The effect of animal-assisted interventions on the course of neurological diseases: a systematic review.

BACKGROUND: In our experience, working with a therapy animal strengthens endurance, maintains motivation, provides a sense of achievement, and boosts overall mental resilience. The aims of this work were to summarize the results of quantitative research on the possibilities of animal-assisted intervention (AAI) among people with neurodegenerative and cerebrovascular diseases and to attempt to assess the effects of animal-assisted interventions in an objective manner and to find supporting evidence based on published literature. METHODS: Our target groups are people diagnosed with Parkinson's disease, multiple sclerosis, or stroke. A systematic search of relevant articles was conducted by two independent researchers in April 2021 and August 2023. The search for studies was conducted using PubMed, Google Scholar, Web of Science, Scopus, and Ovid databases, specifying keywords and search criteria. The qualitative evaluation of the research reports was conducted by four independent researchers, using the Newcastle-Ottawa Quality Assessment Form. RESULTS: According to the scientific criteria and based on the Newcastle-Ottawa Quality Assessment Form, thirteen publications met the search criteria, out of which 9 publications were rated good and 4 publications were rated poor. Evaluating the publications we found evidence that AAI had a measurable impact on participants, as their physical and mental health status significantly improved; however, mental health improvement was more prominent. CONCLUSIONS: By developing evidence-based research methodology and standardized research settings, AAI could be measured effectively as part of health care practice. This would bring significant benefits to the rehabilitation of patients in need. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021255776.

[Reflection about the practice of spirituality and whether this will change psychotherapy].

No abstract available.

A qualitative study of culturally embedded factors in complementary and alternative medicine use.

BACKGROUND: Within the intercultural milieu of medical pluralism, a nexus of worldviews espousing distinct explanatory models of illness, our research aims at exploring factors leading to complementary and alternative medicine (CAM) use with special attention to their cultural context. METHODS: The results are based on medical anthropological fieldwork (participant observation and in-depth interviews) spanning a period from January 2015 to May 2017 at four clinics of Traditional Chinese Medicine in Budapest, Hungary. Participant observation involved 105 patients (males N = 42); in-depth interviews were conducted with patients (N = 9) and practitioners (N = 9). The interviews were coded with Interpretative Phenomenological Analysis; all information was aggregated employing Atlas.ti software. RESULTS: In order to avoid the dichotomization of "push and pull factors," results obtained from the fieldwork and interviews were structured along milestones of the patient journey. These points of reference include orientation among sources of information, biomedical diagnosis, patient expectations and the physician-patient relationship, the biomedical treatment trajectory and reasons for non-adherence, philosophical congruence, and alternate routes of entry into the world of CAM. All discussed points which are a departure from the strictly western therapy, entail an underlying socio-cultural disposition and must be scrutinized in this context. CONCLUSIONS: The influence of one's culturally determined explanatory model is ubiquitous from the onset of the patient journey and exhibits a reciprocal relationship with subjective experience. Firsthand experience (or that of the Other) signifies the most reliable source of information in matters of illness and choice of therapy. Furthermore, the theme of (building and losing) trust is present throughout the patient journey, a determining factor in patient decision-making and dispositions toward both CAM and biomedicine.

[Factors determining the selection of treatment options of complementary and alternative medicine]. / A komplementer és alternatív medicina felé orientálódó terápiaválasztást meghatározó tényezok.

INTRODUCTION: Complementary and alternative medicine have undoubtedly been gaining ground on the healthcare market, thus the vital question arises why patients choose these treatments, oftentimes at the cost of discontinuing the Western medical therapy. AIM: The aim of the authors was to investigate and scrutinize factors leading to the utilization of various alternative medical services. METHOD: The basis of this qualitative research was medical anthropological fieldwork conducted at a clinic of Traditional Chinese Medicine including participant observation (355 hours), unstructured interviews with patients (n = 93) and in-depth interviews (n = 14). RESULTS: Patients of alternative medical systems often do not receive a diagnosis, explanation or cure for their illness from Western medicine, or they do not agree with what they are offered. In other instances, patients choose alternative medicine because it exhibits a philosophical congruence with their already existing explanatory model, that is, previous concepts of world, man or illness. CONCLUSIONS: A particular therapy is always part of a cultural system and it is embedded in a specific psycho-social context, hence choice of therapy must be interpreted in accordance with this perspective.

[Mood, mood fluctuations and depression: role of the circadian rhythms]. / Hangulat, hangulatingadozások és depresszió: a cirkadián ritmusok szerepe.

The statement that circadian rhythmicity is an important component of mood regulation as well as a drive of mood disorders is supported by a growing body of evidence. Diurnal rhythms of the positive and negative components of mood as well as of the level of arousal depend on the circadian phase, the homeostatic sleep regulatory mechanisms and the harmonic interaction of the circadian and homeostatic processes. The chronopathological symptoms which are typical in depression and explain the blunted mood of depressive patients are of the phase-advance and phase-delay type characterized by a misalignment between the circadian rhythms and the sleep-wake schedules, best described by the phase-angle alterations. The abnormal phase angle between circadian rhythms and the timing of the sleep period could emerge from an interaction of the chronotypes and other constitutional factors with adverse environmental effects (inadequate zeitgebers) leading to a disharmony between the diurnal components of mood regulation and consequent extreme mood states. The aim of the chronotherapies of depression and of other affective disorders is that of resynchronizing the circadian rhythms or in other words to reconstitute the harmony between these subsystems. Pharmacological approaches, lifestyle changes and specific chronotherapeutic interventions might help to achieve this goal.

[Association of obesity and depression]. / Az elhízás és a depresszió kapcsolatai.

It has been long known that the frequency of overweight and obese people is higher among depressed and bipolar patients than in the general population. The marked alteration of body weight (and appetite) is one of the most frequent of the 9 symptoms of major depressive episode, and these symptoms occur during recurrent episodes of depression with a remarkably high consequence. According to studies with representative adult population samples, in case of obesity (BMI over 30) unipolar or bipolar depression is significantly more frequently (20-45%) observable. Since in case of depressed patients appetite and body weight reduction is observable during the acute phase, the more frequent obesity in case of depressed patients is related (primarily) not only to depressive episodes, but rather to lifestyle factors, to diabetes mellitus also more frequently occurring in depressed patients, to comorbid bulimia, and probably to genetic-biological factors (as well as to pharmacotherapy in case of medicated patients). At the same time, according to certain studies, circadian symptoms of depression give rise to such metabolic processes in the body which eventually lead to obesity and insulin resistance. According to studies in unipolar and bipolar patients, 57-68% of patients is overweight or obese, and the rate of metabolic syndrome was found to be between 25-49% in bipolar patients. The rate of metabolic syndrome is further increased by pharmacotherapy. Low total and HDL cholesterol level increases the risk for depression and suicide and recent studies suggest that omega-3-fatty acids possess antidepressive efficacy. Certain lifestyle factors relevant to healthy metabolism (calorie reduction in food intake, regular exercise) may be protective factors related to depression as well. The depression- and possibly suicide-provoking effect of sibutramine and rimonabant used in the pharmacotherapy of obesity is one of the greatest recent challenges for professionals and patients alike.