Lege Artis Medicinae

[The modern approach of child-adult transition in chronic diseases]

MAJOR János, ÁDÁM Szilvia

JANUARY 20, 2018

Lege Artis Medicinae - 2018;28(01-02)

[Adolescence is the age of great biological, psychological, social changes and time of coming-of-age, however it is also associated with significant vulnerability. 15-20% percent of teenagers have special health needs and are transfered later to adult care, but the vulnerability of adolescents is more pronounced. The handover of adolescents with chronic medical condition to adult care can be achieved through a simple transfer of care or transition, which is a purposeful, planned movement of adolescents and young adults with chronic medical conditions from child-centred to adult-oriented health-care system. The transition of care requires a holistic approach and covers medical, psychosocial and educational aspects. In the transition the patient, the family, the paediatrician, and the adult specialist are also involved together with the multidisciplinary team including a psychologist as well. The transition according to the international literature improves adherence to care, self-management, knowledge of the di-sease and the adjustment to adult health services. In this review article, the author summarizes the latest knowledge of transition of care from different subspecialties expecting better joint work between the different medical specialties.]



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[BACKGROUND - Nowadays it is an understood fact, that theory of mind has a great psychological significance. Deficits of theory of mind skills are observed in schizophrenia such as depression, dementia, autism and some personality disorders as well. Conceptions of theory of mind and emotion recognition ability have been coming in front at the expanse of the older empathy also in the present-day research in connection with helper connections and their effects. It is probably due to popular approach of cognitive neuroscience exact methods. METHODS - We intended to demonstrate, that the ability of emotion recognition can be developed, or partially restored, even in case of patients suffering from schizophrenia. We compiled an 8-seat training. Our method was a bibliotherapy training, each of chosen novels expressed one of basic emotions (by Ekman). After a common reading we projected validated portraits expressing also those emotions. Participants had to choose reflecting the emotional state of the characters photos. Then they shared stories from their own lives experiencing similar emotions. We measured the effectiveness of our method by the Reading the Mind in the Eyes measured (RMET) test. RESULTS - Comparing data before and after the training in t-test we detected significant difference (p=0.000608 <0.05). Verifying that the observed changes are not only the common effects of the other types of treatment, the same tests were performed on a similar in-patient treated control group. There was no significant difference between the RMET first time and two weeks later values of the control group (p=0.467). The rate of changes in the test and control group (RMET) was compared in a paired-sample t-test, and we also found a significant difference: p=0.000786 <0.005. CONCLUSIONS - The deficit of theory of mind in schizophrenia can be reduced, which indirectly can improve our patients' communication and adaptation skills, or worse, their deterioration can be reduced.]

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