Volume 19, Issue 4, September 2017

In memoriam

Végső búcsú Gaszner Pétertől – Faludi Gábor


Végső búcsú Gaszner Pétertől

Faludi Gábor

Kedves Péter!

Nehezen elmondható megrendültséget érzek, ahogy itt állunk gyászoló családod, barátaid, kollégáid,tisztelőid körében, hogy elbúcsúzzunk Tőled. A végső elköszönés, az emlékezés, a tiszteletadás alkalmából megkíséreljük összegezni, hogy mit jelentettél és jelentesz nekünk, távozásoddal kit veszítettünk el, mit őrzünk és mit viszünk tovább tanításaidból, miért szerettünk és tiszteltünk, és miért fogunk Rád mindig emlékezni.

In Memoriam Peter Gaszner (1939–2017)

Thomas A. Ban and Andrea Tone


On July 25, 2017, Peter Gaszner, a close friend and a member of our International Network for the History of Neuropsychopharmacology, passed away.

Peter Gaszner was born in 1939, in Bekescsaba, Hungary. He received his MD from the University of Debrecen, Hungary, in 1963, and earned diplomas in neurology, psychiatry and clinical pharmacology in 1957, 1970 and 1980, respectively. He was trained in psychiatry in the Department of Psychiatry at the University of Pecs. During the 1980s, Dr. Gaszner became Director of Psychopharmacology at the National Institute of Neurology and Psychiatry of Hungary and Professor of Psychiatry at Semmelweis University and during the 1990s, he served as Vice President of the European College of Neuropsychopharmacology. Dr. Gaszner was Founding President of the Hungarian Psychopharmacology Society and Founding Editorin-Chief of Neuropsychopharmacologia Hungarica, the journal of the society (Salzman 2011).

All through his professional career Peter was involved in research. In the 1970s his research interest was focused on atropine coma therapy and on epilepsy and anticonvulsants (Ban 2011; Faludi and Ban 2001). In a series of studies conducted in the early 1980s in normal subjects, in collaboration with Elemer Szabadi and Christopher Bradshaw, he demonstrated differences in peripheral anticholinergic activity among tricyclic antidepressants. They had also shown adrenergic blocking effect with neuroleptics (Gaszner, Szabadi and Bradshaw 1980; Szabadi, Gaszner and Bradshaw 1980, 1981). In the 1990s, Dr. Gaszner was a member of the international team which demonstrated the efficacy of reboxetine in major depression (Ban, Gaszner, Aguglia, et al 1998). At the time he was Visiting Professor in our Division of Psychopharmacology at Vanderbilt University, in Nashville we collaborated in developing a Composite Diagnostic Evaluation of Hyperthymic Disorders to study the therapeutic profile of drugs used in the treatment of mania (Gaszner and Ban 1998).

On December 15, 2004, Peter Gaszner (PG) was interviewed by Andrea Tone (AT) at the annual meeting of the American College of Neuropsychopharmacology (ACNP) in San Juan, Puerto Rico. His edited interview (see below) was first printed in volume 8 of ACNP’s Oral History Series (Ban 2011; Salzman 2011).

Assessing suicide risk based on a hierarchical classification of risk factors

Zoltán Rihmer, Péter Döme, Xénia Gonda, and Zsuzsanna   Bélteczki 


Suicide risk factors could be organised into a hierarchical order and a questionnaire constructed
based on this hierarchical structure may help clinicians assess suicide risk. The paper presents
analysis of the clinical utility of a questionnaire developed by the authors, in samples of suicidal and nonsuicidal psychiatric patients as well as among normal control subjects. Based
on their results the authors suggest a shorter and expectedly more sensitive, 6-item version
instead of the original 12-item version scale.

Keywords: suicide, suicide attempt, suicide risk factors, hierarchical classification, sensitivity

The importance of anxiety and depression in family practice

Péter Torzsa, Csenge  Hargittay and László Kalabay


Representative studies indicate that prevalence of anxiety disorders among adults is between
12.6-17.2%, while in Hungary it is 17.7%. According to both international and national studies
the point prevalence of diagnosed major depression requiring treatment is 6-10 % in general
practice. As untreated depression is the most important risk factor for suicide, early detection
and effective management of depression are critical in prevention. According to international and national studies the recognition of major depression in primary care significantly
contributes to the decline of suicide mortality. In our article we review screening of anxiety
and depressive disorders and treatment and management of these patients in primary care.
We present two short questionnaires used for recognizing depression and acute suicide risk
and describe their use in family/ general practice.

Keywords: anxiety, depression, suicide, screening, general practitioner

Psychiatric disorders in epilepsy: clinical phenomena

Anna Szűcs, András Horváth, Dániel Fabó, Géza Szabó, Andrea Kovács and Péter Halász


The frequent psychiatric comorbidity in epilepsy compromises the quality of life of those
affected, further increasing their suicide risk and the high burden of stigmatisation. Out of
adulthood epilepsies, mesio-temporal lobe epilepsy carries the highest cognitive and psychiatric risk, making mental health comorbidities its inherent features. The pathomechanism
of the epilepsy-related mental health symptoms and conditions appears to be related to
undetected subclinical seizures, postictal exhaustion and inhibition, and the non-REM sleep
related interictal epileptic activity. In our work we try to present some of the typical psychiatric
syndromes and conditions seen in epilepsy. We aim to highlight the difficulties of treatment
on the borderline of neurology and psychiatry.

Keywords: epilepsy, neuropsychiatry, comorbidity, psychiatric disorders


New aspects in the pathomechanism of diseases of civilization, particularly psychosomatic disorders. Part 2. Chronic hypocapnia and hypercapnia in the medical practice

Andras Sikter1, Zoltan Rihmer2,3 and Roberto de Guevara4

1 Municipal Clinic of Szentendre, Internal Medicine, Szentendre, Hungary

Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary

3 National Institute of Psychiatry and Addictions, Laboratory for Suicide Research and Prevention, Budapest, Hungary

4 Respiras-performance breathing, Colorado Springs, United States of America

The authors seek to find new connections between recent results of biology and older theories. This paper aims to assemble the jigsaw puzzle. The theoretical background of the hypothesis was described in the previous issue of the journal (Sikter et al. 2017a). Human stress response often coexists with persistent hypocapnia or hypercapnia – developing via psychosomatic pathomechanism – which can lead to mental and psychosomatic illnesses. Chronic hypocapnia mainly generates hyperarousal disorders which may be reversible for an extended time, however, vicious cycles may start when hypoxia and/or severe somatic diseases are simultaneously present (commonly in the elderly), which conditions often end with death without medical help. Chronic hypercapnia devastates the organism initially without symptoms, partly due to neurohumoral contraregulation, consequential dysregulation and metabolic remodeling. Psychosomatic disorders (e.g., diseases of civilization that evolve in people with disadvantaged psychosocial situations) develop over years and decades, causing irreversible changes. Hypercapnia usually occurs in clinical pictures of chronic obstructive pulmonary disease, obesity hypoventilation syndrome, obstructive sleep apnea, and its unobstructed version (sleep-related hypoventilation), generating various organic disorders (hypertension, type 2 diabetes, cardiovascular disorders, immunological diseases, depression, etc.). Because of the above, chronic hypocapnia and hypercapnia cannot be regarded as harmless accompanying phenomena. That is why we have to strive for restoring eucapnia and normalizing the induced ionic changes, which does not appear to be a hopeless task.

(Neuropsychopharmacol Hung 2017; 19(3): 159–169)

Keywords: depression as an extreme hypoarousal, diseases of civilization, idea of restoring the milieu intérieur, remodeling of metabolism


Péter László; Móra Balázs



Péter László; Móra Balázs

A relapszus kockázata az antidepresszív terápia elhagyását követően szorongásos betegségekben, kényszerbetegségben és poszt-traumás stressz betegségben
Risk of Relapse After Antidepressant Discontinuation in Anxiety Disorders, Obsessive-compulsive Disorder, and Post-traumatic Stress Disorder; Systematic Review and Meta-analysis of Relapse Prevention Trials; Neeltje M Batelaan, Renske Bosman, Anna Muntingh, Willemijn D Scholten, Klaas M Huijbregts, Anton J L M an Balkom; BMJ, 2017; 358 (j3927)


Az alkohol okozta dependencia farmakoterápiája 
Pharmacotherapy for alcohol dependence – the why, the what and the wherefore; E. T. Goh, M. Y. Morgan; Alimentary Pharmacology & Therapeutics. 2017;45(7):865-882