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Weber H, Maihofer AX, Jaksic N, Bojic EF, Kucukalic S, Dzananovic ES, Uka AG, Hoxha B, Haxhibeqiri V, Haxhibeqiri S, Kravic N, Umihanic MM, Franc AC, Babic R, Pavlovic M, Mehmedbasic AB, Aukst-Margetic B, Kucukalic A, Marjanovic D, Babic D, Bozina N, Jakovljevic M, Sinanovic O, Avdibegović E, Agani F, Warrings B, Domschke K, Nievergelt CM, Deckert J, Dzubur-Kulenovic A, Erhardt A. Association of polygenic risk scores, traumatic life events and coping strategies with war-related PTSD diagnosis and symptom severity in the South Eastern Europe (SEE)-PTSD cohort. J Neural Transm (Vienna) 2022; 129:661-674. [PMID: 34837533 PMCID: PMC9188618 DOI: 10.1007/s00702-021-02446-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/19/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental events and characterized by high emotional distress, re-experiencing of trauma, avoidance and hypervigilance. The present study uses polygenic risk scores (PRS) derived from the UK Biobank (UKBB) mega-cohort analysis as part of the PGC PTSD GWAS effort to determine the heritable basis of PTSD in the South Eastern Europe (SEE)-PTSD cohort. We further analyzed the relation between PRS and additional disease-related variables, such as number and intensity of life events, coping, sex and age at war on PTSD and CAPS as outcome variables. METHODS Association of PRS, number and intensity of life events, coping, sex and age on PTSD were calculated using logistic regression in a total of 321 subjects with current and remitted PTSD and 337 controls previously subjected to traumatic events but not having PTSD. In addition, PRS and other disease-related variables were tested for association with PTSD symptom severity, measured by the Clinician Administrated PTSD Scale (CAPS) by liner regression. To assess the relationship between the main outcomes PTSD diagnosis and symptom severity, each of the examined variables was adjusted for all other PTSD related variables. RESULTS The categorical analysis showed significant polygenic risk in patients with remitted PTSD and the total sample, whereas no effects were found on symptom severity. Intensity of life events as well as the individual coping style were significantly associated with PTSD diagnosis in both current and remitted cases. The dimensional analyses showed as association of war-related frequency of trauma with symptom severity, whereas the intensity of trauma yielded significant results independently of trauma timing in current PTSD. CONCLUSIONS The present PRS application in the SEE-PTSD cohort confirms modest but significant polygenic risk for PTSD diagnosis. Environmental factors, mainly the intensity of traumatic life events and negative coping strategies, yielded associations with PTSD both categorically and dimensionally with more significant p-values. This suggests that, at least in the present cohort of war-related trauma, the association of environmental factors and current individual coping strategies with PTSD psychopathology was stronger than the polygenic risk.
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Affiliation(s)
- Heike Weber
- Department of Psychiatry, Psychosomatics and Psychotherapy, Centre of Mental Health, Julius-Maximilians-University, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany.
| | - Adam X Maihofer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Nenad Jaksic
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Elma Feric Bojic
- Department for Genetic and Biotechnology, International Burch University, Sarajevo, Bosnia and Herzegovina
| | - Sabina Kucukalic
- Department of Psychiatry, University Clinical Center, Sarajevo, Bosnia and Herzegovina
| | | | - Aferdita Goci Uka
- Department of Psychiatry, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Blerina Hoxha
- Department of Psychiatry, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Valdete Haxhibeqiri
- Department of Medical Biochemistry, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Shpend Haxhibeqiri
- Institute of Kosovo Forensic Psychiatry, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Nermina Kravic
- Department of Psychiatry, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | | | - Ana Cima Franc
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Romana Babic
- Department of Psychiatry, University Clinical Center of Mostar, Mostar, Bosnia and Herzegovina
| | - Marko Pavlovic
- Department of Psychiatry, University Clinical Center of Mostar, Mostar, Bosnia and Herzegovina
| | | | | | - Abdulah Kucukalic
- Department of Psychiatry, University Clinical Center, Sarajevo, Bosnia and Herzegovina
| | - Damir Marjanovic
- Department for Genetic and Biotechnology, International Burch University, Sarajevo, Bosnia and Herzegovina
- Center for Applied Bioanthropology, Institute for Anthropological Researches, Zagreb, Croatia
| | - Dragan Babic
- Department of Psychiatry, University Clinical Center of Mostar, Mostar, Bosnia and Herzegovina
| | - Nada Bozina
- Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
| | - Miro Jakovljevic
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Osman Sinanovic
- Department of Neurology, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Esmina Avdibegović
- Department of Psychiatry, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Ferid Agani
- Faculty of Medicine, University Hasan Prishtina, Prishtina, Kosovo
| | - Bodo Warrings
- Department of Psychiatry, Psychosomatics and Psychotherapy, Centre of Mental Health, Julius-Maximilians-University, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, Centre of Mental Health, Julius-Maximilians-University, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Alma Dzubur-Kulenovic
- Department of Psychiatry, University Clinical Center, Sarajevo, Bosnia and Herzegovina
| | - Angelika Erhardt
- Department of Psychiatry, Psychosomatics and Psychotherapy, Centre of Mental Health, Julius-Maximilians-University, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
- Department of Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
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Kučukalić S, Ferić Bojić E, Babić R, Avdibegović E, Babić D, Agani F, Jakovljević M, Kučukalić A, Bravo Mehmedbašić A, Šabić Džananović E, Marjanović D, Kravic N, Pavlović M, Aukst Margetic B, Jaksic N, Cima Franc A, Rudan D, Haxhibeqiri S, Goci Uka A, Hoxha B, Haxhibeqiri V, Muminović Umihanić M, Sinanović O, Božina N, Ziegler C, Wolf C, Warrings B, Domschke K, Deckert J, Džubur Kulenović A. Genetic Susceptibility to Posttraumatic Stress Disorder: Analyses of the Oxytocin Receptor, Retinoic Acid Receptor-Related Orphan Receptor A and Cannabinoid Receptor 1 Genes. Psychiatr Danub 2019; 31:219-226. [PMID: 31291229 DOI: 10.24869/psyd.2019.219] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Exposure to life-threatening events is common and everyone will most likely experience this type of trauma during their lifetime. Reactions to these events are highly heterogeneous and seems to be influenced by genes as well. Some individuals will develop posttraumatic stress disorder (PTSD), while others will not. In this study, our aim was to analyze the correlation between single nucleotide polymorphisms (SNPs) within the oxytocin receptor (OXTR) gene (rs53576 and rs2254298), the RAR-related orphan receptor A (RORA) gene (rs8042149) and the cannabinoid receptor 1 (CNR1) gene (rs1049353) and PTSD. All candidate genes have been previously associated with stress related disorders and the reaction to traumatic events. SUBJECTS AND METHODS Participants (N=719) have been exposed to war-related trauma during the war in South-Eastern Europe (Bosnia and Herzegovina, Croatia and Kosovo). We correlated the presence and absence of current and lifetime PTSD as well as PTSD severity (Clinician Administered PTSD scale (CAPS)) and current psychopathology (Brief Symptom Inventory (BSI) score) with the mentioned SNPs. DNA was isolated from whole blood and genotyped for OXTR rs2254298 and rs53576 following previously published protocols, for RORA rs8042149 via PCR-RFLP and CNR1 rs1049353 via KASP. RESULTS Nominally significant results were found for OXTR rs53576 in connection with the CAPS and BSI scores within lifetime PTSD patients. The additive allelic model indicated that G allele carriers achieved lower CAPS (p=0.0090) and BSI (p=0.0408) scores than participants carrying one or two copies of the A allele. These results did not withstand correction for multiple tests. No significant results were observed for OXTR rs2254298, RORA rs8042149 and CNR1 rs1049353 although the results for RORA showed a slight tendency that rs8042149 may influence the level of BSI scores in current PTSD patients. CONCLUSIONS This study points to a role of the OXTR gene in PTSD and the related psychopathology following war related trauma.
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Affiliation(s)
- Sabina Kučukalić
- Department of Psychiatry, Clinical Center University Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina,
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Jaksic N, Šabić Džananović E, Aukst Margetic B, Rudan D, Cima Franc A, Bozina N, Ferić Bojić E, Kučukalić S, Džubur Kulenović A, Marjanović D, Avdibegović E, Babić D, Agani F, Kučukalić A, Bravo Mehmedbašić A, Kravic N, Muminović Umihanić M, Sinanović O, Babić R, Pavlović M, Haxhibeqiri S, Goci Uka A, Hoxha B, Haxhibeqiri V, Ziegler C, Wolf C, Warrings B, Domschke K, Deckert J, Jakovljevic M. A Candidate Gene Association Study of FKBP5 and CRHR1 Polymorphisms in Relation to War-Related Posttraumatic Stress Disorder. Psychiatr Danub 2019; 31:269-275. [PMID: 31291236 DOI: 10.24869/psyd.2019.269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a highly frequent and disabling psychiatric condition among war-affected populations. The FK506-binding protein 5 (FKBP5) gene and the corticotropin-releasing hormone receptor 1 (CRHR1) gene have previously been implicated in an elevated risk of peritraumatic dissociation and PTSD development. Our aim was to investigate the association between FKBP5 and CRHR1 genotypes and PTSD diagnosis and severity among individuals who were affected by the Balkan wars during the 1990s. SUBJECTS AND METHODS This study included participants with current PTSD, remitted PTSD and healthy volunteers (N=719, 487 males), who were recruited between 2013 and 2015 within the framework of the South Eastern Europe (SEE) - PTSD Study. Psychometric methods comprised the Mini International Neuropsychiatric Interview (M.I.N.I.), the Clinician Administrated PTSD Scale (CAPS), and the Brief Symptom Inventory (BSI). FKBP5 rs1360780 and CRHR1 rs17689918 genotypes were determined using a KASP genotyping assay. RESULTS Tests for deviation from Hardy Weinberg equilibrium showed no significant results. Logistic and linear regression was used to examine the associations between the FKBP5 SNP rs1360780 and the CRHR1 SNP rs17689918 with PTSD diagnosis and severity, as well as general psychiatric symptom severity, separately for current and remitted PTSD patients. There were nominally significant associations under a dominant model between the rs1360780 C allele and PTSD diagnosis as well as symptom severity, which however, were not significant anymore after Bonferroni adjustment (α=0.002). For CRHR1 rs17689918 no significant associations were detected. CONCLUSION We found nominally, but not Bonferroni corrected significant associations between the FKBP5 polymorphism rs1360780 and PTSD susceptibility among individuals affected by the Balkan wars. For elucidating this gene's real resilience/vulnerability potential, environmental influences should be taken into account.
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Affiliation(s)
- Nenad Jaksic
- Department of Psychiatry, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia,
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Muminovic Umihanic M, Babic R, Kravic N, Avdibegovic E, Dzubur Kulenovic A, Agani F, Jakovljevic M, Babic D, Kucukalic A, Kucukalic S, Sabic Dzananovic E, Bravo Mehmedbasic A, Goci Uka A, Haxhibeqiri S, Hoxha B, Haxhibeqiri V, Aukst Margetic B, Jaksic N, Cima Franc A, Rudan D, Pavlović M, Feric Bojic E, Marjanovic D, Bozina N, Ziegler C, Wolf C, Warrings B, Domschke K, Deckert J, Sinanovic O. Associations between Polymorphisms in the Solute Carrier Family 6 Member 3 and the Myelin Basic Protein Gene and Posttraumatic Stress Disorder. Psychiatr Danub 2019; 31:235-240. [PMID: 31291231 DOI: 10.24869/psyd.2019.235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Previous research showed inconsistent results concerning a possible association between solute carrier family 6 member 3 (SLC6A3) gene polymorphisms and dopamine symptoms of posttraumatic stress disorder (PTSD). Several studies also indicate that the myelin basic protein (MBP) gene is of importance in the etiology of several psychiatric disorders. The aim of this study was to investigate the relation of distinct SLC6A3 and MBP gene polymorphisms with PTSD and whether SLC6A3 and MBP genotypes contribute to PTSD symptom severity. SUBJECTS AND METHODS The study included 719 individuals who had experienced war trauma in the South Eastern Europe (SEE). Genotypes of variable number tandem repeat (VNTR) polymorphism within the SLC6A3 gene were assessed in 696 participants, and the single nucleotide polymorphism (SNP) rs12458282 located within the MBP gene region was genotyped in a total of 703 subjects. The Mini International Neuropsychiatric Interview, the Clinical Administrated PTSD Scale (CAPS) and Brief Symptom Inventory (BSI), were used for data collection. RESULTS No significant differences concerning the investigated SLC6A3 and MBP polymorphisms was identifiable between PTSD and non PTSD participants. Also we could not detect significant influence of these distinct SLC6A3 and MBP alleles on the severity of PTSD symptoms (CAPS) or BSI scores. However, the results of MBP rs12458282 within the patients with lifetime PTSD may point to a possible correlation of the major allele (T) with elevated CAPS scores. CONCLUSIONS Our results do not support an association of the analysed SLC6A3 and MBP gene polymorphisms with PTSD in war traumatized individuals. We found that there is a possibility for a correlation of the T allele rs12458282 within the MBP gene with higher CAPS scores in lifetime PTSD patients which would need to be tested in a sample providing more statistical power.
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Feric Bojic E, Kucukalic S, Dzubur Kulenovic A, Avdibegovic E, Babic D, Agani F, Jakovljevic M, Kucukalic A, Bravo Mehmedbasic A, Sabic Dzananovic E, Kravic N, Babic R, Pavlovic M, Aukst Margetic B, Jaksic N, Cima Franc A, Rudan D, Haxhibeqiri S, Goci Uka A, Hoxha B, Haxhibeqiri V, Muminovic Umihanic M, Sinanovic O, Bozina N, Ziegler C, Wolf C, Warrings B, Domschke K, Deckert J, Marjanovic D. ASSOCIATIONS OF GENE VARIATIONS IN NEUROPEPTIDE Y AND BRAIN DERIVED NEUROTROPHIC FACTOR GENES WITH POSTTRAUMATIC STRESS DISORDER. Psychiat Danub 2019; 31:227-234. [DOI: 10.24869/psyd.2019.227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Goci Uka A, Agani F, Blyta A, Hoxha B, Haxhibeqiri S, Haxhibeqiri V, Sabic Dzananovic E, Kucukalic S, Bravo Mehmedbasic A, Kucukalic A, Dzubur Kulenovic A, Feric Bojic E, Marjanovic D, Kravic N, Avdibegovic E, Muminovic Umihanic M, Jaksic N, Cima Franc A, Rudan D, Jakovljevic M, Babic R, Pavlovic M, Babic D, Aukst Margetic B, Bozina N, Sinanovic O, Ziegler C, Warrings B, Domschke K, Deckert J, Wolf C. ROLE OF THE ALLELIC VARIATION IN THE 5-HYDROXYTRYPTAMINE RECEPTOR 1A (HTR1A) AND THE TRYPTOPHAN HYDROXYLASE 2 (TPH2) GENES IN THE DEVELOPMENT OF PTSD. Psychiat Danub 2019; 31:256-262. [DOI: 10.24869/psyd.2019.256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hoxha B, Goçi Uka A, Agani F, Haxhibeqiri S, Haxhibeqiri V, Sabic Dzananovic E, Kucukalic S, Bravo Mehmedbasic A, Kucukalic A, Dzubur Kulenovic A, Feric Bojic E, Marjanovic D, Kravic N, Avdibegovic E, Muminovic Umihanić M, Jaksic N, Cima Franc A, Rudan D, Jakovljevic M, Babic R, Pavlovic M, Babic D, Aukst Margetic B, Bozina N, Sinanovic O, Ziegler C, Warrings B, Domschke K, Deckert J, Wolf C, Vyshka G. The Role of TaqI DRD2 (rs1800497) and DRD4 VNTR Polymorphisms in Posttraumatic Stress Disorder (PTSD). Psychiatr Danub 2019; 31:263-268. [PMID: 31291235 DOI: 10.24869/psyd.2019.263] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a complex stress related disorder, that follows a severe traumatic experience, characterized with an intense sense of terror, fear, and helplessness. The aim of this study is to identify associations of genetic variations within candidate genes DRD2 and DRD4 with various PTSD related phenotypes. PTSD lifetime and PTSD current subjects were analyzed separately, each of them were analyzed in a Case/Control design, as well as regarding BSI and CAPS within cases only. SUBJECTS AND METHODS 719 (487 male, 232 female) participants who had experienced war-related trauma between 1991 and 1999 in Bosnia and Hercegovina, Kosovo and Croatia were included in the study. Sociodemographic questionnaire, Clinician Administered PTSD Scale (CAPS) and the Brief Symptom Inventory (BSI) were used to collect clinical data. RESULTS The DRD2 rs1800497 variant and a variable number tandem repeat (VNTR) located in exon three of DRD4 were investigated for association with PTSD. In case control analyses we did not identify any significant associations. Within the PTSD current patients, we identified an association of DRD2 rs1800497 with BSI in the genotypic and the recessive model with the T allele as the risk allele. CONCLUSION Our findings suggest that rs1800497 of DRD2 gene is involved in pathogenesis of PTSD.
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Affiliation(s)
- Blerina Hoxha
- Department of Psychiatry, University Clinical Centre of Kosovo, Prishtina, Kosovo,
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Ziegler C, Wolf C, Schiele MA, Feric Bojic E, Kucukalic S, Sabic Dzananovic E, Goci Uka A, Hoxha B, Haxhibeqiri V, Haxhibeqiri S, Kravic N, Muminovic Umihanic M, Cima Franc A, Jaksic N, Babic R, Pavlovic M, Warrings B, Bravo Mehmedbasic A, Rudan D, Aukst-Margetic B, Kucukalic A, Marjanovic D, Babic D, Bozina N, Jakovljevic M, Sinanovic O, Avdibegovic E, Agani F, Dzubur-Kulenovic A, Deckert J, Domschke K. Monoamine Oxidase A Gene Methylation and Its Role in Posttraumatic Stress Disorder: First Evidence from the South Eastern Europe (SEE)-PTSD Study. Int J Neuropsychopharmacol 2017; 21:423-432. [PMID: 29186431 PMCID: PMC5932467 DOI: 10.1093/ijnp/pyx111] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 11/22/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder is characterized by an overactive noradrenergic system conferring core posttraumatic stress disorder symptoms such as hyperarousal and reexperiencing. Monoamine oxidase A is one of the key enzymes mediating the turnover of noradrenaline. Here, DNA methylation of the monoamine oxidase A gene exonI/intronI region was investigated for the first time regarding its role in posttraumatic stress disorder risk and severity. METHODS Monoamine oxidase A methylation was analyzed via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells in a total sample of N=652 (441 male) patients with current posttraumatic stress disorder, patients with remitted posttraumatic stress disorder, and healthy probands (comparison group) recruited at 5 centers in Bosnia-Herzegovina, Croatia, and the Republic of Kosovo. Posttraumatic stress disorder severity was measured by means of the Clinician-Administered Posttraumatic Stress Disorder Scale and its respective subscores representing distinct symptom clusters. RESULTS In the male, but not the female sample, patients with current posttraumatic stress disorder displayed hypermethylation of 3 CpGs (CpG3=43656362; CpG12=43656514; CpG13=43656553, GRCh38.p2 Assembly) as compared with remitted Posttraumatic Stress Disorder patients and healthy probands. Symptom severity (Clinician-Administered Posttraumatic Stress Disorder Scale scores) in male patients with current posttraumatic stress disorder significantly correlated with monoamine oxidase A methylation. This applied particularly to symptom clusters related to reexperiencing of trauma (cluster B) and hyperarousal (cluster D). CONCLUSIONS The present findings suggest monoamine oxidase A gene hypermethylation, potentially resulting in enhanced noradrenergic signalling, as a disease status and severity marker of current posttraumatic stress disorder in males. If replicated, monoamine oxidase A hypermethylation might serve as a surrogate marker of a hyperadrenergic subtype of posttraumatic stress disorder guiding personalized treatment decisions on the use of antiadrenergic agents.
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Affiliation(s)
- Christiane Ziegler
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany,Correspondence: Christiane Ziegler, PhD, Department of Psychiatry, University of Freiburg, Hauptstraße 5, D-79104 Freiburg, Germany ()
| | - Christiane Wolf
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Elma Feric Bojic
- Department of Genetics and Bioengineering, International Burch University, Sarajevo, Bosnia and Herzegovina
| | - Sabina Kucukalic
- Department of Psychiatry, University Clinical Center, Sarajevo, Bosnia and Herzegovina
| | | | - Aferdita Goci Uka
- Department of Psychiatry, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Blerina Hoxha
- Department of Psychiatry, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Valdete Haxhibeqiri
- Department of Medical Biochemistry, University Clinical Center of Kosovo, Prishtina, Kosovo,Institute of Kosovo Forensic Psychiatry, University Clinical Center of Kosovo, Prishtina, Kosovo
| | | | - Nermina Kravic
- Department of Psychiatry, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | | | - Ana Cima Franc
- Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
| | - Nenad Jaksic
- Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
| | - Romana Babic
- Department of Psychiatry, University Clinical Center of Mostar, Mostar, Bosnia and Herzegovina
| | - Marko Pavlovic
- Department of Psychiatry, University Clinical Center of Mostar, Mostar, Bosnia and Herzegovina
| | - Bodo Warrings
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | | | - Dusko Rudan
- Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
| | | | - Abdulah Kucukalic
- Department of Psychiatry, University Clinical Center, Sarajevo, Bosnia and Herzegovina
| | - Damir Marjanovic
- Department of Genetics and Bioengineering, International Burch University, Sarajevo, Bosnia and Herzegovina,Institute for Anthropological Researches, Zagreb, Croatia
| | - Dragan Babic
- Department of Psychiatry, University Clinical Center of Mostar, Mostar, Bosnia and Herzegovina
| | - Nada Bozina
- Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
| | - Miro Jakovljevic
- Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
| | - Osman Sinanovic
- Department of Neurology, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Esmina Avdibegovic
- Department of Psychiatry, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Ferid Agani
- Faculty of Medicine, University Hasan Prishtina, Prishtina, Kosovo
| | - Alma Dzubur-Kulenovic
- Department of Psychiatry, University Clinical Center, Sarajevo, Bosnia and Herzegovina
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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Kulenovic AD, Agani F, Avdibegovic E, Jakovljevic M, Babic D, Kucukalic A, Kucukalic S, Dzananovic ES, Mehmedbasic AB, Uka AG, Haxhibeqiri S, Haxhibeqiri V, Hoxha B, Sinanovic O, Kravic N, Muminovic M, Aukst-Margetic B, Jaksic N, Franc AC, Rudan D, Pavlovic M, Babic R, Bojic EF, Marjanovic D, Bozina N, Ziegler C, Wolf C, Warrings B, Domschke K, Deckert J. Molecular Mechanisms of Posttraumatic Stress Disorder (PTSD) as a Basis for Individualized and Personalized Therapy: Rationale, Design and Methods of the South Eastern Europe (SEE)-PTSD study. Psychiatr Danub 2016; 28:154-163. [PMID: 27287790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Posttraumatic Stress Disorder (PTSD) is a major health problem in South Eastern Europe (SEE). Available treatment options are not efficient enough and the course is often chronic. Little is known about molecular mediators and moderators of pathogenesis and therapy. Genetic and epigenetic variation may be one central molecular mechanism. We therefore established a consortium combining clinical expertise on PTSD from SEE countries Bosnia-Herzegovina (Sarajevo, Tuzla and Mostar), Kosovo (Prishtina) and Croatia (Zagreb) with genetic and epigenetic competence from Germany (Würzburg) in 2011 within the framework of the DAAD (Deutscher Akademischer Austauschdienst)-funded Stability Pact for South Eastern Europe. After obtaining ethical votes and performing rater trainings as well as training in DNA extraction from EDTA blood between 2011 and 2013, we recruited 747 individuals who had experienced war-related trauma in the SEE conflicts between 1991 and 1999. 236 participants had current PTSD, 161 lifetime PTSD and 350 did not have and never had PTSD. Demographic and clinical data are currently merged together with genetic and epigenetic data in a single database to allow for a comprehensive analysis of the role of genetic and epigenetic variation in the pathogenesis and therapy of PTSD. Analyses will be done to a great degree by PhD students from participating SEE centers who in addition to participation in the project had an opportunity to take part in spring and summer schools of the DFG (Deutsche Forschungsgemeinschaft) funded Research Training Group (RTG) 1253 and thus meet PhD students from Germany and other countries We are confident that our project will not only contribute to a better understanding of genetic and epigenetic mechanisms of PTSD as a basis for future individualized and personalized therapies, but also to the academic development of South Eastern Europe.
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Affiliation(s)
- Alma Dzubur Kulenovic
- Department of Psychiatry, University Clinical Center Sarajevo, Bolnicka 25, 71000 Sarajevo, Bosnia and Herzegovina,
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Kravic N, Pajevic I, Hasanovic M, Sutovic A, Avdibegovic E. The Association of the Traumatization Severity and Severity of the Psychic Symtoms of the Females Who Lost Their Husbands During the 1992-1995 War in Bosnia-Herzegovina. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31409-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Hasanovic M, Pajevic I, Morgan S, Kravic N. EMDR training for mental health therapists in postwar bosnia-herzegovina who work with psycho-traumatized population for increasing their psychotherapy capacities. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)73014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
IntroductionAfter war 1992–1995 in Bosnia and Herzegovina (BH), whole population was highly psych-traumatized. Mental health therapists had no enough capacities to meet needs of population. They are permanently in need to increase their psychotherapy capacities. EMDR is a powerful, state-of-the-art treatment. Its effectiveness and efficacy has been validated by extensive research. National Institute for Clinical Excellence (NICE) recommended it as one of two trauma treatments of choice.AimTo describe non profit, humanitarian approach in sharing skills of Eye Movement Reprocessing and Desensitization (EMDR) to mental health therapists in BH from Humanitarian Assistance Program (HAP) of UK & Ireland.MethodAuthors described educational process considering the history of idea and its realization through training levels and process of supervision.ResultsHighly skilled and internationally approved trainers from HAP UK & Ireland came four times to Psychiatry Department of University Clinical Center Tuzla in BH where they provided completed EMDR training for 24 trainees: neuro- psychiatrists, residents of neuro-psychiatry and psychologists from eight different health institutions from six different cities in BH. After finishing training process, trainees are obliged to practice their EMDR therapy in daily practice with real clients under the supervision process of HAP UK & Ireland trainers to become certified EMDR therapists. Regarding big physical distance between supervisors and trainees, supervision will be realized via Skype Internet technologyConclusionPsychotherapy capacities of mental health psychotherapists in postwar BH could be increased with enthusiastic help of EMDR trainers from HAP UK&Ireland.
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Kravic N, Hasanovic M. Moral conflict and first sexual experience - case presentation. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72678-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
ObjectivesIn our mind as well as in our body and nature nothing is happened accidentally, we can often see that there is mutual connection between them. There is a case presentation of young man age 29 with obsessive thoughts for getting fatal disease if step on junky needles which he had seen in his neighbor. It thoughts influence his all life he is avoiding to go out of his apartment, poorly sleep, he insisted to be admitted to in patient treatment because he „would probably kill himself if he had to stay there jet…” His first difficulties appeared when he was 20, after his first sexual experience which he has had with prostitute, after his friend’s birthday party. Then he obsessively started to think about getting AIDS, getting died… Four years ago he really have got malignant testicular tumor and in his 24he had passed through exhausting surgery and chemotherapy. As a child he was growing up during the war time, experienced snake bite, often tonsil infections.Now he has no job, live with parents and one year older brother, no girlfriend or other relationship. Treated with antidepressant venlafaxin, and atypical narcoleptic risperidon, with additionally used EMDR, he showed good recovery and getting into every day activities.ConclusionMoral conflict and unsolved guilty feelings lead to real illness and constant fear of fatal disease as a punishment for him.
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Kravic N. Transgenerational transfer of family secret - case presentation. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ObjectiveWe wanted to show how the family secret of adoption can influence even second generation of members.Case studyGirl 15 years of age, high school first grade lived in complete family with older brother and younger sister. Father was a rigid structure, difficult in communication with other family members except youngest daughter. For a first check up she had come with her mother (previously psychiatry treated of depression). Girl was very depressed (CDI 24), her appearance expressed hopelessness, repeatedly thought about suicide, did not accomplish anything she wanted, to study for nurse, or an actress. Two years ago looking through some papers, she had find out that her mother was adopted as a baby, that changed her all life, relationship toward grandparents, could not study, focus on anything else. Just a few days ago she admitted to her mother that she knows a secret about her origins. Her mother also find out that she was adopted when she was 14 (the same age when her daughter find it out), some girls in the school told that to her. Finding out the truth was very devastating for her too.ConclusionTrans - generational transfer of family secret came to resonance of unconscious and girl find out the truth almost in the same age as mother. It has had stressful effect, but also influence trust, and cause anger and feeling of exclusion. Silence has aggressive except protective function. Adolescence as vulnerable developmental age made this girl more sensitive for this.
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Kravic N, Pajevic I, Hasanovic M. Depression in children who experienced severe war trauma. Eur Psychiatry 2007. [DOI: 10.1016/j.eurpsy.2007.01.938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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