Psychiatria Hungarica最新文献

Introduction: 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.

Methods: 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).

Results: 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.

Conclusion: 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.

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.

Introduction: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Background and objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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.

Introduction: In 1977, Meadow coined the term Munchausen Syndrome by Proxy (MSBP) to describe a situation in which a parent or caregiver fabricates or induces illness in a child, leading to painful diagnostic procedures and hospital treatments. This can result in both short- and long-term psychological and physiological damage, with potentially severe consequences.

Method: The aim of this study, beyond summarizing the existing literature, is to explore the underlying personality traits, psychological mechanisms, motives, and dynamics associated with MSBP through two case analyses. These analyses are based on a thematic content analysis of exploratory interview material and the results of psychological personality tests (Rorschach, MMPI, SCID-II).

Results: The thematic analysis of the two interviews identified the following common main themes: Background and pre-existing life events (e.g., loss as a traumatic event); Indicators of Munchausen by Proxy (e.g., manipulation of medical records or samples); Personality traits (e.g., theatricality, manipulative behavior, trivialization, relationship dependency, egocentricity); Motivating factors and consequences of Munchausen by Proxy (e.g., illness-related secondary gain).

Conclusion: Both cases shared a history of multiple traumatic events prior to the onset of MSBP-such as bereavement, miscarriage, and abuse - which likely had a significant impact on their personality and emotional state. Another common factor was the close, intense, and symbiotic relationship with the child. However, the cases differed in the degree of aggression involved in inducing illness in the child. In both cases, a diagnosis of personality disorder was confirmed, predominantly with histrionic traits.

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.

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.

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.