[MMPI-2 profiles in groups of systemic autoimmune disease - rheumatoid arthritis and systemic lupus erythematosus - patients]. / Szisztémás autoimmune betegek - rheumatoid arthritis és szisztémás lupus erythematosus - MMPI-2 profilijának vizsgálata.

OBJECTIVE: Systemic autoimmune diseases like rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are characterized by the alteration of immunological response, which can damage many organs and systems and result in a wide variety of clinical presentations. In addition to physical symptoms, psychiatric disorders are also common to many autoimmune diseases. Anxiety, depression, psychosis and cognitive deficits have the highest prevalence. The aim of this study was to display the degree of psychopathological symptoms in patients with RA and SLE. METHODS: Female inpatients with RA (N=68) and SLE (N=78) were recruited from the Rheumatology and Immunology Clinic of the University of Pecs and were asked to complete the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and a short demografical form. The clinical personality profiles of the patient groups were explored and compared with each other. RESULTS: High scores (above 64T) were detected on the Hypochondriasis (Hs), Depression (D) and Hysteria (Hy) scales in both groups. Besides, the participants performed elevated scores on the Masculinity-Feminity (Mf), Psychasthenia (Pt) and Social Introversion (Si) clinical scales. They scored in the elevated range on the Physical Malfunctioning, Subjective Depression, Lassitude-Malaise and Somatic Complaints subscales of the neurotic triad. No significant difference was found on the ten clinical scales between the SLE and RA patients. CONCLUSION: Characteristics of MMPI-2 profiles in SLE and RA patients seem to be the consequence of the disease and a common feature of chronic conditions. High scores on the neurotic triad scales may reflect the comorbid psychiatric disorders and the somatic symptoms alike, so further investigations with the revised Hungarian MMPI-2 are needed.

[Good general cognitive skills on irony understanding in schizophrenia - an fMRi study]. / Jó általános kognitív készségek hatása az irónia megértesére szkizofréniában. Funkcionális MRI vizsgálat.

In this study we have examined a group of schizophrenia patients during the understanding of irony tasks, who had normal IQ. 14 patients and 14 healthy control subjects were included, 15 irony and 15 control tasks were invertigated during an fMRI investigation. During the contextual phase patients had shown a higher activitation in different brain regions. The healthy controls had shown deactivitation during this phase, while this couldn't be seen in the patiens group. During the irony phase healthy subjects activated brain regions known as mentalisation areas, while patients didn't. Our results can support the view, that behind schizophrenia patients mentalisation deficit the contextual phase can play the central role.

Investigating the effect of grit trait on performance and success in Hungarian athlete's sample.

Background: The aim of the present study is to translate the Grit questionnaire into Hungarian and validate specifically within the context of sports. The second goal is to assess the questionnaire in Hungarian as a pilot study in the athlete population and to compare the grit trait with the coaches' athlete evaluation. Methods: Two hundred and sixty nine athletes, including 40 national team players, took part in the study, with an average age of 18.17 years (SD = 5.51). For the preliminary assessment, the Cloninger Temperament and Character Questionnaire (TCI-RH) was used; the coaches' athlete evaluation was modeled on a talent map. Results: The confirmatory factor analysis confirmed the fit of the two-factor structure, and the internal reliability of the questionnaire scales also proved to be adequate. 2. There is no relationship between adolescents' perceived grit and coach ratings. 3. The national team players achieved a higher grit score. Conclusion: Based on the psychometric indicators, the validity and reliability of the questionnaire proved to be adequate. Therefore, it is applicable and useful for psychological practitioners and researchers in the Hungarian population within the context of sports.

Cognitive and affective aspects of thigmotaxis strategy in humans.

The present article describes the cognitive and emotional aspects of human thigmotaxis (a wall-following spatial strategy) during exploration of virtual and physical spaces. The authors assessed 106 participants with spatial and nonspatial performance-based learning-memory tasks and with fear and anxiety questionnaires. The results demonstrate that thigmotaxis plays a distinct role at different phases of spatial learning. The 1st phase shows a positive correlation between thigmotaxis and general phobic avoidance, whereas there is no association between thigmotaxis and general phobic avoidance during later phases of learning. Furthermore, participants who underperformed in working memory tests and in a spatial construction task exhibited greater thigmotaxis and a higher potential for fear response. Findings are interpreted in the framework of interactions among emotion-, action-, and knowledge-controlled spatial learning theories.

Usefulness of pre-operative copeptin concentrations to predict post-operative outcome after major vascular surgery.

The aim of this study was to investigate whether preoperative determination of plasma copeptin levels in addition to plasma N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) could help improve risk stratification in patients who undergo major vascular surgery. One hundred ninety-eight consecutive patients who underwent major vascular surgery (58.6% infrainguinal aortic reconstruction, 23.7% abdominal aortic aneurysm surgery, 17.7% carotid endarterectomy) were included in this study. Patients were monitored for in-hospital and long-term (2-years) major adverse cardiac events, consisting of cardiac death, nonfatal myocardial infarction, and emergent coronary revascularization. Overall, 40 patients (20.2%) reached the primary end point, and most of these events occurred during the index hospital stay (n = 18 [45%]). In univariate Cox regression analysis, increasing concentrations of copeptin were significant determinants of outcome as a continuous variable (hazard ratio [HR] 1.012, p = 0.005) and as a dichotomized variable according to the recommended cutoff of 14.0 pmol/L (HR 4.116, p <0.001). Subgroup analyses revealed that especially patients at low estimated risk according to plasma NT-pro-BNP levels were at significantly higher risk for worse outcomes with higher copeptin levels (HR 5.983, p = 0.002). In multivariate Cox regression analysis, copeptin concentrations >14 pmol/L were significant independent predictors of outcome (HR 2.842, p = 0.002) in addition to type of surgery, history of myocardial infarction, elevated levels of cardiac troponin T, and NT-pro-BNP levels. In conclusion, the results of this study suggest that preoperative determination of this new biomarker could substantially improve prediction of perioperative and postoperative outcomes in vascular surgery patients.

Prediction of clinical outcome in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) using the TIMI risk score extended by N-terminal pro-brain natriuretic peptide levels.

BACKGROUND: N-terminal pro-brain natriuretic peptide (Nt-proBNP) is a strong independent predictor of death in acute coronary syndromes. In order to improve risk assessment in patients with unstable coronary artery disease we investigated the role of the additional determination of Nt-proBNP levels in patients sub-grouped into high-, medium- and low-risk groups according to the TIMI risk score. METHODS: Nt-proBNP was determined in 145 consecutive patients admitted to our clinic with typical anginal pain in the past 24 hours and normal left ventricular function. Using classification and regression tree analysis, we investigated whether Nt-proBNP levels provide clinically relevant prognostic information in addition to the TIMI risk score. Nt-proBNP concentrations were determined using a commercially available assay from Biomedica, Austria. The normal range of this assay is <2827 pg/ml. RESULTS: Multivariate logistic regression analysis revealed that TIMI scores and Nt-proBNP levels are independent predictors of mortality (P = 0.001 and P < 0.001, respectively). Patients with Nt-proBNP levels >5225 pg/ml had the highest mortality rate, independent of their TIMI risk classification. In the subset of patients with Nt-proBNP < or =5225 pg/ml, patients at TIMI medium risk but with Nt-proBNP above 2827 pg/ml had significantly higher mortality than patients with lower levels of Nt-proBNP (P = 0.03). Accordingly, we developed a combined risk score consisting of four risk groups: very high (Nt-proBNP > or =5225 pg/ml), high (TIMI high-risk group or TIMI medium-risk group and Nt-proBNP >2827 pg/ml), medium (TIMI medium-risk group and Nt-proBNP < or =2827 pg/ml) and low (TIMI low-risk group). The area under the receiver operating characteristic curve was 0.772 for the TIMI score alone and 0.863 for the combined risk score (P < 0.001). CONCLUSION: Determination of plasma Nt-proBNP levels and incorporation of these into TIMI risk classification by creating a combined risk score significantly improves risk assessment of patients with unstable coronary artery disease.

Risk assessment in patients with unstable angina/non-ST-elevation myocardial infarction and normal N-terminal pro-brain natriuretic peptide levels by N-terminal pro-atrial natriuretic peptide.

AIMS: To compare the accuracy of the N-terminal fragment of its pro-hormone (Nt-proBNP) and N-terminal pro-atrial natriuretic peptide (Nt-proANP) in the prediction of the 2 year mortality and to investigate whether additional measurement of Nt-proANP to troponin I (TnI) could improve risk assessment in the subgroups of patients with unstable coronary artery disease (UCAD) and normal Nt-proBNP. METHODS AND RESULTS: Plasma levels of the TnI, Nt-proANP, and Nt-proBNP were determined in 120 consecutive patients with UCAD without ST-segment elevations and normal left ventricular function. In multivariable logistic regression analysis, TnI and Nt-proBNP were independent predictors of mortality (P=0.01 and P=0.02, respectively). However, in the group of patients with normal Nt-proBNP levels, only Nt-proANP and TnI were independently associated with mortality (P=0.007 and P=0.03, respectively). Accordingly, patients with elevated Nt-proANP levels in this group of patients had significantly higher mortality rate than patients with normal Nt-proANP levels (P=0.003). CONCLUSION: Our results suggest that determination of Nt-proANP might improve risk assessment in patients with UCAD, especially when Nt-proBNP is in the normal range.