Volume 18, Issue 3, September 2016
Perényi András (1949–2016) emlékére
Idén áprilisban a szokásos hétvégi telefonbeszélgetések alkalmával közölte András, hogy napokkal azelőtt tudta meg, hónapjai vannak hátra. Sajnos igaza lett, a megkezdett lelki és fizikai küzdelem ellenére betegsége könyörtelenül, rövid idő alatt Melbourne-ben 2016. augusztus 1-jén legyőzte.
Comorbidity of psychiatric disorders and the characteristics of the therapy of the hospitalized patients
Balázs Móra and László Péter
The aim of our retrospective study was to evaluate the diagnostic and therapeutic characteristics of 100 patients who were admitted in our psychiatric department from an index date.
Previous investigation showed high prevalence of comorbidity in patients with psychiatric
disorders. The most common psychiatric comorbidities included dementia (20%), alcohol
dependence (14%) and unipolar depression (8%). The presence of somatic diseases was also
high (73%), including cardiovascular (55%), endocrine (30%), neurological (17%), and gastroenterological (16 %) comorbid disorders. The most frequent diagnostic and/or differential
diagnostic procedures performed were: x-ray (28%), ultrasound (28%), CT-scan (24%), EEG
(24 %). Our results: 1. in accordance with previous studies we also found a high number of
somatic comorbid conditions among the patients hospitalised in the psychiatric ward 2. it is
very important to recognize and treat the somatic conditions of patients hospitalized in psychiatric departments. The complex diagnostic procedures and the introduction of adequate
therapies may help to reduce mortality and improve quality of life of the patients.
Keywords: comorbidity, hospitalized, psychiatric, somatic, therapy, diagnostic procedures
Judit Lazáry, Mónika Eleméry, Irén Csala, and Gábor Faludi
Personalized medicine is a hot topic in the literature of the psychiatric field but it seems that regular clinical application of valid tests are awaited. Urgent requirement of objective tools for screening high-risk patients is postulated by prominent authors because long-term set up time, serious side effects or ineffectiveness of psychiatric agents mean a great challenge for clinicians to find optimal therapy on time. Unwanted suffering from inaccurate medicine, progression of the disorder and mistrust or in adherence of the patients are dramatic consequences of the delay of adequate therapy which is linked with irreversible health and mental damages and financial loss. On the other hand, a growing body of data are published on pharmacogenomic studies in association with psychiatric conditions. Although several pharmacogenetic tests are commercially available, accurate use of these tools are absent from clinical protocols. Here we give a short review on the most important pharmacogenomic results and a discussion on possible conflict of interests around pharmacogenetic tests. We conclude that all participants of the health care system could benefit from personalized medicine in psychiatry.
Keywords: pharmacogenetics, polymorphism, risk variant, personalised treatment
In spite of the fact that the good mental health is indispensable condition of the development
of sound personality, in the past years the somatic and mental state of our children did not
improve. The author ascertains that there are several obstacles in the recognition, treatment
and prevention of child-depression that causes a serious public health problem. He stresses
the neurologic, neuropsychiatric, psychopathological and diagnostic deficiencies, and the low
number of Child and Youth Dispensaries. He describes the situation of Hungarian Child and
Youth Dispensaries network, and states positively that today the child-psychiatric services are
not able to provide optimal provision for every depressive child. In the brief historical introduction he refers the earlier excellent child-psychiatric initiative. He emphasises the huge number
of somatic and psychiatric signs and symptoms among the children. He devotes a separate
chapter to the causes of child-depression, the prevention, recognition, creation of diagnosis
and treatment. According to the literature data and own examination he demonstrates that the
depressive and other psychopathological symptoms among children are not really interested
the parents, health-workers and teachers. There are several depressive symptoms among the
children without mental disorders. The new revisions of BNO and DSM are unable to help the
diagnostic of child-depression. He summarizes the most important tasks for the prevention
and treatment of child-depression. In the near future a great deal more should be done for
prevention and treatment of child-depression than what we have accomplished so far in order
to ensure every child the development of sound personality and becoming healthy adult.
The deep, ramified, complicated roots of self-destructive behaviour are originated from the
early mental abnormalities, primarily from the Conduct, Depressive and Anxiety Disorders.
The prevention and treatment of child-depression are unimaginable without (1) the better
understand of central nervous system, (2) adequate, exact symptom list (3) a new diagnostic
system, (4) exact neuro-psychopharmacology, (5) powerful health-policy, (6) well-trained
primary care health system and (7) paramount Child and Youth Dispensaries-network which
based on the Evidence Based Medicine.
Keywords: child-depression, child psychopharmacology, psychopathologic signs and symptoms, nosology, mental prevention, child-psychiatric care system
Anti-N-methyl-D-aspartate receptor encephalitis and drug abuse – the probable role of molecular mimicry or the overstimulation of CB receptors in a 17-year-old adolescent – case report
Lidia Hau, Gyorgyi Csabi, Barnabas Rozsai, Jozsef Stankovics, Tamas Tenyi and Katalin Hollody
Anti-N-methyl-D-aspartate encephalitis is an autoimmune disorder characterized by
autoantibodies produced against NMDA receptors. We report the case of a 17-year-old drug
user teenager who presented with altered mental scale, psychiatric symptoms and autonomic
dysfunction. In the background we diagnosed NMDA encephalitis. We supposed that synthetic cannabinoids/drugs may have lead to the of trigger NMDA encephalitis via the altered
activation of the immune system and molecular mimicry mechanism.
(Neuropsychopharmacol Hung 2016; 18(3): 162–164)
Keywords: anti-n-methyl-d-aspartate encephalitis, synthtetic drugs, mimicri, autoimmune disorder
Önsértés, véletlen sérülés és öngyilkosság bipoláris affektív betegség fenntartó hangulatstabilizáló kezelése alatt
Self-harm, Unintentional Injury, and Suicide in Bipolar Disorder During Maintenance Mood Stabilizer Treatment; A UK Population-Based Electronic Health Records Study; Joseph F. Hayes, MSc; Alexandra Pitman, PhD1; Louise Marston, PhD; Kate Walters, PhD; John R. Geddes, MD; Michael King, PhD; David P. J. Osborn, PhD; JAMA Psychiatry 2016;73(6):630-637.
A quetiapin monoterápia hatékonysága poszt-traumás stressz betegség kezelésében: randomizált, placebokontrollált vizsgálat
Efficacy of Quetiapine Monotherapy in Posttraumatic Stress Disorder: A Randomized, Placebo-Controlled Trial; Gerardo Villarreal, Mark B. Hamner, José M. Cañive, Sophie Robert, Lawrence A. Calais, Valerie Durklaski, Yusheng Zhai, Clifford Qualls; Am J Psychiatry, 2016 july 15, published online.