Psychiatria Hungarica最新文献

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.

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.

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.

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.

Introduction: 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.

Objective: The authors of the article present the possible influence of masculinity on psychotherapies, focusing on clients suffering from major depressive disorder.

Method: 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.

Results: 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.

Conclusions: 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.

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Introduction: 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.

Method: 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.

Results: This comparison shows how Esquirol's work laid the foundation and initiated the development of suicidology.

Conclusion: 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.

Franco Basaglia's work is the cornerstone of the radical psychiatric movement in Italy. This culminated in the "Basaglia Law" of 1978, which aimed to abolish closed psychiatric institutions. In addition to becoming a symbolic place of movement, Trieste is still trying to preserve and put into practice the Basaglian tradition. The organization called Polisportiva Fuoric'entro implements the integration of marginalized people and groups through various sports activities. Based on the example of this foreign "good practice", the initiative in Pécs aimed at organizing and developing a football team of psychiatric patients.

No Abstract Available.

Introduction: Suicide is a severe public health problem. Impacts of childhood traumas, unsecure adult attachment styles and personality traits have been suggested as possible risk factors for suicide attempts. The aim of this cross-sectional, case-controlled study is to investigate the impact of childhood traumas, adult attachment styles and personality traits on suicide attempt.

Methods: The sample consisted of psychiatric patients who attempted suicide (n=101) on the one hand and those who did not attempt suicide (n=114) on the other. The questionnaires used were the Hungarian validated versions of Adult Attachment Scale (AAS), Childhood Trauma Questionnaire (CTQ), Temperament and Character Inventory (TCI) and a demographic questionnaire.

Results: Results indicated that Novelty Seeking (NS) temperament trait [EH=1.043; 95% C.I.=(0.950-1.145)] p=0.376; emotional abuse [EH=1.034; 95% C.I.=(0.966-1.107)] p=0.336; emotional neglect [EH=1.022; 95% C.I.=(0.936-1.116)] p=0.626; and sexual abuse [EH=1.047; 95% C.I.=(0.959-1.142)] p=0.305 were associated with nonsignificant increases in the odds of suicide attempts. Whereas secure attachment style [EH=0.908; 95% C.I.=(0.842-0.980)] p=0.013 appeared to be a significantly protective factor (c2(1)=6.515 p=0.011). Furthermore, when examining the connection between childhood traumas and adult attachment styles it was found that the anxious attachment style had a positive significant correlation with emotional abuse (rs(197)=0.293) p<0.001, avoidant attachment style with emotional neglect (rs(197)= 0.273) p<0.001.

Conclusion: Our findings suggest that individuals with avoidant attachment style and childhood traumas are likely to present a higher suicide risk. However secure attachment style likely to present a lower risk for suicide.