Lege Artis Medicinae

[Musings of the Guest Editor-in-Chief]

PUREBL György

JANUARY 20, 2019

Lege Artis Medicinae - 2019;29(01-02)

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Lege Artis Medicinae

[Animal-assisted therapies for the treatment of elderly dementia ]

SOMOGYI Szilvia

[The therapeutic value of the relationship between humans and animals should be considered in the cases of patients suffering from dementia with the onset in old age. This paper provides an overview of the animal assisted interventions in dementia. Reviews emphasize the positive effects of pet-keeping on mental and physical quality of life. However, it can also have adverse effects unless the pet is selected with caution. Regular animal assisted therapies within institutional framework provide a valuable potential programme for the patients in care. Articles published so far depict the physiological, social and psychological output variables of animal assisted therapies. The enhancement of social behavior is considered to be a specific factor of animal assisted therapies. Among the physiological symptoms the enhanced physical activity, the decrease of stress response and sympathic activation have been highlighted. Among the psychological functions reduction of state anxiety, mood lift and the reduction of negative emotions such as isolation and abandonment should be underlined. Acknowledging the available results, it seems that cognitive efficacy is less impacted directly by animal assisted therapies. However, promising results have been acquired in the alleviation of the behavioural and psychological symptoms related to dementia ]

Lege Artis Medicinae

[Our stubborn misbeliefs on ageing ]

RAJNA Péter

[Stressing the continuous increase of elderly population, the author demonstrates the negative impact of technical development on everyday routines of old population. It can explain that members of younger generations often create false ideations on mental and cognitive abilities of older ones, and consequently some stubborn misbeliefs are existing here. He deals with the following four of them in details: (1) Young age means worth, while old age is equal to deficit, (2) Every old person becomes demented, (3) Elderly people loose their interest and social sensitivity, (4) Old people means ballast for younger ones. The author emphasizes, that even the elderly persons are able to fall into these traps of misbeliefs. In addition to complex refutations, he states that the “spacecraft-model” described by L. Hayflick offers efficient solutions to preserve an adequate quality of life both for old people and their society. ]

Lege Artis Medicinae

[What brings ICD-11 to psychiatry? ]

SZEKERES György

[On 18 June 2018, after 10 years of working the World Health Organization released the 11th edition of International Clas­si­fi­cation of Diseases. User-friendly development was a definite goal. For the first time, it is completely electronic. The renewal in regard to both formal and content aspects reflects dynamic development of medicine. It contains new chapters on immune sys­tem disorders, sleep disorders, sexual health and traditional medicine. The new edition contains 55000 possible codes. It comes to effect from January 2022 in the member states and that requires users, doctors, insurers, and universities to be well prepared. Coding of mental and behavioral disorders also changes significantly. Fol­lo­wing a brief general description we look at the most important changes in the field of psychiatry. ]

Lege Artis Medicinae

[Eight questions and answers about anxiety in the elderly in family practice ]

CSATLÓS Dalma, VAJDA Dóra, MOHOS András, GONDA Xénia

[Anxiety is one of the most common psychological disorders in the elderly. Physical illnesses contribute to its development, but the opposite is also true: anxiety adversely affects the prognosis of many somatic illnesses, thus significantly enhancing morbidity and mortality. Therefore, the recognition and adequate treatment of anxiety disorders in the elderly are especially important in family practice, too. With the increase of life expectancy, the problems and illnesses of the elderly receive more and more attention in medical practice and anxiety cannot be ignored either, because the early detection of its symptoms improves the quality of life and reduces the chance of bad prognosis. ]

Lege Artis Medicinae

[Pharmacotherapy of dementia ]

PÁKÁSKI Magdolna, KÁLMÁN János

[The goal of treatment of dementia-related disorders is to reserve cognitive and functional ability, minimize behavioral and psychological disturbances, and slow disease progression, since currently available therapies can not reverse the pathologic processes. Among them, the most common is Alzheimer’s disease and vascular dementia. The authors review the therapeutic guidelines of these dementia types adapted to Hungarian conditions. Cho­li­nesterase inhibitors represent first-line therapy for patients with mild to moderate Alzheimer’s disease, whereas a glutamate N-metil-D-aspartate antagonist is used in the treatment of moderate to severe Alzheimer’s disease. In milder stages, phar­macotherapy may be supplemented by the use of nootropics. The progression slowing drugs have not only impact on cognitive symptoms but also affect behavioral and psychological symptoms. De­pen­ding on the severity of dementia and the existence of behavioral and psychological symptoms, these medicines may be re­commended as monotherapy or in combination. To further alleviate behavioral and psychological symptoms a variety non-pharmacological methods are known, at present their effectiveness has not been proven. Antipsychotics may be used to reduce agitation and aggression. Taking into account the side effects profile of antipsychotics, tiapride or risperidon ad­mi­nistration can be considered. In the case of their ineffectiveness, haloperidol may be used. ]

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Clinical Neuroscience

[Comment of the invited editor]

FOLYOVICH András

Lege Artis Medicinae

[LETTER OF THE EDITORS IN CHIEF]

FARSANG Csaba, KAPÓCS Gábor

Lege Artis Medicinae

[Relationships in recovery, recovery in relationships]

SZABÓ József, GEREVICH József

[INTRODUCTION - Some of the recent researches based on analyses of autobiographies pointed out, that the quality and the quantity of our social relations are in connection with our life longevity, and the frequency of words referring social roles and integration gives a respective measurement possibility of it. Conception of the term “social words” had been introduced. The influence of the degree of social support to the recovery from alcohol addiction is also a well-known phenomenon. Based on the above we supposed that examining their autobiography vocabularies we find special differences which can show the distinction between the social support of the relapsed and recovering addicted persons. We planned to prove the being of these special differences via revealing bias of the frequency and pattern of social word usage. PATIENTS AND METHODS - Two separate groups were created for purpose of the examination. The first consisted of relapsed alcohol dependent persons, who were treated in hospital (department of addiction psychiatry) diagnosed alcohol-dependent (F 10.2) (and nothing else) at least twice within a year (N=30). We chose earlier treated (because of alcohol-dependency, and nothing else mental disease) persons who had been being abstinent for at least 2 years into the second group (N=20). Beside the earlier diagnosis we used the parts of the ASI test to sreen any other mental diseases. We created similar groups with regards to gender, age and qualification. We collected autobiographies from the persons, and made two common documents of them. Afterwards we compared these documents by the Atlas.ti 5.0 (trial free version) content analysing software. We defined the frequency of the found social words in the rate of these words and the sum of the words in the whole text. We found the most prominent difference between the frequency of social words referring to the family and relatives, opposite the words dealing with friendship. RESULTS - In the latter case we could not detect any difference between the two groups. We got results confirming our hypothesis in the frequency of such words as “help”, “love”, “give” and “get”. We experienced in connection with the pattern that the words referring to social organisations, for example “team”, “community”, “company”, “club”, “meeting”, “collective” and the word “guest” practically did not appear (R<0.001) in the texts of relapsed persons, while they could be detected in the case of the recovering group (R=0.023). We did khisquare test to compare the frequency in the mentioned categories and we experienced significant differences between the social word usage of the two groups. CONCLUSION - Our results confirmed that the recovery from alcohol addiction was related to the quality and quantity of person's social relations, what we can get relevant information from the frequency of social words in the autobiographies about, so the high frequency of the social words can be considered as a good predictor of recovery.]

Clinical Neuroscience

[Editor’s note]

RAJNA Péter

Clinical Neuroscience

[LETTER OF THE EDITOR IN CHIEF]

RAJNA Péter, TAJTI János