Seasonality and Delirium Tremens in Hospitalized Patients with Alcohol Dependence Syndrome.

INTRODUCTION: Due to the high rate of mortality, recognizing the contributing factors of alcohol-related delirium tremens (DT), which is the most severe form of alcohol withdrawal state (AWS) is pivotal in clinical settings. Previous studies suggested relationship between seasonality and other types of delirium; however, to our knowledge, this is the first empirical study which examined the role of seasonality in DT in alcohol dependence syndrome (ADS). METHODS: A retrospective study was undertaken between 2008 and 2015; medical records of 1,591 patients were included, which yielded 2,900 hospital appearances. Three groups were formed based on the ICD-10 diagnoses: ADS, AWS, and DT. The characteristics of the groups were analysed with one-way ANOVA and χ2 tests. Multinomial logistic regression was used to explore the potential predictors of DT, including seasonality. RESULTS: The highest incidence of DT was in spring (36.8%; χ2 (3) = 27.666; p < 0.001), especially in March (13.9%; χ2 (11) = 33.168; p < 0.001). Spring, higher mean age, higher presence of comorbid somatic disorders, and lower occurrence of comorbid psychiatric disorders were significant predictive variables for DT with the control of socio-demographic and clinical variables. CONCLUSIONS: The present study revealed that spring, especially March is a critical period in temperate climate zone regarding DT. This can be interpreted as a late winter effect since the temperature is lower in this month compared to other spring months. Furthermore, higher age and the occurrence of comorbid somatic disorders can be considered as risk factors in case of DT. These results support the need of further clinical studies to better understand the impact of seasonality on DT.

[The role of socialisation in psychosexual development].

INTRODUCTION: In the recent research and interpretation of the genetical-biological and environmental-social factors shaping psychosexual development, in addition to scientific arguments, more and more ideological and political aspect have received unfortunate emphasis. OBJECTIVE: Since the literature investigating the development of gender identity and gender orientation has not only increased, but also polarized, it is timely to look at the scientific exchange of ideas and debates among the differing positions. METHOD: Exploring the significance of genetic, biological and social factors involved in the development of gender identity and gender orientation based on international literature data. RESULTS: Based on the current state of science it can be concluded that, in addition to the indisputably marked genetic-biological factors, education and social patterns, as well as the extremely complex environmental and media-related influence with its variable intensity and diverse emotional content also play a significant role in the psychosexual development. This is supported, among other observations, by the data indicating that homoerotic behavior is more common in people raised by same-sex couples. CONCLUSION: As psychosexual development is determined jointly by both genetic-biological and social factors (like education, media etc), belonging to a sexual minority group is not a choice, not the result of a personal decision. Therefore, any kind of discrimination in this regard is unacceptable. Further scientific studies are necessary to answer a large number of questions that still remain open.

["Heavy mental" psychopathology in classical music].

Depending on affinity, attitude, preference, understanding, and mental state, music can influence emotions, mood, motivation, psychomotor, cognitive, and spiritual functions in the receptive person. It is presumed that a given music may reflect the actual psychic condition of the composer and, if applicable, the nature of the chosen topic to be characterized. However, extreme situations may emerge from these components i.e. the music might overshoot the frontiers of normal psychological phenomena and 'heavy mental' psychopathological symptoms or syndromes may appear in it. Present search restricts the wide range of music categories to the classical one (instrumental and vocal, opera included) and attempts to screen for such 'heavy mental' psychopathological signs beside mentioning the slighter symptoms. Phenomena of amnesia, dementia/delirium, mental retardation, biased perception, chemical/behavioural addiction, delusion, misidentification, mania, depression, suicide, anxiety, obsession-compulsion, conversion, disso - ciation, para/hyper/insomnia, sexual and personality disorders are listed as examples from the wide repertoire. The figure of the 'fool' and the topic of 'madness' (in general, and folia, tarantella) are mentioned as well as the appearance of some behavioural traits ('seven deadly sins'), feigning psychic/somatic states, pathological lying, mutism, stutterism, famous oracles, mesmerism, and employing magic or various potions. Mad scenes as psychotic conditions (often tran - sient if due to psychotrauma from romantic love) occur in many operas. However, quite a few of them have been written by Donizetti. Considering his life, behaviour and composing features, the question arises about Donizetti's ailment: was it mood disorder, Barbaja, or luetic derailment?

The personality profile of chronic alcohol dependent patients with comorbid gambling disorder symptoms.

BACKGROUND AND AIMS: The importance of personality characteristics in the diagnosis and treatment of gambling disorder (GD) and alcohol use disorder (AUD) is often highlighted in scientific literature. This study aimed to test predictions about the associations of temperament and character in chronic AUD patients with comorbid GD symptoms and without them. METHODS: Chronic AUD patients enrolled from an inpatient clinic were divided in two groups based on cluster analysis, AUD patients with (AUD + GD group: n = 30) and without (AUD group: n = 68) GD symptoms. Severity of GD symptoms and personality dimensions (Cloninger's Temperament and Character Inventory Revised, TCI-R) were assessed. Associations of tested variables were analysed with analysis of covariance, one-sample and independent sample t-tests. RESULTS: GD symptoms proved to be a clustering factor in terms of personality, where AUD + GD group expressed a more maladaptive personality profile. Compared to Hungarian normative TCI-R scores, both patient groups showed elevated levels of Harm Avoidance and Novelty Seeking with lower scores of Self-directedness, while the AUD + GD group scored lower on Persistence and Cooperation as well. The AUD + GD group reported significantly higher levels of Harm Avoidance, with lower scores of Reward Dependence compared to the AUD group. DISCUSSION: Comorbid GD symptom severity is an important factor in chronic AUD, where AUD patients with comorbid GD symptoms exhibited a more maladaptive personality constellation than singular AUD patients. These emphasize the need of special attention for comorbid GD symptoms in AUD, since treatment recommendations and prognosis for them may also differ.

[Tracing trace elements in mental functions]. / Nyomozás a nyomelemek mentális világában.

Trace elements are found in the living organism in small (trace) amounts and are mainly essential for living functions. Essential trace elements are in humans the chromium (Cr), cobalt (Co), copper (Cu), fluorine (F), iodine (I), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), and questionably the boron (B) and vanadium (V). According to the biopsychosocial concept, mental functions have biological underpinnings, therefore the impairment of certain neurochemical processes due to shortage of trace elements may have mental consequences. Scientific investigations indicate the putative role of trace element deficiency in psychiatric disorders such in depression (Zn, Cr, Se, Fe, Co, I), premenstrual dysphoria (Cr), schizophrenia (Zn, Se), cognitive deterioration/de-mentia (B, Zn, Fe, Mn, Co, V), mental retardation (I, Mo, Cu), binge-eating (Cr), autism (Zn, Mn, Cu, Co) and attention deficit hyperactivity disorder (Fe). At the same time, the excess quantity (chronic exposure, genetic error) of certain trace elements (Cu, Mn, Co, Cr, Fe, V) can also lead to mental disturbances (depression, anxiety, psychosis, cognitive dysfunction, insomnia). Lithium (Li), being efficacious in the treatment of bipolar mood disorder, is not declared officially as a trace element. Due to nutrition (drinking water, food) the serum Li level is about a thousand times less than that used in therapy. However, Li level in the red cells is lower as the membrane sodium-Li countertransport results in a Li efflux. Nevertheless, the possibility that Li is a trace element has emerged as studies indicate its potential efficacy in such a low concentration, since certain geographic regions show an inverse correlation between the Li level of drinking water and the suicide rate in that area.

[Eighty limericks with compliments to professor László Tringer].

Current writing is a tribute of respect, on the occasion of his 80th birthday, to professor László Tringer. In a somewhat unusual way, instead of a bouquet of 80 flowers, a bunch of 80 limericks is presented for him with compliments. The origin of the idea is that professor Tringer himself also writes poems and rhymes in his leasure time. The celebrated professor is an eminently recognized person in the profession, and he is one of the founding fathers of modern psychiatry in Hungary. After receiving the diploma in medical sciences, he has obtained one in psychology and in theology as well. Beside other qualifications he has specializations in psychiatry, neurology, clinical pharmacology, clinical psychology, psychotherapy, addictology and geriatry. Thanks to the providence, the author of the current writing has many common and unforgettable experiences with him. The 80 limericks on the one hand refer to these mutual memories and on the other hand reflect the author's subjective observations on some areas of the society, life situations, character depictions, psychiatry, other medical professions, mental functions, the brain's structural and neurochemical features, and several hints for life conduct. It is assumed that professor Tringer may not necessarily agree with all of these opinions. Nevertheless, these might serve as a basis for further mutual (and for him now over 80 years) inspiring consultations and intellectual adventures.

Novel in vivo experimental viability assays with high sensitivity and throughput capacity using a bdelloid rotifer.

Rotifers have been used in biological research as well-characterized models of aging. Their multi-organ characters and their sensitivity for chemicals and environmental changes make them useful as in vivo toxicological and lifespan models. Our aim was to create a bdelloid rotifer model to use in high-throughput viability and non-invasive assays. In order to identify our species Philodina acuticornis odiosa (PA), 18S rDNA-based phylogenetic analysis was carried out and their species-specific morphological markers identified. To execute the rotifer-based experiments, we developed an oil-covered water-drop methodology adapted from human in vitro fertilization techniques. This enables toxicological observations of individual one-housed rotifers in a closed and controllable micro-environment for up to several weeks. Hydrogen peroxide (H2O2) and sodium azide (NaN3) exposures were used as well-understood toxins. The toxicity and survival lifespan (TSL), the bright light disturbance (BLD) the mastax contraction frequency (MCF) and the cellular reduction capacity (CRC), indices were recorded. These newly developed assays were used to test the effects of lethal and sublethal doses of the toxins. The results showed the expected dose-dependent decrease in indices. These four different assays can either be used independently or as an integrated system for studying rotifers. These new indices render the PA invertebrate rotifer model a quantitative system for measuring viability, toxicity and lifespan (with TSL), systemic reaction capacity (with BLD), organic functionality (with MCF) and reductive capability of rotifers (with CRC), in vivo. This novel multi-level system is a reliable, sensitive and replicable screening tool with potential application in pharmaceutical science.

[Neuroscience of mental flexibility]. / A mentális rugalmasság idegtudománya.

Mental flexibility enabling shifts from the usual prepotent behaviour to new strategies and solutions is a significant factor in the successful adaptation to the changing environment. Components of mental flexibility comprise attention, salience detection, inhibition, working memory and switch processes which can be measured by neurocognitive tests. Data derived from examinations by the methods of cognitive neuroscience can be compared to the features, observed under resting state and during task performance, of brain structures and functions. Studying central nervous system correlates of mental flexibility by imaging, neurobiological, and pharmacological techniques revealed that certain cerebral regions (prefrontal cortex, anterior cingulate and insula, striatum, inferior parietal lobule) with their network connectivities, and some neurotransmitters (e.g. dopamine) have profound roles in this respect. Flexibility shares some similarities with artistic/scientific/everyday creativity and openness as a personality trait and this is also reflected in neurobiological parameters. According to precedents in art history, the public reception and acceptance of nonconform avant-garde artistic products are also dependent on flexibility and openness. Alterations of mental flexibility have been found in diseases (psychiatric and others), and in stress situations. Although flexible switch is generally considered as positive and beneficial, under certain conditions advantages might arise from keeping stability maintaining customs, conventions, and traditions. Orv Hetil. 2017; 158(45): 1771-1786.

[Everyday suspicion: our life is delusional]. / Hétköznapi gyanakvás: életünk a paranoia.

Suspicious thinking in given situations can be useful and helps the adaptation as events occurring in the world also corroborate this. Factors participating in the development of paranoia can be listed as psychodynamic (projection), salience attributional, neurobiological (dopamine), impaired perceptual (hearing loss), sociocultural (minority, pseudocommunity), self-esteem (worrying, depression, mania), and cognitive (jump-to-conclusion) mechanisms. Along the spectrum of thinking, from the mild to the severe, enhanced worrying, salience attribution, overvalued concepts, suspicion/mistrust, paranoid ideations, and crystallized delusions may occur with different contents. In recent years intensive research has been started to reveal the presence of subclinical paranoid thoughts in the general population. Applying various screening methods developed for this purpose (delusions inventories, psychometric tests, virtual reality laboratory) it has been found that suspicious/mistrustful ideations are fairly common in nonclinical samples and some of these are comparable to that seen in patient population. From the larger occurrence of milder forms to the smaller frequency of more severe delusional thoughts the whole hierarchical phenomenon can be described as a 'paranoia pyramid'. Based on this everyday paranoid thinking style lurking in people, it may well be that 'our life is delusional'. Orv. Hetil., 2016, 157(50), 1979-1988.

[EVENT-RELATED POTENTIALS AND CLINICAL SYMPTOMS IN SCHIZOPHRENIA]. / ESEMÉNYFÜGGO POTENCIÁLELTÉRÉSEK ÉS KLINIKAI TÜNETEK ÖSSZEFÜGGÉSEI SZKIZOFRÉNIÁBAN.

The investigation of schizophrenia's aetiology and pathomechanism is of high importance in neurosciences. In the recent decades, analyzing event-related potentials have proven to be useful to reveal the neuropsychological dysfunctions in schizophrenia. Even the very early stages of auditory stimulus processing are impaired in this disorder; this might contribute to the experience of auditory hallucinations. The present review summarizes the recent literature on the relationship between auditory hallucinations and event-related potentials. Due to the dysfunction of early auditory sensory processing, patients with schizophrenia are not able to locate the source of stimuli and to allocate their attention appropriately. These deficits might lead to auditory hallucinations and problems with daily functioning. Studies involving high risk groups may provide tools for screening and early interventions; thus improving the prognosis of schizophrenia.

[THE THERAPUETIC USE OF TRANSCRANIAL MAGNETIC STIMULATION IN MAJOR DEPRESSION]. / TRANSCRANIALIS MÁGNESES STIMULÁCIÓ TERÁPIÁS ALKALMAZÁSA MAJOR DEPRESSZIÓBAN.

The antidepressive effect of repetitive transcranial magnetic stimulation (rTMS) has been investigated for almost 20 years now. Several studies have been published aiming to identify the exact and reliable parameters leading to the desired therapeutic effect. However, the related literature shows great variability. The current overview aims to provide a comprehensive overview of factors associated with the therapeutic effect of rTMS in major depression. High frequency stimulation of the left dorsolateral prefrontal cortex (DLPFC) for 3-6 weeks leads to mood improvement comparable to the effect of antidepressive medications in 35-40% of patients. Pharmacotherapy resistant patients treated with rTMS reach remission for 3 months on average. Low frequency stimulation of the right DLPFC appears to be similarly effective, though much less investigated so far. In addition to the exact delineation of the stimulation area, treatment outcome is also related to stimulation intensity as well as the number of sessions and impulses. Considering the safety and tolerability aspects of rTMS, it might be a significant therapeutic support for therapy resistant patients. Above this, patients diagnosed with major depression might benefit from the additional positive influence of rTMS improving the effect of antidepressive medication. Based on converging research evidence, the Food and Drug Administration (FDA) agency approved the use of rTMS as a treatment option for therapy resistant major depression in 2008. So far, in Hungary rTMS is primarily considered as a promising tool in research settings only. Hopefully, patients suffering from major depression will increasingly benefit from the positive therapeutic effect of this intervention.

[Gambling disorder and alcohol use disorder -- similarities and differences]. / Szerencsejáték-használati zavar és alkoholhasználat-zavar -- hasonlóságok és különbségek.

Gambling disorder has been listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for more than three decades. During this time, its diagnostic set of criteria has gone through significant changes. In the DSM-5, gambling disorder has been moved from Disruptive, Impulse-Control and Conduct Disorders to Substance- Related and Addictive Disorders, which acknowledges and expresses that gambling disorder has similar features compared to substance related disorders. The aim of the present review is to reveal the reasons behind this category replacement, and to examine the similarities between gambling disorder and alcohol dependence from the perspectives of symptomatology, etiology and epidemiology.

[SHIFTING FUNCTION OF WORKING MEMORY IN PSYCHOTIC DISORDERS]. / A MUNKAMEMÓRIA VÁLTÁSI FUNKCIÓJA PSZICHOTIKUS KÓRKÉPEKBEN.

BACKGROUND AND AIMS: Mental disorders with psychotic features are overlapping in many ways and there are a growing number of comparative studies in the last decades regarding this. Cognitive deficit is well underpinned in schizophrenia, but fewer studies are conducted in this area including patients with bipolar affective disorder. Therefore the aim of the present study was to investigate the cognitive performance of these two patient groups and healthy controls. The Wisconsin Card Sorting Task is a very sensitive measure of the shifting function. Schizophrenic patients perform consistently poorer on this task than healthy controls, while there are not much data about individuals with bipolar affective disorder. METHODS: The Wisconsin Card Sorting Task and clinical symptom rating scales were administered to 26 patients with schizophrenia, 24 with bipolar affective disorder and 21 healthy controls. RESULTS: Significant differences were found among the performance of the three groups using four different dimensions of the Wisconsin Card Sorting Task. The schizophrenic group made more perseverative errors and achieved less conceptual level responses and completed fewer categories compared to healthy controls. Patients with schizophrenia were able to complete fewer categories and had fewer conceptual level responses than the bipolar group. No significant differences were observed between patients with bipolar disorder and healthy controls. CONCLUSIONS: According to these results, patients with schizophrenia and bipolar affective disorder showed no similarities on the Wisconsin Card Sorting Task. Bipolar patients performed the task on the same level as healthy individuals did. The two mental disorders influence cognitive performance differently.

Direct and indirect symptom severity indicators of alcohol dependence and the personality concept of the biosocial model.

Temperament and character factors are strongly related to the developmental, clinical, and treatment aspects of alcohol dependence. This study had the aim of revealing the underlying personality structure and individual differences in the symptoms of alcohol dependence measured by multiple severity indicators. Patients with alcohol dependence exhibited higher levels of novelty seeking and harm avoidance, and lower levels of persistence, self-directedness, and cooperativeness. Especially novelty seeking was connected with more severe alcohol dependence. These characteristics could be useful targets of interventions and Temperament and Character Inventory is therefore a useful measurement to identify patients with more severe alcohol-related problems.

[Psychological and biological background of the correlation between psoriasis and stress]. / A pikkelysömör és a stressz közötti összefüggés pszichológiai és biológiai alapjai.

Stress is considered as a major contributor to the development and exacerbation of psoriasis by a significant proportion of patients and dermatologists. As both stressor and its effects are subject-dependent, thus extremely difficult to measure, our understanding of the exact role of stress in disease development was limited for a long time. In the past decade several new studies were carried out which expanded our knowledge on the pathophysiologic processes linking stress to psoriasis via with their objective measurements and the applied new techniques. The authors review the current literature of both psychological (alexithymia, personality, affect) and biological (cortisol, epinephrine, neurogenic inflammation) factors influencing stress perception and response in psoriasis. Results of recent investigations support previous reports about the interaction between stress and psoriasis with objective evidence. Knowing how effective stress-reducing psychopharmacologic and psychotherapeutic interventions are in the treatment of psoriasis the authors hope that this review contributes to a wider acceptance of the psychosomatic attitude in everyday dermatologic practice.

Peripheral blood mono-nuclear cells derived from Alzheimer's disease patients show elevated baseline levels of secreted cytokines but resist stimulation with ß-amyloid peptide.

OBJECTIVES: Among several other factors, the neuro-toxic ß-amyloid peptide (ßAP)-induced inflammatory mechanisms have also been implicated in the pathogenesis of Alzheimer's dementia (AD). Cytokines have recently emerged as prime candidates underlying this immune reaction. The purpose of this study was to evaluate the inflammatory response of peripheral blood mono-nuclear cells (PBMC) in AD. DESIGN: Cross-sectional (observational) study. SETTING: Behavioral and cognitive neurology clinic of the Universidade Federal de Minas Gerais in Belo Horizonte, Brazil. PARTICIPANTS: AD patients (n=19), healthy elderly (n=19) and young (n=14) individuals. MEASUREMENTS: Cytokine levels were assessed by enzyme-linked immuno-sorbent assay (ELISA) after exposing cells to a broad range of ßAP concentrations (10(-4)-10(-10)M) as a stimulus. AD samples were weighed against leukocytes harvested from non-demented young and elderly subjects. RESULTS: Cytokine production of PBMCs in the youth was characterized by low baseline levels when compared to cells from the older generation. In the aging population, AD cells were distinguished from the healthy elderly sub-group by an even higher basal cytokine secretion. The low resting concentration in young individuals was markedly increased after treatment with ßAP, however cells from the elderly, irrespective of their disease status, showed unchanged cytokine release following ßAP administration. Non-specific activation of PBMCs with anti-CD3/CD28 antibodies resulted in elevated interleukin (IL)-1ß concentrations in AD. CONCLUSIONS: These results demonstrate a general over-production of cytokines and resistance to ßAP in the old comparison group, with a more pronounced disruption/boosted pattern in AD. Our findings are in line with the hypothesis of "inflammaging", i.e. an enhanced inflammatory profile with normal aging and a further perturbed environment in AD. The observed cytokine profiles may serve as diagnostic biomarkers in dementia.

[Neuroscience of creativity or can the ungraspable be captured?] / A kreativitás idegtudománya, avagy megragadható-e a megfoghatatlan?

Creativity is a particularly complex entity that can be best conceptualized along dimensions of opposite polarities. It can simultaneously be considered as a phenomenon that comprises a multitude of processes but also be interpreted as a complex construct which indeed does not have a uniformly accepted definition despite extensive literature on creativity. Creativity researchers of various approaches offer alongside methodological diversity a vast array of paradigms and definitions, leading, on the other hand, to contradictions of results. Nevertheless, the concept of creativity is to be maintained in the sense that it encompasses the ability to produce innovatively original, valuable, adaptive solutions breaking with pre-existing categories and developing unconventional alternatives. Since creativity cannot definitely be subject of scientific investigations as an overarching entity and its essence has not been grasped so far, some of its components can be measured and defined such as specific cognitive processes (divergent and convergent thinking, remote associations, conceptual expansion, working memory), motivational factors, emotional/affective conditions or personality traits considered as predictors of creative performance (schizotypal, autistic spectrum traits). Even though definitional inconsistencies persist, gradually neurobiological approaches have become the main issue of creativity research. Recently, the analysis of brain network activity applying methods of electrophysiology and brain imaging seems to promote the understanding of the functional localization of creative performance. Certain brain regions were initially identified as correlates of creativity, such as lateral prefrontal cortex, inferior parietal lobe, insula, striatum. More recent studies emphasize the activation and effective functional connectivity of large brain networks (default mode network, frontoparietal executive control, and others) as well as highlight the importance of their brain and neurochemical substrate (gray matter volume, white matter integrity, dopamine), connecting with cognitive processes of opposite style (flexibility versus persistence). While this paradigm seems to converge toward the delineation of a coherent neurobiological model of creativity, obviously we would not infer the essence of such a complex phenomenon from a simplified sub-process. Orv Hetil. 2023; 164(18): 683-693.

Restraint stress in rats alters gene transcription and protein translation in the hippocampus.

Stress is a relatively new and emerging risk factor for Alzheimer's disease (AD). Severe stress can alter brain characteristics such as neuronal plasticity, due to changes in the metabolism of cytoskeletal proteins. In this study, male Wistar rats were exposed to restraint stress (RS) for 5 h daily for different time periods. At the end of the exposure periods, the amounts of ß-actin, cofilin, amyloid precursor protein (APP) and mitogen-activated protein kinase 1 (MAPK-1) RNAs and proteins were investigated. The mRNA expressions of ß-actin, cofilin and MAPK-1 followed U-shaped time course. Acute (3 days) and chronic (21 days) RS caused a fourfold and tenfold increases, respectively, in hippocampal ß-actin mRNA expression. In the case of cofilin mRNA expression, elevations were detected in the hippocampus on days 3, 7 and 21. The APP mRNA level was increased on day 21. On protein level, chronic stress elevated the levels of ß-actin, cofilin and APP in the hippocampus. These results suggest that stress causes the induction of some genes and proteins that are also elevated in AD selectively in the hippocampal region of the rat brain.

Personality traits and coping compensate for disadvantageous decision-making in long-term alcohol abstinence.

AIMS: High relapse rate and extreme difficulty to maintain abstinence are core characteristics of alcohol dependence (AD). Previous studies have demonstrated a persistent decision-making (DM) deficit in AD. We aimed to reveal specific personality features and stress-coping mechanisms presumed to compensate for ineffective DM skills. METHODS: Eighty-eight unmedicated patients with AD were enrolled. Intact general cognitive status was assured by IQ above 90. Forty-three patients had an average abstinence period of 12 weeks and were currently in an inpatient treatment program (short-term abstinence group, STA) and 45 patients were abstinent for at least 3 years (long-term abstinence group, LTA). The two groups were assessed using an integrative approach combining domains of DM, temperament and character dimensions and stress-coping measures. RESULTS: Both groups performed at chance level with no linear improvement tendency on the gambling task assessing DM adequacy. The LTA group scored significantly higher on scales of self-directedness and cooperativeness. In contrast, levels of harm avoidance, emotion-oriented coping and perceived stress were significantly higher in the STA group. CONCLUSION: Our findings provide new evidence for a persistent DM deficit with no learning effect in AD. Despite the deficit, alcohol-dependent patients can achieve LTA. STA patients perceive higher levels of stress and use non-adaptive coping strategies. We propose that the more adaptive personality profile of LTA patients contributes to the compensation of the trait-like DM deficit in alcoholism. These compensatory features represent promising new targets for preventive measures and therapeutic interventions in AD.

Marking the markers of Alzheimer's: too good to diagnose, too bad to use?

One of the most important neurodegenerative diseases of our time is Alzheimer's disease, which mainly affects the elderly population. The accumulation of ß-amyloid and tau protein in the brain tissue is the most characteristic pathomechanical event of the disease, later causing neuronal cell death. Setting up an accurate diagnosis of Alzheimer's disease has essentially changed recently, since besides psychometry, neurochemical and neuroimaging examinations are also gaining greater importance in the clinical routine. Thanks to the widening of diagnostic methods, in the future the disease could be recognised even during the preclinical phase. The most remarkable source of brain-derived compounds is the cerebrospinal fluid. Although obtaining cerebrospinal fluid is greatly unpleasant, it poses a low risk and is frequently used as part of the diagnostic procedure. The assay of cerebrospinal fluid means the identification of the level of ß-amyloid(1-42), tau and phospho-tau and their ratio, but to get more specific and sensitive investigations there is intensive research work both on the utility of their combination and on finding even more specific biomarkers. This review gives a summary of the biomarkers that are being used and being researched for the diagnostic tests of both familial and sporadic forms of Alzheimer's disease. Other notable sources of neurochemical compounds are the serum and the plasma, however, the identification of their biomarkers is under preclinical examinations. Unfortunately neither the validation of these markers nor the consistent acceptance of the experimental results is possible due to the wide range of protocols in international research. The importance of biomarkers in the development of potential drug candidates is also discussed.