Volume 23, Number 1, March 2021


Gábor Faludi

The National Survey on Addiction Problems in Hungary 2019 (NSAPH): Methodology and sample description

Borbala Paksi, Peter Pillok, Anna Magi, Zsolt Demetrovics and Katalin Felvinczi


Objectives: This paper presents the methods and main methodological fi ndings of the third wave of data collection of the National Survey on Addiction Problems in Hungary (NSAPH). In addition to mapping the addiction problems of the Hungarian population and monitoring the general population addiction trends in Hungary, the research formulates objectives for the development of the methodology used in addiction research. The study presents the measurement tools used in the research, the sampling and data collection strategy, as well as the methodological results related to sample access and the reliability and validity of the applied measurement tools used.

Methods: The research was carried out on a nationally representative sample of the Hungarian adult population aged 16-64 yrs (gross sample 1800, net sample 1385 persons). The extent of the theoretical margin of error in the sample
is ±2,6%, at a reliability level of 95%. Sample attrition was corrected by matrix weighting by layer categories. The research aimed at studying the different type substance use behaviours (smoking, alcohol use and other psychoactive substances) as well as several behavioural addictions (problematic internet use, problematic online gaming, problematic social media use, problematic gambling, exercise addictions, eating disorders, work addiction, compulsive buying, problematic mobile phone use).

Results: Based on the analysis of reliability and the extent of non-sampling errors within the context of the database we concluded that valid and reliable statements can be formulated on the basis of the research data regarding the current characteristics and patterns of the examined addiction behaviours. At the same time, in case of psychoactive substance use the observed trends of non-sampling errors indicate that the analysis of the changes requires outstanding attention whilst interpreting them; in some cases correction procedures might become necessary during estimating and interpreting the tendencies. This wave of the research was the first which examined the reliability and validity of prevalence data related to behavioural addictions. Based on this analysis it can be said that these data are less exposed to non-sampling errors than the ones related to substance use.

Keywords: addictive behaviours, general population survey, representative data collection, methodology, smoking, alcohol consumption, substance use, behavioural addictions

(Neuropsychopharmacol Hung 2021; 23(1): 184–207)


Coronavirus Pandemic - #STAYHOME: How Are You Holding Up? Questions And Tips For 11-18-Year-Olds To Make It Better

Dora Szentiványi, Lili Olga Horvath, Anne Kjeldsen, Kirsten L. Buist, Bernadett Frida Farkas, Gyongyvér Ferenczi-Dallos, Peter Garas, Dora Gyori, Agnes Gyorfi, Dora Gyorfi, Ulrike Ravens-Sieberer and Judit Balazs


Purpose: Adolescents have to cope with several challenges and restrictions due to the COVID-19 pandemic, with many of those incongruent with the typical developmental tasks of adolescent age. Some adolescents might be particularly vulnerable in this situation, including those who are deprived of psychological, social or health care services and/or are exposed to abuse or neglect in their home environment. The aims of the current international
multicentre follow-up study are to: 1. collect data on the mental health and quality of life of adolescents during
and after the pandemic; 2. improve their mental health by providing an online prevention program that addresses
their actual needs; 3. accelerate the development of culturally adapted prevention programs by involving an
international team, and 4. to contribute to adequate preparation for any potentially occurring, similar situation
in the future.

Methods: Participants aged 11-18 years and their parents/caregivers from diff erent parts of Europe
and non-European countries are recruited online. Data are collected regularly in a follow-up study by means
of structured self-administered online questionnaires on adolescents’ mental health, quality of life and current
attitudes and needs. The baseline data collection was in March 2020 at fi rst restrictions of the COVID pandemic
in Europe. It is followed up several times (at the beginning weekly, later monthly, bi-monthly, three-monthly) to
study changes in mental health, quality of life and attitudes of children and adolescents during the coronavirus
disease pandemic. Data were collected by means of structured questionnaires (see below). The time frame of the
study is set to one year from study start, March 2021. The last data collection was done in December 2020. The
prevention program is developed and provided based on continuously analysed incoming data.

Conclusions: Prevention based on the results of the study is expected to contribute to maintaining adolescents’ mental health, improve their quality of life, increase their and their environment’s cooperation with the necessary restrictions during the pandemic, and to make reintegration easier once the restrictions are over. Furthermore, the study has the potential to inform on the wellbeing of children and adolescents in extreme situations in general, thus
contribute to future preventive measures and policymaking. Implications and Contribution: The proposed international online follow-up study is expected to provide scientifi c evidence for 1. possible changes in the mental health and quality of life of adolescents during and after a pandemic situation, 2. the eff ectiveness of a culturally adapted prevention program developed to address challenges associated with these changes.

(Neuropsychopharmacol Hung 2021; 23(1): 208-214)

Keywords: COVID-19 pandemic, restrictions, adolescent, mental health, quality of life, online prevention program


Here we propose that the Western world lifestyle disrupts phosphate metabolism and homeostasis due to caloric or acidic hyperphagia. Psychic factors such as social defeat due to stressed social coexistence characterized by reduced activity and chronic hypoventilation (hypercapnia) also play a role. At least two mechanisms mediate the harmful vascular eff ects of phosphates with intracellular acidosis being a feature in both of them. First, insufficient lifestyle and adjacent diet together with the psychosomatic mechanism of social defeat (mainly through chronic hypercapnic acidosis) lead to insulin resistance characterized by the classical Cardiometabolic Syndrome. Secondly, overload with fi xed acids caused by renal insuffi ciency or acidic diet (due to intracellular metabolic acidosis) leads to our here proposed Exhausting Buff er Syndrome (EBS) which tends to elevate serum inorganic phosphate levels. These two mechanisms overlap and are regulated through genetically determined processes that drive the disruption of phosphate metabolism and lead to vascular calcifi cation. To have a lower intake of calories and less acidic foods combined with low-grade hypocapnia, might be one of several solutions.

(Neuropsychopharmacol Hung 2021; 23(1): 215-220)

Keywords: Cardiometabolic Syndrome, Exhausting Buff er Syndrome, intracellular acidosis,
social defeat


Objectives: Patients’ attitude towards treatment is one of the most signifi cant factors which has determining eff ect on suffi cient adherence. Data are lacking on Hungarian patients’ attitude towards psychiatric treatment, however, high prevalence of suicide suggests that eff ectiveness of psychiatric treatments need to be improved. To pave the way for such studies, we performed the validation of the recently developed Patients’ Health Belief Questionnaire on Psychiatric Treatment (PHBQPT) in a sample of Hungarian psychiatric patients.

Methods: We enrolled 188 Hungarian patients diagnosed with psychiatric disorders. The PHBQPT was translated into Hungarian by our group. Comparison of item and subscale mean scores with the original data are presented. Internal consistency, item-total and item-item correlations were calculated and factorial structure was analysed.

Results: Single item means, the highest item score and subscale mean scores were similar to data published in the original article. The factorial analysis confi rmed the validity of a fi ve-subscale structure in our sample. The eff ects of gender and age were not signifi cant on any of the subscales.

Conclusions: The PHBQPT is a valid, reliable instrument with replicable psychometric properties. The Hungarian version is suitable for clinical practice and for further investigations on attitudes towards psychiatric treatment.

(Neuropsychopharmacol Hung 2021; 23(1): 221-231)

Keywords: drug attitude; adherence; health belief; medication treatment; psychiatric treatment


A COVID 19 pandémia mentális egészségre gyakorolt hatása depresszióval, szorongásos zavarral és kényszerbetegséggel diagnosztizált, illetve egészséges populációk körében: 3 longitudinális holland vizsgálat bemutatása
The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: a longitudinal study of three Dutch case-controll cohorts; Kuan-Yu Pan, Almar A L Kok, Merijn Eikelenboom, Melany Horsfall, Frederike Jörg, Rob A Luteijn, Didi Rhebergen, Patricia van Oppen, Erik J Giltay, Brenda W J H Penninx; Lancet-Psychiatry 2021; 8:121-129

2020. február 27-én diagnosztizálták az első COVID-19 fertőzésben szenvedő beteget Hollandiában, és a járvány elszabadulásával a társadalom szinte összes rétege érintetté vált azóta. 2020. március közepétől a többi országhoz hasonlóan Hollandiában is különböző korlátozó intézkedéseket vezettek be (karantén, lezárás, távolságtartás, stb.). Az egészségügyi kockázatok mellett a pandémia negatívan érintette a gazdaságot, fi nanciális problémákat, munkanélküliséget generált. A pszichiátriai betegek vulnerábilis csoportot alkotnak, anyagi helyzetük instabil, szociális kapcsolataik szegényesek, így várható volt, hogy betegségük romlik a pandémiás időszakban. Történtek
vizsgálatok Kínában és Ausztráliában is, amelyek igazolták, hogy sokkal több depressziós-szorongásos tünet, alvászavar volt megfi gyelhető a pszichiátriai betegek körében összehasonlítva az egészséges populációval.
Ebben a bemutatásra kerülő holland vizsgálatban az a kuriózum, hogy már a 2000-es években megkezdték a minták gyűjtését, majd közülük a járvány kitörésekor ismételten beválogattak betegeket (2-8 héttel a lezárást
követően), így meg tudták becsülni, hogy a pandémia következményeként kialakult pszichés tünetek hogyan alakultak a már korábban is mentálisan érintett, illetve az egészséges csoportokban. Az első vizsgálatba 2004 és 2007 között 18-65 év közötti személyeket válogattak be, 2329-en depressziós és/vagy szorongásos betegségben szenvedtek, 367-en ezek testvérei voltak, míg volt egy 652 fős egészséges kontrollcsoport is. A beválogatást követően 2, 4, 6 és
9 évvel történtek négyszemközti interjúk, az állapot aktuális felmérése céljából. A második vizsgálatba 378 idős, depressziós beteg tartozott (60-93 év), akiket 2007 és 2010 között vontak be, 132 fős egészséges kontrollt alkalmaztak.
A beválogatást követően 2 és 6 év múlva újra meginterjúvolták őket. A harmadik vizsgálatban 419 kényszerbeteget követtek nyomon, akik 18-65 év közöttiek voltak, 2, 4 és 6 év múlva ismételt becslések, mérések történtek.
Különböző, nemzetközileg elfogadott és sztenderdizált skálákat alkalmaztak a betegségek diagnosztizálására (Quick Inventory of Depressive Symptoms, Beck Szorongás Skála, Penn State Worry Questionnaire, De Jong Gierveld Loneliness Scale, CIDI, SCID-I). 2020. április 1. és május 13. között történt az online kérdőívek felvétele. A még élő 2748 személyből végül 1517-en vettek részt a vizsgálat ezen szakaszában. Akik végül nem válaszoltak, azok fi atalabbak, alacsonyabb iskolai végzettségűek voltak, és körükben jóval magasabb volt a már korábban is fennálló pszichiátriai betegség, a nemek között azonban nem volt különbség.