Psychiatria Hungarica最新文献

We consider the disorders of arousal and sleep-related hypermotor epilepsy as genetic twin-conditions, one without, one with epilepsy. They share an augmented arousal-activity during NREM sleep with sleep-wake dissociations, culminating in sleep terrors and sleep-related hypermotor seizures with similar symptoms. The known mutations underlying the two spectra are different, but there are multifold population-genetic-, family- and even individual (the two conditions occurring in the same person) overlaps supporting common genetic roots. In the episodes of disorders of arousal, the anterior cingulate, anterior insular and pre-frontal cortices (shown to be involved in fear- and emotion processing) are activated within a sleeping brain. These regions overlap with the seizure-onset zones of successfully operated sleep-related hypermotor seizures, and notably, belong to the salience network being consistent with its hubs. The arousal-relatedness and the similar fearful disorientation occurring in sleep terrors and hypermotor seizures, make them alike the acute stress-responses emerging from sleep; triggered by false alarms. An acute stress-response can easily mobilize the hypothalamo-pituitary-adrenal axis (preparing fight-flight responses in wakefulness); through its direct pathways to and from the salience network. This hypothesis has never been studied.

In recent decades a global problem in mental health has been the increase in the relative proportion of patients who do not receive care, which is associated with loss of life years and deterioration in quality of life. The practical application of artificial intelligence (AI) can help in the fields of data analysis, diagnosis, therapy planning, among others in psychiatric care, thus reducing the human resource input. Today's artificial narrow intelligence (ANI), also known as weak AI, can recognise patterns and correlations in large data sets with the help of machine learning procedures and to make autonomous decisions while making its own refinements. The use of AI-based systems may be effective in the classification of mental health disorders, in disease prevention, in clinical diagnosis and treatment without human input, and finally, it can play a supporting role in many areas of data analysis (quality care assessment, research). A key area of diagnostics is the estimation of suicidal risk and the assessment of mood status using machine learning, which can be used to make predictions with high accuracy, by analysing written text or speech. By examining correlations within large data sets, advances in precision medicine could also be made, allowing more accurate prediction of medication. Psychotherapeutic programs using artificial intelligence are already available today, which can provide users with easily accessible help, mainly using cognitive therapy tools. In addition to its obvious benefits, the use of artificial intelligence also raises ethical and methodological questions, making its regulation a key issue for the future.

The relationship of mentally ill patients and the relational society has constantly changed during the course of history. The changes are true reflexions of the given society. In the management of behaviours disturbing community life medical treatment, law enforcement and religious measures change periodically, sometimes one, sometimes the other comes to the fore. One of the most influential spiritual currents of the 20th century has been the dismantling of large institutions, called deinstitutionalisation, which process could be experienced by the currently active professional generations. New ideas have followed each other since the turn of the millennium at an ever-accelerating pace. The postmodern age threatens to fragment our profession. The mentally ill person finds less and less space for the global suffering of his or her person to be heard. The system forces the professional to reflect the mental illness as a malfunction of an organ, or name it in the form of a recently published linguistic invention (diagnostic category). The global nature of the person is lost, in its biological, psychological, social and spiritual wholeness. This paper searches for and tries to articulate modern, forward-looking clues to the identity of psychiatry (and the psychiatrist). The facts of the subject of the person come to the fore, such as self-identity, value-drivenness, intentionality, future-orientation, and the spiritual dimension.

Objective: The aim of this study was to examine whether different types of cartoons (related and unrelated shifts, cuts and other formal features) immediately influence preschool-aged children's executive function (e.g. working memory, inhibition).

Methods: Participants were 29 children aged four to five years. They were assigned to watch a fast-paced cartoon that used high concentrations of perceptually salient features or an educational cartoon or draw for 10 minutes. Preschoolers' executive function was assessed via 4 tasks (Sentence repetition, Hand game, Tower of Hanoi, Multi step commands). Parents completed questionnaires regarding demographics and the media habits and executive function of the participating child.

Results: Using age as a covariate we found a significant main effect of intervention on the composite executive function score. The fast paced television group performed significantly worse on the executive function tasks than the drawing group. The difference between the fast-paced and the educational cartoon groups approached significance, and there was no difference between drawing and watching the slow-paced cartoon.

Conclusion: The effects of media consumed during early childhood are mediated not only by quantity but also by the formal features of television programming. Just one episode of viewing a fast-paced cartoon has (at least a short-term) negative effect on preschoolers' executive function.

Sándor Weöres is well-known as the poetrist, who has been generous not only to children but also to elderly readers. Children's poems play a huge role in his oeuvre, he has been able to become one with the world of children and use their language authentically. Being connected with childhood is probably particularly profound and is not only the source of inspiration. Weöres has suffered from neuasthenia and alcohol addiction, the regression behind addiction may indirectly reflect to childhood (1). It raises the questions of how addiction is related to his poetry, and how poetry and life facts reflect to each other. The author also aims to explore the coexistence of alcohol addiction and codependency through the poetrist's letters, interviews and present the wider context of alcohol addiction through his art.

Not all women in Frigyes Karinthy's art were presented as evil: the figures of the deceased mother and first wife are reflected as inaccessible goddesses in his late works. These characters do possess some negativity that stems from the pain they caused by their death. On the other hand, feminine characters inspired by Aranka Böhm, the second wife are in contact with the men of Karinthy's works but do not connect to them on an emotional level and they exploit men as well. This tipology of women in Karinthy's art represents his relationships well with Karolina Engel, Etel Judik and Aranka Böhm - suggesting that his works are heavily influenced by events in his life. There might be two types of motivation behind these confessions: the first one is finding an explanation for the sudden death of the mother and first wife through philosophical works which might have arisen from Karinthy's feeling of guilt; the second is relieving stress coming from his stormy marriage with Aranka Böhm, while thinking about the way of his wife's (and humanity's) salvation.

Background: In this study, we examined psychiatric teams in a Hungarian sample before the COVID-19 pandemic. The aim of our research is to examine Hungarian psychiatric teams along different workplace psychosocial factors (collaboration management, organization and job, workplace requirements, work-life balance, trust, health and well-being) in order to assess them in terms of hierarchy and competence. Moreover we examine the mental and somatic effects of these factors.

Methods: We conducted a cross-sectional survey of Hungarian mental health care workers (N =79). The main question of the study was how perceived hierarchy and competence boundary violations are associated to psychosocial factors of the COPSOQ-II questionnaire (Copenhagen Psychosocial Questionnaire II) in general, and among employees in different job groups.

Results: Based on bootstrapped binary logistic regression performed on the full sample, we found that perceived hierarchy is associated with control, social support of co-workers and stress, while violation of competence boundaries is associated with job recognition, job clarity and fairness.

Discussion: Our results show that where mental health care workers experienced less perceived hierarchy within the team, they were more likely to feel that they had control over their work. Furthermore, in hierarchies perceived as superior-subordinate relations, the quality of the relationships within the team seems to be much more important.

Conclusions: This research can be the starting point for a comprehensive study of other psychiatric teams with the aid of a widely used measure, providing an opportunity for comparison with other health teams at an international level.

In recent years there has been a shift in the long-term treatment of patients living with schizophrenia, the institutional focus being increasingly replaced by outpatient and community-based interventions. Relatives of patients with schizophrenia play a key role in treatment, greatly assisting the monitoring of patients' condition and facilitating their involvement in long-term care. The challenges associated with the varied symptoms of schizophrenia place an increased burden on family members, including psychological distress often accompanied by a deterioration in quality of life. In this context, the literature and international protocols highlight the need for interventions involving the patients' family, which in most cases focus on psychoeducation and development of communication skills. At the Department of Psychiatry and Psychotherapy, Semmelweis University, we have initiated and organized psychoeducational support groups for relatives of patients living with schizophrenia since August 2019. The first half of the 10-session training focuses on providing information about the disease, therapeutic options, and relapse prevention, reflecting on the family members' own experiences. In the second half of the training, we focus on the psychological difficulties that family members face in their daily lives, such as stress management and communication problems within the family, stigmatization and decreased self-care. In this article besides summarizing the literature, we present the structure of the training for relatives and our experiences with the process of the groups, including our future plans and possibilities for improvement.

The development of the new diagnostic systems (DSM-5; ICD-11) once again generated an interesting discussion around the personality disorders. In this paper we first review the historical traditions, than we examine and compare the new diagnostic suggestions appearing in DSM-5 and ICD-11. Our main goal is to help with the under standing of the new dimensional models and to clarify the questions that arose during the creation of these models. Although the DSM-5 keeps the classic categorical system, it also proposes a hybrid dimensional-categorical diagnostic alternative. Within the hybrid model, the first step is to investigate the impairment of the personality by evaluating the damages to the self and the interpersonal functions. The next step is to form categories along the Big-Five traits. The constellation of the impaired traits dimensions creates the final categories. ICD-11 broke up with the category approach and moved on with the hybrid proposal of DSM-5. Here the first step is to determine the severity of the personality disorder. After that the personality disorder can be specified by a new code. This system does not use the dimensions of the intact personality traits (Big-Five), but the dimensions emerging from the factor analysis of personality disorders. Since in ICD-11 the borderline diagnostic possibility appears in addition to the dimensions, in the last part of the study we review the critical, scientific data of this specific borderline syndrome and its therapy.

Introduction: Suicide attempts and their consequences have been the leading causes of death among prisoners. Meta-analyses suggest that the main risk factors are current suicidal ideation, the presence of a mental disorder, high perceived stress levels, previous suicidal attempts or self-harm, and institutional and criminogenic variables. Empirical evidence is consistent with the integrated motivational-volitional model of suicidality, which also emphasizes the role of impulsivity in suicidal behaviour. The main objectives of our research are: (a) factor analysis of the Barratt Impulsiveness Scale-Brief-8 (BIS-R-8); (b) examination of the mental health status of prisoners, and the suicidal risk factors in our sample; (c) modeling the effect of mindfulness skills on the main risk factors.

Methods: In our cross-sectional survey, we matched a sample of inmates to a convenience sample according to gender and age (N=378). Based on our hypotheses, we examined the factor structure and reliability of the BIS-R-8. An independent sample t-test was used for comparison, and a two-step linear regression and mediation modeling were used to examine the risk of suicide.

Results: Based on factor analysis, the BIS-R-8 can be used as a unidimensional scale. A two-factor structure with cognitive and behavioral impulsivity subscales has also been confirmed. However, the internal and external reliability of the one-factor structure proved to be better. Depression, hopelessness, perceived stress and impulsivity turned out to be of higher level in the prisoner sample; lower levels of coping skills, self-esteem, mindfulness skills and well-being were also confirmed. Depression and perceived stress level seems to be the main modifiable risk factors for suicidal thoughts in the total and prisoner's sample. Previous suicide attempts and non-suicidal self-harm are the main unmodifiable risk factors of suicidal thoughts. Low level of mindfulness skills directly and indirectly via perceived stress explains 50% of the heterogeneity in depression.

Discussion: In correctional institutions BIS-8-R can be a suitable screening tool for measuring impulsivity as a suicide risk factor. Mindfulness-based interventions seem promising for improving the mental health status of prisoners and reducing the risk of suicide.