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Biomedical subjects

A Eytan

Publications and source records attributed to A Eytan.

13 recordsLinked to original sources

Religious beliefs in schizophrenia: their relevance for adherence to treatment.

The study examined how religious beliefs and practices impact upon medication and illness representations in chronic schizophrenia. One hundred three stabilized patients were included in Geneva's outpatient public psychiatric facility in Switzerland. Interviews were conducted to investigate spiritual and religious beliefs and religious practices and religious coping. Medication adherence was assessed through questions to patients and to their psychiatrists and by a systematic blood drug monitoring. Thirty-two percent of patients were partially or totally nonadherent to oral medication. Fifty-eight percent of patients were Christians, 2% Jewish, 3% Muslim, 4% Buddhist, 14% belonged to various minority or syncretic religious movements, and 19% had no religious affiliation. Two thirds of the total sample considered spirituality as very important or even essential in everyday life. Fifty-seven percent of patients had a representation of their illness directly influenced by their spiritual beliefs (positively in 31% and negatively in 26%). Religious representations of illness were prominent in nonadherent patients. Thirty-one percent of nonadherent patients and 27% of partially adherent patients underlined an incompatibility or contradiction between their religion and taking medication, versus 8% of adherent patients. Religion and spirituality contribute to shaping representations of disease and attitudes toward medical treatment in patients with schizophrenia. This dimension should be on the agenda of psychiatrists working with patients with schizophrenia.

Adaptation, Psychological↗

[Travel and psychiatric problems].

Despite a spectacular increase of international travels, related psychiatric problems remain understudied. Travelling is a stressing factor that may trigger or aggravate mood disorders, anxiety disorders or substance related problems. Expatriates are especially at elevated risk for adaptation problems due to the length of their stays abroad. Some destinations with strong symbolic or mystical connotations are associated with acute psychotic episodes. Anticipating changes and being prepared to face new solicitations to come allows to reduce risks for mental health while travelling.

Humans↗

Successful treatment of alcohol withdrawal with trazodone.

Trazodone, a second generation antidepressant, is helpful in the treatment of lasting alcohol withdrawal symptoms, such as sleep disturbances and craving. We report a case suggesting that trazodone is also efficient for the treatment of the acute phase of alcohol withdrawal treatment. A 30-year-old male patient with severe alcohol withdrawal symptoms was successfully treated with an adjuvant administration of 600 mg trazodone per day, while he had remained symptomatic for several days under high doses of diazepam and clomethiazolum. Controlled trials with trazodone for this indication could be useful.

Adult↗

[Injury from fireworks and firecrackers during holidays].

BACKGROUND: Every year during the holidays of the Arab and Druze population, and especially during Id el-Adha, scores of injured from firecrackers, crackers, skyrockets and other homemade explosive devices arrive at the Western Galilee Hospital. Similar casualties present during the Jewish Purim Festival. OBJECTIVES: To characterize the population of the injured and to analyze various aspects of this kind of accidents, in order to reduce injury and minimize disability. METHODS: A retrospective survey of records of all injured from firecrackers and similar devices during holidays that arrived at our hospital between 1999 and 2003 was conducted. Between 2001 and 2002 the trauma team, in cooperation with the local leadership, directed an education and information campaign in the community, in an attempt to reduce these injuries. RESULTS: During the study period, a decrease in the rate of injury was observed, which in the year 2003, reached a level of 50% of the 1999 figures. Of the injured, 53% were children (< or = 15 years old), 93% were Arab or Druze, and 93% were males. The rate of injuries from fireworks in 2003 was significantly lower than the mean rate of the years 1999, 2001, 2002 (p=0.045). The major cause of injury was firecrackers (67%) followed by fireworks (21%). Major injuries were to the extremities (58%), followed by facial and eye trauma (24%) and burns (11%). Of the casualties, 54% were lightly injured, 46% were hospitalized, 24% required surgical intervention and 7% lost fingers. Two individuals lost eyesight in one eye, but no fatalities occurred. CONCLUSIONS: The reduced rate of injury from fireworks and similar devices can be attributed to two major reasons: intervention by the trauma team and enforcement by the police and the Ministry of Trade and Industry. We recommend conducting a combined campaign of education and parental guidance with the involvement of community leaders and local media, and to increase law-enforcement. The organization of central firework displays in each community during this holiday should be considered.

Adolescent↗

Patterns of use of ambulatory mental health services in a universal care setting.

OBJECTIVE: As health care expenditures grow, it is important to understand whether mental health services are being used appropriately. This study examined participants' reasons for seeking the services of a psychiatrist or psychologist to determine the extent to which factors other than an existing clinical disorder, such as culture, stress, or lack of social support, played a role. METHODS: A total of 1,257 randomly selected students who were enrolled at the University of Geneva in 1997 and who had unrestricted access to psychiatric services were asked how many times in the past 12 months they had consulted a psychiatrist or a psychologist. The respondents' mental health, perceived stress, self-esteem, sense of mastery, and social support were measured with validated instruments. RESULTS: A total of 131 respondents (10 percent) reported an encounter with a mental health provider in the past year. In adjusted analyses, female sex, Swiss citizenship, a higher level of stress, and a lower level of mental health were significantly associated with a greater number of visits to a mental health specialist, and self-esteem, sense of mastery, and social support were not. CONCLUSIONS: The respondents' use of mental health services was determined by a lower level of mental health, indicating appropriate use of services based on clinical need. However, service use was also determined by consumer-related variables such as perceived stress and sociocultural characteristics.

Adult↗

Chronic pain presenting as major depression in a cross-cultural setting.

We report on a female African immigrant who developed chronic pain as a consequence of osteomalacia. Due to cultural particularities in pain expression, her symptoms were first attributed to a major depressive episode. Cultural factors influencing pain perception and expression are reviewed. The importance of working with competent interpreters in cross-cultural settings is emphasized.

Attitude to Health↗

Addressing language barriers to health care, a survey of medical services in Switzerland.

Two descriptive, quantitative cross-sectional surveys including all services of internal medicine and psychiatric services examined how Swiss medical services address the problem of language barriers in health care and how they respond to the high number of allophone patients. Of all the medical services (MS), 244 responded to the questionnaire (Internal medicine: 166; Psychiatry: 78; overall response rate 86.6%). Half of them (51%) estimated the proportion of allophone to the total number of patients at 1-5%. Only 4% of the MS collected statistics on the number of allophone patients (2 internal medicine, 8 psychiatric services). A third of the MS perceive communication with allophone patients as significantly difficult. Only 14% often use qualified interpreters, while 79% often use relatives, 75% often health staff, 43% often employees. Qualified interpreters are less frequently used in internal medicine than in psychiatry. There is an expressed need for qualified interpreters speaking Albanian, Bosnian/Serbo-croat, Tamil and Kurdish. Only 11% of the studied MS have a budget for interpreters, and 17% have access on an interpreter service. 48% express the need to have access to interpreter services. There is a need to raise the awareness of health professionals on the advantages of having access to trained interpreters and on the limits of using relatives as translators. This calls for coordination at national level, policy development and training, in order to ensure adequate communication and quality care for migrants.

Cross-Sectional Studies↗

Up-regulation of immunolabeled alpha2A-adrenoceptors, Gi coupling proteins, and regulatory receptor kinases in the prefrontal cortex of depressed suicides.

Suicide and depression are associated with an increased density of alpha2-adrenoceptors (radioligand receptor binding) in specific regions of the human brain. The function of these inhibitory receptors involves various regulatory proteins (Gi coupling proteins and G protein-coupled receptor kinases, GRKs), which work in concert with the receptors. In this study we quantitated in parallel the levels of immunolabeled alpha2A-adrenoceptors and associated regulatory proteins in brains of suicide and depressed suicide victims. Specimens of the prefrontal cortex (Brodmann area 9) were collected from 51 suicide victims and 31 control subjects. Levels of alpha2A-adrenoceptors, Galphai1/2 proteins, and GRK 2/3 were assessed by immunoblotting techniques by using specific polyclonal antisera and the immunoreactive proteins were quantitated by densitometry. Increased levels of alpha2A-adrenoceptors (31-40%), Galphai1/2 proteins (42-63%), and membrane-associated GRK 2/3 (24-32%) were found in the prefrontal cortex of suicide victims and antidepressant-free depressed suicide victims. There were significant correlations between the levels of GRK 2/3 (dependent variable) and those of alpha2A-adrenoceptors and Galphai1/2 proteins (independent variables) in the same brain samples of suicide victims (r = 0.56, p = 0.008) and depressed suicide victims (r = 0.54, p = 0.041). Antemortem antidepressant treatment was associated with a significant reduction in the levels of Galphai1/2 proteins (32%), but with modest decreases in the levels of alpha2A-adrenoceptors (6%) and GRK 2/3 (18%) in brains of depressed suicide victims. The increased levels in concert of alpha2A-adrenoceptors, Galphai1/2 proteins, and GRK 2/3 in brains of depressed suicide victims support the existence of supersensitive alpha2A-adrenoceptors in subjects with major depression.

Adult↗