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Biomedical subjects

A Apter

Publications and source records attributed to A Apter.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Anorexia nervosa and obsessive-compulsive disorder in a young Russian immigrant].

Anorexia nervosa is a psychiatric disorder characterized by excessive dieting, severe weight loss, disturbed body image and inexplicable fear of gaining weight. It afflicts mainly upper class women of developed countries. We present a 16-year-old recent immigrant from Russia, where she had developed anorexia nervosa, obsessive-compulsive disorder and depression. The management of this patient is presented in the light of the sociocultural theory of the pathogenesis of anorexia nervosa and the clinical link between eating disorders and depression and obsessive-compulsive disorders.

Adolescent↗
PubMed1993

Death without warning? A clinical postmortem study of suicide in 43 Israeli adolescent males.

Forty-three consecutive Israeli male suicides, 18 to 21 years of age, that occurred during compulsory military service were studied using preinduction assessment data, service records, and extensive postmortem interviews with family and peers. At preinduction, subjects, as a group, appeared above average in intelligence, physical fitness, and measures predictive of successful adaptation to military service. Active duty performance was generally satisfactory. Ascertained post mortem, 53.5% met formal criteria for major depressive disorder; most cases, however, appeared recent and reactive. Narcissistic and/or schizoid traits were common. Substance abuse was absent and antisocial personality disorder was rare (4.7%). Furthermore, in eight patients (18.6%) no Axis I diagnosis could be made; half of these also lacked any significant Axis II pathology. These findings, at partial variance with US studies, suggest a complex relationship between suicide and mental disorder. The striking failure of intensive screening and preventive measures to prevent these suicides highlights unresolved questions of etiology and intervention.

Adaptation, Psychological↗
PubMed1993

An epidemiologic study of Gilles de la Tourette's syndrome in Israel.

OBJECTIVES: The goal of this study was to estimate the lifetime prevalence of Gilles de la Tourette's syndrome (GTS) in adolescents aged 16 to 17 years. DESIGN: Population-based epidemiologic study. SUBJECTS: Eighteen thousand three hundred sixty-four males and 9673 females aged 16 to 17 years screened for induction into the Israel Defense Force. RESULTS: Of the 28,037 individuals screened, 12 met diagnostic criteria for GTS. The point prevalence in this population was 4.3 +/- 1.2 (mean +/- SE) per 10,000. The 95% confidence interval for this estimate is 1.9 to 6.7 per 10,000. The point prevalence was 4.9 +/- 1.6 per 10,000 for males (95% confidence interval, 1.8 per 10,000) and 3.1 +/- 1.8 per 10,000 for females (95% confidence interval, 0 to 6.6 per 10,000). The rate of obsessive-compulsive disorder (OCD) was significantly elevated among the subjects with GTS (41.7%) compared with the population point prevalence of OCD (3.4) in those without GTS. In contrast, the rate of attention deficit hyperactivity disorder was only 8.3% compared with the population point prevalence of 3.9% in those individuals without GTS. CONCLUSIONS: The prevalence estimates from this population-based study are in agreement with previous results based on surveys of younger children. The sex ratio observed in this study is not as large as reported in previous studies and remains to be explored in other studies of adolescents and adults.

Adolescent↗
PubMed1993

Fears of death in suicidal and nonsuicidal adolescents.

Suicidal, psychiatric, and normal adolescent girls and boys, ages 15-17 years, participated in a study on five types of death fears. A mixed within-between multivariate analysis of variance (5 factors x 3 groups) yielded significant interactive effects of indicating that there were different profiles of fears among the three groups: Relative to the other groups, suicidal adolescents displayed little differentiation between facets of fear, with differences in the magnitude of fear limited to the intrapersonal facets. Correlates of fear varied between groups: Fear was positively correlated with suicidality in normal subjects, negatively correlated with suicidality among suicidal ones, and unrelated to suicidality in the psychiatric group. It is suggested that fear of death is processed and experienced differently by suicidal and nonsuicidal adolescents to serve as a facilitator or inhibitor of suicidal behavior.

Adolescent↗
PubMed1993

Cytokine production in anorexia nervosa.

The capacity of peripheral blood mononuclear cells (PBMCs) of anorexia nervosa (AN) patients to produce interleukin-1 (IL-1), interleukin-2 (IL-2), and interleukin-3-like activity (IL-3-LA) was studied. A significantly lower (-49%, p < 0.005) capacity to synthesize IL-2 and an almost significantly impaired ability (-35%, p = 0.058) to release IL-3-LA by PBMCs of AN patients was found, as compared with cells of the control group. IL-1 production, either spontaneous or after stimulation with lipopolysaccharide (LPS), did not differ significantly between AN patients and healthy subjects. The lessened capacity to produce IL-2 was accompanied by an enhanced stimulatory activity of the patient sera on the production of this cytokine by PBMCs of healthy subjects. It is therefore suggested that the serum of AN patients contains a stimulatory factor or factors for cytokine production that compensates for the lower production of cytokines by AN PBMCs. Such a compensatory mechanism may explain why AN patients do not have an higher susceptibility to infections.

Adolescent↗
PubMed1993

The Ganser syndrome in two adolescent brothers.

The Ganser syndrome is rare in children and adolescents. Two cases of Ganser syndrome in adolescent brothers, both of whom developed the syndrome while in jail and awaiting trial, are presented. Both brothers subsequently developed signs and symptoms indicative of affective disorder. The differential diagnosis and the management of these two patients are discussed in the light of the nosological controversies surrounding this clinical entity.

Adolescent↗
PubMed1993

Anxiety, impulsivity and depressed mood in relation to suicidal and violent behavior.

Many different variables have been associated with suicidal behavior as well as with violent behavior. This study was designed to test a model that attempts to relate such variables to violence and suicide risk. Sixty psychiatric patients were evaluated and divided into suicidal and nonsuicidal groups and then into violent and nonviolent groups. Scores on suicide risk, violence risk, anxiety, anger, impulsivity and mood were then compared between these groups. In a second analysis, scores on suicide risk and violence risk were correlated with all the other variables. Anxiety and impulsivity were found to strongly correlate with suicide risk. Angry and resentful mood correlated with violence risk; trait anxiety correlated negatively with violence risk. The results contribute further insight into the authors' two-stage model of countervailing forces.

Adult↗
PubMed1992

[Anorexia nervosa in a young diabetic].

Coexistence of diabetes mellitus and anorexia nervosa has been noted in the past 2 decades. The nature and treatment of diabetes offer numerous opportunities for the anorectic patient to lose weight. Improper adjustment of the insulin dose, failure to inject insulin, clandestine vomiting and failure to provide urine samples allow the anorectic diabetic to achieve morbid weight loss. The treatment of patients with both conditions is difficult; behavioral management combined with psychotherapy was found to be most effective. An illustrative case is presented.

Adolescent↗
PubMed1992

Neuroendocrine response to trihexyphenidyl in depressed patients.

The effect of a single dose (10 mg P.O.) of trihexyphenidyl (THP) on plasma cortisol, growth hormone (GH), and immunoreactive beta-endorphin (ir-beta-EP) was studied in seven major depressed patients and seven controls. GH secretion was suppressed (34-41%) by THP in both groups. THP did not affect cortisol secretion in depressed patients and controls. An increase (18%; p less than 0.05) in plasma ir-beta-EP levels was detected in the healthy subjects only. The results of this study do not support the hypothesized altered responsiveness to anticholinergic provocation in major depression. The inhibitory activity of THP on GH secretion indicates the involvement of the cholinergic system in the regulation of GH release in humans.

Adult↗
PubMed1992

Elevated plasma immunoreactive beta-endorphin in anorexia nervosa.

Basal morning plasma levels of immunoreactive-beta-endorphin (ir-beta-EP), and 17-beta estradiol (E2) were assessed in 25 adolescents with anorexia nervosa (AN) in comparison to 24 healthy controls. All subjects were drug free for at least 6 weeks. The mean plasma level of ir-beta-EP was significantly higher (84%) in the AN patients when compared with the control subjects. The elevated plasma ir-beta-EP may be relevant to the suppression of appetite, tolerance of fasting, and to the hypothalamic hypogonadism in AN.

Adolescent↗
PubMed1992

An epidemiological study of obsessive-compulsive disorder and related disorders in Israeli adolescents.

Five hundred and sixty-two, 16- to 17-year-old consecutive inductees into the Israeli Army, constituting a random sample of their cohort, were screened for obsessive-compulsive disorder (OCD), Tourette's syndrome, transient tics (TT), chronic multiple tics (CMT), and attention-deficit hyperactive disorder (ADHD). Two child psychiatrists interviewed the subjects, using screening items from structured interviews that implement DSM-III-R diagnostic criteria. For OCD, a point prevalence of 3.6% was found, 3.9% for ADHD, 1.8% for CMT, and 1.6% for TT. For ADHD, TT, and CMT, but not for OCD, there was a significantly higher prevalence for males than for females. Among the OCD individuals, there was an elevation of TT, CMT, and Tourette's syndrome relative to the population rates.

Adolescent↗
PubMed1992

Cognitive modifiability of adolescents with schizophrenia: a research note.

It is well documented that schizophrenic patients suffer from numerous cognitive defects. In a preliminary investigation, the Learning Potential Assessment Device was used under controlled conditions to examine the cognitive modifiability of institutionalized adolescent schizophrenics (N = 12) and a contrast group of adolescents with severe conduct disorders (N = 10). Feuerstein's theory of structural cognitive modifiability was thus applied in assessing potential for change. Results are encouraging in that there was evidence of the modifiability of the experimental subgroups of both the schizophrenic and conduct disorder groups.

Adolescent↗
PubMed1992

Structural equation modelling of some of the determinants of suicide risk.

Much of the psychological research with suicidal patients has examined, individually or in combination, correlates and predictors of the various measures in the suicide process. The present study investigated suicidal risk as an outcome measure. Several questionnaires were administered to a sample of 94 soldiers, 61 of whom had manifested some suicidal symptoms. Using LISREL analysis, the data showed that the best model had suicide risk as directly influenced by depression and indirectly by impulsivity.

Adult↗
PubMed1992

The factor structure and criterion validity of the short form of the Eating Attitudes Test.

One of the more frequently used measures of eating disorders is the 40-item Eating Attitudes Test (EAT) developed by Garner and Garfinkel (1979). Although originally designed to diagnose anorexia nervosa, the test has recently been applied to nonclinical populations also. In this study, we examined psychometric and validity data for a short version of the scale, the EAT-26. Using a sample of 809 female soldiers in their late teens, results showed that the EAT-26 is reliable, the factor structure is different from that obtained in clinical groups, and the EAT-26 is significantly correlated with body image, weight, and diet.

Adolescent↗