Lege Artis Medicinae

[What brings ICD-11 to psychiatry? ]

SZEKERES György1

JANUARY 20, 2019

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

DOI: https://doi.org/10.33616/lam.29.011

[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. ]

AFFILIATIONS

  1. Semmelweis Egyetem, Pszichiátriai és Pszichoterápiás Klinika, Kútvölgyi Klinikai Tömb

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Is Unacceptable Acceptable? – Michael Haneke: Love ]

SOPSITS Árpád

Lege Artis Medicinae

[Musings of the Guest Editor-in-Chief]

PUREBL György

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

[Biological rhythms and ageing ]

PUREBL György

[Biological rhythms plays key role in maintaining health and preventing diseases. The changes of rhythms are normally associated to aging. Biological rhythms become more fragile along with the age and therefore they are connected to various age-related health problems. The interest about the strategies aiming to maintain or restore biological rhythms is increasing. There are evidences about the beneficial effect of rhythm restoration therapies in dementia and depression, but future studies are needed to clarify the general health promoting and also geroprotecting effect of these interventions. ]

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. ]

All articles in the issue

Related contents

Clinical Neuroscience

The etiology and age-related properties of patients with delirium in coronary intensive care unit and its effects on inhospital and follow up prognosis

ALTAY Servet, GÜRDOGAN Muhammet, KAYA Caglar, KARDAS Fatih, ZEYBEY Utku, CAKIR Burcu, EBIK Mustafa, DEMIR Melik

Delirium is a syndrome frequently encountered in intensive care and associated with a poor prognosis. Intensive care delirium is mostly based on general and palliative intensive care data in the literature. In this study, we aimed to investigate the incidence of delirium in coronary intensive care unit (CICU), related factors, its relationship with inhospital and follow up prognosis, incidence of age-related delirium and its effect on outcomes. This study was conducted with patients hospitalized in CICU of a tertiary university hospital between 01 August 2017 and 01 August 2018. Files of all patients were examined in details, and demographic, clinic and laboratory parameters were recorded. Patients confirmed with psychiatry consultation were included in the groups of patients who developed delirium. Patients were divided into groups with and without delirium developed, and baseline features, inhospital and follow up prognoses were investigated. In addition, patients were divided into four groups as <65 years old, 65-75 yo, 75-84 yo and> 85 yo, and the incidence of delirium, related factors and prognoses were compared among these groups. A total of 1108 patients (mean age: 64.4 ± 13.9 years; 66% men) who were followed in the intensive care unit with variable indications were included in the study. Of all patients 11.1% developed delirium in the CICU. Patients who developed delirium were older, comorbidities were more frequent, and these patients showed increased inflammation findings, and significant increase in inhospital mortality compared to those who did not develop delirium (p<0.05). At median 9-month follow up period, rehospitalization, reinfarction, cognitive dysfunction, initiation of psychiatric therapy and mortality were significantly higher in the delirium group (p<0.05). When patients who developed delirium were divided into four groups by age and analyzed, incidence of delirium and mortality rate in delirium group were significantly increased by age (p<0.05). Development of delirium in coronary intensive care unit is associated with increased inhospital and follow up morbidity and mortality. Delirium is more commonly seen in geriatric patients and those with comorbidity, and is associated with a poorer prognosis. High-risk patients should be more carefully monitored for the risk of delirium.

Clinical Neuroscience

[Can we influence the negative drug attitude? Interpretation of the rejection of COVID-19 vaccine in the light of results of a pilot study ]

POGÁNY László , HORVÁTH A. András, LAZÁRY Judit

[Vaccination refusal is a serious obstacle to minimizing the spread of COVID-19. Nevertheless, the rejection of vaccine can be considered the result of a negative attitude towards medical treatment, and according to our previously published data, it can be influenced by the underlying affective state. Increased incidence of affective disorders and anxiety could be observed globally during the pandemic, which may have a significant impact on vaccination acceptance. The aim of our pilot study was to determine the association between clinical improvement of affective and neurocognitive symptoms and change of drug attitude and health control beliefs in a sample of psychiatric patients. A data set of 85 patients with psychiatric disorder has been analysed with the use of Patient’s Health Belief Questionnaire on Psychiatric Treatment (PHBQPT) with 5 subscales (Negative Aspect of Medication – NA; Positive Aspect of Medication – PA; Doctor health locus of control- Doctor HLOC; Internal HLOC; Psychological Reactance – PR); Hospital Anxiety Depression Scale (HADS-Anx; HADS-Dep) and neurocognitive tests, such as the Stroop test and the Trail Making Tests. All the tests were performed before and after a 14 days treatment. Paired t-tests and generalized linear models were performed to assess the associations between the variables. The baseline scores of NA and HADS-Anx correlated significantly (p=0.001) and after two weeks of treatment NA decreased (p=0.001), while Doctor HLOC and Internal HLOC increased (p=0.001 and p=0.006). The patients performance of the neurocognitive tests improved (all p<0.05). The reduction of HADS-Anx (p=0.002) and HADS-Dep (p=0.006) scores showed significant associations with the decrease of NA. Increase of the PA score was associated with reduction of HADS-Dep (p=0.028). Improvement of neurocognitive functions had no effect on PHBQPT scores. Important conclusions can be drawn regarding the rejection of the COVID-19 vaccine based on the associations found between the intensity of affective and anxiety symptoms and the attitude towards treatment. Our findings suggest that affective symptoms have a negative influence on the attitude towards treatment and that the improvement of these symptoms can facilitate the acceptance of the therapy, regardless of diagnosis. The modest effect of the improvement of neurocognitive functioning on the attitude towards drugs and the significant role of affective-emotional factors suggest that the accep­tance of vaccination probably cannot be facilitated solely with the aid of educational programs. Considering the increasing incidence of affective disorders during the COVID-19 pandemic, the screening of affective and anxiety symptoms and treatment of these disorders could be an important step towards the acceptance of the vaccine. Although psychiatry is not considered as a frontline care unit of the COVID cases, more attention is needed to pay on the availability of mental health services because refuse of vaccine can develop due to affective disorders too.]

Lege Artis Medicinae

[Commemorating the Lipótmező. Part 1.]

RIHMER Zoltán

[“What did Lipótmező mean to you?” My friends and acquaintances asked frequently this question in the past decades, concerning the National Institute for Psychiatry and Neurology or well known as the Lipótmező my past workplace and the role it played in my life thus far. It is difficult to give a short answer, but the three and a half decades I have spent there were certainly of decisive importance in my professional and private life as well. Since I was banned from tobacco smoking due to my disease ten years ago, I cannot keep my pipe in my mouth any more. Thus, I decided to recollect the dearest stories kept in my memory, which had the deepest impact on me during my 35 years in Lipótmező both as a doctor and as a man. ]

Clinical Neuroscience

What is the real effect of pregabalin in patients with diabetic neuropathic pain? (Do patients suffer from less pain or do they less care about it?)

CAGDAS Erdogan, NEDIM Ongun, SELIM Tümkaya, HAKAN Alkan, NEŞE Öztürk

Objectives - Depression and anxiety are frequent in patients with chronic diseases such as diabetic neuropathic pain. The pain seems to be more severe in patients in whom depressive findings accompanied pain symptoms. Pregabalin was reported to have positive effects on anxiety and depression. This brings out the question, whether the pain relief effect of pregabalin is due to its analgesic effect or to its effects on mood? The aim of this study is to find out whether the positive effect of pregabalin in patients with diabetic neuropathic pain is limited to its effect on pain. Thus the question - do patients suffer from less pain or do they less care about pain? - should be answered. Methods - With this aim the NRS scores of 46 patients with diabetic neuropathic pain, whose HADS scores did not change with pregabalin treatment were compared with their baseline levels, retrospectively. Results - The NRS scores of the group were reduced with pregabalin treatment. Conclusion - This results suggests that the reduced pain in pregabalin treatment should be independent from its effects on depression and anxiety.

Clinical Neuroscience

[Before setout...]

Z. I.

[The first psychiatric and neurological journal in Hungary is now launched. The support of the Academy of Sciences and the Medical-Health Trade Union made it possible to make up for the omission made by the pseudo-scientific cultural policy of the reactionary period. It has already happened in the past that Hungarian medicine started to flourish. Developments in the fields of neurophysiology, neurology and psychiatry began in the second half of the last century, during which Hungarian researchers were connected to the leading medical discoveries of the time in the world.]