Aim: The paper presents the general methodological background and main methodological results of the 2023 wave of the National Survey on Addiction Problems in Hungary (NSAPH). The ultimate aim of the research was to provide a comprehensive epidemiological overview of addictive problems, including substance use-related behaviours and behavioural addictions) among the adult population in Hungary, complemented by some objectives to develop/refresh the conceptual framework and indicators. The study presents the measurement instruments used in the research, the sampling and data collection strategy employed, and the methodological results related to sample selection and the reliability and validity of the measurement instruments used. Methods: The survey was conducted on a nationally representative sample of 2200 gross, 1800 net population aged 18-64, using a mixed survey technique combining face-to-face interviewing with self-completion elements. The theoretical margin of error at the 95% confidence level is ±2.3%. Sample outliers were corrected by matrix weighting by stratum category. The data collection battery used in the survey covered substance use behaviours (smoking, alcohol and other psychoactive substance use), different behavioural addictions (problematic internet use, gaming disorder, problem social media use, problematic mobile phone use, gambling disorder, exercise addiction, eating disorders, work addiction, compulsive buying-shopping behaviour) and included instruments to map socio-demographic and psychological background. The reliability and validity of the data obtained along the target variables were analysed by means of indicators calculated on the basis of the correlations between the answers to the different logically related questions in the questionnaire, the proportion of missing and invalid answers, the proportion of consumption responses to a so-called dummy drug, and by examining the internal consistency of the standard scales used. Results: Based on the proportion of consistent users in relation to the lifetime prevalence value, it can be concluded that for the majority of the substances tested, the lifetime prevalence values contain a higher proportion of consistent data. Compared to sociodemographic questions, which can be considered neutral, the proportion of missing and invalid responses for the addictive behaviours studied can be considered relatively high, but good compared to other sensitive questions. The degree of overestimation is negligible. Conclusions: Ove-rall, the methodological results of the OLAAP 2023 survey suggest that valid and reliable conclusions can be drawn from the survey data with regard to the current characteristics and patterns of the addictive behaviours under investigation. The trends in out-of-sample errors in substance use behaviour indicate that, in addition to the increased attention that is still needed, the careful interpretation of results and the use of estimation procedures developed over the years and continued in this research, we can rely somewhat greater confidence than before on results obtained using standard measurement instruments when analysing changes.

Keywords: addiction problems, representative population survey, methodology, smoking, alcohol consumption, psychoactive substance use, behavioral addictions

The prevalence of neurocognitive impairment subsequent to haemorrhagic stroke is notably high, thus constituting a significant predictor of survival and functionality. To date, however, there has been a paucity of studies that have described the profile of specific cognitive impairments in patients suffering from haemorrhagic strokes. The objective of the present study is twofold: firstly, to analyse in detail cognitive impairment after haemorrhagic stroke; secondly, to investigate the improvement in cognitive function and to determine its association with potential prognostic factors. The present pilot study comprised 17 haemorrhagic stroke patients who underwent a detailed cognitive assessment on day 14 and 3 months after the haemorrhage using the Montreal Cognitive Test, Rey Auditory-Verbal Learning Test, Letter Fluency and Semantic Fluency Tests, Number Span Test and CANTAB. At baseline, 18.8% of patients exhibited minor neurocognitive impairment, while 43.8% demonstrated major neurocognitive impairment. A number of significant changes were observed between the two time points in spatial-visual abilities, executive functions, attention/concentration, short-term memory and orientation. A subsequent investigation into the laterality of the haemorrhage revealed a significant discrepancy, as determined by the t-test results. Specifically, the right hemisphere haemorrhage exhibited a reduced degree of cognitive impairment. Among the factors influencing improvement, a significant correlation was identified between residual bleeding and perifocal edema size as seen on the 3rd month CT. The findings of our subsequent study demonstrated considerable neurocognitive and domain-specific impairments subsequent to haemorrhagic stroke. It is important to note that improvement was observed in several cognitive domains three months after the event, and we were able to identify prognostic factors influencing recovery. It is hypothesised that these findings may inform the design of rehabilitation programmes. This is due to the fact that they provide clinicians with a more precise understanding of the cognitive status of patients suffering from post-haemorrhagic stroke.

Keywords: cognitive function, neurocognitive dysfunction, poststroke cognitive impairment, cognitive evaluation

One of the serious problems in educational systems around the world is the increase in academic burnout among university students. The aim of the present study was to investigate the relationship between academic support and students’ academic burnout through the mediating variable of academic engagement. The research method was descriptive-correlational. The population included all undergraduate students of Islamic Azad University, Qaenat Branch during the academic year of 1998-99, from which 205 (98 females and 107 males) were selected based on stratified random sampling. To collect data, three questionnaires were used, including the Sands and Plankt (2005) Academic Support Scale, the Modified Maslach Academic Burnout Questionnaire (2002) and the Academic Engagement Questionnaire (Reeve, 2013). Data analysis was performed using AMOS software (version 20) and structural equation modeling method. The results of data analysis revealed that the model has a good fit with research data. According to the findings, the direct path of academic support to academic burnout was significant. The indirect path from academic support to academic burnout through the mediating variable of academic engagement was also significant. Overall, the results of the present study show that academic support through influencing students’ academic engagement as well as reducing their academic burnout can lead to active involvement of students in academic activities.
(Neuropsychopharmacol Hung 2025; 27(4): 270–281)

Keywords: Academic Involvement, Academic Support, Academic Burnout, Structural Equation Method

In my narrative paper, I describe the development of the bipolar spectrum concept and its clinical heterogeneity observed in everyday practice. I review relevant findings from biological marker research and phenomenology-based screening tools. Furthermore, I provide an overview of the advantages and disadvantages of the bipolar spectrum theory, as well as the challenges of diagnosis.
(Neuropsychopharmacol Hung 2025; 27(4): 282–295)

Keywords: bipolar disorder, bipolar spectrum disorder, biomarker, psychodiagnostics

Objectives: The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation. A NLR≥3 is considered abnormal (and ≥1.8 for benign ethnic neutropenia, BEN). Methods: NLR values were added to longitudinal data including c-reactive protein (CRP) in 5 published clozapine-induced myocarditis cases. Results: Case 1 had two NLRs with normal values, but on clozapine day 19, the CRP became abnormal (10.0 μg/d, ≤0.9) and the NLR=3.9. Clozapine was stopped on day 26. Case 2 had three normal NLRs before myocarditis, but on day 19 clozapine was stopped due to abnormal CRP (16. μg/dL, ≤0.9) with abnormal NLR (6.7). Case 3 received 25 mg on the first day (on valproic acid and quetiapine) with a NLR=3.4 on day 2. On day 11, CRP and NLR were normal. On day 14, he had chest pain, abnormal CRP (4.9 μg/dL,≤0.9) and abnormal NLR (7.4). Clozapine was discontinued on day
17. CRP and NLR finally normalized on day 35. Skin abscesses led to abnormal CRP and NLR values. On day 148, 12.5 mg of clozapine was restarted leading to a skin rash the next day. On day 155, this dose was stopped. Case 4 had two normal NLRs before myocarditis, but on day 16, clozapine was stopped (abnormal CRP, 15.8 μg/dL, ≤0.5 and abnormal NLR=4.4). Case 5 had BEN. NLR was normal on day 7, but became abnormal (NLR=1.9) on day 11 on 250 mg/day. He died five days later. Conclusions: An abnormal NLR during titration may suggest clozapine-induced inflammation and/or infection.
(Neuropsychopharmacol Hung 2025; 27(4): 296–311)

Keywords: clozapine/administration and dosage, clozapine/adverse effects, clozapine/ blood, clozapine/metabolism, clozapine/pharmacokinetics, drug interaction, drug moni-toring, inflammation, myocarditis/chemically induced, myocarditis/etiology, myocarditis/ prevention and control, schizophrenia