Katalin Barabás

Anxiety, depression and smoking in schoolchildren - implications for smoking prevention

The prevalence of smoking among 14 to 18-year-old adolescents (one out of three) is as high as in the general population in Hungary. Depression and anxiety disorders are also major public health problems. Our objective was to investigate the correlations between smoking status and anxiety and depressive symptoms, as well as to identify potential implications for the prevention of nicotine dependence. We used a self-developed questionnaire to survey smoking behaviour, and standard self-evaluation tests (the Hungarian version of the Spielberger’s State-Trait Anxiety Inventory for Children and the Children’s Depression Inventory) to capture anxiety and depressive symptoms in 215 students from randomly selected technical and high schools. Smoking students showed significantly more anxiety and depressive symptoms compared to their non-smoking peers. Importantly, occasional smokers appeared to be more anxious than non-smokers, whereas daily smokers scored higher on the depression inventory than either non-smokers or occasional smokers. The majority of students with high scores suggestive of anxiety or depressive disorders were smokers. Interestingly, levels of anxiety and depression were associated with smoking status in boys but not in girls. The strong association found between anxiety and depressive symptoms and youth smoking, particularly in boys, suggests that reducing these symptoms (especially high, school-related anxiety) may be preventive against the onset of addictive smoking. This, together with the high level of anxiety and depression found in girls, makes it essential for all professionals dealing with adolescents and education to recognise these symptoms and their significance, and to be aware of the ways of reducing them by changes in the educational system, or medically, if necessary.

Can a Brief Antepartum Preventive Group Intervention Help Reduce Postpartum Depressive Symptomatology

Background: Psychosocial and psychological interventions are generally effective in reducing depressive symptomatology in the postpartum period. Our aim was to evaluate the effectiveness of a brief preventive group intervention for postpartum depression (PPD) in a naturalistic setting, and study the effect of this on social and psychological risk factors. Methods: We conducted a randomized controlled trial (n = 1,719) in south-eastern Hungary in 62 antepartum centers. Pregnant women (n = 710) underwent a 4-session preventive group intervention whereas a control group (n = 1,009) attended 4 sessions providing the same information given in usual care. Results: Our intervention appeared to significantly reduce the risk of PPD, as defined by Leverton Questionnaire total scores (OR = 0.69). It resulted in an absolute risk reduction of about 18% in those with antepartum depression and 0.5% in those with no depression at recruitment. A multiple logistic regression analysis revealed a much reduced risk in those with a perceived lack of partner support (OR = 0.4) in the treatment group. Unplanned pregnancy, an irreversible risk factor affecting every fifth woman, also seemed to have a reduced effect on PPD after our group intervention (OR = 0.81). Conclusions: A brief preventive antepartum group intervention focusing on psychoeducation, stress management, improving coping mechanisms, and the development of social support can be effective in reducing postpartum depressive symptomatology.

Health risk behaviour of a medical student population report on a pilot study

A pilot study of a cross-sectional nature was carried out to observe and describe the health risk behaviour of a medical student population. The participants (242) were drawn from the students of the University Medical School of Szeged, Hungary. The stu dents were aged 18-31 years (x = 23) and were randomly selected. The response rate was 73%. The project focussed on 4 harmful habits ranked in the following order of prevalence: excessive coffee drinking (35%), smoking (20.9%), regular alcohol use (6.8%) and illicit drug use (5.1%). The non-parametric (Chi-square) test showed significant differences between the higher and lower physical activity groups in terms of psychological well-being (p<0.05) and health behaviour changes (p<0.005). Harmful habits, however, were report ed more frequently by the higher physical activity group. Significant differences could be detected in terms of womens illicit drug use (p<0.05). Using the Mann-Whitney U-test, it was detected that those who performed more physical activities rated their health signif icantly higher (p<0.001). This study will be pursued in an expanded study with a larger sample and concentrate especially on the relationship of physical activity behaviour to harmful habits. Follow-up methods are also planned to study the medical student population over time, which should yield some greater insight into these relationships.

Obstetric and psychosocial risk factors for depressive symptoms during pregnancy

We aimed to determine the psychosocial and obstetric correlates of depressive symptomatology during pregnancy in South-Eastern Hungary. A total of 1719 women were screened for depression in four counties in 2006 and 2007, based on a Leverton Questionnaire (LQ) score of ≥12 at 14-24 weeks of gestation. The LQ scores indicated a probable depressive illness (PDI) in 17.2% of the study group. The best predictors in a multiple regression analysis were history of major depression (adjusted odds ratio [AOR]=3.23), and major life events (AOR=2.43). A perceived lack of social support from partner (AOR=1.79) and lack of support by family (AOR=1.23) were also significant determinants. Lack of planning of pregnancy (AOR=1.12) and a history of unfavourable obstetric outcome (AOR=1.42) also seem to predispose to PDI. Overall, psychosocial factors appeared important in the prediction of PDI, whereas economic features did not.

Effects of neuroleptics on the lipid peroxidation and peroxide metabolism enzyme activities in various discrete areas of the rat brain

The effects of a 7-day treatment with Haloperidol or reserpine (in both cases 0.1 mg/kg per day) were studied on the superoxide dismutase and catalase activities and the lipid peroxidation in various discrete regions of the rat brain. It was found that these neuroleptics change the lipid peroxidation and the activities of the enzymes in similar directions in the brain areas tested.

Effects of paraquat on peroxide metabolism enzymes and lipid peroxidation in the rat

Investigation has been made of how the LD50 and LD100 of PQ influence the peroxide metabolism enzymes and lipid peroxidation in organ homogenates and blood samples of the rat. The peroxide metabolism enzyme activities were changed in a concentration dependent manner. In general, the effect of the lower doses of PQ on the superoxide dismutase, catalase activities and lipid peroxidation are increased. The glutathione peroxidase activity was decreased. Higher doses of PQ enhanced all of enzyme activities and lipid peroxidation studied.

In vivo effects of paraquat on some oxidative enzymes of mice

Abstract 1. By means of a comparison with untreated controls, a study was made of the effects of LD50 and LD100 of paraquat in vivo on the peroxide metabolism enzymes (superoxide dismutase, peroxidase and catalase), on the tissue lipid peroxidation, and on the microsomal cytochrome P-450 concentrations of the main organs. 2. The results reveal that the enzymes and the tissue properties compared are influenced by the herbicide in different manners, depending on its concentration. 3. The effect is connected first of all with the redox properties of paraquat, which in mice acts either as an electron donor or as an electron acceptor, depending on its concentration.

Validation of the Leverton Questionnaire as a screening tool for postnatal depression in Hungary

OBJECTIVE To assess the validity of the 24-item Leverton Questionnaire (LQ) in screening for postnatal depression (PND). METHOD A two-phase, cross-sectional study was designed. Between January and October 2006, a sample of 1552 women attending a routine postnatal check-up at 6 weeks postpartum completed the LQ in southeast Hungary. On the basis of the LQ total score, the participants were stratified and randomly selected within each stratum for clinical evaluation (Structured Clinical Interview for DSM-IV). Receiver operating characteristic (ROC) analyses were used to examine the sensitivity and specificity of the LQ to detect PND. RESULTS The best cut-off on the Hungarian version of the LQ for PND was 11/12, with a sensitivity of 88.0%, and a specificity of 94.4%, and a positive predictive value of 53.1%. Internal consistency was satisfactory (Cronbach alpha coefficients > or = 0.753). The sensitivity of the modified Beck Depression Inventory (BDI) in detecting PND was 86.2% and the specificity 90.4%. Although the BDI performed slightly better than the LQ in distinguishing between minor and major depression, both psychometric scales showed satisfactory screening performance. CONCLUSIONS Our data confirm the validity of the Hungarian version of the LQ reliably to identify PND. We propose a cut-off of 11/12 for screening purposes for PND, the range of 11-14 for detecting minor depression and regarding a total score of 15 points or above as indicative of major depression.

Determinants of emergency contraceptive use after unprotected intercourse: Who seeks emergency contraception and who seeks abortion?

Objective. To compare differences in contraceptive characteristics and the knowledge of emergency contraception (EC) between women who used EC after unprotected intercourse and those who sought abortion. Design. A questionnaire survey. Setting. A Hungarian university hospital. Sample. Two large clinical groups were enrolled: women who were prescribed EC after unprotected intercourse (n= 952) (EC group) and women who presented for termination of pregnancy who had not taken EC after a contraceptive failure despite being suitable candidates to take EC (n= 577) (control group). Methods. Questionnaire evaluation. Main outcome measures. Knowledge concerning, previous use of, and other factors related to EC use. Results. The EC group experienced a condom failure significantly more often (odds ratio (OR) = 3.07), while the control group reported more failures with the contraceptive pill (OR = 0.69) and with periodic abstinence (OR = 0.09). Use of EC depended on age, education level, place of residence, accurate knowledge of EC (OR = 3.87) and previous EC use (OR = 1.16). Awareness of EC was influenced by information obtained from healthcare providers (OR = 3.63) or by school education (OR = 1.28). Conclusions. Women who use less reliable contraceptive methods should be targeted for health education that stresses the importance of reliable contraception and provides more detailed knowledge on EC and when it should be used.

Predictive model of repeat induced abortion in Hungary

BackgroundContraceptive and sociodemographic risks of repeat induced abortion have not yet been interpreted in Central Eastern Europe.MethodsA consecutive series of women requesting initial (n=647) or repeat (n=553) artificial abortion were surveyed by means of a questionnaire at a Hungarian university teaching hospital in Szeged, in 2005 and 2006. Self-reported demographic characteristics, attitudes and habits regarding contraceptives were assessed as potential correlates of repeat induced abortion in multivariate logistic regression.ResultsReliable contraceptive methods were applied slightly less frequently in case of repeat versus first abortion seekers (21.0% vs. 20.1%, P=0.72, [odds ratio (OR) = 1.06, 95% confidence interval (CI): 0.80–1.40]). Adjusted odds ratios (AORs) for undergoing repeat versus first abortion increased significantly with age (1.10, 95% confidence interval [CI] 1.07–1.14), more children (AOR: 2.66, 95% CI: 1.57–4.50), secondary education compared to the tertiary level (AOR: 1.15, 95% CI: 1.08–1.30). A better knowledge of the fertile period of the menstrual cycle was present among women who had had previous abortion (AOR=2.05, 95% CI 1.37–3.05).ConclusionsAttitude improvement towards modern contraception and promotion of knowledge of correct use of contraceptives among women with reproductive ages may lead to the prevention of recurrent abortion more effectively. EC: emergency contraceptive pill; NS: not significant