Harefuah最新文献

Introduction: In this issue of Harefuah, we present several aspects of mental health during hospitalization and rehabilitation and in the community. Most mental health care is now in the community. This issue begins with a study of sleep monitoring in the community aiming to predict the development of depression; and continues with an interesting characterization of seasonality in presentation to the emergency room, noting the importance of family and community connections as a protective factor. The relevance of early diagnosis and treatment of post-traumatic syndrome is discussed using a multidimensional approach to assessment. Since many individuals with mental disorders have experienced sexual trauma, it is of utmost importance to raise the issue during intake.

Introduction: This is the first health economics study to calculate and analyze public expenditure on mental health in Israel from 2019 through 2021. Financing of the NIS 4 billion expenses is divided equally between the health funds and direct financing from the state budget.

Introduction: In recent years, there is a significant increase in the "revolving door" phenomenon, when patients, discharged from psychiatric hospitals, return to hospitalization in less than a month. During the last decade, experience with clinical activity at the Beer- Sheva Mental Health Center raised a question regarding whether there is a similar trend in our center as well.

Introduction: Objective: To examine the feasibility of sleep monitoring using an innovative wearable technology, as a predictive tool for MDE (major depressive episode) recurrence in high risk patients.

Introduction: Diagnosis of combat post-traumatic stress disorder (PTSD) is largely based on the subjective reports of the claimant and is therefore prone to over-diagnosis of symptoms. Over-diagnosis of combat PTSD is associated with harm. Therefore, it is important to assess the claimant's credibility in assessing PTSD as accurately as possible.

Introduction: Nurses in psychiatric and forensic departments encounter unique difficulties and ethical dilemmas regarding the contrast between providing care and maintaining safety. Are psychiatric nurses incarceration wardens or agents of nursing care?

Introduction: Post-Traumatic Stress Disorder (PTSD) has been clinically known for over 3500 years, but due to political and financial reasons it was referred to by many names, to put the blame for its existence on the weakness of the victim instead of the abnormal hazards of war. Since it entered the DSM-3 as a specific illness entity (1980), the research and treatment methods grew tremendously, yet the way to diagnosis, understanding how the illness affects the victim, his family members and surrounding were left behind. Diagnosis of PTSD is largely based on the subjective reports of the victim. Talking about the trauma goes often in contradiction with the disorders' related feelings of avoidance, shame and guilt. On the other hand, the patient needs the recognition of his illness so that he can be compensated. These aspects lead to under- and over-diagnosis in many cases. Adding to the oddities of the illness in its diagnosis are the chronicity but wavy tendencies of the clinical picture (such as getting worse near the date of the trauma or when the terror rises) and the option of late onset PTSD etc.. One can understand the gaps between the suffering of the victims and the recognition of their handicap level.

Introduction: Amendment no. 18 to the Legal Capacity and Guardianship Law, 5722-1962, introduced a new concept in Israel - Ongoing Power of Attorney. This is a comprehensive digital legal document which enables an adult, while possessing full cognitive and mental abilities, to determine in advance who will look after his or her interests - medical, financial and personal - in the future, should he or she become incapacitated to manage them. This enables him to provide detailed instructions as to how the appointed person should act. This special (Ongoing) POA allows one to plan the future and live by one's choices and is in accordance with medical ethics principle of autonomy.

Introduction: In the mental health system, there is a challenging variety of risks, which stems from both the uniqueness of the patients and the treatments provided. How can we deal with the risk? A classic risk-management approach is based on a 4-step model: identification of the risks; analysis of the identified risks and prioritizing the treatment; treatment: dealing practicably with the risks; evaluation of the activity's effectiveness in retrospect.

Introduction: A history of sexual trauma (ST) and, especially, of childhood sexual abuse (CSA) is common among men and women with mental disorders. The estimated prevalence ranges between one-third to two-thirds of psychiatric patients who have experienced sexual trauma. These survivors are at increased risk for developing psychiatric disorders, including schizophrenia and bipolar disorder. Despite the great prevalence of sexual trauma and its mental implications, it remains under-diagnosed and under-recognized within the mental health system in Israel, as well as worldwide. This is due to the absence of a suitably comprehensive procedure for taking patient histories that will uncover sexual trauma. A history of sexual trauma also has implications for the course of the illness and prognosis. Trauma-informed treatment for survivors can reduce symptoms and alleviate mental suffering even many years after the traumatic events.