Psychiatria Hungarica最新文献

{"title":"[What is adult ADHD after all?]","authors":"Tünde Kilencz, Sára Bálint, Beatrix Mersich, Szilvia Papp, Ákos Ferencz, Lívia Balogh, Attila József Pulay, Kinga Farkas, János Réthelyi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset mental disorder, demonstrates genetical effects, and is characterized by attention deficit, hyperactivity, and impulsivity. While ADHD was previously only considered a childhood disorder, longitudinal studies over the past decades have proven that in a significant number of cases, the symptoms of the disorder can also be detected in adulthood, and therefore affects 2-4% of the adult population. In Hungary, adult ADHD programs started about 20 years ago and has been able to provide help to many adults living with ADHD. However, this form of care needs further development in many aspects and suffers from capacity deficits at the national level. On July 4-6, 2023 we organized a CME course on adult ADHD at the Department of Psychiatry and Psychotherapy Semmelweis University. The objective of this course was to deepen the knowledge of participants and alleviate care difficulties in the long term through the sharing of information and good practices. As part of this, a narrative review was written, which touches on the current issues of diagnosing and treating ADHD in adults.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"39 1","pages":"80-95"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Munchausen by proxy qualitative case analysis].","authors":"Petra N Tamás, Anna Lisincki, Éva Jekkel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>In 1977, Meadow coined the term Munchausen Syndrome by Proxy (MSBP) to describe a situation in which a parent or caregiver fabricates or induces illness in a child, leading to painful diagnostic procedures and hospital treatments. This can result in both short- and long-term psychological and physiological damage, with potentially severe consequences.</p><p><strong>Method: </strong>The aim of this study, beyond summarizing the existing literature, is to explore the underlying personality traits, psychological mechanisms, motives, and dynamics associated with MSBP through two case analyses. These analyses are based on a thematic content analysis of exploratory interview material and the results of psychological personality tests (Rorschach, MMPI, SCID-II).</p><p><strong>Results: </strong>The thematic analysis of the two interviews identified the following common main themes: Background and pre-existing life events (e.g., loss as a traumatic event); Indicators of Munchausen by Proxy (e.g., manipulation of medical records or samples); Personality traits (e.g., theatricality, manipulative behavior, trivialization, relationship dependency, egocentricity); Motivating factors and consequences of Munchausen by Proxy (e.g., illness-related secondary gain).</p><p><strong>Conclusion: </strong>Both cases shared a history of multiple traumatic events prior to the onset of MSBP-such as bereavement, miscarriage, and abuse - which likely had a significant impact on their personality and emotional state. Another common factor was the close, intense, and symbiotic relationship with the child. However, the cases differed in the degree of aggression involved in inducing illness in the child. In both cases, a diagnosis of personality disorder was confirmed, predominantly with histrionic traits.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"39 4","pages":"381-387"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Introduction of the Low and Medium Security Psychiatry Unit at the Nyírô Gyula National Institute of Psychiatry and Addictology].","authors":"Luca Caspar, Péter Srádi, Gábor Gaszner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Under the direction of the National Directorate General for Hospitals, and based on British examples and methodology, a new inpatient psychiatric ward with a high security level started operating at the National Institute of Psychiatry and Addictology in October 2023. As a new, independent unit, the High Security Psychiatry is a niche in Hungarian psychiatric care. The aim of the project was to reduce the burden on the whole mental health care system in Hungary, to increase public confidence in care and the safety of society through organizing of a specialised care team operating in an appropriate infrastructural environment. The creation of the department was preceded by a process that started in 2017, including the drafting of the necessary legislation to ensure operation, the creation of the infrastructural background, the training of specialised staff, the development of a professional protocol and a risk assessment and referral system, and the establishment of a funding mechanism. In this paper, we would like to describe the professional and environmental conditions and patient care arrangements in our department, looking at the operation of similar forms of care in other countries, mentioning our experience to date and our hopes for the future.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"39 3","pages":"242-253"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The basics of metabolic psychiatry].","authors":"István Szendi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The stability of brain functions is mainly determined by the energy management of the cells, and mental health is, therefore, profoundly affected by metabolic dysfunctions and immune and inflammatory processes. Research sheds light on more and more details and connections about the efficacy of diet and exercise, based on which we can develop effective metabolic interventions. The roots of this discipline, which is emerging today, go back to thousands of years of traditions and hundreds of years of documented observations. This paper reviews the role of mitochondria in healthy cell functions, in the distress cascade, and in the neurobiology of mental illnesses, as well as the modern knowledge related to metabolic interventions that support mitochondrial function, the therapeutic fasting, the ketogenic diet therapy, the regular exercise, and the use of nutritional supplements, and finally discusses the role of metabolic interventions in curing psychiatric diseases and improving mental health. The purpose of metabolic psychiatric interventions is to prevent neuroprogression in the broad sense, if it is already developing, to stop it, to break it, to restore the degraded functions, as a supplement to the usual psychosocial, pharmacological, somatic and neuromodulation treatments.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"39 2","pages":"161-179"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The effects of changes in attitudes toward masculinity in the psychotherapy of depression].","authors":"Bence Szerdahelyi, Zsuzsanna Almássy, Anita Szemán-Nagy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>In recent decades, serious changes have been observed in social gender roles. More and more publications have been published regarding the connection between masculinity and mental disorders. Most of the professional guidelines related to major depression have not been adapted yet to social changes in gender roles, or only to a small extent.</p><p><strong>Objective: </strong>The authors of the article present the possible influence of masculinity on psychotherapies, focusing on clients suffering from major depressive disorder.</p><p><strong>Method: </strong>In our manuscript, we first summarize the psychosocial changes that affect the male gender role in Western societies. After that, we review the possible impact of this transformation on psychotherapies. We mainly deal with the relationship between the onset of major depressive disorder and the male gender role. At the end of our publication, we make recommendations on how to integrate our knowledge of masculinity into the context of therapy.</p><p><strong>Results: </strong>Individual socialization differences related to the male gender role and social expectations can greatly influence the appearance of mental illnesses. Internalized and externalized symptoms should also be taken into account in the recognition and treatment of major depressive disorder. Positive masculinity as a therapeutic framework can be successfully combined with specific psychotherapies in order to personalize the healing process.</p><p><strong>Conclusions: </strong>In recent years, mental health care sensitive to gender roles has gained more and more space. Although we already have more and more information about how masculinization affects the clinical picture of mental illness, such as major depressive disorder, further studies are needed for more effective diagnosis and therapy.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"39 2","pages":"180-193"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Psychological interventions in the field of neurotraumatology during the acute care].","authors":"Noémi Mónika Szeifert","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neurotrauma means head or spine injury caused by an external force. Neurotraumatology care requires coordinated teamwork on the part of specialists, including psychological care as part of the multidisciplinary treatment team. Psychological interventions in the field of neurotraumatology aim to address the psychological consequences and challenges associated with head or spine injury. These interventions play a vital role in crisis intervention, promoting recovery, enhancing quality of life, and supporting individuals and their families in coping with the psychological impact of neurotrauma. Serious physical injuries always cause severe psychological consequences, both in short and long term. A critical accident is a sudden, unexpected, often directly life-threatening event that exceeds the individual's ability to respond and can create a potential crisis response, including suicidal risk, as well as the development of psychological disorders, in most cases acute stress disorder, adjustment disorder and post-traumatic stress disorder. Psychological interventions in neurotraumatology are often provided by a multidisciplinary team that may include psychologists, psychiatrists, social workers, and other healthcare professionals. These interventions are tailored to the unique needs and circumstances of each individual, with the goal of reducing psychological symptomps, promoting psychological well-being, adjustment, and overall recovery following neurotrauma. It is essential that not only patients who have experienced severe physical trauma, but also their family members have access to expert psychological support. This study summarizes psychological interventions during the treatment of neurotaruma patients at the intensive care unit.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"39 2","pages":"142-160"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the classical to the modern view of suicide. Analysis of Esquirol's work on suicide.","authors":"Mátyás Mészáros, Péter Osváth","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>In 1838, Jean-Étienne Dominique Esquirol published his book Des Maladies Mentales, which has been widely cited ever since in the literature dealing with the problem of suicide. Based on his clinical experience, he summarized the psychiatric knowledge of his time, and up to that time, devoting a special attention and a chapter to suicide. In this study, we shall be analysing this chapter in the Des Maladies Mentales, which sometimes contradicts itself, in the sense of the criterion system of modern suicide research.</p><p><strong>Method: </strong>We shall be showing the chapters, highlighting the key statements Esquirol did, and showing the modern research of the problems mentioned. Our goal is to demonstrate the parallel nature of the contemporary and the 19th century theories.</p><p><strong>Results: </strong>This comparison shows how Esquirol's work laid the foundation and initiated the development of suicidology.</p><p><strong>Conclusion: </strong>In his approach, which often seems inconsistent and not without contradictions, Esquirol pointed out the complex issues of suicide research with maximum sensitivity and scientific thoroughness.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"39 3","pages":"227-234"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The End of the Smoking Path: The Aspects of Changing Smoking Habits in Psychiatric Care].","authors":"Oguz Kelemen, Adrienn Máttyássy, Gergely Tari, Dávid Pócs","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Smoking prevalence is particularly high among individuals with psychiatric disorders, and the low success rate of permanent cessation further exacerbates the situation. However, smoking represents a modifiable risk factor, and addressing it can significantly improve patients' health, quality of life, and life expectancy. This review article explores the most common fears and misconceptions - both from patients and healthcare professionals - that may hinder successful cessation. We examine psychological and pharmacological treatments that support cessation, emphasizing options preferred for psychiatric patients. Special attention is given to the use of nicotine replacement therapies, bupropion, and varenicline, as well as their interactions with psychotropic medications. We also discuss recommended strategies for smoking cessation, the latest guidelines regarding pharmacological interventions, and the direct cessation-supporting effects of psychopharmacological agents. In conclusion, targeted support strategies combined with appropriate pharmacological treatment can significantly increase cessation rates, thereby improving the long-term health outcomes and quality of life for psychiatric patients.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"39 4","pages":"388-402"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-evaluation and revision of the Eating Habits Questionnaire.","authors":"Dávid Simon, Nikolett Bogár, Szilvia Dukay-Szabó, Ferenc Túry","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The Eating Habits Questionnaire (EHQ) is a key tool in evaluating orthorexia nervosa, an obsession with healthy eating. However, the evaluation process of EHQ has witnessed considerable variation, with one item notably excluded from the last phase of its development. This study undertakes a thorough re-evaluation of the English version of the EHQ, focusing on its original 35 items, within two diverse populations (fashion models and university students) where English serves predominantly as a second language.</p><p><strong>Methods: </strong>Through an online survey involving 163 female models and 243 non-models (mean age=26.0 years (SD=4.7) and mean age=25.1 years (SD=5.0), respectively) with various ethnic background (proportion from non-English speaking EU countries: 28.5% and 90.4%, respectively). Participants completed the EHQ along with the Eating Disorder Inventory (EDI) and SCOFF questionnaire.</p><p><strong>Results: </strong>Using confirmatory factor analysis, we analysed the factorial validity of EHQ subscales, eliminating items that did not align with the factor structure. After eliminating 17 items from the original 35-item questionnaire, the fit of the model for EHQ-18 was acceptable. Cronbach's alpha values indicated acceptable reliability. The EHQ-18 problem sub - scale showed significant positive correlations with all EDI subscales, while all EHQ-18 subscales demonstrated significant positive correlations with the EDI Drive for Thinness subscale. Comparison of the groups based on the SCOFF threshold revealed positive and significant differences across all subscales.</p><p><strong>Conclusion: </strong>We examined the impact of replacing an item in the EHQ-21 previously during its development process, and found that this potentially influenced the resulting factor structure. We recommend a new version of EHQ, the 18 item EHQ-18, supported by the analysis of the factorial and convergent validity, as well as the reliability. Furthermore, the findings suggest a potential discriminant validity of EHQ-18 in a diverse population, mostly speaking English as a second language.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"39 3","pages":"217-226"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Body image dissatisfaction in the light of alexithymia and self-development].","authors":"Petra Balogh, Zita Fekete","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The development of the self is an important factor in body image disorders. The child expects the parents to satisfy the narcissistic needs (mirroring, idealization, twinship needs). Disturbances in self-development can result in the person experiencing himself through the physical self, and the ability to recognize and express emotions is impaired. The body is given a prominent role, whereby changes to the body are associated with major identity changes and it also becomes a means of emotional expression. The aim of our study is to explore the possible relationship between the deficits in self-development and body image dissatisfaction and the role of alexithymic traits in this.</p><p><strong>Methods: </strong>The sample consisted of individuals aged 18 years and older with no psychiatric history (n=131). The Self Psychology Questionnaire translated into Hungarian was used to assess self-development and narcissistic needs, the Toronto Alexithymia Scale to assess alexithymia, and the Body Attitudes Test for women and the Muscle Appearance Satisfaction Scale for men to assess body image dissatisfaction. Data analysis was performed using correlations, linear regression analysis and mediation analysis.</p><p><strong>Results: </strong>Regarding the whole sample the relationship between body image dissatisfaction and alexithymia was confirmed (B=0.41, p<0.001). Regarding the subsample of women, the narcissistic needs had an indirect effect on body image, which contributes to body image dissatisfaction through the mediating effect of alexithymia (B=0.51, p<0.001). Regarding the subsample of men, the dissatisfaction of the need for idealization predicted body image dissatisfaction (B=0.77, p=0.017). In their case, the mediating effect of alexithymia was not detected.</p><p><strong>Conclusions: </strong>While for men the dissatisfaction of the need for idealization necessary for adequate self-development is itself a factor in body image dissatisfaction, for women inadequate self-development is associated with inadequate emotional development, which is associated with body dissatisfaction.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"39 4","pages":"354-367"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}