Háttér és célkitűzések: Kutatásunk célja volt megvizsgálni, hogy serdülőkorúaknál a biológiai és a kronológiai életkor összefügg-e a negatív és pozitív affektivitással, valamint az érzelemszabályozással, továbbá hogy ezek a kapcsolatok milyen összefüggést mutatnak az internalizáló problémákkal. Az internalizáló problémákat mint a fejlődési változók és az érzelmi feldolgozás közötti kapcsolat moderátorát; az érzelmi feldolgozást mint a fejlődési változók és az internalizáló problémák közötti kapcsolat moderátorát vizsgáltuk. Módszer: Összesen 96 fő ( M életkor = 14,96 év, SD = 0,525; 22% nő) vett részt a vizsgálatunkban. A Pozitív és Negatív Affektivitás Skálát, Érzelemszabályozási Nehézségek Skálát, Achenbach-féle Gyermekviselkedési Kérdőívet, valamint a csontkor mérésére ultrahangos mérőeszközt alkalmaztunk. Eredmények: A bivariáns elemzésekben a biológiai életkor nem, a kronológiai életkor pedig gyenge kapcsolatban állt az érzelmi diszreguláció egyik mutatójával. A moderációs elemzések alapján a csontkor bejósolta a szorongás és a depresszió hatásain túl a negatív affektivitást. Az idősebb csontkor alacsonyabb negatív affektivitással társult, a kronológiai életkor esetében nem volt megfigyelhető összefüggés. Közepes negatív affektivitás mellett a csontkor és az egyik internalizáló tünetcsoport kölcsönhatása bejósolta az internalizáló tünetek másik csoportját olyan módon, hogy közepes negatív affektivitás mellett az idősebb csontkor alacsonyabb szorongást, de magasabb depressziós problémákat eredményezett. A kronológiai életkor esetében nem figyelhető meg összefüggés. Következtetések: Eredményeink arra utalnak, hogy az internalizáló problémák összpontszáma elfedheti az internalizáló problémák különböző területeinek egyedi hatását. Megállapíthatjuk, hogy azoknál a serdülőknél, akiknél az internalizáló problémák kialakulásának kockázata fennáll (a megnövekedett negatív affektivitás miatt), a biológiai érés szorongáscsökkentő, ugyanakkor depressziót előidéző hatásokat is kifejthet, és a környezet valószínűleg másképp reagál a serdülőre az internalizáló problémák megjelenésének időzítésétől függően.

Eating disorders (EDs) in the athlete population are often discussed in terms of comparing with non-athlete samples, however little is known regarding their gender clinical differences. Therefore, this study aimed to compare clinical and psychopathological features among athletes with an eating disorder (ED+A), non-athletes with an eating disorder (ED-A) and healthy controls (HCs), in addition to observing gender differences. The sample consisted of 192 participants, all were age and gender matched, ED+A n = 64, ED-A n = 64 and HCs n = 64, with each group consisting of 50 females and 14 males. And each participant completed a face-to-face interview and various self-report questionnaires regarding personality traits (Temperament and Character Inventory-Revised), eating (Eating Disorder Inventory – 2) and general psychopathology (Symptom Checklist 90 - Revised), as well as relevant clinical indexes (lifetime suicidal attempts/ideation and sport activities conducted). In the ED+A group females had significantly higher eating and general psychopathology compared to males, especially body dissatisfaction (BD) and drive for thinness (DT) (p <.001). Overall, ED+A males had the lowest BD across the 3 groups. In terms of personality traits, ED+A females had significantly higher harm avoidance and lower self-directedness compared to their male counterparts. Lastly, suicidal ideation was significantly higher in ED+A females compared to males. These results suggest that it may be imperative to better understand the risk factors in the athletic realm which may lead to the development of EDs, and which factors may be protective as well. It may also be helpful to encourage trainers to include preventive and screening strategies for athletes. Eating disorders are mental illnesses which can affect anyone and may also be seen in athletes, where studies normally look at differences between athletes and non-athletes. However, there has been a lack of research comparing specific gender differences in athletes who have an eating disorder. This study looked at the differences not only between the groups, but also within the groups, in terms of eating disorder behaviors, psychological factors and personality. The findings were that in the athlete group, females had higher dissatisfaction with their body and had a higher desire to be thin. Female athletes were also more anxious and had more suicidal thoughts compared to male athletes.

Eating disorders (EDs) are complex phenomena that are partly influenced by sociocultural factors. The thin body ideal of Western civilization, disseminated by mass media and reinforced by the fashion industry, plays a significant role. In this cultural environment, the social perception of the human body has undergone a change.

Reinforcement sensitivity is a hypothesized attention-deficit/hyperactivity disorder (ADHD) intermediate phenotype but its role in transgenerational transmission of ADHD-linked psychopathology risk is largely unknown. We examined, in a carefully phenotyped, N = 123 sample of adolescents (Mage = 15.27 years, SD = 0.984; 61.78% boys), whether (1) parental psychopathology is differentially associated with fMRI-indexed neural response to reward receipt and (2) both maternal and paternal psychopathology are associated with neural response to reward; across adolescents at-risk for and not at-risk for ADHD. Indices of parental psychopathology were differentially associated with adolescent offspring neural response to reward such that across measures, parental psychopathology was negatively or not associated with offspring superior frontal gyrus (SFG) response to reward receipt in adolescents at-risk for ADHD, but parental psychopathology was positively associated with offspring SFG response in adolescents not at-risk. Further, across measures, greater maternal psychopathology was associated with blunted adolescent SFG response to reward in adolescents at-risk for ADHD whereas greater maternal externalizing problems were linked to enhanced adolescent SFG response in adolescents not at-risk. Across measures, paternal psychopathology was not associated with adolescent response to reward, in either group. ADHD risk confers differential reward-related susceptibility to the effects of parental psychopathology. Results also show this association is nonspecific in terms of parental psychopathology type but is specific to maternal psychopathology.

Introduction: The association of chronic diseases with eating disorders requires increased attention due to the potential for serious complications and increased risk of mortality. Eating disorders and sub-clinical eating disorders are associated with maladaptive emotion regulation, which may be both triggers and maintaining factors of the disease. To our knowledge, the role of cognitive emotion regulation in eating disorders in adolescents with inflammatory bowel disease and type 1 diabetes mellitus has not been investigated to date.Objective: We analysed the relationship between cognitive emotion regulation and symptoms of eating disorder in adolescents aged 14 to 18 years, focusing on young people with type 1 diabetes mellitus and inflammatory bowel disease. Our research aimed to identify the role of specific cognitive emotion regulation strategies in eating disorders in patient populations with chronic disease.Method: In our study, 300 adolescents completed the Cognitive Emotion Regulation Questionnaire and the Self Administrated Psychiatric Scales for Children and Adolescents after informed consent. The four study groups consisted of 157 physically healthy adolescents, 51 adolescents diagnosed with IBD, 61 adolescents diagnosed with type 1 diabetes mellitus and 31 adolescents diagnosed with anorexia nervosa.Results: The results of our study showed that rumination and positive reframing were significantly associated with symptoms of eating disorders in adolescents with inflammatory bowel disease, and self-blame and rumination were significantly associated with symptoms of eating disorders in adolescents with type 1 diabetes mellitus diagnosis, through an indirect pathway.Discussion: Our results suggest that cognitive emotion regulation strategies are indirectly related to symptoms of eating disorders among adolescents with the chronic illness studied. More frequent use of negative emotion regulation strategies of self-blame and rumination increases the incidence of eating disorder symptoms, and less frequent use is associated with fewer eating disorder symptoms. Greater use of positive reappraisal is associated with fewer eating disorder symptoms.Conclusion: We recommend the incorporation of cognitive emotion regulation strategies in the complex care of chronically ill adolescents, both in screening and in interventions.

Purpose of ReviewFood addiction (FA) has been found to be associated with impulsivity, mainly urgency (negative and positive) and lack of perseverance. The present systematic review aimed to identify differences in impulsivity by gender and current implications of treatment regarding FA and impulsivity in clinical populations. The search was conducted in PubMed, Scopus, and Web of Science (WOS) databases, using the following search terms: "food addiction" and "impuls*." Studies were included if they were written in English, had an observational design (e.g., cross-sectional, longitudinal, case-control), and used a quantitative methodology, without a limited search period to avoid selection bias.Recent FindingsWe included twenty-nine articles that aimed to examine whether there is a relationship between FA and impulsivity in clinical populations. Looking at gender differences, attentional and motor impulsivity were found to be related to FA in samples of women with obesity, whereas in the only study in a sample of men with obesity, cognitive and non-planning impulsivity appeared to be more associated with FA. Moreover, we identified three studies on the effects of interventions which included motivational, psychosocial, nutritional, and mindfulness components to address impulsivity and FA in cohorts with overweight/obesity and with substance use disorder (SUD). While some studies reported decreased levels of impulsivity, in other studies only FA decreased, and only one study showed significant changes in both FA and impulsivity after treatment.SummaryFurther research is needed to better understand the association between impulsivity and FA. Specifically, more studies with male populations could provide further evidence on how to better tailor treatment designs.

We evaluated event-related potential (ERP) indices of reinforcement sensitivity as ADHD biomarkers by examining, in N=306 adolescents (Mage=15.78, SD=1.08), the extent to which ERP amplitude and latency variables measuring reward anticipation and response (1) differentiate, in age- and sex-matched subsamples, (i) youth with vs. without ADHD, (ii) youth at-risk for vs. not at-risk for ADHD, and, in the with ADHD subsample, (iii) youth with the inattentive vs. the hyperactive/impulsive (H/I) and combined presentations. We further examined the extent to which ERP variables (2) predict, in the ADHD subsample, substance use (i) concurrently and (ii) prospectively at 18-month follow-up. Linear support vector machine analyses indicated ERPs weakly differentiate youth with/without (65%) - and at-risk for/not at-risk for (63%) - ADHD but better differentiate ADHD presentations (78%). Regression analyses showed in adolescents with ADHD, ERPs explain a considerable proportion of variance (50%) in concurrent alcohol use and, controlling for concurrent marijuana and tobacco use, explain a considerable proportion of variance (87 and 87%) in, and predict later marijuana and tobacco use. Findings are consistent with the dual-pathway model of ADHD. Results also highlight limitations of a dichotomous, syndromic classification and indicate differences in neural reinforcement sensitivity are a promising ADHD prognostic biomarker.

Dietitians play an important role in the care of patients with eating disorders. However, the precise conditions are not yet defined. This limits the clarity of the role of the dietitian within the dietetic profession as well as in a broader sense among the health care providers. In Hungary, there is no comprehensive guideline on it yet, so the aim of the present paper is to clarify the role, tasks, and competence boundaries of the dietitians. First, we provide guidance for the recognition of eating disorders by overviewing the symptoms, the diagnostic criteria, and the most important aspects of biopsychosocial assessment. Second, we take stock of the tasks of the dietitian, as a member of the therapeutic team in the treatment of eating disorders in outpatient and inpatient settings.

Bevezetés: A krónikus betegségek evészavartünetekkel való társulása fokozott figyelmet igényel a súlyos szövődmények lehetősége és a mortalitási rizikó növekedése miatt. Az evészavarok és a szubklinikai evészavarok maladaptív érzelemszabályozással járnak együtt, melyek kiváltó és fenntartó tényezői is lehetnek a betegségnek. Ismereteink szerint a gyulladásos bélbetegséggel és 1-es típusú diabetesszel élő serdülők kognitív érzelemszabályozásának szerepét az evészavartüneteikben ez idáig még nem vizsgálták. Célkitűzés: 14 és 18 év közötti serdülők körében elemeztük a kognitív érzelemszabályozás és az evészavartünetek kapcsolatát, különös tekintettel az 1-es típusú diabetesben és gyulladásos bélbetegségben érintett fiatalokra. Kutatásunk arra irányult, hogy krónikus betegek csoportjaiban kimutatható-e egyes kognitív érzelemszabályozó stratégiák szerepe az evészavartünetekben. Módszer: Vizsgálatunkban 300 serdülő töltötte ki tájékozott beleegyezés után a Kognitív Érzelemreguláció Kérdőívet és a Pszichopatológiai Tünetlista Gyermekek és Serdülők Számára kérdőívet. A négy vizsgálati csoportot 157, testileg egészséges serdülő, 51, gyulladásos bélbetegség diagnózisával élő serdülő, 61, 1-es típusú diabetes diagnózisú serdülő és 31, anorexia nervosa diagnózissal rendelkező serdülő alkotta. Eredmények: Vizsgálatunk eredményei alapján a gyulladásos bélbetegséggel élő fiatalok esetében a ruminatio és a pozitív átértékelés, az 1-es típusú diabetes diagnózisú serdülőknél pedig az önvád és a ruminatio közvetett úton szignifikáns kapcsolatban állt az evészavartünetekkel. Megbeszélés: Eredményeink arra utalnak, hogy a kognitív érzelemszabályozó stratégiák a vizsgált krónikus betegséggel élő serdülők körében indirekt módon kapcsolatban állnak az evészavartünetekkel. Az önvád és ruminatio negatív érzelemszabályozó stratégiák gyakoribb alkalmazása növeli az evészavartünetek előfordulását, ugyanakkor kisebb mértékű használatuk kevesebb evészavartünettel jár együtt. A pozitív átértékelés nagyobb mértékű alkalmazása kevesebb evészavartünettel jár együtt. Következtetés: A kognitív érzelemszabályozó stratégiák vizsgálatát és fejlesztését javasoljuk beépíteni a krónikus beteg serdülők komplex ellátásába. Orv Hetil. 2023; 164(48): 1895–1903.

Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous disorder. Data on the role of transdiagnostic, intermediate phenotypes in ADHD-relevant characteristics and outcomes are needed to advance conceptual understanding and approaches to precision psychiatry. Specifically, the extent to which the association between neural response to reward and ADHD-associated affective, externalizing, internalizing, and substance use problems differ depending on ADHD status is unknown. Aims were to examine, in 129 adolescents, whether concurrent and prospective associations of fMRI-measured initial response to reward attainment (relative to loss) with affectivity and externalizing, internalizing, and alcohol use problems differs between youth at-risk for (i.e., subclinical) (n = 50) and not at-risk for ADHD. Adolescents were, on average, 15.29 years old (SD = 1.00; 38% female), 50 were at-risk for (Mage = 15.18 years, SD = 1.04; 22% female) and 79 not at-risk for (Mage = 15.37 years, SD = 0.98; 48.1% female) ADHD. Both concurrent and prospective relations differed given ADHD risk: across analyses, in at-risk youth, greater superior frontal gyrus response was associated with lower concurrent depressive problems but in not at-risk youth, these characteristics were not related. Controlling for baseline use, in at-risk youth, greater putamen response was associated with greater 18-month hazardous alcohol use, whereas in not at-risk youth, greater putamen response was associated with lower use. Where in brain and for which outcomes modulate (direction of) observed relations: superior frontal gyrus response is relevant for depressive problems whereas putamen response is relevant for alcohol problems and greater neural responsivity is linked to less depressive but to more alcohol problems in adolescents at-risk for ADHD and less alcohol problems in adolescents not at-risk. Differences in neural response to reward differentially confer vulnerability for adolescent depressive and alcohol problems depending on ADHD risk.

Emotion dysregulation (ED) is a key correlate and risk factor of a range of externalizing and internalizing disorders and symptoms and a core target for psychopharmacologic and psychosocial interventions. Adolescence is arguably the most important developmental period for acquisition of adaptive, adult-like emotion regulation skills and, as such, a particularly vulnerable phase for the development of ED. Gaps in knowledge remain about normative changes in emotion regulation across time in adolescence or about intraindividual characteristics that predict those changes. We examined, in 241 adolescents (Mage=15.73 years, SD=.1.07, 60.2% boys), (1) developmental patterns in emotion regulation across 18 months, (2) whether ADHD risk status and relevant clinical and demographic variables predict those patterns, and in a subsample of 84 adolescents (Mage=14.84 years, SD=.5245), (3) whether ADHD risk status and relevant clinical and demographic variables, including level of biological maturity, predict developmental patters. Findings indicated average ED scores did not change across time but also that considerable individual-level heterogeneity in the direction and magnitude of changes accounted for lack of group-level differences. Results also showed ADHD risk and depression had opposing effects on changes in ED across time such that ADHD risk status was associated with a relative decrease or stagnation of ED, but earlier development of elevated depression problems predicted an increase in ED. These results indirectly support the delay in brain maturation hypothesis of ADHD such that adolescents at-risk for ADHD, relative to adolescents not at-risk, albeit exhibited higher ED at baseline, showed a reduction in ED by follow-up. Results are also consistent with conceptual models of the relation between ED and internalizing problems being a reciprocal process with developmentally earlier onset of elevated depression as a risk factor for the exacerbation of ED.

Adolescence is a key developmental phase with regard to affective processing and is associated with affective lability, development of adult-like emotion regulation skills, and onset of internalizing pathologies. Yet, beyond research on pubertal development, less is known about the unique associations of biological development and chronological age with affective processing and there is a paucity of research on anxiety and boys. Aims were to examine, in a sample of N=96 adolescents (22% female; Mage=14.96 years, SD=.525), first, whether biological and chronological age are associated with negative (NA) and positive (PA) affectivity, and emotion regulation as indices of affective processing; and second, the relation of this association with internalizing problems. Specifically, given evidence for a bidirectional link between affectivity/emotion regulation and internalizing pathology, we examined both internalizing problems as a moderator of the association between developmental variables and affective processing and affective processing as a moderator of the association between developmental levels and internalizing problems. In bivariate analyses, biological age was not and chronological age was weakly associated with one index of emotion dysregulation. In moderational analyses, bone age but not chronological age predicted NA above and beyond anxiety and depression, such that more advanced biological development was associated with lower NA. At moderate levels of NA, an interaction between bone age and one domain of internalizing symptoms (but not chronological age) predicted the other domain of internalizing symptoms, such that at moderate levels of NA, more advanced biological development was associated with lower anxiety but higher depressive problems. Results suggest composite internalizing scores may mask unique effects of the different domains of internalizing problems. Results further suggest that in adolescents at-risk for developing internalizing problems (because of heightened NA), the effect of biological development may exert anxiolytic but also depressogenic effects and the environment likely interacts differently with that development in bringing about adolescent onset internalizing problems.

Sex and gender are essential, inalienable characteristics of the human being permeating the biological, psychological, interpersonal, social, transcendental aspects of our existence. Human sexual development takes place in the context of physical, emotional, cognitive, and social development, beginning at conception and continuing throughout life. It is influenced by biological maturation and complex interactions of psychological, interpersonal, cultural factors and (physical) environmental conditions. Using a developmental-psychopathology approach, we summarise our under standing of the life course-specific features of sexual development, placing them in the broader context of development. We will address gender differences, the development of gender-related concepts, sexual orientation, gender identity, and the development of sexual behaviour at different stages of life. In the field of sexual development and gender, science is often pushed to its limits. It is important that professionals express their opinions and make their decisions with due caution and objectivity.

A jelen tanulmány célja, hogy a gyermek és a serdülő pszichodiagnosztikában használt kérdőíves és projektív eszközök eredményeinek diszkrepanciáját megvitassa. Stephen Finn véleménye szerint mind a két tesztelési forma megbízható, azonban más működési elven alapulnak. Előfordulhat, hogy a két tesztelési forma látszólagosan más eredményt mutat, azonban a diszkrepancia megértése értékes információt adhat a vizsgálni kívánt személyről. Cikkünkben kitérünk arra, hogy a különböző tesztelési eljárások (kérdőívek, projektív tesztek) hogyan működnek, illetve arra is, hogy milyen szerepük lehet a pszichodiagnosztikai folyamatban. Az egyén viselkedésének megértése szempontjából a kérdőívek a laboratóriumi tesztekkel, a projektív tesztek pedig az agyi képalkotó eljárásokkal hozhatók párhuzamba az orvosi diagnosztikában. A projektív eljárások ingeranyagtól függően más módon készítenek „felvételeket” a lélekről, mint ahogy a CT, a PET és az MR a képalkotó diagnosztikában az agyról. A kérdőívek és a projektív eszközök integrált alkalmazása gyakran pontosabb diagnózisalkotást és kezelési terv felállítását tesz lehetővé.The current study aims to discuss the distinction between the results of various tools used in child and adolescent psychodiagnostic, namely between questionnaires and projective measures. According to Stephen Finn, both methods are reliable but operate based on different principles. It may seem that the two methods of testing present different responses, but understanding discrepancies can provide valuable information about the subject. In our article, we discuss how these various testing methods (questionnaires, projective tests) work, and how they may play a role in the psychodiagnostic process. In our study, we consider for understanding human behaviour, non-projective tests being compared to laboratory tests and projective measures being compared to brain imaging techniques. Projective procedure stimuli elicit different features of the subject’s personality, analogous to imaging diagnostics of medical science (CT, PET and MR). The discrepancy between questionnaires and projective methods can have important indications for both diagnosis and therapy.

Abstract Objective Sociocultural influences, including an increasing pressure for fashion models to maintain a thin body frame may be crucial in the development of eating disorders. The present study aimed to establish whether fashion models are more likely than non‐models to develop eating disorders. Methods Female fashion models were selected by snowball sampling (n = 179, mean age: 25.9 SD = 4.70 years). They were compared with an age adjusted control group (n = 261, mean age: 25.0 SD = 4.97 years). Participants completed an online questionnaire containing the Eating Disorder Inventory. Results The average BMI of the fashion models was in the underweight range (mean BMI = 18.1 SD = 1.68). The BMI of the control group was significantly higher (mean = 22.1 SD = 4.23, p < 0.001). The frequency of simulated anorexia nervosa was 3.9% among the fashion models and 1.1% in the control group (p = 0.057). 14.6% of the models showed subclinical anorexia nervosa symptoms versus 2.7% in the control group (p < 0.001). The ratio of bulimia nervosa and subclinical bulimia nervosa showed no significant difference between the two groups. Conclusion Female fashion models showed no significant difference from the control group in the frequency of anorexia nervosa and bulimia nervosa but had a significantly higher frequency of the subclinical form of anorexia nervosa.

Despite advantage of neuroimaging measures in translational research frameworks, less is known about the psychometric properties thereof, especially in middle-late adolescents. Earlier, we examined evidence of convergent and incremental validity of reward anticipation and response event-related potentials (ERPs) and here we examined, in the same sample of 43 adolescents (M-age = 15.67 years; SD = 1.01; range: 14-18; 32.6% boys), data quality (signal-to-noise ratio [SNR]), stability (mean amplitude across trials), and internal consistency (Cronbach's alpha and split-half reliability) of the same ERPs. Further, because observed time course and peak amplitude of ERP grand averages and thus findings on SNR, stability, and internal consistency may depend on preprocessing method, we employed a custom and a standardized preprocessing pipeline and compared findings across those. Using our custom pipeline, reward anticipation components were stable by the 40th trial, achieved acceptable internal consistency by the 19th, and all (but the stimulus-preceding negativity [SPN]) achieved acceptable SNR by the 41st trial. Initial response to reward components were stable by the 20th trial and achieved acceptable internal consistency by the 11th and acceptable SNR by the 45th trial. Difference scores had worse psychometric properties than parent measures. Time course and peak amplitudes of ERPs and thus results on SNR, stability, and internal consistency were comparable across preprocessing pipelines. In case of reward anticipation ERPs examined here, 41 trials (+4 artifacted and removed) and, in case of reward response ERPs, 45 trials (+5 artifacted) yielded stable and internally consistent estimates with acceptable SNR. Results are robust across preprocessing methods.

Összefoglaló. Bevezetés: Magyarországon a csecsemőhalandóság 2014 óta folyamatosan javult, azonban 2019-ben az előző évi adathoz képest 11%-kal magasabb érték mutatkozott. Célkitűzés: A vizsgálat célja a 2019. évi kedvezőtlenebb csecsemőhalálozási mutató lehetséges összetevőinek feltárása. Módszer: A 2018. és 2019. évi csecsemőhalálozási adatokat hasonlítottuk össze a csecsemő kora, a halál oka és a gyógyintézeti, illetve nem gyógyintézeti elhalálozás szerint. A vizsgálathoz a Központi Statisztikai Hivatal adatait használtuk. A trendvizsgálatnál 2010-től elemeztük az adatokat. A nem gyógyintézeti haláleseteket 10 évre összevonva járásonként térképesen ábrázoltuk. Eredmények: 2018-ban 304, 2019-ben 335 csecsemő halt meg Magyarországon, a csecsemőhalálozási arányszám 3,4 ezrelékről 3,8 ezrelékre emelkedett. A 2019. évi érték az előző évtizedek trendjére illesztett görbe alapján megfelelt a várható értéknek. 2019-ben a 0-27 napos csecsemőhalálozás alig változott a 2018. évihez képest, a 28-364 napos korban bekövetkezett halálesetek száma viszont növekedett. A vizsgált évben 59%-kal emelkedett a nem gyógyintézeti csecsemőhalálozás. A 2019. évi csecsemőhalálozás növekedéséért 74%-ban a nem gyógyintézeti esetek voltak felelősek. A nem gyógyintézeti halálozás döntő többsége késői csecsemőkorban következett be. A járásonkénti, 10 évre összevont, nem intézményben elhunyt csecsemők számában és 1000 élve születésre vonatkozó arányában ötszörös területi különbségek mutatkoztak. A halálokok közül a perinatalis szakban keletkező bizonyos állapotok miatt meghalt csecsemők száma emelkedett a leginkább, a nem gyógyintézeti halálozás esetében pedig a hirtelen csecsemőhalál szindrómában meghaltaké. Következtetés: 2019-ben kiugróan magas volt a nem gyógyintézeti, késői csecsemőhalálozás száma és részaránya, ezen esetek feltűnő regionális halmozódást mutattak. A csecsemőhalandóság csökkentésének hatásos eszköze lehetne a jövőben minden egyes csecsemőhalál részletes szakmai értékelése. Orv Hetil. 2021; 162(1): 830-838.SUMMARY:INTRODUCTION:In Hungary, infant mortality has been steadily declining since 2014, but in 2019 it increased by 11% compared to 2018.OBJECTIVE:The aim of our study is to explore the possible components of the above increase.METHOD:Ten-year trends of infant mortality were analized and compared by age, cause, place of deaths (hospital or non-hospital environment) and location, using Central Statistical Office data.RESULTS:There were 304 infant deaths in Hungary in 2018 and 335 in 2019. Infant mortality rate rose from 3.4‰ to 3.8‰, however, it was in line with the expected value based on the curve fitted to the trend of previous decades. In 2019, 0-27-day infant mortality basically did not change compared to 2018, while the number of deaths at 28-364 days of age increased. Non-hospital infant mortality increased by 59% in 2019 and these cases accounted for 74% of the total increase in infant mortality; the vast majority of these deaths occurred in late infancy. There were fivefold regional differences in the number of non-hospital infant deaths. Among the causes of death, the conditions related to the perinatal period and sudden infant death syndrome increased the most.CONCLUSION:In Hungary, the number and proportion of non-hospital infant mortality was remarkably high in 2019 compared to previous years. These cases showed a striking regional accumulation. An effective tool for reducing infant mortality could be an appropriate professional assessment of each infant death in the future. Orv Hetil. 2021; 162(21): 830-838.

Összefoglaló. A divatiparra vonatkozó egészségvédelmi szabályozások hiányosak. A karcsúság elérését célzó szociokulturális nyomás a divatiparon belül fokozott, a divatmodelleket gyakran késztetik kórosan alacsony testsúly elérésére, ami pszichológiai abúzusnak felel meg. Ezért a modellek közt az evészavarok prevalenciája magasabb az átlagpopulációhoz képest. A divatvilág veszélyei között ezeken túl a szexuális abúzus, a financiális visszaélések, illetve a fiatalkorúak foglalkoztatásával kapcsolatos szabályozatlanság említendő. A kockázatok csökkentése érdekében fontos volna nemzetközi szabályozásokat bevezetni a divatszakmában. Az erre irányuló kezdeményezések először 2006-ban jelentek meg Spanyolországban: a modellek foglalkoztatásának feltétele volt az egészséges tápláltsági állapot alsó határától minimálisan elmaradó testtömegindex (18,0) elérése. Később Franciaországban az evészavarok gyakoriságának mérséklésére törvénybe foglalták a modellek kötelező egészségügyi vizsgálatát, illetve az utólagosan módosított divatfotók megjelölését. E szabályozások azonban könnyen kijátszhatók. A törvényhozás mellett különböző szervezetek alkottak olyan irányelveket, amelyek a modellek egészségvédelmét szolgálták. Ezek az iránymutatások elsősorban a biztonságos munkavégzésre, a fiatalkorúak foglalkoztatásának korlátozására és az emberi méltóság megtartására irányulnak. A divatszakmában előforduló feszültségek vezettek továbbá olyan nonprofit szervezetek megalakulásához, amelyek a modellek érdekvédelméért dolgoznak. A divatmodellek egészségvédelmét célzó jogi szabályozás a mai kultúrában domináns karcsúságideál megváltoztatását is szolgálná, mert a szociális tanulás révén a divatot követő átlagnépesség utánozza a modelleket. A divatmodellek egészségének védelme tehát népegészségügyi vonatkozással is bír. Orv Hetil. 2021; 162(23): 905-910. Summary. The fashion industry is lacking sufficient health protective regulations. There is an increased sociocultural pressure to be thin. Fashion models are often forced to reach abnormally low body weight, which can be regarded as psychological abuse. This leads to a higher prevalence of eating disorders among models compared with the general population. Some of the other dangers associated with the fashion industry are sexual harassment, financial exploitation, and unregulated minor labour force. To reduce these risks, it is crucial to introduce international regulations in the fashion industry. The first initiative for such regulations took place in Spain in 2006 when the condition for models' employment was for their body mass index (BMI) not to drop below 18.0, which is close to the low end of healthy BMI. Later in France, to decrease the prevalence of eating disorders, a legislation on compulsory medical examination for models was made. Also, retouching of photos had to be disclosed. Regulations like these, however, can easily be eluded. Different organisations implemented guidelines, such as establishing safe working conditions, limiting underage labour force, and maintaining dignity to protect models' health. Tension within the fashion industry led to the formation of non-profit organisations seeking the protection of models' interest. Regulations protecting models' health in the fashion industry would encourage society to adjust its predominant ideal for thinness. Just as the general population tends to follow fashion trends portrayed by fashion models, so would they likely imitate the new look of models. Hence, the protection of models' health goes beyond the fashion industry. It has public health implications as well. Orv Hetil. 2021; 162(23): 905-910.

Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients.