Novel motivational interviewing-based intervention improves engagement in physical activity and readiness to change among adolescents with chronic pain.

INTRODUCTION: Engaging adolescents with chronic pain in physical activities is challenging. Motivational interviewing (MI) combined with activity promotion may encourage teens to make behavioural changes. This research aimed to assess the feasibility and acceptability of our MI-based physical activity promotion programme, the M3 training. METHODS: In our exploratory study with 35 adolescent-parent dyads, we evaluated the feasibility by enrolment, drop-out and retention rates. Acceptability of the M3 training was examined by adherence rates and participation experiences through open-ended questions. We also assessed changes in pain self-efficacy and readiness to change after the M3 training intervention. RESULTS: The M3 training was feasible with an adequate enrolment (77.8%) and retention (85.7%) rate. Both teens and parents found the M3 training acceptable and considered exercise and physical activity the most helpful elements of the programme (36% and 37%, respectively). While self-efficacy remained unchanged, we identified a significant increase in the readiness to change for adolescents and parents. CONCLUSION: M3 training improved physical activity engagement while prioritising adolescents' autonomy. Furthermore, it appears to be a clinically relevant approach and could result in a positive shift in readiness to change within a shorter timeframe. PATIENT OR PUBLIC CONTRIBUTION: The preliminary version of the M3 training was reviewed and commented upon by the public (adolescents and adults). Adolescents who participated in this study were designing their own movement programme, considering their lived experiences. Participants' feedback was used to create the online version of the M3 training (which will be published elsewhere).

Self-reported specific learning disorders and risk factors among Hungarian adolescents with functional abdominal pain disorders: a cross sectional study.

BACKGROUND: Despite its increasing clinical significance and diagnostic challenges, little is known about functional abdominal pain disorders (FAPDs) in Central-Eastern Europe. In this paper, the prevalence and potential sociodemographic correlates of FAPDs among Hungarian adolescents are explored. METHODS: A cross-sectional, nationwide, questionnaire study in a representative sample of 657 adolescents has been conducted. With a response rate of 80.2%, 522/527 (99.1%) questionnaires were eligible for data analysis (N = 267, 51.1% girls, mean age 14.8, SD 2.4 years). The questionnaire included sociodemographic variables (age, sex, place of residence, marital status of the parents, family income, religion, educational level of parents), questions regarding self-reported specific learning disorders and the Questionnaire for Paediatric Gastrointestinal Symptoms Rome ΙΙΙ Edition. RESULTS: The prevalence of FAPDs was 11.9% (N = 62). FAPDs were significantly associated with female sex. Living in a county town showed a negative correlation with FAPD. Adolescents with self-reported arithmetic learning disorders had an 8.7-fold likelihood of FAPD (OR, 8.7; 95% CI (3.5-21.9). Adolescent girls reported pain in all subtypes of FAPDs more frequently than adolescent boys except functional abdominal pain syndrome. The most prevalent FAPD was abdominal migraine (N = 32, 6.1%), followed by irritable bowel syndrome (N = 24, 4.6%). CONCLUSIONS: The prevalence of FAPDs in Hungary is similar to that reported worldwide, however, contrary to international data, abdominal migraine is the most frequently encountered FAPD in Hungary. In addition to well-known correlates of FAPDs, such as female sex and place of residence, arithmetic learning disorders have also been identified as correlating with the prevalence of FAPDs. Our results suggest culture-specific differences in the distribution of FAPDs, and confirm the significance of school performance indicators such as specific learning disorders as a correlate of FAPDs.

[Comparative analysis of the full and shortened versions of the Oldenburg Burnout Inventory]. / Az Oldenburg Kiégés Kérdôív és rövidített változatának összehasonlító elemzése.

Background - The two free-to-use versions of the Oldenburg Burnout Inventory (OLBI) have been increasingly utilised to assess the prevalence of burnout among human service workers. The OLBI has been developed to overcome some of the psychometric and conceptual limitations of the Maslach Burnout Inventory, the gold standard of burnout measures. There is a lack of data on the structural validity of the Mini Oldenburg Burnout Inventory and the Oldenburg Burnout Inventory in Hungary. Purpose - To assess the structural validity of the Hungarian versions of the Oldenburg Burnout Inventory and the Mini-Oldenburg Burnout Inventory. Methods - We enrolled 564 participants (196 healthcare workers, 104 nurses and 264 clinicians) in three cross-sectional surveys. In our analysis we assessed the construct validity of the instruments using confirmatory factor analysis and internal consistency using coefficient Cronbach's α. Results - We confirmed the two-dimensional structure (exhaustion and disengagement) of the Mini-Oldenburg Inventory and a shortened version of the Oldenburg Burnout Inventory Internal consistency coefficient confirmed the reliability of the instruments. The burnout appeared more than a 50 percent of the participants in every subsample. The prevalence of exhaustion was above 54.5% in each of the subsamples and the proportion of disengaged clinicians was particularly high (92%). Conclusions - Our findings provide support for the construct validity and reliability of the Hungarian versions of the Mini-Oldenburg Burnout Inventory and a shortened version of the Oldenburg Burnout Inventory in the assessment of burnout among clinicians and nurses in Hungary.

Potential correlates of burnout among general practitioners and residents in Hungary: the significant role of gender, age, dependant care and experience.

BACKGROUND: Burnout is increasingly prevalent among general practitioners (GPs) in Hungary, which may lead to functional impairment and, subsequently, to poor quality of patient care. However, little is known about potential predictors of burnout among GPs. The aim of this study was to explore psychosocial correlates of burnout among GPs and residents in Hungary. METHODS: We collected socio-demographic and work-related data with self-administered questionnaires in a cross-sectional study among GPs (N = 196) and residents (N = 154). We assessed burnout with the Maslach Burnout Inventory Human Services Survey (MBI-HSS) and calculated the mean level of burnout and the proportion of physicians suffering from low, intermediate and high degree of burnout. To identify potential socio-demographic and work-related correlates of burnout among physicians, we determined Spearman's and Mann-Whitney U correlation coefficients and conducted stepwise linear regression analyses. We deployed Mann-Whitney U test to explore gender disparity in the level of burnout between female and male physicians and between general practitioners and residents. RESULTS: The prevalence of moderate to high level emotional exhaustion, depersonalisation, and impaired personal accomplishment was 34.7, 33.5 and 67.8% as well as 41.0, 43.1, and 71.1% among GPs and residents, respectively. Residents reported significantly lower level of personal accomplishment vs GPs. We identified a significantly higher level of depersonalization among male physicians compared to female physicians. Age correlated negatively with emotional exhaustion and depersonalization and positively with personal accomplishment among GPs. Dependant care was positively associated with burnout among female GPs. Female residents were more likely to report depersonalization. High workload was positively correlated with depersonalization among female GPs. Younger age emerged as the strongest predictor of emotional exhaustion. Male gender and fewer years of experience predicted depersonalization best, and male gender showed a significant predictive relationship with low personal accomplishment. CONCLUSION: We identified specific socio-demographic and work-related correlates of burnout, which may guide the development of specific and effective organizational decisions to attenuate occupational stress and subsequent burnout as well as functional impairment among GPs, and thus, may improve the quality of patient care.

Quantifying Multiple Work-Related Psychosocial Risk Factors: Proposal for a Composite Indicator Based on the COPSOQ II.

PURPOSE: To determine national reference values for the Copenhagen Psychosocial Questionnaire (COPSOQ II) across occupational sectors and develop a composite score to estimate the cumulative effect of multiple work-related stressors, in order to facilitate the implementation of occupational health directives on psychosocial risk assessment. METHOD: Cross-sectional data was collected via an online questionnaire. The sample included 13,104 individuals and was representative of the general Hungarian adult working population in terms of gender, age, education, and occupation. Mean scores were calculated for 18 scales on work environment and for 5 outcome scales of the COPSOQ II across 18 occupational sectors. We analyzed the association between a composite psychosocial risk score (CPRS), reflecting severity of exposure to multiple risk factors, and high stress, burnout, sleep troubles, and poor self-rated health. RESULTS: We found occupation-related differences in the mean scores on all COPSOQ II scales. Scores on the "Stress" scale ranged from 47.9 to 56.2, with the highest mean score in accommodation and food services sector. Variability was greatest with respect to emotional demands (range 40.3-67.6) and smallest with respect to role clarity (range 70.3-75.7). The prevalence of negative health outcomes increased with the CPRS. Five risk categories were formed, for which the odds ratio of negative outcomes ranged from 1.6 to 56.5. CONCLUSION: The sector-specific psychosocial risk profiles covering 18 work environmental factors can be used as a reference in organizational surveys and international comparisons. The CPRS proved to be a powerful predictor of self-reported negative health outcomes.

Validation of the Hungarian version of Carlson's Work-Family Conflict Scale.

BACKGROUND AND PURPOSE: Work-family conflict has been associated with adverse individual (e.g., cardiovascular diseases, anxiety disorders), organizational (e.g., absenteeism, lower productivity), and societal outcomes (e.g., increased use of healthcare services). However, lack of standardized measurement has hindered the comparison of data across various cultures. The purpose of this study was to develop the Hungarian version of Carlson et al.'s multidimensional Work-Family Conflict Scale and establish its reliability and validity. METHODS: In a sample of 557 employees (145 men and 412 women), we conducted confirmatory factor analysis to investigate the factor structure and factorial invariance of the instrument across sex and data collection points and evaluated the tool's validity by assessing relationships between its dimensions and scales measuring general, marital, and job-related stress, depressive symptomatology, vital exhaustion, functional somatic symptoms, and social support. RESULTS: Our results showed that a six-factor model, similarly to that of the original instrument, fit the data best. Internal consistency of the six dimensions and the whole instrument was adequate. Convergent and divergent validity of the instrument and discriminant validity of the dimensions were also supported by our data. CONCLUSION: This study provides empirical support for the validity and reliability of the Hungarian version of the multidimensional Work-Family Conflict Scale. Deployment of this measure may allow for the generation of data that can be compared to those obtained in different cultural settings with the same instrument and hence advance our understanding of cross-cultural aspects of work-family conflict.

[Facilitating the diagnosis of depression and burnout by identifying demographic and work-related risk and protective factors among nurses]. / A kiégés és a depresszió diagnosztizálásának elosegítése demográfiai és munkahelyi védo- és kockázati tényezoik feltárásával egészségügyi szakdolgozók körében.

INTRODUCTION: Depression and burnout are frequent comorbidities among nurses. Despite similar symptoms, their management differ. Therefore, their timely diagnosis is essential. AIM: To identify demographic and work-related risk and protective factors of burnout and depression, and facilitate their diagnosis. METHOD: A cross-sectional study among 1,713 nurses was carried out. Depression and burnout were assessed by the shortened Beck Depression Questionnaire and Maclach Burnout Inventory, respectively. Risk and protective factors were explored using t-tests and analysis of variance. RESULTS: The prevalence of depression and moderate-to-high burnout was 35.1% and 34-74%, respectively. Having a partner/child and longer employment in the outpatient setting protected from burnout. Lack of a partner and male sex emerged as risk factors of depression and depersonalisation, respectively. CONCLUSIONS: High prevalence of depression and burnout among nurses poses a significant public health issue. Familiarity with the disease-specific risk and protective factors identified in this research may facilitate timely diagnosis and effective disease management.

[The relationship of work-related psychosocial risk factors with depressive symptoms among Hungarian workers: preliminary results of the Hungarian Work Stress Survey]. / Munkahelyi pszichoszociális kockázati tényezok kapcsolata a depressziós tünetegyüttessel a magyar munkavállalók körében. Az Országos Munkahelyi Stresszfelmérés elozetes eredményei.

INTRODUCTION: Research has shown that psychosocial stress acts as a risk factor for mental disorders. AIM: The present study aims at processing the preliminary results of the Hungarian Survey of Work Stress, concerning the relationship between depressive symptoms and work stress. METHODS: Cross-sectional survey among Hungarian workers was carried out (n = 1058, 27.5% man, 72.5% woman, age 37.2 years, SD = 11 years). Psychosocial factors were measured using the COPSOQ II questionnaire, while BDI-9 was used for the assessment of depressive symptoms. Statistical analysis was carried out applying Spearman's correlation and logistic regression. RESULTS: A quarter of the workers reported moderate or severe symptoms of depression (BDI≥19). The study confirmed the association between depressive symptoms and work-family conflict (OR = 2.21, CI: 1.82-2.68), possibilities for development (OR = 0.76, CI: 0.59-0.97) meaning of work (OR = 0.69, CI: 0.59-0.89) and commitment (OR = 0.60, CI: 0.47-0.78). CONCLUSION: The results point toward the need of such organizational measures that allow for the reduction of psychosocial stress.

[HIGH PREVALENCE OF BURNOUT AND DEPRESSION MAY INCREASE THE INCIDENCE OF COMORBIDITIES AMONG HUNGARIAN NURSES]. / A MAGYAR EGÉSZSÉGÜGYI SZAKDOLGOZÓK KÖRÉBEN MEGFIGYELHETO GYAKORI KIÉGÉS ÉS DEPRESSZIÓ MEGNÖVELHETI SZÁMOS BETEGSÉG MEGJELENÉSÉNEK AZ ESÉLYÉT.

BACKGROUND AND PURPOSE: Poor mental health among health care professionals may have a significant impact on public health. There is limited information about the prevalence and potential consequences of burnout and depression among nurses in Hungary. The objective of this study is to explore the relationship between burnout as well as depression and somatic symptoms as well as comorbidities among nurses in Hungary. METHODS: Cross-sectional study with self-administered questionnaires among 1,713 nurses. Burnout and depression were assessed by the Maslach Burnout Inventory (MBI-HSS) and the Shortened Beck Depression Questionnaire, respectively. Somatisation was measured by the Patient Health Questionnaire (PHQ-1 5). Correlates of burnout and depression were assessed by logistic and linear regression analyses. RESULTS: The prevalence of depressive symptom and clinical depression was 35% and 13%, respectively. The prevalence of moderate and high level emotional exhaustion, depersonalisation, and decreased personal accomplishment was 44%, 36% and 74%, respectively. We identified burnout and depression as a predictor of high prevalence of subjective somatisation. Whilst burnout showed a strong association with increased prevalence of hypertension, depression predicted almost all examined diseases, in particular, cardiac and cerebrovascular diseases, as well as neoplasms. CONCLUSION: We found high prevalence of burnout and depression among nurses in Hungary. As depression has been shown to be associated with higher prevalence of comorbidities than burnout, its consequences may be more significant. Appropriate prevention, diagnosis, and adequate treatment of burnout and depression may decrease the prevalence of ensuing comorbidities.

[Negative and positive predictive relationships between coping strategies and the three dimensions of burnout among Hungarian medical students]. / A megküzdési stratégiák negatív és pozitív prediktív kapcsolata a kiégés három dimenziójával orvostanhallgatók körében.

INTRODUCTION: Effective management and prevention of widespread burnout among medical students in Hungary require thorough understanding of its relations to coping strategies, which lacks sufficient data. AIM: To explore the prevalence of burnout and its relations to coping strategies among medical students. METHOD: Cross-sectional study with 292 participants. Burnout was assessed by the Maslach Burnout Inventory-Student Survey. Coping strategies were evaluated by the Folkman-Lazarus Ways of Coping Questionnaire and questions about health-maintenance behaviours. Associations between burnout and coping strategies were explored with linear regression analyses. RESULTS: The prevalence of high-level burnout was 25-56%. Both problem-focused coping and support-seeking were protective factors of exhaustion and cynicism, however, they predicted reduced personal accomplishment. Emotion-focused coping predicted exhaustion and cynicism and correlated negatively with reduced personal accomplishment. Health-maintenance behaviours were protective factors for exhaustion and predicted reduced personal accomplishment. CONCLUSIONS: Deployment of coping strategies that target the most prevalent burnout dimension may improve effective management of burnout.

High prevalence of burnout among midwives in Hungary: High job demands and low resources as potential persistent stressors, a focus on prevention.

Background: Midwifery practice in Hungary is characterized by chronic stress, which may in turn lead to burnout and impaired perinatal care. However, little is known about the degree and potential stressors of burnout, which hinder the development of strategies to promote well-being among midwives in Hungary. Aim: To assess the prevalence of burnout and identify persistent individual and occupational stressors among midwives in Hungary over the past decade to inform prevention. Methods: We conducted two cross-sectional studies among midwives in 2014 and 2022. We used the Maslach Burnout Inventory to assess burnout (emotional exhaustion, depersonalization, and personal accomplishment) over time. We also collected data on individual and work characteristics. We performed a multivariate regression analysis to explore associations between burnout and respondents' characteristics. Findings: The degree and prevalence of emotional exhaustion among midwives increased significantly between 2014 (N = 224) and 2022 (N = 152). High workload, not feeling valued at work, poorly perceived health status and work dissatisfaction emerged as a significant positive correlate of emotional exhaustion or depersonalization in both studies. Living alone showed both a positive and inverse association with burnout in 2014 and 2022, respectively. Work satisfaction was a positive correlate of personal accomplishment in both studies. Conclusions: Our results add to and confirm the growing body of evidence about the high prevalence of burnout among midwives in Hungary. We identified potential risk factors and outcomes of burnout, which remained unchanged over time. To prevent or reduce burnout among midwives, future interventions should focus on addressing these potential persistent risk factors. However, the time-varying role of factors influencing burnout makes it advisable to review preventive interventions from time to time.

[Somatic and mental morbidity of young female physicians. Does emotional exhaustion constitute the missing link?]. / Fiatal orvosnok testi-lelki egészsége. Az emocionális kimerülés a hiányzó láncszem?

INTRODUCTION: The high prevalence of morbidity among female physicians in Hungary is well documented, however, little is known about the prevalence of that in certain age groups. AIMS: To assess the prevalence of somatic and psychiatric morbidity in two age cohorts (Cohort 1: age 24-43 and Cohort 2: age 44-76) of female physicians and to explore the relationship between morbidity and potential risk factors including work-related stressors. METHODS: Representative, cross-sectional, quantitative survey among representative samples of female physicians (N = 408). RESULTS: Physicians in Cohort 1 reported more frequent night shift rotation, less leisure time, and fewer days off compared to physicians in Cohort 2. Physicians in Cohort 1 were less satisfied with their work, workplace, reported less support from their colleagues, and received lower salary compared to physicians in Cohort 2. Physicians in Cohort 1 scored significantly higher on the emotional exhaustion and the personal accomplishment scales MBI as compared to Cohort 2 physicians. In Cohort 1 emotional exhaustion and personal accomplishment were associated with high depression scores and frequent suicidal ideation. CONCLUSIONS: The role of emotional exhaustion is decisive of young physicians' well-being. Future research should focus on understanding the psycho-social, individual, organizational, and societal correlates of the high prevalence of morbidity among young female physicians in Hungary.

[Coping with work-related stress in health care professionals -- strategies for the prevention of burnout and depression]. / A munkahelyi stresszel való megküzdés egészségügyi szakdolgozók körében -- lehetoségek a kiégés és depresszió megelozésének szolgálatában.

BACKGROUND: The prevalence of depression and burnout among health care professionals is high in Hungary. However, there is limited empirical data on disease prevention among these populations. AIMS: This study aims at evaluating the mediating role of coping mechanisms in preventing depression and burnout. METHODS: Cross-sectional survey among 1333 health care professionals. Participants completed self-administered questionnaires about their perception of work stress, burnout and depressive symptoms, as well as their preferred coping strategies. Analyses were performed using structural equation modelling. RESULTS: The prevalence of severe depression and lack of personal accomplishment was 5.6% and nearly 50%, respectively. Work stress predicted symptoms of burnout and depression both directly and indirectly through the mediation by coping strategies. Of the coping strategies, cognitive restructuring, which accentuates the realistic assessment of challenging situations, was found to reduce the probability of the development of burnout and depression symptoms. CONCLUSIONS: This study provides further data for the development of cognitive interventional strategies and highlights the significance of these strategies in the prevention of depression and burnout among Hungarian health care professionals.

Diagnostic and treatment recommendations from international guidelines for chronic low back pain / A krónikus derékfájdalom korszeru diagnosztikája és kezelése a nemzetközi irányelvek tükrében.

Összefoglaló. Nemzetközi kutatások szerint a deréktáji fájdalom 2019-ben 568 millió embert érintett világszerte. Magyarországon a lakosság 20%-a él krónikus derékfájdalommal, ami nemcsak egészségügyi, de szociális és ökonómiai krízist is jelent. A probléma aktualitását jól mutatja az is, hogy a Nemzetközi Fájdalomkutatási Társaság a 2021. évet a derékfájdalomról szóló globális évnek kiáltotta ki. A derékfájdalmak megfelelo kezelése és a krónikussá válás megelozése tehát kiemelten fontos. Ebben nyújthatnak segítséget az evidenciákon alapuló irányelvek. Magyarországon azonban jelenleg nincs hatályos, egységes irányelv, mely a derékfájdalmakkal, azon belül is a krónikus derékfájdalom kezelésével foglalkozna. A jelen közleményben a krónikus derékfájdalom evidenciákon alapuló diagnosztikai és kezelési lehetoségeinek áttekintését tuztük ki célul. Az irodalomkutatást követoen, a jelenleg is hatályos, AGREE II. rendszer szerinti magas minoségu besorolást eléro, krónikus deréktáji fájdalomra vonatkozó, angol nyelvu nemzetközi irányelvek ajánlásainak összehasonlítását végeztük el. Tanulmányunkban hét irányelvet dolgoztunk fel (négy európai, ketto amerikai, egy kanadai), melyek mindegyikében a következo közös ajánlások kerültek megfogalmazásra: a súlyos patológiák kizárása az alarm tünetek alapján, a pszichoszociális tényezok figyelembevétele, a szükségtelen képalkotó vizsgálat visszaszorítása, az elsosorban aktív, nem gyógyszeres terápiák preferálása és a nemszteroid gyulladáscsökkentok körültekinto felírása. Az európai irányelvekben új elemként szerepelt a krónikussá válás korai rizikóbecslése. Orv Hetil. 2021; 162(49): 1951-1961. Summary. In 2019, low back pain caused the highest burden globally, among musculoskeletal disorders, affecting 568 million people. According to Hungarian sociodemographic data, 20% of the Hungarian adults live with chronic low back pain that is a global health priority. Therefore, the International Association for the Study of Pain announced 2021 as the global year about back pain. Evidence-based guidelines about the appropriate treatment of acute low back pain and prevention of chronic low back pain are therefore of paramount importance. However, there are currently no valid, uniform treatment guidelines in Hungary about acute and chronic lower back pain. In this paper, we aimed at summarizing up-to-date, evidence-based diagnostic and treatment recommendations for chronic low back pain. Using a literature review, we identified seven international treatment guidelines (four from Europe, two from the United States and one from Canada) in English for the management of chronic low back pain that were previously assessed by the AGREE II quality assessment tool. We found consistent recommendations in the guidelines such as exclusion of alarm symptoms, assessment of psycho-social factors, reduction of unnecessary imaging, initialization of primarily active, non-pharmacological therapies, and careful and cautious prescription of non-steroidal anti-inflammatory medications. A new recommendation in the European guidelines is the early risk assessment of low back pain becoming chronic. Orv Hetil. 2021; 162(49): 1951-1961.

[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.

[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.

[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.

[Potential risk factors and consequences of chronic pain among Hungarian adolescents]. / A krónikus fájdalom lehetséges rizikótényezoi és következményei a magyar tizenévesek körében.

Introduction: Based on international data, the prevalence of chronic pain is 25% among adolescents which is associated with poor quality of life, extensive use of healthcare, and overuse of pain medication. Little is known about the medication use and chronic pain in Hungary. Aim: To assess the prevalence and potential socio-demographic risk factors of chronic pain and medication use among Hungarian adolescents. Method: We conducted a cross-sectional epidemiological study at primary and secondary schools with 354 school-children. Adolescents responded to questionnaires about demographic variables, characteristics of chronic pain, use of health-care system and medication. Results: 110 adolescents (31.1%) suffered from chronic pain in our sample. Pain in extremities was the most prevalent pain type. 4.6% (n = 5) of children suffered from continuous pain. The prevalence was lower among boys (χ2 = 9.4; p = 0.002) and younger subjects (Mann-Whitney U = 10906.5; p = 0.004). Sleep disorder was more frequent among adolescents with chronic pain (χ2 = 8.9; p = 0.03). Time from onset, intensity, prevalence and duration of pain were associated with the prevalence of visits to physicians. 78% (n = 276) of the sample took medication in the previous 6 months, however, regular medication use was as high as 48.3% (n = 171). We found a significant association between medication use and older age, female sex, and the presence of chronic pain. Medication use against pain among adolescents with chronic pain was significantly higher (n = 83.0, 75.5%). Conclusion: The prevalence of chronic pain, medication use and visits to physicians is considerable among Hungarian adolescents. It is an important healthcare challenge with long-term consequences until adulthood. Orv Hetil. 2020; 161(13): 502-509.

Factors associated with serious intent to die among suicide attempters in Hungary.

As suicide attempts pose major risk for future suicide death, understanding the underlying factors of suicide attempts and suicidal behaviour is an important mental health imperative. The aim of this study was to examine suicide attempts with a special focus on the intention. A total of 2540 discharge summaries were collected between 2009 and 2011 in Miskolc, Hungary, and a content analysis was conducted. Data regarding the method, the reason for suicide attempts, the amount, the source, and the type of the medication taken were examined. Deliberate self-poisoning was the most frequent method (73.8%) committed with more than 200 different types of drugs. 40.5% of the patients attempted suicide with an intent to die, whilst 35.6% of the patients wanted to escape from an unbearable situation. Older age groups, greater amount of taken pills, and affective disorders were associated with self-reported serious intention to die. Our findings should be taken into consideration when monitoring drugs for older patients with depressive disorders.

[High prevalence of work-family conflict among female physicians: lack of social support as a potential antecedent]. / Magas a munkahelyi és a családi szerepek közötti konfliktus prevalenciája az orvosnok körében: a társas támogatás hiánya mint lehetséges rizikótényezo.

UNLABELLED: According to stress theory, social support from work and non-work-related sources may influence the level of perceived work-family conflict. Despite the high prevalence of work-family conflict as a source of distress among female physicians, no information is available on the associations between work-family conflict and social support in a traditional, family-centric cultural setting, where female role expectations are demanding. The author hypothesized that high prevalence of work-family conflict could be attributed to the lack of social support among female physicians. AIMS: To investigate the prevalence and psychosocial characteristics of social support and its relations to work-family conflict among female physicians. METHODS: Quantitative and qualitative study using questionnaires ( n = 420) and in-depth interviews ( n = 123) among female and male physicians. RESULTS: Female physicians reported significantly higher mean level and prevalence of work-family conflict compared to men. The predominant form of work-family was work-to-family conflict among physicians; however, significantly more female physicians experienced family-to-work conflict and strain-based work-family conflict compared to men (39% vs. 18% and 68% vs. 20%, respectively). Significantly more male physicians experienced time-based work-family conflict compared to women. Content analyses of interview data revealed that provision of support to physicians manifested itself in parental support in career selection, spousal support with household duties, peer support with enabling access to professional role models-mentors, peer support to ensure gender equity, and organizational support with family-centric policies. Female physicians reported significantly less parental, spousal, and peer support compared to men. Female physicians lacking parental, peer, or organizational support experienced significantly higher level of work-family conflict compared to appropriate control. In regression analyses, high job demands, job strain, high workload and number of children, younger age, and lack of support in the workplace predicted work-family conflict best (adjusted R 2 0.59). CONCLUSIONS: Lack of social - particularly parental, peer, and organizational - support may play an important role in the pathogenesis of work-family conflict experienced by female physicians.