Biomedical subjects

M Ritsner

Publications and source records attributed to M Ritsner.

31 records · Page 2Linked to original sources

PubMed1996

Psychological adjustment among Soviet immigrant physicians: distress and self-assessments of its sources.

The purpose of this study is to examine the psychological distress of Soviet immigrant physicians in Israel and their self-assessed sources of this distress. The subject of this study included 385 (152 men and 233 women) Soviet immigrant physicians who had participated in preparatory licensing courses. The investigation shows that women have higher scores of distress than men in Global Stress Index of the Brief Symptom Inventory and its subscales which reflect anxiety. A comparison of Global Stress Index of the subjects of this study with U.S. and British published non-patient norms shows a significantly higher distress level among the immigrant physicians. Most of the respondents evaluated their psychologic state before immigration to Israel as better (303 or 78.7%). These assessments are found to be directly dependent on the stress load of the respondents at the time of the interview. Perception of the sources of absorption difficulties and distress scores are also found to be in close dependence. The results of the multiple regression analysis indicate that both sex and distress are statistically significant predictors of immigrants' estimation of their difficulties. However, it is the level of distress that has the greatest influence on the assessments of the respondents.

Adaptation, Psychological↗

PubMed1993

Psychological adjustment and distress among Soviet immigrant physicians: demographic and background variables.

The goal of the present study was to examine the psychological distress of Soviet immigrant physicians in Israel and to identify risk and resilience factors in the psychological adjustment to immigration. This is a first report on a study conducted among 385 (152 men and 233 women) Soviet immigrant physicians who participated in preparatory licensing courses. The design of the study is described in detail and initial results are presented. These include demographic characteristics of the sample, background variables connected with motivation for immigration and reported absorption difficulties encountered in Israel. Family problems were found to be significantly correlated with depression: the highest rate of reported depression was found among single parents. Subjects who were examined during the second year after immigration reported depression more often than subjects who were in Israel less than a year. The findings suggest that motivational and family factors may enhance or mitigate the psychological distress experienced by immigrants.

Acculturation↗

PubMed1992

Genetic epidemiological study of schizophrenia: reproduction behaviour.

Data from the Tomsk Epidemiological Register and epidemiological family sample were used to study the relationship between schizophrenics' reproductive behaviour (marital status and fertility rate), severity of ICD-9 schizophrenia and risk of illness among relatives of probands. The results are interpreted in terms of multifactorial threshold and single monolocus models. Their importance for the interpretation of epidemiological data (a change of prevalence rate, cohort effect and clinical polymorphism) is discussed.

Adult↗

PubMed1992

The psychological profile of Jewish late adolescents in the USSR: a pre-immigration study.

Psychological well-being and the level of psychological autonomy were studied in a group of 109 Jewish late adolescents in the USSR. The subjects were not found to be more distressed than their American peers, but their dependency on their parents was significantly higher. The findings are discussed in the light of Soviet social values and child rearing attitudes and their impact on the adjustment of Soviet immigrant adolescents in Israel.

Acculturation↗

PubMedDate not supplied

Changes in diagnosis in a 9-year national longitudinal sample.

Studied are changes in diagnosis in a random sample of 10% of all first admissions to psychiatric hospitals and psychiatric wards of general hospitals in Israel from 1983 to 1990 with follow-up evaluation to 1991. This included 4,570 hospitalizations of 2,220 patients. Data were extracted from the National Psychiatric Case Registry of the Ministry of Health. Almost 59% of the sample had one admission, 18% had two, 9% had three, and 14% had four or more. From the first admission to the last discharge (a mean of 2.15 years), 59.2% of the patients' diagnoses did not change. In 89.46% of the cases in which the diagnosis changed, the changes took place during the first admission. Diagnostic change differed between diagnostic groups. In descending order of stability in diagnosis from the first admission to the last discharge were neurotic and personality disorder (73.6%), mental retardation (73.5%), schizophrenia (73.0%), organic conditions (70.6%), affective disorders (66.2%), substance abuse (65.6%), childhood disorders (60%), paranoid disorder (43.6%), other nonorganic psychosis (30.3%), and V-codes (25.0%). The average level of diagnostic agreement between the first admission and the last discharge was a kappa of .52. The average length of stay for patients whose diagnosis became more severe was considerably longer than for patients whose diagnosis became less severe or did not change in level of severity. Older age was related to less change in diagnosis. For patients aged less than 18 years, diagnosis changed in 46.7% of the cases, for patients aged 19 to 44, 31.2%, and for patients older than 45, 27.8%.

Adolescent↗

PubMedDate not supplied

Relatedness of schizotypal personality to schizophrenic disorders: multifactorial threshold model.

Genetic analysis of schizophrenia and schizotypal personality disorder (SPD) was conducted on two pedigree samples. The results are interpreted in terms of a multifactorial threshold (MFT) model. A high rate of schizophrenia was found in relatives of both samples, but any excess of SPD was found only in relatives of the SPD sample. Based on these data, the hypotheses assuming a single liability with two thresholds (Reich's model) and different liability (Smith's model) for both disorders were rejected. The coefficient of genetic correlation is 0.61. Our data suggest that schizophrenia and SPD are separate nosological entities and that some of the factors which constitute liability to SPD influence the development of schizophrenia, but not vice versa.

Adolescent↗

PubMedDate not supplied

The Talbieh Brief Distress Inventory: a brief instrument to measure psychological distress among immigrants.

The purpose of this study was to develop and test the Talbieh Brief Distress Inventory (TBDI), a 24-item self-report questionnaire that measures psychological distress among immigrants. The TBDI combines items from the Brief Symptom Inventory (BSI) and the Psychiatric Epidemiology Research Interview Demoralization Scale (PERI-D). It includes a global score and six scales (obsessiveness, hostility, sensitiveness, depression, anxiety, and paranoid ideation). A convenience sample of 966 recent immigrants to Israel from the former Soviet Union were asked to complete a Russian-language version of the BSI and PERI-D as part of a study on immigrants' psychological adjustment. The TBDI is a combination of 13 items from the BSI and 11 items from the PERI-D. Items for inclusion were based on results of a separate factor analysis for the BSI and PERI-D and removal of repetitive items. We compared the total score with the total PERI-D and BSI and developed gender-specific cutoff points of caseness for the TBDI by comparison to known PERI-D and BSI cutoff points. We also checked for reliability using Cronbach's alpha. The TBDI correlated highly with the PERI-D (r = .93) and with the BSI (r = .82). Reliability of the scales and the overall instrument ranged from Cronbach's alpha of .60 to .89. TBDI caseness cutoff points were in close agreement with the BSI and PERI-D as reflected by kappa scores that ranged from .66 to .79. The TBDI is a promising instrument for screening populations for psychological distress and symptomatology. It is available in English, Hebrew, and Russian.

Adult↗

PubMedDate not supplied

Effects of immigration on the mentally ill--does it produce psychological distress?

This report explores psychological distress among immigrants seeking help from psychiatric outpatient clinics as compared with control nonpatient immigrants. Our hypothesis is that nonpsychotic mentally ill immigrants will react to acculturation by psychological distress similarly to healthy individuals. Three questionnaires were used in this survey: Demographic Psychosocial Inventory, Brief Symptom Inventory (BSI), and Psychiatric Epidemiology Research Interview-Demoralization Scale (PERI-D). They were completed by patient and control groups consisting of recent adult immigrants to Israel from the former Soviet Union. The patient group included 158 subjects seeking psychiatric help from outpatient clinics. Among them, 51 met ICD-10 criteria for neurotic, stress-related, and somatoform disorders; 41 for schizophrenia; 32 for mood disorders; 18 for organic illnesses; and 16 for personality disorders. The control group consisted of 222 immigrants with no previous psychiatric history, matched by gender and age to the patient group. Although all distress symptoms were significantly more severe in the patient group than in the control group, the BSI profile, showing a high level of depression, anxiety, interpersonal sensitivity, and obsessive-compulsive dimensions, was similar in both groups. The psychological distress level as measured by the PERI-D was 1.4 times higher in patients than in the control group. Within the patient group, the lowest distress level was found in patients suffering from organic disorders. No significant differences in the level of psychological distress were found among other diagnostic subgroups. The results suggest that mentally ill immigrants react to acculturation by a psychological distress syndrome similarly to nonpatient immigrants but more severely than nonpatient immigrants.

Acculturation↗

PubMedDate not supplied

Psychological symptoms among an immigrant population: a prevalence study.

A community survey evaluating the prevalence of psychological symptoms among 1,953 Russian immigrants living in Israel was conducted. Symptoms of psychological distress were measured using a self-administered questionnaire, the Talbieh Brief Distress Inventory (TBDI). Criterial thresholds for six symptoms--obsessiveness, hostility, interpersonal sensitivity, depression, anxiety, and paranoid ideation--were established. Respondents with four or more psychological symptoms met the criterion for psychological distress syndrome (PDS) with a likelihood greater than 73%. A total of 13% of the respondents reported no psychological symptoms, and 21% reported all six symptoms of distress in the last month. One-month prevalence figures for distress-free and distress-related symptoms are presented. The prevalence rate for distress-free symptoms is 9% to 20%, and for distress-related symptoms, 38% to 43%. Sex differences were found regarding most symptoms, with higher prevalence rates in women than in men. No age differences were found for distress-related symptoms, whereas distress-free symptoms generally tended to change with age. The findings of this survey emphasize the importance of using our suggested quantitative approach when assessing psychological symptoms in further epidemiological investigations of stress-related psychopathology.

Adult↗

PubMedDate not supplied

Changes in psychological symptoms during the adjustment of recent immigrants.

In the present study, we sought to compare the number, severity, and frequency of psychological symptoms and the intensity of perceived stressors among immigrants with previously identified positive, negative, or normal patterns of distress. We evaluated 199 recent immigrants from the former Soviet Union to Israel using the Talbieh Brief Distress Inventory (TBDI) and the Perceived Immigration-Related Stressors Scale (PIRSS) with a 1-year follow-up period. As predicted, the number, severity, and frequency of psychological symptoms and the intensity of perceived stress factors vary among immigrants showing different distress patterns. A negative pattern was associated with an increase in the total number, severity, and frequency of distress-related symptoms and persisting cultural-related stress over time. A positive pattern was associated with a reduction in the overall number and severity of symptoms, as well as a decline in the frequency of distress-free symptoms and the intensity of all but informational-related stressors. A normal pattern was characterized by the reduction of distress symptoms within a normal range along with material- and health-related stresses. Our findings confirm the validity of the suggested classification for different patterns of distress and its usefulness in establishing the prognosis for the adjustment of immigrants.

Depression↗

PubMedDate not supplied

Gender differences in psychosocial risk factors for psychological distress among immigrants.

The reasons for a greater prevalence of psychological distress among women than men remain unknown. We sought to test two hypotheses that gender operates either as (1) a moderator or (2) a mediator between psychosocial risk factors and experienced distress. A cross-sectional community survey of 1,062 adult Russian-born Jewish immigrants to Israel was conducted. The Demographic Psychosocial Inventory (DPSI) and the Talbieh Brief Distress Inventory (TBDI) were used to measure the parameters of interest. Univariate and multivariate analyses were used to test the moderation versus mediational hypotheses of gender in the stress-distress relationship. The aggregate levels of psychological distress and depression, anxiety, and obsessive symptoms were significantly higher for women than for men. Five sources of distress were more likely to be reported by women: family problems, inappropriate climatic conditions, anxiety about the future, poor health status, and uncertainty in the present life situation. Men scored higher on three stress-protective factors: the number of reasons for immigration, commitment to the host country, and job adequacy. Results of multiple regression and multivariate analysis of variance (MANOVA) supported the mediation hypothesis that gender differences in psychological distress stem from women's greater exposure to specific psychosocial stressors. Our findings demonstrate the validity of gender as an important mediating mechanism underlying the differential perception of risk factors for the development of psychological distress.

Adaptation, Psychological↗

PubMedDate not supplied

Increased prevalence of negative life events in subtypes of major depressive disorder.

The prevalence of negative life events is known to be increased among patients with depression. Little data exist on the specific subtypes of depression that are related to negative life events. Our study aimed to address this issue. We compare 115 patients with major depressive disorder (MDD) to 60 normal controls. MDD patients reported experiencing one (P = .0001) or two (P = .01) negative life events more frequently than controls. Patients reported marital, other personal problems, and medical events significantly more often than controls (P < .01). Patients did not report more positive life events, and did not attribute greater severity to their adversities than controls. Younger MDD patients experienced four (P = .01) negative life events significantly more often than older patients. Similarly, patients with mild-moderate depression, nonmelancholic depression, or first episode of depression (FDE), respectively, experienced three or four life events significantly more often than patients with severe, melancholic, or recurrent depression (RDE). Other patient and illness characteristics such as gender, early parental loss, family history of depression or other mental disorders, psychotic features, suicide attempts, and chronicity were not related to increased prevalence of negative life events. Our results support the hypothesis that a subset of patients with MDD is especially prone to suffer from a cluster of negative life events. This subgroup is at increased risk for relapse and poor prognosis. The implications of these results for further research and for treatment are discussed.

Adult↗

PubMedDate not supplied

Neural network detection of files of suicidal patients and suicidal profiles.

The optimal configuration of backpropagation (BP) neural networks was determined after 35 trials with different BP configurations evaluating the total detection rate. Ten different training and testing sets were used to identify optimal samples. All trials included sample files of patients with medically serious suicidal attempts (MSSA) and those of non-suicidal patients. Fifty files were used in each group for training and 49 files for testing with no overlap between the samples. The target variable for training was seriousness of suicide attempt (0 = non-suicidal, 1 = MSSA). The input set included 44 demographic, clinical and patient-history variables. The optimal results showed that 93.8% of MSSA and 89.8% of the non-suicidal patient files were detected. Total success rate (TSR) was 91.8% and positive and negative prediction values (PPV, NPV) were 92% and 95.6%, respectively. Living alone (6.76), treatment compliance (5.86), drug abuse or dependence (2.8), global assessment of functioning (GAF) score (1.49), non-paranoid delusions (1.22) and suicide of first degree relative (1.1) were highly associated with MSSA according to the Garson calculation. However, logistic regression attributed high importance to hallucinations (p < 0.0001), diagnosis (p < 0.002), number of children (p < 0.006), GAF score (p < 0.006), employment status (p < 0.02) and stressors (p < 0.03). It was shown that: backpropagation neural networks are very successful in identifying records of MSSA patients; a high GAF score is associated with high risk of MSSA and is the only common variable identified by both methods; and backpropagation identified two non-specific factors (living alone and treatment compliance) whereas statistics found specific factors (hallucinations and diagnosis) highly associated with MSSA.

Adolescent↗