoholics were more frequent smokers (86% vs. 50%). They did not start drinking earlier, but they started smoking earlier, with higher daily cigarettes use than controls. On average, alcoholics had mild depression after detoxification. The personality dimensions did not show differences between groups, except neuroticism. The neuroticism showed significantly higher level among alcoholics vs. controls (12.72 ± 5.19 vs. 5.00 ± 3.36 respectively) and among depressive vs. non-depressive alcoholics (15.07 ± 4.89 vs. 10.37 ± 4.40 respectively). The depression correlated only with neuroticism (r = 0.487, p < 0.001). Conclusions. The majority of detoxified alcoholics were smokers who started smoking earlier, with mild depression and higher neuroticism compared to controls. Our results suggest that the alcoholics with high neuroticism may experience higher depression and may require more intensive integrative treatment.

Introduction. Recent studies have shown that diagnostic differences in the opinion whether some case is a psychotic subtype of posttraumatic stress disorder (PTSD) or a comorbid psychotic disorder still exist. In a case of mental disorders, a specific nature of military environment requires a detailed evaluation of abilities for military service (MS). Case report. A 34-year old male noncommissioned officer (NCO) showed symptomatology of PTSD (according to the Diagnostic and Statistical Manual of Mental Disorders-DSM-IV) after experiencing a traumatic event in peacetime conditions. In addition to experiencing trauma as an adult, the patient was also exposed to early-age trauma, when his father committed suicide. After a pharmacotherapy and cognitive behavioral therapy treatment, he was remitted and returned to his duty. Triggered by new stress caused by unfavorable environmental factors (occupational environment), psychotic phenomenology appeared. After two years of psychiatric treatment, patient was evaluated unfit for MS. Conclusion. Early-age trauma and/or PTSD are predispositions for a comorbid psychotic disorder, while the diagnostic entity of psychotic subtype of PTSD requires further research. Evaluation of MS abilities in patients with psychotic disorder based on our clinical experience, will require a psychiatric treatment for at least two years, which is in accordance with a research conducted in the British Army.