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Lege Artis Medicinae

APRIL 18, 2020

[The relationship of traumatic experiences and eating disorders – therapeutical options]

KOVÁCS-TÓTH Beáta, TÚRY Ferenc

[In the etiology of eating disorders (espe­cially bulimia nervosa and binge eating) traumatic experiences (sexual, physical, emo­tional abuse, neglect) play an important role. Traumatization can have a serious impact, which is influenced by the parameters of the traumatization, risk and protective factors, and the resiliency of the traumatized patient. The consequences may lead to the development of specific psychiatric and somatic disorders, and may cause lifetime revictimization. The exploration of data related to the traumatization is essential in eating disorders as well. If traumatic expericences can be detected in the back­ground of eating disorders, the targeted therapy of eating disorders while applying its specific elements should also follow the guide­lines of the general trauma-therapy. Providing safety in therapeutical relation­ship is fundamental. The therapeutic options are extensive. Along with psychodynamically oriented therapies, the newer methods based on cognitive-behavioral therapy (e.g., dialectic behavior therapy, integrative cognitive analytic therapy) are also proposed. Hyp­no­therapy can also be useful. ]

Clinical Neuroscience

MARCH 30, 2016

[Hungarian adaptation of a short eating disorder questionnaire (SCOFF)]

DUKAY-SZABÓ Szilvia, SIMON Dávid, VARGA Márta, SZABÓ Pál, TÚRY Ferenc, RATHNER Günther

[Aim - Eating disorders are becoming an increasingly relevant health issue, therefore the fast and accurate screening of people at risk is of great practical importance. The aim of SCOFF questionnaire is to assess this risk and the extent to which a person is affected, by using five simple yes or no questions. The objective of our study was to assess the validity of the Hungarian version of the test Methods - 777 medical students (210 men, 567 women, mean age 22.3±2.33 years) participated in the survey. The online questionnaire contained anthropometric data, the Eating Behaviour Severity Scale and, beside the SCOFF, the Eating Disorder Inventory (EDI). Results - The SCOFF is excellent at screening clinical eating disorders. Its sensitivity was 100% and specificity 85.1%. It is less efficient at detecting subclinical cases, but it does not show worse results than EDI. According to the data SCOFF is better at identifying more serious cases. Applying on the same sample SCOFF had higher sensitivity and lower specificity than EDI. Discussion - SCOFF is suitable for primary screening of eating disorders with a non-diagnostic purpose, taken two “yes” answers out of five as the critical margin, specified by the authors.]

Clinical Neuroscience

NOVEMBER 20, 2015

[Attachment as a predictor of risk for eating disorders on a representative hungarian adult sample]

SZALAI Dömötör Tamás, CZEGLÉDI Edit

[Background and purpose – Many studies confirm the relationship between attachment disturbances and (the severity of) eating disorders, however among them only one Hungarian study can be found. The exact predisposing traits of attachment and the strength of relationship is still uncleared. Our aim was to explore these aspects. Methods – Study was based on a cross-sectional nationally representative survey, called „Hungarostudy 2013” (N=2000, 46.9% males, mean age 46.9 years, SD=18.24 years). Measures: Sociodemographic and self-reported anthropometric data (weight and height), short Hungarian version of Relationship Scale Questionnaire, SCOFF questionnaire and short Hungarian version of Beck Depression Inventory. Results – The frequency of risk for eating disorders (anorexia or bulimia nervosa) was 3.9% (N=76) among the respondents (N=1860). Attachment anxiety was significantly higher in the risk for eating disorders group (t(1888)=-3.939, p<0.001), and significantly predicted the risk for eating disorders after adjusting for the potential background variables (OR=1.09, p=0.040). Detachment was not a significant predictor of risk for eating disorders (OR=0.98, p=0.515). Younger age (OR=0.97, p<0.001), higher level of depression (OR=1.09, p<0.001) and higher body mass index (OR=1.08, p<0.001) were also significant cross-sectional predictors of risk for eating disorders. The explained variance of the model was 10.7%. Conclusion – The study supported, that higher attachment anxiety is associated with the increased risk of eating disorders, with a possible therapeutic relevance. Assessment of attachment’s further aspects and creating multivariable models are required for more thorough understanding and optimising of intervention points.]

Clinical Oncology

DECEMBER 10, 2018

[Medical use of marihuana especially in oncology]

VÉGH Éva

[The medical use of marijuana has gained a considerable attention among wide range of cancer patients lately in Hungary. Consequently, oncologist sare facing questions related to cannabinoids more and more in their clinical practice. This article aims to clarify some basic concepts and to give a brief introduction on the current international and national legislation on their accessibility. Numerous publications have dealt with the application of marijuana in various indications. Among the tumour related indications, the concerned studies mainly refer to chemotherapy induced nausea and vomiting, chronic pain, sleep disorders, anorexia and cachexia. The article also to uches upon on knowledge connected to the causal treatment of malignant tumours, which are currently limited to glioblastoma. Information on the carcinogenic potential of cannabis and information on the popularity and attitudes of American oncologists can be found in this article. This paper gives a literature review in the above mentioned themes.]

Lege Artis Medicinae

JULY 20, 2019

[Gynecological correlations of eating disorders]

GALIGER-DOBOS Kitty, TÚRY Ferenc

[In recent decades, the incidence of eating disorders (its two major forms are anorexia nervosa and bulimia nervosa) has increased, their course has been delayed, and their complications are becoming more frequent and severe. Eating disorders cannot only damage physical and mental health but also affect reproductive health, future mothers and their children. Understanding the biological and psychosocial factors that explain the gynecological conditions related to eating disorders is essential regarding fertility and pregnancy. The present review summarizes data published from 2000 about the gynecological effects of eating disorders. In daily practice, the multidisciplinary collaboration is particularly important to pro­vide women with eating disorders with comprehensive care. The appropriate information of women who plan to have children is essential in order to increase the likelihood of conception and reduce the risk of miscarriage. ]

Lege Artis Medicinae

SEPTEMBER 20, 2018

[The liaison between internal medicine and psychiatry can be life-saving in the treatment of severe anorexia nervosa]

SZÉNYEI Gábor, BENE László, TÚRY Ferenc

[INTRODUCTION - In the severe forms of anorexia nervosa hospitalization may be required, and the somatic treatment is provided in a department of internal medicine. In such cases, collaboration between internist and psychiatrist is essential. Psycho­logical support is necessary even in the period of nutritional rehabilitation. This can be applied in the framework of consultation-liaison psychiatry. After the initial weight gain providing psychotherapy in an outpatient setting is fundamental. In the case of anorexic patients who maintain a close relationship with the family, family therapy is the most effective treatment. CASE REPORT - A 26-year old female patient with anorexia was hospitalized in a department of internal medicine after an extreme emaciation, her body mass index was 11.6. During this period there was a psychiatric consultation involving the fa-ther of the patient as well. Her body weight increased, and outpatient family therapy was initiated. Fifteen family sessions were conducted in nine months, with special focus on the separation-individuation process. At the end of the therapy a full remission could be observed, with a normal body weight, and her periods returned. After a four-month follow-up her state was stable, and she got married. CONCLUSION - Interdisciplinary collaboration can be cardinal when somatic and psychological disorders are interwoven. The role of family therapy is crucial in those cases where emotional separation from the family of origin is difficult, even if the patient does not live with the parents any longer. ]

Lege Artis Medicinae

MAY 02, 2018

[The role of fathers in the family therapy of eating disorders, with special regard to mosaic families]

TÚRY Ferenc, SZENTES Annamária

[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.]

Clinical Neuroscience

SEPTEMBER 30, 2016

[Eating disorders and pregnancy - a review of literature]

DUKAY-SZABÓ Szilvia, VARGA Márta, TÚRY Ferenc

[Eating disorders are psychosomatic disorders affecting primarily women, and influence reproductive functions as well. They have an impact on ovarial cyclem fertility, course of pregnancy, process of delivery, post partum period. Moreover, some data show that they can influence the adult health status. Extensive research from the last three decades call the attention to the fact that besides the classical eating disorders (anorexia nervosa and bulimia nervosa) the newer types (e.g., orthorexia nervosa), and subclinical disorders also occur in a subgroup of pregnant women. For this reason it is of key importance that the personnel working in the territory of obstetrics and gynecology have a solid knowledge about the symptoms, screening and therapeutical opportunities, and outcome of these disorders. The review summarizes the recent research data about the relationship of eating disorders and pregnancy.]

Lege Artis Medicinae

MARCH 20, 2016

[The value of the SCOFF questionnaire in the screening of eating disorders]

DUKAY-SZABÓ Szilvia, VARGA Márta, TÚRY Ferenc

[Having become an increasingly relevant health issue from the second half of the 20th century, eating disorders have presented the need for screening, carried out in the simplest possible way, by a short questionnaire. Morgan and his colleagues identified this necessity and in 1999 created the SCOFF test to screen eating disorders with five yes or no questions. The questionnaire promptly became popular due to its briefness and easy adaptability. It was translated into several languages, its validity was measured on numerous populations. According to the results SCOFF is suitable for primary screening of eating disorders with a non-diagnostic purpose, taken two “yes” answers out of five as the critical margin, specified by the authors. Our objective was to give a review of the history of the SCOFF questionnaire.]

Clinical Oncology

MAY 10, 2015

[Nutritional support in cancer anorexia-cachexia syndrome]

HARISI Revekka

[Cancer anorexia-cachexia syndrome (CACS) defi ned by ongoing loss of skeletal muscle mass, with or without loss of fat mass. In contrast to serious non tumorous cachexia it can not be reversed by conventional nutritional support. CACS affects most of cancer patients and has negative impact on physical function, anticancer treatment response, quality of life and survival. It is known that interactions between tumor and reactive host cells are responsible for tumor progression, metastasis formation and chronic infl ammation, as well. All of the processes are induced by cytokines. The CACS associated changes in carbohydrate, protein and lipid metabolism are caused by the elevated level of infl ammatory cytokines. The new anti-CACS drug development aimed at normalizing of the pathologic pathways. Up to now, megestrol-acetate (MA) administration seems to be the most effective drug in CACS treatment. MA has dual effect, stimulates the NPY activation and inhibits the synthesis and expression of infl ammatory cytokines. Its clinical effects are on line with the aboves, improves appetite, calorie intake and increases body weight. There is paradigm shift in CACS treatment, the traditional nutritional support is replaced by combination of pharmaceutical interventions, nutritional support and use of dietary supplements.]