Psychiatria Hungarica最新文献

{"title":"[Anxiolytics and mood stabilizers in modern psychopharmacological practice with an emphasis to specific patient populations].","authors":"János Réthelyi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anxiolytics and mood stabilizers are essential components of modern psychopharmacological practice, with indications spanning multiple diagnostic categories. Although most currently used agents have been available for decades, their clinical application has evolved considerably in recent years. This review focuses on practical aspects of clinical decision-making. We discuss major classes of anxiolytics, including benzodiazepines, azapirones, and selected antiepileptic agents, as well as key issues related to mood stabilizers such as lithium, valproate, and lamotrigine. Special attention is given to specific patient populations where pharmacokinetic and safety considerations are critical. The importance of individualized treatment and continuous risk-benefit assessment is emphasized. Keywords: mood stabilizers; anxiolytics; special patient populations.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 3-4","pages":"298-317"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406157","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":"[What to do in the case of a failed first antidepressive trial? To switch or to augment?]","authors":"Zoltán Rihmer, Annamária Rihmer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Since SSRIs and other new antidepressant agents entered the market, the possibilities to treat depression improved substantially but 50 percent of major depressives do not respond to the first, and 25-35 percent do not respond even to the second antidepressant trial. Pharmacotherapy-resistant depression is a multicausal phenomenon. Along with its well-known risk-factors, investigations of the past decade have revealed that unrecognised or hidden (sub syndromal or subthreshold) bipolarity is one of the most frequent causes of treatment resistance. In the case of bipolar depression (either as a part of syndromal bipolar I or II disorder or a subsyndromal manifestation) antidepressant mono therapy should be avoided and, instead of it, the administration of a mood stabilizer (primarily lithium and lamotrigine) or certain atypical antipsychotics (preferably quetiapine, aripiprazole and cariprazine) is recommended. If anti depressant is inevitably necessary in bipolar depression, we should use it always in combination with mood stabilizers or atypical antipsychotics. After the first failed antidepressant trial, augmentation with lithium, lamotrigine, or anti psychotics is recommended at first, and if this is not successful switching the antidepressant is recommended. Keywords: antidepressants; augmentation, treatment resistance; bipolar disorder; bipolar spectrum; switch the anti depressant, unipolar major depressive disorder.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 3-4","pages":"242-246"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406127","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":"[\"My Own Inner Child Is Basically Homeless\" - Examining Sense of Self and Identity in Adult Children of Parents with Addiction: A Qualitative Study].","authors":"Szilvia Kassai, Georgina Mucsi, Tímea Békési, Boglárka Belányi, Csaba Jancsák","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Children of parents with substance use disorders often develop dependent, dysfunctional roles within the family system to adapt and maintain its fragile balance. While these coping mechanisms may provide short-term relief, they can significantly disrupt identity formation and the development of a stable sense of self in the long term.</p><p><strong>Methods: </strong>The aim of this qualitative study was to explore the lived experiences of adults who grew up with substance-dependent parents, with particular attention to how this environment shaped their identity and how it influences their self-perception in adulthood. Semi-structured interviews were conducted with a purposive sample of 16 participants, and the data were analysed using Interpretative Phenomenological Analysis (IPA). Three main themes were identified: Main Theme 1: \"I Pretended Nothing Was Wrong\"; Main Theme 2: \"The Question of the Right to Exist\"; Main Theme 3: \"The 'Homeless' Inner Child.\" The findings highlight the long-term psychological effects of growing up in a family affected by addiction, including difficulties in self-acceptance, boundary-setting, and autonomy.</p><p><strong>Conclusion: </strong>The study underscores the therapeutic potential of \"inner child\" work in processing unresolved losses-collectively referred to as the \"loss of childhood\"-and in strengthening self-identity. A deeper understanding of these processes may contribute to the development of targeted interventions for adult children of parents with substance use disorders.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 2","pages":"121-129"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851007","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":"[Quantitative analysis of autism online forums].","authors":"Brigitta Kakuszi, Szilvia Hetesy, Pál Czobor","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Social media platforms are becoming increasingly popular for discussing health-related topics. Our research focused on analyzing autism-related posts on the Reddit platform, including the r/autism, r/aspergers, and r/AutismIn - Women subreddits. We employed multiple approaches in our investigation: we conducted word frequency and sentiment analysis, defined symptom-based categories, and explored their interrelations. For the analyses, we used machine learning models in a Python environment, including BERT and DistilRoBERTa. Final statistical analyses were performed using SAS version 9.4. Our findings indicate that the discussions primarily focus on challenges related to emotional regulation, social relationships, and sensory issues. In the textual data analysis, emotional expressions prominently featured fear beyond the neutral category, while expressions of joy were less prevalent. The results of our study highlight the distinctive characteristics of online conversations about autism. These insights can help professionals and healthcare providers better understand the everyday challenges and needs of individuals with autism, enabling them to offer more effective and targeted support.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 1","pages":"49-59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683323","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":"[Psychedelics and pyschodelic-associated psychotherapies - Who is PAP for after all?]","authors":"Noémi Papp, Xénia Gonda","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Psychedelic drugs, historically recognized for their effects on perception, cognition, and emotion, are entering their renaissance, as a growing body of both preclinical and clinical evidence supports their potential for the treatment - mostly as an adjunct to psychotherapy, i.e., psychedelic-assisted psychotherapy (PAP) - of various psychiatric disorders. The recent approval of lysergic acid diethylamide (LSD) for generalized anxiety disorder, as well as that of 3,4-methylenedioxymethamphetamine (MDMA) for posttraumatic stress disorder and psilocybin for depression, suggests a new era in psychiatry. However, numerous questions remain unanswered, including how exactly PAP works. Here, we aimed to review the latest results of clinical trials and to summarize current knowledge on psychedelics, focusing on their use in psychiatry while addressing limitations and challenges to be faced in the future. Keywords: psychedelic; psilocybin; LSD; MDMA; MDMA-AT; psychedelic-assisted psychotherapy; PAP; PAT.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 3-4","pages":"318-327"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406098","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":"[Tailored Treatment: Opportunities for Algorithm-Based Modular Psychotherapy in Hungarian Mental Health Care].","authors":"Oguz Kelemen, Adrienn Máttyássi, Szabolcs Kéri","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The efficacy of psychotherapeutic interventions remains limited for many mental disorders, particularly in cases involving comorbidities and histories of childhood trauma. Traditional diagnosis-specific protocols often fail to address patients' underlying transdiagnostic mechanisms, which may hinder therapeutic success. Algorithm-Based Modular Psychotherapy (MoBa) is a personalized, mechanism-focused treatment model that integrates empirically supported therapeutic modules selected through a decision-making algorithm tailored to each patient. This article reviews the theoretical background of MoBa, key international findings, the structure of the modular approach, and its core transdiagnostic targets (e.g., rejection sensitivity, emotion dysregulation, impaired social cognition). Special emphasis is placed on the potential implementation of MoBa in the Hungarian mental health system, including clinical and institutional challenges. The authors provide practical recommendations for adapting MoBa in Hungary and outline directions for future research. Keywords: algorithm-based psychotherapy, MoBa, transdiagnostic approach, depression, personalized treatment, psychotherapy modules.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 2","pages":"172-183"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851004","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 avoidant/restrictive food intake disorder: a new feeding and eating disorder in the diagnostic systems].","authors":"Orsolya Demetrovics, Zsolt Demetrovics","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Avoidant-restrictive Food Intake Disorder (ARFID) was included in the fifth edition of the DSM in 2013 and in the BNO-11 diagnostic manual in 2019. Prior to this, the problem was often unrecognised or diagnosed as an eating disorder not otherwise specified or feeding and eating disorders of infancy or early childhood. The new diagnosis allows for better targeting of patients who have not been diagnosed earlier, as well as for the diagnosis of patients over the age of six. The authors, in their review, describe the diagnostic features and symptom profile of ARFID, and they discuss the role of the main etiological factors involved in its development, such as sensory hypersensitivity, congenitally strong aversive and neophobic reactions, cognitive rigidity, high levels of anxiety, relative insensitivity to interoceptive cues of hunger, and characteristic taste and smell preferences. Different treatment options are also discussed. Although there are still gaps in evidence-based treatments due to the short history of the diagnosis, some existing therapies with some modifications or newer approaches may be well suited to treat ARFID. In addition to cognitive behavioural therapy, exposure therapy, and family-based treatment approaches with modifications, the importance of psychoeducation of parents and a family-tailored treatment plan is emphasised. The authors highlight that effective approaches to ARFID are often counter-intuitive, making it of paramount importance to gain the trust and cooperation of parents.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 1","pages":"70-83"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683324","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 practice of electroconvulsive therapy at Department of Psychiatry and Psychotherapy, Semmelweis University].","authors":"Levente Hermán, Ilona Bella Császár, Réka Ildikó Zsigmond, Máté Fullajtár, Judit Nagy, Mónika Varga, János Réthelyi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) is a highly effective biological treatment in psychiatry with a history of nearly one hundred years. In contemporary clinical practice, its primary indications include treatment-resistant affec tive disorders, catatonia, and selected psychotic conditions. Although the overall use of ECT has declined internationally, with appropriate infrastructure and organization it remains a safe and effective intervention and can be delivered in an outpatient setting. The aim of this paper is to present the organizational, technical, and clinical changes implemented at the Department of Psychiatry and Psychotherapy, Semmelweis University since 2018, and to describe the development of the local ECT service based on a retrospective analysis of clinical data. Key developments included the acquisition of a new ECT device, the establishment of a dedicated ECT treatment unit, the formation of a permanent multidisciplinary ECT team, expansion of anesthesiology support, and the introduction of outpatient, continuation, and maintenance ECT protocols. In parallel, a marked shift occurred in the diagnostic distribution of treated patients toward affective disorders. Results demonstrate a substantial increase in both the number of treated patients and the total number of ECT sessions, particularly following the COVID-19 pandemic. More than 80% of patients received ECT for affective disorders, consistent with current international trends. Severe catatonia emerged as a key indication, along with the provision of ECT for psychiatric patients treated in intensive care settings, where rapid symptom reduction is critical and pharmacological options may be limited or contraindicated. Authors' experience suggests that a structured ECT service incorporating outpatient care, continuation and maintenance treatment, and integrated practical education can improve the safety, effectiveness and accessibility of ECT, while also contributing to the reduction of stigma associated with this therapeutic modality in contemporary psychiatric practice. Keywords: electroconvulsive therapy; ECT; depression; catatonia.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 3-4","pages":"338-344"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406085","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":"[Phenomenology of Redeployed Psychiatric Nurses].","authors":"Ilona Liliána Birtalan, József Rácz, Oguz Kelemen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The global coronavirus outbreak posed a threat to healthcare providers. This study explored how psychiatric nurses (PNs) perceived their redeployment experiences.</p><p><strong>Methodology: </strong>Using a phenomenological approach, semi-structured interviews were conducted with PNs deployed to care for COVID-19 patients.</p><p><strong>Findings: </strong>Our findings suggest that three themes emerge from the data: (1) Awareness of the mental health perspective, as a reference (2) Operating inside the community as opposed to maximizing functioning (3) Professional understanding of evidence.</p><p><strong>Conclusions: </strong>To enhance future healthcare responses, it's vital to recognize psychiatric nurses' expertise in managing mental health crises, delirium, and altered mental states, ensuring comprehensive emergency care.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 1","pages":"60-69"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683322","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":"[A novel approach to the mental health condition of the great Hungarian painter, Csontváry].","authors":"Péter I Temesvári, László Tringer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Csontvary (1853-1919), the great Hungarian painter was retrospectively diagnosed by psychiatrists as having paraphrenia expansiva or schizotypal personality disorder, respectively. He conducted a double life: beside his regular, productive artistic and private life, he also had a long lasting, secrectly kept mystical connection with higher powers, in his own words \"perhaps God\". However, his handwritten diary drafts suggest that he was suffering eventually from an affective disorder. We analyzed the 400 pages of this diary as well as 200 pages of an antology with testimonies of his contemporaries. Using the data of some of the Csontvary literature comprising over 500 references, we analysed his life events focusing on the data and episodes, looking for putative psychopathological, including affective manifestations. We could define a total of 39 events relative to our topic. 6 episodes turned out to be just normal. In 4 cases we could not define their exact nature, because of insufficient data. 29 out of the 39 events, along with 24 testimonies of contemporaries seemed to be pathological, demonstrating clearly the features of an affective disorder, such as elevated mood, euphoria; ego- diastole; impulsive behaviour; rapid thinking and speech; a tendency to logorrhea and graphomania; increased mental and psychomotor activities; megalomania; a decrease in judicial faculty but no complete loss of it; and occasionally some tendency to incoherence. Our results suggest the presence of sporadic and minor affective manifestations . However, we found only one questio nable episode of a depression. This can be due to the fact that for long periods of time the painter lived in isolation thus hiding an eventual depression. This new approach, the possibility of an affective disorder in the painter's history can help us to better understand some open questions concerning his life and work. However, it also seems clear that his pathological manifestations did not significantly impact his dominantly integral mental health nor the extraordinary high level of his artistic achievement. Keywords: analysis of life events; testimonies of contemporaries ; a dominantly integral mental health ; rare and minor affective manifestations; remarkable artistic achievement.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 2","pages":"194-213"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850953","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}