Moshe Birger - Academia.edu (original) (raw)
Papers by Moshe Birger
The Israel Journal of Psychiatry and Related Sciences, Feb 1, 2006
It is our contention that computer-based two-alternative forced choice techniques can be useful t... more It is our contention that computer-based two-alternative forced choice techniques can be useful tools for the detection of patients with schizophrenia who feign acute psychotic symptoms and cognitive impairment as opposed to patients with schizophrenia with a true active psychosis. In our experiment, Visual Simple and Choice Reaction Time tasks were used. Reaction time in milliseconds was recorded and accuracy rate was obtained for all subjects' responses. Both types of task were administered to 27 patients with schizophrenia suspected of having committed murder. Patients with schizophrenia who were clinically assessed as malingerers achieved significantly fewer correct results, were significantly slower and less consistent in their reaction time. Congruence of performance between the Simple and Choice tasks was an additional parameter for the accurate diagnosis of malingering. The four parameters of both tests (accuracy of response, reaction time, standard deviation of reaction time and task congruency) are simple and constitute a user-friendly means for the detection of malingering in forensic practice. Another advantage of this procedure is that the software automatically measures and evaluates all the parameters.
American Journal of Medical Genetics, Nov 12, 1997
Velocardiofacial syndrome (VCFS) is associated with an increased frequency of schizophrenia and o... more Velocardiofacial syndrome (VCFS) is associated with an increased frequency of schizophrenia and other types of psychiatric morbidity. In this study, we tried to identify a subgroup of schizophrenic patients with deletions in the VCFS region of the long arm of chromosome 22. For that purpose, we screened the records of two major general hospitals for patients with abnormalities characteristic of VCFS, such as cardiac anomalies and cleft palate, and cross-checked the data with the register of psychiatric hospitalizations in four psychiatric hospitals. Of the 24 patients that qualified, only seven patients could be studied. An additional eight schizophrenic inpatients were ascertained clinically, based on a working VCFS Clinical Scale. FISH studies and molecular analyses, using polymorphic markers from the VCFS region, documented hemizygosity of 22q11 in three out of 15 patients (20.0%). Increased awareness of psychiatrists to signs of VCFS among patients with psychiatric illnesses is encouraged, in order to direct molecular studies effectively. In order to cut down the cost of testing, we suggest screening suspected patients with a single marker, such as D22S941, and to study further only those who have a single electrophoretic band.
The Israel journal of psychiatry and related sciences, 2015
While the presence of comorbid anxiety disorders such as obsessive-compulsive disorder and panic ... more While the presence of comorbid anxiety disorders such as obsessive-compulsive disorder and panic disorder have been well described in schizophrenia, comorbid social anxiety disorder (SAD) has been less emphasized. The goal of this study was to examine the prevalence of SAD in our ambulatory population of patients with schizophrenia. A group of 50 outpatients with schizophrenia randomly selected from our public mental health outpatient population was evaluated with the Structured Clinical Interview for DSM-IV (SCID)-schizophrenia section, the Positive and Negative Syndrome Scale (PANSS), the Schizophrenia Quality of Life Scale (SQLS), the Liebowitz Social Anxiety Scale (LSAS) and the Global Assessment of Functioning Scale (GAF). After completion of assessments, a retrospective chart review was conducted on all study patients who met criteria for a diagnosis of SAD in order to determine how many of these patients had been previously given a diagnosis of SAD. Based on a cutoff score of...
The journal of the American Academy of Psychiatry and the Law, 2011
The number of incarcerated sex offenders in the Israeli prison system has steadily increased duri... more The number of incarcerated sex offenders in the Israeli prison system has steadily increased during the past decade. While treatment of sex offenders is complex, treatment of those in prison seems to be more challenging. This publication presents major considerations and dilemmas, clinical as well as ethics-related, derived from the experience of the psychiatric division in the Israeli prison service in treating sex offenders in this special setting. The psychiatrist treating the incarcerated offender must always maintain a sensitive balance between the needs and wishes of his patient and the potential threat to society stemming from recidivism.
Harefuah, 2009
Dangerousness is the propensity for performing aggressive and/or criminal acts. The tension betwe... more Dangerousness is the propensity for performing aggressive and/or criminal acts. The tension between denying the liberty of a suspect and the necessity to protect the environment he/she threatens makes evaluation of the "extent of dangerousness" a significant factor in decisions regarding compulsory intervention and denial of rights. EvaLuation of dangerousness aims to protect the Life of the patient--prevent harm and defend public safety. Most decisions concerning the "extent of dangerousness" of an individual are based on clinical evaluation, patient interview and structured evaluation. The examination can be performed directly with the patient, psychodiagnostic tests or via proxy reports of his/her behavior. The cLinicaL method, influenced by the examiner's clinical experience, training, bias and prejudices is subjective versus an actuarial examination that involves a mathematical model. The authors reviewed three instruments: (A) Psychopathology Checklist-...
The Israel journal of psychiatry and related sciences, 2006
Neuropsychological examination (NPE) is an important tool for evaluation of cognitive functioning... more Neuropsychological examination (NPE) is an important tool for evaluation of cognitive functioning in clinical and forensic situations. In forensic practice, NPE usually focuses on competency to stand trial, the mental state at the time of the offense, risk for future violence and malingering/aggravation issues. Real-time computerized NPE shows more accurate results than traditional pen-and-paper tests and provides quantitative data in a relatively standard format. It permits detection of any manipulation by the examinee in "real time." Therefore, it makes it possible not only to analyze the final results, but also to monitor closely the sequence of single acts of the assessment procedure. Thus, the computerized NPE attenuates possible examinee-related manipulations, which may distort the test results. The real-time NPE report of these elementary behavioral parameters can be used in the courts as acceptable evidence under cross-examination. This method leaves less room for ...
The Israel journal of psychiatry and related sciences, 2006
It is our contention that computer-based two-alternative forced choice techniques can be useful t... more It is our contention that computer-based two-alternative forced choice techniques can be useful tools for the detection of patients with schizophrenia who feign acute psychotic symptoms and cognitive impairment as opposed to patients with schizophrenia with a true active psychosis. In our experiment, Visual Simple and Choice Reaction Time tasks were used. Reaction time in milliseconds was recorded and accuracy rate was obtained for all subjects' responses. Both types of task were administered to 27 patients with schizophrenia suspected of having committed murder. Patients with schizophrenia who were clinically assessed as malingerers achieved significantly fewer correct results, were significantly slower and less consistent in their reaction time. Congruence of performance between the Simple and Choice tasks was an additional parameter for the accurate diagnosis of malingering. The four parameters of both tests (accuracy of response, reaction time, standard deviation of reaction...
The Israel journal of psychiatry and related sciences, 2006
Stalking is a frequently reported crime. It has a strong impact on the lives and mental health of... more Stalking is a frequently reported crime. It has a strong impact on the lives and mental health of the victims. It is perpetrated by persons who often suffer from mental disorders. This paper is an overview on the subject. It encompasses the various definitions of stalking, a number of classifications or sub-divisions of the phenomenon according to different approaches, a description of the psychopathology of the stalker, the psychological effect of the stalking on the victim, ways of evaluating and managing the phenomenon both in the victims and in the perpetrators, prevention of stalking, and also relevant bibliography. In addition, the paper includes an Appendix containing case series (clinical vignettes which include diagnosis, medical and legal interventions and outcome).
International Library of Ethics, Law, and the New Medicine, 2013
The Israel Medical Association journal : IMAJ, 2003
The relevance of central neurotransmission to aggressive and impulsive behavior has become more e... more The relevance of central neurotransmission to aggressive and impulsive behavior has become more evident due to extensive research in humans and animals. Among other findings, there are abundant data relating low serotonergic activity--as measured by low cerebrospinal fluid 5-hydroxyindolacetic acid, and a blunted response of prolactin to fenfluramine--to impulsive behavior. Many studies on testosterone activity show a relation between high plasma levels and a tendency towards aggression. It is hypothesized that the interaction between low serotonin and high testosterone levels in the central nervous system has a significant effect on the neural mechanisms involved in the expression of aggressive behavior. It seems that testosterone modulates serotonergic receptor activity in a way that directly affects aggression, fear and anxiety. Our survey reviews the main findings on serotonin, testosterone and the possible interaction between them with regard to these behavioral phenomena.
Psychological Reports, 1989
To examine correlations among chronic Posttraumatic Stress Disorder (PTSD), control-related belie... more To examine correlations among chronic Posttraumatic Stress Disorder (PTSD), control-related beliefs, and sleep difficulties 7 PTSD casualities and 7 non-PTSD matched subjects were compared in their laboratory sleep patterns as well as in their beliefs about personal control over external and internal events in general and over sleep-related events in particular. Analyses indicated that PTSD casualties had poorer sleep and reported more doubts regarding their ability to control external and internal events than control subjects. Further, we found a significant association between perceived control and sleep difficulties. Results were discussed in terms of Horowitz's conception of intrapsychic processes related to PTSD.
Journal of Traumatic Stress, 1990
The purpose of the present study was to investigate the sleep of people diagnosed as suffering fr... more The purpose of the present study was to investigate the sleep of people diagnosed as suffering from chronic Post-Traumatic Stress Disorder (PTSD). The sleep of seven chronic post-traumatic patients with no known physical injuries was compared with that of seven matched control subjects. The post-traumatic patients had poorer sleep: decreased sleep efficiency, increase in number of awakenings, and decreased SWS, as well as longer REAl latency. It was also found that their complaints correlated with relevant sleep-monitored measures. The findings add further support for the inclusion of sleep difficulties in the definition of the Post-Traumatic Stress Disorder.
International Journal of Rehabilitation Research, 2007
The quality of life of 127 Israeli young adults diagnosed as having borderline intelligence quoti... more The quality of life of 127 Israeli young adults diagnosed as having borderline intelligence quotient and attention-deficit/hyperactivity disorder, and living in community residences, was studied with respect to personal, disability and social ecology data. Overall, quality of life was associated with studying in inclusive education, total attention-deficit disorder symptomatology score, monthly income, participation in leisure activities and having a personal friend. Two significant predictors of quality of life were attention-deficit disorder symptomatology score and monthly income. Additional analysis indicates that among younger residents the two significant predictors were inclusive education and high monthly income, whereas the predictors for older residents were low level of medical disability and low attention-deficit disorder symptomatology score.
International Journal of Law and Psychiatry, 2007
While the incidence of criminal offense in individuals with schizophrenia does not necessarily di... more While the incidence of criminal offense in individuals with schizophrenia does not necessarily differ from that of the normal population, in contrast, the rate of sexual crimes among individuals with schizophrenia is relatively low. Due to low numbers, description of sexual criminal behavior among schizophrenia patients remains relatively unexplored. In order to investigate clinical, socio-demographic and sexual factors associated with deviant sexual behavior in schizophrenia sex offenders we retrospectively compared a large subgroup of schizophrenia sex offenders with a group of schizophrenia patients incarcerated for other criminal behaviors and a group of sex offenders without schizophrenia. Results indicated significant differences distinguishing schizophrenia sex offenders from schizophrenia non-sex offenders, the former of whom were more likely to be married, employed, non-heterosexual (homosexual and bisexual orientations) and demonstrated less hospitalization, antisocial personality, substance abuse, negative symptoms and overall illness severity. Individuals with schizophrenia had a tendency towards female victims compared to nonschizophrenia sex offenders whose victims tended to be male. Study observations indicate important differences between the 3 subgroups suggesting that the schizophrenia sex offender subpopulation may be a unique subgroup of comorbid conditions.
International Journal of Geriatric Psychiatry, 2004
Early detection of depression in elderly demented patients may assist in adequate treatment. The ... more Early detection of depression in elderly demented patients may assist in adequate treatment. The aim of this study was to evaluate the utility of Visual Analogue Scale for depression among demented and mild cognitively impaired elderly patients. 157 Patients, aged from 65 to 92 years, in a memory clinic were divided into two groups according to scores on the Mini Mental State Examination (MMSE): Demented group (62 patients) with MMSE scores from 16 to 23, and Mild Cognitively Impaired group (MCI-95 patients) with MMSE scores from 24 to 29. Subjects were diagnosed for depression according to DSM-IV criteria, using Hamilton Depression Rating Scale (HDRS) and a comprehensive clinical evaluation. All were administered a Visual Analogue Scale (VAS) for depression. In the demented group, 25 subjects were diagnosed as depressive. In the MCI group, 46 subjects were diagnosed as depressive. Mean VAS scores for the demented and MCI groups were similar, both for depressive and non-depressive patients. Correlations between VAS scores with HDRS scores and with the clinical diagnosis were high, although somewhat lower for the demented group. Analyzing data with ROC curve technique yielded significantly different ROC curves. Optimal cutoff point for the demented group was VAS value of 60, and 50 for the MCI group. VAS seems to be a useful tool for evaluation of depression among cognitively impaired patients. Severity of cognitive decline in the elderly may influence the cutoff points on VAS for detecting depression. Further large-scale studies are needed to substantiate our observation.
European Psychiatry, 2010
European Neuropsychopharmacology, 2004
P1, Affeetioe disorders and antidepressants placebo 0.8%, p=.371). Duloxetine-treated patients ha... more P1, Affeetioe disorders and antidepressants placebo 0.8%, p=.371). Duloxetine-treated patients had a small mean decrease in weight (-0.5 kg), compared with an increase of 0.2 kg for patients receiving placebo. No significant differences were found between duloxetine and placebo in the incidence of treatment-emergent abnormal laboratory values at awtime while on treatment. Subgroup analyses of laboratory values, vital signs, and ECGs, revealed no significant safety issues associated with age, raee, or gender.
European Neuropsychopharmacology, 1995
European Neuropsychopharmacology, 2010
Results: Out of 927 enrolled patients, 903 were included in analysis (612 patients with schizophr... more Results: Out of 927 enrolled patients, 903 were included in analysis (612 patients with schizophrenia, 291 patients with bipolar disease): 410 (45%) with the SOT form. Baseline CGI score was higher in patients initiated on the OD form (4.2 vs 3.8, p < 0.001, in patients with schizophrenia and 4.1 vs 3.7, p = 0.005, in patients with bipolar disease). 775 patients (86%) completed the 12-month study period. Overall 95% (95% CI=[93; 96]) of patients remained on olanzapine at 12 months with similar rates in patients with schizophrenia and patients with bipolar disease. The rates were also similar in SOT 94% (95% CI=[91; 96]) and OD 95% (95% CI=[93; 97]) formulations. In the Cox regression (n = 747), the only factor significantly associated with discontinuation was baseline severity (HR=0.78; p = 0.035) where patients with higher baseline CGI had lower risk of discontinuation; the formulation effect was not significant (HR OD/ OC =0.72, p = 0.30). Table. Mean (standard deviation) change of patient outcomes from baseline to endpoint CGI GAF PGWI MARS WAI Weight (kg)
American Journal of Medical Genetics, 1997
Velocardiofacial syndrome (VCFS) is associated with an increased frequency of schizophrenia and o... more Velocardiofacial syndrome (VCFS) is associated with an increased frequency of schizophrenia and other types of psychiatric morbidity. In this study, we tried to identify a subgroup of schizophrenic patients with deletions in the VCFS region of the long arm of chromosome 22. For that purpose, we screened the records of two major general hospitals for patients with abnormalities characteristic of VCFS, such as cardiac anomalies and cleft palate, and cross-checked the data with the register of psychiatric hospitalizations in four psychiatric hospitals. Of the 24 patients that qualified, only seven patients could be studied. An additional eight schizophrenic inpatients were ascertained clinically, based on a working VCFS Clinical Scale. FISH studies and molecular analyses, using polymorphic markers from the VCFS region, documented hemizygosity of 22q11 in three out of 15 patients (20.0%). Increased awareness of psychiatrists to signs of VCFS among patients with psychiatric illnesses is encouraged, in order to direct molecular studies effectively. In order to cut down the cost of testing, we suggest screening suspected patients with a single marker, such as D22S941, and to study further only those who have a single electrophoretic band.
The Israel Journal of Psychiatry and Related Sciences, Feb 1, 2006
It is our contention that computer-based two-alternative forced choice techniques can be useful t... more It is our contention that computer-based two-alternative forced choice techniques can be useful tools for the detection of patients with schizophrenia who feign acute psychotic symptoms and cognitive impairment as opposed to patients with schizophrenia with a true active psychosis. In our experiment, Visual Simple and Choice Reaction Time tasks were used. Reaction time in milliseconds was recorded and accuracy rate was obtained for all subjects' responses. Both types of task were administered to 27 patients with schizophrenia suspected of having committed murder. Patients with schizophrenia who were clinically assessed as malingerers achieved significantly fewer correct results, were significantly slower and less consistent in their reaction time. Congruence of performance between the Simple and Choice tasks was an additional parameter for the accurate diagnosis of malingering. The four parameters of both tests (accuracy of response, reaction time, standard deviation of reaction time and task congruency) are simple and constitute a user-friendly means for the detection of malingering in forensic practice. Another advantage of this procedure is that the software automatically measures and evaluates all the parameters.
American Journal of Medical Genetics, Nov 12, 1997
Velocardiofacial syndrome (VCFS) is associated with an increased frequency of schizophrenia and o... more Velocardiofacial syndrome (VCFS) is associated with an increased frequency of schizophrenia and other types of psychiatric morbidity. In this study, we tried to identify a subgroup of schizophrenic patients with deletions in the VCFS region of the long arm of chromosome 22. For that purpose, we screened the records of two major general hospitals for patients with abnormalities characteristic of VCFS, such as cardiac anomalies and cleft palate, and cross-checked the data with the register of psychiatric hospitalizations in four psychiatric hospitals. Of the 24 patients that qualified, only seven patients could be studied. An additional eight schizophrenic inpatients were ascertained clinically, based on a working VCFS Clinical Scale. FISH studies and molecular analyses, using polymorphic markers from the VCFS region, documented hemizygosity of 22q11 in three out of 15 patients (20.0%). Increased awareness of psychiatrists to signs of VCFS among patients with psychiatric illnesses is encouraged, in order to direct molecular studies effectively. In order to cut down the cost of testing, we suggest screening suspected patients with a single marker, such as D22S941, and to study further only those who have a single electrophoretic band.
The Israel journal of psychiatry and related sciences, 2015
While the presence of comorbid anxiety disorders such as obsessive-compulsive disorder and panic ... more While the presence of comorbid anxiety disorders such as obsessive-compulsive disorder and panic disorder have been well described in schizophrenia, comorbid social anxiety disorder (SAD) has been less emphasized. The goal of this study was to examine the prevalence of SAD in our ambulatory population of patients with schizophrenia. A group of 50 outpatients with schizophrenia randomly selected from our public mental health outpatient population was evaluated with the Structured Clinical Interview for DSM-IV (SCID)-schizophrenia section, the Positive and Negative Syndrome Scale (PANSS), the Schizophrenia Quality of Life Scale (SQLS), the Liebowitz Social Anxiety Scale (LSAS) and the Global Assessment of Functioning Scale (GAF). After completion of assessments, a retrospective chart review was conducted on all study patients who met criteria for a diagnosis of SAD in order to determine how many of these patients had been previously given a diagnosis of SAD. Based on a cutoff score of...
The journal of the American Academy of Psychiatry and the Law, 2011
The number of incarcerated sex offenders in the Israeli prison system has steadily increased duri... more The number of incarcerated sex offenders in the Israeli prison system has steadily increased during the past decade. While treatment of sex offenders is complex, treatment of those in prison seems to be more challenging. This publication presents major considerations and dilemmas, clinical as well as ethics-related, derived from the experience of the psychiatric division in the Israeli prison service in treating sex offenders in this special setting. The psychiatrist treating the incarcerated offender must always maintain a sensitive balance between the needs and wishes of his patient and the potential threat to society stemming from recidivism.
Harefuah, 2009
Dangerousness is the propensity for performing aggressive and/or criminal acts. The tension betwe... more Dangerousness is the propensity for performing aggressive and/or criminal acts. The tension between denying the liberty of a suspect and the necessity to protect the environment he/she threatens makes evaluation of the "extent of dangerousness" a significant factor in decisions regarding compulsory intervention and denial of rights. EvaLuation of dangerousness aims to protect the Life of the patient--prevent harm and defend public safety. Most decisions concerning the "extent of dangerousness" of an individual are based on clinical evaluation, patient interview and structured evaluation. The examination can be performed directly with the patient, psychodiagnostic tests or via proxy reports of his/her behavior. The cLinicaL method, influenced by the examiner's clinical experience, training, bias and prejudices is subjective versus an actuarial examination that involves a mathematical model. The authors reviewed three instruments: (A) Psychopathology Checklist-...
The Israel journal of psychiatry and related sciences, 2006
Neuropsychological examination (NPE) is an important tool for evaluation of cognitive functioning... more Neuropsychological examination (NPE) is an important tool for evaluation of cognitive functioning in clinical and forensic situations. In forensic practice, NPE usually focuses on competency to stand trial, the mental state at the time of the offense, risk for future violence and malingering/aggravation issues. Real-time computerized NPE shows more accurate results than traditional pen-and-paper tests and provides quantitative data in a relatively standard format. It permits detection of any manipulation by the examinee in "real time." Therefore, it makes it possible not only to analyze the final results, but also to monitor closely the sequence of single acts of the assessment procedure. Thus, the computerized NPE attenuates possible examinee-related manipulations, which may distort the test results. The real-time NPE report of these elementary behavioral parameters can be used in the courts as acceptable evidence under cross-examination. This method leaves less room for ...
The Israel journal of psychiatry and related sciences, 2006
It is our contention that computer-based two-alternative forced choice techniques can be useful t... more It is our contention that computer-based two-alternative forced choice techniques can be useful tools for the detection of patients with schizophrenia who feign acute psychotic symptoms and cognitive impairment as opposed to patients with schizophrenia with a true active psychosis. In our experiment, Visual Simple and Choice Reaction Time tasks were used. Reaction time in milliseconds was recorded and accuracy rate was obtained for all subjects' responses. Both types of task were administered to 27 patients with schizophrenia suspected of having committed murder. Patients with schizophrenia who were clinically assessed as malingerers achieved significantly fewer correct results, were significantly slower and less consistent in their reaction time. Congruence of performance between the Simple and Choice tasks was an additional parameter for the accurate diagnosis of malingering. The four parameters of both tests (accuracy of response, reaction time, standard deviation of reaction...
The Israel journal of psychiatry and related sciences, 2006
Stalking is a frequently reported crime. It has a strong impact on the lives and mental health of... more Stalking is a frequently reported crime. It has a strong impact on the lives and mental health of the victims. It is perpetrated by persons who often suffer from mental disorders. This paper is an overview on the subject. It encompasses the various definitions of stalking, a number of classifications or sub-divisions of the phenomenon according to different approaches, a description of the psychopathology of the stalker, the psychological effect of the stalking on the victim, ways of evaluating and managing the phenomenon both in the victims and in the perpetrators, prevention of stalking, and also relevant bibliography. In addition, the paper includes an Appendix containing case series (clinical vignettes which include diagnosis, medical and legal interventions and outcome).
International Library of Ethics, Law, and the New Medicine, 2013
The Israel Medical Association journal : IMAJ, 2003
The relevance of central neurotransmission to aggressive and impulsive behavior has become more e... more The relevance of central neurotransmission to aggressive and impulsive behavior has become more evident due to extensive research in humans and animals. Among other findings, there are abundant data relating low serotonergic activity--as measured by low cerebrospinal fluid 5-hydroxyindolacetic acid, and a blunted response of prolactin to fenfluramine--to impulsive behavior. Many studies on testosterone activity show a relation between high plasma levels and a tendency towards aggression. It is hypothesized that the interaction between low serotonin and high testosterone levels in the central nervous system has a significant effect on the neural mechanisms involved in the expression of aggressive behavior. It seems that testosterone modulates serotonergic receptor activity in a way that directly affects aggression, fear and anxiety. Our survey reviews the main findings on serotonin, testosterone and the possible interaction between them with regard to these behavioral phenomena.
Psychological Reports, 1989
To examine correlations among chronic Posttraumatic Stress Disorder (PTSD), control-related belie... more To examine correlations among chronic Posttraumatic Stress Disorder (PTSD), control-related beliefs, and sleep difficulties 7 PTSD casualities and 7 non-PTSD matched subjects were compared in their laboratory sleep patterns as well as in their beliefs about personal control over external and internal events in general and over sleep-related events in particular. Analyses indicated that PTSD casualties had poorer sleep and reported more doubts regarding their ability to control external and internal events than control subjects. Further, we found a significant association between perceived control and sleep difficulties. Results were discussed in terms of Horowitz&amp;#39;s conception of intrapsychic processes related to PTSD.
Journal of Traumatic Stress, 1990
The purpose of the present study was to investigate the sleep of people diagnosed as suffering fr... more The purpose of the present study was to investigate the sleep of people diagnosed as suffering from chronic Post-Traumatic Stress Disorder (PTSD). The sleep of seven chronic post-traumatic patients with no known physical injuries was compared with that of seven matched control subjects. The post-traumatic patients had poorer sleep: decreased sleep efficiency, increase in number of awakenings, and decreased SWS, as well as longer REAl latency. It was also found that their complaints correlated with relevant sleep-monitored measures. The findings add further support for the inclusion of sleep difficulties in the definition of the Post-Traumatic Stress Disorder.
International Journal of Rehabilitation Research, 2007
The quality of life of 127 Israeli young adults diagnosed as having borderline intelligence quoti... more The quality of life of 127 Israeli young adults diagnosed as having borderline intelligence quotient and attention-deficit/hyperactivity disorder, and living in community residences, was studied with respect to personal, disability and social ecology data. Overall, quality of life was associated with studying in inclusive education, total attention-deficit disorder symptomatology score, monthly income, participation in leisure activities and having a personal friend. Two significant predictors of quality of life were attention-deficit disorder symptomatology score and monthly income. Additional analysis indicates that among younger residents the two significant predictors were inclusive education and high monthly income, whereas the predictors for older residents were low level of medical disability and low attention-deficit disorder symptomatology score.
International Journal of Law and Psychiatry, 2007
While the incidence of criminal offense in individuals with schizophrenia does not necessarily di... more While the incidence of criminal offense in individuals with schizophrenia does not necessarily differ from that of the normal population, in contrast, the rate of sexual crimes among individuals with schizophrenia is relatively low. Due to low numbers, description of sexual criminal behavior among schizophrenia patients remains relatively unexplored. In order to investigate clinical, socio-demographic and sexual factors associated with deviant sexual behavior in schizophrenia sex offenders we retrospectively compared a large subgroup of schizophrenia sex offenders with a group of schizophrenia patients incarcerated for other criminal behaviors and a group of sex offenders without schizophrenia. Results indicated significant differences distinguishing schizophrenia sex offenders from schizophrenia non-sex offenders, the former of whom were more likely to be married, employed, non-heterosexual (homosexual and bisexual orientations) and demonstrated less hospitalization, antisocial personality, substance abuse, negative symptoms and overall illness severity. Individuals with schizophrenia had a tendency towards female victims compared to nonschizophrenia sex offenders whose victims tended to be male. Study observations indicate important differences between the 3 subgroups suggesting that the schizophrenia sex offender subpopulation may be a unique subgroup of comorbid conditions.
International Journal of Geriatric Psychiatry, 2004
Early detection of depression in elderly demented patients may assist in adequate treatment. The ... more Early detection of depression in elderly demented patients may assist in adequate treatment. The aim of this study was to evaluate the utility of Visual Analogue Scale for depression among demented and mild cognitively impaired elderly patients. 157 Patients, aged from 65 to 92 years, in a memory clinic were divided into two groups according to scores on the Mini Mental State Examination (MMSE): Demented group (62 patients) with MMSE scores from 16 to 23, and Mild Cognitively Impaired group (MCI-95 patients) with MMSE scores from 24 to 29. Subjects were diagnosed for depression according to DSM-IV criteria, using Hamilton Depression Rating Scale (HDRS) and a comprehensive clinical evaluation. All were administered a Visual Analogue Scale (VAS) for depression. In the demented group, 25 subjects were diagnosed as depressive. In the MCI group, 46 subjects were diagnosed as depressive. Mean VAS scores for the demented and MCI groups were similar, both for depressive and non-depressive patients. Correlations between VAS scores with HDRS scores and with the clinical diagnosis were high, although somewhat lower for the demented group. Analyzing data with ROC curve technique yielded significantly different ROC curves. Optimal cutoff point for the demented group was VAS value of 60, and 50 for the MCI group. VAS seems to be a useful tool for evaluation of depression among cognitively impaired patients. Severity of cognitive decline in the elderly may influence the cutoff points on VAS for detecting depression. Further large-scale studies are needed to substantiate our observation.
European Psychiatry, 2010
European Neuropsychopharmacology, 2004
P1, Affeetioe disorders and antidepressants placebo 0.8%, p=.371). Duloxetine-treated patients ha... more P1, Affeetioe disorders and antidepressants placebo 0.8%, p=.371). Duloxetine-treated patients had a small mean decrease in weight (-0.5 kg), compared with an increase of 0.2 kg for patients receiving placebo. No significant differences were found between duloxetine and placebo in the incidence of treatment-emergent abnormal laboratory values at awtime while on treatment. Subgroup analyses of laboratory values, vital signs, and ECGs, revealed no significant safety issues associated with age, raee, or gender.
European Neuropsychopharmacology, 1995
European Neuropsychopharmacology, 2010
Results: Out of 927 enrolled patients, 903 were included in analysis (612 patients with schizophr... more Results: Out of 927 enrolled patients, 903 were included in analysis (612 patients with schizophrenia, 291 patients with bipolar disease): 410 (45%) with the SOT form. Baseline CGI score was higher in patients initiated on the OD form (4.2 vs 3.8, p < 0.001, in patients with schizophrenia and 4.1 vs 3.7, p = 0.005, in patients with bipolar disease). 775 patients (86%) completed the 12-month study period. Overall 95% (95% CI=[93; 96]) of patients remained on olanzapine at 12 months with similar rates in patients with schizophrenia and patients with bipolar disease. The rates were also similar in SOT 94% (95% CI=[91; 96]) and OD 95% (95% CI=[93; 97]) formulations. In the Cox regression (n = 747), the only factor significantly associated with discontinuation was baseline severity (HR=0.78; p = 0.035) where patients with higher baseline CGI had lower risk of discontinuation; the formulation effect was not significant (HR OD/ OC =0.72, p = 0.30). Table. Mean (standard deviation) change of patient outcomes from baseline to endpoint CGI GAF PGWI MARS WAI Weight (kg)
American Journal of Medical Genetics, 1997
Velocardiofacial syndrome (VCFS) is associated with an increased frequency of schizophrenia and o... more Velocardiofacial syndrome (VCFS) is associated with an increased frequency of schizophrenia and other types of psychiatric morbidity. In this study, we tried to identify a subgroup of schizophrenic patients with deletions in the VCFS region of the long arm of chromosome 22. For that purpose, we screened the records of two major general hospitals for patients with abnormalities characteristic of VCFS, such as cardiac anomalies and cleft palate, and cross-checked the data with the register of psychiatric hospitalizations in four psychiatric hospitals. Of the 24 patients that qualified, only seven patients could be studied. An additional eight schizophrenic inpatients were ascertained clinically, based on a working VCFS Clinical Scale. FISH studies and molecular analyses, using polymorphic markers from the VCFS region, documented hemizygosity of 22q11 in three out of 15 patients (20.0%). Increased awareness of psychiatrists to signs of VCFS among patients with psychiatric illnesses is encouraged, in order to direct molecular studies effectively. In order to cut down the cost of testing, we suggest screening suspected patients with a single marker, such as D22S941, and to study further only those who have a single electrophoretic band.