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OBJECTIVES: The outbreak of the COVID-19 pandemic was followed by the widespread proliferation of conspiracy beliefs (CBs) regarding the origin and harmfulness of the virus and a high level of hesitancy to vaccinate. We aimed to test a series of hypotheses on the correlates of CBs and vaccination, including socio-demographic factors, personality dispositions, somatic health, stressful experiences during pandemics, and psychological distress. METHOD: The sample (N = 1203), was based on a multistage probabilistic household sampling representative of the general population. The subjects were randomly split into two approximately equal subgroups, enabling cross-validation. Based on the findings in the exploratory, the SEM model was tested in the confirmatory subsample. RESULTS: The correlates of CBs were Disintegration (proneness to psychotic-like experiences), low Openness, lower education, Extraversion, living in a smaller settlement and being employed. The correlates of vaccination were older age, CBs and larger places of living. Evidence on the role of stressful experiences and psychological distress in CBs/vaccination was not found. The findings of moderately strong and robust (cross-validated) paths, leading from Disintegration to CBs and from CBs to vaccination were the most important ones. DISCUSSION: Conspiratorial thinking tendencies-related to health-related behaviour such as vaccination-appear to be, to a considerable extent, manifestations of the mechanisms that are part of our stable, broad, trait-like thinking/emotional/motivational/behavioural tendencies, primarily proneness to psychotic-like experiences & behaviours.

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RATIONALE: Eye rubbing (ER) is a proven factor that can trigger the onset and progression of keratoconus (KC). Apart from allergy, ER is a repetitive motor stereotypy. Eye rubbing is frequently observed in children with autism spectrum disorders (ASDs) and in individuals who may be at risk for developing KC. We present a child with ASD who developed progressive KC following standard corneal cross-linking (CXL), most likely because of abnormal ER associated with allergy and repetitive behavior due to ASD symptoms. PATIENT CONCERNS: A 14-year-old boy was referred to our clinic because of asymmetric visual acuity reduction. DIAGNOSIS: The child was diagnosed as having keratoconus. He had a strong ER habit. The child had been previously diagnosed as having ASD. INTERVENTIONS: Corneal cross-linking was performed in both the eyes. On account of keratoconus progression, most likely associated with persistent ER habit, he was retreated with CXL in the right eye. Behavioral modification intervention for ER habit reversal was also applied. OUTCOMES: Corneal cross-linking in combination with behavioral modification intervention for ER habit reversal prevented further KC progression. LESSONS: Behavioral interventions are likely to provide positive results in an ER habit reversal in children with ASD. Keratoconus treatment with CXL combined with behavioral management for ER reversal seemed effective in halting keratoconus progression in a young patient with ASD.

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BACKGROUND: New classification system Diagnostic and statistical manual of mental disorders. 5th ed.(DSM - 5) includes sensory problems as one of the symptoms in diagnostic profile of Autism Spectrum Disorder (ASD). Researching the effects of sensory integration treatment may improve new approaches to the individuals with ASD. The objective of this study is to determine the effects of Snoezelen, multisensory environment on the severity of ASD and stereotyped/repetitive behaviours in adolescents and adults using CARS scale. METHOD: The study involved 40 subjects with ASD associated with intellectual difficulties of both sexes, aged 15-35. The subjects were randomly divided into two groups: a control one (without treatment) and an experimental one (with treatment). The assessments were rated by CARS (Childhood Autism Rating Scale) before and after the three-month treatment. RESULTS: In the experimental group, there was a statistically significant difference of the total CARS score before and after the treatment (p < 0.0005). Comparing the results of both experimental and control groups, a statistically significant difference was found on total CARS score (p < 0.0005). Conslusion: The results in the present study indicate that the continual sessions in Snoezelen room had effects on reducing severity of ASD and repetitive and stereotyped behaviours on CARS scale.

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Drug-induced Extrapyramidal Symptoms Scale (DIEPSS) is developed in the era of second-generation antipsychotics and is suitable for evaluation of the low incidence of extrapyramidal symptoms occurring in the treatment of atypical antipsychotics, as well as the relationship between personal and social functioning. The study was carried out at the Institute of Mental Health in Serbia in 2015 Study used the 127 DIEPSS video clips material, recorded from 1987 till 2015. Four raters performed the assessment simultaneously, individually rating one assigned item immediately after seeing the video clip. For the purpose of evaluating test-retest reliability the second assessment of the same material was performed nine months after the first assessment. Inter-rater reliability was high for each individual item, with ICCs ranging from 0.769 to 0.949. The inter-rater reliability was highest for akathisia item and lowest for dyskinesia. The test-retest reliability was high for each individual item, with ICC ranging from 0.713 to 0.935. The test-retest reliability was highest for bradykinesia item and lowest for dystonia. The Serbian version of DIEPSS has high level of inter-rater and test-retest reliability. High values of concordance rates (ICC > 0.7) for each evaluated individual item suggest that items of DIEPSS are well defined.

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BACKGROUND/AIM: Child abuse may be related to adverse psychological outcomes in adult life. However, little is known about specific clinical, family and resilience profiles of adolescents that have experienced child abuse. The aim of this study was to investigate clinical symptoms, family functioning and resilience characteristics of adolescents with the experience of abuse, first referred to psychiatrists. METHODS: The study included 84 young participants (mean age 14.90 +/- 3.10, ranging from 11 to 18 years) as consecutive first referrals to the Clinic for Children and Youth of the Institute of Mental Health, Belgrade, Serbia. The sample consisted of two groups, based on the Child Abuse Matrices of Risks. The first group included adolescents with the experience of abuse in childhood (n = 38, 13 males, 25 females), whereas the second, control group, comprised of non-abused adolescents (n = 47, 20 males, 27 females). The presence of abuse was evaluated by the Child Abuse Matrices of Risks. The study used the following questionnaires: Youth Self-Report (YSR), Adolescent Resilience Attitudes Scale (ARAS), and Self-Report Family Inventory (SFI). RESULTS: Significant differences were found only among females. According to YSR, the abused girls had significantly higher scores on the Delinquent Behavior scale and marginally higher scores on Anxious/Depressed and Social Problems scales. Analyses of the SFI showed significantly lower family functioning among the girls with the child abuse history for all scales except for the Directive Leadership. The abused girls also showed significantly lower scores on the Insight scale, and marginally lower Initiative scores at the ARAS. CONCLUSIONS: These findings may have practical application in the creation of specific preventive and treatment strategies, particularly focused on delinquent tendencies, as well as on enhancing resilience through providing positive environments within families, schools and communities.

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Schizophrenia is an idiopathic mental disorder with a heritable component and a substantial public health impact. We conducted a multi-stage genome-wide association study (GWAS) for schizophrenia beginning with a Swedish national sample (5,001 cases and 6,243 controls) followed by meta-analysis with previous schizophrenia GWAS (8,832 cases and 12,067 controls) and finally by replication of SNPs in 168 genomic regions in independent samples (7,413 cases, 19,762 controls and 581 parent-offspring trios). We identified 22 loci associated at genome-wide significance; 13 of these are new, and 1 was previously implicated in bipolar disorder. Examination of candidate genes at these loci suggests the involvement of neuronal calcium signaling. We estimate that 8,300 independent, mostly common SNPs (95% credible interval of 6,300-10,200 SNPs) contribute to risk for schizophrenia and that these collectively account for at least 32% of the variance in liability. Common genetic variation has an important role in the etiology of schizophrenia, and larger studies will allow more detailed understanding of this disorder.

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Serbia has, along with other countries in the region, begun reform of its mental healthcare services. The delivery of mental healthcare was hitherto only partially regulated by law. Hence the National Committee for Mental Healthcare in Serbia has prepared a draft Mental Health Law within the context of a multicentre project entitled 'Enhancing social cohesion through strengthening community care' as part of the Stability Pact for South Eastern Europe. It is expected that new mental health legislation will soon be approved by Parliament and lead to the implementation of changes concerning mental healthcare. It should contribute to the destigmatisation of patients, mental health professionals and psychiatry as a discipline.

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Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune disease of unknown etiology, which affects multiple organ systems, including the central nervous system (CNS). Neuropsychiatric manifestations are seen in 13-75% of all SLE patients, with equal frequency in children and adults. Despite a high prevalence of psychiatric manifestations, there is no consensus on the proper treatment of such cases. We report here a case of an 11-year-old girl diagnosed with a severe depressive episode with psychotic features, treated successfully with risperidone and sertraline as an adjunct to immunosuppressive therapy.

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Serbia has been exposed to many severe stressors during the last 20 years and as a result there is an increase of the incidence of mental health problems in its population, so that mental disorders are the second largest public health problem, after cardiovascular diseases. The National Strategy for Development of Mental Health Care was approved by the government in January 2007 which initiated the reform of psychiatry in the country. The major advantages of the existing organization of mental healthcare are a sufficient number of psychiatric services and the number of well educated professionals, but there are considerable problems in big psychiatric hospitals which are significantly overcrowded with patients, as well as with the lack of a network of community services. In the future, key points of mental health reform aim to focus on improved cooperation and collaboration between primary, secondary and tertiary healthcare levels, definition of catchment areas and responsibilities, continuing education of general practitioners in mental health issues, and better cooperation between psychiatric and social welfare institutions. The profile of the Institute for Mental Health is described as a case of good practice in the field of mental healthcare in Serbia.

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INTRODUCTION: Autism spectrum disorders (ASDs) are a group of complex pervasive developmental disorders characterized by impairments in communication, social interaction and behavior. In most cases autism is caused by a combination of genetic factors and environmental risk factors. In 10% to 20% of cases it has been shown that the cause of ASD is genetic. CASE OUTLINE: We are describing a 2-year-old boy who was referred to genetic counseling because of speech delay and certain autism-like behavior. By cytogenetic analysis the karyotype 46, inv(X),Y was obtained. The boy was a carrier of a paracentric inversion of the short arm of the chromosome X. After cytogenetic analysis of parental blood, it was detected that mother was a carrier of identical aberration, but had no clinical signs. The method of fluorescent in situ hybridization (FISH) yielded the precise breakpoint in the region (p21.2p11.23). Mother and son were carriers of identical X chromosome. CONCLUSION: Breakpoints are located in the regions that have already been linked to autism, which indicates that the positional effect of the gene could have been a possible cause of the patient's genotype. In addition to positional effects, in order to better understand the etiology of autism other genetic and environmental factors should be always taken into consideration.

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Serbia is located on the Balkan peninsula, which served for centuries as a vulnerable crossroads between the East and the West. At the beginning of the 1990s, some of the republics of the former Yugoslavia, including Serbia, were involved in disastrous civil conflicts. In 2006 Serbia became a sovereign republic. At the 2002 census, its population was 7 498 000.

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PURPOSE OF REVIEW: This review summarizes the findings of recent researches from selected empirical and nonempirical publications focused on stressful life events and physical health. RECENT FINDINGS: The findings can be divided into biological, psychological, and social issues concerning the important relationship between stressful life events and physical health. Growing evidence in the field of psychoneuroimmunology contributes to the understanding of the mechanisms by which stressful events affect physical health. The interactions between behavior, central nervous system, and endocrine system that might cause immunosuppression is the most fascinating finding in modern medicine, and its implications are important for the prevention and treatment of somatic illnesses. Trauma, abuse, and stressful events have been studied extensively, especially among vulnerable groups such as children, women, caregivers, and combatants. Risk factors and resilience were the focus of attention of some authors as well as the behavioral intervention for coping with stressful events. SUMMARY: The findings support old observations and case reports of a close link between stressful life events and physical health and emphasize the necessity of early recognition and timely management of stress-induced illnesses. Psychosomatic approach, multidimensional diagnostics, and treatment should be sine qua non in the integrated care of affected people and should improve their quality of life.

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