To estimate prevalence and incidence of attention deficit hyperactivity disorder (ADHD) in children and adolescents in Slovenia using different epidemiological models.Data from the National Institute of Public Health of the Republic of Slovenia for the ...

In most Eastern and Central European countries, except Germany, there is a lack of drug consumption studies for attention-deficit/hyperactivity disorder (ADHD). The main purpose of the present study was to present the pattern and the evolution of national ADHD drug consumption in Slovenia. The national consumption data for the period 2001-2012 and medication costs were obtained from the database of the Health Insurance Institute of Slovenia. A defined daily dose (DDD) per 1000 inhabitants per day and the total medication cost in euro were extracted. Only immediate-release methylphenidate (IR-MPH), methylphenidate-osmotic release oral delivery system (OROS-MPH) and atomoxetine (ATX) have been approved for ADHD in Slovenia and are included in this study. Amphetamines have not been available in Slovenia. ADHD drug consumption increased in Slovenia from 0.0537 DDD/1000 inhabitants/day in 2001 to 0.0687 DDD/1000 inhabitants/day in 2006 and to 0.3076 DDD/1000 inhabitants/day in 2012. The rise was largely because of an increase in OROS-MPH consumption and increase in ATX consumption, whereas the consumption of IR-MPH decreased rapidly. During the study period, the total cost of the medicines increased 31-fold. From 2007 to 2010, the total cost of ADHD medicines increased 14-fold and from 2010 to 2012 the cost increased by 11.4% only. When new drugs are licensed in a jurisdiction, their prescription rates increase rapidly. The changes in the pattern of prescribing medicines are evident in Slovenia, primarily in the increase of OROS-MPH and ATX prescriptions and in the rapid decrease of IR-MPH prescriptions. Results indicate a need for appropriate interventions in Slovenia.

Stigma associated with depression is a major public health issue in the EU, with over 20 million people experiencing depression and its associated personal distress each year. While most programmes against stigma related to mental health problems are of a general nature, the knowledge about programmes tackling stigma against people with depression is limited. This study therefore aims to assess the nature and impact of depression-specific programmes in EU countries. Using a web-based tool, 26 programmes were identified across the 18 EU countries taking part in the study. Most were universal and targeted the whole population, while many also targeted specific population groups or settings, such as young people or health professionals. The most common programme aim was improving literacy, although reducing stigmatizing attitudes and discriminatory behaviour and promoting help-seeking were also common. Most programmes originated from professional bodies, or as grassroots initiatives from service user groups/NGOs, rather than as part of national and local policy. The approaches used were primarily different forms of education/information, with some, but very limited, use of positive personal contact. Overall, the quality and extent of impact of the programmes was limited, with few leading to peer-reviewed publications. Specific programmes were identified with evidence of positive impact, and we drew on these examples to develop a framework to be used for future programmes against stigma and discrimination associated with depression. These findings are provided in full in the Anti-Stigma Partnership European Network Toolkit available at www.antistigma.eu.

Background: Development of mental health services in Slovenia has some originalities described in the present article. Slovenia is a small Central European country with a population of 2 million. Its mental health system has been influenced by the western de-institutionalization movement and eastern models of care which are predominately institutional. Aims: Mental health reform in the 1970s was a silent one with displacement of long-term psychiatric patients to old-people's homes, asylums and to their families. During the last decade community mental health services have been established in the non-government sector, primarily as social institutions providing support to patients with severe mental illness. Psychosocial rehabilitation movement changed some therapeutic approaches in hospitals and has been gaining more and more influence in the NGO services. Results: The article describes Slovene psychiatric hospitals and community rehabilitation services. Mental health services in Slovenia are compared to services in Slovakia, the United Kingdom and the Netherlands. Conclusions: The authors are proposing guidelines for future development of mental health services for the severely mentally ill in our country in order to improve the present deficient state of care.

As part of the ASPEN (Anti-Stigma Programme - European Network) project’s Work Package 4 (‘Anti-stigma’ best practice), Aspen sites were to conduct a literature review on stigma in their country. In Slovenia, besides the peer review publications and reports, we also included all media reports on stigma in the last five years to illustrate the impact of various professional and public initiatives to reduce stigma and discrimination against depression. The Slovenian report includes several areas of mental health stigma defined through peer reviewed literature and other professional publications.