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Biomedical subjects

I Levav

Publications and source records attributed to I Levav.

At least 37 records · Page 2Linked to original sources
PubMed1997

Jews and their intraethnic vulnerability to affective disorders, fact or artifact? II: Evidence from a cohort study.

This paper, which complements a prior review of published studies, reports findings from a community-based survey of 4,914 Israel-born offspring of immigrants from Europe (Ashkenazim) and North Africa. Respondents were examined by psychiatrists using the Schedule for Affective Disorders and Schizophrenia, Israel version, and diagnosed with the Research Diagnostic Criteria. Unlike previous studies, this investigation found that Israelis of North African origin had significantly higher rates of affective disorders, including major depressive and intermittent depressive disorders. The Ashkenazim, however, had higher rates of bipolar I disorder at the definite level of diagnosis. Differential patterns in help-seeking may account for the divergent findings between this community-based study and earlier treatment-based reports. These results suggest the need to further investigate social and genetic etiological factors that may explain the differential rates.

Africa↗
PubMed1996

Practices and attitudes among Swedish psychiatrists regarding the ethics of compulsory treatment.

Few empirical studies have examined the attitudes and ethical beliefs of psychiatrists. In this study, 328 members of the Swedish Psychiatric Association were randomly selected to respond to a questionnaire containing three clinical vignettes examining involuntary hospitalization, other compulsory interventions, and restraint. The questionnaire also contained 16 controversial statements and items on the abuse of psychiatry. A 60% response rate was obtained. Psychiatrists' responses were influenced not only by the severity of and risks associated with the patient's disorder, but also by family pressure which affected the decision-making process. Female psychiatrists less often suggested the use of physical restraints and the compulsory use of ECT. Sexual misconduct, and also the inadequate treatment of refugees, were the most frequently reported forms of abuse of psychiatry.

Adult↗
PubMed1996

PTSD symptoms and comorbid mental disorders in Israeli war veterans.

BACKGROUND: The purpose of this study was to investigate patterns of mental disorders co-morbid with PTSD symptoms in young Israeli men exposed to combat. METHOD: Six hundred and seventeen subjects were selected via a general population sample and evaluated in a two-phase case-identification procedure, culminating in a modified SADS-L interview, administered by psychiatrists. RESULTS: Major depressive disorder (OR = 3.2), substance use disorders (OR = 1.9) and personality disorders (OR = 3.0) occurred more frequently in men reporting symptoms of PTSD than in men who had been under fire who did not report symptoms. With the possible exception of personality disorders, comorbid disorders did not constitute risk factors for PTSD. Comorbid PTSD and RDC disorders were associated with increased help-seeking. CONCLUSIONS: The results suggest similar rates and types of PTSD comorbidity in Israeli war veterans as in veterans in the US assessed in general population studies, and are consistent with shared risk factors for PTSD and comorbid disorders.

Adult↗
PubMed1994

Minor depression in a cohort of young adults in Israel.

BACKGROUND: A diagnosis of minor depression was considered for DSM-IV. Mild depression is thought to be common in primary care settings and the community, but studies of the validity of minor depression as a separate diagnostic category are few. METHODS: Minor depression as defined by Research Diagnostic Criteria was assessed by psychiatrists using a modified Schedule for Affective Disorders and Schizophrenia-Lifetime version in a cohort of 5200 young adults in Israel. Subjects with year-prevalent minor depression were compared with subjects with major depression or generalized anxiety disorder and with controls on aspects of psychopathologic condition, psychosocial functioning, help-seeking behaviors, and demographic correlates. RESULTS: Symptomatically, minor depression appeared to be a mild version of major depression. Minor depression was associated with good teenage and general social functioning, but also with absence from work, separation or divorce, recent impairment in overall functioning, and help-seeking. CONCLUSIONS: The results lend support for including minor depression or expanding severity modifiers in future classifications to better capture the phenomenon of subthreshold depression.

Adult↗
PubMed1994

Nongenetic familial transmission of psychiatric disorders? Evidence from children of Holocaust survivors.

There is considerable evidence that psychiatric disorders aggregate in families, a phenomenon for which both genetic and nongenetic explanations have been proposed. However, since genetic and social inheritance usually co-occur, it is difficult to separate out their effects. In this paper, we argue that examining the rates of disorder among children of Holocaust survivors provides a special situation where genetic and nongenetic factors in familial transmission can be separated, and where specific nongenetic mechanisms can be tested. We specify competing hypotheses, and test their viability using data from an epidemiological study of psychiatric disorders conducted in Israel. We find no evidence of higher symptom scale scores or higher rates of current psychiatric disorders for the children of Holocaust survivors. However, they did have higher rates of past disorders.

Family Health↗
PubMed1994

Jews and their intraethnic differential vulnerability to affective disorders, fact or artifact? I: An overview of the literature.

The observation that Ashkenazim have higher rates of affective disorders than either Sephardi or Oriental Jews was reanalyzed from the available literature. Statistical reanalysis of these studies was consistent with rates being elevated for Ashkenazim. The results of these treatment-based studies, however, suffer from biases due to differential help-seeking patterns, lack of accounting for readmission rates, diagnostic unreliability, misuse of frequency ratios relative to other disorders and failure to control for confounding variables. As a result of these causes for biases and in the absence of a true incidence or prevalence study serving as a basis for these observations, the assumption that Ashkenazim are at an increased risk for affective disorders is questionable and may be a mere result of methodological artifacts.

Bipolar Disorder↗
PubMed1994

The restructuring of psychiatric care in Latin America: a new policy for mental health services.

This article discusses the epidemiologic and programmatic bases for action as well as the political, historical and technical background for "The Initiative for Restructuring of Psychiatric Care in Latin America." It discusses also the broad implications of this health policy, the modus operandi of its implementation and monitoring, and the chief obstacles that it has encountered. Lastly, it briefly sketches the results obtained thus far.

Female↗
PubMed1993

An epidemiological study of mental disorders in a 10-year cohort of young adults in Israel.

This is an overview of a two-phase epidemiological study of mental disorders among young adults in a ten-year birth cohort (1949-58) conducted in Israel. A sample of 4914 Israel-born offspring of Jewish immigrants was obtained by full probability sampling procedures and screened for caseness using psychometric symptom scales from the Psychiatric Epidemiology Research Interview (PERI). Those screened positive and almost a fifth of the negatives (N = 2741) were interviewed by psychiatrists using the Schedule for Affective Disorders and Schizophrenia, Israel version (SADS-I), in order to determine prevalence rates of specific disorders as defined by the Research Diagnostic Criteria (RDC). The completion rates for each interview phase were 94.5% and 90.7% respectively. Six-month prevalence rates are presented by gender, ethnic origin, and education. Approximately one-fifth of the birth cohort met current RDC criteria for a disorder at the definite level, excluding the RDC category of 'other psychiatric disorder'. Generalized anxiety disorder and major depressive disorder were the most commonly found types. The striking findings centre on alcoholism and drug use disorder which were exceedingly rare, and the unusually similar rates of major depression for males and females. The results from this study are discussed in comparison with those obtained from other epidemiological studies.

Adult↗
PubMed1993

Telephone vs face-to-face interviewing in a community psychiatric survey.

This study compared telephone with face-to-face interviewing in a community psychiatric survey. Two groups of women were investigated, Holocaust survivors and Europe-born respondents who were in prestate Israel during World War II. Both were administered the Psychiatric Research Interview Demoralization Scale and a short item scale investigating World War II experiences. Results showed a high compliance rate to the telephone mode. The subjects' scores in the two modes were highly correlated. Telephone interviewing seems to be a reliable and efficient method in areas with a well-developed network of subscribers.

Community Psychiatry↗
PubMed1993

[Restructuration of psychiatric care in Latin America].

Both the epidemiological and program bases for action are reviewed as well as the political, historical, and technical background of the Initiative for a Re-structuration Psychiatric Care in Latin America. Attention is also paid to (a) the wide repercussion of this new-old health policy, (b) procedures for its implementation, and (c) the main obstacles the Initiative has been facing to date. Results obtained so far are reviewed.

Latin America↗
PubMed1992

Socioeconomic status and psychiatric disorders: the causation-selection issue.

Are inverse relations between psychiatric disorders and socioeconomic status due more to social causation (adversity and stress) or social selection (downward mobility of genetically predisposed)? This classical epidemiological issue is tested by focusing on ethnic status in relation to socioeconomic status. Ethnic status cannot be an effect of disorder because it is present at birth whereas socioeconomic status depends on educational and occupational attainment. A birth cohort sample of 4914 young, Israel-born adults of European and North African background was selected from the country's population register, screened, and diagnosed by psychiatrists. Results indicate that social selection may be more important for schizophrenia and that social causation may be more important for depression in women and for antisocial personality and substance use disorders in men.

Education↗
PubMed1992

[Primary prevention in mental health programs. Possible or impossible? Now or later?].

The point in discussion is: Does any possibility exist of having primary prevention actions included in mental health plans and programs of the countries pertaining to the Latin-American and Caribbean region? On the one hand, such actions are becoming more and more necessary if the higher mental health demands are taken into account--which exceed the offer of services at a secondary preventive level. On the other hand, recent literature has been accumulating scientific evidence bringing rational basis for interventions at a primary preventive level. Mental health workers--if adequately trained--may find a fruitful field for action in assistance and research as well.

Humans↗
PubMed1991

Demoralization and gender differences in a kibbutz.

Gender differences in demoralization (depressive symptoms) were examined in a first-ever true prevalence study conducted in a kibbutz. The unusual organizational arrangements of this commune, where women have achieved higher levels of equality than in most other societies, offered a laboratory-like opportunity to test the psychosocial factors imputed as a partial explanation for the higher rates of demoralization in women. Demoralization was studied using the 27-item scale of the Psychiatric Epidemiology Research Interview (PERI) in all of the adult population of a single kibbutz. The response rate was close to 95%. Univariate and multivariate analyses were conducted to assess the effects of key sociodemographic and kibbutz-related variables on gender differences. The results showed that women had higher mean scores and rates even after these variables were controlled. The female:male demoralization ratio was well within the range of results obtained in non-socialist Israeli urban settings. The paper concludes with a discussion on the tentative relevance of the study results for the interpretation of the 2:1 female-male ratio of depression found in the epidemiological literature.

Adaptation, Psychological↗
PubMed1991

Demoralization and social supports among Holocaust survivors.

This study attempted to investigate the opposing effects of degree of traumatization and of contemporary social supports on the demoralization scores of World War II survivors. The respondents were all married, Poland-born respondents living in socially contrasting neighborhoods in Tel Aviv, Israel. Two subgroups were defined, one that had been in Europe during World War II (index cases) and another that was in prestatehood Israel during the same period (comparison cases). All respondents were administered the Psychiatric Epidemiology Research Interview/Demoralization Scale, a short item scale investigating World War II experiences, and the Social Supports Network Inventory. Uni- and multivariate analyses were conducted using means and rates of demoralization as the dependent variable. The results show that demoralization scores were associated positively with dose effect (the more brutal the experience, the higher the scores) and inversely with social supports (the higher the acknowledged presence of contemporary supports, the lower the scores).

Adult↗