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Biomedical subjects

E Witztum

Publications and source records attributed to E Witztum.

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

Paradise regained: "miraculous healing" in an Israeli psychiatric clinic.

The articulation of the experience of distress in terms of prevailing cultural idioms is deemed a crucially important factor in the effectiveness of healing devices across the globe. This curative factor, however, is not easily attainable in multicultural settings where therapist and patient do not share the same world view or explanatory models. In the following case presentation we report a culturally sensitive employment of strategic therapy with an ultra-orthodox psychiatric patient in Jerusalem. Despite the enormous cultural gap between the parties, the therapists were sufficiently sensitive to the patient's mythic world to enable him to recast his traumatic experiences in the mold of key idioms of his cultural background. These idioms were amplified by providing the patient with a myth-congruent metaphor and manipulated to afford a dramatic resolution of his emotional conflict. In what follows we discuss the setting of the therapy, the patient's background and diagnosis and the course of treatment. Following a verbatim account of the last therapeutic session, in which the patient's self-reconstitution had been completed, we discuss the cultural idioms synthesized in the text and the pertinence of hypnotic and metaphoric therapies to multicultural settings.

Adult↗
PubMed1990

Mental illness and religious change.

Over the last 20 years there has been a revival of interest in orthodox Judaism in Israel. In an area of Jerusalem with a large concentration of academies of study for 'baalei teshuva' (those who have undergone change to orthodox Judaism), it was noted that 12.6 per cent of referrals to the community mental health centre were newly religious. These referrals tended to have schizophrenia or severe personality disorders and were less likely than other referrals to have anxiety, depressive or adjustment disorders. Most of the newly religious referrals had psychiatric problems prior to becoming religious. Subsequent to religious change, many married and started a family before their psychiatric referral. The link between religious change and mental illness is explored.

Adaptation, Psychological↗
PubMed1990

Hoarding as a psychiatric symptom.

Collecting is a normal behavior in childhood and adulthood, while hoarding--the gathering, ordering, and disposal of articles without clear conscious motivation or control--is characterized as the pathologic counterpart of collecting. The literature describing the characteristics of collecting and the theories concerning its underlying mechanisms is presented along with eight case studies of adults who exhibited hoarding as a prominent symptom. It is apparent that hoarding is the final common pathway for a variety of processes: compulsive hoarding in obsessive compulsive disorder, fears of theft and poisoning in paranoid delusions, and the deterioration of habits in organic mental disorder.

Adult↗
PubMed1990

Summoning a punishing angel: treatment of a depressed patient with dissociative features.

The authors describe their treatment of a 24-year-old repentant, extremely observant Jewish man with major depressive disorder who complained of persecution by a personal angel. The therapists initiated a culturally sensitive psychotherapy of the patient, enacting a ritual summoning of the angel that resulted in the angel's transformation into an ally. The authors discuss the relationship of the patient's symptomatology to pathological mourning, trance, and dissociation. They advocate the use of a strategic combination of culture-specific concepts with modern psychiatric approaches in similar cases.

Adult↗
PubMed1989

Supernatural impotence: historical review with anthropological and clinical implications.

The historical and cultural background of the belief in supernatural impotence is presented, emphasizing its possible implications for clinical practice. A brief historical survey of the concept in Judaism and Christianity is followed by a short anthropological survey of supernatural impotence in different ethnic subcultures in Israel. A case demonstration exemplifies the connection between understanding the patient's cultural background and beliefs and the clinical competence of the therapist. The relationship between the clinical-therapeutic process in psychiatric practice and knowledge of the patient's cultural background and beliefs is stressed.

Adult↗
PubMed1989

A two-year follow-up of time limited therapy in a community mental health center in Jerusalem.

The present paper reports on a quantitative two-year follow-up of small cohort of somewhat unusual, selected, brief therapy cases treated by modified James Mann methods. The follow-up demonstrates the feasibility of conducting qualitative research in time limited therapy in a setting of community mental health care. The findings show favorable and durable clinical results.

Adult↗
PubMed1989

Adolescent attitudes toward suicide.

Jewish Israeli adolescent attitudes toward suicide were studied and overall demonstrated a positive approach. Adolescents related to suicide as representing a crisis rather than a mental disorder. Nearly half the subjects did not regard suicide as a shameful act, and approximately two-thirds considered it justifiable under certain conditions. The majority stated they would not punish a suicidal person, nor expel a suicidal adolescent from school. Approximately two-thirds said they would not change their attitude toward a suicidal friend. Female subjects consistently demonstrated a more accepting attitude, regardless of their religious beliefs, however, religious male adolescents consistently demonstrated a more negative attitude than nonreligious males.

Adolescent↗
PubMed1989

Long-term effects of sibling incest.

Although sexual abuse of children is recognized as a serious problem, sibling incest has received relatively little attention. A distinction has been made between power-oriented sibling incest and nurturance-oriented incest. The authors review the relevant literature and present four clinical examples. The cases illustrate the broad range of sibling incest and demonstrate its effects, including the long-term consequences for the perpetrator. Lasting difficulties in establishing and maintaining close relationships, especially sexual ones, are prominent features of each case. Without denying the occurrences of benign sex-play between siblings, the authors emphasize exploitation and abuse as pathogenic aspects of sibling incest.

Adult↗
PubMed1987

Bulimia. An underlying behavioral disorder in hyperlipidemic pancreatitis: a prospective multidisciplinary approach.

Between 1978 and 1985, we conducted a prospective study of 21 patients who survived several attacks of pancreatitis and were diagnosed as having primary hyperlipidemia. None of the patients suffered from chronic alcoholism, primary diabetes, or cholelithiasis or was receiving prolonged steroid therapy. Lowering of plasma lipid values toward normal was achieved in all patients following a program of combined dietary and drug (bezafibrate) therapy. Five patients had recurrent episodes of pancreatitis during the treatment program. These patients were diagnosed subsequently as suffering from bulimia and were all given cognitive behavioral therapy. One patient died following an attack of pancreatitis. An underlying eating disorder should be suspected in patients who relapse after treatment for pancreatitis and hyperlipidemia. Multidisciplinary treatment should be used in these patients to improve therapeutic efficacy and uncover behavioral patterns that have a direct impact on their life expectancy.

Adult↗
PubMed1987

Scrupulosity: religious attitudes and clinical presentations.

The attitudes of Catholicism and Judaism to scrupulosity are presented and the similarity between their management programmes and present-day behavioural psychotherapy is noted. Two famous cases are presented from 16th-century Europe and a further four cases from our 20th-century clinic in Jerusalem. Certain common features are noted, typical of obsessive-compulsive disorders, while some features, typical of scrupulosity, are best understood by considering both their religious and psychological importance.

Adult↗
PubMed1986

Use of a metaphor in the treatment of combat-induced posttraumatic stress disorder.

In this case of posttraumatic stress disorder, instead of interpretation, we used a metaphor that was indirectly yet concretely related to the patient's trauma. It subsequently became a symbol for other crucial events and situations in the patient's life. Mann's original approach to this type of patient had to be modified since the traumatic experience was not only too painful and isolated but also untouchable. The use of metaphor was thus a viable, indirect approach. Matching the metaphor to the therapeutic situation of patients with severe trauma, makes successful treatment possible where other approaches are excessively painful or almost impossible. The use of metaphor offers a solution to the therapeutic dilemma of too much resistance to brief therapy versus dependency-inducing long-term therapy for the patient suffering from posttraumatic stress disorder.

Adult↗
PubMed1984

Development of topical treatment for cutaneous leishmaniasis caused by Leishmania major in experimental animals.

Topical treatment, with drug-containing ointments, of cutaneous leishmaniasis caused by Leishmania major in BALB/c mice was studied. Twenty chemotherapeutic agents having potential or established antileishmanial activity were formulated in different ointment and cream bases. Only 15% paromomycin sulfate with 12% methylbenzethonium chloride, 12% benzethonium chloride, 12% cetalkonium chloride, or 12% dimethyl sulfoxide, all incorporated in white soft paraffin (United Kingdom patent application no. 2117237A), were completely effective. Topical treatment twice daily for 6 or more days caused total elimination of the parasites and healing of the lesion in all treated mice. All the other antileishmanial compounds, including sodium stibogluconate, pentamidine, amphotericin B, emetine hydrochloride, metronidazole, co-trimoxazole, allopurinol, and rifampin, either showed a slight effect on the parasites or were highly toxic to the animal host at the concentrations tested.

Administration, Topical↗
PubMed1983

Frozen stored Leishmania tropica vaccine: the effects of dose, route of administration and storage on the evolution of the clinical lesion. Two field trials in the Israel Defense Forces.

The first field trial of frozen vaccine against cutaneous leishmaniasis yielded a 100% take rate and a high ulceration rate at a dose of four million units. Two further trials were designed to investigate differences in response rates on the basis of duration of storage, sex of vaccinee, vaccination dose and method of administration. 257 soliders (151 males and 106 females) were inoculated in 1978 with an isolate of Leishmania tropica major that had been stored at the temperature of liquid nitrogen for 11 months before use. Those inoculated with an intradermal jet injector and those receiving half a million units by conventional injection yielded very low take rates. For those receiving two million and one million units, no difference in response was demonstrated between males and females or between doses. The over-all take rate for these groups after six months of follow-up was 71.6% with an ulceration rate of only 23.7%. In a subsequent trial in 1979, 131 men were inoculated with one of two frozen isolates of L. tropica major that had been stored for 11 and 18 months, respectively, at doses of either two million or four million units. The take rate after 12 months of follow-up was 91% and 93% for the four and two million units dose, respectively. The corresponding ulceration rates were 39.5% and 25%. The lesions produced by the higher dose developed more rapidly than those produced by the lower dose. The ability of the parasites to produce lesions rapidly with high ulceration rates appears to decline during prolonged storage, even in the frozen state.

Adolescent↗
PubMed1981

The antigenicity of whole virus versus subunit trivalent influenza vaccines -- a field trial in the Israel Defence Forces, 1978.

A single dose of a commercial trivalent influenza subunit vaccine (SV) and two whole virus vaccines (WVV) were compared in a randomized, placebo-controlled field trial of subjects under 23 years of age in the Israel Defence Forces. Sixty percent of SV recipients and 29% and 37% of WVV recipients showed no measurable response to the H1N1 subtype (A/USSR). When the prevaccination titer to H1N1 was less than 10, SV did not differ significantly from the placebo, and when greater than or equal to 10, the SV was poorer than the WVV. Response to the H3N2 (A/Texas) component was excellent, but when the prevaccination titer was less than 10, SV appeared less immunogenic than WVV. All three vaccines performed equally against the B/Hong Kong strain.

Adolescent↗
PubMed1979

Development of a storable Leishmania tropica vaccine: field testing with frozen promastigotes.

The development of a frozen vaccine against cutaneous leishmaniasis offers the possibility of controlling the quality, efficiency and sterility of the promastigotes used for inoculation. Thirty-nine soldiers in a settlement in a hyperendemic area were inoculated with a fresh isolate of Leishmania tropica that was stored at the temperature of liquid nitrogen. Thirty of the soldiers were injected by conventional syringe while the rest were inoculated by an intradermal jet injector. The infective material was transported either in ice or at liquid nitrogen temperature. All the subjects developed lesions at the site of inoculation, without unwarranted reactions. One month after inoculation 31 subjects were examined by a physician. All the reactions were positive--12 ulcers and 19 nodules. After four months, all 39 soldiers were examined: 25 (64%) had ulcers; eight (21%) had nodules; and six (15%) were without visible reaction. The different methods of transporting the vaccine, as well as the different responses of men and women, are discussed.

Adolescent↗
PubMed1978

Blast transformation in different stages of cutaneous leishmaniasis.

Lymphoblast transformation was studied in patients with cutaneous leishmaniasis, in immune donors with scars of leishmanial lesions and in normal control subjects. Lymphocytes from immune donors and from some of the patients were stimulated by extracts of Leishmania tropica. The test can be used as a measure of immunity and may, in certain circumstances, be of help in differential diagnosis.

Antigens↗