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Biomedical subjects

A Bleich

Publications and source records attributed to A Bleich.

At least 91 records · Page 5Linked to original sources
PubMed1990

Debate reawakened: premorbid factors for soldiers with refractory posttraumatic stress disorder.

Soldiers with severe Posttraumatic Stress Disorder who did not respond favourably to the front echelon treatment units, were treated in a rear echelon treatment centre, named Combat Fitness Retraining Unit, an alternative to psychiatric hospitalization. The soldiers were given individual clinical interviews; their combat potential scores were measured to tap premorbid factors which may have contributed to the development of symptoms. Analysis indicated that (1) in the clinical interview subjects showed clear interpersonal, school, family, and army adjustment problems prior to the trauma, (2) soldiers with Posttraumatic Stress Disorder treated in the rear unit tended to come from the lower end of the military combat potential level. Ramifications of these findings were carefully elucidated.

Adolescent↗
PubMed1990

Collaboration and mental health education for military primary care physicians.

This paper highlights the diverse ways in which army mental health specialists can intervene as therapists, consultants and supervisors to the primary care physician and his team. Various consultation and collaboration approaches are described, as well as the need for army medical staff to participate in ongoing mental health training workshops.

Affective Symptoms↗
PubMed1990

Competency for military arrest as a psychiatric problem.

Military law does not invest doctors with the authority to determine whether a soldier is competent to enter military arrest. This determination is legal in nature. Therefore, medical (or psychiatric) examination which is carried out before or within military arrest or detention, is aimed at preventing deterioration in the health of the soldier in prison. Hence, medical opinion serves only as 'credentials' of sorts. This is the formal language of the military law. In reality, the examining psychiatrist has to consider many factors, bearing in mind that his conclusions will probably become a prominent basis for the final decision on the military legal officer (whether to enforce military arrest). In order to illustrate the complicated considerations which are set forth before military psychiatrists, several case reports are presented of soldiers, who were examined in the Israel Defence Forces central psychiatric clinic for the determination of competency for military arrest.

Adult↗
PubMed1989

[Competency for military arrest as a psychiatric problem].

Military law does not invest physicians with the authority to determine whether a soldier is competent when faced with military arrest, as this is a legal determination. Therefore, medical (or psychiatric) examination carried out before or during military arrest or detention, is aimed at preventing deterioration in the health of the imprisoned soldier. Hence, medical opinion serves only as a "credential" of sorts, the formal language of the military law. In reality, the examining psychiatrist has to consider many factors, including the probability that his conclusions will provide an important basis for the decision of the military legal officer as to whether to enforce military arrest. To illustrate the complicated considerations facing military psychiatrists, several case reports are presented of patients examined in the Israel Defence Forces central psychiatric clinic as to competency for military arrest.

Forensic Psychiatry↗
PubMed1989

[Combat stress reaction].

The case of an atypical combat reaction in a 32-year-old soldier is presented. The initial phenomenon was a self-inflicted gunshot wound of the foot, while the post-traumatic symptoms appeared after a latent period 10 months. The combat stress reaction itself was identified during psychotherapy as the reactivation of trauma experienced in a previous war. Dimensions highlighted by this case include functional versus clinical measures used in diagnosis, and therapeutic considerations, such as the principles of immediacy, proximity and expectancy involved in the immediate combat stress reaction and thereafter.

Adult↗
PubMed1988

Audiological evaluation of nonalcoholic, drug-free posttraumatic stress disorder patients.

Auditory functions of 32 Israeli soldiers with posttraumatic stress disorder (PTSD) were evaluated and compared with those of 32 matched controls without PTSD. The evaluation included peripheral auditory functions, tolerance to noise, and central auditory informational functions. Tolerance of intense auditory stimuli by PTSD patients was similar to that of controls. Significant differences were found between left and right ear central auditory functions in a subgroup of 13 PTSD subjects, but neither in other PTSD patients nor in controls. These findings are discussed in the light of previous research concerning abnormal responses to auditory stimulus in PTSD, hemispheric disconnection, alexithymia, and psychosomatic disorders.

Adult↗
PubMed1988

Characteristic expressions of combat-related posttraumatic stress disorder among Israeli soldiers in the 1982 Lebanon War.

This study assessed the clinical picture of two groups of Israeli soldiers: front-line soldiers who had been treated for combat stress reaction during the 1982 Lebanon War (n = 382); and matched control front-line soldiers who did not sustain combat stress reaction (n = 334). Subjects were screened one year after the war for posttraumatic stress disorder (PTSD) and psychiatric symptomatology using the symptom checklist-90 (SCL-90). Results indicated that anxiety, depression, hostility, and obsessive-compulsive problems were the most salient features of PTSD among combat stress reaction casualties. The contribution of DSM-III criteria as well as their limitations in the diagnosis of PTSD are discussed.

Adult↗
PubMed1988

The role of serotonin in schizophrenia.

Studies examining serotonin (5-hydroxytryptamine; 5HT) in schizophrenia show variable and inconsistent findings, which might reflect the heterogeneity of the disease. When these studies are reviewed in the light of Crow's "two-syndrome" paradigm of schizophrenia, a new trend emerges. It appears that 5HT findings may be related to certain features of Type II schizophrenia such as negative symptoms, degenerative brain changes, and chronicity in the following manner: (1) 5HT2 antagonists, which have recently become available, have been shown to have an antipsychotic effect, particularly on the negative symptom cluster. (2) Decreased levels of 5-hydroxyindoleacetic acid in cerebrospinal fluid have been found to be correlated with cortical atrophy or ventricular enlargement in schizophrenic patients. (3) A subgroup of chronic schizophrenic patients has been shown to have elevated levels of platelet or whole blood 5HT. We propose, then, that 5HT dysfunction might be related to Type II, or negative syndrome, schizophrenia, and that the nature of this dysfunction might involve 5HT postsynaptic receptor hypersensitivity. We further suggest that the pharmacotherapy of schizophrenia should include a 5HT-blocking component, as well as a dopamine-blocking component, and we propose that future research should address the role of selective 5HT receptor hypersensitivity in schizophrenia.

Brain↗
PubMed1987

Posttraumatic stress disorder in Israeli combat veterans. Effect of phenelzine treatment.

Twenty-five Israeli combat veterans fulfilling DSM-III criteria for posttraumatic stress disorder (PTSD) participated in an open, prospective trial of phenelzine sulfate administration (median daily dose, 60 mg; range, 30 to 90 mg); three patients withdrew early due to side effects. Treatment was continued for at least four weeks in 22 cases and thereafter for as long as it was felt to be of benefit. Therapeutic efficacy was rated using a new PTSD scale, the Hamilton Depression Scale, and the Hamilton Anxiety Scale administered at four weekly intervals. Six patients completed four to eight weeks of phenelzine treatment; seven patients, nine to 13 weeks; and nine patients, 14 to 18 weeks. Comparison of mean prediscontinuation scores with pretreatment ratings showed, at best, only small (23% to 38%) differences (on the PTSD and Hamilton Anxiety scales) in the group treated for nine to 13 weeks. Two patients with a concurrent diagnosis of panic disorder and two with a concurrent diagnosis of dysthymic disorder were the most improved symptomatically but fell short of clinically significant remission. Although statistically significant improvement was observed on seven of the 12 items of the PTSD scale, sleep disturbance was the only symptom showing a clinically impressive change. These results only partially support previous positive reports of phenelzine treatment of PTSD.

Adult↗
PubMed1987

Reactivation of combat-related posttraumatic stress disorder.

The authors conducted an exploratory study of the nature and course of reactivation of combat-related posttraumatic stress disorder. Experienced psychiatrists, they each independently assessed 35 men with recurrent combat-related posttraumatic stress disorder. Two major types of reactivated posttraumatic stress disorder, each representing a different degree of pathology, were delineated: uncomplicated reactivation and heightened vulnerability. The second category was further subdivided into specific sensitivity, moderate generalized sensitivity, and severe generalized sensitivity. The authors conclude that reactivation of war-related trauma is a complex phenomenon that may take different forms.

Adult↗
PubMed1987

Varieties of combat stress reaction. An immunological metaphor.

The use of an immunological metaphor allows the incorporation of established theoretical ideas about trauma and stress in an integrative way which enables delineation and illustration of several varieties of combat stress reaction, including subtle forms of that condition which do not often appear in post-traumatic stress disorder literature.

Acute Disease↗