Publications by authors named "Gad Lubin"

In the mental health system, there is a challenging variety of risks, which stems from both the uniqueness of the patients and the treatments provided. How can we deal with the risk? A classic risk-management approach is based on a 4-step model: identification of the risks; analysis of the identified risks and prioritizing the treatment; treatment: dealing practicably with the risks; evaluation of the activity's effectiveness in retrospect.

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In this article, we have attempted to summarize the achievements and the challenges of the mental health department (MHD) of the IDF Medical Core from the past four decades, since its initiation. We approach this wide scope question through the investigation of the MHD according to the perspective of its main fields of endeavor. These domains are widely arrayed.

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Background: Combat exposure is associated with elevated risk for post-traumatic stress disorder (PTSD). Despite considerable research on PTSD symptom clustering, it remains unknown how symptoms of PTSD re-organize following combat. Network analysis provides a powerful tool to examine such changes.

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Objective: To study the association between bed occupancy in psychiatric wards and rate of adverse incidents (AIs) including aggressive behavior and falls.

Methods: This is a retrospective study analyzing bed occupancy and AIs' data in 4 closed wards in a state psychiatric hospital in Israel over a 20-month period. Ward-level daily records were extracted from the hospital's electronic admission-discharge and AI registries, creating a log of 609 days for each of the 4 wards.

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Importance: Combat places soldiers at risk for posttraumatic stress disorder (PTSD). The excessive rates of PTSD and other adjustment disorders in soldiers returning home make it imperative to identify risk and resilience factors that could be targeted by novel therapeutic treatments.

Objective: To investigate the interplay among attention to threat, combat exposure, and other risk factors for PTSD symptoms in soldiers deployed to combat.

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Previous studies have shown that people who develop psychopathology such as posttraumatic stress disorder (PTSD) following stress exposure are characterized by reduced hippocampal (HC) volume and impaired HC functional connectivity with the ventromedial prefrontal cortex (vmPFC). Nevertheless, the exact interrelationship between reduced HC volume and HC-vmPFC connectivity deficits in the context of stress has yet to be established. Furthermore, it is still not clear whether such neural abnormalities are stress induced or precursors for vulnerability.

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Trauma-related psychopathology has been associated with an intense emotional reaction to stressful event. Emotional responses have evolved to signal the presence of risks to be avoided or of rewards to be approached in the environment. Thus, individuals' sensitivity to signals of risk and reward may affect the level of stress vulnerability.

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Background: Although previous studies indicate that people with lower intelligence quotient (IQ) scores are more likely to become cigarette smokers, IQ scores of siblings discordant for smoking and of adolescents who began smoking between ages 18-21 years have not been studied systematically.

Methods: Each year a random sample of Israeli military recruits complete a smoking questionnaire. Cognitive functioning is assessed by the military using standardized tests equivalent to IQ.

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Variations in people's vulnerability to stressful life events may rise from a predated neural sensitivity as well as from differential neural modifications in response to the event. Because the occurrence of a stressful life event cannot be foreseen, characterizing the temporal trajectory of its neural manifestations in humans has been a real challenge. The current prospective study examined the emotional experience and brain responses of 50 a priori healthy new recruits to the Israeli Defense Forces at 2 time points: before they entered their mandatory military service and after their subsequent exposure to stressful events while deployed in combat units.

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Background: Evidence indicates an association between older parents at birth and increased risk for schizophrenia and autism. Patients with schizophrenia and autism and their first-degree relatives have impaired social functioning; hence, impaired social functioning is probably an intermediate phenotype of the illness. This study tested the hypothesis that advanced father's age at birth would be associated with poorer social functioning in the general population.

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Aim: Retrospective studies indicate that patients with psychotic disorders and schizophrenia often suffer from depressive symptoms before the onset of psychosis. In a historical-prospective design, we studied the association between dysthymia in adolescence and later hospitalization for psychotic disorders and schizophrenia.

Methods: The Israeli Draft Board screens the entire, unselected population of 16-17 years old male adolescents for psychiatric disorders.

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Research indicates that persons with learning disorders often suffer from psychopathology. We assessed current and future psychopathology in male adolescents with discrete impairments in reading comprehension (IRC) or arithmetic abilities (IAA) but with average or above-average general intellectual abilities. Subjects were a population-based cohort of 174,994 male adolescents screened by the Israeli Draft Board with average or above-average intellectual abilities but with low scores (8.

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Background: Previous work suggests that the association between urbanicity and schizophrenia may be greatest in those with pre-existing vulnerability.

Aims: To test for synergism in risk of schizophrenia between population density and a combined exposure of poor premorbid social and cognitive functioning.

Method: For 371 603 adolescent males examined by the Israeli Draft Board on social and cognitive functioning, data on population density of place of residence and later hospitalisation for schizophrenia were obtained from population-based registries.

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Background: Previous studies have reported that as a group, individuals affected by psychotic and nonpsychotic disorders perform below norms on cognitive tests. Other studies have indicated that unaffected siblings of individuals affected by psychotic disorders also perform below norms on the same tests. We investigated cognitive performance on a large, population-based sample of individuals, affected at the time of testing by nonpsychotic disorders, and their unaffected siblings.

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Hospitalization costs are lower in psychiatric hospitals than in psychiatric departments of general hospitals. However, soldiers hospitalized in psychiatric hospitals are subject to the stigma associated with mental illness. The goal of this study was to examine the financial costs of preventing such stigma by hospitalizing soldiers in psychiatric departments of general hospitals, rather than less expensive psychiatric hospitals.

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Introduction: Approximately one third of schizophrenia patients show partial or no response to pharmacotherapy. Despite intensive investigations, the phenomenological and biological characteristics of such patients are far from elucidated. This study examined the premorbid behavioral and intellectual functioning of schizophrenia patients who showed poor response to antipsychotic treatment.

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Objective: We aimed to evaluate the incidence of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) among medical staff members serving in Judea and Samaria during 2000-2003.

Methods: The study population included 141 medics and 19 medical doctors who provided emergency medical treatment during 23 violent events. Information regarding the incidence of ASD and PTSD was abstracted from Israel Defense Forces mental health files, as was a history of previous exposures to similar events, personal acquaintance with the victims, being under fire during the event, number of victims killed and/or wounded in the event, and length of time in service.

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Context: Maternal and paternal ages are associated with neurodevelopmental disorders.

Objective: To examine the relationship between advancing paternal age at birth of offspring and their risk of autism spectrum disorder (ASD).

Design: Historical population-based cohort study.

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