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Biomedical subjects

B Maoz

Publications and source records attributed to B Maoz.

At least 37 records · Page 2Linked to original sources

Physicians' detection of psychological distress in primary-care clinics.

This study investigated the amount of psychological distress reported by 182 soldiers in the Israeli military and compared soldiers' self-ratings of distress with ratings by military physicians of observed distress. Comparisons indicated a low detection rate by physicians with only 13% of self-reported cases of emotional distress identified. This and several related findings were taken to indicate shortcomings in medical care. Possible remedies include additional psychiatric training for military physicians, less frequent rotation of physicians to allow for more stable care, and the initiation of mental health education among soldiers.

Adult↗

Measuring psychological stress in primary care military medical clinics.

In this study, the amount of psychological distress reported by soldiers is investigated and measured over time. The soldiers--enlisted and career--were randomly chosen while visiting five different military primary care clinics (for ostensible somatic problems) and administered the General Health Questionnaire (Goldberg and Huxley, 1980). A third of the subjects were given the GHQ a year later. Fifty-two percent showed psychological stress: combat soldiers showed considerably less distress than technical/maintenance and administrative soldiers, and the psychological stress findings remained relatively stable over time. Possible explanations for these findings are discussed.

Adult↗

Detection of emotional problems in the primary care clinic.

Emotional problems are an important component of general morbidity in primary care settings. Research on the sensitivity of primary care physicians to such problems is, however, scanty. This study examines the prevalence of emotional problems among 776 patients in primary care clinics in Israel using the GHQ-28 and as detected by their physicians. Hypotheses were tested relating to physician and practice characteristics and the extent to which they affect the matching of the two methods of problem identification. Using the GHQ, 69% of the patients were classified as 'cases'; physicians identified 31% of the patients as 'cases'. Specialist status in family medicine, interest and belief in the importance of emotional health, good communication, a low patient load and familiarity with the patient all predicted a better match of physician classification to GHQ-defined 'caseness'. The implications of these findings for ongoing medical education are briefly discussed.

Adolescent↗

[Psychiatric approach to problems of pain].

The problem of pain is presented from a liaison-psychiatric point of view. Pain is a frequent symptom of medical illness but may also be a manifestation of a psychiatric disorder or a psychological condition, as in the somatization of affect. Pain is not only a symptom but also a set of behaviors, an expression of personality traits, and a personal way of coping. Hence pain as such affects the patient's interaction with his environment, including the medical staff. Psychiatric approaches to treating pain include explorative and supportive psychotherapy, behavioral and cognitive therapy, hypnosis, relaxation, biofeedback and group therapy. 4 cases are presented which demonstrate the physician's understanding of the patient's psychological condition, the combined treatment of the pain problem and related limitations and applications.

Adult↗

Personal and health factors associated with frequency of visits to the primary care clinic.

A random sample of 170 patients registered in two primary care clinics of the workers' sick fund in Beer Sheva was selected to investigate the impact of health factors and personal coping style on visits to the primary care physician. It was hypothesized that health state (presence or absence of long-term illness) would be directly related to the frequency of visits as well as indirectly related to frequency of visits through its impact on the number of transient symptoms reported and patterns of response to common symptoms such as headaches, fever, and body aches. It was hypothesized, also, that an individual's personal coping style (according to the degree of repression or sensitization to illness) would be indirectly related to visits in a similar manner. The hypotheses were supported for persons suffering from long-term illnesses. Among the people who did not have long-term illnesses, personal coping style as measured on the repression-sensitization scale was related to the number of symptoms reported and the pattern of response to common symptoms but neither of these were related to frequency of visits.

Adaptation, Psychological↗

The doctor and his feelings: a course for residents in family medicine.

A course on the doctor and his feelings was presented as part of a programme for family medicine residents. The course was led by family physicians and behavioural science professionals who taught as an integrated team. Various teaching techniques were utilized to highlight emotional aspects of the doctor-patient relationship to inexperienced residents. Pre- and post-course assessments suggested there were benefits in a short intensive course of this nature. Possible explanations for the findings are discussed.

Education, Medical, Graduate↗

The use of khat. An epidemiological study in two Yemenite villages in Israel.

Chewing of khat leaves has been noted to be widespread in Yemen. Immigrants to Israel brought that practice along and have kept it alive ever since their initial settlement over thirty years ago. The small epidemiological study reported here made an inquiry into the extent of khat use in two agricultural villages. It also explored the association of that practice with social and psychiatric variables. Of interest was the finding that--contrary to most addictions--the prevalence rate of psychopathology was not higher among users than among abstainers.

Adolescent↗

Sulpiride-induced hyperprolactinemia and impotence in male psychiatric outpatients.

The relationship between erectile dysfunction and sulpiride stimulatory effect on prolactin secretion was studied in 13 married male psychiatric outpatients. The patients population was comprised of 2 groups: patients with anxiety disorders resistant to minor tranquilizers who were treated with sulpiride up to 200 mg/day, and schizophrenic patients treated with sulpiride 600 mg/day. All the patients were maintained on maximal dose for a period of 3 weeks. Sexual function and blood prolactin levels were monitored once weekly. The patients who developed impotence were maintained on higher doses of sulpiride and exhibited higher prolactin levels in comparison to the potent patients. Restoration of potency was observed after reduction or discontinuation of sulpiride treatment. It is concluded that sulpiride induced impotence is associated with hyperprolactinemia.

Adult↗

Sexual satisfaction among middle-aged couples: correlation with frequency of intercourse and health status.

The central hypothesis of this investigation is that the greater the sexual satisfaction that a couple reports from their sexual relationship, the better will be their adjustment to the changes that occur during middle age, as reflected in their reported health status and health behaviour. Forty-seven married couples, of North African Jewish origin, were investigated, the women being in the age range 48-53 yr. The findings regarding reported frequency of sexual intercourse and sexual satisfaction of women and men separately showed that a great majority of both men (87%) and women (74%) reported a decrease in sexual activity over the 5 yr preceding the study. Most of the men (56%) said the change was due to the aging process, whereas the women's responses were more varied and included aging, worries and decrease in sexual interest or desire. Eighty percent of the men reported satisfaction in their sexual relationship with their wives, but only 43% of the women stated that they were satisfied. A significant correlation was found, for women only, between the degree of satisfaction and the change in frequency of intercourse. Among the women there was also a positive correlation between general life satisfaction and sexual satisfaction. The hypothesis in regard to mutual (couple) sexual satisfaction was not confirmed in the men. It was validated in the women in regard to only two of the four criteria used - their perception of their health status and of their well-being. The women perceived the sexual satisfaction of their husbands much more accurately than the husbands perceived that of their wives.

Adaptation, Psychological↗

Relationship between biological changes and symptoms and health behaviour during the climacteric.

The object of this investigation was to assess the impact of biological (hormonal) changes during the climacteric on self-reported health status and health behaviour in a group of middle-aged women. The central research question was whether or not the menopausal phase (pre, peri, post) affects the number and frequency of the symptoms a women reports, the frequency of her visits to the primary-care clinic and her perception of her general state of health. The subjects comprised a random sample of 47 women aged 48-53 yr who were judged by their family doctors to be healthy or to be suffering from a chronic disease which was inactive at the time the study was carried out. The women were chosen from among a population of married couples under investigation in a larger study. The sample was homogeneous both ethnically (all subjects born in North Africa) and in terms of social class (lower to lower-middle class). No relationships were found between menopausal phase and any of the health criteria considered. The number and frequency of symptoms was low for all the women. Only a small number of women (2-10%) reported a frequent occurrence even of symptoms that are considered to be direct consequences of hormonal changes. These findings conflict with those deriving from studies of women attending gynaecological clinics, but confirm those of other community (non-clinic) studies. The results of this study bear out the general theoretical conclusion that climacteric symptoms are 'psychological and cultural artifacts' rather than consequences of biological changes.

Attitude to Health↗

Overutilization of the general hospital emergency room for psychiatric referrals in an Israeli hospital.

Consecutive referrals numbering 177 to the psychiatrist in an Israeli general hospital emergency room (ER) over a two-month period were evaluated. Only one-third met our criteria of justifiability. When the general practitioner (GP) was the referral source, we considered only 29 per cent of cases justified as compared to 70 per cent of the self-referrals. A combination of poor understanding by the GP of when to refer urgently, efforts by the GP to bypass clinic waiting lists, and lack of alternative community facilities may have accounted for this finding.

Adolescent↗

Sexual dysfunction associated with hyperprolactinemia in males and females undergoing hemodialysis.

Fifty-nine uremic patients (38 males and 21 females) maintained on chronic hemodialysis (CHD) served as the subjects in a study of the relationship between sexual dysfunction and serum prolactin levels (SPL). Sexual desire and activity were evaluated by a self-report sexual function rating scale (SFRS). About half the population of this study reported sexual dysfunction. Males and females reporting disturbance of sexual function had significantly higher SPL than those with normal sexual function. Bromocriptine treatment in five hyperprolactinemic patients reduced SPL to normal range and improved the sexual function. Association between sexual dysfunction and hyperprolactinemia in uremic patients is suggested.

Adult↗

The correlation of increased serum prolactin levels with decreased sexual desire and activity in elderly men.

Serum prolactin levels and sexual function were evaluated in 28 men from 60 to 64 years of age and in 44 men from 65 to 70 years of age. All subjects were married, physically healthy, and had no psychopathology or marital problem. About a third of the men aged 60 to 70 years suffered from impotence. No obvious correlation between elevated levels of serum prolactin and impotence was obtained. Subjects aged 65 to 70 who had decreased libido exhibited a significant elevation of serum prolactin levels, while subjects of the same age group who had reserved (normal) libido appeared to have low serum prolactin levels. Nine of ten men aged 60 to 70 years with serum prolactin levels above 40 ng/ml reported decreased libido. Potent men of both age groups (60-70 years) with high prolactin levels showed a tendency to have a decrease in frequency of sexual intercourse. Thus, it seems that mild hyperprolactinemia in aging men may be associated with decreased sexual desire and frequency of sexual activity.

Aged↗