Biomedical subjects

Sofi Marom

Publications and source records attributed to Sofi Marom.

13 recordsLinked to original sources

PubMed2006

Social phobia symptoms: prevalence, sociodemographic correlates, and overlap with specific phobia symptoms.

BACKGROUND: Social phobia (SP) is a highly prevalent disorder in Western countries, but is rather rare in Eastern societies. Prevalence rates range from 0.5% in Eastern samples up to 16% in Western studies. Its prevalence in Israel, an Asian state characterized by Western culture, has not yet been studied. The present study aimed to assess the prevalence of SP symptoms in a nonclinical sample of Israeli adolescents, to characterize sociodemographic correlates of SP symptoms and to evaluate comorbidity with specific phobia symptoms. METHODS: Participants included 850 young soldiers from the Israel Defense Forces. Measures included the Liebowitz Social Anxiety Scale (LSAS; self-report version), a questionnaire on specific fears and phobias, and a sociodemographic questionnaire. Clinical and demographic correlates of SP were also examined. RESULTS: Probable SP (LSAS >or=80) was present in 4.5% of the sample. Overall, SP symptoms were reported by a great percentage of the subjects, as displayed by the rather high mean LSAS scores (29; SD = 23.79) in this nonclinical sample. The following variables were accompanied by higher LSAS scores according to our regression model: inability to perform command activities, receiving psychotropic medication before army service, having less than two friends, shy family members, and treatment during military service. Subjects with probable SP had a rate of comorbidity with specific phobia symptoms of 44%. CONCLUSIONS: Our findings corroborate those from other studies in Western countries, both regarding the high prevalence of SP symptoms and its demographic and clinical correlates, as well as regarding the high overlap rate with specific phobia symptoms.

Absenteeism↗

PubMed2005

Red cell membrane omega-3 fatty acids are decreased in nondepressed patients with social anxiety disorder.

The "phospholipid hypothesis" attributes a pathophysiologic role to the polyunsaturated fatty acid (PUFA) composition of phospholipids in depression. The aim of the present study was to determine whether the hypothesis is relevant to social anxiety disorder (SAD). The study sample consisted of 27 untreated, nondepressed patients with SAD (DSM-IV) and 22 controls. Severity of SAD was assessed with the Liebowitz Social Anxiety Scale (LSAS). Erythrocyte PUFA concentrations were measured by gas-liquid chromatography. Concentrations of most n-3 PUFAs were lower in the patients: 18:3n-3 by 32% (p < 0.002), 20:3n-3 by 34%, 20:5n-3 by 36% (all p < 0.001) and 22:6n-3 by 18% (p = 0.002). No significant differences were observed in other fatty acids. Significant inverse correlations were obtained between levels of n-3 PUFAs and LSAS scores. In conclusion, the phospholipid hypothesis may apply to SAD, thereby opening new therapeutic options. The robust relationship between low erythrocyte n-3 PUFA concentrations and SAD justifies exploration of relevant neuropathophysiological mechanisms.

Adult↗

PubMed2005

Involvement of GABAA receptor modulating neuroactive steroids in patients with social phobia.

Dehydroepiandrosterone (DHEA) and its sulfate ester (DHEA-S), neurosteroids synthesized in the brain, are weak gamma-aminobutyric acid (GABA) A receptor allosteric antagonists that may be involved in anxiety disorders. In the present study we measured the circulatory [corrected] levels of DHEA, DHEA-S, pregnenolone and cortisol in [corrected] untreated patients (n=26) diagnosed with social phobia (SP) compared with sex- and age-matched healthy controls (n=21). No significant differences in neurosteroids were observed in [corrected] untreated SP patients and [corrected] compared with healthy controls. The findings may reflect an absence of involvement of the GABA(A) modulators DHEA, DHEA-S and pregnenolone in SP.

Adult↗

PubMed2005

Platelet vesicular monoamine transporter density in untreated patients diagnosed with social phobia.

The vesicular monoamine transporter (VMAT2) is important in the storage and release of monoamines. Platelet VMAT2 was characterized using high-affinity [(3)H]dihydrotetrabenazine ([(3)H]TBZOH) binding in untreated social phobia (SP) patients (n=20) compared with sex- and age-matched healthy controls (n=15). No significant differences in VMAT2 density (B(max)) and affinity constants (K(d)) were observed.

Adult↗

PubMed2005

Serotonin uptake to lymphocytes of patients with social phobia compared to normal individuals.

Several trials have indicated that selective serotonin reuptake inhibitors (SSRIs) are most efficient in the treatment of social phobia (SP). The activity of the serotonin transporter (5-HTT), as determined by [3H]5-HT uptake to blood lymphocytes, was measured in 15 drug-free patients with generalized SP (7M/8F, aged 21-37 years) and compared to 18 healthy control subjects (10M/8F, aged 21-32 years). The maximum uptake velocity (Vmax) of [3H]5-HT to fresh lymphocytes and the affinity (Km) of the 5-HTT were similar in the two groups (295+/-155 versus 227+/-117 pmol/min/mg protein and 767+/-425 versus 709+/-408 nM, respectively). This study suggests that the functioning of lymphocyte 5-HTT is unaltered in SP.

Adult↗

PubMed2005

Expressed emotion: relevance to rehospitalization in schizophrenia over 7 years.

Expressed emotion (EE) is an established factor in short-term relapse in schizophrenia. However, data on its long-term predictive ability are scarce. We extended our short-term investigation over 7 years' followup. The study population consisted of 108 patients, 93 with schizophrenia and 15 with schizoaffective disorder. EE of the key relatives was rated with the Five Minute Speech Sample (FMSS). Patient households were categorized by EE and its two components: criticism (CR) and emotional overinvolvement (EOI). High CR was associated with earlier first and second readmissions (Breslow p = 0.002 and 0.04, respectively). High CR was associated with a higher rate of readmissions (p = 0.01) and a longer hospital stay (p = 0.02) compared with low CR. Both compliance with pharmacotherapy and the interaction of high-CR x poor compliance were additional contributors to time to first readmission. This study is the first to demonstrate the prolonged predictive validity of EE. Our results support the value of CR as a prognostic indicator of the course of schizophrenia. The FMSS appears to have predictive power in respect to psychiatric hospitalization. Therapies aimed at lowering high EE seem warranted as a long-term preventive approach.

Adult↗

PubMed2005

The effects of social anxiety and depression on the evaluation of facial crowds.

Facial crowds of emotion connoting approval or criticism are linked to the fears of socially anxious individuals. We examined evaluation ratings and decision latencies of mixed facial displays by individuals with generalized social phobia (GSPs, n = 18), individuals with comorbid depression and GSP (COMs, n = 18), and normal controls (CONs, n = 18). First, we postulated that GSPs will assign more negative ratings to predominantly disapproving audiences as compared to CONs, and that GSPs will be faster in their evaluation of these audiences (negative bias hypothesis). Second, we expected depression, but not social anxiety, to be associated with diminished positive evaluation of audiences containing predominantly happy expressions and with a slower processing of such positive cues (the impaired positivity hypothesis). Results supported the negative bias hypothesis, and provided partial support for the impaired positivity hypothesis. The importance of examining the processing of complex non-verbal cues in social anxiety and in depression is discussed.

Adult↗

PubMed2004

QT dispersion in patients with social phobia.

BACKGROUND: QT dispersion (QTd) is the maximal interlead difference in QT interval on the surface 12-lead electrocardiogram (ECG). An increase in QTd is found in various cardiac diseases and reflects cardiac autonomic imbalance. It has recently been associated with increased anxiety levels, thereby predisposing affected individuals to fatal heart disease. This is the first study to assess QTd in social phobia, as a marker of anxiety-induced cardiac dysregulation. METHODS: QTd and rate-corrected QTd were measured in 16 physically healthy and non-depressed outpatients with long-term (mean 28+/-12.2 years; age 37.9+/-9.6 years) social phobia (SP) and in 15 physically and mentally healthy age- and gender-matched controls. The Liebowitz Social Anxiety Scale (LSAS) was scored concomitantly. The intra- and inter-observer reproducibilities of QTd were highly correlated (r=0.96, P<0.001; r=0.74, P=0.002, respectively). RESULTS: QTd and rate-corrected QTd were significantly higher in the patients with SP compared to the controls (70+/-21 versus 43+/-10 ms, P<0.001 and 75+/-23 versus 46+/-10 ms, P<0.001, respectively), and highly correlated with the two LSAS subscores. CONCLUSIONS: Prolonged SP is associated with an increase in QTd. This association may result from prolonged anxiety and, in turn, a decrease in vagal modulation and/or increase in sympathetic modulation. Further large-scale epidemiological studies are needed to determine if increased QTd can serve as a trait/state marker, and if it is a risk factor for sudden cardiac death in patients with SP.

Adult↗

PubMed2004

Musical hallucinations: prevalence in psychotic and nonpsychotic outpatients.

BACKGROUND: Musical hallucinations have been considered a rare manifestation of psychotic states or brain and hearing abnormalities. However, an obsessive-compulsive disorder (OCD) assessment tool refers to musical hallucinations and our preliminary study showed that about one third of OCD patients experienced musical hallucinations. AIMS: To elucidate the lifetime prevalence of musical hallucinations among psychotic and nonpsychotic psychiatric outpatients. METHODS: Lifetime experience of musical hallucinations was examined with a specially designed structured interview in 190 consecutive outpatients with diagnoses of anxiety, affective, and schizophrenia disorders. RESULTS: Musical hallucinations occurred in more than one fifth of all diagnoses. The prevalence of musical hallucinations was highest in OCD patients (41%). Musical hallucinations were significantly more frequent with more comorbid disorders, and logistic regression revealed that this finding was mainly due to OCD combined with either social phobia or schizophrenia. CONCLUSION: Musical hallucinations are more common among psychiatric patients than previously reported and are more suggestive of OCD than of other mental disorders.

Adult↗

PubMed2003

Cognitive behavior therapy (CBT) in anxiety disorders.

This review examines CBT as a leading evidence-based psychotherapy. It describes briefly the major components of CBT: exposure, reduction of safety behaviors, attention focus modification and cognitive restructuring. Specific CBT strategies suited for the main anxiety disorders are reported (specific phobias, panic disorder and agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder and post-traumatic stress disorder). The review emphasizes the efficiency of the use of CBT as a psychotherapeutic method in anxiety disorders. Finally, it points to the lack of the use of CBT in Israel and recommends its wide use in the mental health service here.

Anxiety Disorders↗

PubMed2002

Psychometric properties and three proposed subscales of a self-report version of the Liebowitz Social Anxiety Scale translated into Hebrew.

We investigated the overall test-retest reliability and other psychometric properties of a self-report version of the Liebowitz Social Anxiety Scale (LSAS) translated into Hebrew. We also evaluated the utility of three new subscales that were identified by nonparametric analysis (multidimensional scaling; MDS). Two hundred and seven patients who sought treatment for social anxiety or panic disorder were evaluated. All patients completed the self-administered version of the LSAS. A subsample completed the LSAS a second time prior to the beginning of treatment. The results indicate that the self-report format of the LSAS translated into Hebrew demonstrates high test-retest reliability, internal consistency, and discriminant validity. Additionally, some evidence for convergent and divergent validity was noted, and treatment sensitivity was high. MDS analysis followed by the investigation of common underlying facets for items related in two-dimensional space identified three subgroups: 1) the Group Performance/Interaction ("Group") subscale that consists of group performance and group interaction items; 2) the Dyadic Interaction ("Dyadic") subscale that consists of Dyadic interaction items; and 3) the Public Activities ("Public") subscale that consists of individual activities carried out in public. The three new subscales identified by MDS appear to provide clinically relevant information that relates to both demographic and treatment outcome variables and warrant further study.

Adult↗

PubMed2002

Familial expressed emotion: outcome and course of Israeli patients with schizophrenia.

We investigated the validity of expressed emotion (EE) in Israel. The study sample consisted of 108 patients with schizophrenia and 15 with schizoaffective disorder, and their key relatives. EE was rated with the Five Minute Speech Sample (FMSS). Patient households were categorized by EE and its two components: criticism and emotional overinvolvement. Patients were rated with the Brief Psychiatric Rating Scale (BPRS) at admission, at discharge, and 6 months after discharge. Readmissions were determined over a 9-month period. High EE and particularly high criticism were significantly associated with poorer outcome (higher rate of and earlier readmissions, and higher BPRS score at followup) and worse illness course (higher annual number of prior psychiatric hospital admissions). Odds ratios between high EE and high criticism and readmission were 2.6 and 3.5, respectively. The strongest predictor of earlier readmission was the interaction of high criticism x poor compliance with medication. The results converge to further confirm the notion that familial EE is a valid crosscultural predictor of the clinical course of schizophrenia. Moreover, EE has predictive power in very chronic samples. Criticism appears to be the crucial EE component linked with short-term outcome. Treatment aimed at reducing high criticism is warranted. The FMSS appears to have predictive validity.

Adult↗

PubMed2002

Sexual function and behavior in social phobia.

BACKGROUND: Social phobia is a type of performance and interpersonal anxiety disorder and as such may be associated with sexual dysfunction and avoidance. The aim of the present study was to evaluate sexual function and behavior in patients with social phobia compared with mentally healthy subjects. METHOD: Eighty subjects participated in the study: 40 consecutive, drug-free outpatients with social phobia (DSM-IV) attending an anxiety disorders clinic between November 1997 and April 1999 and 40 mentally normal controls. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Liebowitz Social Anxiety Scale were used to quantitatively and qualitatively assess sexual function and behavior. RESULTS: Men with social phobia reported mainly moderate impairment in arousal, orgasm, sexual enjoyment, and subjective satisfaction domains. Women with social phobia reported severe impairment in desire, arousal, sexual activity, and subjective satisfaction. In addition, compared with controls, men with social phobia reported significantly more frequent paid sex (p < .05), and women with social phobia reported a significant paucity of sexual partners (p < .05). CONCLUSION: Patients with social phobia exhibit a wide range of sexual dysfunctions. Men have mainly performance problems, and women have a more pervasive disorder. Patients of both genders show difficulties in sexual interaction. It is important that clinicians be aware of this aspect of social phobia and initiate open discussions of sexual problems with patients.

Adult↗