[Empty chairs - Dilemmas of artistic and emotional commintment].

Two paintings by the Dutch-born painter Vincent van Gogh of his own and his friend Paul Gauguin's chair in Arles have had a major impact on twentieth and twenty-first century art, in the visual and photographic arts, literature and film. The literature interpreting the paintings, particularly art history, art psychology and psychiatry, agrees that the two paintings, painted in a psychotic state, can be seen as a coping response to van Gogh's fear of death, a kind of mourning. There is, however, another interpretation of the paintings, which emerges when the two paintings are seen as a unified whole. In this case, the picture refers to the relationship between artistic and emotional commitment, and conveys the message that the painter's artistic mission does not tolerate a partner, and that he must sacrifice his private life for his art. This concept is in line with the basic idea of the poem "Choice" by the Nobel Prize-winning Irish poet Samuel Butler Yeats. In some examples from the history of art, such as Csontváry, Gulácsy and Cézanne, creative and private life are indeed mutually exclusive, but in others, such as Leonardo da Vinci, Bach, Woolf and Joyce, artistic and emotional commitment have proved compatible.

[Spontaneity and awareness in art In memory of Bertalan Petho].

The psychological characteristics of artistic activity emerge along the spontaneity-awareness dimension. Artistic development proceeds from spontaneous manifestations to conscious planning. At each step of this process, the effects of attractive and repulsive reference predecessors appear until the individual voice, style and creative inventions are formed. This development may be completed by the establishment of the artistic identity and conscious image creation. A certain group of artists - naive, autodidactic artists, psychiatric patients - stay in the state of spontaneity; or they get stuck halfway in the development, and thus their works of art have some self-healing nature as among the confessional poets. Regressive states (emerging due to effects of chemicals or old-age dementia etc.) might re-call spontaneity. The spontaneous manifestations of some artists might be overwritten by conscious image building. Based on the characteristic features of artistic socialization, the following categories of artists can be set up: experienceoriented, ability-oriented, child, citizen/scholar, and psychiatric patient artist types.

[Anna Karenina-effect, the impact of art].

No abstract available.

[The oeuvre, life history and illness of Sylvia Plath].

The roots of confessionalism reach back to the early Middle Ages and to the Confessions of Rousseau. Confessional literature gained a theoretical foundation in the age of Romanticism, then in the 20th century the genre underwent a revival and late modernisation in the works of the "confessional poets" (Lowell, Sexton, Plath etc.). The literary studies and psychobiographical examination of these authors threw light on the psychiatric aspects of confessionalism; most of them suffered from psychiatric or addictive disorders and committed suicide. Confessional poetry takes repetition of the (fragmented) psychological process of the individual life history as its almost sole theme. The poet builds up, demolishes, then again builds up his or her own life history, blurring the boundaries of reality and fiction. Interrupted personality development and the failure to work through traumatic experiences can be observed in the psychological background, to which Vladimir Nabokov also referred in his personal notes. In this collection of Psychiatria Hungarica about Sylvia Plath, titled The Broken-necked Deer the studies in three parts under the headings oeuvre, life history, illness are imbued with considerations of literary psychology and literary psychiatry that expand and enrich both literary studies and the psychiatric field of vision.

[The risk of imagination, or orgy of anger. Trying to reconstruct and understand the Sylvia Plath-phenomenon].

To clarify the relationship between literature and psychiatry we can call on the help of the American-English writer Sylvia Plath, who was given electroconvulsive therapy and psychotherapy on a number of occasions for psychiatric illness and later took her own life. This study seeks an answer to five questions. Did Sylvia Plath suffer from psychiatric illness? Did she show signs of the bipolar triad (bipolar affective disorder, trait aggression, substance or behavioural dependence)? Did her activity as a writer have a therapeutic effect? What was the nature of her "confessionalism"? To what extent does her oeuvre reflect her life? Sylvia Plath very probably suffered from a psychiatric illness, namely bipolar 2 affective disorder. The unsuitable treatment of her illness and the interruption of intensive psychotherapy could have contributed to her early death. Together with the bipolar affective disorder, she was also characterised by serious dispositional aggression and emotional dependence. For her, writing was both a source of stress, because her dysthymia intensified her inhibitions, and at the same time self-healing and a self-fulfilling prophecy. The roots of her confessionalism can be found in her personality development suspended in the stage of becoming an adult, and the failure to work through her traumas. Unlike Goethe and Salinger who killed their heroes, having them commit suicide in The Sorrows of Young Werther and A Perfect Day for Bananafish, while both writers recovered from their crisis, Sylvia Plath described a positive development in The Bell Jar and in Ariel, her verse cycle, then put her head in the gas oven. Would she have stayed alive if she had followed the patterns of Goethe and Salinger?

Schizophrenia with prominent catatonic features: A selective review.

A widely accepted consensus holds that a variety of motor symptoms subsumed under the term 'catatonia' have been an integral part of the symptomatology of schizophrenia since 1896, when Kraepelin proposed the concept of dementia praecox (schizophrenia). Until recently, psychiatric classifications included catatonic schizophrenia mainly through tradition, without compelling evidence of its validity as a schizophrenia subtype. This selective review briefly summarizes the history, psychopathology, demographic and epidemiological data, and treatment options for schizophrenia with prominent catatonic features. Although most catatonic signs and symptoms are easy to observe and measure, the lack of conceptual clarity of catatonia and consensus about the threshold and criteria for its diagnosis have hampered our understanding of how catatonia contributes to the pathophysiology of schizophrenic psychoses. Diverse study samples and methodologies have further hindered research on schizophrenia with prominent catatonic features. A focus on the motor aspects of broadly defined schizophrenia using modern methods of detecting and quantifying catatonic signs and symptoms coupled with sophisticated neuroimaging techniques offers a new approach to research in this long-overlooked field.

[Facilitating role of traumatic experiences in art]. / A traumatikus élmények facilitáló szerepe a muvészetben.

Traumatic experiences can not only have unfavourable consequences, they can also contribute, with a kind of creative twist, to the development of the person affected by the trauma. The artistic responses to traumas can be examined on the basis of the different types of trauma. This study reports on an investigation focusing on six types of trauma: emotional deprivation/neglect; near-death experience; becoming the victim of violence; war; accident/sickness and emotional frustration. Examples taken from the history of art indicate that works of art can draw attention to the traumatic experiences of the artists with frequently repeated motifs and portrayal techniques (sun, mother image, objects referring to the person lost, motifs of violence or symbols of violence, artistic manifestations of an exaggerated self-image, surreal visions, dry irony, substituting other objects for the beloved person), or a sudden change of style and subject that can express a heightened interest in human suffering (Lovis Corinth). An emphasis placed on self-portrayal can indicate the artist's increased self-examination, in cases of sickness, or continuous monitoring of the state of mind (Frida Kahlo, Otto Dix, Lovis Corinth, Edvard Munch). In some cases artistic activity can help to work through the trauma (Hans Bellmer, Oskar Kokoschka, Max Ernst, René Magritte), in other cases it is not able to prevent the development of psychological/psychiatric consequences of the trauma (Artemisia Gentileschi, Edvard Munch, Lajos Gulácsy). Traumas can be the sources of motivation and provide themes for works of art; and, although not in all cases, artistic creativity can contribute to effectively working through traumatic experiences. Orv Hetil. 2017; 158(17): 668-677.

[Associations between concurrent use of tobacco and alcohol and symptoms of attention-deficit hyperactivity disorder among ninth grader students]. / A dohányzás és az alkoholfogyasztás együttes elofordulásának összefüggései a figyelemhiányos hiperaktivitás-zavar tüneteivel kilencedik osztályos tanulók körében.

INTRODUCTION: Attention-deficit hyperactivity disorder is a risk factor of smoking and alcohol drinking in adolescence. Since attention-deficit hyperactivity disorder and smoking and alcohol drinking in adolescence are predictors for the development of substance use disorders in adulthood, it is important to understand the nature of these associations. AIM: The aim of the authors was to investigate associations between attention-deficit hyperactivity disorder symptoms and the joint use of alcohol and nicotine among 9th graders. METHOD: A representative sample of 944 pupils attending state-run secondary schools in Budapest were recruited. Generalized Linear Mixed Model and logistic regression analyses have been conducted. RESULTS: The prevalence was 29.6% and 41.4% for current smoking and current alcohol drinking, respectively. The prevalence of their concurrent-use was 21.7%. Alcohol drinking and smoking showed a significant positive association with the total scores of Attention-Deficit Hyperactivity Disorder Scale and with the Attention Deficit and Hyperactivity/Impulsivity subscales. CONCLUSIONS: The findings highlight the potential importance of attention-deficit hyperactivity disorder in the development of the joint use of these substances.

[Personal motif in art]. / Személyes motívum a müvészetben.

One of the basic questions of the art psychology is whether a personal motif is to be found behind works of art and if so, how openly or indirectly it appears in the work itself. Analysis of examples and documents from the fine arts and literature allow us to conclude that the personal motif that can be identified by the viewer through symbols, at times easily at others with more difficulty, gives an emotional plus to the artistic product. The personal motif may be found in traumatic experiences, in communication to the model or with other emotionally important persons (mourning, disappointment, revenge, hatred, rivalry, revolt etc.), in self-searching, or self-analysis. The emotions are expressed in artistic activity either directly or indirectly. The intention nourished by the artist's identity (Kunstwollen) may stand in the way of spontaneous self-expression, channelling it into hidden paths. Under the influence of certain circumstances, the artist may arouse in the viewer, consciously or unconsciously, an illusionary, misleading image of himself. An examination of the personal motif is one of the important research areas of art therapy.

[Trait-aggression and suicide of Vincent van Gogh]. / Vincent van Gogh vonás-agressziója és öngyilkossága.

Although in recent decades the literature has paid special attention to Vincent van Gogh's life, work and illness, there has still not been an examination of the connections between his trait aggression and his suicide. The present study traces, in the light of this trait aggression, the predictive factors that can be observed on the path leading to the artist's suicide. Biographical documents, case history data, as well as letters and the findings of earlier research have been used in the course of the analysis. Among the distal suicide risk factors we find a positive family anamnesis, childhood traumas (emotional deprivation, identity problems associated with the name Vincent), a vagrant, homeless way of life, failures in relationships with women, and psychotic episodes appearing in rushes. The proximal factors include the tragic friendship with Gauguin (frustrated love), his brother Theo's marriage (experienced as a loss), and a tendency to self-destruction. Both factor groups on the one hand determined the course of development of the trait aggression and on the other can also be regarded as a manifestation of that trait aggression. It can be said that the trait aggression played an important role in Van Gogh's suicide.

[Trait-aggression and conscious poetic attitude in the background of Attila József's suicide]. / A vonás-agresszió és a költoi tudatosság szerepe József Attila öngyilkosságában.

Although recently many studies have indicated close connection between aggressive behaviour and suicide, and we can infer at Attila Jozsef's high trait-aggression from several cases, there is no research so far that would analyse the topic of the poet's aggression. We examine in this study the high trait-aggression and conscious poetic attitude of Attila Jozsef and put the question how could those two contribute to his suicide. Recollections of Attila Jozsef's contemporaries reveal that the poet's life was accompanied along with auto- and heteroaggression. By analysing his Rorschach-test, we can also conclude on the weakness of his aggression-control. During his psychoanalytic treatment from 1931 on, some difficult memories and unacceptable desires became revoked, and his aggressive outbreaks became unmanageable, first of all against some females in his life. His free-association works from this period are full of rude, incestuous, aggressive expressions. In spite of these, there is no trace of aggression in his poems - he masks his aggression in them by keeping precisely to formal criteria. We suppose that behind the masking there are unconscious processes, such as a very strong desire to get attached and fear of solitude that led to his aspiration to consciously form "the myth of the good poet". Art's healing power could not prevail as the spontaneous creative process has been turned into a conscious one. His impulses that came to light in the analytic process and were only partly sublime may have returned thus and became urgent and pressing again. We suppose that his high trait-aggression and his conscious poetic attitude together contributed to his life's tragic ending.

The description of the litigious querulant: Heinrich von Kleist's Novella Michael Kohlhaas.

OBJECTIVE: To illustrate the use of fiction in understanding psychiatric disorders and refocus attention towards fiction as a valuable source of psychopathology, thereby contributing to the restoration of the narrative in psychiatry. METHOD: A psychopathological analysis of the novella Michael Kohlhaas written by Heinrich von Kleist, one of the outstanding literary figures of the German romantic movement of the early 19th century. RESULTS: The protagonist of Kleist's novella, Michael Kohlhaas, a querulant horse trader, carries out an armed uprising disproportionate to the minor injustice of the unlawful seizure of his horses. Following unsuccessful attempts at legal recourse, Kohlhaas takes up arms against the authorities, and in the course of his uncompromising pursuit of justice eventually sacrifices his own and his family's lives. Kleist accurately portrays Kohlhaas' psychopathological development from a psychologically balanced, emotionally warm family man to one who causes utter destruction, mayhem and the loss of innocent lives. This literary work is a remarkably authentic, insightful and rich representation of litigious/querulant behaviour, described by classical authors as litigious paranoia, a diagnostic category currently subsumed under 'delusional disorder, persecutory type', in DSM-5 and 'persistent delusional disorder' in ICD-10. CONCLUSIONS: Kleist's novella offers important clues to better understand the development of litigious-querulant behaviour and the inner world of its sufferers. An analysis of the novella also illustrates the contribution that fiction could make to resuscitate the narrative as a complement to criterion-based diagnostic practice prevailing in contemporary psychiatry. © 2014 S. Karger AG, Basel.

Psychometric characteristics of the Drug Use Disorders Identification Test (DUDIT) and the Drug Use Disorders Identification Test-Extended (DUDIT-E) among young drug users in Hungary.

BACKGROUND: The Drug Use Disorders Identification Test (DUDIT) was developed for problematic substance use screening, and for a more detailed assessment of problematic use, the Drug Use Disorders Identification Test-Extended (DUDIT-E) was additionally developed. PURPOSE: Examining the psychometric properties of DUDIT and DUIT-E across diverse settings in populations of young drug users. METHODS: We examined the psychometric characteristics of these instruments across various settings in populations of young substance users differing in substance use severity and treatment status. Data were collected from three clinically relevant groups (n = 259) as well as a control sample of college students (n = 109). RESULTS: Reliability analyses indicated good internal consistency for both instruments; high intraclass correlations further indicated good test-retest reliability. Differences among study groups were significant on the DUDIT scale and all DUDIT-E subscales (p < 0.01), with the target groups exhibiting higher scores compared to controls. A two-factor solution was identified for the factor structure of DUDIT. CONCLUSION: The Hungarian version of DUDIT and DUDIT-E can effectively identify substance use problems among young users.

[Teenage and adult pregnancy: different correlations between socio-economic status and smoking]. / A dohányzás és az anyagi helyzet összefüggése serdülokori és felnottkori terhesség esetén.

INTRODUCTION: Smoking occurs frequently during pregnancy, thereby putting mother and child at health risks. Low socio-economic status is a risk factor for smoking. AIM: To investigate the relationship between smoking and low income in teenage and adult pregnancy, which is an important measure of poor socioeconomic status. METHOD: The authors used subject-level data from the US NSDUH database, which contains information on pregnancies and smoking. RESULTS: Teenage pregnancy is associated with higher, whereas adult pregnancy with lower prevalence of smoking, compared to the age-matched female population. The association between income and smoking is age-dependent. Among adults there is an inverse relationship (high income -- low-risk of smoking), while in teenage pregnancy smoking increases with income. CONCLUSIONS: To investigate in teenage and adult pregnancy the relationship between smoking and low income, which is an important measure of poor socio-economic status. Higher socioeconomic status may be associated with risky behaviour, thereby increasing both the risk of smoking and early pregnancy.

[The psychiatric aspects of animal assisted therapy]. / Az állatok által asszisztált terápiák pszichiátriai vonatkozásai.

Animal assisted therapy is a known preventive and interventive method which is held by the contribution of specially trained animals and professionals. One of its main indication fields is psychiatry. The purpose of this summary is to give an overview on the animal assisted therapy's background, possible uses and effectiveness with literature. It looks for the answer if this therapeutic method can be used for effectively easing the symptoms of specific psychiatric diseases and on which fields can it be used most effectively. Due to the data provided by literature it can be determined that the therapy supported by animals is able to give an effective help on the fields of various psychiatric supports, preventions, interventions and rehabilitations regardless of the age. It is mostly used in the case of depression, anxiety, addiction, schizophrenia and autism spectrum disorder. Aside from these it could also be used effectively in the rehabilitation of victims of sexual abuse especially in the case of children. It can also play a role in the re-socialization of inadapted adolescences and adults, even with farmtherapy. Due to experiences the therapies supported by animals are effective on the following fields: improving social and communication skills, easing anxiety, improving mood, helping independent living, improving emphatic skills.

Trait aggression, depression and suicidal behavior in drug dependent patients with and without ADHD symptoms.

The objective of this study was to investigate trait-aggression, depression and suicidal behavior of drug dependent patients with and without ADHD symptoms. The cross sectional survey was conducted in outpatient drug centers in Hungary. The Adult Self-Report Scale (ASRS), the Buss-Perry Aggression Questionnaire (AQ), the European Version of the ADolescent Assessment Dialogue (EuroADAD), and the Beck Depression Inventory (BDI) were used for measures. GLM analyses, adjusting for age and gender, indicated that patients who screened positive for ADHD (ADHD+ group) had significantly higher severity of overall trait aggression, as well as physical and verbal aggression than patients who did not (ADHD negative group). The highest severity of aggression was observed when the ADHD+ status co-occurred with heroin use, while the lowest severity of aggression was detected when ADHD- status co-occurred with the use of marijuana. ADHD+ patients showed a marked increase in depression symptoms, suicidal ideation, suicidal attempts as well as self-injuries associated with suicidal attempts. Considering the substantial costs of aggression and suicide from a societal perspective and from the point of view of the individual sufferer, our results highlight the importance of the diagnostic investigation of ADHD in the treatment of drug dependent patients.

[Empirical data regarding the relationship between religiosity and substance abuse]. / Empirikus adatok a vallasossag es droghasznalat kapcsolatanak kerdeskorehez.

Research concerning the topic of possible association of religiosity and substance use has already brought forth a significant amount of data, identifying strong belief in a religion as a protective factor in most cases. However, as in all other subject areas dealing with correlations between religion and health components, the issue of religiosity and substance (ab)use also produced some conflicting findings, hindering the formulation of a clear and stable consensus interpretation of this relationship. The aim of our examination was to provide empirical data for clarifying uncertainties about the possible effects of religiosity on substance use by examining a sample which is remarkable in Hungary: 1337 clinically diagnosed drug abuser patients and 205 normal controls. Based on our results we suggest some changes on the general approach of the effect of religiosity on substance use.