Volume 20, Issue 3, September 2018

Editoral in Hungarian

Gábor Kovács


A lapszám, amelyet kezében tart, vagy akár a képernyőjén tanulmányoz a tisztelt olvasó, az onkológiai és pszichiátriai, döntően affektív betegségek komorbiditásával, diagnosztikai és terápiás aspektusaival foglalkozik. A magyar szakirodalmat áttekintve elég kevés tanulmányt találunk, amely a „testi” és „lelki” betegségek összefüggésével foglalkozik, pedig általánosságban a teljes populáció több mint fele szenved valamilyen szomatikus betegségben, közülük kb 30%-nál pszichiátriai probléma is feltárható. A népesség ¼-nél fordul elő pszichés megbetegedés, közülük 70%-nál mutatható ki szomatikus kórfolyamat (1). Ezek az adatok is arra utalnak, hogy a klinikai gyakorlatban nagyobb figyelmet kell szentelnünk a komorbid folyamatok felismerésére, terápiájára.


Judit Lazáry


Nyírő Gyula OPAI, Budapest

Oncopsychology affects and intensively increasing number of patients due to the growing prevalence of cancers and the rapid development of oncological therapies. The comorbidity between tumorous diseases and psychiatric disorders has been known for a long time but its significance has become outstanding in the recent years. The relationship between these two types of disorders is considerably complex and may have determining consequences for clinical practice therefore dealing with these conditions is a serious challenge for clinicians.
Our knowledge concerning the association of mental illnesses and oncological diseases has been undergoing a significant change in recent years thanks to big data researches and more precise measurements of psychiatric phenotypes. This review provides a summary of the latest epidemiological results related to comorbitiy between mental and oncological illnesses. The novel, more sophisticated studies reinforce the importance of managing comorbid patients in a multidisciplinary team.

Keywords: oncopsychology, mental illnesses in cancers, psychiatric disorder related cancers,
oncologic and psychiatric comorbidity, dual diagnosis in psychiatric patients


Gábor Kovács 1 és László Péter2


Pozitron-Diagnosztika Központ, Budapest

2 Magyar Honvédség Egészségügyi Központ Honvédkórház, Pszichiátriai Osztály, Budapest


When facing comorbidity, effects of medicating one disorder on the other disease is a key question for the clinician. As depression influences both development and outcome of onco-logical diseases, early diagnosis and therapy, primarily with antidepressants, is of paramount importance. This paper gives a survey on the effects of antidepressants on comorbid mood disorders, on the course of cancerous diseases and on the tumor itself. Response to therapy is similar for patients with comorbid and primary depression, just as there is no significant difference in tolerability. Early studies have shown that antidepressants increase the risk of
tumor development, have negative effects on the outcome of oncological diseases and even increase mortality. However, recent epidemiological and clinical studies show opposing results and demonstrate beneficial action of antidepressants on various oncological diseases suchas glióma and hepatocellular cancer. Like any drug, antidepressants have effects not only on targets in the brain but also on other organs, hence on tumor tissues as well. Latest preclinical studies demonstrate that certain antidepressants facilitate apoptosis, autophagy of tumor cells and potentiate the efficacy of anticancer agents acting as chemosensitizers. Direct and indirect antitumor effects of antidepressants are proven, however, their clinical use requires
further studies focusing on the specificity of agents on different tumor types.
Keywords: comorbidity, oncological disease, depression, antidepressants


The role of positron emission tomography (PET) in tumor diagnostics and therapy monitoring

Kornélia Kajáry , Sarolta Szekeres, Máté Lázár, Andrea Németh, Hajna Galgóczy, Péter Molnár and Zsolt Lengyel


Pozitron-Diagnosztika Központ, Budapest

Positron emission tomography (PET) is a medical imaging method belonging to the realmof nuclear medicine. It has been a clinical research tool since the sixties but during the late nineties it became widely utilized in clinical practice too. PET technique requires special radioactive isotopes, which may be generated only in particle accelerators (cyclotrons) and their transport is limited owing to the short physical half-life. PET/CT was born from the com-bination of PET and CT (computer tomography). The first combined PET/CT scanner began to operate in 1998 and the method has been used in clinical practice since 2001. It is a hybrid (multi-modality) medical imaging equipment which can provide anatomical, morphologic (CT) and functional, metabolic information (PET) simultaneously. PET/CT imaging has gained
clinical acceptance mainly in oncology – owing to the attributes of the most frequently used PET tracer, fluoro-deoxy glucose (FDG) – and in a lesser extent in neuropsychiatry and cardiol-ogy. The authors in this paper review the basics and key indications of the method, the wider used radiofarmacons, including potential neurological and psychiatric applications, and the possible causes of false positivity and false negativity.

(Neuropsychopharmacol Hung 2018; 20(3): 99–111)

Keywords: positron emission tomography (PET), positron emission tomography/computed tomography (PET/CT), fluoro-deoxy glucose (FDG)


Gyöngyvér Szentmártoni 1, Zoltán Makkos2 és Magdolna Dank1


Gyöngyvér Szentmártoni 1, Zoltán Makkos2 és Magdolna Dank1


1 Semmelweis Egyetem Onkológiai Központ, Budapest

2 Nyírő Gyula OPAI „C” Pszichiátriai Osztály, Budapest

Over the past ten years, in oncology there is an increased interest in understanding the cognitive dysfunction caused by chemotherapy also known as chemobrain or chemofog. As a result of oncological therapies the number of survivors of malignant diseases has increased considerably, but the side effects also appear to be more prevalent and severe including per-sistent cognitive symptoms. Symptoms of  hemobrain include memory impairment, loss of concentration, speech and psychomotor deceleration, attention and learning coordination problems, and disturbance of executive functions. The symptoms may be transient but are often long-lasting, the latter negatively affecting functionality and quality of life. Structural and functional imaging studies (MRI, fMRI, PET) and neuropsychological tests are not consistent in the diagnosis of chemobrain. Several factors are suspected leading to the appearance of symptoms, but the specific patomechanism is not yet known. Nutrition status, age, anemia,inflammatory cytokines, stress, and depression can all affect the quality of life and may be related to cognitive symptoms. Currently, there is no treatment strategy for preventing or al-leviating cognitive impairement related to chemobrain, and several pharmacotherapies are under investigation. Results imply that understanding the patomechanism of chemobrain can also yield a deeper understanding of cognitive dysfunction associated with depression.

(Neuropsychopharmacol Hung 2018; 20(3): 112–116)

Keywords: chemobrain, chemofog, cognitive symptoms, oncotherapy, antidepressants


László Péter


Antiepileptikumok használata és a demencia kialakulásának kockázata

Use of Antiepileptic Drugs and Dementia Risk; An Analysis of Finnish Health Register and German Insurance Data; Heidi Taipale, Willy Gomm, Karl Broich, Wolfgang Maier, Anna-Maija Tolppanen, Antti Tanskanen, Phil Lic, Jari Tijhonen, Sirpa Hartikainen, Britta Haenisch; J Am Geriatr Soc. 2018; 66(6): 1123-1129


Szívműtéten átesett betegek körében a szelektív szerotonin reuptake inhibitorok és a szerotoninnoradrenalin reuptake inhibitorok használata nem mutatott összefüggést a kialakult vérzéssel és a következményes transzfúzióval

Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors Are Not Associated With Bleeding or Transfusion in Cardiac Surgery Patients; Mark M Smith, Bradford B Smith, Brian D. Lahr, Gregory A Nuttall, William J. Mauermann, Timothy J. Weister, Joseph A. Dearani, David W. Barbara; Anesth Analg. 2018; 126(6): 1859-1866