The Israel journal of psychiatry and related sciences最新文献

Schizophrenia is a devastating and poorly understood disease for which the only accepted therapy is nonspecific antipsychotic and anti-seizure medication. This article summarizes the evidence that certain vitamin deficiencies likely worsen the symptoms of schizophrenia, and the evidence that large doses of certain vitamins could improve the core metabolic abnormalities that predispose some people to develop it; it recounts the history of a controversial vitamin-based therapy for schizophrenia called orthomolecular psychiatry; and it concludes by advocating a process for discovering promising new schizophrenia therapies that involves small, carefully conducted clinical trials of nutrient combinations in appropriately selected patients.

Background: Taurine is a conditionally-essential amino acid that is found in high concentrations in the CNS and is essential for growth and survival of neurons. Taurine had been clinically tested in a number of diseases with variable results. In the context of neuropsychiatry, taurine was found to be altered in some neurological and psychiatric disorders and its levels affected by mood stabilizers and by antidepressants as well as anti-Alzheimer drugs. Taurine is also a common component in energy drinks and it is claimed (without scientific support) to have stimulant properties. The present study was designed to test taurine's effects in animal models of affective and anxiety disorders and to evaluate its properties as a stimulant.

Method: Mice were treated with two doses of taurine with sub-chronic or chronic administration (for different experiments) and tested in the open field, the black/white box and the forced swim test. Taurine's possible stimulant effects were also tested in conjunction with amphetamine administration.

Results: For the doses and schedules tested, taurine did not have an effect on measures of anxiety- or depression-like behaviors and did not act as a stimulant, neither alone nor in conjunction with amphetamine. In contrast, high dose taurine administration resulted in a transient decrease in activity.

Conclusion: We suggest that any effects of taurine on affective-like behavioral measures may be very subtle (if any) and that prudence is recommended in claims regarding taurine activity as a stimulant.

Most studies have shown reduced levels of polyunsaturated fatty acids, particularly docosahexaenoic acid and arachidonic acid, in the cell membranes of red blood cells from schizophrenic patients. This has led to research interest in the possible therapeutic benefits of omega-3 fatty acids in schizophrenia. There is evidence from double-blind placebo-controlled trials that omega-3 fatty acids might prevent conversion from a prodromal state into first episode psychosis, and reduce the antipsychotic drug requirement in first episode patients. Results in chronic and acutely relapsing schizophrenia have been mixed. The problems associated with single nutrient studies are discussed. Nutrients are normally ingested in complex combinations, and they interact with each other in their normal metabolic and physiological functions. It is likely that optimal nutritional treatment will involve complex combinations of nutrients, preferably as part of a healthy balanced diet rather than by using supplements. However, such approaches have been little evaluated in mental health..

Introduction: Post-traumatic Stress Disorder (PTSD) symptoms cause dysfunction in broad areas of patients' lives and those of their families. Sexual dysfunction (SD) is common in these patients and aggravates their distress, affecting overall sexual activity, desire, arousal, orgasm, activity and satisfaction. PTSD clinic patients are frequently referred for consultation and treatment in the SD clinic. This prospective naturalistic follow-up study of a random group of patients was intended to evaluate response to pharmacologic and psychotherapeutic interventions for SD, in terms of both sexual functioning and overall symptomatology.

Methods: Ten patients fulfilling DSM-IV diagnostic criteria for PTSD (one woman and nine men) were recruited. Treatment for the sexual symptoms was tailored individually and was administered in addition to the continuing (stable) treatment in the PTSD clinic.

Results: After two months of treatment for the sexual symptoms, statistically significant improvements in all domains of sexual functioning were observed. In parallel, statistically significant improvements in all domains of the Impact of Events Scale scores were observed, both on the avoidance and intrusive subscales. There were no significant differences in response to treatment in terms of time elapsed since the onset of PTSD, or the pattern or severity of sexual and PTSD symptoms.

Conclusions: The results of this modest study demonstrate the importance of relating to the SD of PTSD patients irrespective of the duration or severity of their disorder. In this mixed group of PTSD patients with varied duration of symptoms, both SD and PTSD core symptoms improved significantly in response to individually tailored adjunctive treatment of the SD.

Background: Despite the fact that the assumption of a relationship between self-mutilation and dissociative disorders (DD) has a long history, there is little empirical evidence to support this premise. The present study examined this relationship and investigated whether this commonality is associated with innate hypnotic capacity.

Methods: Fifty patients diagnosed with DD and 50 control subjects with major depression were assessed by using a self-mutilation questionnaire, Dissociative Experiences Scale, Traumatic Experiences Checklist, and the Eye-Roll Sign for their self-mutilating behaviors, dissociative symptoms, early trauma, and innate hypnotic capacity, respectively.

Results: We have found that 82% of the present sample of patients with DD injured themselves. They had higher scores on trauma, dissociation and eye-roll measurements than controls. In addition, DD patients with self-mutilation were more likely to have high scores of trauma, dissociation and eye-roll than those without self-mutilation. Innate hypnotic capacity was a strong predictor of self-mutilating behavior in DD patients.

Conclusions: This study strongly supports the assumption that patients with DD are at high risk for self-mutilating behavior and points to the necessity of routine screening for self-mutilating behavior as well as the hypnotic capacity which may constitute a high risk for self-injury in this patient group.

Objective: Throughout the world and among different cultural groups, physical symptoms are the most common expressions of social problems and distress; chest pain is one of the most widely seen, medically unexplained physical symptoms. Most of the time, chest pain cases in which an organic etiology cannot be determined over time and in those presenting with atypical features should be evaluated as a component or an accompanying symptom of various specific psychiatric disorders, primarily such as panic disorder and depression. The aim of this study was to determine the psychiatric comorbidity rate in patients with chest pain without a cardiac etiology.

Method: Seventy patients admitted to the cardiology clinic with a complaint of chest pain but without any detectable cardiac etiology were included in the study. All patients were evaluated using a Sociodemographic Data Collection Form and Structured Clinical Interview for DSM-IV.

Results: Panic disorder was diagnosed in 47.1% of the non-cardiac chest pain group, depressive disorders in 21.4%, generalized anxiety disorder in 5.7%, anxiety disorders not otherwise specified in 5.7%, obsessive compulsive disorder in 5.7%, and undifferentiated somatoform disorder in 2.9%. Two psychiatric diagnoses were established in 12.9% of the patients and no psychiatric diagnosis in 24.3%.

Conclusion: Psychiatric disorder rates are quite high in patients with chest pain that cannot be explained cardiologically. These results show the importance of psychiatric evaluations in patients with non-cardiac chest pain or unexplained chest pain (UCP). In addition, understanding the psychiatric symptom profile of these patients will make an important contribution to the treatment of non-cardiac chest pain.

Background: To determine whether the emotional distress of infertile Turkish women is related to social support and influences the outcome of their IVF and/or ICSI treatment.

Methods: The Beck Depression Inventory, State- Trait Anxiety Inventory, and Social Support scales were administered to 104 primary infertile Turkish women before the date of their embryo transfer. Comparisons were made between the women who became pregnant and those who did not following the embryo transfer.

Results: Compared to the pregnant women, the non-pregnant women had a greater number of emotional symptoms despite similar levels of social support. Also, the increased severity of depressive symptoms and higher levels of anxiety were predictive of low pregnancy rates.

Conclusion: The pregnancy rate of infertile Turkish women was associated with emotional distress and low levels of social support were associated with increased emotional distress. Further research is needed to determine the factors and mechanisms that contribute to emotional distress in the treatment of infertility.