Clinical Neuroscience

[The Hourglass Model of Psychiatric Diseases, illustrated by the example of endogenous psychoses]

PETHŐ Bertalan1

MAY 01, 1985

Clinical Neuroscience - 1985;38(05)

[Taking Jaspers' concept as a starting point, the author has previously proposed an orientation along the conceptual continuum of disease entities. Along this conceptual continuum of disease, which is not a continuum between disease and normality, the psychopathological syndrome is defined as a disease with a defined duration (small disease unit) or a psychopathological syndrome with a defined duration (small disease unit). The variables of the disease process indicating psychopathological and social adaptation disorders are empirically shown to form a relatively antagonistic open system. Based on this finding and using the concepts of multiaxial classifications, the author has developed the so-called hourglass model as an extension of the linear model of illness, which reflects the interweaving of life history and pathology, and allows the development of testable hypotheses and the synthesis of a biological and a social psychiatric approach. ]


  1. Semmelweis Orvostudományi Egyetem Psychiatriai Klinika



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Clinical Neuroscience

[ Parkinsonism bromocriptine (Parlodel) 5-year experience of treatment ]

LIPCSEY Attila, PERES Aladár, RÉVÉSZ Tamás

[The authors have been conducting systematic trials of Parlodel (bromocriptine) in combination treatment of patients with Parkinson's disease for 5 years.Parlodel has been used in 56 patients. Their patient population includes a significant number of elderly patients and patients tolerated Parlodel better than any other antiparkinsonian drug. No significant side effects were observed. In complex treatment, the use of Parlodel has been shown to reduce the dose of other antiparkinsonian drugs (including L-dopa) in some cases. It was found to be effective in patients with on-off, wearing-off phenomena in therapy-resistant cases. ]

Clinical Neuroscience

[Migraine with atypical and persistent symptoms]

MOLNÁR Erzsébet, GÁCS Gyula

[The authors analyze data on complicated migraine patients treated for headaches in an inpatient unit. They highlight the relative prevalence, variations, and differential diagnostic problems of the pathology. One of their cases of complicated migraine attacks developed posterior cerebral artery occlusion with permanent visual field loss. They emphasize the importance of cases of "migraine without a headache" with persistent symptoms in approaching the pathomechanism of the pathology from a clinical point of view. ]

Clinical Neuroscience

[Treatment of Parkinson's disease in Bács-Kiskun county]

MATEJKA Zsuzsanna

[The communication describes the number of Parkinson's disease patients registered in Bács-Kiskun County and the use of drugs in the treatment of the disease. The author concludes that due to the disastrously low number of neuro-mental beds and the lack of specialists, the reassuring screening, care, and drug therapy of the disease in the county are not solved. ]

Clinical Neuroscience



[Report of the Synapse-50 conference, held to celebrate the 50th anniversary of the Montreal Neurological Institute and Hospital, 23-26 September 1984 in Montreal. ]

Clinical Neuroscience

[Report of the SM conference held by the Department of Neurology of the Polish Academy of Sciences on 14 and 15 June 1984 in Lodz]


[During the two-day session, national and international experts reported on their research in the biochemical histochemistry, immunology, clinical and epidemiology of multiple sclerosis.]

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Atypical presentation of late-onset Sandhoff disease: a case report

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Sandhoff disease is a rare type of hereditary (autosomal recessive) GM2-gangliosidosis, which is caused by mutation of the HEXB gene. Disruption of the β subunit of the hexosaminidase (Hex) enzyme affects the function of both the Hex-A and Hex-B isoforms. The severity and the age of onset of the disease (infantile or classic; juvenile; adult) depends on the residual activity of the enzyme. The late-onset form is characterized by diverse symptomatology, comprising motor neuron disease, ataxia, tremor, dystonia, psychiatric symptoms and neuropathy. A 36-year-old female patient has been presenting progressive, symmetrical lower limb weakness for 9 years. Detailed neurological examination revealed mild symmetrical weakness in the hip flexors without the involvement of other muscle groups. The patellar reflex was decreased on both sides. Laboratory tests showed no relevant alteration and routine electroencephalography and brain MRI were normal. Nerve conduction studies and electromyography revealed alterations corresponding to sensory neuropathy. Muscle biopsy demonstrated signs of mild neurogenic lesion. Her younger brother (32-year-old) was observed with similar symptoms. Detailed genetic study detected a known pathogenic missense mutation and a 15,088 base pair long known pathogenic deletion in the HEXB gene (NM_000521.4:c.1417G>A; NM_000521:c.-376-5836_669+1473del; double heterozygous state). Segregation analysis and hexosaminidase enzyme assay of the family further confirmed the diagnosis of late-onset Sandhoff disease. The purpose of this case report is to draw attention to the significance of late-onset Sandhoff disease amongst disorders presenting with proximal predominant symmetric lower limb muscle weakness in adulthood.

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[History of vaccine production in Hungary ]


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[Second game, 37th move and Fourth game 78th move]

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[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]