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Biomedical subjects

Z Rihmer

Publications and source records attributed to Z Rihmer.

At least 19 recordsLinked to original sources
PubMed2002

Gender differences in panic disorder symptoms and illicit drug use among young people in Hungary.

The authors have investigated the frequency of illicit drug use, and spontaneous and drug-provoked panic disorder symptoms in Hungarian youths. A semi-structured self-reporting questionnaire (with questions about drug usage and the persistence of some DSM-IV panic disorder symptoms) was filled out in discos/nightclubs, secondary schools and universities. Almost 17% of the total sample (n = 1298) reported on illicit drug-use at least once in their life, and this rate was significantly higher among males. Regardless of the illegal drug use 14.6% of the total sample reported on four or more DSM-IV symptoms of panic disorder, and this rate was significantly higher among females. Analyzing the panic disorder symptoms only among drug-users (n = 219), the frequency of persons with four or more anxiety symptoms was 14.1% before drug use, and it increased to 30.6% during the period of drug use (P < 0.001). The findings support previous results showing (i) higher prevalence of anxiety symptoms among females; (ii) higher rate of illicit drug use among males; and (iii) a possible anxiety-provoking effect of illicit drugs.

Adult↗
PubMed2001

Anxiety disorders comorbidity in bipolar I, bipolar II and unipolar major depression: results from a population-based study in Hungary.

BACKGROUND: The aim of this study was to analyze the lifetime comorbidity between DSM-III-R anxiety disorders in separate subgroups of patients with major depression, bipolar II and bipolar I disorder in a community sample of a Hungarian population. METHODS: Randomly selected subjects (aged between 18 and 64 years, N=2953) were interviewed by the Diagnostic Interview Schedule (DIS) which generated DSM-III-R diagnoses. RESULTS: The prevalence of generalized anxiety disorder, agoraphobia and simple phobia was the highest among bipolar II patients (20.8, 37.5 and 16.7%, respectively), social phobia was most prevalent in (nonbipolar) major depression (17.6%), while the rate of panic disorder was the same in the (nonbipolar) major depressive and bipolar II subgroups (12.4 and 12.5%, respectively). Bipolar I patients showed a relatively low rate of comorbidity. CONCLUSIONS: The findings support previous results on the particularly high rate of lifetime comorbidity between anxiety disorders and unipolar major depression and particularly bipolar II illness. LIMITATIONS: Underestimation of the prevalence of bipolar II disorder by the diagnostic methodology used, resulting in a small number of bipolar II cases, lack of analysis of data by gender, no data on obsessive-compulsive disorder.

Adolescent↗
PubMed2001

Can better recognition and treatment of depression reduce suicide rates? A brief review.

Depression, the major cause of suicide, is prevalent but an under-detected, underdiagnosed and, under-treated illness and it is particularly true for depressed suicide victims. However, several studies consistently show that successful treatment of depression not only relieves depressive symptoms, but also decreases and makes suicidality vanish. If the rate of treated depressions in the population increases gradually, at a given point it will appear in the decline of the suicide rates. Although absolute evidence is lacking at present, recent reports from some European countries strongly suggest that increasing utilisation of antidepressants is one of the most important contributing factors in the decrease in suicide rates.

Antidepressive Agents↗
PubMed2000

Sensitivity and specificity of DSM-IV atypical features for bipolar II disorder diagnosis.

The aim of the study was to find the sensitivity and the specificity of DSM-IV atypical features (mood reactivity, weight gain, appetite increase, hypersomnia, leaden paralysis, interpersonal rejection sensitivity) for the diagnosis of bipolar II disorder. Consecutive 557 unipolar (54.9%) and bipolar II (45.0%) major depressive episode (MDE) outpatients were interviewed with the Structured Clinical Interview for DSM-IV and the Global Assessment of Functioning Scale. Bipolar II was diagnosed broadly, with a minimum duration of hypomania of at least some days, instead of the 4 days required by DSM-IV. MDE with atypical features was significantly more common in bipolar II patients. For the diagnosis of bipolar II disorder, MDE with atypical features, sensitivity was 0.45, and specificity was 0. 74. Among individual atypical features, hypersomnia had the best combination of sensitivity (0.35) and specificity (0.81). Combinations of two and three features did not improve sensitivity and specificity. As the diagnosis of past hypomania may not be very reliable from a patient's interview, atypical features may be an important marker of bipolar II disorder.

Adult↗
PubMed2000

Suicide attempts in the Hungarian adult population. Their relation with DIS/DSM-III-R affective and anxiety disorders.

Prevalence of suicide attempts and their relationship with DIS anxiety and affective disorder diagnoses were investigated in a Hungarian adult community sample. Despite the high suicide mortality rate, the rate of suicide attempts was similar to that reported in other studies using similar methods. Suicide attempts occurred more frequently among women and previously married persons. Although the presence of any lifetime anxiety and/or affective disorder increased the rate of reported suicide attempts, the effect of co-morbidity, recurrence and chronicity might be considered significant predictors. The highest odds of an attempt were related to the diagnoses of dysthymic or bipolar disorders. Agitation was the only depressive symptom, which increased the odds of a suicide attempt.

Adolescent↗
PubMed1999

Bipolar II disorder and suicidal behavior.

Despite the fact that the nosologic position of bipolar II disorder continues to be debated, several lines of research indicate that it is a distinct nosologic category that should be separated from both bipolar I and unipolar major depression. This review of the authors' and others' work demonstrates that the lifetime risk of suicide attempts is highest in bipolar II and lowest in unipolar patients, whereas risk is intermediate in bipolar I patients. Moreover, two reports show that bipolar II patients are over represented among suicide victims. Clinicians must take great care in not missing this diagnosis, which, when untreated, has ominous prognostic implications.

Adult↗
PubMed1998

Decreasing tendency of seasonality in suicide may indicate lowering rate of depressive suicides in the population.

The seasonality of suicide is well known and a repeatedly demonstrated phenomenon. The authors analyzed the seasonality of 148 suicide events on Gotland between 1981 and 1996. A marked and significant seasonality with a spring and summer peak was found between 1981 and 1989, when the prescription of antidepressants was relatively low and stable. However, this seasonality disappeared in the period between 1990 and 1996, when prescription of antidepressants increased dramatically, indicating that more and more depressed patients were pharmacologically treated. As the seasonality of suicide in the population is the reflection of the seasonal nature of depressive suicides, the result suggests that a decreasing tendency of seasonality in suicide may indicate the lowering rate of depressive suicides in the given population.

Adolescent↗
PubMed1998

SSRI supplementation of antimanic medication in dysphoric mania.

The authors report on a 42-year-old female inpatient with bipolar I disorder, whose dysphoric mania responded rapidly and completely while her antimanic medication (lithium, carbamazepine, clozapine, haloperidol and clonazepam) was supplemented by 20 mg of paroxetine daily. The practical and theoretical importance of this case is briefly discussed.

Adult↗
PubMed1996

Strategies of suicide prevention: focus on health care.

Suicide is a major health problem, showing an increasing tendency in many developed countries. In this synthetic review, having briefly described the possible risk factors of suicide, those recent strategies that have been proved to be effective methods of reducing the suicide rate are summarised. Psychiatric illness, first of all the affective disorders (particularly in the case of a previous suicide attempt), are the most powerful predictors of this manner of death. Early recognition and appropriate treatment of affective and other psychiatric disorders, as well as aftercare of persons with a high suicidal risk are, consequently, the most successful methods of preventing suicide. Training health-care workers in order to increase their knowledge on the means of suicide prevention and educating patients so as to improve their compliance is highly beneficial. Since health care professionals can help only those patients who contact them, public education on the symptoms, dangers and the treatable nature of depression, other psychiatric illnesses and psychological crises becomes also very important.

Cause of Death↗
PubMed1996

Antidepressant-induced hypomania in obsessive-compulsive disorder.

Out of ten consecutive patients with DSM-III-R obsessive-compulsive disorder without any previous history of bipolarity, three patients showed antidepressant-induced hypomania (clomipramine, one patient; fluvoxamine, two patients) within the first 5 to 8 weeks of the drug treatment. These data support the previous results on a strong association between obsessive-compulsive disorder and bipolar affective illness.

Adolescent↗
PubMed1995

Depression and suicide on Gotland. An intensive study of all suicides before and after a depression-training programme for general practitioners.

In 1983 and 1984, the Swedish Committee for the Prevention and Treatment of Depression (PTD) organised a postgraduate training programme on the diagnosis and treatment to all the general practitioners on Gotland, Sweden. In the following years, the frequency of suicide and inpatient care for depression decreased significantly, as well as the frequency of sick leave for depression. The results of the Gotland study have provided evidence for the view that early recognition and adequate treatment of depression is one essential method of suicide prevention (Rutz et al., 1989; Rutz et al., 1992). A detailed retrospective clinical analysis, of all 115 consecutive suicide victims on Gotland between 1981 and 1992 presented in this study, showed that male gender and violent methods were overrepresented. 50 suicides had a DSM-III-R axis I diagnosis and half of them (n = 25) had primary major depression. Bipolar II disorder was relatively overrepresented in this sample. After the PTD programme, the proportion of depressive suicides was significantly lower than before. This finding strongly suggests that the significant decrease in the suicide rate after the PTD programme is a direct result of the robust decrease in depressive suicides of the area served by trained GPs. The practical importance of this finding is briefly discussed.

Adolescent↗