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Abstract
Background and Aims
This study sought to identify patterns of psychedelic use among American psychiatrists, to compare the demographic variables across categories of social proximity and personal use, and to determine how these categories influenced psychiatrists' attitudes towards drugs and people who use drugs.
Methods
Respondents (N = 180; mean age = 48.4 [SD = 16.2]; male = 65.5%; trainees = 24.1%) were recruited via email lists/listservs and personal networks (snowball sampling).
Results
Approximately one-third (32.8%) of psychiatrists reported Personal Connection (i.e., history of personal use and social connection) to psychedelics. Psychiatrists with Personal Connection to psychedelics were more likely to be younger (p = 0.006, ηp 2 = 0.057) and have fewer years of practice (p = 0.008, ηp 2 = 0.058). Almost all (92%) of those with No Connection to psychedelics were out of training, compared with only 8% of those in training. Those with Personal and Social Connection to psychedelics were more likely to disagree: that using illegal drugs is morally wrong (p < 0.001, ηp 2 = 0.28), that illegal drug users should go to prison (p < 0.001, ηp 2 = 0.15), are weak minded (p < 0.001, ηp 2 = 0.10), have no future (p < 0.001, ηp 2 = 0.12), are not well educated (F(2.0, 170) = 7.38. p < 0.001, ηp 2 = 0.08), are dishonest (p < 0.001, ηp 2 = 0.10), and that illegal drug users ‘make me angry’ (p < 0.001, ηp 2 = 0.10).
Conclusions
Personal and social connection to psychedelics is associated with decreased stigma towards drug use and people who use drugs. Future research should examine whether proximity to psychedelic use impacts other factors (e.g., empathy, therapeutic alliance) involved in psychiatry training and practice.
Állkapocsízületi diszfunkció kezelése skeletalis horgonylattal kombinált fogszabályozással
Skeletal anchorage combined orthodontic treatment of temporomandibular disorder
Temporomandibular disorder is the most common form of orofacial pain. Today it affects 15% of the adult population and 7% of adolescents. It is characterised by pain originating from the muscles and/or the temporomandibular joint and vocal symptoms accompanying jaw movements, as well as muscle fatigue, lockjaw and tooth wear. Chronic pain due to jaw dysfunction can lead to the deterioration of the patient’s psychological state and negatively affect their quality of life. As the temporomandibular joint is closely related to dentition, any modification of the existing bite must be taken into account from gnathological aspects. Orthodontic treatment can also be seen as a guided change of occlusion, and therefore the greatest possible attention should be paid to maintaining the stability of the temporomandibular joint (orthopaedic stability) when planning treatment, as this is closely related to joint health. If gnathological considerations are not met during treatment planning, altered bite position may lead to craniomandibular dysfunction; on the other hand, restoring stability may be an effective way to reduce symptoms. The aim of our case presentation and brief summary of the literature is to provide an overview of the pathology of temporomandibular joint complaints due to orthopaedic instability, the characteristics and symptomatology of stable and unstable occlusion, and the possible prevention and therapeutic options for temporomandibular joint dysfunction. Orv Hetil. 2024; 165(37): 1472–1477.
A cochlearis implantátumok fejlesztési iránya a perimodiolaris diszkriminációs elhelyezkedés korrekciójára
Direction of cochlear implant developments used for the correction of perimodiolar discrimination location
Introduction: Cochlear implant is a hearing enhancement device that directly stimulates nerve cells with electrical impulses. The optimal placement of the implanted electrode array is crucial for device wearers. Numerous domestic and international studies have confirmed a significant correlation between the quality of restored electrical hearing after surgery. During optimal implantation, electrodes are placed as close as possible to the spiral ganglion cells, allowing for more focused stimulation to improve speech perception and speech intelligibility. Objective: Our aim is to investigate the positioning of the electrode array and optimize the smallest distance to the cochlear midline. Additionally, we analyze the favourable position virtually and digitally redesign the shape of the inserted electrodes. Method: For our research, we analyzed the positioning results of 10 perimodiolar implanted electrode arrays. The results of intraoperative imaging procedures were compared with electrophysiological methods (impedance, neural response telemetry examination). Results: Based on our measurements, we compared virtually created electrode arrays with differentially deformed basal segments (0°, 15°, 30° and 45°). Electrophysiological and imaging techniques confirm that the electrode array is in a more favourable position when it is closer to the cochlear midline. Conclusion: The repositioning of the reshaped electrode array can have a drastic impact on future speech perception, speech quality, and device energy consumption. Orv Hetil. 2024; 165(37): 1452–1460.
A digitális 3D tomoszintézises mammográfia az emlőrák diagnosztikájában és szűrésében
Digital 3D tomosynthesis in the diagnosis and screening of breast cancer
Breast cancer mortality and morbidity are significantly reduced with the introduction of the mammography screening program. From the point of view of complete recovery, there is an extremely high demand for early detection. Digital 3D tomosynthesis is a complementary modality to digital mammography (full-field digital mammography – FFDM), which has been accepted by the FDA since 2011, and is well suited for the diagnosis of breast diseases and breast screening. Basic principle of digital 3D tomosynthesis: during the examination, an x-ray tube moving in a given circular arc takes 10–15 overlapping digital images of the breast – with a small dose of radiation – in a short time. From the data set obtained in this way, thin-slice layer images (3D tomosynthesis) and reconstructed, so-called synthetic 2D images – similar to the traditional mammographic image – are also produced. In addition to the advantages (higher cancer detection rate, more accurate assessment of abnormal patterns, structural distortion, asymmetric density, reduction of the number of unnecessary biopsy, decreasing recall rate in screening), knowing the dilemmas related to the disadvantages (e.g., radiation exposure, need for larger storage space) is also important. Orv Hetil. 2024; 165(37): 1443–1451.
Dr. Romics Imre urológusprofesszor (1947–2024)
In memoriam Dr. Imre Romics professor of urology (1947–2024)
Abstract
Background and Aims
Problem gambling (PG) represents a significant public health concern with widespread effects in various cultures and regions globally, with younger individuals and males at a particularly higher risk. This disparity is attributed to a mix of cultural, developmental, and biological influences. To date, there has not been a comprehensive examination to determine whether this risk pattern holds consistently across different jurisdictions.
Methods
We performed a systematic review and meta-analysis using the PRISMA framework, identifying 21 eligible studies from 18 countries, encompassing 156,249 participants (47.6% male and 52.4% female).
Results
The studies varied considerably by region (Asia: 19%, Europe: 52%, Oceania: 19%, North America: 10%), the diagnostic criteria for PG, and participation rates in gambling (ranging from 12% to 92%). Data on PG prevalence was categorised by gender and three age groups (young: 18–35, middle: 30–55, and older: 45–65). Using a random-effects meta-analysis, we found a global PG prevalence of 1.9%. Europe reported a significantly lower prevalence (1.3%) compared to North America (5.3%). Men were found to be 3.4 times more likely than women to engage in problem gambling, although the gap narrows in North America. The young demographic showed a 1.51 times higher likelihood of reporting PG compared to the middle-aged group, whereas older adults were 0.80 times less likely to report PG. Notably, age-related effects varied significantly across regions.
Conclusions
Our findings confirm that age and gender significantly influence PG risk across cultures, with significant heterogeneity observed across jurisdictions.
Abstract
Background and aims
The aim of the present study was to estimate the complex association between Internet Gaming Disorder (IGD), substance use, and other risky behaviours in Czech adolescents whilst providing prevalence estimates of IGD and psychometric information regarding the Czech Internet Gaming Disorder Scale–Short-Form (IGDS9-SF).
Methods
A representative sample of 3,950 Czech adolescents was recruited through stratified random sampling in the school setting.
Results
Disordered gamers showed frequent use of specific substances such as pharmaceuticals, methylenedioxymethamphetamine, and lysergic acid diethylamide. In contrast, non-gamers had higher prevalence of alcohol, cigarettes, sedatives and tranquillisers, and marijuana use. A logistic regression, utilising IGDS9-SF raw scores and average daily gaming time, revealed a U-shaped relationship between gaming and both alcohol and cigarette use. Additionally, conduct problems such as bullying, and risky in-game behaviours were more prevalent among disordered gamers, with the exception of forging parents' signatures. The overall prevalence of IGD was 3.62% (95% CI = [3.1%, 4.3%]), with higher rates in males (5.89%; 95% CI = [4.9%, 7.0%]) than in females (1.45%; 95% CI = [1.0%, 2.1%]).
Discussion and conclusions
The Czech IGDS9-SF used in the present study showed adequate psychometric properties. The association between gaming and substance use behaviours may be specific and multifaceted depending on the severity of the gaming-related problems. Furthermore, disordered gamers may become more vulnerable due to a higher incidence of conduct problems, bullying (victimisation), and in-game risky behaviours such as engagement with microtransactions mechanics (e.g., loot box) within video games.
Abstract
Background
Research on individual differences in brain structural features of internet gaming disorder (IGD) and established addictions such as tobacco use disorder (TUD) is currently limited. This study utilized normative modeling to analyze the cortical thickness (CT) development patterns of male patients with IGD and TUD, aiming to provide further insights into whether IGD qualifies as an addiction.
Methods
Surface-based brain morphometry (SBM) was used to calculate CT from T1-weighted magnetic resonance imaging data of 804 male participants (665 healthy individuals, 68 IGD and 71 TUD). Gaussian process regression was employed to generate normative models of CT development. Deviation maps were produced to depict deviations of IGD and TUD participants from the typical developmental patterns.
Results
Both addiction groups exhibited widespread cortical thinning, particularly in regions such as the bilateral temporal pole and medial orbitofrontal cortex. The TUD group demonstrated a higher degree of individualization and limited spatial overlap compared to the IGD group. Opposite trends in CT changes were observed between the two groups in the bilateral pericalcarine cortex and pars triangularis.
Conclusions
These findings regarding the similarities and differences between IGD and TUD provide support for the idea that IGD shares common features with substance-related addictions and contribute to a deeper understanding of the neural mechanisms underlying IGD.
Abstract
Background and Aims
This naturalistic mixed methods field study, aimed to assess the potential of a psilocybin induced experience, to help Emergency Medical Service Workers (EMSW) to address psychological and stress related symptoms stemming from a challenging working environment, known to contribute to occupational burnout (OB).
Methods
This exploration was conducted with an intentional sample of five participants, recruited through an online survey who self-administered a therapeutic dose of psilocybin mushrooms to manage psychological symptoms resulting from their work as EMSW, allowing the authors to assess the outcome. To measure the impact of the experience, changes in OB measures were assessed with psychometric instruments previously used in this population at three timepoints, before and after the session. The subjective impact of the psychedelic experience, through psychological insights and emotional breakthroughs, was also assessed, and two follow-up interviews were conducted to collect further data.
Results
The results showed that, two weeks after the session, a visible improvement was noticed in several measures of pre-existent OB, that remained stable after two months. Additionally, most participants reported a strong subjective impact, that they perceived as fundamental for the positive outcome.
Conclusions
After one therapeutic psylocibin session, several measures of OB showed an encouraging level of improvement and may constitute an important step towards finding alternative and innovative solutions to address high rates of psychological distress experienced by EMSWs, also benefiting the organization and the quality of patient care. The limitations and implications of the study and suggestions for future research are discussed.
