Psychiatria Hungarica最新文献

{"title":"[The role of positive childhood experiences in adult well-being: Theoretical frameworks and applications].","authors":"Sejla Gubucz-Pálfalvi, Tamás Kurimay, Ildikó Danis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Childhood experiences play a decisive role in shaping long-term physical and mental health as well as overall well-being in adulthood. In recent years, alongside adverse childhood experiences, increasing attention has been directed toward positive childhood experiences, which not only compensate negative effects, but also independently contribute to resilience and to maintaining mental health. This paper reviews how these experiences support adult well-being, outlines the theoretical frameworks that help in understanding their diversity and impact mechanisms, and highlights potential measurements in science and intervention practice. Special emphasis is placed on the importance of strengthening positive, protective and compensatory experiences in the fields of prevention, health promotion, and clinical interventions. Our aim is to demonstrate how positive childhood experiences can open new perspectives in understanding and supporting well-being. Keywords: adverse childhood experiences, positive childhood experiences, protective and compensatory experiences, resilience, well-being, mental health, developmental assets, supportive relationships, health promotion, trauma-informed approach.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 2","pages":"151-171"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850997","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":"[Possible mechanisms of action of electroconvulsive therapy].","authors":"Gábor Gazdag, Hunor Girasek, Rozália Takács","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) remains one of the most effective biological treatment methods in psychiatry. The development of convulsive treatment methods was based on a theory of its mechanism of action, namely the presumed biological antagonism between schizophrenia and epilepsy. Later studies did not confirm this antagonistic diseases theory, but intensive research started to clarify ECT's mechanism of action. In early studies on ECT, attention was drawn to the anticonvulsant effect , its impact on cerebral circulation and the change of permeability of the blood-brain barrier. Later research focused on the effect of ECT on the neurotransmitter and neurohormonal systems. The inflammatory theory of the mechanism of action was based on the improvement of the laboratory findings observed in conditions that responded well to ECT. With the development of the imaging techniques, the volume reduction of certain brain areas in depression and schizophrenia came into focus. These changes turned out to be reversible with ECT which provided the basis of the neuroplasticity theory of ECT's mechanism of action. The network theory explanation of the effect of ECT was based on the correction of the abnormal circuits of the brain's electrical networks. Finally, in recent years, increasing attention has been paid to the microbiome-gut-brain axis, which, according to preliminary findings, is also affected by ECT. However, the extent to which this is responsible for the therapeutic effects of ECT in psychiatric disorders needs further investigations. Keywords: electroconvulsive therapy; mechanism of action; neuroplasticity; network theory; microbiome.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 3-4","pages":"328-337"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406105","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 Practical aspects of managing treatment-resistant depression - with a focus on esketamine].","authors":"Csilla Bolyós, Levente Hermán, Péter Döme, László Fehér, János Réthelyi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It is relatively common for patients suffering from major depressive disorder to experience no significant improvement in their depressive symptoms despite trying several antidepressants and/or other treatment methods. This phenomenon is referred to in the scientific literature and clinical jargon as \"treatment-resistant depression\" (TRD). In our review paper, we attempt to present various definitions of TRD and conceptually related categories (e.g., \"therapy-refractory depression\"; \"difficult-to-treat depression\") and to discuss the risk factors, differential diagnosis, and treatment options for TRD. Among the therapeutic options used in the treatment of TRD, we focus on the theoretical and practical aspects of the use of esketamine nasal spray, which has been available in Hungary for several years. The section discussing the practical aspects of esketamine use is based not only on the literature but also on the long-term experience gained by the staff of the esketamine treatment center at the Semmelweis University Department of Psychiatry and Psycho therapy with a large patient population. Keywords: treatment-resistant depression; major depressive disorder; antidepressant; esketamine; treatment.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 3-4","pages":"247-273"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406136","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 role of dissociation, childhood maltreatment, and early attachment in the development and maintenance of anorexia nervosa].","authors":"Szilárd Hamvas, Kinga Nőger, János Réthelyi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anorexia nervosa (AN) is a chronic, life-threatening psychiatric disorder that typically begins in adolescence and imposes a considerable psychological and socioeconomic burden on atients, families, and healthcare systems. Although biological, psychological, and social factors have been identified, the mechanisms underlying the development and maintenance of AN remain only partially understood. This review examines the role of dissociation, childhood maltreatment, and early attachment patterns in the pathogenesis of AN. Evidence from the literature indicates that dissociative phenomena are particularly prevalent among eating disorder patients and are strongly associated with emotional abuse, and insecure attachment. These findings suggest that both dissociation and attachment disturbances contribute to the development, and maintenance of AN symptom, where impaired emotional regulation may play a mediating role. Recognizing and addressing these mechanisms in psychotherapy may play a crucial role in facilitating recovery and improving therapeutic outcomes in individuals with severe and chronic forms of AN. Keywords: noexia nervosa, dissociation, childhood trauma, emotional abuse, early attachment, emotion regulation, psychotherapy.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 2","pages":"184-193"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850977","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":"[Escape from Personality: The Life, Work, and Illness of John Berryman].","authors":"József Gerevich","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The psychobiographical analysis of John Berryman's life story aims to bridge the gap between his life's work and his life story; to shed light on the psychological background of his dream songs and other poems, to make his confession intelligible, and to explore whether his psychiatric-dictatorial illness contributed to the genesis and thematic content of his works. It was also questioned whether his literary activity influenced his illness in any direction. The compulsive recollection of his father's suicide was a significant source of motivation for the creation of many of his poems. He was in conflict with his mother over the death of his father. His attachment phobia was due to the traumatogenic influence of his parents; he was unable to dissolve with his wife in any of his three marriages. Although his poetry became more precise as he grew older, his poetry did not contribute to an effective elaboration of early trauma. Part of the reason for this was that he saw literary creation as an escape from his personality, not as an expression of himself. His personality was characterised by a fatal attraction to self-destruction. The dichotomy of the boisterous and the quiet Berryman runs through his biography, until at the end of his life his boisterousness gradually disappeared. From the life history data, the dynamics of a progressive, increasingly severe alcoholism emerge. Alcohol helped him to escape from his personality and to maintain the proximity to death that drove his creativity. His alcoholism and his poetry grew out of the same roots, drinking and writing dream songs were two manifestations of the same compulsion. Her illness was dominated by the self-destructive triad (trait-aggression, bipolar illness, addiction) observed in Sylvia Plath, Robert Lowell and Ann Sexton. At the end of his life, he was converted in AA and came closer to the image of God he had constructed. He only got to the fourth of the twelve steps of AA. His unresolved traumas, alco holism and the lyricism of near death contributed to his suicide. Berryman's literary self-revelations shared with his readers behaviours, fantasies and biographical events that are usually surrounded by a sense of shame. In this sense, many of his poems can be seen as confessional.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 1","pages":"84-103"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683319","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":"[Fathers and Their Adult Autistic Sons. An Interpretative Phenomenological Analysis of a Lifelong Experience].","authors":"Borbála Gabriella Koltai, Eszter Pados, József Rácz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Autism is a unique pathway of human development, rooted in the atypical development and functioning of the neurocognitive system. Its lifelong nature affects not only the individual but also the lives of family members. Although an increasing number of studies address the experiences of parents raising autistic children, the fathers' perspective - particularly in the context of adult autistic children - remains underexplored. This study aims to explore the experiences and meaning-making processes of fathers raising autistic children, from early childhood through adulthood.</p><p><strong>Methods: </strong>This qualitative study involved semi-structured interviews with ten fathers whose sons had been diagnosed with autism spectrum disorder and had reached the age of 18. The interview data were analysed using the method of Interpretative Phenomenological Analysis (IPA).</p><p><strong>Results: </strong>Four main group experiential themes were identified, revealing experiences that deeply influenced participants' parental roles and identities: (1) Dual control: A revolving cycle around losing and regaining control; (2) Crossing boundaries: accep ting and adapting; (3) Being in the world as a father: experiences of eternality and liminality; and (4) Personal growth through pervading experience.</p><p><strong>Conclusion: </strong>Fathers' experiences were fundamentally shaped by the unpredictability of the future and the lack of systemic support. Our findings may inform the development of support services that are sensitively attuned to the specific needs of fathers raising autistic children.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 1","pages":"32-48"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683320","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":"[Hungarian adaptation of the Group Schema Therapy Rating Scale - revised (GSTRS - R): a pilot study regarding the reliability measures of the scale].","authors":"Diána Antal, Zsolt Unoka, Júlia Simon, Krisztina Tóth, Barbara Eszik, László Grúz, Ella Salgó, Luca Egervári, Eszter Berán","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies supported the effectiveness of schema therapy in personality disorders, especially in borderline personality disorder. The goal of our methodological pilot study is to examine the reliability measures of the Hungarian version of the Group Schema Therapy Rating Scale - revised (GSTRS - R) created by Zarbock and colleagues (1) using a Hungarian sample. The scale makes it possible to assess the attitudes and working skills of group schema therapy psychotherapists, so that by evaluating therapeutic work in a clinical setting schema therapy could be further developed.</p><p><strong>Methods: </strong>In the current study five independent coders (university students of psychology) trained in the coding of the Group Schema Therapy Rating Scale examined of ten video-taped sessions of schema group therapy taking place at the Psychiatric Clinic at Semmelweis University, Budapest. They evaluated the adherence and competence of the two participating schema therapists using various criteria described in the Group Schema Therapy Rating Scale. We have used Cronbach-alfa measure to evaluate the inner consistency of the two subscales (General and Specific subscale), and used Cohen's kappa and interclass correlation coefficient (ICC) to measure reliability of the scales and inter-rater reliability between coders.</p><p><strong>Results: </strong>Based on our results regarding competence the inner consistency of the General subscale proved to be excellent, whereas regarding adherence the reliability was high on both subscales. Regarding competence reliability of the General subscale was excellent.</p><p><strong>Conclusions: </strong>Based on our study of the reliability measures of the Hungarian version of GSTRS - we can state that they proved to be excellent. One limitation of our study is that we could not test fully the adherence and competence of the two schema therapists. In order to complete this, and other validity measures of the GSTRS, further studies are necessary.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 1","pages":"5-18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683321","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 risk of depression among Hungarian female teachers: role of work motivations, burnout, and teacher well-being and resilience].","authors":"Bettina Pikó, Orsolya Tóthpál-Halasi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and objectives: </strong>Depression, as part of mental health issues among professionals working in the field of education, is associated with burnout and several personal protective and risk factors in relatin to their work environment. Considering gender distribution of the profession, investigation of female educators should get special attention, partly due to their substantial overrepresentation, partly due to their elevated involvement. Therefore, the aim of our study was to analyze risk and protective factors (burnout, work motivatons, teacher resilience and well-being) of depressibe symptomatology in a sample of female educators.</p><p><strong>Methods: </strong>Participants of our online, anonymous, cross-sectional survey were Hungarian female teachers (N = 520). We applied the following scales for measuring variables: Center of Epidemiologic Studies - Depression Scale; The Mini Oldenburg Burnout Inventory; Teacher Subjective Wellbeing Questionnaire; The Multidimensional Work Motivation Scale; Teachers' Resilience Scale. Data analysis was conducted with the help of SPSS, using descriptive statistics, correlation, and logistic regression analyses.</p><p><strong>Results: </strong>Thirty-five percent of the sample demonstrated depressive symptoms based on the CES-D scale. Risk factors were identified with logistic regression analysis including dimensions of burnout, especially exhaustion, and amotivation. Teacher well-being, intrinsic and identified motivation, personal and social resilience emerged as protective factors.</p><p><strong>Conclusions: </strong>The novelty of our research is the involvement of occupational factors in relation to mental health. Our findings highlight the great risk of depressive symptoms among female teachers, which has been strongly linked to exhaustion dimension of burnout and amotivation. Screening for depression in due time would be important among teachers as well as strengthening protective factors and detecting workplace stressors, and managing risk factors.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 2","pages":"140-150"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850964","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":"[Recent developments in the antipsychotic treatment of schizophrenia].","authors":"István Bitter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This publication is an expanded and updated version of three topics selected from a lecture, which was pre sented at a continuing medical education event held in Spring 2025 at the Department of Psychiatry and Psycho therapy at Semmelweis University. The three topics are: 1. The value and usefulness of Real World Data (RWD) and Real World Evidence (RWE) in the treatment of schizophre nia. We highlight RWD and RWE on the efficacy of combined antipsychotic treatments (polypharmacy), and a publi cation on a potentially serious adverse reaction (breast cancer) identified using a Finnish national database. 2. Recent developments, professional opinions and regulatory actions on the use of clozapine. In the USA, new regula tions have already been introduced in summer 2025, with a reduction in the number of blood count (absolute neutrophil granulocyte count) checks. In Europe, preparations are underway at the time of the writing of this manuscript. 3. The efficacy of placebo in the treatment of negative symptoms of schizophrenia. Almost all investigational drugs developed for the treatment of negative symptoms of schizophrenia have been tested with negative results over the last 20-30 years. The main reason for this was the high placebo response rate, which suggests that at least part of the tested negative symptoms were not theatment resistant. Considering the evidence that several psychosocial interventions have been shown to be significantly more effective than standard treatments in treating negative symptoms of schizophrenia, it is justified to accurately assess and treat negative symptoms. Keywords: schizophrenia; real world data; real world evidence; clozapine; negative symptoms; placebo response.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 3-4","pages":"229-235"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406171","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 pharmacological treatment of substance use disorders].","authors":"Erika Szily","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The pharmacological treatment of substance use disorders requires a complex, differentiated approach, in which acute withdrawal treatment, relapse prevention and the treatment of comorbid psychiatric symptoms are imple mented separately, but in close connection with each other. Alcohol, opioid, cannabis and nicotine use disorders, as well as problems associated with benzodiazepine use, show significant heterogeneity in terms of their clinical presentation, course, pharmacological treatment and outcome. The aim of this paper is to provide an overview of the pharmacological treatment of the most important addiction disorders, primarily based on the domestic and international clinical guide lines available in 2024-2025, as well as recent review articles. The paper is not intended as a systematic literature review or meta-analysis, but as a practice-oriented, guideline-based narrative summary that aims to support everyday clinical decision-making. Keywords: substance use disorder; complex treatment; relapse prevention; dual diagnosis.</p>","PeriodicalId":35063,"journal":{"name":"Psychiatria Hungarica","volume":"40 3-4","pages":"282-297"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406169","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}