Seeds that bloom on stony ground - Concept paper of the future perspectives of the unexploited capacities of positive clinical psychology in Hungary.

Positive psychology has fully examined the flourishing among healthy people but neglected to understand how "optimal human functioning" can apply to the life experiences of a vulnerable person. Considering methodological issues, this article gives a brief overview on how the conceptualization of mental health and mental disorders affects the consideration of strengths along with the presence of dysfunction with the emergence of positive psychology. First, we summarize the shortcomings of the applicability of clinical positive psychology, focusing especially on Hungarian clinical practice. Second, we discuss the problems with the conceptualization of mental health in positive psychological framework. Third, we propose a model, the Maintainable Positive Mental Health Theory based on capacities and competences. Finally, we conclude with methodological questions and present a research protocol. The key finding of our review is that the opportunity exists for psychiatrists and psychologists to embrace disability as part of human experiences and to show how people with vulnerabilities can be supported to recover. (Neuropsychopharmacol Hung 2022; 24(3): 113-119).

Mental Health Profiles in Clinical and Non-clinical Samples in Light of the Maintainable Positive Mental Health Theory: Protocol Paper.

Clinical psychology has invested a lot of energy in the thorough examination of the characteristics of mental disorders, but less in the implication of the accessible mental health capacities in the recovery phase. Our aim in the present study is to verify the two-continuum mental health model in clinical and non-clinical samples in the light of the Maintainable Positive Mental Health Theory. A further aim is to investigate the interrelationship between positive mental health and mental disorder by examining various groups of mental disorders with different levels of severity. We also examine the prevalence of the diagnostic categories of the Complete Mental Health Model. Furthermore, we aim to identify mental health profiles and their correlates. In the present paper, we introduce the protocol for the ongoing research. A cross-sectional, case-control design is employed to investigate the two-continuum model of mental health. The clinical sample (n = 400) is recruited from four Hungarian hospitals. The non-clinical sample (n = 400) is collected using an online self-report survey-based research design. The two-continuum model of mental health will be tested using exploratory factor analysis and confirmatory factor analysis, with the symptoms of mental disorders and mental health as outcome variables. We will then separate groups of mental disorders according to the leading symptoms. Analysis of variance will be used to examine mental health as the dependent variable at a certain severity level in different mental disorder groups. Analysis of covariance will be used to identify the effect of different sociodemographic indicators.The prevalence of the diagnostic categories of the Complete Mental Health Model will be calculated and compared using chi-square tests. Finally, mental health profiles will be identified using latent profile analysis. Our study draws attention to the fact that "optimal human functioning" can be understood in ways that includes, and not excludes, people living with mental disorder.

The validity of the diabetes self-management questionnaire (DSMQ) in Hungarian patients with type 2 diabetes.

BACKGROUND: A wide range of measuring instruments are available for diabetes self-management. According to several studies, a relatively new instrument, the diabetes self-management questionnaire (DSMQ), shows a consistent relationship with outcomes of diabetes treatment as well, such as glycated hemoglobin (HbA1c). Furthermore, the questionnaire is short, but covers the main aspects of diabetes management. Given the increasing prevalence of diabetes in Hungary, our goal was to adapt this user-friendly questionnaire and analyze its validity. METHODS: After the standard translation process, we analyzed a sample of 221 people. The construct validity of the questionnaire was tested with HbA1c and body mass index. Morisky Medication Adherence Scale-8 values were tested via Pearson correlations. Known-groups validity of the DSMQ in relation to groups based on glycemic control levels was investigated using one-way ANOVA. RESULTS: The "sum scale" of the questionnaire and the HbA1c values show an inverse relationship (r = - 0.253, p < 0.01). Body mass index was related to the "sum scale" (r = - 0.214, p < 0.01) and to the "physical activity" (r = - 0.219, p < 0.01), while questionnaire results reflecting medication adherence correlated with the "glucose management" (r = - 0.291, p < 0.01), "health-care use" subscale (r = 0.236, p < 0.01) and the "sum scale" (r = 0.281, p < 0.01). A significant difference (F = 6.225, p = 0.002) was found between the DSMQ mean scores of the three groups, defined by good, medium, and poor glycemic control levels. CONCLUSIONS: The Hungarian version of the DSMQ was considered a valid tool for the measurement of diabetes self-management. With its help, problematic areas of self-management could be uncovered, and interventions can be improved.

Preliminary validation of the Mental Health Test in a psychiatric sample.

To assist psychiatrists and clinical psychologists to assess their patients' psychological immune competence-based capacities and resources, depending on the mental health disorder diagnosis and the severity of the symptoms, the present study examined the psychometric properties of the Mental Health Test in a psychiatric sample. The research was carried out in four Hungarian healthcare facilities using a cross-sectional design. A total of 331 patients (140 male, 188 female, and 3 who preferred not to disclose their gender) completed the Mental Health Test, six well-being and mental health measures, and the Symptom Checklist-90. Psychiatrists and clinical psychologists reported the mental disorder status of each participant. Confirmatory factor analysis showed a good fit of the five-factor model to the data for the clinical version of the Mental Health Test (CFI = 0.972, RMSEA = 0.034). High internal consistency coefficients (α: 0.70-0.84; ω: 0.71-0.85) and excellent external and content validity were reported. The test is not sensitive to sociodemographic indicators but is sensitive to the correlates of well-being and to the symptoms of different types of mental disorders. Our preliminary findings suggest that the Mental Health Test is a suitable measure for assessing mental health capacities and resources in psychiatric samples.

Mental health competencies are stronger determinants of well-being than mental disorder symptoms in both psychiatric and non-clinical samples.

The present study aimed to investigate whether the strength of mental health competencies and the severity of mental disorder symptoms, and their interaction, differ in the strength of their associations with several dimensions of well-being in Hungarian adult psychiatric and non-clinical samples. All respondent in the psychiatric sample (129 patients (44 male, 85 female)) and in the non-clinical community sample (253 adults (43 male, 210 female)) completed the Mental Health Test, six measures of well-being and mental health, and the Symptom Checklist-90-Revised. Including both mental health competencies and mental disorder symptoms in a regression model in both samples can predict patients' well-being even more accurately. Mental health competencies were positively related; mental disorder symptoms were negatively related to subjective well-being. In all models and in both samples, mental health competencies were found to be stronger determinants of well-being than mental disorder symptoms. The interaction of mental health competencies and mental disorder symptoms is no more predictive of well-being in either psychiatric or non-clinical samples than when the effects of each are considered separately. The assessment of mental health competencies has an important predictive value for well-being in the presence of psychopathological symptoms and/or mental disorders.

[Association between self-efficacy, depression and self-care in type 2 diabetes mellitus]. / Az énhatékonyság, a depresszió és az öngondoskodás kapcsolata 2-es típusú diabetes mellitusban.

INTRODUCTION: Type 2 diabetes care mostly depends on self-care. However, a large proportion of patients suffer from depression, which has a negative effect on adherence. Treating depression is important for the effective therapy of diabetes. In the last years, examination of self-efficacy has become an important topic in adherence research. It has arisen that an appropriate self-efficacy may minimalize the negative effect of depression on self-care. OBJECTIVE: We aimed to determine the prevalence of depression in a Hungarian sample, to examine the correlation between depressive symptoms and self-care, and the possible mediating effect of self-efficacy between depression and self-care. METHOD: In the cross-sectional questionnaire study, we analyzed data of 262 patients. Median age was 63 years, average BMI was 32.5 (SD = 6.18). MEASURES: socio-demographic data, DSMQ (Diabetes Self-Management Questionnaire), PHQ-9 (Patient Health Questionnaire), Self-Efficacy for Diabetes Scale. RESULTS: Frequency of depressive symptoms is 18% in our sample. Depressive symptoms (PHQ-9 score) and self-care (DSMQ score) were in inverse correlation (r = -0.275, p<0.001). In the model, we examined the impact of self-efficacy; beside controlling for age and gender, BMI (ß = 0.135, t = -2.367) and self-efficacy (ß = 0.585, t = 9.591, p<0.001) were independent impacts, while depressive symptoms lost their significance (ß = -0.033, t = -0.547). DISCUSSION: Prevalence of depression was identical to literature. Depressive mood had a negative effect on self-care, while self-efficacy may play a mediating role in the connection between depression and self-care. CONCLUSION: Reinforcing the theory on the mediating role of self-efficacy may open new perspectives for the treatment of depression as a comorbidity of type 2 diabetes. Orv Hetil. 2023; 164(17): 667-674.

[The relationship between diabetes, stress and sleep problems in the light of the Hungarostudy 2013 research data]. / A diabetes, a stressz és az alvásproblémák kapcsolata a Hungarostudy 2013 kutatás adatainak fényében.

Introduction: The problem of diabetes worldwide raises increasingly serious public health issues in Hungary. In recent years, the emphasis on obesity as a primary cause of diabetes has been driven by a complex understanding of the causes of civilization: the role of sleep problems and stress in the development of the disease and the aggravation of the condition has been proven and supported. Aim: The aim of the study was to investigate the relationship between stress, sleep problems and diabetes in the representative Hungarostudy 2013 survey. Method: In the cross-sectional questionnaire study, 2000 adults participated. Mean of age was 46.9 (SD = 18.24) years. The average BMI was 26.0 (SD = 4.97) kg/m2. Measures: socio-demographic data, question about the presence of treated diabetes, symptomatic list, Perceived Stress Scale. Results: The frequency of diabetes treated one year before the date of the survey was 8.2%. The levels of stress experienced by diabetic patients were significantly higher than those experienced by participants not treated with diabetes (t(1944) = -2.586, p = 0.010). After adjusting potential background variables, perceived stress shows a marginally significant relationship with diabetes (OR = 1.03, p = 0.052). 26.0% of the respondents reported sleep problems last month, while 40.2% of them reported fatigue and energy shortages. The presence of sleep problems (χ2(2) = 61.108, p<0.001) and feeling of fatigue or lack of energy (χ2(2) = 51.061, p<0.001) are significantly more frequent among people with diabetes. Treated diabetes also predicts the presence of sleep problems (OR = 1.77, p = 0.003) as well as fatigue and lack of energy (OR = 1.88, p = 0.004) under the control of potential background variables. Conclusion: Our results show that, according to trends in other parts of the world, both sleep problems and stress play a significant role in the development of diabetes in Hungary. This draws attention to the need for effective screening and treatment of these factors in the prevention and treatment of diabetes in accordance with international protocols. Orv Hetil. 2019; 160(47): 1872-1880.