Volume 11, Issue 3, September 2009

Editoral in hungarian

Réka Mlinarics, Oguz Kelemen, Tamás Sefcsik, Dezső Németh



Az alkoholfüggõség klinikai képének hátterében jellegzetes kognitív információfeldolgozási folyamatok feltételezhetõk. Kutatásunkban ezek vizsgálatára a gyakorlatban és a klinikumban egyaránt hatékonyan alkalmazott neuropszichológiai teszteket használtuk. Avizsgálatban 20 legalább 6 hónapja absztinens, de a DSM-IV szerint diagnosztizált alkoholfüggõ beteg és 20 illesztett kontroll személy vett részt. A neuropszichológiai deficitek mérésére a komplex munkamemória terén a hallási mondatterjedelem tesztet és a fordított számterjedelem tesztet, a végrehajtó funkciók terén a Trail Making A, Trail Making B, betûfluencia, szemantikus fluencia tesztet, a verbális rövidtávú emlékezet mérésére a számterjedelem és a szólista visszamondás tesztet, figyelmi tesztként a Digit Symbol Substitution Tesztet alkalmaztuk. Általánosabb memória tesztként a Rivermead Viselkedéses Memória Tesztet használtuk. Eredmények. A hosszú absztinenciát tartani tudó alkoholbetegeknél a kognitív képességek károsodása megfigyelhetõ volt a végrehajtó-funkciót, a frontális és frontotemporális mûködést vizsgáló teszteknél (csökkent szemantikus fluencia, hallási mondatterjedelem értékek). A vizsgálatban érintettnek mutatkozott a kognitív feldolgozási sebesség, illetve a pszichomotoros gyorsaság terén is deficit volt észlelhetõ. Ugyanakkor a végrehajtó funkciókat és a szemantikus fluenciát mérõ tesztekben mért károsodás az absztinencia idõtartalmával fordítottan korrelált. Mindezek mellett az epizodikus, valamint a késleltetett memória funkciók, a Rivermead Viselkedéses Memória Teszt eredménye nem mutatott szignifikáns csökkenést, mely felvetheti a hosszútávú memória rekonszolidációs lehetõségét. A kognitív funkciók, ezen belül is a végrehajtó funkciók, a szemantikus fluencia értékek tekintetében javulás volt kimutatható, az absztinencia tartás hosszával arányosan. Ugyanakkor számos területen hosszútávú absztinencia mellett is észlelhetõ kognitív érintettség, amely vagy primer érintettségre utalhat, vagy az adott terület sokkal lassúbb regenerációjárt jelezheti.

Kulcsszavak: alkoholdependencia, alkohol, kognitív funkciók, memória, absztinencia

Why do hungarian men die early?

Mária Kopp, Árpád Skrabski


The mortality rate for 40-69 years old men was 12.2 /thousand males of corresponding age in 1960 and 16.2 in 2005: it increased by 33 %, while among 40-69 years old women it decreased from 9.6 0/thousand females of corresponding age to 7.8. The aim of the present follow up study was to analyze which psychosocial risk factors might explain the high premature mortality rates among Hungarian men? Participants in the Hungarostudy 2002 study, a nationally representative sample, 1130 men and 1529 women were contacted again in the follow up study in 2006, who in 2002 were between the age of 40-69 years. By 2006, 99 men (8.8%) and 53 women (3.5 %) died in this age group. Socioeconomic, psychosocial and work related measures, self-rated health, chronic disorders, depressive symptoms (BDI), WHO well-being, negative affect, self-efficacy, meaning in life and health behavioral factors were included in the analysis. After adjustment according to smoking, alcohol abuse, BMI, education and age a number of variables were significant predictors of mortality only in men: low education, low subjective   social status, low personal and family income, insecurity of work, no control in work, severe depression, no meaning in life, low social support from spouse, low social support from child. Socioeconomic and work related risk factors predicted
only male premature death. Among women dissatisfaction with personal relations was the most important risk factor. Among men depression seems to intermediate between these chronic stress factors and premature death.

KEYWORDS: premature mortality, gender differences, depression, chronic stress, psychosocial determinants


The aim of the current manuscript is to provide a short overview on autisms, attention deficit hyperactivity disorder (ADHD) and Tourette syndrome. According to international data, the prevalence of autisms is 2-5/10000 and the symptoms persistence during the entire life; the prevalence of ADHD among children and adolescents is 2,4-12,0% and the symptoms cause problem in 30-50% in the adulthood as well; while the prevalence of tic disorder is 1-6,6% among children and adolescents and the symptoms persistence in 10% in adulthood. According to Hungarian data, these disorders are relatively rare in adult psychiatric practice. Presenting case reports of adults with autisms, ADHD and Tourette syndrome, we would like to demonstrate the symptoms, treatment possibilities of these disorders and how they can influence the patients’ quality of life. 

KEYWORDS: autism, attention deficit hyperactivity disorder (ADHD) and Tourette syndrome



Are the diseases of civilization caused by learnt behaviour, not the stress itself?

The role of carbon dioxide (CO2) is underestimated in the pathomechanism of neuropsychiatric disorders, though it is an important link between psyche and corpus. The actual spiritual status also influences respiration (we start breathing rarely, frequently, irregularly, etc.) causing pH alteration in the organism; on the other hand the actual cytosolic pH of neurons is one of the main modifiers of Ca2+-conductance, hence breathing directly, quickly, and effectively influences the second messenger system through Ca2+-currents. (Decreasing pCO2 turns pH into alkalic direction, augments psychic arousal, while increasing pCO2 turns pH acidic, diminishes arousal.) One of the most important homeostatic function is to maintain or restore the permanence of H+-concentration, hence the alteration of CO2 level starts cascades of contraregulation. However it can be proved that there is no perfect compensation, therefore compensational mechanisms may generate psychosomatic disorders causing secondary alterations in the “milieu interieur”. Authors discuss the special physico-chemical features of CO2, the laws of interweaving alterations of pCO2 and catecholamine levels (their feedback mechanism), the role of acute and chronic hypocapnia in several hyperarousal disorders (delirium, panic disorder, hyperventilation syndrome, generalized anxiety disorder, bipolar disorder), the role of “locus minoris resistentiae” in the pathomechanism of psychosomatic disorders. It is supposed that the diseases of civilization are caused not by the stress itself but the lack of human instinctive reaction to it, and this would cause long-lasting CO2 alteration. Increased brain-pCO2, acidic cytosol pH and/or increased basal cytosolic Ca2+ level diminish inward Ca2+-current into cytosol, decrease arousal – they may cause dysthymia or depression. This state usually co-exists with ATP-deficiency and decreased cytosolic Mg2+ content. This energeticaland ion-constellation is also typical of ageingassociated and chronic organic disorders. It is the most important link between depression and organic disorders (e.g. coronary heart disease). The above-mentioned model is supported by the fact that H+ and/or Ca2+ metabolism is affected by several drugs (catecholemines, serotonin, lithium, triaecetyluridine, thyroxine) and sleep deprivation, they act for the logically right direction.

KEYWORDS: arousal, behaviour, bipolar disorder, carbon dioxide, delirium, depression, diseases of civilization,
generalized anxiety disorder, hyperventilation syndrome, locus minoris resistentiae, milieu interieur, panic disorder, stress


Olanzapine pamoate, a long-acting depot preparation of olanzapine, is being evaluated by regulatory agencies for the treatment of schizophrenia. Clinical trial information was accessed by
on-line query of http://www.pubmed.gov, http://
www.clinicaltrials.gov and http://www.fda.gov,
along with an examination of poster presentations at scientific meetings held in 2008. Two
double-blind randomised clinical trials of olanzapine pamoate were conducted and demonstrate
efficacy for both the acute treatment of schizophrenia and for the maintenance of antipsychotic
response. Long-term open-label studies provide
additional information on safety.
The overall tolerability profile for olanzapine
pamoate is similar to that for the oral formulation; however, with the depot there is a risk of a
postinjection delirium sedation syndrome which
resembles an overdose of oral olanzapine and
which occurs in 0.07% of injections, requiring
patients to be observed for 3 h after injection.
At present, there are no studies available that directly compare olanzapine pamoate with other
antipsychotics other than oral olanzapine.

KEYWORDS: olanzapine, depot, long-acting, pamoate


The close and complex relationship between serotonin and sleep-waking states has special theoretical and practical importance. There are available scientific data regarding this issue, but the
apparently contradictory and insufficiently clarified nature of the problem halts up the systematization and exploitation of this knowledge. While
reviewing the role of serotonin in sleep regulation a special attention to the differentiation between the immediate arousing and the slowly developing circadian phase resetting and sleep
homeostatic functions of serotonin is paid. As regarding the differentiation of receptor subtypes
the article focuses on circadian rhythm and REM
regulatory/modulatory functions in relation with
5-HT1A/7 and 5-HT3 receptors, as well as on
sleep homeostasis, sleep intensity, ultradian
sleep organization, and sleep continuity in relation with 5-HT2A receptors. Moreover, there is
suggestive data for the reciprocal interactions between serotonin, neural plasticity and sleep spindling, which might provide new insights to the
neuropsychopharmacological characterization
of the mechanisms of action and effects of drugs
acting through the serotoninergic system.

KEYWORDS: 5-HT2A receptor, sleep stages,
slow-wave sleep, biological clocks, circadian
rhythm, delta rhythms