PubMed HealthSearch

Biomedical subjects

R Mester

Publications and source records attributed to R Mester.

At least 19 recordsLinked to original sources

Decreased platelet imipramine binding in Tourette syndrome children with obsessive-compulsive disorder.

[3H]Imipramine binding to blood platelets was assessed in eight untreated Tourette syndrome (TS) children, nine drug-free TS children with obsessive-compulsive disorder (OCD), and nine age-matched and gender-matched control subjects. The density of [3H]imipramine binding sites in TS + OCD patients was significantly lower compared with TS-OCD patients (28%) as well as when compared with controls (31%). This alteration was not accompanied by differences in the affinity of the binding site to the ligand. The decreased density of the platelet serotonin "transporter" might implicate the involvement of the serotonergic system in the pathophysiology of OCD in TS patients, but not in TS per se.

Adolescent

Delayed amnesia and disorientation after electroconvulsive treatment.

Memory-related effects of electroconvulsive therapy (ECT) are known to appear immediately after the treatment. The case of a 39-year-old woman who underwent a course of ECT because of a recurrent major depressive disorder is described. After a symptom-free period of 48 hours, transient amnesia developed. Her condition appeared to be associated with the electroconvulsive therapy, thereby raising questions about its pathogenicity and management.

Adult

Ideology and budgeting.

Israel has undergone rapid change and development during the last few decades, and extraordinary advances have been made in the field of psychiatry. At the same time, however, it is this progress that has outdated certain methods and styles of public service planning. Universal accessibility to good treatment is put at risk by the centralized planning that is more concerned with bed utilization and less so with community services, now the heart of the psychiatric system. While general health services are undergoing reorganization, progress has been slow in the restructuring of the psychiatric system.

Community Mental Health Services

Increased serotonin 5-HT2 receptor binding on blood platelets of suicidal men.

In search of a physiological marker of depression and suicidal behavior, serotonin receptors of the 5-HT2 type were studied on platelet membranes from 19 control and 22 suicidal subjects. All were young, drug- and medication free men (18-21-years-old). 5-HT2 receptor binding was assayed using tritiated ketanserin at two concentrations. Receptor binding in the suicidal subjects was significantly higher than controls at both concentrations, the mean difference being around 50%. A similar difference between patients with major depressive disorder and matched controls has been observed previously. These findings support the use of 5-HT2 receptors on platelets as a research and diagnostic tool in depression and suicide.

Adolescent

Prolonged fear of AIDS as an early symptom of schizophrenia.

A modern complaint--fear of AIDS--is making its way into the world of psychopathology and is becoming a symptom of a wide range of psychiatric disorders, including severe ones. We present a case of a young man who developed a pathological bizarre preoccupation of having AIDS and underwent various unnecessary medical procedures, until finally he was diagnosed as suffering from a paranoid schizophrenic disorder. With the high media profile that AIDS has achieved in recent years, it is expected that AIDS has become the object of psychopathological processes. However, the length of time elapsed between the onset of symptoms and the appropriate psychiatric diagnosis, despite being examined by other medical professionals, is surprising. The discussion focuses on the diagnostic questions and on issues related to primary and secondary psychiatric prevention.

Acquired Immunodeficiency Syndrome

Clarification on competence to stand trial.

The assessment of CST is a multidimensional set of operations, including the systematic gathering of data and the formulation of a prognostic opinion. It is a common procedure in forensic psychiatry and usually has a major influence on the future of the examinee. The art of examining competence is dependent on the careful consideration of the semantics of the concept, the ethical implications of the process and on the examiner's awareness of the interpersonal and intrapsychic aspects involved in formulating the assessment.

Criminal Law

Countertransference envy toward the religious patient.

Four illustrations have been presented which demonstrate the uses and interpretations of envy in countertransference reactions to religious patients. To be sure, envy reactions to any patient are significant, whether they simply distort the therapist's perception or contribute to a deeper understanding of the patient. In the case of the religious patient, envy reactions in the therapist may serve as an additional instrumentality for under-standing the ways in which the dynamic determinants of religious behavior and metaphor become enmeshed in and also transform the pathology of the patient as well as the therapeutic process itself. Both the constructive and destructive object relational implications of envy must be borne in mind by the therapist in order to adequately explore the range of reciprocating forces between therapist and patient. Primitive mechanisms such as projective identification and psychotic transference are particularly prone to evoke envy reactions of surprising intensities, yet an empathic attitude will usually enable the therapist to differentiate the true source of his envy as he more carefully comprehends the quality of object relational and dynamic needs such envy serves.

Adolescent

On the use of group therapy in non-combat military psychiatry.

The application of group therapy with hospitalized Israeli soldiers and with their parents reveals specific dynamic themes whose elaboration plays a significant role in the treatment of the crisis and in the subsequent extramural adaptation, including, on occasion, reintegration into the army.

Combined Modality Therapy

The psychotherapy of mania.

Focal dynamic psychotherapy with acute manic patients has been a neglected treatment modality. In young adults with sound premorbid personalities and well-developed ambition systems, focal dynamic psychotherapy is useful in the manic stage; it shortens the process of elaboration of major conflicts related to self-image and self-ideal. Three young Israeli soldiers' case material is discussed in whom, due to different growth constellations, the hope to serve in the army in specific capacities had been a central motivating and consolidating factor in their personality development. Their confrontation with the realities and frustrations of military life caused them to react with a manic syndrome which brought them to treatment. Therapeutic insight led to the reshaping of their ambition to a more adaptive level.

Adolescent

Trazodone-induced mania.

Two bipolar depressed patients and one unipolar depressed patient developed manic symptoms after receiving trazodone. The symptoms resolved when the treatment was discontinued or reduced. We believe the two bipolar patients are the first cases of this reaction reported in the literature.

Adult

Induced abortion and psychotherapy.

The modern women's emancipation movement, concerned with the right of women for self-determination in the question of abortion, embraces the assumption, borne out by most recent epidemiological studies, that abortion does not produce psychological damage in most women. However, an induced abortion is a stressing experience and may for some few susceptible women, even be a traumatic one. The psychotherapist who is overly influenced by statistics and the socio-political climate and/or his own insufficiently resolved inner conflicts, may unconsciously ignore or minimize the importance of an abortion experience for a specific patient in his care. As the case illustrations show, the focusing and through elaboration of this experience may determine the final successful outcome of treatment, especially in brief psychotherapies.

Abortion, Induced

Israeli culture and the emergence of community mental health practices: the case of the West Jerusalem Mental Health Center.

The action assumptions which characterize and differentiate cultures affect the creation and functioning of their institutions. Using this analytic framework, the development of a community mental health center in Israel reflects a culture which contains both pioneering and bureaucratic action assumptions. The effects of these assumptions on staff interventions in community problems are traced. Finally, various dimensions of the emerging definition of community mental health practice in Israel are discussed and their problematic features identified.

Adult

The optimum principle in community psychiatry.

In community psychiatry, just as in dynamic psychotherapy, aiming too high may be just as ineffective as setting too minimal goals. In this article, causes and effects of maximalistic and minimalistic attitudes in therapists, community workers and their patients are discussed. The optimum principle and the optimal preventive and therapeutic approaches are presented at a theoretical level. Three clinical examples, where therapeutic techniques based on the optimum principle were applied, are described in detail.

Aspirations, Psychological

A programme for the establishment and functioning of a community mental health service in the area of Beit Shemesh and the Jerusalem Corridor, Israel.

The area of Beit Shemesh, situated in the Jerusalem Corridor has a socioeconomic structure of the pluralistic type characteristic of modern Israel. It includes a small but quickly growing industrial city, several cooperative (moshav) and communal (kibbutz) agricultural settlements, and has a population of colourful ethnic heterogenity. The main effort in the community mental health program which was established and developed in this area was made on the levels of primary and secondary psychiatric prevention. The psychiatric community work was accomplished with a highly flexible approach and an abundance of tactics and techniques, examples of which are presented in this article.

Acculturation