Tünetmentes hozzátartozók vizsgálata szkizofréniában – endofenotipikus markerek azonosítása felé

Ayahuasca is a decoctum made of admixture plants containing dimethyltryptamine and
harmine. For millennia it has been used as a central element of spiritual, religious, initiation,
and other – foremost healing – rituals, originally by the indigenous groups of the Amazon
basin and later by the mestizo populations of the region. During the last two decades the
brew has raised increased scientific and lay interest about its healing potentials within the
framework of Western therapeutic settings. The typical ayahuasca effects consist of strong
somatic reactions, vivid visions, relived personal memories, cathartic emotions, and insightful,
introspective experiences when the emerging mental contents take different context and get
deeper perspectives. The ayahuasca-experience can be exhausting necessitating the presence
of an experienced leader for helping participants to pass difficult phases and for maximizing
therapeutic benefits. No health damaging adverse effect has been confirmed thus far as result
of its well-structured, institutionalized use. The scientific investigation of ayahuasca is hindered
by legal issues, methodical problems, and sociocultural preconceptions. The present review
outlines the therapeutic potentials of ayahuasca use in psychiatry with its psychobiological
and spiritual background.

Keywords: addictions, ayahuasca, depression, dimethyltryptamine, post-traumatic stress
disorder

The author ascertains that healthy personality development faces increasingly serious obstacles
and consequently the number of children in need of mental healthcare is on the rise. Child
and adolescent psychiatry has drawn increasing appreciation, however, it is only formal and
deficient in Hungary today and cannot assure optimal mental care according to the principles
of evidence-based medicine. The author emphasizes that 75% of the first manifestation of the
psychiatric disorders occurs during adolescence and young adulthood. In spite of legal regulation, several deficiencies hinder the development of children into healthy adults. The author
analyses the most important obstacles in the development of child and adolescent Psychiatry.
The author emphasizes the role of keypersons, describes the situation of and problems faced
by Hungarian child psychiatric care. The author lists in detail the most important contradictions, deficiencies and obstacles and outlines suggestions for resolving the present crisis.
The author emphasizes (1) the responsibility of institutions, and people dealing with society
and children, and the disinterest of competent authorities. (2) The somatic, mental, cultural
and spiritual ignorance/illiteracy among parents, teachers, healthcare workers, and the general
population partly related to crises among the pedagogues. (3) The lack of holistic approach
to treatment of children suffering from mental disorder. (4) The importance and the lack
of knowledge concerning central nervous system function in child psychiatry. (5) Application
of evidence-based medicine in child and adolescent psychiatry based on understanding the
relationship between central nervous system alterations and mental functions. (6) Respecting
keypersons’ competence limits. (7) Immediate development of inpatient and outpatient child
and adolescent psychiatry in the whole country. (8) Reform of child psychiatry board exam.
(9) Development of currently missing textbooks and handbooks and promoting benefits
of internet use. (10) The almost complete lack of the permanent and systematic mental health
prevention in education and healthcare, especially in primary health care. (11) The ignorance
of possible and achievable opportunities. Overcoming the obstacles of child and adolescent
psychiatry can only be achieved by a coordinated action of dedicated child psychiatrists, child
psychologists, informed parents, well-trained pediatricians, district nurses, excellent teachers
and other committed keypersons.

Keywords: child and adolescent psychiatry, key persons, mental illiteracy, biological-psychological-mental-cultural-social-spiritual model, role of central nervous system alterations

Marchiafava–Bignami disease (MBD) is caused by damage of the corpus callosum. There
are acute, subacute and chronic forms, it occurs most frequently among alcoholic patients.
A variety of neurological symptoms, epileptic seizures, and coma may be associated with the
disease, but the chronic form may start with acute confusion and dementia, interhemispherial disconnection syndrome or with slow progressive changes in behavior. In 2001, only 250
cases were reported, of which 200 died, 30 cases contributed to severe dementia or bed rest,
and favorable outcome occured in only 20 cases. The MBD diagnosis of our patient was based
on the anamnesis and cranial MRI and the treatment consisted of administration of B vitamin
complex, folic acid, memantine, piracetam and haloperidol. Reviewing the international literature currently recommended therapeutic options are thiamin and folic acid. According to
some authors the immediate administration of thiamine affects the outcome of the disease,
and there are case reports of beneficial effects of amantadine and steroids.

Keywords: Marchiafava–Bignami disease, alcoholism, dementia, corpus callosum