Search PubMed⌕ Search

Biomedical subjects

A Bleich

Publications and source records attributed to A Bleich.

At least 37 records · Page 2Linked to original sources
PubMed1999

The Cambridge Cognitive Examination (CAMCOG): validation of the Hebrew version in elderly demented patients.

BACKGROUND AND PURPOSE: The CAMCOG is the second most popular cognitive testing instrument in use by Israeli clinicians. The present study examines the reliability and validity of a Hebrew version of the CAMCOG in a group of dementia sufferers in a clinical setting. METHOD: Study participants included 36 dementia sufferers and 19 control non-demented, depressed elderly subjects, consecutive referrals to an outpatient psychogeriatric service and an 'open' ward of a psychiatric hospital. Operational clinical criteria for dementia and its subtypes and for the various forms of depression were used as the 'gold' standards. The CAMCOG was translated into Hebrew and then back to English. Seven items needed modifications for local usage. RESULTS: Interrater and test-retest scores calculated as exact agreement rates ranged from good to excellent for all items, although test-retest reliability scores were generally lower than interrater scores. Kappa statistics ranged from good to excellent for all but one item in the interrater scores and for two items in the test-retest scores. A strong convergent validity was found with the MMSE score (r=0.89, p<0.01). The 79/80 cutoff point provided moderate sensitivity (57.9%), excellent specificity (97.2%) and a strong predictive value (83.6%). CONCLUSION: The Hebrew version of the CAMCOG was found to be an appropriate instrument to discriminate between demented and non-demented depressed controls in a clinical setting. In light of the demographic, cultural and linguistic heterogeneity of the Israeli elderly population, further studies should examine the psychometric characteristics of the CAMCOG in a more varied sample and also using other cutoff points in order to establish if an increase in its discriminatory power is obtainable.

Aged↗
PubMed1999

[Post-traumatic stress disorder with psychotic features].

Post-traumatic stress disorder (PTSD) is often accompanied by psychiatric comorbidity, usually depressive and anxiety disorders. Comorbidity with psychosis has seldom been described. We present 6 case-studies of Israeli military veterans with PTSD and psychosis (all men aged 28-43). All developed PTSD shortly after a period of months or even years, sometimes following trauma-related triggering. Psychotic symptoms such as delusions or auditory hallucinations usually had paranoid or depressive features related in content to the traumatic experience. The combined course and interaction between PTSD and psychotic disorder is discussed, as well as the diagnosis of PTSD with psychotic features.

Adult↗
PubMed1998

Patient outcomes after initiation of Sabbath closure of a methadone maintenance clinic in Israel.

The study examined whether closing of a methadone maintenance clinic in Israel on the Sabbath was associated with adverse patient outcomes. One take-home dose of methadone was given to all patients for that day regardless of whether they had earned take-home privileges. No difference was found in dropout rates for the six-month periods before and after Saturday closure was initiated. Results of random, twice-weekly urinalyses for all patients did not indicate increased use of heroin. The findings suggest that closure of a methadone clinic at least one day a week does not jeopardize patient outcome. Cutting hours of operation would reduce workload and enable clinics to function more economically.

Adult↗
PubMed1997

Elevated levels of serum interleukin-1 beta in combat-related posttraumatic stress disorder.

Levels of serum interleukin-1 beta (IL-1 beta) and soluble interleukin-2 receptor (sIL-2R) were assessed in 19 male patients with combat-related posttraumatic stress disorder (PTSD) in comparison to 19 age- and sex-matched healthy volunteers. Serum IL-1 beta levels (but not sIL-2R) were significantly higher (p < .001) in the PTSD patients than in the controls. IL-1 beta levels did not correlate with cortisol levels, severity of PTSD, anxiety, depressive symptoms, or alexithymia score; however, they did correlate significantly (r = .54, p < .005) with the duration of PTSD symptoms. It is possible that desensitization of the hypothalamic-pituitary-adrenal axis in chronic PTSD patients counteracts the stimulatory effect of IL-1 beta on cortisol secretion.

Adult↗
PubMed1997

Post-traumatic stress disorder and depression. An analysis of comorbidity.

BACKGROUND: We examined psychiatric morbidity following war-related psychic trauma, with a special focus on the depressive comorbidity of post-traumatic stress disorder (PTSD). METHOD: Subjects consisted of 60 Israeli veterans who sought psychiatric treatment 4-6 years after having been exposed to war trauma. PTSD and psychiatric comorbidity were diagnosed using the Structured Interview for PTSD and the Schedule for Affective Disorders and Schizophrenia. RESULTS: Both lifetime (100%) and current (87%) PTSD were the most prevalent disorders. Comorbidity was extensive, with major depressive disorder (MDD) most prevalent (95% lifetime, 50% current), followed by anxiety disorders, minor affective disorders, and alcoholism or drug misuse. CONCLUSIONS: Within post-traumatic psychiatric and MDD are the most prevalent disorders. In addition it appears that PTSD, although related to post-traumatic MDD beyond a mere sharing of common symptoms, is at the same time differentiated from it as an independent diagnostic category.

Adult↗
PubMed1996

Event-related potentials in post-traumatic stress disorder of combat origin.

Visual event-related potentials (ERPs) of primary interest in this study of post-traumatic stress disorder (PTSD) were N1, N2, P2, and P3. Forty Israeli combat veterans consisting of 20 PTSD sufferers and 20 normal controls were evaluated. ERPs were recorded in response to three sets of computer-generated visual stimuli, presented in the form of a modified oddball paradigm. These stimuli included: domestic animal pictures (targets), emotionally neutral pictures of furnishings (nontargets), and combat-related pictures (nontarget probes). Subjects were required to discriminate between target and nontarget stimuli by pressing a button in response to target stimuli only. Subjects were instructed to ignore all nontarget stimuli. As expected, target stimuli evoked accentuated P3 amplitudes in both controls and PTSD patients. The nontarget combat-related pictures elicited enhanced P3 and N1 amplitudes in the PTSD patients only. N2 amplitudes were accentuated in PTSD patients for both targets and combat-related pictures. P3 latencies and reaction times to target stimuli were prolonged in PTSD patients. The same tendency was observed for N1 latencies. These results may indicate that an altered state of early and late cognitive selective attention processing exists in PTSD patients in addition to a vulnerability to traumatic reminiscences.

Adult↗
PubMed1996

[Pruritus due to obstructive jaundice, with delusions of parasitosis].

A wide range of nonpsychiatric medical conditions can cause delusions. We present a 62-year-man with pruritus due to obstructive jaundice, who developed delusions of parasitosis, which he considered to be the reason for his pruritus++. The holistic approach to diagnosis and treatment of this combined disorder is important.

Cholestasis↗
PubMed1996

Effects of stressful stimuli: a comparison between two time periods.

Studies of the effects of stressful stimuli that occurred sometime in the past have generally found both intrusion and avoidance as consequences. The present investigation used Horowitz et al.'s (1979) Impact of Events Scale to compare the responses of victims who had been recently evacuated to a hotel after a missile attack on their home with a similar group one year later. Although during the attacks intrusion responses were found to be significantly higher than avoidance, the means on the two mental states did not differ significantly one year after. In addition, intrusion was found to be more highly correlated with several functioning measures; this latter trend becoming more pronounced at Time 2. Implications of the findings and limitations of the study were mentioned.

Adaptation, Psychological↗
PubMed1996

Seven-year follow-up of child survivors of a bus-train collision.

OBJECTIVE: To assess the long-term effects of a traumatic bus-train collision and to examine the effect of levels of exposure and immediate reactions on long-term adjustment. METHOD: Seven years after the accident, 389 subjects, all doing compulsory army service, filled out self-report questionnaires assessing symptoms of posttraumatic stress disorder (PTSD), psychiatric symptomatology, and military functioning. In addition, subjects were questioned about their immediate reactions to the traumatic event. RESULTS: The most highly exposed subjects reported the highest levels of somatization, depression, phobic anxiety, and psychoticism and more PTSD symptoms. Acute stress symptoms and manifestations of fear immediately after the accident were strongly related to long-term maladjustment CONCLUSIONS: The results suggest that the investigation and assessment of long-term adjustment after traumatic events should take into account both contextual factors, such as the level of exposure to the event, and personal factors, such as the victims' immediate reactions.

Accidents, Traffic↗
PubMed1996

Classification of veterans with post-traumatic stress disorder using visual brain evoked P3s to traumatic stimuli.

BACKGROUND: Post-traumatic stress disorder (PTSD) typically involves a re-experiencing of traumatic events. In a previous P3 study it was found that PTSD patients react both selectively and involuntarily to combat-related pictures, exhibiting augmented P3 event-related potentials and thus providing a brain activity measure. The clinical application of these findings in differentiating PTSD patients from controls was tested. METHOD: Twenty Israeli combat veterans suffering from PTSD and 20 age-matched veterans without PTSD were evaluated. P3 potentials were recorded at Pz and Cz in response to visual motor-task target stimuli (pictures of domestic animals), non-target probe stimuli (combat-related pictures), and non-target irrelevant stimuli (pictures of furnishings and flowers). RESULTS: Using the Fisher Linear Discrimination Method the P3 measures correctly classified 90% of the PTSD patients and 85% of the controls. CONCLUSIONS: Visual P3s recorded in response to combat-related pictorial stimuli may introduce an efficient tool for studying higher brain activity in PTSD, complementing other behavioural and psychophysiological measurements.

Adult↗
PubMed1996

[Possible relationship between psychological stress and bleeding erosive upper gastrointestinal lesions].

The development of gastric and/or duodenal erosive lesions with bleeding is often related to an identified pathogenic factor such as the use of nonsteroidal anti-inflammatory drugs or alcohol. Extreme physiologic stress has also been shown to cause similar erosive lesions, known as "stress ulcer syndrome." We describe a 42-year-old woman, who over the course of a few months had 6 episodes of upper gastrointestinal bleeding due to various gastroduodenal erosive lesions. Prior to all these episodes she reported anxiety and stress of varied origins, but no other pathogenic factor was identified.

Adult↗
PubMed1995

Changes of brain anatomy in patients with posttraumatic stress disorder: a pilot magnetic resonance imaging study.

No abnormalities in magnetic resonance images were recorded in patients with posttraumatic stress disorder other than an increased incidence (50%) of a small cleft in the callosal-septal interface, a cavum of the septum pellucidum. A similar grade of cavum was obtained in 14% of normal volunteers matched for age, socioeconomic background, and military experience. The cavum is believed to have antedated the disorder and is conceived to be a neurodevelopmental aberration. The possibility that the cavum is a marker of vulnerability to stress in psychopathology is discussed.

Adult↗
PubMed1995

A nested case-control study of mammographic patterns, breast volume, and breast cancer (New York City, NY, United States).

The relations of Wolfe mammographic patterns, quantitative mammographic densities, and mammographically estimated breast size to breast cancer risk were investigated prospectively in a case-control study nested in the New York University Women's Health Study, a cohort of 14,291 women in New York City, NY (United States). The archived mammograms of 197 breast cancer cases who were identified during the first 5.5 years of the study and of 521 individually matched controls from the same cohort were retrieved and classified according to Wolfe parenchymal patterns and mammographic densities by two expert radiologists. Breast size and volume were estimated on the mammogram's cranio-caudal projection. In both premenopausal and postmenopausal subjects, the risk of breast cancer increased progressively with increasing density and percent density area. A significantly increased risk was found also for Wolfe pattern DY in premenopausal women and P2 pattern in postmenopausal subjects. In premenopausal women, mammographically determined breast volume and breast height also were associated positively with breast cancer risk. Although the results of the present study confirmed that mammographic parenchymal patterns and densities were important predictors of breast cancer risk, their practical use in screening seems limited due to the high prevalence of high risk patterns.

Adult↗
PubMed1995

Psychological profile of help-seeking and non-help-seeking tinnitus patients.

The psychological profile of tinnitus patients who sought treatment (Help-Seeking, HS) was compared with that of patients who did not seek help (non-help-seeking, NHS) and with normal control subjects. Psychological evaluations as well as hearing, tinnitus loudness, and tinnitus pitch were measured. Overall, the psychiatric symptomatology of HS (n = 50) was more severe with poorer effective coping abilities and externalization of locus of control than NHS (n - 50). However, the psychiatric symptomatology of the NHS was remarkably more severe than that in the normals (n = 73) and more like that in the HS even though they did not turn to treatment. Tinnitus loudness was significantly lower in HS than in NHS subjects. The lower the tinnitus loudness, the higher the psychiatric symptomatology. The trend towards subclinical abnormalities in NHS indicates their vulnerability to pathology and this requires the attention of the therapist in order to increase the patient's self-awareness and to suggest preventive coping strategies or relaxation techniques.

Adaptation, Psychological↗
PubMed1994

[Implication of compensation in recovery from combat-induced post-traumatic stress disorder].

The effect of compensation payment on long-term adjustment of soldiers with war-induced psychic trauma was studied. 2 groups of combat stress reaction casualties of the 1982 Lebanon War were examined: 109 casualties had been recognized by the Ministry of Defence as eligible for benefits, while 111 casualties had not applied for compensation benefits. Data were collected from their IDF medical charts and computerized personal records, from clinical data collected by IDF clinicians, and by mail and telephone surveys. Results indicated that the groups were quite similar in social functioning before the war. However, in those compensated there was more distress and impaired functioning following the war and at follow-up. The role of compensation in recovery from war-induced psychic trauma is discussed.

Adaptation, Psychological↗