János Zámbori - Academia.edu (original) (raw)
Papers by János Zámbori
BJCP. British journal of clinical pharmacology/British journal of clinical pharmacology, Jun 16, 2024
European Neuropsychopharmacology, Aug 1, 2022
Phytotherapy Research, 2019
Earlier studies suggested that specific Echinacea preparations might decrease anxiety. To further... more Earlier studies suggested that specific Echinacea preparations might decrease anxiety. To further study the issue, we performed a double blind, placebo controlled trial with a standardized Echinacea angustifolia root extract. Participants were volunteers scoring above 45 points on the state or on the trait subscale of the State Trait Anxiety Inventory (STAI). They were treated with 40 mg Echinacea or with placebo tablets twice daily for 7 days followed by a 3 week‐long washout period. Participants were also administered the Beck Depression Inventory (BDI) and the Perceived Stress Scale (PSS). In the Echinacea group, state anxiety scores decreased by approximately 11 points by the end of the treatment period, whereas the decrease was around 3‐points in the placebo group (p< 0.01). The effect maintained over the washout period. The difference from placebo was significant from the 7th day of treatment throughout. Changes were less robust with trait anxiety scores, but the preparatio...
International Clinical Psychopharmacology, 2019
Journal of Affective Disorders, 2004
Phytotherapy Research, Dec 25, 2019
Earlier studies suggested that specific Echinacea preparations might decrease anxiety. To further... more Earlier studies suggested that specific Echinacea preparations might decrease anxiety. To further study the issue, we performed a double blind, placebo controlled trial with a standardized Echinacea angustifolia root extract. Participants were volunteers scoring above 45 points on the state or on the trait subscale of the State Trait Anxiety Inventory (STAI). They were treated with 40 mg Echinacea or with placebo tablets twice daily for 7 days followed by a 3 week‐long washout period. Participants were also administered the Beck Depression Inventory (BDI) and the Perceived Stress Scale (PSS). In the Echinacea group, state anxiety scores decreased by approximately 11 points by the end of the treatment period, whereas the decrease was around 3‐points in the placebo group (p< 0.01). The effect maintained over the washout period. The difference from placebo was significant from the 7th day of treatment throughout. Changes were less robust with trait anxiety scores, but the preparation performed better than placebo in patients with high baseline anxiety. Neither BDI nor PSS scores were affected by the treatments. Adverse effects were rare and mild, and all were observed in the placebo group. These findings suggest that particular Echinacea preparations have significant beneficial effects on anxiety in humans.
BEVEZETÉS -Számos vizsgálat bizonyítja, hogy a szorongásos és hangulatzavarban szenvedô betegek n... more BEVEZETÉS -Számos vizsgálat bizonyítja, hogy a szorongásos és hangulatzavarban szenvedô betegek nagy része az alapellátásban keres segítséget panaszaira. Ismert, hogy ezeknek a zavaroknak a felismerése világszerte nehézséget jelent a családorvos számára. 1998-ban indított vizsgálatunk célja a családorvosi praxisban megjelenô személyek pszichés zavarainak feltérképezése. Ebben a közleményben azt a kérdést vizsgáljuk, hogy milyen tényezôknek van különös jelentôsége abban, hogy a betegek pszichés zavarait nehezen ismerik fel. MÓDSZER -A 12 családorvosi praxisban megjelenô 1815 beteg szorongásos és/vagy hangulatzavarait térképeztük fel a Diagnostic Interview Schedule (DIS) magyar változatával végzett interjúk során. A kapott diagnózisokat összevetettük a betegek panaszaival, tüneteivel és a családorvos által felállított diagnózisokkal. EREDMÉNYEK -A családorvosok és a felmérések alapján nyert (DIS-) diagnózisok egyezése kismérvûnek bizonyult. A különbség legfontosabb tényezôje a belgyógyászati betegségek jelenléte volt. Szociodemográfiai tényezôk nem játszottak számottevô szerepet a kórismék együttjárásában. Az orvosi és DIS-diagnózisok akkor mutatták a legnagyobb egybeesést, amikor a betegek sem krónikus, sem akut betegségre utaló diagnózist nem kaptak. Ezekben az esetekben a családorvos olyankor is adott affektív zavarra utaló diagnózist, amikor azt a DIS nem igazolta.
The Journal of Mental Health Policy and Economics
The purpose of this paper is to estimate the changes in health utilization and indirect costs of
Psychiatria Hungarica : A Magyar Pszichiátriai Társaság tudományos folyóirata, 2005
The authors sum up the question of suicide and lithium prophylaxis on the basis of their own thre... more The authors sum up the question of suicide and lithium prophylaxis on the basis of their own three cases.
The journal of mental health policy and economics, 2002
The purpose of this paper is to estimate the changes in health utilization and indirect costs of ... more The purpose of this paper is to estimate the changes in health utilization and indirect costs of anxiety and affective disorders in primary care patients after initiation of mental health treatment. This study was conducted in 12 general practices for the primary care of adult populations in Budapest, Hungary. Among 2,000 eligible patients aged 18 to 64 years, 1,815 gave written informed consent to participate in the study. The Hungarian version of the Diagnostic Interview Schedule (DIS) for anxiety and mood disorders was used to generate psychiatric diagnoses. For all patients, health care utilization data for the previous 12 months was collected including number of visits, specialist consultations, days spent in hospital, sick days in the last year and prescribed medication. Among the first 1,000 attenders, 151 patients were given DIS/DSM-III-R diagnoses of current anxiety and/or mood disorder or uncomplicated bereavement. Fifty-one patients who agreed to psychiatric treatment wer...
We investigated the toxicity, psychotropic side effects and anxiolytic potential of an Echinacea ... more We investigated the toxicity, psychotropic side effects and anxiolytic potential of an Echinacea angustifolia extract that produced promising effects in laboratory tests performed earlier. Rats were studied in the elevated plus-maze, conditioned fear, open-field, object recognition and conditioned place preference tests. Toxicity was studied in rats after intragastric administration. The preparation decreased anxiety in the elevated plus-maze and ameliorated contextual conditioned fear. No lethality or behavioural signs of discomfort were noticed in rats treated with 1000 and 3000 mg/kg Echinacea angustifolia. The extract was without effect in tests of locomotion (open-field), memory (object recognition) and rewarding potential (conditioned place preference) within a wide dose range. A pharmacological formulation based on the same E. angustifolia extract was tested in human subjects. One or two tablets per day were administered for 1 week to healthy volunteers scoring high on the State-Trait Anxiety Inventory (STAI). The tablets contained 20 mg of the plant extract. Data were collected using a structured self-assessment diary technique. The high dose (2 tablets per day) decreased STAI scores within 3 days in human subjects, an effect that remained stable for the duration of the treatment (7 days) and for the 2 weeks that followed treatment. The lower dose (1 tablet per day) did not affect anxiety significantly.
International Journal of Psychiatry in Clinical Practice, 2004
Anxiety and mood disorders are common conditions in primary health care service. Primary care phy... more Anxiety and mood disorders are common conditions in primary health care service. Primary care physicians (PCPs) have a privileged role in the early recognition of these conditions. In this study, the prevalence rates of threshold and subthreshold mood and anxiety disorders were surveyed among 1815 primary care attendees in 12 PCPs&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; offices in Budapest, using the Diagnostic Interview Schedule (DIS). The 1-year prevalence of DIS/DSM-III-R anxiety and/or mood disorders was 16.8%, and the 1-month prevalence was 12.5%. The occurrence rates of subthreshold anxiety and/or depression were 25.7 and 13.1%, respectively. The impact of threshold anxiety and mood disorders on work performance was considerably higher than the impact of subthreshold symptoms. At the time of the interview, 6.7% of the patients received mood and/or anxiety disorder diagnoses by their PCPs. The measure of agreement between the diagnoses generated by the DIS and the ones given by the PCPs was low. The presence of an acute or chronic physical illness made it more difficult for the PCPs to recognize a psychiatric disorder. Conversely, patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; psychological complaints significantly improved the recognition of anxiety and/or mood disorders. The use of the Beck Depression Inventory (BDI) brief version would help the patients to reveal their psychological symptoms, and the physicians to recognize an underlying psychiatric disorder.
European Neuropsychopharmacology, 2013
We conducted a nationwide, full-population based investigation to evaluate the comparative effect... more We conducted a nationwide, full-population based investigation to evaluate the comparative effectiveness of all marketed second generation antipsychotic drugs (SGA) prescribed for outpatients with the diagnosis of schizophrenia in Hungary. Using the national central register, our observational follow-up study included all patients with schizophrenia or related disorder between 01/01/2006 and 30/06/2008. The study cohort comprised 9567 patients who started new SGA during the inclusion period (01/07/2007-30/06/2008). All-cause medication discontinuation of 8 SGAs (1 depot and 7 oral formulations) marketed during the inclusion period, and the time to all-cause discontinuation were the main outcomes. Statistical models included the Kaplan-Meier and the Cox proportional hazards models with propensity score adjustment. Patients treated with a depot formulation risperidone had the longest time to discontinuation with a median of 215 days (95%CI:181-242 days), which was statistically significantly different compared to patients treated with the rest of the medications: olanzapine (136 days, 95%CI:121-153 days), aripiprazole (102 days, 95%CI:81-126 days), ziprasidone (93 days, 95%CI:82-119 days), quetiapine (89 days, 95%CI:81-100 days), clozapine (76 days, 95%CI:54-92 days), amisulpride (73 days, 95%CI:62-85 days), and risperidone (55 days, 95%CI: 41-63 days). Our results in Hungary are partly similar to those of a recent register-based study in Finland with patients who were discharged from their first hospitalization for schizophrenia ; namely the median times to all-cause medication discontinuation were o120 days for the majority of the oral SGA. In terms of medication differences, our data support the superior effectiveness of the depot formulation regarding all-cause discontinuation, followed by olanzapine at the efficacy rank order.
Journal of Affective Disorders, 2004
In this 2-year prospective study, we searched for predictive factors influencing the 2-year outco... more In this 2-year prospective study, we searched for predictive factors influencing the 2-year outcome of major depressive episodes. Demographic characteristics (age, gender, education, employment), illness-related variables (severity, age at onset, number and duration of previous episodes), personality characteristics (DSM-IV personality disorders, trait anxiety, coping style), life context factors (life events before and during the depressive episode, social support, social adjustment), and biological markers (dexamethasone suppression test, thyroid stimulating hormone levels) of 117 inpatients with major depressive episode were assessed. A structural equation model was used to test the proposed correlational structure of the relevant variables.
BJCP. British journal of clinical pharmacology/British journal of clinical pharmacology, Jun 16, 2024
European Neuropsychopharmacology, Aug 1, 2022
Phytotherapy Research, 2019
Earlier studies suggested that specific Echinacea preparations might decrease anxiety. To further... more Earlier studies suggested that specific Echinacea preparations might decrease anxiety. To further study the issue, we performed a double blind, placebo controlled trial with a standardized Echinacea angustifolia root extract. Participants were volunteers scoring above 45 points on the state or on the trait subscale of the State Trait Anxiety Inventory (STAI). They were treated with 40 mg Echinacea or with placebo tablets twice daily for 7 days followed by a 3 week‐long washout period. Participants were also administered the Beck Depression Inventory (BDI) and the Perceived Stress Scale (PSS). In the Echinacea group, state anxiety scores decreased by approximately 11 points by the end of the treatment period, whereas the decrease was around 3‐points in the placebo group (p< 0.01). The effect maintained over the washout period. The difference from placebo was significant from the 7th day of treatment throughout. Changes were less robust with trait anxiety scores, but the preparatio...
International Clinical Psychopharmacology, 2019
Journal of Affective Disorders, 2004
Phytotherapy Research, Dec 25, 2019
Earlier studies suggested that specific Echinacea preparations might decrease anxiety. To further... more Earlier studies suggested that specific Echinacea preparations might decrease anxiety. To further study the issue, we performed a double blind, placebo controlled trial with a standardized Echinacea angustifolia root extract. Participants were volunteers scoring above 45 points on the state or on the trait subscale of the State Trait Anxiety Inventory (STAI). They were treated with 40 mg Echinacea or with placebo tablets twice daily for 7 days followed by a 3 week‐long washout period. Participants were also administered the Beck Depression Inventory (BDI) and the Perceived Stress Scale (PSS). In the Echinacea group, state anxiety scores decreased by approximately 11 points by the end of the treatment period, whereas the decrease was around 3‐points in the placebo group (p< 0.01). The effect maintained over the washout period. The difference from placebo was significant from the 7th day of treatment throughout. Changes were less robust with trait anxiety scores, but the preparation performed better than placebo in patients with high baseline anxiety. Neither BDI nor PSS scores were affected by the treatments. Adverse effects were rare and mild, and all were observed in the placebo group. These findings suggest that particular Echinacea preparations have significant beneficial effects on anxiety in humans.
BEVEZETÉS -Számos vizsgálat bizonyítja, hogy a szorongásos és hangulatzavarban szenvedô betegek n... more BEVEZETÉS -Számos vizsgálat bizonyítja, hogy a szorongásos és hangulatzavarban szenvedô betegek nagy része az alapellátásban keres segítséget panaszaira. Ismert, hogy ezeknek a zavaroknak a felismerése világszerte nehézséget jelent a családorvos számára. 1998-ban indított vizsgálatunk célja a családorvosi praxisban megjelenô személyek pszichés zavarainak feltérképezése. Ebben a közleményben azt a kérdést vizsgáljuk, hogy milyen tényezôknek van különös jelentôsége abban, hogy a betegek pszichés zavarait nehezen ismerik fel. MÓDSZER -A 12 családorvosi praxisban megjelenô 1815 beteg szorongásos és/vagy hangulatzavarait térképeztük fel a Diagnostic Interview Schedule (DIS) magyar változatával végzett interjúk során. A kapott diagnózisokat összevetettük a betegek panaszaival, tüneteivel és a családorvos által felállított diagnózisokkal. EREDMÉNYEK -A családorvosok és a felmérések alapján nyert (DIS-) diagnózisok egyezése kismérvûnek bizonyult. A különbség legfontosabb tényezôje a belgyógyászati betegségek jelenléte volt. Szociodemográfiai tényezôk nem játszottak számottevô szerepet a kórismék együttjárásában. Az orvosi és DIS-diagnózisok akkor mutatták a legnagyobb egybeesést, amikor a betegek sem krónikus, sem akut betegségre utaló diagnózist nem kaptak. Ezekben az esetekben a családorvos olyankor is adott affektív zavarra utaló diagnózist, amikor azt a DIS nem igazolta.
The Journal of Mental Health Policy and Economics
The purpose of this paper is to estimate the changes in health utilization and indirect costs of
Psychiatria Hungarica : A Magyar Pszichiátriai Társaság tudományos folyóirata, 2005
The authors sum up the question of suicide and lithium prophylaxis on the basis of their own thre... more The authors sum up the question of suicide and lithium prophylaxis on the basis of their own three cases.
The journal of mental health policy and economics, 2002
The purpose of this paper is to estimate the changes in health utilization and indirect costs of ... more The purpose of this paper is to estimate the changes in health utilization and indirect costs of anxiety and affective disorders in primary care patients after initiation of mental health treatment. This study was conducted in 12 general practices for the primary care of adult populations in Budapest, Hungary. Among 2,000 eligible patients aged 18 to 64 years, 1,815 gave written informed consent to participate in the study. The Hungarian version of the Diagnostic Interview Schedule (DIS) for anxiety and mood disorders was used to generate psychiatric diagnoses. For all patients, health care utilization data for the previous 12 months was collected including number of visits, specialist consultations, days spent in hospital, sick days in the last year and prescribed medication. Among the first 1,000 attenders, 151 patients were given DIS/DSM-III-R diagnoses of current anxiety and/or mood disorder or uncomplicated bereavement. Fifty-one patients who agreed to psychiatric treatment wer...
We investigated the toxicity, psychotropic side effects and anxiolytic potential of an Echinacea ... more We investigated the toxicity, psychotropic side effects and anxiolytic potential of an Echinacea angustifolia extract that produced promising effects in laboratory tests performed earlier. Rats were studied in the elevated plus-maze, conditioned fear, open-field, object recognition and conditioned place preference tests. Toxicity was studied in rats after intragastric administration. The preparation decreased anxiety in the elevated plus-maze and ameliorated contextual conditioned fear. No lethality or behavioural signs of discomfort were noticed in rats treated with 1000 and 3000 mg/kg Echinacea angustifolia. The extract was without effect in tests of locomotion (open-field), memory (object recognition) and rewarding potential (conditioned place preference) within a wide dose range. A pharmacological formulation based on the same E. angustifolia extract was tested in human subjects. One or two tablets per day were administered for 1 week to healthy volunteers scoring high on the State-Trait Anxiety Inventory (STAI). The tablets contained 20 mg of the plant extract. Data were collected using a structured self-assessment diary technique. The high dose (2 tablets per day) decreased STAI scores within 3 days in human subjects, an effect that remained stable for the duration of the treatment (7 days) and for the 2 weeks that followed treatment. The lower dose (1 tablet per day) did not affect anxiety significantly.
International Journal of Psychiatry in Clinical Practice, 2004
Anxiety and mood disorders are common conditions in primary health care service. Primary care phy... more Anxiety and mood disorders are common conditions in primary health care service. Primary care physicians (PCPs) have a privileged role in the early recognition of these conditions. In this study, the prevalence rates of threshold and subthreshold mood and anxiety disorders were surveyed among 1815 primary care attendees in 12 PCPs&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; offices in Budapest, using the Diagnostic Interview Schedule (DIS). The 1-year prevalence of DIS/DSM-III-R anxiety and/or mood disorders was 16.8%, and the 1-month prevalence was 12.5%. The occurrence rates of subthreshold anxiety and/or depression were 25.7 and 13.1%, respectively. The impact of threshold anxiety and mood disorders on work performance was considerably higher than the impact of subthreshold symptoms. At the time of the interview, 6.7% of the patients received mood and/or anxiety disorder diagnoses by their PCPs. The measure of agreement between the diagnoses generated by the DIS and the ones given by the PCPs was low. The presence of an acute or chronic physical illness made it more difficult for the PCPs to recognize a psychiatric disorder. Conversely, patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; psychological complaints significantly improved the recognition of anxiety and/or mood disorders. The use of the Beck Depression Inventory (BDI) brief version would help the patients to reveal their psychological symptoms, and the physicians to recognize an underlying psychiatric disorder.
European Neuropsychopharmacology, 2013
We conducted a nationwide, full-population based investigation to evaluate the comparative effect... more We conducted a nationwide, full-population based investigation to evaluate the comparative effectiveness of all marketed second generation antipsychotic drugs (SGA) prescribed for outpatients with the diagnosis of schizophrenia in Hungary. Using the national central register, our observational follow-up study included all patients with schizophrenia or related disorder between 01/01/2006 and 30/06/2008. The study cohort comprised 9567 patients who started new SGA during the inclusion period (01/07/2007-30/06/2008). All-cause medication discontinuation of 8 SGAs (1 depot and 7 oral formulations) marketed during the inclusion period, and the time to all-cause discontinuation were the main outcomes. Statistical models included the Kaplan-Meier and the Cox proportional hazards models with propensity score adjustment. Patients treated with a depot formulation risperidone had the longest time to discontinuation with a median of 215 days (95%CI:181-242 days), which was statistically significantly different compared to patients treated with the rest of the medications: olanzapine (136 days, 95%CI:121-153 days), aripiprazole (102 days, 95%CI:81-126 days), ziprasidone (93 days, 95%CI:82-119 days), quetiapine (89 days, 95%CI:81-100 days), clozapine (76 days, 95%CI:54-92 days), amisulpride (73 days, 95%CI:62-85 days), and risperidone (55 days, 95%CI: 41-63 days). Our results in Hungary are partly similar to those of a recent register-based study in Finland with patients who were discharged from their first hospitalization for schizophrenia ; namely the median times to all-cause medication discontinuation were o120 days for the majority of the oral SGA. In terms of medication differences, our data support the superior effectiveness of the depot formulation regarding all-cause discontinuation, followed by olanzapine at the efficacy rank order.
Journal of Affective Disorders, 2004
In this 2-year prospective study, we searched for predictive factors influencing the 2-year outco... more In this 2-year prospective study, we searched for predictive factors influencing the 2-year outcome of major depressive episodes. Demographic characteristics (age, gender, education, employment), illness-related variables (severity, age at onset, number and duration of previous episodes), personality characteristics (DSM-IV personality disorders, trait anxiety, coping style), life context factors (life events before and during the depressive episode, social support, social adjustment), and biological markers (dexamethasone suppression test, thyroid stimulating hormone levels) of 117 inpatients with major depressive episode were assessed. A structural equation model was used to test the proposed correlational structure of the relevant variables.