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Newsletter            
NO 7 JUNE 2004    

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The history of HCNP:
Exchanging information and catalysing progress

Csaba M. Banki,
president HCNP

The Mediterranean coastline of Andalusia, southern Spain, is among the driest, sunniest regions in Europe. One of the rare exceptions was in October 1992. During the 5th ECNP Congress held in Marbella, the sky was continually covered with dark clouds and heavy rains showered intermittently throughout the whole week. It was during those damp days that five Hungarian psychiatrists, while unwillingly staying indoors in the late afternoons, decided to establish a new national organisation for the promotion of psychopharmacological thinking, research, and information exchange in Hungary: the Hungarian College of NeuroPsychopharmacology (HCNP).

Those 'founding fathers' were Mihaly Arato, Istvan Bitter, Zoltan Janka, Zoltan Rihmer and I. At that time Hungary was simmering with new endeavours, ambitious enterprises, reforming and reorganising practically everything – and all this in an atmosphere of constant flux, savouring the long-awaited return of western-style social freedom. By forming the HCNP we did not seek to create just another formal association with membership lists, stamps, secretaries, showy offices and busy accountants - though we did create a simple letterhead and a logo emphasising our commitment to ECNP - but rather a small group of opinion leaders. Our modest objective was to bring the experts together and to let them regularly exchange experience as well as harmonise views about clinical psychopharmacology and psychopharma-cology research.

 

 

 
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  17th ECNP Congress
logomklein.gif (949 bytes) Neuropsychopharma-cology traditionally strong position in Sweden
  
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  2003-2004 Awards
logomklein.gif (949 bytes) 2003 ECNP-ACNP Exchange Award
  
logomklein.gif (949 bytes) 2004 ECNP Neuropsycho- pharmacology Award
  
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  2005 Workshop
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  Interview
logomklein.gif (949 bytes) Jan K. Buitelaar: "Children are not simply small adults"
  
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  ECNP
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Mark J. Millan

  
logomklein.gif (949 bytes) The history of HCNP
  
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  Events
logomklein.gif (949 bytes) Calendar of ECNP Events
  
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Little competition
HCNP was formally inaugurated in May
1993. Although the College has always enjoyed full and unreserved professional support from several parties, it has remained an independent College with no direct financial ties. This proud independence has, of course, had the obvious downside that the organisation on its own could only afford pure  intellectual activity: exactly what we intended. Being a loosely formalised group, HCNP members have had little competition for board positions in the past decade. The true originator of the College, Mihaly Arato (who unexpectedly died on July 27 2003 at the age of 55), chose to serve first as general secretary; later this duty was taken over by Zoltan Rihmer, a prolific author of clinical psychopharmacology papers and a renowned clinician and teacher at the National Institute of Psychiatry and Neurology in Budapest. Zoltan Janka, professor and chair at the Szent-Gyorgy University Medical School in Szeged, and Istvan Bitter, now professor of psychiatry at the Semmelweis University Medical School in Budapest, keep holding the positions of vice-presidents. Having faithfully served almost thirty years (which at times feels like 300) at the Regional Psychiatric Hospital in Nagykallo (the second largest specialist institution close to the eastern border), currently as scientific director I was unanimously elected HCNP President in 1993. I consider this a genuinely privileged appointment that has remained (to my surprise) in effect until now.

Founding fathers

A platform
Membership is free to anyone with an
academic degree, demonstrating significant activity in neuropsycho- pharmacology and with original research papers published in international journals. Despite the fact that the initial board meetings repeatedly rejected the idea of a membership fee, HCNP has never had more than fifty members. Hungary is a small country with less than eight hundred psychiatrists and only a few dozen dedicated neuropsychopharmacologists. The prime aim of HCNP has been to serve as a platform for information exchange and consensus seeking in clinical practice and research. It has always been active in promoting and shaping a psychiatric residency training programme. In cooperation with the Hungarian Psychiatric Association and all its allied organisations, this university-based postgraduate educational network has been gradually developed countrywide (with regional centres). HCNP has contributed to the psychopharmacology part of the curriculum. This training system in psychiatry was de jure adopted in 1998. HCNP continues to provide educational workshops and local or regional thematic courses for the residents.
Continuous Medical Education (CME)
was another important issue that had to wait decades until becoming reality. It also started as a voluntary movement, slowly progressing into a nationwide structure. HCNP was among the proponents of adopting a uniform continuing medical education scheme in Hungary, which came to formal existence in 1999. The first official CME training courses in biological psychiatry and psychopharma- cology took place at the Semmelweis University Medical School in Budapest each year between 1995 and 1999, co-organised by HCNP and the Hungarian Psychopharmacological Society.

The very best
Clinical therapeutic guidelines in psychiatry
were absent in Hungary before 1990. HCNP therefore considered it first priority to organise a series of national consensus meetings with the objective of formulating and publishing guidelines, possibly evidence based views of the available pharmaco-therapeutical options in Hungary. The first four HCNP consensus conferences were held in 1996, and the resulting material was reproduced in the pharmacotherapy section of the general therapeutic proposals in psychiatry, issued by the Hungarian College of Psychiatrists. HCNP assumed responsibility for maintaining and regularly updating these guidelines; we have since then convened national consensus conferences at least once every three years. It is a small country’s advantage that almost all the potential participants in a field already know each other and that they are able and willing to personally attend these meetings (or at least forward their comments). This makes HCNP documents true 'consensus papers'.

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    Though originally we did not have it in mind, HCNP could not long resist the temptation to introduce its own scientific meetings, customarily held in Nagykallo in late November every other year. These thematic conferences have always attracted the very best presenters and about three hundred participants. The last conference took place in November 2003, with a somewhat provocative title: 'Do Recent Results in Neuroscience Affect Psychiatric Diagnosis and Treatment?'.

Dedicated cooperation
HCNP is an advocate of international
cooperation as well. We started out with the immediate intellectual support of ECNP and after only two years, we became a Correspondent Organisation of CINP, a mark of respect we consider most encouraging. The somewhat less formal but no less dedicated cooperation with ACNP is another source of élan. The board members of HCNP are among the most productive and most cited authors in their field. They publish in international journals or in any of the existing Hungarian ones. Moreover we have an HCNP Newsletter that contains all the consensus conference papers, the guidelines, the conference abstracts, and any relevant news.


Founding meeting in 1993

Trying to facilitate communication between the clinicians, the health authorities and the pharmaceutical industry is delicate. The new Central European democracies have particular sensitivities in this field due to their low-income population and strong etatism in health administration. The best a professional organisation can do is to promulgate information and campaign for open negotiations among all parties. A few years ago a promising initiative called for the direct involvement of the health professionals through their Colleges – in government decisions about, among others, pharmaco-therapy related issues like availability, prescription rules and reimbursement regulation. A short-lived committee was set up for this purpose but this initiative, although fully conform to similar boards in the European Union, did not survive the 2002 elections. We look to the future with somewhat mixed feelings. Ten years ago neuropsychopharmacology research and practice in Hungary was on the rise. Diagnosis and pharmacotherapy improved spectacularly and the disreputably high suicide rate decreased by more than 30% within less than 15 years. The scientific output in Hungary was remarkable both in quantity and in quality. More recently this progress slowed down significantly. Neuropsychopharmacological research now seems to be less attractive to the younger generation (with due respect to the few exceptions) and the modernisation of pharmacotherapy has been severely hampered by government interventions and their firm unwillingness to even negotiate with professional organisations. We definitely hope that this is just a transient period and still look forward to a renewed scientific interest and research activity in years to come.

 



Hungarian College of NeuroPsychopharmacology

 
President: Csaba M. Banki;
Secretary: Zoltan Rihmer;
Vice-presidents: stvan Bitter, Zoltan Janka;
Treasurer: Erika Szadoczky
   
Secretariat: H–4321 Nagykallo, P.O.Box 18.
Phone:
Fax:
(36-42) 563-810;
(36-42) 263-128,
e-mail: csamba@axelero.hu
 
 

 


 

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