Lege Artis Medicinae

[Family therapy, a therapeutic paradox? Part I]

KURIMAY Tamás1

NOVEMBER 30, 1992

Lege Artis Medicinae - 1992;2(11)

[The author outlines the theory and practice of family therapy including Hungarian and international experiencies. He gives an overview of the structure of family therapy and its terapeutic possibilities in medical practice. ]

AFFILIATIONS

  1. Semmelweis Orvostudományi Egyetem Oktató Kórháza Budapest

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[The beta-adrenoceptor blocking drugs]

KÉKES Ede

[The beta-blockers have been primary in cardiovascular pharmacology since the 1960's. Clinical experiences in the last 25 years have confirmed that the beta-adrenergic blockade is essential in treating the different forms of angina pectoris. Hypertension, hypertrophic cardiomyopathy, and all situations including acute myocardial infarction and some rhythm disturbances qualified by sympathetic overdrive. The beta-blockers have been shown in large scale clinical trials to reduce the cardio vascular morbidity and mortality associated with hypertension and post-infarction period. The possibility of using them as a combined therapy with a great number of other drugs without any difficulties, is very important. Toxicity is rare with beta-blockers and the side effect profile is generally good. There fore, there is no question that the risk/benefit ratio is weighted toward the benefit. Nevertheless there are some problems such as hemodynamic profile, and effects on lipid metabolism, etc. Research has advanced from the first generation to the third generation with direct or indirect effects on the vascular bed, producing strong vasodilation. Because of the above mentioned facts, it is essential to know correctly the pharmacological effects and precise pharmacokinetics, of the beta-blockers.]

Lege Artis Medicinae

[Calcitonin-secreting ovarian strumal carcinoid]

ÉSIK Olga, NÉMETH György, SZEPESHÁZI Károly

[On the basis of a case report, the clinical picture, pathologic characteristics and possible histogenesis of ovarian strumal carcinoid are discussed. A 3 mm strumal carcinoid, i.e. thyroid tissue intimately mixed with a calcitonin-secreting neuroectodermal tumour, was found in a mature ovarian cystic teratoma of a 38 year old woman. Although the thyroid component demonstrated a typical normal light microscopic appearance, no thyroglobulin and thyroxine were found immunohistochemically. Immunoreactive calcitonin was demonstrated within the tumour cells, even in the transitional zone of the biphasic tissue elements. No amyloid was detected. The argentaffin and argyrophilic reactions were negative. The close relationship between functionally imperfect thyroid tissue and a neuroendocrine marker-secreting tumour seems to be concordant with the theory of the existence of a pluripotential stem cell capable of differentiating multidirectionally.]

Lege Artis Medicinae

[Plasma Exchange]

JÁKÓ János, SCHOPPER János

[As a technique, is one of the indispensable means of supportiv therapy. Possibilities and approaches representing new trends of up to date therapy are offered by its application. Such approaches are, the nonsubstitutive application of IVIG, or exploiting the advantages of the functioning LAK and TIL cells. However, the authors also point out dangers of this technique, therefore plasma exchange should be applied only after thorough consideration. ]

Lege Artis Medicinae

[A new operative technique in the internal carotid artery surgery]

ENTZ László, MOGÁN István, JÁRÁNYI Zsuzsa, PAPP Sándor, NEMES Atilla

[The primary author spent one year at the Vascular Department of Nurenberg Town Hospital where an opportunity presented it self to get acquainted with a new surgical method. The eversion endarterectomy of the carotid artery has been developed by the Nurenberg team in 1985. Since that time more then 1500 operations of this type was performed. Using the experiences gained in Nurenberg, the author introduced this new method at the Budapest Cardiovascular Surgery Clinic as well, and from January 1, 1991 until June 30, 1992, 213 operations were performed. Concerning short term results the new method is acceptable compared to the traditional methods. Owing to the method being a new one, long term results can only be read about from 2 authors. After a five year postoperative period restenosis of 1,3 percent was found after 212 operations by Kieny and after 105 operations, a 1.9 percent was reported by Kasprzak. These results seem to be encouraging if they are compared to the 10–25% restenosis rate of traditional operations. ]

Lege Artis Medicinae

[APSAC Intervention Mortality Study]

MATOS Lajos

[Within 30 days of the infarct, 12.2% of the placebo group and 6.4% of the APSAC group had died. The active agent reduced mortality at 30 days by a mean of 47.5% (21-65%) within a 95% confidence interval. Side effects and adverse effects were rare.]

All articles in the issue

Related contents

Lege Artis Medicinae

[The role of intergenerational stress in the background of anorexia nervosa]

TÚRY Ferenc, PÁSZTHY bea

[In childhood and adolescence, family therapy is a crucial therapeutic method in the treatment of anorexia nervosa. Among the family stress factors there are the tensions often too obvious between the parental and grandparental generations. Three case reports are presented, where the transgenerational tensions played an important role in the family of a young patient, suffering from anorexia nervosa. During the family therapy, the treat­ment of interrelated family stress factors and focusing on transgenerational relations proved to be crucial in the successful outcomes. While treating anorexia nervosa by family therapy there are not only important the recognition and treatment of tensions within the nuclear family, but also those of stressed relations emerging from grandparental generation through multigenerational transfer mechanisms. This treatment may be successful either with the grandparent’s inclusion, or exclusion. ]

Lege Artis Medicinae

[The role of fathers in the family therapy of eating disorders, with special regard to mosaic families]

TÚRY Ferenc, SZENTES Annamária

[Eating disorders (anorexia nervosa, bulimia nervosa) are the typical forms of modern disorders of civilization. In the therapy of young (below age of twenty years) patients the family therapy can play a decisive role. During family therapy, in the case of mosaic families (newly organized families after divorce and second marriage) it is a frequent question, which family members should be involved into the therapeutical sessions: the biological parents, or the members of the actual families. In this paper two cases are reported where mosaic families were consulted. In the family therapy the new distribution of parental roles, the strengthening of the paternal responsibility of the foster-father were crucial in the families. In both cases a full remission occurred. As a conclusion we can state that during family therapy of eating disordered patients - and supposedly in other psychosomatic disorders - in the case of mosaic families the involvement of the actual family members, and the strengthening of the parental role can be an important factor in the therapeutical efficacy.]

Lege Artis Medicinae

[Family therapy, a therapeutic paradox? Part II]

KURIMAY Tamás

[The author provides an overview of theories and practice of family therapy based on national and international literature and experience. He describes the organisational structure of family therapy and its application in medical practice. ]

Lege Artis Medicinae

[The liaison between internal medicine and psychiatry can be life-saving in the treatment of severe anorexia nervosa]

SZÉNYEI Gábor, BENE László, TÚRY Ferenc

[INTRODUCTION - In the severe forms of anorexia nervosa hospitalization may be required, and the somatic treatment is provided in a department of internal medicine. In such cases, collaboration between internist and psychiatrist is essential. Psycho­logical support is necessary even in the period of nutritional rehabilitation. This can be applied in the framework of consultation-liaison psychiatry. After the initial weight gain providing psychotherapy in an outpatient setting is fundamental. In the case of anorexic patients who maintain a close relationship with the family, family therapy is the most effective treatment. CASE REPORT - A 26-year old female patient with anorexia was hospitalized in a department of internal medicine after an extreme emaciation, her body mass index was 11.6. During this period there was a psychiatric consultation involving the fa-ther of the patient as well. Her body weight increased, and outpatient family therapy was initiated. Fifteen family sessions were conducted in nine months, with special focus on the separation-individuation process. At the end of the therapy a full remission could be observed, with a normal body weight, and her periods returned. After a four-month follow-up her state was stable, and she got married. CONCLUSION - Interdisciplinary collaboration can be cardinal when somatic and psychological disorders are interwoven. The role of family therapy is crucial in those cases where emotional separation from the family of origin is difficult, even if the patient does not live with the parents any longer. ]