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Article: The role of the psychiatrist in improving patient compliance.

Hotujac, Ljubomir

2007 Volume 28 Suppl 1, Page(s) 27–33

Abstract: Compliance, usually referring to how well the patient takes the medication as prescribed, is an important issue in clinical practice. However, many patients, especially those with a psychiatric illness, stop taking their medications despite physician ... ...

Abstract	Compliance, usually referring to how well the patient takes the medication as prescribed, is an important issue in clinical practice. However, many patients, especially those with a psychiatric illness, stop taking their medications despite physician advice to continue. This cessation can lead to a deterioration in the condition, a relapse, or a recurrence of the illness. In the literature, many different factors contributing to poor compliance have been described, but the doctor's role and responsibilities are hardly mentioned. These factors will be discussed here with special emphasis on what a doctor should do and what a doctor should avoid.
MeSH term(s)	Antipsychotic Agents/therapeutic use ; Humans ; Patient Compliance ; Psychiatry ; Psychotic Disorders/drug therapy ; Psychotic Disorders/psychology ; Treatment Outcome
Chemical Substances	Antipsychotic Agents
Language	English
Publishing date	2007-02
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	135951-4
ISSN	0172-780X
ISSN	0172-780X
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Treatment of rapid cycling bipolar disorders.

Hotujac, Ljubomir

Neuro endocrinology letters

2005 Volume 26 Suppl 1, Page(s) 67–73

Abstract: Rapid cycling (RC) bipolar disorder is defined as four or more affective episodes within one year. RC bipolar disorder constitutes one of the most difficult forms of the illness to treat effectively. According to several studies, RC bipolar patients have ...

Abstract	Rapid cycling (RC) bipolar disorder is defined as four or more affective episodes within one year. RC bipolar disorder constitutes one of the most difficult forms of the illness to treat effectively. According to several studies, RC bipolar patients have more severe symptoms than non-rapid cycling bipolar patients. Most studies indicate that only 10% to 20% of patients with bipolar disorders experience rapid cycling, but this is of great concern to psychiatrists because of its association with treatment refractoriness. Second generation antipsychotics are increasingly being used in the treatment of bipolar disorder. A first step in the management of rapid-cycling bipolar disorder is the thorough assessment of possible medications or environmental factors that may destabilize the disorder and contribute to the recurrence of episodes, increasing cycle frequency, or both. All currently approved antidepressant drugs pose some risk of mood destabilization, but the risk is highest for tricyclic antidepressants. Discontinuation of antidepressants should be the first step in the management of RC patients.
MeSH term(s)	Antidepressive Agents, Second-Generation/therapeutic use ; Antipsychotic Agents/therapeutic use ; Bipolar Disorder/diagnosis ; Bipolar Disorder/drug therapy ; Cyclothymic Disorder/drug therapy ; Humans ; Treatment Outcome
Chemical Substances	Antidepressive Agents, Second-Generation ; Antipsychotic Agents
Language	English
Publishing date	2005-08
Publishing country	Sweden
Document type	Journal Article ; Review
ZDB-ID	135951-4
ISSN	0172-780X
ISSN	0172-780X
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Book: Pola stoljeća Nikole Peršića u hrvatskoj psihijatriji

Hotujac, Ljubomir

(Biblioteka Posebna izdanja)

2001

Author's details	Ljubomir Hotujac i Vlado Jukić, urednici
Series title	Biblioteka Posebna izdanja
MeSH term(s)	Psychiatry
Keywords	Croatia
Language	Croatian
Size	352 p. :, ill., ports.
Publisher	Medicinska naklada
Publishing place	Zagreb
Document type	Book
ISBN	9789531761406 ; 953176140X
Database	Catalogue of the US National Library of Medicine (NLM)

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Article: Vagus nerve stimulation in the treatment of pharmacoresistant depression.

Hotujac, Ljubomir / Kuzman, Martina Rojnic

Neuro endocrinology letters

2008 Volume 29 Suppl 1, Page(s) 133–146

Abstract: Treatment-resistant depression is one of the major challenges in clinical psychiatry, considering that its current treatments are far from optimal. Although known for decades, in the last few years vagus nerve stimulation (VNS) has become increasingly ... ...

Abstract	Treatment-resistant depression is one of the major challenges in clinical psychiatry, considering that its current treatments are far from optimal. Although known for decades, in the last few years vagus nerve stimulation (VNS) has become increasingly popular as a novel method of treatment of pharmacoresistant depression. In spite of an emerging body of literature concerning the effectiveness and potential mechanisms of action of VNS, some crucial questions regarding those issues remain to be answered. We review the pre-clinical and clinical literature relating to VNS, with the impact of studies of efficacy and safety in treatment of pharmacoresistant depression and also in other clinical applications in the field of psychiatric disorders. We conclude that in light of emerging reports, VNS warrants more controlled studies for the treatment of other forms of depression, including depression in a younger population, and also of other psychiatric disorders. Because of its safety, VNS could potentially become a treatment of choice in fields in which treatment procedures traditionally require the least aggressive methods.
MeSH term(s)	Depressive Disorder/therapy ; Humans ; Mental Disorders/therapy ; Risk Factors ; Vagus Nerve/physiology ; Vagus Nerve Stimulation/methods ; Vagus Nerve Stimulation/utilization
Language	English
Publishing date	2008-11
Publishing country	Sweden
Document type	Journal Article ; Review
ZDB-ID	135951-4
ISSN	0172-780X
ISSN	0172-780X
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Article: Premenstrual dysphoric disorder--a neglected diagnosis? Preliminary study on a sample of Croatian students.

Rojnić Kuzman, Martina / Hotujac, Ljubomir

Collegium antropologicum

2007 Volume 31, Issue 1, Page(s) 131–137

Abstract: The aims of this study were to assess prevalence and symptom profile of premenstrual dysphoric disorder (PMDD) in a sample of Croatian students and young university graduates. We obtained data for 87 healthy women, aged 18-30, at their regular ... ...

Abstract	The aims of this study were to assess prevalence and symptom profile of premenstrual dysphoric disorder (PMDD) in a sample of Croatian students and young university graduates. We obtained data for 87 healthy women, aged 18-30, at their regular gynecologic outpatient visits over the period of 2003 to 2004. The severity of premenstrual symptoms were assessed daily, during two cycles, with the Daily Record of Severity of Problems (DRSP) and criteria for PMDD according to DSM-IV were applied. Fifteen out of 87 women fulfilled PMDD criteria and reported statistically significantly higher prevalence of co morbid disorders in their medical history compared to non-PMDD group. The most common symptoms in the PMDD group were psychological, while in non-PMDD group were vegetative. Overall, relatively high prevalence of PMDD in studied group indicates the need to continue the study.
MeSH term(s)	Adolescent ; Adult ; Croatia ; Female ; Humans ; Mood Disorders/diagnosis ; Mood Disorders/epidemiology ; Premenstrual Syndrome/diagnosis ; Premenstrual Syndrome/epidemiology ; Students
Language	English
Publishing date	2007-03
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	233430-6
ISSN	0350-6134 ; 0353-3735
ISSN	0350-6134 ; 0353-3735
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Article ; Online: Psychological consequences of rape on women in 1991-1995 war in Croatia and Bosnia and Herzegovina.

Loncar, Mladen / Medved, Vesna / Jovanović, Nikolina / Hotujac, Ljubomir

Croatian medical journal

2006 Volume 47, Issue 1, Page(s) 67–75

Abstract: Aim: To explore the short- and long-term psychological consequences of rape on women victims of rape during the 1992-1995 war against Croatia and Bosnia and Herzegovina.: Methods: The study included 68 women victims of rape and was conducted at the ... ...

Abstract	Aim: To explore the short- and long-term psychological consequences of rape on women victims of rape during the 1992-1995 war against Croatia and Bosnia and Herzegovina. Methods: The study included 68 women victims of rape and was conducted at the Medical Center for Human Rights, Zagreb, Croatia, from 1992 to 1995. Testimony method and a questionnaire were used to retrospectively obtain the description of rapes and symptoms women suffered immediately after rape and at the time of the study, ie, 11.9-/+2.4 after the trauma. Structured clinical interviews were conducted to diagnose psychiatric disorders that were present at the time of study, according to the third edition of Diagnostic and Statistical Manual of Mental Disorders. Results: The raped women were Croatian and Muslim (Bosniak) women, residents of Croatia and Bosnia and Herzegovina. Forty-four of them were raped more than once, 21 were raped every day during their captivity, and 18 were forced to witness rapes. Most of the rapes (n=65) were accompanied by physical torture. The most frequent psychological symptoms felt immediately after the rape were depressiveness (n=58), avoidance of thoughts or conversations associated with the trauma (n=40), and suicidal ideas (n=25). Although none of the women had a psychiatric history before the rape, at the time of study 52 suffered from depression, 51 from social phobia, 21 from posttraumatic stress disorder (PTSD), and 17 had sexual dysfunctions. These disorders were often comorbid. Out of 29 women who got pregnant after rape, 17 had artificial abortion. The decision to have an abortion was strongly predicted by suicidal thoughts and impulses (odds ratio, 25.8; 95% confidence interval, 2.53-263.2). Conclusion: War-time rapes had deep immediate and long-term consequences on the mental health of women victims of rapes and their social and interpersonal functioning.
MeSH term(s)	Bosnia and Herzegovina ; Croatia ; Female ; Humans ; Mental Disorders/etiology ; Rape/psychology ; Stress Disorders, Post-Traumatic/etiology ; Warfare
Language	English
Publishing date	2006-02
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	1157623-6
ISSN	1332-8166 ; 0353-9504
ISSN (online)	1332-8166
ISSN	0353-9504
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Organizacija zastite mentalnog zdravlja u zajednici.

Ivezić, Sladana Strkalj / Jukić, Vlado / Hotujac, Ljubomir / Jukić, Marija Kusan / Tikvica, Ana

Lijecnicki vjesnik

2010 Volume 132, Issue 1-2, Page(s) 38–42

Abstract: Integration of the psychiatry in primary care is beneficial for the early detection of mental disorder, better outcome of mental disorder and reduction of stigma. Psychiatry is a leading profession in organisation of mental health services. General ... ...

Title translation	The organization of mental health care in community.
Abstract	Integration of the psychiatry in primary care is beneficial for the early detection of mental disorder, better outcome of mental disorder and reduction of stigma. Psychiatry is a leading profession in organisation of mental health services. General practitioners (GPs) in Europe deal with mental disorders in their everyday practice, so the same is expected in Croatia. Graduate and postgraduate education of our GPs is insufficient for this new role. The paper compares actual situation in Croatia with forthcoming needs. The paper suggests that community psychiatry, anti-stigma program, continuing medical education of GPs and network of consultant psychiatrists give the best results in the early detection and treatment of mental disorder.
MeSH term(s)	Community Mental Health Services/organization & administration ; Croatia ; Humans ; Mental Disorders/therapy ; Primary Health Care ; Psychiatry ; Referral and Consultation
Language	Croatian
Publishing date	2010-01
Publishing country	Croatia
Document type	English Abstract ; Journal Article
ZDB-ID	128938-x
ISSN	1849-2177 ; 0024-3477 ; 1330-4917
ISSN (online)	1849-2177
ISSN	0024-3477 ; 1330-4917
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Posttraumatic stress disorder in women--experiences form the Psychiatric Clinic, University Hospital Center Zagreb, Croatia.

Jovanović, Nikolina / Kuzman, Martina Rojnić / Medved, Vesna / Sabolić, Andelina Bokić / Grubisin, Jasmina / Hotujac, Ljubomir

Collegium antropologicum

2009 Volume 33, Issue 1, Page(s) 267–272

Abstract: Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumatic event or experience. Lifetime prevalence rate in the European population is 1.9 % and it is higher for women (2.9%) then for men (0.9 %). The aim of this ... ...

Abstract	Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumatic event or experience. Lifetime prevalence rate in the European population is 1.9 % and it is higher for women (2.9%) then for men (0.9 %). The aim of this study was to examine rates and sociodemographic and clinical characteristics of women with PTSD who were hospitalized at the Psychiatric clinic of University Hospital Center in Croatia over the years 1990-2007. Data were gathered retrospectively from the medical charts. We found that 67 women were diagnosed with PTSD which is 0.58% of all admissions over these years. Majority suffered from comorbid depression (N = 51) and various somatic conditions, especially malignant gynecological tumors (N = 23). No significant differences were found in distribution of PTSD symptoms in relation to the combat vs. civilian trauma. We found that patients with combat trauma often suffer from comorbid depression, while those with civilian traumas more often reported somatic conditions, especially malignant gynecological tumors. Our institution is a speciality clinic at a tertiary care medical center which tends to accumulate patients with serious forms of the disorder, and therefore our results can not be generalized to other settings involved in working with women with PTSD. Our results indicate that psychiatrists' assessment of female patients should inevitably include lifetime traumatic experiences, and among those with PTSD, special attention should be paid to comorbid depression and malignant tumors.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Croatia/epidemiology ; Female ; Hospitals, University ; Humans ; Middle Aged ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/epidemiology
Language	English
Publishing date	2009-03
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	233430-6
ISSN	0350-6134 ; 0353-3735
ISSN	0350-6134 ; 0353-3735
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Article ; Online: Psychiatric symptoms in idiopathic intracranial hypertension.

Kuzman, Martina Rojnic / Jovanovic, Nikolina / Vukelja, Dinko / Medved, Vesna / Hotujac, Ljubomir

Psychiatry and clinical neurosciences

2008 Volume 62, Issue 3, Page(s) 367

MeSH term(s)	Acetazolamide/therapeutic use ; Adult ; Borderline Personality Disorder/diagnosis ; Borderline Personality Disorder/psychology ; Depersonalization/diagnosis ; Depersonalization/psychology ; Diagnosis, Differential ; Dissociative Disorders/diagnosis ; Dissociative Disorders/drug therapy ; Dissociative Disorders/psychology ; Diuretics/therapeutic use ; Empty Sella Syndrome/diagnosis ; Empty Sella Syndrome/psychology ; Female ; Headache/etiology ; Histrionic Personality Disorder/diagnosis ; Histrionic Personality Disorder/psychology ; Humans ; Mood Disorders/diagnosis ; Mood Disorders/drug therapy ; Mood Disorders/psychology ; Mutism/diagnosis ; Mutism/psychology ; Papilledema/etiology ; Pseudotumor Cerebri/diagnosis ; Pseudotumor Cerebri/drug therapy ; Pseudotumor Cerebri/psychology ; Puerperal Disorders/diagnosis ; Puerperal Disorders/drug therapy ; Puerperal Disorders/psychology ; Stereotyped Behavior ; Tomography, Spiral Computed ; Vomiting/etiology
Chemical Substances	Diuretics ; Acetazolamide (O3FX965V0I)
Language	English
Publishing date	2008-06
Publishing country	Australia
Document type	Case Reports ; Letter
ZDB-ID	1292906-2
ISSN	1440-1819 ; 1323-1316
ISSN (online)	1440-1819
ISSN	1323-1316
DOI	10.1111/j.1440-1819.2008.01810.x
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Associations between MDR1 gene polymorphisms and schizophrenia and therapeutic response to olanzapine in female schizophrenic patients.

Bozina, Nada / Kuzman, Martina Rojnic / Medved, Vesna / Jovanovic, Nikolina / Sertic, Jadranka / Hotujac, Ljubomir

Journal of psychiatric research

2008 Volume 42, Issue 2, Page(s) 89–97

Abstract: Multidrug resistant protein (MDR1) gene, which codes for P-glycoprotein and functions as an efflux transporter in different cells, is widely localized in normal tissues including the gastrointestinal tract, blood cells, biliary tract, kidney and brain ... ...

Abstract	Multidrug resistant protein (MDR1) gene, which codes for P-glycoprotein and functions as an efflux transporter in different cells, is widely localized in normal tissues including the gastrointestinal tract, blood cells, biliary tract, kidney and brain and plays a major role in absorption, distribution and elimination of various xenobiotics. Therefore, MDR1 gene variants were proposed as potential susceptibility factors for diseases and as determinants of treatment response to various drugs. We investigated the relationships between exon 21 G2677T and exon 26 C3435T genetic variants of MDR1 gene with susceptibility and treatment response in female schizophrenic patients. The study was conducted in two steps. We first compared allele, genotype and haplotype distributions between 117 female schizophrenic patients and 123 control female subjects. Afterwards, we studied treatment response to olanzapine, in 87 out of 117 previously unmedicated female patients. Overall, we found lower representation of G2677/C3435 haplotype in schizophrenic female patients compared to controls. Test result for linkage disequilibrium between loci was found to be significant. Furthermore, we found significant associations between MDR1 exon 21 G2677T genotypes and treatment response measured with positive PANSS percentage changes, with T allele and TT genotype being associated with significantly better treatment response. A borderline, non-significant statistical association was found between MDR1 exon 26 C3435T genotypes and treatment response, with TT genotype being associated with better treatment response. Our data support functional importance of the MDR1 mutations for the susceptibility and treatment response in female schizophrenic patients.
MeSH term(s)	ATP Binding Cassette Transporter, Sub-Family B ; ATP-Binding Cassette, Sub-Family B, Member 1/genetics ; Adult ; Alleles ; Antipsychotic Agents/adverse effects ; Antipsychotic Agents/therapeutic use ; Benzodiazepines/adverse effects ; Benzodiazepines/therapeutic use ; DNA Mutational Analysis ; Exons/genetics ; Female ; Genetic Predisposition to Disease/genetics ; Genotype ; Haplotypes ; Humans ; Linkage Disequilibrium ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length/genetics ; Psychiatric Status Rating Scales ; Reference Values ; Schizophrenia/diagnosis ; Schizophrenia/drug therapy ; Schizophrenia/genetics ; Treatment Outcome
Chemical Substances	ABCB1 protein, human ; ATP Binding Cassette Transporter, Sub-Family B ; ATP-Binding Cassette, Sub-Family B, Member 1 ; Antipsychotic Agents ; Benzodiazepines (12794-10-4) ; olanzapine (N7U69T4SZR)
Language	English
Publishing date	2008-01
Publishing country	England
Document type	Journal Article
ZDB-ID	3148-3
ISSN	1879-1379 ; 0022-3956
ISSN (online)	1879-1379
ISSN	0022-3956
DOI	10.1016/j.jpsychires.2006.10.002
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