[Antidepressants sometimes lead to rapid remission in the treatment of anorexia nervosa]. / Az antidepresszívumok az anorexia nervosa kezelésében néha gyors remisszióhoz vezetnek.

In the treatment of anorexia nervosa the dominant role of psychotherapies is proposed, while pharmacotherapy has a limited effi cacy. Because of the broad comorbidity spectrum of the disorder, other psychiatric disorders are often present. Among them depression is frequent, so one of the selective theories of eating disorders stresses the importance of the relationship with depression. In everyday practice we frequently encounter anorexic patients whose depressive symptoms are mild or moderate, and these are often regarded as usual accompanying phenomena of anorexia. The three case reports described in the present study support that it is worth to consider the application of antidepressants in such situations. In all three cases antidepressants were initiated following ineffi cacy of psychotherapy, and they produced a dramatic eff ectiveness not only in depressive symptoms, but also in the whole anorexic syndrome. In the complex therapy of anorexia nervosa antidepressants may yield a very good therapeutic eff ect in cases with comorbid, even subthreshold depression.

[Image of their careers and of the future of Hungarian psychiatrists]. / A hazai pszichiáterek pálya- és jövôképe.

AIM: Former studies call the attention to the somatic and mental dangers of the medical profession. There are some international data relating to the special risk factors of psychiatrists, but only a few Hungarian data are available. The evaluation of the image of the career is necessary because of the social changes and modifications of the health care system. METHODS: An anonymous questionnaire screening was performed by the support of the Hungarian Psychiatric Association in 2006. The questionnaire included sociodemographic data, items of the image of the career, questionnaires of the health status and work stress. The present paper summarizes the data relating to the career. RESULTS: The questionnaire was completed by 220 persons (60 males, 160 females). The mean age is 46.9 years. 59.4% of the males and 51.6% of the females work in a clinical/hospital setting, 22-22.9% in outpatient departments. 53.5% of the males and 51.3% of the females have at least two board examinations. In the career preference the personal interest was dominant (males: 86.2%, females: 71.0%). 89.3% of the males and 84.4% of the females would choose again the psychiatry. 35.0% of the males and 23.7% of the females plan to work abroad in five years. In the background of the migration tendency the better financial and work circumstances are predominant (72.5% and 28.8%), but special professional causes also play a role. The intention to come back is high (males: 81.0%, females: 86.8%). CONCLUSION: The data suggest a high level of professional call. However, the high rate of migration tendency relate to the insufficient work circumstances and low level of the social appreciation.

[Work load and work related stress factors among Hungarian psychiatrists]. / A munkamegterhelés és a munkával kapcsolatos stressztényezok a magyarországi pszichiáterek körében.

BACKGROUND: This study represents the continuation of previous research published in Psychiatria Hungarica in two papers, "The health of psychiatrists in Hungary" and "Hungarian psychiatrists' views on their career and future", which evaluated the quality of life of Hungarian psychiatrists. AIMS: To explore work-related stressors including workload among psychiatrists in Hungary. METHODS: Epidemiological study of a sample of psychiatrists (N=220) to explore the objective and subjective dimensions of workload and the level of burnout. RESULTS: We have found high prevalence of work-related stressors both in terms of objective factors (e.g., high number of work hours and multiple employment) and subjective factors (e.g., feeling stressed, over-loaded with work, lack of peer support, effort-reward inbalance). We have also found low levels of personal accomplishment, one of the dimensions of burnout. CONCLUSIONS: High levels of workload and work stress may adversely impact psychiatrists' health status and may thus have a negative effect on patient care, which may have significant public health consequences in terms of morbidity and mortality.

[Psychiatric and somatic morbidity among Hungarian psychiatrists]. / A magyarországi pszichiáterek egészségi állapota.

BACKGROUND: A growing body of evidence in the international literature suggests that the prevalence of psychiatric morbidity including suicide is high among psychiatrists. Based on these data, we hypothesised that the prevalence of psychiatric and somatic morbidity is higher among psychiatrists in Hungary compared to the other graduate population. Aims. To assess the psychiatric and somatic health status of psychiatrists in Hungary. METHODS: Data for this epidemiological study were collected from 160 female and 60 male psychiatrists using questionnaires. 1,754 white collar female and male workers from a representative survey (Hungarostudy 2002) and 407 representative physicians served as controls. RESULTS: We found that the prevalence of chronic somatic morbidity among both female and male physicians was significantly higher than that in the respective control groups. The prevalence of malignancies, diabetes, renal impairment, depression, hypertension, myocardial infarction and cardiovascular diseases, other infectious diseases, allergies and gastrointestinal ulcers was higher among male psychiatrists compared to controls. Female psychiatrists exhibited higher prevalence of malignant diseases, liver disease, depression, hypertension, myocardial infarction, other infectious diseases, bronchial asthma, other pulmonary and cardiovascular diseases, allergies, gastrointestinal diseases including ulcer, ophthalmologic and gynecological disorders compared to the other graduate and female physician population. A significantly higher prevalence of maternal reproductive morbidity including miscarriage, therapeutic termination of pregnancy, high-risk pregnancy among female psychiatrists was found compared to women in the control groups. CONCLUSIONS: The prevalence of psychiatric and somatic morbidity is higher among physicians compared with that in the normative population. Furthermore, female physicians consumed more anxiolytics, reported exhaustion more frequently, and exhibited poorer health maintenance behaviours than male colleagues. Increased mortality among Hungarian physicians may be attributed to high prevalence of somatic and psychiatric morbidity and inattentive health behaviours.