Israel journal of psychiatry最新文献

The purpose of the present study is to present the empirical basis for the capability of the theory of psychodynamic self-psychology to predict in crosssectional and prospective longitudinal studies, both the development of and the remission from eating disorders. In addition, we present the effectiveness of psychodynamic self-psychological treatment in a randomized control study over two other techniques. Theoretical constructs of the theory and technique suggestions will be weaved into the empirical data.

Background: Fibromyalgia (FM) is a rheumatological diseases characterized by diffuse pain and stiffness accompanied with fatigue, insomnia and headache. Physical and psychological factors were implicated in sexuality of patients with FM. There are few studies investigating the effect of childhood trauma on sexuality of patients with FM. The aim of this study is to investigate effect of childhood trauma on sexuality of FM.

Methods: Thirty-six patients with FM and 29 healthy females were included in this study. The patients with FM and healthy controls were assesed in terms of sociodemographic and clinical variables, sexual function and childhood traumas.

Results: The healthy controls had significantly longer duration of marriage with higher rate of marriage by arrangement. Communication subscale score was significantly higher in patients with FM. General and emotional trauma scores were significantly higher in patients with FM. There was no correlation between the scores of GRSSS, CTQ and FIQ.

Conclusion: The type of marriage and duration of marriage were important sociodemographic variables concerning sexuality in FM. This study indicated that childhood trauma was not a related factor in sexuality of FM.

Background: The efficacy and safety of Electroconvulsive Therapy (ECT) are well established; nevertheless, public attitude remains stigmatic. To date, few studies have been published that examine the attitudes and practical knowledge of medical staff with regards to ECT. Moreover, the attitudes of different parts of mental health staff still need to be explored. The aim of this study was to assess the knowledge and attitudes towards ECT of mental health staff in different disciplines.

Methods: A multi-group comparative study used questionnaires translated from several similar studies; 120 questionnaires were distributed equally to four groups of professionals in mental health centers in Beer Yaakov - Ness Ziona Complex: psychiatrists, psychologists, nurses and social workers. The questionnaires aimed to measure knowledge and attitude towards ECT treatment.

Results: The questionnaires showed significant differences in knowledge, subjective knowledge and, respectively, attitudes. Psychiatrists and nursing staff demonstrated higher knowledge and more positive approaches compared with social workers and psychologists. No significant differences were found between the knowledge and attitudes of psychiatrists, psychiatry residents and nursing staff.

Conclusions: The mental health sector can serve as an indicator of the level of knowledge and attitude towards ECT treatment. It is necessary to recognize the differences between various sectors and to deepen our knowledge regarding this treatment to all sectors, especially social workers and psychologists.

Background: Adherence to medication is a key factor for successful treatment of children with ADHD. However, most children do not adhere to their pharmacotherapy regimen, and have no contact with their physician during the first month of pharmacotherapy. A mobile health (mHealth) approach may bridge the gap between physicians and patients, allowing for more frequent communications as well as better monitoring of adherence to the prescribed treatment.

Method: The study sample included 39 children with ADHD (27 boys), aged 9.56±2.41 years. Participants were randomly assigned to one of the following two groups: (1) a study group in which participants and their parents were prompted to use a mobile application (i.e., mobile app or app); or to (2) a control group in which participants were treated as usual, without the app. Pill counts, which is a common strategy for confirming medication adherence, was recorded at week 4 and week 8. Clinical assessment conducted at baseline, week 4, and week 8.

Results: Participants who were prescribed with the app demonstrated higher overall pill counts over 8-weeks period, F=4.33, p<.05. In addition, a significant improvement in total CRS score was found among the study group compared to controls in week 4 and week 8, F=4.74, p<.05.

Conclusions: The current study provides initial support for the feasibility of a new mobile app in promoting adherence to stimulants among youth with ADHD.

Background: To determine the long-term prevalence of combat-related treatment seeking for PTSD in Israel Defense Force (IDF) veterans deployed to war.

Methods: A seven-year surveillance records-based study determined the prevalence of treatment seeking and DSM-IV-TR diagnosis among treatment seeking IDF veterans in relation to the 2006 Israel-Hezbollah War. The whereabouts and combat exposure of veterans during the war was determined based on the IDF's Operations Directorate records.

Results: Overall prevalence of psychological/psychiatric treatment seeking was 1.32%, and was significantly higher in soldiers deployed to high combat-exposure zones (2.19%), relative to low combat-exposure zones (0.24%), OR=9.20, CI=6.68-12.66, p<0.001. Treatment seeking did not differ between soldiers deployed in low combatexposure zones and soldiers deployed elsewhere than the war area (0.26%), OR=0.90, CI=0.65-1.24, p=0.45: 42% of care-seeking contacts occurred within the 3.5 months of the war's end. An additional 27.9% of all contacts occurred during the ensuing year, and decreased drastically in subsequent years. PTSD was more prevalent among treatment-seeking veterans deployed in high combatexposure zones relative to veterans who were deployed in low exposure zones or elsewhere.

Conclusions: Based on previous reports on postcombat PTSD prevalence using stratified samples, there appears to be a service-gap of anywhere between 3-11% between treatment seeking by IDF veterans following war deployment and the actual prevalence of PTSD and related symptoms in this soldier population. As in prior research, treatment seeking and PTSD strongly related to level of combat exposure.

Background: The prevalence of alcohol related harm (ARH) in Israel has traditionally been low. The lack of familiarity with ARH may derive from the fact that in the past there was limited clinical exposure to these harms. However, ARH is becoming more common in Israel but it is unclear whether the medical and nursing workforce's knowledge is adequate to manage these problems. Our main objective was to assess knowledge regarding ARH among medical and nursing staff (MNS) in an Israeli university affiliated general hospital. We also aimed to compare knowledge of different MNS groups Methods: One hundred and twenty-seven MNS including consultants (senior physicians), residents, interns and nursing staff completed the Knowledge of Psychiatric Aspects of Alcohol Questionnaire (KPAAQ), a validated measure of knowledge concerning ARH comprised of five categories.

Results: There was no significant difference between the four MNS groups in overall mean KPAAQ scores that varied from 45% (nurses) to 54% (interns). However, direct comparisons indicate that physicians scored higher than nurses (p=0.02). overall. The mean score for the KPAAQ category "alcohol withdrawal syndrome" was below 40% for all MNS groups. Physicians scored significantly higher than nursing staff (p=0.005). All MNS mean scores were greater than 63% for the category "alcohol in pregnancy." This was the highest category score.

Conclusions: Assessment of knowledge regarding ARH among MNS in a general hospital with a standardized instrument demonstrated no significant difference in knowledge of ARH among nursing staff, interns, residents and consultants apart from knowledge about alcohol withdrawal. However, the overall score of the physicians as a whole was significantly higher than the nursing group. These findings suggest a need to implement educational interventions in MNS to increase knowledge of ARH so as to promote the provision of brief interventions for patients with ARH.

Background: We investigated the correlation between eating-related pathology and the Superwoman ideal among ultra-Orthodox (Haredi) and National-Religious women in Israel using self-figure drawings and related narratives.

Method: A sample of 55 women filled out self-report eating attitudes questionnaire (EAT-26), the Superwoman Ideal questionnaire, and a self-drawing followed by a narrative.

Results: No significant difference in eating pathology was found between the ultra-Orthodox and NationalReligious women. A gap was found between the selfdrawings and the narratives, which was greater among the ultra-Orthodox women. Exposed body parts were more significant than sexual signs, which are almost completely covered in these societies.

Conclusion: There was no significant difference in the eating disorders' level among ultra-Orthodox and NationalReligious women. The percentage of risk of developing eating problems was similar to that of the secular population. The self-drawings with narratives was found to be an effective tool for researching these societies.

Background: Research indicates that women with an eating disorder are more insecurely attached than those without. Over-restrictive maternal feeding practices in childhood are associated with elevated BMI and more disordered eating in adult women.

Goals: The goal of the current study was to examine the extent to which the two insecure attachment styles contribute to women's body dissatisfaction indices and to examine their role in moderating the influence of restrictive maternal child feeding practices.

Methods: 283 women between the ages of 18-42 (mean=25.04; SD=3.53) sampled through social networking completed an online self-report, including the Figure Rating Scale (from which Self-Ideal comparison was calculated), retrospective child feeding questionnaire (RCFQ), the experience in close relationship (ECR) questionnaire, and the EDI's Drive for Thinness and Body Dissatisfaction subscales.

Results: Insecure-anxious attachment positively predicted Drive for Thinness, Body Dissatisfaction and Self-Ideal Disparity. However, insecure-avoidant attachment did not predict indices of body dissatisfaction. Recalled over-controlling maternal childhood feeding behaviors were associated with Drive for Thinness, Body Dissatisfaction and greater Self-Ideal body image disparity. Significant interactions between attachment styles, maternal childhood feeding behaviors, and body dissatisfaction indices emerged.

Conclusions: In the presence of restrictive feeding practices in childhood, insecure attachment styles moderate women's adult body dissatisfaction indices. Avoidant attachment style plays a protective role while anxious attachment style exacerbates body dissatisfaction indices.

Background: Disordered eating pathology (DEP) and body dissatisfaction are well-documented risk factors for eating disorders and have become more prevalent among adolescent males.

Method: The sample consisted of 256 Israeli boys, in grades 8-12. Participants completed questionnaires measuring, Sense of Coherence (SOC), Body Shape (BSQ), Eating attitudes (EAT-26), and the Eating Disorder Inventory (EDI-2).

Results: Findings revealed low levels of DEP among adolescent boys. Younger adolescents (grade 8-9) had higher levels of clinically relevant DEP than older adolescents (grade 10-12). SOC was negatively associated with DEP and a significant interaction for age and SOC emerged with younger age being associated with both lower levels of SOC and higher DEP.

Conclusion: These results demonstrate a low overall prevalence rate of DEP among adolescent boys and is consistent with the developmental literature relating to SOC and mental health and in contrast with a similar population of girls documented in Israel and the US.

Background: Psychiatry is changing as medicine adopts a patient-centered approach. This model of care places greater emphasis on the patients' involvement in determining the goals of their treatment and the nature of their care. This study offers a non-verbal patient-centered intervention by using relaxing music chosen by patients in a closed psychiatric ward to achieve reduction in levels of stress and psychomotor agitation.

Method: Participants, patients in closed wards, entered a seclusion room whenever they showed psychomotor agitation, overwhelming stress or physical and verbal aggression. While in the seclusion room, participants in the research group (n=24) were exposed to relaxing music of their choice whereas the comparative group (n=28) did not receive any sensory stimulation. The participants filled out the Visual Analogue Scale to measure their emotional state before and after this experience while the staff filled out the Behavioral Activity Rating Scale.

Results: Results show significantly higher emotional calm and prominent reduction in psychomotor agitation among the research group in comparison with the comparative group.

Conclusions: Relaxing music chosen by patients has a positive effect on their emotional state and behavioral activity and may therefore serve as an alternative sensory intervention before patients reach violent situations that require restraint.