[Clinical memory traces on Professor Petho].

No abstract available.

[The phenomenological psychopathology of prodromal schizophrenia].

No abstract available.

[Problems of aggressive behaviour and its measurement in various age levels. Introduction of two questionnaires]. / Az agressziv magatartás és mérésének problémái eltéro életkorokban. Két kérdoív bemutatása.

Authors give a detailed overview on aspects of aggressive behaviour in childhood and adolescence especially on the basis of the literature of the last two decades, then. the measurement opportunities of aggression is discussed. The Children's Aggression Scale- parent version (Halperin et al 2002) rated by parents is presented and Hungarian validity data are published. In the second part of the publication, authors focus on the viewpoints of differences between aggressiveness of IQ deficit people and those of having normal intelligence, preliminary experiences are reported about the behavioural dimensions of intellectually disabled (ID) patients rated by the Behaviour Problem Inventory (BPI, Rojahn et al, 2001) suitable for measuring frequency and severity of behavioural qualities of both ID adolescents and adults.

Behaviour profile of Hungarian adolescent outpatients with a dual diagnosis.

The behaviour dimensions of 244 Hungarian adolescent psychiatric outpatients with a dual diagnosis (intellectual disability and psychiatric diagnosis) were examined by means of the adapted version of the Behaviour Problem Inventory (BPI, Rojahn, Matson, Lott, Esbensen, & Smalls, 2001). Four IQ subgroups were created: borderline, mild, moderate and profound ID subsamples. Significantly higher means were found in the self-injury/stereotyped behaviour/summarized scale categories both in the frequency and severity of symptoms in the more disabled groups against the samples having milder IQ impairment. Adolescents with a dual diagnosis showed much higher BPI scale means than an adult residential ID sample. ADHD and emotional disorders were the most frequent psychiatric diagnostic comorbidities of ID (20.67% and 11.73%). Academic achievement disorder, depression and psychosis had low occurrences (3.35, 2.23 and 1.17%, respectively) but showed convergency with other authors' data. The comorbid emotional disorders may create challenges for the care of the mildly intellectually disabled group.

Are there temperament differences between major depression and dysthymic disorder in adolescent clinical outpatients?

AIMS: The aim of the study was to explore possible differences in temperament and character dimensions between 2 monodiagnostic adolescent groups of depression, namely, one with a present episode of major depression and subjects with the other being their dysthymic peers. SAMPLE: From a multisite Western Hungarian sample of consecutively referred 14- to 18-year-old new psychiatric adolescent outpatients, 2 groups were compared: group I, n = 56 (9 males, 47 females), with major depressive disorder (MDD) and group II, n = 27 (6 males, 21 females), with a diagnosis of dysthymic disorder (DD). All other comorbid diagnoses including bipolar and double depression (MDD + DD) cases were excluded. Present suicide events, if the attempter had an underlying diagnosis of depression, were not causes for exclusion. Assessment methods used were the adapted Hungarian versions of the Mini International Neuropsychiatric Interview and the Junior Temperament (Cloninger) Character Inventory. RESULTS: The only difference between the major depressive and dysthymic adolescents was harm avoidance, adolescents with major depression having a higher level practice of harm avoidance, whereas the temperament type of MDD vs DD seems to differ only in the aspect of avoiding painful stress. Expectations regarding a worse degree of self-directedness and lower levels of persistence and cooperativeness in the MDD sample were not proved. CONCLUSIONS: No essential temperament differences were found between the 2 adolescent depressive groups. Scarce differences between temperament qualities of MDD and DD may support Akiskal's continuum theory of depressive disorders. More research and the use of closer clinical personality typologies are warranted to explore possible personality trait differences (if they exist) between clinical diagnostic groups of adolescent patients.

A study of behaviour profiles among intellectually disabled people in residential care in Hungary.

The authors investigated the behavioural dimensions of 269 intellectually disabled (ID) people in residential care in specialized institutions in Tolna county (South-West Hungary) with the aim of screening the frequency and severity of the relevant behavioural symptoms associated with intellectual disability and depending on the level of intellectual impairment. Only 120 residents had an International Classification of Disease (ICD) diagnosis of "mental retardation (MR)" and a valid IQ grading either by means of the Hungarian standard version of the HAWIK or by the coloured Raven test. 4 IQ groups were created: borderline (B), mild (MID), moderate (MOD) and profound (PID) intellectual disability subgroups. The Hungarian pilot version of the Behaviour Problem Inventory (BPI) was used. seventy-two percent of the residents displayed behavioural problems. All scale score means exhibited an enhancing tendency with IQ loss, as both frequency and Seventy increased linearly towards the more severe groups, but significantly only in the category of stereotyped behaviour. The authors focussed on problems of patient recruitment and discussed the measurement of behavioural and other psychiatric symptoms when researchers reported on the increased occurrence of behaviour and psychiatric symptoms in ID populations.

[A study of behaviour profile and psychiatric symptom dimensions among intellectually disabled people in residential care]. / Magatartásprofil és psichiátriai tünetdimenziók vizsgálata értelmi akadályozottsággal gondozott intézeti betegeken.

AIMS: Authors investigated the psychiatric symptoms and behaviour dimensions of people in residential care of institutions in Tolna county (South-West Hungary, Trans-Danubian region) aimed at screening the frequency of the relevant affective and behavioural symptoms associated with intellectual disability and their dependency on the level of intellectual impairment. METHODS: On the basis of HAWIK test, Hungarian standard version, 4 groups were created: subnormal, mild, moderate and profound MR subgroups. The Hungarian standard of Derogatis' Symptom Distress Checklist (SCL-90) and the validated Behaviour Problem Profile (BPI by Rojahn et al) were used. RESULTS: Towards the more profound categories, the self-injurious and stereotype behaviour are increasing, while the aggressive behaviour is most characteristic in the moderately intellectually disabled group.Concerning stereotype behaviour, both frequency and seriousness dominated in the more serious group. Although psychiatric symptoms decrease depending on the level of intellectual impairment, in 5 out of 9 dimensions, the mild intellecually impaired group has the leading role. These symptoms dimensions are: interpersonal difficulties, depression, phobic, paranoid and psychotic symptoms. CONCLUSION: Authors focus on the paramount psychiatric risks of mild intellectually disabled group (old term "debility") and emphasize the detection and treatment of the psychiatric problems.

A study of Hungarian adolescent outpatients suffering from self-injurious behaviour.

In this pilot study (Study A), the authors administered the Hungarian standard version of Beck Depression Inventory (BDI) and the translated version of the Ottawa Self Injury Inventory (OSI) to students of 3 educational facilities in a county town. Fourteen to eighteen year old pupils were tested in order to measure the key symptoms of depression and the frequency and characteristics of self-injurious behaviour among this sample of the high school population. Twentysix youngsters were found to have had any form of self-injurious actions in their life-time. The paper presents descriptive data on the basis of statistics of symptom occurence. Although the depressive symptoms have an expected correlation with the self-injurious ideas,depression seems not to have the same relationships with actual self-harm action. In study B, the authors present descriptive statistics on the data of 48 female outpatients from the total pool of 72 adolescents aged 14 through to-18 years (average age 16.1 years) showing symptoms of self-injurious behavior according to the Ottawa Self Injury Inventory (OSI). All patients were recruited from a one-year clinical,representative sample of the "Pannonia" multicentre adolescent psychiatry survey. Ten point two percent of consecutively referred and 25.6% of treated adolescent patients had symptoms of self-injurious behavior over a one-year period in 4 Transdanubian Child Psychiatric Centers, which is more frequent than the expected rate. Referring to the clinical diagnoses of adolescents confirmed by M.I.N.I. Plus Diagnostic Interview, the authors estimate, that the majority of these young people suffered from episode(s) of present or past major depression, from whatever form of anxiety disorder and/or from suicidal behaviour. The study presents details of risk behavior including motivations, frequency of acts, ideas, afflicted body regions, emotional correlates, secondary obtained benefits , escalation of problem behavior and consequences in detail.

Novelty seeking: difference between suicidal and non-suicidal Hungarian adolescent outpatients suffering from depression.

AIMS: The aim of the study was to explore possible differences in temperament and character dimensions between two focused clinical adolescent groups, namely suicidal (1) and non-suicidal (2) depressive adolescent outpatients. SAMPLE: From a multisite Western-Hungarian sample of consecutively referred 14-18 year old new psychiatric outpatients, two groups of adolescent outpatients were compared: Group I, n=39 (9 boys, 30 girls) "Suicidal-depressives" and Group II, n=51 (12 boys, 39 girls) "Non-suicidal depressives". Other diagnoses as major depression and/or dysthymia and suicidal behaviour were excluded including bipolar disorder, and the groups were matched by age, sex and family status. Assessment methods used were the Hungarian standard versions of the Mini International Neuropsychiatric Interview (M.I.N.I Plus), and the Junior Temperament (Cloninger) Character Inventory (JTCI). RESULTS: The only difference between the groups was that suicidal-depressive adolescents exhibited significantly higher novelty-seeking compared to "pure" depressive clinical peers. CONCLUSIONS: More research and the use of closer clinical personality typologies are warranted to explore the fine differences between these two clinical groups of depressive adolescent patients that are similar to each other in many aspects: suicidal and non-suicidal youngsters.

Profiles of suicidality and clusters of Hungarian adolescent outpatients suffering from suicidal behaviour.

BACKGROUND: The aim of the study was to reveal the background dimensions of suicidal behaviour (SB) and to identify clusters of Hungarian adolescent outpatients suffering from suicidality by means of the following correlates of SB: depression, inadequate conflict-solving methods, dysfunctional attitudes, maladaptive coping, help-seeking strategies and negative life events. SAMPLING AND METHODS: A self-report test battery was completed by every consecutive new adolescent outpatient from a representative patient pool of 5 local child psychiatric centres in Western Hungary over an 18-month period (n = 644). The questionnaires used were the pilot version of the Columbia Depression Scale, the Hungarian standard versions of the Beck Depression Inventory, the Ways of Coping Questionnaire, the Dysfunctional Attitude Scale and the Junior High Life Experiences Survey. A total of 110 adolescent outpatients (88 females, 22 males, mean age = 16.21 years, SD = 1.38) suffering from SB were included in the study. All diagnoses including SB were confirmed by the MINI Plus Mini International Neuropsychiatric Interview. K means clustering was used to compare variances of 19 variables to decide which ones are the major criteria for assigning subjects to clusters, and principal component analysis was utilized to identify background SB dimensions in the patient sample. RESULTS: The cluster analysis identified 3 homogenous clusters differentiating suicidal adolescents characteristically: 'stress-laden/medium depressive', 'low depressive/low achievement' and 'high depressive' cluster groups. While cluster analysis confirmed the role of the severity of depression only, principal component analysis explored the following 4 underlying profiles of SB: stress-laden, dysfunctional, maladaptive and depressive/risky factors. CONCLUSIONS: Although important coping qualities failed to register as major criteria in the development of separate groups of suicidal adolescent outpatients, distinct background profiles of SB among Hungarian adolescents were found covering the risk groups according to clinical experience. Future research is warranted to identify possible variation in the coping strategies among different adolescent suicidal samples.

["Risk factors for childhood depression"--research design, implementation, proceedings: history of 13 years: experience in grant preparation, writing, organization in connection with an American NIMH Grant]. / A gyermekkori depresszió rizikótényezio kutatás megtervezése, megvalósítása, lefolyása.

The authors summarize their experiences in research organization accumulated during 13 years. At first they outline preliminary studies which are prerequisites of high prestige international grants. Then they describe the huge administrative apparatus dedicated - besides skilled professionals - for the construction and organization of the research, the management, continuous checking and evaluation of data in such a multisite study. Finally, they report on the scientific results obtained after 13 years of hard work.

Clinical diagnoses, characteristics of risk behaviour, differences between suicidal and non-suicidal subgroups of Hungarian adolescent outpatients practising self-injury.

OBJECTIVE: Self-injury (SI), self-injurious behaviour (SIB), including suicidal or non-suicidal self-injury (SSI, NSSI) represent an increasing problem among teenagers amounting to a 6-17% prevalence rate in adolescence, yet little data exists on detailed characteristics and associated factors of SI reaching clinical severity. There is also a scarcity of data distinguishing between suicidal and non-suicidal subsamples of self-injuring patients, i.e. showing which predictors contribute to develop self-injurious behaviour with a previous suicidal history (SSI). METHOD: Clinical diagnoses and characteristics of risk behaviour were examined in a crosssectional design in suicidal and non-suicidal subgroups of Hungarian adolescent outpatients practising self-injurious behaviour. From the total pool of 708 new patients consecutively referred with various psychiatric problems in five regional child psychiatric centres in Western-Hungary over an 18-month period, 105 adolescent outpatients suffering from self-injurious behaviour participated in the study (28 males and 77 females aged from 14 to 18 years, mean age 15.97, SD 1.05). The Ottawa/Queen's self-injury questionnaire (OSI) was used to measure the characteristics of risk behaviour, while the comorbid clinical diagnoses were confirmed by the M.I.N.I. Plus International Neuropsychiatric Interview. Descriptive statistics presented the frequencies of the characteristics of SI, bilateral comparisons were used to reveal relevant items to differentiate between sex, duration of practice and SSI versus NSSI and logistic regression was performed to identify significant predictors of suicidal subtype of self-injuring practice. RESULTS: A total of 60% of the clinical SI population experienced a present or past episode of major depression. The motivation of patients to resist impulses and to discontinue malpractice was low. Cutting and scratching was the most common self-injuring methods. Two-thirds of the sample practised the impulsive type of SI, while 30% practised premeditated SI having an incubation time from 30 min to days and weeks before carrying out SI. Although duration of SI did not distinguish the sample in important aspects, girls and boys differed in several aspects of SI practice. SSI adolescents differed from their NSSI peers in a number of important characteristics including the frequency of actions, injured areas, methods, specific stresses and motivations. SSI adolescents were more likely to favour cutting of the lower leg and drug overdose as modes of SI. SSI adolescents were more likely to report addictive features than their peers with no suicidal motivation. From the aspect of self-injurious practice, logistic regression analysis found only two significant predictors for the combined pathology.

[A comparison of dysfunctional attitudes and coping strategies in Hungarian adolescents suffering from certain child psychiatric disorders]. / Diszfunkcionális attitudök és megküzdési stratégiák összehasonlítása serdülokorban az egyes pszichiátriai kórképekben.

INTRODUCTION: The evaluation of dysfunctional attitudes and coping mechanisms to identify specific characteristics of certain psychiatric diseases is an important research objective also in the field of child and adolescent psychiatry. METHOD: Authors compared dysfunctional attitudes and coping strategies of various monodiagnostic groups recruited from a sample of 158 adolescent outpatients (54 males, mean age 16.0 SD 1.16 and 104 females, mean age 15.9 SD 1.11) suffering from major depression (n=35), dysthymia (n=20), social phobia (n=11), generalized anxiety disorder (GAD n=12), conduct disorder (n=15) and adjustment disorder (n=65). The questionnaires and tests used in the study were the shortened standard Hungarian version a) of Dysfunctional Attitude Scale (DAS, Burns 1980) and b) of Ways of Coping Checklist (Folkmann et al 1986). Patients were collected from the 5-county, representative, cross-sectional pool of "Pannonia" Transdanubian Adolescent Psychiatric Survey. Diagnoses were confirmed by the M.I.N.I. International Neuropsychiatric Diagnostic Interview, Hungarian version, and patients with comorbid diagnoses were excluded from the study. RESULTS: Contrary to expectations, the patient samples differed from one another significantly only in a few test items, but all the differences that had been found were as expected between the internalizing (overcontrolled) and externalizing (undercontrolled) disorder domains. The MD group had a significantly higher score in achievement scale than those in the group of adjustment disorder (behavioural subtype). Dysthymic adolescents had a significantly higher level of support seeking than the patients suffering from conduct disorder. The variation seen in some parameters (autonomy and passive coping scales) of two samples of the internalizing disorder group and of externalizing one (behaviour disorder and adjustment disorder samples) was probably due to the differences among groups in the ratio of sex. CONSEQUENCES: Coping tests used in adult psychological studies are useful and confirm the occurrence of some typical mechanisms in adolescence too, but there exist strong need for more specific methods to identify adolescent coping qualities.

[Maladaptive strategies, dysfunctional attitudes and negative life events among adolescents treated for the diagnosis of "suicidal behaviour"]. / Maladaptív stratégiák, diszfunkcionális attitudök, megküzdés és negatív életesemények, "öngyilkos magatartás" diagnózissal kezelt serdülo betegeknél.

OBJECTIVE: To identify underlying factors and subgroups (depression and substance abuse, their school and behavioural consequences, suicide spectrum (ideas + attempts + attitudes), inadequate problem-solving methods, dysfunctional attitudes, maladaptive coping and help-seeking strategies and negative life events) for suicidality in Hungarian adolescent outpatients suffering from "suicidal behaviour". METHOD: A multidimensional self-report test battery - consisting of the Columbia Depression Scale (CDS), including the BDI and the Drug Use Screening Inventory /DUSI/, and of the Hungarian versions of the Ways of Coping questionnaire, of the Dysfunctional Attitude Scale, and of the Junior High Life Experience?? Survey - was completed by every new adolescent outpatient from a representative patient pool of five local Child Psychiatric Centres of the Western-Hungarian region over an 18-month period (n=596). 99 adolescent outpatients (78 females, 21 males, mean age 16.2 years, SD 1.18) with clinical diagnosis of suicidal behaviour confirmed by the Hungarian version of M.I.N.I. Plus Psychiatric Diagnostic Interview were included in the study. RESULTS: A four-factor solution of the principal component analysis was constructed to explore the underlying dimensions for suicidality labelled as follows: 1. Stress-laden/Risk-taking, 2. Depressed/Dysfunctional, 3. Addictive/Risk-taking and 4. Suicidal/Maladaptive factors. DISCUSSION: The robust and isolated representation of suicidal ideas+attempts associated with maladaptive coping strategies and with younger age confirms not only the specificity of coping qualities collected by CDS but also the risk position of younger adolescent generation in the most serious subgroups of suicidal population. Our study confirms the association of depression with dysfunctional attitudes and with maladaptive coping distinctly, but risky problem solving, maladaptive coping and dysfunctional attitudes seem to characterize different groups of depressive syndromes with only a moderate overlap. The demarcated factoring of the "Risky" conflict-solving technique of the Ways of Coping Questionnaire from the coping factor of the Columbia test proves that both presumably measure different dimensions of coping. Authors present and explain the PCA results in detail.

[Symptom specificity of adolescents with self-injurious behavior]. / Onsérto magatartású serdülok tüneti jellegzetességei.

As an introductory part of the paper, authors give a short overview of existing results in the literature related to self-injurious behaviour and adolescents' deliberate self-harm. In their own random sample study, authors organized a self-report screen (provincial town, 3 educational facilities, 470 pupils aged between 14 and 18 years) by means of the translated version of Ottawa Self Injury Inventory (OSI) used widely in community-based studies in Canada. The Beck Depression Inventory was introduced to measure the key symptoms of depression among youngsters. 26 youngsters were found to have had at least one self-injurious action in their life-time. The authors describe the characteristics of these subjects on the basis of symptom occurrence statistics. Although the depressive symptoms have an expected correlation with the self-injurious ideas, depression does not seem to have the same relationships with the actual self-harm action. The authors attempt to give an explanation of this contradiction.

Suicidal depressed vs. non-suicidal depressed adolescents: differences in recent psychopathology.

BACKGROUND: Few studies have focused on the differences between two depressed groups of patients in child psychiatry: the suicidal and the non-suicidal adolescent population. As in other countries, depression is one of the most prevalent diagnoses in adolescents in Hungary. AIMS: The present study was designed to determine (a) whether there are specific symptoms to differentiate between two clinical samples of depressed children: patients expressing suicidal behaviour and their peers with no suicide attempts, and (b) if there are significant differences between parents' and adolescents' reports of the same symptoms. METHODS: Using a recently developed semi-structured interview (Diagnostic Evaluation Schedule for Children and Adolescents-Hungarian version, ), 132 symptoms were assessed for two clinical groups of depressed adolescents: a suicidal group (N=54) [corrected], and a non-suicidal group (N=78) [corrected]. The suicidal group had all made an unsuccessful suicide attempt and/or had had frequent suicidal thoughts during the 6 months prior to the study. The non-suicidal group had neither attempted suicide, nor had had suicidal thoughts during the previous 6 months. All cases were selected from a larger sample of 490 consecutively referred new outpatient children over a 1 year period in five psychiatric facilities in Hungary. Only 13-17-year-old adolescents participated in the study. Both samples were identified using operationalised computer algorithm criteria of DSM-IV major depressive disorder episode (MDD) irrespective of the current clinical diagnosis of the patients. The Pearson Chi-square test with Monte Carlo correction was used to evaluate the differences between the suicidal and the non-suicidal depressed samples. RESULTS: Hopelessness, negative self-esteem and violent behaviour were the only significant discriminators between the two study groups according to the parent interviews, with increased problem scores in the suicidal sample compared to the non-suicidal sample. Suicidal depressed adolescents view themselves as more depressed and violent than do non-suicidal depressed individuals and were less anxious about their parents. CONCLUSIONS: The two depressed samples (suicidal vs. non-suicidal individuals) have only very few dissimilarities. There are, however, some essential differences between the parental and adolescent perceptions of the suicidal and depressive symptoms of the adolescent. The findings of the study underscore the necessity of collecting data from both the parent and the adolescent. LIMITATIONS: Cross-sectional, no lifetime psychopathology, referred samples, no blind estimation of the suicidal status of patients.