Volume 25, Number 4, December 2023

Editorial in Hungarian

Gabor Faludi


Background: This study examined the relationship between alcohol use, protective behavioral strategies, and self-determination among young adults. Young adults may be particularly prone to risky forms of alcohol use (e.g., heavy episodic drinking) and the resulting negative consequences. Protective behavioral strategies are behaviors used to reduce negative consequences arising from alcohol use. Based on existing literature, autonomous motivation as defined in self-determination theory and the satisfaction of psychological needs may influence these factors and have potential implications for interventions. The main objective of this research is to examine the four-factor structure of the Treatment Self-Regulation Questionnaire in a young adult sample from Hungary, and to explore the association between autonomous motivation related to responsible alcohol use, satisfaction of basic psychological needs, protective behavioral strategies, and the extent of harmful alcohol use. Methods: The study was based on a cross-sectional questionnaire survey with a total of 272 participants (32.4% male, 67.6% female, average age 23.8 years). The questionnaire package included the Alcohol Use Disorders Identification Test, Protective Behavioral Strategies Scale, Treatment Self-Regulation Questionnaire, and the Basic Psychological Need Satisfaction and Frustration Scale. Results: Confirmatory factor analysis revealed a modified four-factor structure (amotivation, external regulation, introjected regulation, and autonomous motivation) with the best fi t indices. Autonomous motivation and satisfaction of basic psychological needs showed significant positive, moderate to strong correlations with the frequency of protective strategies use and significant negative, moderate to strong correlations with the extent of harmful alcohol use. There was a significant positive, weak association between autonomous motivation and satisfaction of basic psychological needs. Mediation analysis indicated that protective behavioral strategies partially mediate the relationship between autonomous motivation and harmful alcohol use. Conclusions: These results are consistent with other literature findings, suggesting that the questionnaire could be applied in future research. Furthermore, both autonomous motivation and satisfaction of basic psychological needs may increase the frequency of protective strategies use and reduce the extent of harmful alcohol use.

Keywords: alcohol consumption, protective behavioral strategies, self-determination, autonomous motivation, basic psychological needs

A sound mind in a sound body: a novel concept unravelling heterogeneity of depression

Gábor Hullám, Zsófia Gál, Xénia Gonda, Tamás Nagy, András Gézsi, Isaac Cano, Sandra Van der Auwera, Mikko Kuokkanen, Péter Antal, Gabriella Juhász


Depression is a highly prevalent and debilitating condition, yet we still lack both in-depth knowledge concerning its etiopathology and sufficiently efficacious treatment options. With approximately one third of patients resistant to currently available antidepressants there is a pressing need for a better understanding of depression, identifying subgroups within the highly heterogeneous illness category and to understand the divergent underlying biology of such subtypes, to help develop and personalise treatments. The TRAJECTOME project aims to address such challenges by (1) identifying depression-related multimorbidity subgroups and shared molecular pathways based on temporal disease profiles from healthcare systems and biobank data using machine learning approaches, and by (2) characterising these subgroups from multiple aspects including genetic variants, metabolic processes, lifestyle and environmental factors. Following the identification of multimorbidity trajectories, a disease burden score related to depression and adjusted for multimorbidity was established summarising the current state of the patient to weigh the molecular mechanisms associated with depression. In addition, the role of genetic and environmental factors, and also their interactions were identified for all subgroups. The project also attempted to identify potential metabolomic markers for the early diagnostics of these multimorbidity conditions. Finally, we prioritized molecular drug candidates matching the multimorbidity pathways indicated for the individual subgroups which would potentially offer personalised treatment simultaneously for the observable multimorbid conditions yet minimising polypharmacy and related side effects. The present paper overviews the TRAJECTOME project including its aims, tasks, procedures and accomplishments. (Neuropsychopharmacol Hung 2023; 25(4): 183–193)

Keywords: depression, multimorbidity, metabolomics, genetics, machine learning


Introduction: Yawning is a normal, stereotyped physiological event in humans and animal kingdom. When excessive (>3 per 15 minutes), it is termed as pathological yawning (PY). PY could be due to many causes but more commonly associated with side-effect of drugs, notably involving those used in psychopharmacology. Though there are isolated case reports and case-series, there are no large-scale reports of PY. This work attempted to address this lacuna. Material and Methods: The current work attempted to identify characteristics of PY as collated from adverse drug effect databases of Australia (Database of Adverse Event Notifications), Canada (Canada Vigilance Adverse Reaction Online Database) and the United States of America (FDA Adverse Event Reporting System – FAERS). These databases collect and provide public access to reports of adverse events related to drugs and therapeutic goods. They act as a prime pharmacovigilance tool as well as a first-line resource for healthcare professionals, researchers, and the public to monitor the safety of these products and make informed decisions. In the first week of June 2023, open access, unrestricted adverse effect of drug databases were explored, using the word “YAWNING” as the only search term for the side effect of any drug without any restrictions. The collected details of PY cases with their gender, age, reason for drug use, other concomitant complaints as well as the nature of adverse event(s) and its treatment requirements were assessed. Descriptive statistics were used. Result: Of the 2655 instances in USA database, 398(15%) had more than 1 suspect drug and in total 578 medications involved. The most commonly involved drugs were apomorphine, sertraline, fluoxetine and paroxetine. In all 341(12.8%) cases reported of YAWN alone or with one another sleep disorder, the most common off ending drug were fluoxetine hydrochloride. Discussion and Conclusion: The neural mechanism and physiology of yawning are explained. This study stresses that a health care professional, particularly mental health professionals and neurologists, should be aware of the importance of PY to deliver the best for the patients under their care. (Neuropsychopharmacol Hung 2023; 25(4): 194–205)

Keywords: Pathological Yawning, Adverse Drug Reaction, Medications, Psychiatric Medication, Neurological Side Effects, Etiopathogens


Frontotemporal dementia is a neurodegenerative disease characterized by atrophy of the frontal and temporal lobes of the brain, and it is believed to primarily develop based on genetic factors. Its initial symptoms can appear relatively early, even between the ages of 40-50, affecting approximately 15-22 individuals out of 100,000 annually. The disease manifests in various forms, categorized into behavioral, aphasic, and motor variants due to its diverse presentations. The behavioral variant, constituting about half of the cases, is the most common type. It involves personality changes, behavioral problems, and cognitive decline, with patients surviving an average of 8.5 years from the onset of symptoms. Currently, there is no curative therapy available, and only symptomatic treatment can be administered to improve the quality of life. In the case we presented, the symptoms of the behavioral variant of frontotemporal dementia appeared atypically, accompanied by perceptual disturbances and a paranoid attitude, further complicating the definitive diagnosis.

Keywords: frontotemporal dementia, behavioral variant, dementia


Objective: Psychostimulants are widely used pharmacotherapeutic tools in the treatment process of severe or non-responsive childhood attention-deficit/hyperactivity disorder. Despite their efficacy, stimulants can influence the quality and quantity of sleep as a side effect, but this issue remains insufficiently clarified in the existing literature, with partly contradictory findings. The aim of this review is to provide a comprehensive analysis of research results based on polysomnography, shedding light on the current state of knowledge in this area. This insight can be valuable for guiding the design of future research and optimizing therapeutic plans. Methods: Following the PRISMA guidelines, we systematically reviewed and analyzed studies that assessed the quality of sleep using polysomnography during stimulant treatment. As a result of our search, we identified 331 potential publications, which were independently screened, and a total of 13 relevant articles were analyzed in detail. Results: Based on the results of the examined studies, there were a total of 5 instances of sleep-facilitating effects reported in the context of stimulant treatments, while 5 studies indicated sleep-inhibiting effects, and in three cases, no effects were observed. Conclusions: Although it is important to consider the impact of medication on sleep in the treatment of childhood attention-deficit/hyperactivity disorder, further research is required to clarify this issue. This will enable the customization of therapeutic recommendations and plans, aligning with the principles of precision medicine, taking into account the varying research designs and sample sizes.

Keywords: attention deficit hyperactivity disorder, sleep disorder, sleep pattern, electroencephalography, stimulants, systematic review