Bevezetés: Az igazságügyi pszichiáter szakértők számának csökkenése Magyarországon napjainkra kri... more Bevezetés: Az igazságügyi pszichiáter szakértők számának csökkenése Magyarországon napjainkra kritikus szintet ért el. A szakértőhiány az utóbbi időben mind az egészségügyben, mind az igazságszolgáltatás működésében zavarokat okoz. Célkitűzés: Annak felmérése, hogy hogyan lehetne az igazságügyi pszichiáter szakértővé válást és az igazságügyi pszichiáter szakértői munkát a szakorvosképzés oldaláról vonzóbbá tenni. Módszer: Internetes kérdőíves felmérést végeztünk igazságügyi pszichiáter és pszichiáter szakorvosok körében. A demográfiai adatok mellett 4 témakört felölelő kérdőívet szerkesztettünk. A kérdőív 2, a szakorvosképzésre vonatkozó témakörben az igazságügyi pszichiáter szakorvosképzés egyszerűsítésére (10 tétel) és az igazságügyi pszichiáteri szakorvosképzés költségeinek csökkentésére (5 tétel) vonatkozó egyszerű állításokat tartalmazott. A válaszadóknak 10 fokozatú Likert-skálán kellett értékelniük, hogy mennyire értenek egyet a megfogalmazott állítással. Az utolsó 2 témakörb...
Summary The Hungarian psychiatrist Laszlo Meduna was the first who induced epileptic fits to infl... more Summary The Hungarian psychiatrist Laszlo Meduna was the first who induced epileptic fits to influence the course of mental illness. The following account, based on a review of Meduna's recently unearthed files and his writings, traces the beginnings of convulsive therapy.
The aim of this survey was to identify predictors of suicide attempts that immediately followed a... more The aim of this survey was to identify predictors of suicide attempts that immediately followed a violent crime in patients with schizophrenia. Documentations of patients diagnosed with schizophrenia and released in a 10 years period from the National Institute of Forensic Psychiatry were reviewed. Twenty-six out of 223 patients attempted suicide after the violent crime. The young age of the victim, and living in partnership were those factors differentiating suicidal violent offenders from their non-suicidal counterparts.
To investigate the presence of offences in the previous past history of perpetrators of violent a... more To investigate the presence of offences in the previous past history of perpetrators of violent acts who have undergone forced medical treatment. The documentation of all patients released over a 10-year period from the National Institute of Forensic Psychiatry (IMEI) was reviewed. A comparison was drawn between patients who were convicted of any type of offense before the violent act (patients with previous offences-PPO) and those who were not (patients with no previous offences-PNO). Eighty-six (29%) and 208 (71%) patients formed the PPO and PNO groups, respectively. Prior contact with psychiatric services was significantly higher in the PPO group (p=0.038) and this group was also more likely to offend under the influence of a psychoactive substance (p<0.001). Exceptional brutality and other qualifying factors were more frequent in the PNO group (p=0.019). As IMEI is the only forensic institution in Hungary, the picture presented here reflects the situation in the entire countr...
Convulsive therapy (COT) is a major European contribution to the psychiatric armamentarium and bi... more Convulsive therapy (COT) is a major European contribution to the psychiatric armamentarium and biological psychiatry. COT was introduced in psychiatry by László Meduna, a Hungarian neuropsychiatrist. All subsequent publications about the first patient treated with COT, Zoltán L (ZL), were based on Meduna's papers and autobiography. After 4 years of catatonic stupor, ZL received camphor-induced COT which resulted in full remission and discharge from the institution. The aim of this paper is to reconstruct ZL's case history from the original case notes-partly written by Meduna himself-which were recovered from the archives of the National Institute of Psychiatry and Neurology. The case notes show that ZL repeatedly received COT between 1934 and 1937, first with camphor and then with cardiazol induction. After the first course of COT the catatonic stupor was resolved and the psychotic symptoms subsided. However, the remission lasted for only a few months and was followed by a r...
Psychiatric disorders which indicate the use of electroconvulsive therapy (ECT) also occur in epi... more Psychiatric disorders which indicate the use of electroconvulsive therapy (ECT) also occur in epileptic patients, but there is a lack of medical authority concerning the use of ECT in epileptic patients. This is surprising because in recent years it has been proved that ECT has an anti-convulsive effect to some degree. A case study of an epileptic patient is presented whose progress has been monitored for several years. Antiepileptic drugs were seemingly able to control his epilepsy but at the same time progressive behavioural disturbance (schizophreniform psychosis) accompanied by agitation and violent behaviour developed. Considering the recurrent psychotic decompensations and the relative ineffectiveness of antipsychotics, the authors decided to administer ECT. As a result they were able to bring about the longest symptom free balanced period in the patient. According to the data based on previous medical studies and the experience they can suppose that ECT is not immediately con...
Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakológiai Egyesület lapja = official journal of the Hungarian Association of Psychopharmacology, 2011
Referring to the scientific literature the authors analyze the correlation between criminal offen... more Referring to the scientific literature the authors analyze the correlation between criminal offense and psychiatric disorders. Frequency of violent behaviour in schizophrenia together with the risk factors are reviewed. The issue of violent offense is separately discussed. Impact of deinstitutionalization on offense is also analyzed. Results regarding the genetic correlations are also reviewed. Finally the question of re-offending is discussed. In summary the importance of this issue in stigmatization and in the development of the mental health care system is highlighted.
Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakológiai Egyesület lapja = official journal of the Hungarian Association of Psychopharmacology, 2008
The history of the first convulsive treatment is summarized here in commemoration of its 75th ann... more The history of the first convulsive treatment is summarized here in commemoration of its 75th anniversary. The neuropathological and clinical findings underlying the theoretical basis of the method are reviewed, together with the case histories of the first batch of patients who underwent convulsive therapy. The early indications and effectiveness of convulsive therapy are also discussed. Finally, in a broader context, the role of convulsive treatment in the development of modern biological psychiatry and Laszlo Meduna's contribution to this development touched upon.
In the 1940s, regressive and intensive methods were developed to increase the therapeutic effects... more In the 1940s, regressive and intensive methods were developed to increase the therapeutic effects of electroconvulsive therapy. The diagnostic indications, methods of application, effectiveness, complications, and mortality of these techniques are briefly discussed here. An attempt is also made to evaluate the risks and benefits of these methods from a historical perspective.
The number of Hungarian citizens travelling to countries infected with malaria is increasing year... more The number of Hungarian citizens travelling to countries infected with malaria is increasing year by year. Mefloquine is the most effective medicine in the prophylaxis and treatment of malaria. However, neuropsychiatric side-effects can more often be seen with the use of mefloquine compared to other anti-malaria drugs. To assess the neuropsychiatric side-effects with mefloquine prophylaxis; to screen those patients who are possibly affected by the side-effects and to explore factors that forecast the possible side-effects. The retrospective analysis of patients, who in the past 2 years, have had mefloquine prophylaxis and then turned up at Semmelweis University, Department of Psychiatry and Psychotherapy and at Szent László Hospital, Outpatient Department of Psychiatry and Addictology because of neuropsychiatric symptoms. Out of the 6 cases presented, whose neuropsychiatric symptoms ranged from slight dizziness, malaise through panic attacks and depression to psychosis, the preceedi...
There are a great number of psychopathological symptoms which manifest themselves in 70-75% of ep... more There are a great number of psychopathological symptoms which manifest themselves in 70-75% of epileptic patients but most of them remain unrecognised and untreated. These symptoms may affect the patients' quality of life more negatively than the epileptic seizures themselves. Anxiety is one of the most frequently occurring interictal psychopathological symptom. A number of specialists agree that chronic epilepsy causes the amplification of endogenic seizure suppressing mechanisms which hinder the epileptic seizures and are responsible for the development of interictal psychopathological symptoms. However the physiological effects of the interictal psychopathological conditions (e.g. anxiety) have epileptogenic effect as well. There is a high chance that the conditions of epilepsy and anxiety will mutually create a destructive vicious circle and it will be illustrated by our two case reports. In our experience, before modifying the pharmacotherapy of a patient suffering from chr...
Psychiatria Hungarica : A Magyar Pszichiátriai Társaság tudományos folyóirata, 2008
Convulsive treatment was introduced to psychiatry by László Meduna, a Hungarian neuropsychiatrist... more Convulsive treatment was introduced to psychiatry by László Meduna, a Hungarian neuropsychiatrist. In his autobiography, Meduna gave a detailed description of his first patient who underwent convulsive therapy. According to Meduna's recollections, this patient was L. Zoltán, who after 4 years of fluctuating catatonic stupor received several sessions of camphor-induced convulsive therapy resulting in full remission and discharge from the institution. In this communication, the authors reconstruct L Zoltán's case history from the original case notes, which were recovered from the Archives of the National Institute of Psychiatry and Neurology, Budapest. The case notes show that L. Zoltán received courses of convulsive treatment between 1934 and 1937, first induced with camphor and then with cardiazol. After the first course of treatment the catatonic stupor was resolved and the psychotic symptoms subsided. However, this incomplete remission lasted only for a few months and was ...
Bevezetés: Az igazságügyi pszichiáter szakértők számának csökkenése Magyarországon napjainkra kri... more Bevezetés: Az igazságügyi pszichiáter szakértők számának csökkenése Magyarországon napjainkra kritikus szintet ért el. A szakértőhiány az utóbbi időben mind az egészségügyben, mind az igazságszolgáltatás működésében zavarokat okoz. Célkitűzés: Annak felmérése, hogy hogyan lehetne az igazságügyi pszichiáter szakértővé válást és az igazságügyi pszichiáter szakértői munkát a szakorvosképzés oldaláról vonzóbbá tenni. Módszer: Internetes kérdőíves felmérést végeztünk igazságügyi pszichiáter és pszichiáter szakorvosok körében. A demográfiai adatok mellett 4 témakört felölelő kérdőívet szerkesztettünk. A kérdőív 2, a szakorvosképzésre vonatkozó témakörben az igazságügyi pszichiáter szakorvosképzés egyszerűsítésére (10 tétel) és az igazságügyi pszichiáteri szakorvosképzés költségeinek csökkentésére (5 tétel) vonatkozó egyszerű állításokat tartalmazott. A válaszadóknak 10 fokozatú Likert-skálán kellett értékelniük, hogy mennyire értenek egyet a megfogalmazott állítással. Az utolsó 2 témakörb...
Summary The Hungarian psychiatrist Laszlo Meduna was the first who induced epileptic fits to infl... more Summary The Hungarian psychiatrist Laszlo Meduna was the first who induced epileptic fits to influence the course of mental illness. The following account, based on a review of Meduna's recently unearthed files and his writings, traces the beginnings of convulsive therapy.
The aim of this survey was to identify predictors of suicide attempts that immediately followed a... more The aim of this survey was to identify predictors of suicide attempts that immediately followed a violent crime in patients with schizophrenia. Documentations of patients diagnosed with schizophrenia and released in a 10 years period from the National Institute of Forensic Psychiatry were reviewed. Twenty-six out of 223 patients attempted suicide after the violent crime. The young age of the victim, and living in partnership were those factors differentiating suicidal violent offenders from their non-suicidal counterparts.
To investigate the presence of offences in the previous past history of perpetrators of violent a... more To investigate the presence of offences in the previous past history of perpetrators of violent acts who have undergone forced medical treatment. The documentation of all patients released over a 10-year period from the National Institute of Forensic Psychiatry (IMEI) was reviewed. A comparison was drawn between patients who were convicted of any type of offense before the violent act (patients with previous offences-PPO) and those who were not (patients with no previous offences-PNO). Eighty-six (29%) and 208 (71%) patients formed the PPO and PNO groups, respectively. Prior contact with psychiatric services was significantly higher in the PPO group (p=0.038) and this group was also more likely to offend under the influence of a psychoactive substance (p<0.001). Exceptional brutality and other qualifying factors were more frequent in the PNO group (p=0.019). As IMEI is the only forensic institution in Hungary, the picture presented here reflects the situation in the entire countr...
Convulsive therapy (COT) is a major European contribution to the psychiatric armamentarium and bi... more Convulsive therapy (COT) is a major European contribution to the psychiatric armamentarium and biological psychiatry. COT was introduced in psychiatry by László Meduna, a Hungarian neuropsychiatrist. All subsequent publications about the first patient treated with COT, Zoltán L (ZL), were based on Meduna's papers and autobiography. After 4 years of catatonic stupor, ZL received camphor-induced COT which resulted in full remission and discharge from the institution. The aim of this paper is to reconstruct ZL's case history from the original case notes-partly written by Meduna himself-which were recovered from the archives of the National Institute of Psychiatry and Neurology. The case notes show that ZL repeatedly received COT between 1934 and 1937, first with camphor and then with cardiazol induction. After the first course of COT the catatonic stupor was resolved and the psychotic symptoms subsided. However, the remission lasted for only a few months and was followed by a r...
Psychiatric disorders which indicate the use of electroconvulsive therapy (ECT) also occur in epi... more Psychiatric disorders which indicate the use of electroconvulsive therapy (ECT) also occur in epileptic patients, but there is a lack of medical authority concerning the use of ECT in epileptic patients. This is surprising because in recent years it has been proved that ECT has an anti-convulsive effect to some degree. A case study of an epileptic patient is presented whose progress has been monitored for several years. Antiepileptic drugs were seemingly able to control his epilepsy but at the same time progressive behavioural disturbance (schizophreniform psychosis) accompanied by agitation and violent behaviour developed. Considering the recurrent psychotic decompensations and the relative ineffectiveness of antipsychotics, the authors decided to administer ECT. As a result they were able to bring about the longest symptom free balanced period in the patient. According to the data based on previous medical studies and the experience they can suppose that ECT is not immediately con...
Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakológiai Egyesület lapja = official journal of the Hungarian Association of Psychopharmacology, 2011
Referring to the scientific literature the authors analyze the correlation between criminal offen... more Referring to the scientific literature the authors analyze the correlation between criminal offense and psychiatric disorders. Frequency of violent behaviour in schizophrenia together with the risk factors are reviewed. The issue of violent offense is separately discussed. Impact of deinstitutionalization on offense is also analyzed. Results regarding the genetic correlations are also reviewed. Finally the question of re-offending is discussed. In summary the importance of this issue in stigmatization and in the development of the mental health care system is highlighted.
Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakológiai Egyesület lapja = official journal of the Hungarian Association of Psychopharmacology, 2008
The history of the first convulsive treatment is summarized here in commemoration of its 75th ann... more The history of the first convulsive treatment is summarized here in commemoration of its 75th anniversary. The neuropathological and clinical findings underlying the theoretical basis of the method are reviewed, together with the case histories of the first batch of patients who underwent convulsive therapy. The early indications and effectiveness of convulsive therapy are also discussed. Finally, in a broader context, the role of convulsive treatment in the development of modern biological psychiatry and Laszlo Meduna's contribution to this development touched upon.
In the 1940s, regressive and intensive methods were developed to increase the therapeutic effects... more In the 1940s, regressive and intensive methods were developed to increase the therapeutic effects of electroconvulsive therapy. The diagnostic indications, methods of application, effectiveness, complications, and mortality of these techniques are briefly discussed here. An attempt is also made to evaluate the risks and benefits of these methods from a historical perspective.
The number of Hungarian citizens travelling to countries infected with malaria is increasing year... more The number of Hungarian citizens travelling to countries infected with malaria is increasing year by year. Mefloquine is the most effective medicine in the prophylaxis and treatment of malaria. However, neuropsychiatric side-effects can more often be seen with the use of mefloquine compared to other anti-malaria drugs. To assess the neuropsychiatric side-effects with mefloquine prophylaxis; to screen those patients who are possibly affected by the side-effects and to explore factors that forecast the possible side-effects. The retrospective analysis of patients, who in the past 2 years, have had mefloquine prophylaxis and then turned up at Semmelweis University, Department of Psychiatry and Psychotherapy and at Szent László Hospital, Outpatient Department of Psychiatry and Addictology because of neuropsychiatric symptoms. Out of the 6 cases presented, whose neuropsychiatric symptoms ranged from slight dizziness, malaise through panic attacks and depression to psychosis, the preceedi...
There are a great number of psychopathological symptoms which manifest themselves in 70-75% of ep... more There are a great number of psychopathological symptoms which manifest themselves in 70-75% of epileptic patients but most of them remain unrecognised and untreated. These symptoms may affect the patients' quality of life more negatively than the epileptic seizures themselves. Anxiety is one of the most frequently occurring interictal psychopathological symptom. A number of specialists agree that chronic epilepsy causes the amplification of endogenic seizure suppressing mechanisms which hinder the epileptic seizures and are responsible for the development of interictal psychopathological symptoms. However the physiological effects of the interictal psychopathological conditions (e.g. anxiety) have epileptogenic effect as well. There is a high chance that the conditions of epilepsy and anxiety will mutually create a destructive vicious circle and it will be illustrated by our two case reports. In our experience, before modifying the pharmacotherapy of a patient suffering from chr...
Psychiatria Hungarica : A Magyar Pszichiátriai Társaság tudományos folyóirata, 2008
Convulsive treatment was introduced to psychiatry by László Meduna, a Hungarian neuropsychiatrist... more Convulsive treatment was introduced to psychiatry by László Meduna, a Hungarian neuropsychiatrist. In his autobiography, Meduna gave a detailed description of his first patient who underwent convulsive therapy. According to Meduna's recollections, this patient was L. Zoltán, who after 4 years of fluctuating catatonic stupor received several sessions of camphor-induced convulsive therapy resulting in full remission and discharge from the institution. In this communication, the authors reconstruct L Zoltán's case history from the original case notes, which were recovered from the Archives of the National Institute of Psychiatry and Neurology, Budapest. The case notes show that L. Zoltán received courses of convulsive treatment between 1934 and 1937, first induced with camphor and then with cardiazol. After the first course of treatment the catatonic stupor was resolved and the psychotic symptoms subsided. However, this incomplete remission lasted only for a few months and was ...
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