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Biomedical subjects

E Witztum

Publications and source records attributed to E Witztum.

At least 37 records · Page 2Linked to original sources
PubMed2000

Medical confidentiality in the new Israeli Patients' Rights Act (1996): does it add or detract?

Medical confidentiality is dealt with in various laws in Israel. The 1996 Israel Patient's Rights Act approaches the subject of confidentiality in an extensive and fairly detailed manner which includes several innovations in relation to previous laws. This article will review the old and the new legislations on confidentiality, and will analyze and discuss the implications and potential problems for psychiatric clinical practice. The new Act will also be examined in light of the World Health Organization guidelines on Mental Health Care Laws.

Confidentiality↗
PubMed1999

[Alcoholic delirium: warning signs and diagnosis].

Lately an increasing number of physicians are asked to diagnose and treat physical and mental disorders caused by alcohol abuse, a phenomena which had been quite rare in Israel until recently. Early diagnosis and efficient treatment are essential for the management of alcohol-dependent patients. Primary care physicians and hospital personnel should be more alert to the growing numbers of alcohol abusers and to their appropriate diagnosis and treatment. This article describes and summarizes the symptoms of alcohol withdrawal in general, and alcoholic delirium in particular. Problems in diagnosis and treatment are illustrated by typical cases, pointing out early clinical warning signs and suggesting some treatment guidelines.

Adult↗
PubMed1999

The "Jerusalem syndrome"--fantasy and reality a survey of accounts from the 19th century to the end of the second millennium.

The so-called "Jerusalem Syndrome" is behavioral phenomena observed in eccentric and psychotic tourists with religious delusions. A significant number of pilgrims and tourists have been visiting the Holy City, at least since the beginning of the 19th century, including some delusionary and eccentric characters. The authors present a selection of vivid descriptive accounts of such 19th century visitors, by six local residents and writers about Jerusalem (including one psychiatrist). It should be noted that those writers already noticed and documented the so-called syndrome more than a century ago. In comparison to modern research of the phenomena in contemporary Jerusalem, a striking similarity in the narrative and the clinical picture emerges. However, based on accumulated data, the authors suggest that in most cases the religious atmosphere of the city is not the primary cause for the disorder. The psychotic visitors had set out for their journey to the Holy City already guided by a delusionary system derived from their religious belief and cultural background.

Delusions↗
PubMed1998

Treatment of men with paraphilia with a long-acting analogue of gonadotropin-releasing hormone.

BACKGROUND: Men with deviant sexual behavior, or paraphilia, are usually treated with psychotherapy, antidepressant drugs, progestins, and antiandrogens, but these treatments are often ineffective. Selective inhibition of pituitary-gonadal function with a long-acting agonist analogue of gonadotropin-releasing hormone may abolish the deviant sexual behavior by reducing testosterone secretion. METHODS: In an uncontrolled observational study, we treated 30 men (mean age, 32 years) with severe long-standing paraphilia (25 with pedophilia and 5 with other types of abnormal behavior) with monthly injections of 3.75 mg of triptorelin and supportive psychotherapy for 8 to 42 months. The efficacy of therapy was evaluated monthly by the Intensity of Sexual Desire and Symptoms Scale and yearly by the Three Main Complaints questionnaire. RESULTS: All the men had a decrease in the number of deviant sexual fantasies and desires, from a mean (+/-SD) of 48+/-10 per week before therapy to zero during therapy (P<0.001), and a decrease in the number of incidents of abnormal sexual behavior (from 5+/-2 per month to zero, P<0.001) while receiving triptorelin. These effects were evident after 3 to 10 months of therapy (P<0.001) and persisted in all 24 men who continued therapy for at least 1 year. The men's mean serum testosterone concentration fell from 545+/-196 ng per deciliter (18.9+/-6.8 nmol per liter) before therapy to 23+/-14 ng per deciliter (0.8+/-0.5 nmol per liter, P<0.001) after 42 months of triptorelin. The main side effects were erectile failure, hot flashes, and decrease in bone mineral density in some men. CONCLUSIONS: Continuous administration of triptorelin, a long-acting agonist analogue of gonadotropin-releasing hormone, together with supportive psychotherapy, may be an effective treatment for men with severe paraphilia.

Adult↗
PubMed1998

The association between attitudes toward suicide and suicidal ideation in adolescents.

The aims of this study were to determine whether adolescent attitudes to suicide could be grouped into distinct factors, and then to examine the relationship between these factors and the psychosocial parameters known to be associated with suicide, and between attitudes towards suicide and suicidal ideation. A questionnaire designed to assess attitudes to suicide was distributed to a total of 525 Israeli adolescents. Statistical analysis indicated that the attitude items could be grouped into four distinct factors: the right of society to prevent suicide; suicide as a symptom of mental illness; the right of the individual to talk about suicide; and taking suicidal behaviour seriously. Each factor was differentially associated with the various psychosocial parameters examined. The association between the attitude factors and subjects' suicidal ideation was significant and at least as strong as that of the psychosocial parameters normally associated with adolescent suicide, namely gender and exposure to suicide. A generally approving attitude towards suicide was correlated with a high level of suicidal ideation.

Adolescent↗
PubMed1998

Debriefing with brief group psychotherapy in a homogenous group of non-injured victims of a terrorist attack: a prospective study.

This study describes a follow-up of 15 non-injured women, all from the same socio-economic background, who were exposed to a terrorist attack in Israel. All of the women participated in group debriefing with brief group psychotherapy, involving six meetings during the first 2 months following the event. Two days after the attack, and 2 months and 6 months after the event, the women were administered a post-traumatic stress disorder (PTSD) diagnostic scale, the Impact of Event Scale (IES) and the SCL-90. At 6 months, four subjects (27%) were diagnosed with full PTSD. The IES showed significantly higher scores at the first measure than at the other two measures. Furthermore, the phobic anxiety subscale score immediately after the event was significantly associated with the General Severity Index of the SCL-90 and the severity of PTSD symptomatology at 6 months. The present paper discusses the effectiveness of psychological intervention following trauma, and raises questions concerning the need to invest public resources in this kind of intensive intervention. Suggestions are proposed regarding the desired emphasis of the psychological treatment in order to improve its benefits to victims.

Cost-Benefit Analysis↗
PubMed1998

Koro-like syndrome in a Bedouin man.

A case report is presented of a koro-like syndrome in a 34-year-old Bedouin man living in the Negev desert in Israel. The patient's disturbance is accompanied by voyeurism and the onset appears to be related to his sexual practices. This is the first reported case among Bedouins, who are an Arab nomadic tribe living in Asia and Africa.

Adult↗
PubMed1997

Possession by the 'Zar' among Ethiopian immigrants to Israel: psychopathology or culture-bound syndrome?

The article describes a cultural pattern related to altered states of consciousness, observed amongst new immigrants from Ethiopia to Israel. The belief in possession by Zar spirits is one of the most common possession phenomena in Africa and in other continents. Possession by Zar is expressed by a wide range of behaviors, such as involuntary movements, mutism and incomprehensible language. Such behavior can be misinterpreted as representing symptoms of neuralgic or psychiatric disorders. We demonstrate the Zar phenomenon by a description of a detailed case. The article discusses the cultural and anthropological aspects of the Zar and its clinical implications and suggests that the Zar phenomenon should be understood as a culture-bound syndrome.

Adult↗
PubMed1997

Value-sensitive therapy: learning from ultra-orthodox patients.

This paper explores the issues that arise when psychotherapists and patients do not share a common value system. Using three case studies of ultra-Orthodox Jewish patients who hold religious values and beliefs, the paper illustrataes and defines a strategy of "value-sensitive therapy." It argues for treating patients without demeaning or discounting their values and beliefs.

Adult↗
PubMed1997

Ethnic background and antecedents of religious conversion among Israeli Jewish outpatients.

This study explored the association of ethnocultural background (Ashkenazi vs Sephardi origin) with antecedents of religious conversion among Israeli Jewish penitents who applied for psychiatric help in an outpatient clinic. A basic assumption underlying the comparison was that Sephardic Jews in Israel are more inclined toward Jewish tradition and collectivistic than Ashkenazim. The interview data indicated that for both groups emotional factors were more dominant in the conversion process than cognitive ones; however, cognitive factors were more strongly present in the conversion process of the Ashkenazim whose prepenitence cultural orientation had been more secularized and individualistic. In both groups a high prevalence of problematic relations with the father (but not with the mother) during childhood was noticed. Over-all, conversion tended to be gradual rather than abrupt and devoid of mystical experiences.

Adolescent↗
PubMed1996

The 'Zar' possession syndrome among Ethiopian immigrants to Israel: cultural and clinical aspects.

This article describes a cultural pattern related to altered states of consciousness, observed amongst new immigrants from Ethiopia in Israel. The belief in possession by Zar spirits is one of the most common possession phenomena in Africa and in other continents. Possession by Zar is expressed by a wide range of behaviours, such as involuntary movements (often resembling epileptiform convulsions), mutism and incomprehensible language. Such behaviour can be misinterpreted as representing symptoms of neurologic or psychiatric disorders. Such misinterpretation has led to inappropriate psychiatric admissions and to misdiagnosis of such cases as major psychiatric disorders. The article illustrates the Zar phenomenon by three clinical vignettes and discusses its cultural and anthropological aspects, as well as its clinical implications within a Western society.

Adult↗