Lege Artis Medicinae

[Meditation of the guest editor-in-chief]

PUREBL György

JANUARY 20, 2020

Lege Artis Medicinae - 2020;30(01-02)

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Lege Artis Medicinae

[Personality development in East and West, and some clinical implications ]

PUREBL György

[Exploring human personality focused mainly on trait and state markers of behaviour so far. Nevertheless, the concept of the universal, culture-independent model of personality carries more disturbing difficulties: hardly understandable inter-cultural conflicts, culture-related mental disorders and scientific experiences with unexpected outcomes. It can be hypothesized, that beside personality concept represented by the Euro-Atlantic civilisation and mainstream psychology there is an alternative concept of personality. Opposed to the independent, autonomous ego concept of individualistic cultures, collectivistic (primarily far-eastern) cultures are providing an interdependent model. According to this model, the core element of personality are determined rather by social embedding instead of the person’s own characteristics, which are secondary to the personal traits and characteristics. This study attempts to briefly outline the concept of interdependent personality, with some illustrative clinical examples. ]

Lege Artis Medicinae

[American-Hungarian forerunners of humanistic psychology and medicine: Andras Angyal and Bela Mittelmann ]

KELEMEN Gábor

[The fact that there are two significant Hungarian pioneers in humanistic psycho­therapy is still not recognised in the Hungarian academic community. In order to redress this omission the author compares and considers the careers of András Angyal and Béla Mittelmann. Both individuals left Hungary in 1920, settling first in Europe and subsequently in America, where they separately enjoyed successful careers. According to the author the trajectory of their lives is quite representative of many Hungarian emigrants during this period in history. This study examines the course of their life and explores their main achievements in the context of their contemporary relevance and enduring legacies. In the case of Angyal, it is the holistic-organismic theory of personality and influence on Maslow, which are his paramount achievements. As regards Mittelmann his topical contribution has been to the practice of “coaching” on the one hand and the application of dance and body therapy to recovery on the other. ]

Lege Artis Medicinae

[History of Daytime Hospital of the Department of Psychiatry in the University of Debrecen ]

ÉGERHÁZI Anikó, CSERÉP Edina, MAGYAR Erzsébet

[In Hungary, there was a ward related psychotherapy already since the 1960s, yet without any national network to the 1980s. In Debrecen the spreading of the psychotherapeutic approach started in the psychiatric facilities since the 1990s. Daytime Hospital was founded first in the County Hospital and later on in the Department of Psychiatry of the University. The latter option was provided by separating the psychiatry from neurology. This study presents the development of the day care at the Psychiatric Department along the opportunities and shows the structure of the actually functioning system finally reports on our future plans respectively. Initially started the occupational therapy, gymnastics, community cooking and walking, which did not require any separate rooms. The 22-bed psychotherapeutic unit was established 2014 with its joined capacity for 11 persons in the Daytime Hospital. The County Hospital is engaged primarily in socio-therapy of psychotic psychiatry pa­tients, however the Psychiatric Department is rehabilitating mainly patients with affective spectrum disorders. Patients are treated in socio-therapy and psychotherapy small groups for a half or one year. Afterward they enter the outpatient program, may join the Patient Club or decide for therapeutic occupation aiming the best way of recovery. According to the feedback, there is a long-term change in the mental state of the patients leading to improvement in their quality of life, which we plan to prove by an efficacy research program. ]

Lege Artis Medicinae

[The Veszprém model, alias a different approach of psychiatric care]

BALCZÁR Lajos, ENGLERT Tímea

[This study describes an integration of a county-level psychiatric care unit with two elements of primary social care, namely the community psychiatric care and the daycare for psychiatric patients via mediation of a specific foundation. Adequate trainings make the connection and dual employment possible in the presented system. On the health care side development is characterized by extended psychiatric care with effective psychosocial interventions. Adding specialized group psychotherapies and sociotherapies to the activity of the social care also brought a quality change, extension of which provided self-help and the consumers' applicability as therapy leaders in sociotherapy group. Based on our ten years of practice we may declare that recovery-based psychiatric rehabilitation can be realized more effectively in this community-based biopsychosocial model of care. ]

Lege Artis Medicinae

[End of the line? Addenda to the health and social care career of psychiatric patients living in Hungary’s asylums]

KAPÓCS Gábor, BACSÁK Dániel

[The authors are focusing on a special type of long term psychiatric care taking place in Hungary outside of the conventional mental health care system, by introducing some institutional aspects of the not well known world of so called social homes for psychiatric patients (asylums). After reviewing several caracteristics of institutional development of psychiatric care in Hun­gary based on selected Hungarian and in­ternational historical sources, the main struc­tural data of present Hungarian institutional capacities of psychiatric health and social care services are shown. Finally, the authors based on own personal experiences describe several functional ascpects of the largest existing asylum in EU, a so­cial home for long term care of psychiatric pa­tients. By the beginning of the 20th century, Hungarian psychiatric institutions were operating on an infrastructure of three large mental hospitals standing alone and several psychiatric wards incorporated into hospitals. Nevertheless, at the very first session of the Psychiatrists’ Conference held in 1900 many professionals gave warning: mental institutions were overcrowded and the quality of care provided in psychiatric hospital wards, many of which located in the countryside of Hungary, in most cases was far from what would have been professionally acceptable. The solution was seen in the building of new independent mental hospitals and the introduction of a family nursing institution already established in Western Europe; only the latter measure was implemented in the first half of the 20th century but with great success. However, as a result of the socio-political-economic-ideological turn following the Second World War, the institution of family nursing was dismantled while different types of psychiatric care facilities were developed, such as institutionalised hospital and outpatient care. In the meantime, a new type of institution emerged in the 1950s: the social home for psychiatric pa­tients, which provided care for approximately the same number of chronic psychiatric patients nationwide as the number of functioning hospital beds for acute psychiatric patients. This have not changed significantly since, while so­cial homes for psychiatric patients are perhaps less visible to the professional and lay public nowadays, altough their operational conditions are deteriorating of late years. Data show, that for historical reasons the current sys­tem of inpatient psychiatric care is proportionately arranged between health care and social care institutions; each covering one third. Further research is needed to fully explore and understand the current challenges that the system of psychiatric care social- and health care institu­tions are facing. An in-depth analysis would significantly contribute to the comprehensive improvement of the quality of services and the quality of lives of patients, their relatives and the health- and social care professionals who support them. ]

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[How can the specialists be contacted? Ways of communication in the specialist-patient consultation]

MOLNÁR Regina, PAULIK Edit, SÁGI Zoltán, KÖVES Béla

[Consulting the specia­list means face-to-face meetings traditionally. Nowadays patients do not need to go to the outpatient clinic to see the doctor since many new communication options have already been available. The aim of our study was to explore how typically doctors and patients use other options (as phone call or e-mail) beside face-to-face appointments in the outpatient clinic. We conducted a focus group interview with specialists and health workers and an in-depth interview with the chief nurse of an outpatient clinic in Budapest. The specialist-patient consultation is mostly face-to-face in the specialist’s office in the presence of the nurse, whose role is complex and pivotal. Fur­ther­more, the landline phone is an essential device, as the patients can reach the specialist or nurse in their office hours. The application of e-mail or mobile phone is incidental. The website of the outpatient clinic provides practical information to patients. Traditional postal letters, leaflets, and publications are also typical for providing information. The doctors’ opinion was rather heterogeneous about the pa­tients’ Internet usage and about the on­line contact with patients. Beside increasing the capacities the deliberate and organized introduction and application of technical de­vices, may reduce the overburdening of health professionals.]

Lege Artis Medicinae

[A forgotten physician in the history of Hungarian Psychiatry. Dr. Ferenc Klein’s biography]

SZABÓ József

[The Psychiatry Department of St. Raphael’s Hospital in Zala County celebrated its 110th anniversary last year. This important anniversary raised the idea of studying deeper than usual the life of our professional ancestors. We tried to discover the personality, character, and oeuvre of our first appointed chief physician Ferenc Klein while using historical recollections and press articles published by our county, city and hospital. An image of a prominent physician, psychiatrist, patriot and individual was emerging before our very eyes by processing the available sources. As a pulmonologist, a field surgeon, or a psychiatrist he was able to meet the expectations of his age. He was highly appreciated by his patients and the people of Zalaegerszeg. Despite his significant oeuvre and martyrdom, he sank in oblivion and his name was not preserved either in the history of psychiatry or in the general memory. In the present study, we want to commemo­rate him by collecting and publishing his biography. ]