The timeliness of Telepsychiatry.

Both worldwide and in Hungary, telemedicine and telepsychiatric guidelines and legal regulations have come into force in connection with the outbreak of the COVID-19 epidemic, which are aimed at both the current situation and the future. Due to the need for social distance and isolation during the epidemic, there was a need for the use of telemedicinal solutions in psychiatric care as well. This consisted primarily of telephone and videophone visits from the home of psychiatric patients. By now, we seem to be facing protracted waves of epidemics, which could also mean a prolongation of the quarantine state, so changes in psychiatric patient care are even more necessary and will be expected, so telemedicine/telepsychiatry is expected to gain even more ground. The rapid development and introduction of the practical application of telepsychiatric applications, which appeared many years ago (mainly in the United States), can be expected. In the United States, for example, the frequency of telepsychiatric visits is predicted to be 47% for the near future, and the American Psychiatric Association is constantly publishing new and newer guidelines for telepsychiatry related to the COVID-19 epidemic. The recommendation of the Psychiatry and Psychotherapy section of the Professional Health College of EMMI in connection with the COVID-19 care system has also been published in Hungary. According to the latter, the use of telepsychiatry and e-prescription was also recommended, which is also included in the rules of procedure issued by the Child Psychiatry Section. (Neuropsychopharmacol Hung 2021; 23(2): 266-271).

[The first lockdown due to COVID-19 pandemic from the psychiatric patients' perspective: an ambulatory care client experience survey]. / A COVID-19 járvány miatt elrendelt elso veszélyhelyzet a pszichiátriai betegek szemszögébol: gondozói felmérés.

INTRODUCTION: The coronavirus pandemic (COVID-19) required the declaration of a state of emergency in Hungary from 11 March 2020 to 18 June 2020. These governmental actions led to changes in everyday life, implementation of new rules, and reduced access to healthcare. Hospital beds were reserved for emergency use, face-to-face ambulatory care was mainly replaced by telemedicine. In our study we assessed opinion of the patients in two outpatient psychiatric care units in Budapest regarding the state of emergency. METHODS: We enrolled 438 patients in the survey (305 women and 133 men, mean age: 51.9±16.2 years). The patients completed a short questionnaire on a voluntary and anonymous basis following verbal informed consent. The questionnaire was comprised of 10 items and a 12-item "Problem Evaluation Scale" (fear, isolation and healthcare subscales). The comparison of groups was done using general linear models (GLM), pairwise comparison was performed using Tukey's test for post hoc analysis. The data set was analyzed with SPSS software, version 24.0. RESULTS: Up to 34% of enrolled patients believed that their condition worsened during the state of emergency, but 12% of these patients thought that this worsening was not related to the state of emergency. Twice as many patients (12.8%) were concerned about their financial situation than about their health status (6.1%). Loneliness and the implementation of specific regulations didn't cause relevant distress in almost half of the patients, isolation was the most frequently (55.2%) reported difficulty. The worsening of health status was reported more frequently (p=0.001) by the patients younger than 50 years, the sensation of fear was stronger (p=0.045), and they reported more serious adaptation difficulties (p=0.003) than subjects older than 50 years. Isolation caused significantly (p=0.003) more serious distress among women. The abundance of pandemic-related information caused more distress in the case of patients treated for anxiety than participants treated for psychotic disorders (p=0.024). Patients suffering from affective disorders perceived more pronounced feelings of vulnerability compared to patients treated for psychotic disorders (p=0.004). CONCLUSION: Approximately half of the enrolled psychiatric patients was able to adapt to this situation without major difficulties, the other half of this sample was more or less distressed by these circumstances. Unfortunately, depletion of emotional, psychological, social and material resources can be expected during the next stage of the pandemic. As a result, we can expect further worsening of the above presented aspects.

[Psychopharmacological aspects of nutrition]. / A táplálkozás pszichofarmakológiai vonatkozásai.

Nowadays the role of nutrition is increasingly appreciated in the development of the various mental disorders as well as in employing effi cacious therapies. Realizing this development and following international professional examples we have established the Hungarian Psychiatric Association's Nutritional Science Section in 2018. Our present paper reports on the connection between mental disorders and nutrition, reviewing the relevant literature from two directions. On the one hand, insuffi cient consumption of essential micronutrients, trace elements, (pro) vitamins cause defi ciencies leading to disrupted production and function of essential enzymes and neurotransmitters and consequentially to emergence of psychopathological symptoms as well as impeding the development of eff ect of adequately administered psychopharmacons and the effi ciency and success of pharmacotherapy. On the other hand, our paper also reviews potentially dangerous pharmacokinetic and pharmacodynamic interactions of nutraceuticals and dietary supplements used for health prevention purposes in parallel to pharmacotherapies which may infl uence or decrease eff ectiveness of medications.