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Sándor Fekete

Publications and source records attributed to Sándor Fekete.

10 recordsLinked to original sources
PubMed2006

[Assessment of suicidal behaviour in general practice].

AIM: To assess the prevalence of suicidal behavior (wish to die, suicidal thoughts, suicide attempts) and to determine the characteristics of suicide attempters in primary care, including screening for major mental disorders. METHOD: A Hungarian urban general practitioner's district with 1248 inhabitants was screened for suicidal behavior as well as for major mental disorders. All the patients (n=382) who visited their general practitioner within a two-week period were asked to participate. 277 patients completed the Prime-MD questionnaire, an easy-to-use diagnostic instrument developed for general practitioners to recognize the most common psychiatric disorders, like depressive (major depressive disorder, minor depressive disorder), anxiety (panic disorder, generalized anxiety disorder), somatoform, eating and alcohol related disorders. Detailed data about suicidal thoughts and attempts were also collected by the structured questions of MINI-Plus diagnostic interview. RESULTS: Prevalence of suicide attempts in primary care was 2.9%. 9% of the patients had either suicidal thoughts or suicide attempts in the previous month. Suicidal patients were more ready to use psychotropic drugs, they assessed their health status more poorly, and had more mental symptoms than the control group (non-suicidal patients). 60% of suicidal patients and 11.5% of the investigated population had a current depressive episode. Beside depressive symptoms, anxiety disorders and alcohol problems were also more common among suicidal patients. The rate of previous psychiatric treatments was also higher in suicidal patients, who generally visited their general practitioners less frequently than non-suicidal patients. According to multivariate logistic regression, suicidal patients are more ready to take antidepressants, they tend to have more previous psychiatric treatments and suicidal attempts, and they visit their general practitioners less frequently and have a current depressive episode. CONCLUSION: Suicidal behavior and mental disorders are frequent in primary care. Since almost every tenth patient visiting their general practitioner has suicidal thoughts or depressive or anxiety disorder, the recognition of suicide risk and mental disorders is very important in primary care. As for preventing suicides, the diagnosing and treating of mental disorders -especially affective disorders- are very important for general practitioners. In addition to pharmacotherapy, psychotherapies are also important in treating patients in crisis situations, or with suicidal thoughts or depressive disorder. The modified Prime-MD questionnaire can be an effective, easy-to-use method in the hand of the general practitioners to identify suicidal risk and to recognize the most common mental disorders in the average population.

Adult↗
PubMed2005

Suicide attempt and melancholic depression in a male with erotomania: case report.

Erotomania is a delusional disorder, which is more common among women. A case of erotomania in a 34-year-old male associated with depression and suicidal behavior is presented. At the time he attempted suicide his erotomania fulfilled the diagnostic criteria of "pure" erotomania, described by de Clérambault. A depressive picture with melancholic features emerged four months later. Antidepressant medication was given and two months later he became euthymic. The erotomanic delusion disappeared in the third month of the euthymic state. In this case primary erotomania was associated with a depressive illness, presumably unipolar depression. The patient developed delusional guilt and suicidal ideation before the unequivocal change in his mood. To the authors' knowledge this is the first reported case where the erotomanic symptomatology led to suicidal attempt.

Adult↗
PubMed2005

Use of antipsychotics in the management of schizophrenia during pregnancy.

The rapid development of pharmacotherapy has resulted in a growing clinical importance for the treatment of the increasing number of women with schizophrenia during pregnancy. An evolving database on reproductive health safety factors for women with schizophrenia has begun to be of assistance in optimising clinical benefits for women with childbearing potential. Given the prevalence of antipsychotic use during pregnancy in women with schizophrenia, it is important for the clinician to have a prepared approach to the administration of these agents. In general, the use of psychotropic medication during pregnancy is indicated when risk to the fetus from exposure to this medication is outweighed by the risks of untreated psychiatric illness in the mother. The preponderance of evidence from registries to large health surveys indicate that treatment with antipsychotic medication confers either no or a small nonspecific risk for organ malformations. According to the relevant literature published on the safety of antipsychotic medication during pregnancy, the findings are encouraging; however, the currently available data are very limited. Until there are more controlled prospective data on the impact of drugs on fetal and later development, the clinician will continue to work in a state of potential uncertainty, weighing partially estimated risks against managing individual clinical problems. The aim for the clinician should be to provide the best information available regarding the scope of possible risks associated with the treatment of schizophrenia during pregnancy. On the basis of the available data, generalisation is impossible and recommendations should be made on a drug-by-drug basis. The risks and benefits must always be carefully weighed for each patient on an individual basis. Only a woman who is well enough to acknowledge her pregnancy and her mental illness can effectively weigh the relative and partially unknown risks of treatment with antipsychotic medication against the highly probable risks of illness exacerbation if untreated.

Antipsychotic Agents↗
PubMed2005

[Suicidal behavior in adolescents--psychopathology and addictive comorbidity].

Despite of the decreasing suicide rates, the number of suicide attempts--peculiarly in the adolescent population--shows a growing tendency. Due to the small amount of study results the problem remains hard to assess. Child and Adolescent Self harm in Europe (CASE) study, allows us to explore self-reported suicidal behavior among adolescents more exactly. This European multicentre study has a special focus on adolescent suicidal behavior (suicidal thoughts, ideation, deliberate self harm, suicide attempt) and other self destructive behavior (drug, alcohol) as well as psychopathological symptoms (anxiety, depression, impulsivity, aggression) and it also investigates coping strategies, life events and family background. In the representative school-based community study an anonymous, self-reported questionnaire were conducted with 4408 (males: 2388, females: 2020) 15 and 16 year-old pupils. Out of the 4408 pupils 7.8% (males: 4.6%, females: 11.6%) of the adolescents reported former suicide attempt, 1.6% of the boys and 3.6% of the girls reported about more than one suicide attempts. According to the statistical analysis the suicidal group greatly differs from the non-suicidal one. Suicidal adolescents were more likely to use alcohol, drugs or nicotine than their non-suicidal peers. Drug abuse was four times more common among suicidal boys, and five times more common among suicidal girls than in the non-suicidal group. 30% of the boys and 13% of the girls used more than one kind of drug. The use of ecstasy and sedatohypnotic drugs showed the most spectacular difference between suicidal and non-suicidal teenagers in both genders. Suicide attempters usually had higher scores in scales measuring anxiety, depression, impulsivity, while their self-esteem was significantly lower. The comparative analysis has revealed that suicide attempters compose a subgroup with more severe psychopathology (anxiety, depression, and impulsivity), lower self-esteem and ineffective coping strategies. Suicidal behavior frequently appeared with addictive problems. The results of our study may help in recognizing the role of risk factors coexisting with suicidal behavior and thus making it easier for schools to have adequate and effective prevention programs.

Adolescent↗
PubMed2005

[Suicide attempt, psychopathology and genetics].

BACKGROUND: There is compelling evidence that suicidal behaviour has a heritable component and is associated with disturbances in serotonergic mechanisms. Thus genes coding for proteins of the serotonergic pathways are leading candidates for investigating possible associations. METHOD: We studied three serotonergic gene polymorphisms (5-HTTLPR S/L, TPH A779C, 5-HT1B G861C) in a sample of 114 unrelated suicide attempters (mainly non-violent methods), in 112 patients, 23 siblings and 56 healthy controls. Genotyping was done using polymerase chain reaction (PCR) based assays. The primary analyses compared allele and genotype frequencies between patients and controls and to test for presence of linkage disequilibrium using the family based association test (FBAT). The genotypes were further related to clinical characteristics and to psychological traits. RESULTS: There was a trend towards an increase in the L-allele frequency of the 5-HTTLPR in suicidal patients (p=0.066, OR=1,57, 95%CI 0,96-2,52). No other polymorphisms were associated with suicidal behaviour and the FBAT showed no excess transmission of any allele from parents to the offsprings. We found a slight reduction in "Novelty Seeking Scores" in patients having at least one S-allele (one-way ANOVA F=3,90, p=0.024). All the other traits were not related to any of the genotypes. CONCLUSION: Our data extend the evidence that genetic factors do not play a major role in non-violent suicidal behaviour. The 5-HTTLPR S/L variants may have an impact on personality traits.

Adult↗
PubMed2005

[Changes in sexual function in mirtazapine treatment. Primary data of a national, multicenter, prospective observational study in depressed patients].

INTRODUCTION AND OBJECT: It is a well-known fact, that in most of the psychiatric diseases problems can break out on the field of sexual life as well, which frequently occurs particularly in depression. The problems can be even worse, because of the side effects of the antidepressants causing sexual dysfunction. Nowadays there are some new antidepressants, which have more favourable side effect profiles. The aim of this study was to follow up the occuring side effects during mirtazapine treatment with special regard to incidence of sexual problems. PATIENTS AND METHOD: Altogether 102 outpatients (44 men, 58 women) were recruited to this prospective, observational, non-interventional study, who were suffering from depression and had stable partner, permanent sexual life and who signed the informed consent. The screening was followed by three visits, when the 17-HAMD, CGI and 9-BDI scales were used. The change of sexual life was monitored by a self- completing questionnaire. RESULTS AND CONCLUSION: Both the depression rating scales and the CGI have shown a significant mood improvement. From monitoring the changes in sexual life it turned out, that patients reported sexual problems much rarer as they had done it at the beginning of the study (screening: 93.2%, one month later 61%, three months later 27.1%, at the end of the study only 24.6%) Patients were evaluating their sexual life better and better during the study, and parallel to this, frequency of sexual intercourse was also increased. On the basis of the results it can be established, that mirtazapine is an effective tool for even those depressed patients who suffer from sexual dysfunction. Together with curing the depression and improving the sexual life mirtazapine can also help to restore the good quality of life.

Adult↗
PubMed2004

[Gender differences in suicidal behavior].

Gender-specific differences in suicidal behaviour have been analysed in a number of recent studies. According to these, several socioeconomic, demographic, psychiatric, familial, help-seeking differences can be identified in protective and risk factors between males and females. Gender is one of the most replicated predictors for suicide. In the framework of the WHO/EURO Multicentre Study on Suicidal Behaviour, more than fifty thousand suicide attempts have been registered so far. Until now data on more than 1200 monitored suicidal events have been collected in Pecs centre. In most countries male suicid rates are higher. In contrast to suicides, rates of suicide attempts are usually higher in females. Concerning the differences in methods, it is a recognised fact that males use violent methods of both suicide and attempted suicide more often than females. The summarised clinical impression suggests that compliance of male patients is poorer than that of females. According to our data, a typical male attempter is characterised as follows: unemployed, never married, lives alone. He tends to use violent methods; if he takes drugs, it is mostly meprobamate or carbamazepine. A lot of male attempters have alcohol problems or dependence. As for the females, we found high odds ratios in the following cases: divorced or widowed, economically inactive, depressive state in the anamnesis. Female attempters are mainly repeaters using the method of self-poisoning, mostly with benzodiazepines. As suicide is a multicausal phenomenon, its therapy and prevention should also be complex and gender differences should be taken into account in building up our helping strategies.

Adolescent↗
PubMed2003

[Characteristics of the choice of psychotropic drugs in suicide attempts].

UNLABELLED: Review of results of Pecs centre in WHO/EURO Multicentre Study on Suicidal Behaviour. OBJECTIVE: Studies concerning the choice of methods and psychotropics in the suicidal acts have a great importance because the outcome of suicides is decisively determined by the potential lethality of the method. In the sample of patients who attempted suicides, the features of overdoses have been investigated as well as their relations to the age, sex and repetition. METHOD: Within the framework of the WHO/EURO Multicentre Study on Suicidal Behaviour data, 1158 cases with suicide attempts were collected from 1997 to 2001. RESULTS: Among methods of suicide attempts the most frequents were overdoses, while cutting, and hanging were more rarely, and alcohol consumption associated with 15% of attempts. Psychotropics were found in three-quarters of overdoses. A more detailed analysis of the methods used by suicidal patients shows that benzodiazepines represented almost two-thirds of all the drugs taken followed by meprobamate, carbamazepine and antidepressants. Repeaters used frequently antidepressants, antipsychotics, carbamazepine, while benzodiazepines and meprobamate poisoning were rather typical of first-ever group. CONCLUSION: Considerable differences in the use of psychotropics for parasuicide related to gender, age and repetition were found. The results suggest, that the features of overdoses may be in connection with the availability of drugs and the special national characteristics of drug-prescribing. The differences of repeaters may reflect the insufficiency of the mental health care system. The authors emphasize the importance of these facts among the possibilities of prevention.

Adolescent↗
PubMed2003

The main factors of repetition: review of some results of the Pecs Center in the WHO/EURO Multicentre Study on Suicidal Behaviour.

The authors obtained more information about the characteristics of suicide attempters in order to examine the most important differences between those who attempted suicide for the first time (first-evers) and those who had a previous attempt (repeaters). Within the framework of the WHO/EURO Multicentre Study on Suicidal Behaviour in Pecs Center, 1158 cases of parasuicide were collected over 4 years (July 1, 1997-June 30, 2001). In the monitoring sample, 728 (62.9%) parasuicide acts were committed by women and 430 (37.1%) by men, and more than half of the attempters had made a previous attempt In the logistic regression model a higher risk of repetition was found to be related to being divorced (OR 1.84), unemployed or economically inactive (OR 1.45), and without higher education (OR 2.54). In the sample, mental disorders were the most significant risk factor for repeated attempts. The odds ratio was highest (OR 5) for personality disorders. The results may reflect (besides some factors of social destabilization) a higher importance of major mental health problems among repeaters. For this reason, more effective recognition and treatment of the underlying psychiatric and social conditions of suicide attempters has special importance to prevent future suicidal behaviour.

Academic Medical Centers↗