Biomedical subjects

P Rosca

Publications and source records attributed to P Rosca.

6 recordsLinked to original sources

PubMed2006

Monitoring long-term court order psychiatric hospitalization: a pilot project in Israel.

BACKGROUND: In Israel, the rules of compulsory psychiatric hospitalization, including hospitalization under a court order, are set out in the Israel Mental Health Act, 1991 (MHA). The MHA does not specifically define the time limits of hospitalization by Court Order, though every patient, by law has to be brought before the Regional Psychiatric Board (RPB) once every six months for reevaluation. The Supreme Court recently addressed this issue and suggested that by having no specific time span, the way lies open for infringement of individual rights (Criminal Appeals 3854\02). Consequently the Supreme Court suggested that some court committed patients should be moved from the criminal to the civil track which inflicts less severe infringement of the mentally ill patient's rights. This ruling generated rethinking at the ministerial level aimed at improving the monitoring of the care of long-term psychiatric hospitalization in criminal cases. The Ministry of Health initiated a project designed to study this issue. OBJECTIVES: The main objective of this project, which is described below, is to monitor the type and incidence of forensic mental patients hospitalized in Israel for more than 10 years, and to propose alternatives to replace this untenable situation. METHODS: All the 12 psychiatric hospitals in Israel which hospitalize forensic patients were sent written requests for data on criminal patients hospitalized under court orders, including demographic data, diagnosis and type of offense. We identified in all 65 such patients. The data received were compared with the National Psychiatric Register databank of the Ministry of Health and divided in subgroups according to diagnosis, type of offence, demographic variables and length of hospitalization. RESULTS: Most of the subjects of the sample (89%) suffered from psychotic disorder mainly schizophrenia of the paranoid type. 95.5% were male. The most prominent type of offense was assault against family members (37%), which is in keeping with statistics reported in the relevant literature. The profile of the typical patient of this sample is: male, aged 45-65, unmarried, with 8 years of education and suffering from paranoid schizophrenia. DISCUSSION: No correlation between type and severity of offense and length of involuntary forensic hospitalization was found. We suggest some possible alternatives to improve the current handling of the group of long term hospitalized forensic patients. We also feel that a further study should be carried out on forensic patients hospitalized for a period of five to ten years.

Hospitalization↗

PubMed2003

[Risk versus confidentiality: the therapist's responsibility for his psychiatric patient's acts].

In this article we deal with the responsibility and liability of the therapist for aggressive and criminal acts perpetuated by his psychiatric patient against third parties. This issue has been the object of controversial discussion among professionals in the legal and medical field since the famous case of Tarasoff (this psychiatric patient killed his former girlfriend after he informed his therapist of his intention to harm her. The therapist was sued because he did not warn nor protect the potential victim and did not prevent the criminal act). We describe the situation in the U.S. before Tarasoff and the implications of the decision of the Supreme Court of California in 1974-76 which dealt with this case and broadened the therapist's responsibility towards third parties. We also analyze the actual legal situation in Israel on this issue, its disadvantages and shortcomings. We suggest some proposals for improvement, together with some operational measures to cope with this complex issue including a thorough evaluation of the patient's clinical state, identification of the potential victim, warning and involvement of the relevant authorities, and hospitalization if needed.

Confidentiality↗

PubMed1996

[Medication group for noncompliant patients in a psychiatric day unit--experiences during a one year period].

A group of noncompliant psychiatric patients was treated on a weekly basis over a 6-month period; 13 started but 3 dropped out. Results indicated greater feeling of security with medication; increased desire to maintain follow-up treatment in the outpatient clinic; greater likelihood of patients accepting their illness; and strong desire to discuss medication-related topics with staff. Our medication group appears to offer a convenient and organized method for addressing issues of psychiatric medication, especially for chronic patients, which we recommend to clinicians in other medical disciplines.

Adult↗

PubMed1994

[Lithium-associated alopecia].

A 39-year-old woman who developed alopecia shortly after treatment with lithium carbonate was initiated is described. The alopecia resolved 2 months after lithium was discontinued. Though this side-effect is relatively rare, we suggest that patients getting lithium for short or long term treatment be monitored for it.

Adult↗

PubMed1991

Serum melatonin levels in schizophrenic and schizoaffective hospitalized patients.

Conflicting results on changes of the diurnal melatonin rhythms of patients with affective disorders have been reported in the literature. The heterogeneous data may derive from the great discrepancy in the diagnostic criteria of different authors. A study of 12 schizoaffective and chronic schizophrenic psychotic patients found a constant pattern of an obliterated nocturnal melatonin rise only in the latter group. The presence or absence of the nocturnal melatonin rise was determined in drug-free hospitalized patients and remained unchanged despite 2 months of drug treatment including large doses of neuroleptics. This finding, when confirmed in a larger number of patients, could possibly serve as a marker for the type of mental disorder, drug to be applied and response expected.

Adult↗

PubMed1990

The late effects of Nazi persecution among elderly Holocaust survivors.

Eighty-six survivors of the Holocaust from a nonclinical population were interviewed to examine the recent mental state, coping and adjustment of elderly Holocaust survivors. Most of the interviewees suffered after the war and are still suffering from the results of persecution. Death camp survivors suffer more than survivors who were subjected to other forms of Nazi persecution. Despite the mental suffering, Holocaust survivors succeeded to cope and to adjust. They are successful at work and in society. They managed to raise warm families. They behaved and still behave as if fulfilling a testament to those who perished.

Adaptation, Psychological↗