Psychiatria Hungarica最新文献

Introduction: The non-litigation legal proceeding, known as "judicial review" is intended to ensure that people receiving psychiatric treatment in Hungary are not subject to any discrimination and that their freedom is restricted only within the limits of the law. At the same time, this proceeding constitutes the legal framework for involuntary psychiatric treatment of patients who, as a result of their acute mental disorder, exhibit so-called "direct threatening behavior". The vast majority of complaints about psychiatric care are understandably related to the judicial review and the resulting treatment or the lack thereof. Over the past decade, the problems with the judicial review have attracted particular attention from the Hungarian psychiatric profession, the courts, and NGOs dealing with patients' rights, resulting in complaints to, and subsequent investigations by the Ombudsman. The authors assessed the staff provision and the current practice of the judicial review in acute psychiatric wards providing involuntary treatment in Hungary.

Methods: The authors sent a 23-item questionnaire on all aspects of the practice of the judicial review to all acute psychiatric wards (n=48).

Results: Thirty-three (77%) of the 48 psychiatric wards returned the completed questionnaires. The survey revealed a need for change and standardization in a number of areas, including staffing conditions and the whole practice of the judicial review.

Conclusions: The high response rate and the comments on the local characteristics of the judicial review indicate the high level of professional interest of the Hungarian psychiatric community in the judicial review of involuntary treatment and the expressed need for change resulting in its modernization and standardization. The authors set out the steps to be taken by all parties (psychiatric profession, courts, legislators) to ensure that the judicial review can fully achieve its objective: the protection of the fundamental rights of psychiatric patients and the possibility of their lawful treatment.

Background: Anxiety disorders are often diagnosed in adolescents (7%) and children (6.5%), yet most of them do not receive adequate psychotherapy. Cognitive behavioral therapy (CBT) is a proven effective first-line treatment for anxiety disorders. Our aim was to develop an eight-session group CBT intervention adapted for adolescent population with anxiety symptoms, focusing on reducing cognitive distortions and avoidance behaviours and associated physical symptoms.

Methods: The participants (N= 51, age group: 15-20 ys.) were diagnosed with anxiety and comorbid mood disorders. Groups of 8-12 patients were formed to apply group CBT. To assess the effectiveness of CBT, the following questionnaires were administered before and after the intervention: BDI, STAI-S, RSES-H, BHS, CERQ, FNE-8, Non-productive Thought Q. (NPTQ-C). Paired-sample and independent sample t-test were used for statistical analysis of the results.

Results: Anxiety (t(50)=3.82; p<0.001), depressive symptoms (t(49)=4.09; p<0.001) and fear of negative appraisal (t(50)=3.15; p=0.001) were significantly decreased after therapy. In addition, there were reductions in unproductive thoughts (t(49)=3.47; p<0.001), hopelessness (t(50)=1.69; p=0.049), while self-esteem increased (t(49)=-1.76; p=0.042). Baseline levels of depressive symptoms differed significantly between anxiety-only and comorbid groups (t(48)=-2.016; p=0.049), while not between final scores.

Conclusion: In our country, we were the first to examine brief, group CBT to reduce anxiety disorders in adolescents. We found that group CBT reduced patients' anxiety, depression, self-esteem and hopelessness, and the presence of comorbid disorders did not reduce the effectiveness of the intervention. These findings support the method's broader application in Hungary.

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.

Introduction: 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.

Methods: 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.

Conclusion: 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.

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.

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.

Introduction: The global coronavirus outbreak posed a threat to healthcare providers. This study explored how psychiatric nurses (PNs) perceived their redeployment experiences.

Methodology: Using a phenomenological approach, semi-structured interviews were conducted with PNs deployed to care for COVID-19 patients.

Findings: 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.

Conclusions: 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.

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.

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.

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.