Lege Artis Medicinae

[Therapy and examination of generalized anxiety disorder in general practitioner practice]

BECZE Ádám, HARGITTAY Csenge, KALABAY László, TORZSA Péter

MAY 02, 2018

Lege Artis Medicinae - 2018;28(03)

[Anxiety disorders are the most common psychiatric conditions in primary care, but still the ratio of treated patients is low. Clinically significant anxiousness decreases work efficacy and quality of life, it can cause and often goes with somatic and other psychiatric comorbidities. Patients with anxiety disorders usually undergo many diagnostic tests and interventions turning out negative on all levels of the health system. The general practitioner has a significant role in diagnosing and assessing anxiety disorders, based on a focused history, tests for differential diagnosis and questionnaire screening tools. The generalised anxiety disorder (GAD) is highly prevalent in primary care, appr. 8- 10%, 2-4 times frequent in women. Treat - ment is complex, evidence-based methods are available as certain lifestyle modifications, psychotherapy and pharmacotherapy. A regular consultation with a psychiatrist colleague can improve the chronic care of patients with anxiety disorders.]

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[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.]

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ORAVECZ Márk, MÉSZÁROS Judit, YU Funian, HORVÁTH Ildikó

[BACKGROUND - Randomized controlled trials (RCT) of acupuncture show heterogeneity in several ways. Acupuncture interventions used for the same conditions are greatly variable and so are study designs. METHOD - We evaluated the most frequently cited randomized controlled trials of acupuncture based on traditional Chinese medicine by examining practitioner background using elements of the “STandards for Reporting Interventions in Clinical Trials of Acupuncture”. The extracted data was compared with international guidelines and standards of traditional Chinese medicine and acupuncture education. RESULTS - We identified 5 heterogenous educational systems with contact training hours ranging from 120 to 3000. The educational criteria set by 93.75% of the reviewed trials did not meet the standards of the World Health Organization guidelines for acupuncture education or the World Federation of Chinese Medicine Societies standard for Chinese medicine education. Education in traditional Chinese acupuncture is internationally heterogeneous and this heterogeneity was found to be underreported in 87.5% of these trials, not provided for in study design. DISCUSSION - The generalizability and external validity of the reviewed trials may be questioned regarding the participating practitioners’ training background. In the future, a similar evaluation of systematic reviews could help further elucidate the issue of educational heterogeneity in traditional Chinese medicine acupuncture trials.]

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