Lege Artis Medicinae

[Why is it important and ethical to treat anxiety patients?]

RADICS Judit

JUNE 20, 2018

Lege Artis Medicinae - 2018;28(04-05)

[The identification of anxious patiens is not always an easy task. The diagnose is clear in that case, when the symptoms (psychic or somatic) are evident or/and patients complain about anxiety. Anxiety itself is not a pathological symptom if it is adequate in strength and duration. Anxiety reactions have large individual variety -, they are pathological if inadequate and irrelevante and don’t match with the actual situation. According to epidemilogical data one third of patients of family doctors suffer from anxiety but somatic symptoms come to the front, so the patients participate in a great number of medical examinations. It is important to emphasise that medical examinations are necessary to preclude the possibility of any somatic disease. The di­ag­nostic criteria of DSM-5. are an excellent assistance for a good diagnosis. Anxiety is a risk factor for cardiological diseases and diabetes mellitus. The prevalence of anxiety disorders are 12.6-17.2%. Anxiety di­sorders are well-manageable, they need complex therapy: benzodiazepines, antidepressants, hypnotics and psychotherapy. They frequently co-exist with depression and insomnia so they have to be treated together. ]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Treatment of EGFR mutant lung adenocarcinoma after progression]

BOGOS Krisztina

[Precision medicine proposes the personalization of health services in order to make the best individual decisions about the interventions and treatments for the patient. Molecular genetic diagnostic tests help to select the appropriate therapy, so-called targeted therapy. In the case of extensive lung cancer with EGFR mutation, EGFR tyrosine kinase inhibitors are immediately applicable; they are very effective and can reach long-term remission of the disease. However, resistance mutation can develop during the treatment, which causes the progression of the disease; therefore change of therapy is needed. In our case, we show the possibility of targeted treatment beyond the progression, emphasizing the importance of detecting resistance mutation. ]

Lege Artis Medicinae

[Autopsy by Pencil – When Anatomy and Art Meet ]

CZIGLÉNYI Boglárka

Lege Artis Medicinae

[Oncophilosophy]

SINKÓ Dániel

[Combining oncology with philosophy, as seemingly two different disciplines, is an exciting task but the question arises as to why this is necessary. For thousands of years philosophers have been trying to find answers to the basic questions of being-existence, reality, death, morality but from the twentieth century we see less and less the daily significance of these. Are not “questions of existence” important or are they no longer relevant? We would like to believe they are not but there are situations where suddenly our existence is threatened and all our already gained life experiences are proved to be a failure…]

Lege Artis Medicinae

[The “room” for death in the family - dying as a role]

MÚJDRICZA Ferenc

[The Hungarian literature has quite ignored so far Noyes & Clancy’s Role Theory approach of dying. I present the outline and a critique of this conception, then lay the foundations of a reformed concept of the dying role. For the optimal and desired dying role is not one of peripherising and objectifying, rather one of placing the dying in the centre of the system of relations and roles radically restructuring under the influence of such role. The personality of the dying remains a true value in this central position. The reintegration of the dying can begin parallel to her disintegration by the progressive loss of her normal social roles (‘the loneliness of the dying’). Death can thus transform into a social phenomenon. I illustrate the argumentation on the central dying role with a case study using the method of a heterophenomenological, second-person character. By promoting the central and autonomous dying role, i.e. by the development of the necessary social role competences, or at least by publicising the thanatological knowledge, death can turn from an avoided, socially disintegrative taboo into a phenomenon that can strengthen the community even after the dying departed.]

Lege Artis Medicinae

[Konzerválószer-mentes krónikus kezelés glaucomában: a cseppkezelés okozta szemfelszín-betegség elkerülése]

HOLLÓ Gábor

[Ocular surface disease is a frequently seen condition in the elderly in the general po-pulation. In glaucoma patients the glaucoma-therapy related ocular surface disease is a particularly serious and common condition with complex pathogenenesis. Pre-servatives, most commonly benzalkonium chloride, employed in intraocular pressure lowering eye drops frequently cause or worsen ocular surface disease in glaucoma. The symptoms frequently undermine both the adherence to the prescribed intraocular pressure lowering drops and the vision related quality of life. Therefore the success of long-term glaucoma care in glaucoma-therapy related ocular surface disease is reduced. The current article summarizes the main pathogenetic aspects of glaucoma-therapy related ocular surface disease, and presents how to eliminate the main causative factor and normalize the ocular surface by using completely preservative free topical medication in glaucoma. ]

All articles in the issue

Related contents

Clinical Neuroscience

Evaluation of anxiety, depression and marital relationships in patients with migraine

DEMIR Fıgen Ulku, BOZKURT Oya

Aim - The aim of this study was to evaluate the frequency and characteristics of attacks in patients with migraine, to determine the effects of anxiety or depressive symptoms, and to evaluate the marital relationships of patients with migraine. Method - Thirty patients who were admitted to the neurology outpatient clinic of our hospital between July 2018 and October 2018 and were diagnosed with migraine according to the 2013 International Headache Society (IHS) diagnostic criteria were included in this cross-sectional study. Age, sex, headache frequency and severity, depressive traits, marital satisfaction and anxiety status were examined. We used the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maudsley Marital Questionnaire (MMQ) and Visual Analogue Scale (VAS) for measuring relevant parameters. Results - The mean severity of migraine pain according to VAS scale was 6.93 ± 1.41 and the mean number of migraine attacks was 4.50 ± 4.24. The mean BDI score of the patients was 12.66 ± 8.98, the mean MMQ-M score was 19.80 ± 12.52, the mean MMQ-S score was 13.20 ± 9.53, the mean STAI-state score was 39.93 ± 10.87 and the mean STAI-trait score was 45.73 ± 8.96. No significant correlation was found between age, number of migraine attacks, migraine duration, migraine headache intensity, and BDI, STAI and MMQ scores (p>0.05). But there was a positive correlation between MMQ-S and scores obtained from the BDI and STAI-state scales (p<0.05). Conclusion - In this study more than half of the migraine patients had mild, moderate or severe depression. A positive correlation was found between sexual dissatisfaction and scale scores of depression and anxiety.

Clinical Neuroscience

[Effect of two month positive airway pressure therapy on the structure of sleep, cognitive function and anxiety]

CSÁBI Eszter, VÁRSZEGI Mária, SEFCSIK Tamás, NÉMETH Dezsõ

[Obstructive sleep apnea is a common disorder, characterized by repeated episodes of upper airway obstruction during sleep, resulting intermittent hypoxia and disruption of the normal sleep pattern, which caused cognitive dysfunction in these patients. Nasal continuous positive airway pressure is the treatment of choice for this disorder. The aim of the study is to evaluate the effect of short-term positive airway pressure on sleep pattern (polisomnographic measures), cognitive function and anxiety. Twenty four newly diagnosed and previously untreated patients with obstructive sleep apnea were evaluated a battery of neuropsychological tests before and after 2 and a half months of the treatment. We focused on working memory, short and long-term episodic memory, executive functions, anxiety and subjective sleepiness. Our results showed that the two and half month of treatment improved the respiration during sleep, sleep pattern and the subjective sleepiness. We found improvement in short- and long-term verbal memory, and complex working memory. Despite of treatment we did not find improvement in visuospatial learning. These results reveal that 2 and a half months of positive airway pressure treatment restored not only the normal respiration during sleep and normal sleep pattern, but also the cognitive functions. Our study suggests that cognitive dysfunction is at least partial reversible in obstructive sleep apnea patients after positive airway pressure treatment.]

Clinical Neuroscience

[Tracing trace elements in mental functions]

JANKA Zoltán

[Trace elements are found in the living organism in small (trace) amounts and are mainly essential for living functions. Essential trace elements are in humans the chromium (Cr), cobalt (Co), copper (Cu), fluorine (F), iodine (I), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), and questionably the boron (B) and vanadium (V). According to the biopsychosocial concept, mental functions have biological underpinnings, therefore the impairment of certain neurochemical processes due to shortage of trace elements may have mental consequences. Scientific investigations indicate the putative role of trace element deficiency in psychiatric disorders such in depression (Zn, Cr, Se, Fe, Co, I), premenstrual dysphoria (Cr), schizophrenia (Zn, Se), cognitive deterioration/de­mentia (B, Zn, Fe, Mn, Co, V), mental retardation (I, Mo, Cu), binge-eating (Cr), autism (Zn, Mn, Cu, Co) and attention deficit hyperactivity disorder (Fe). At the same time, the excess quantity (chronic exposure, genetic error) of certain trace elements (Cu, Mn, Co, Cr, Fe, V) can also lead to mental disturbances (depression, anxiety, psychosis, cognitive dysfunction, insomnia). Lithium (Li), being efficacious in the treatment of bipolar mood disorder, is not declared officially as a trace element. Due to nutrition (drinking water, food) the serum Li level is about a thousand times less than that used in therapy. However, Li level in the red cells is lower as the membrane sodium-Li countertransport results in a Li efflux. Nevertheless, the possibility that Li is a trace element has emerged as studies indicate its potential efficacy in such a low concentration, since certain geographic regions show an inverse correlation between the Li level of drinking water and the suicide rate in that area. ]

Lege Artis Medicinae

[THE GENERAL PRACTITIONER’S ROLE IN THE MANAGEMENT OF ACUTE CORONARY SYNDROME]

SZABÓ János, BALOGH Sándor

[The recovery chances of patients with acute coronary syndrome are substantially affected by the time elapsed before the exact diagnosis is set up, by the standards of professional attendance on the spot, and by the speed of transportation to the most adequate medical institution that can offer the patient optimal definitive treatment. Thus, the responsibility of the physician who first sees the patient, often the general practitioner, is extremely high. In case of typical chest pain a 12-lead ECG should be made on the spot. If acute myocardial infarction is suspected, acetylsalicylic acid, short-acting sublingual nitrate, morphine, beta receptor blocker (if not contraindicated), and oxygen should be administered until the emergency ambulance arrives.]

Crisis in psychiatry