Psychiatria Hungarica最新文献

Author analyses the process of care of somatic symptom disorder in the general medical practice with special concern to iatrogenic harms. In his opinion the latency of the patients' first appointment with a psychiatrist or clinical psychologist is caused by multiple factors. Patients do not have knowledge on the basic activities of central nervous system necessary to recognize the pathomechanism. On the other hand, physicians do not know the real clinical picture and the cutpoints of the illness. For laypersons the official nosological definition(s) can be very deceptive and frustrating. While somatic symptom disorder is recently an exclusional diagnosis, there are plenty of unnecessary expensive medical appointments and investigations prior to the first efficient intervention. There is a lack of aimed guidelines and protocols. Consequently both pharmaco- and psychotherapy start late and not in the optimal (individually tailored) way. Considering the real capacities in general practice and also in psychiatry, author points to the most urgent steps which can improve the medical care of patients living with somatic symptom disorders.

Tivadar Csontváry Kosztka, the great Hungarian artist was called a sort of a "crazy painter" by his contemporaries. Retrospectively, he was diagnosed as suffering not from psychosis but a schizotypal personality disorder based on seven out of nine diagnostic criteria. However, we still need a more precise definition of these criteria. It was also said that his paintings are like those made by the mentally ill. But following the principles and methods of the psychopathological art, especially that of Rennert, we find definitely more dissimilitudes than resemblances. In order to obtain a more accurate profile of this extraordinary creator, we still need further research focusing on the facts.

Introduction: We provide an overview of the development and validation of the Hungarian long (ECR-R-HU) and short (ECR-R-HU-SF) versions of the Experiences in Close Relationships - Revised (ECR-R) questionnaire on a nationally representative adult sample and highlight the practical applications of the measurement tool.

Methods: The original ECR-R consists of 36 items, while the short form includes 8 items. Both versions have two subscales, Avoidance and Anxiety. Respondents rated the items on a 7-point Likert scale. We assessed the construct validity of the measurement tools using indicators of well-being and family functioning (depressive mood, perceived stress, well-being, and family functioning).

Results: Consistent with prior research, skewed distributions were observed in the Hungarian sample; both subscale scores skewed towards attachment security (low scores on both Avoidance and Anxiety). Risk cut-off values for both subscales were determined based on the 75th and 90th percentiles of the population data. Relationship status was the only sociodemographic factor that showed a significant effect across the subscales, with individuals not in a relationship reporting significantly higher scores on both Avoidance and Anxiety. Indicators used to assess construct validity showed weak to moderate correlations with both attachment subscales in the expected directions. These findings were further supported by analyses based on risk groups.

Conclusions: The long and short forms of the Hungarian version of the ECR-R are reliable and valid tools with established baseline distributions. We recommend them as scientific assessment tools and as practical instruments for screening and follow-up.

Introduction: Mindfulness based interventions belongs to the third wave of cognitive behavioural therapies, where the focus is shifted from restructuring negative automatic thoughts and dysfunctional attitudes to the awareness and acceptance of mental events. The effectiveness of mindfulness based interventions also encouraged researchers to explore more precisely the mechanism of mindfulness. One of the most common measuring instruments is the Five Facet Mindfulness Questionnaire (FFMQ). In recent years, several versions of the questionnaire have been developed, but so far no Hungarian sample has yet been used to assess which version is the most suitable for clinical and research use.

Objective: Hungarian adaptation and internal / external validity testing of the short version of FFMQ.

Method: In our cross-sectional, non-randomized study, we included 1413 patients from the psychotherapy outpatient clinic of our institution between 2018 and 2022.

Results: Compared to the original 39 items, the 15-item version of the FFMQ has better validity indicators. Based on the confirmatory factor analysis, the five-factor model shows an excellent fit. The internal and external reliability of the five-factor structure proved to be better, than the one-factor model. The correlation coefficients also are indicating, that the direction and strength of the relationship are equivalent for the examined variables.

Conclusions: The FFMQ-SF-15 version is a reliable and valid instrument for measuring mindfulness in a clinical sample.

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.

Psychiatric diagnosis formulation has undergone continuous evolution over the past century and a half, always adapting to the scientific, social, and technological challenges of the given era. During recent decades, there has been a shift towards the dimensional, transdiagnostic approach in many areas, but this had little impact on everyday patient care. In our view, in order to benefit as much as other medical fields from the advances in artificial intelligence and big data analytics, there needs to be a shift towards the dimensional approach in psychiatry. In our study, we present an easy-to-use transdiagnostic tool for assessing the longitudinal course of psychotic disorders, the Catatonia-Psychosis-Affective-Negative/Neurodevelopmental (CPAN) scale. The CPAN is used to assess four basic symptom spectra in the field of psychotic disorders (bipolar affective disorder, schizoaffective disorder, schizophrenia) on a scale of 0-4 (catatonia, psychotic symptoms, affective symptoms and negative/neurodevelopmental symptoms). In addition, it is possible to use binary symptom markers (specifiers) to refine the symptom picture. Currently, the scale is being tested in clinical care and a large-scale validation study is in preparation at the Department of Psychiatry and Psychotherapy, Semmelweis University.

Background: Online trolling has gained significant research attention, yet certain aspects remain understudied. Previous studies have focused on defining trolling and exploring dark personality traits, but there is limited research on less dark underlying personality traits of trolls. This study aimed to address these gaps by investigating the motivation, personality traits, and experiences of internet "trolls", and exploring social media users' perceptions of trolls versus cyberbullies.

Methods: A cross-sectional online survey was conducted with a Hungarian sample (N=383), assessing attitudes towards offensive online behavior, social media usage, and experiences as trolling perpetrators or victims.

Results: Results showed 48,56% of Hungarian social media users experienced trolling, while 31,07% engaged in it. Facebook had the highest occurrence. Key predictors of trolling behavior were sadism and enjoyment of aggressive humor. Psychopathy showed a negative association with trolling when combined with other variables, indicating trolling is influenced by the complex interplay of personality traits and social factors. The study also found that the prevalence of trolling in Hungary has tripled compared to previous research, indicating a concerning trend.

Conclusion: These findings can inform interventions to address trolling behavior, emphasizing positive online norms and respectful communication. By integrating technological solutions, policy frameworks, and educational initiatives, a safer online environment can be created, reducing the prevalence and impact of trolling.

Autism spectrum disorder is a neurodevelopmental condition with unique characteristics of perception and neurocognition that begins in childhood and persists into adulthood. It significantly affects social integration and adaptation, and is a great challenge in terms of psychological coping. Intensive genetic and neurobiological research is focused at understanding the brain underpinnings of autism, and it is also at the forefront of pharmacological development. From the point of view of people living with autism spectrum disorder, the quality of help they receive during examination and care, in terms of biological therapies and psychotherapy, is of great importance. Support in the higher education system and legal-financial help are similarly important issue. The purpose of this review article is to provide assistance to professionals working in the psychiatric system in Hungary in order to gain insight and develop their skills in the care of adults lining with autism spectrum disorder.