Medication use in nursing home residents with advanced dementia.

Objective: To describe medication usage in nursing home residents with advanced dementia, to identify how this usage changed as patients advanced towards death, and to identify correlates of increased medication usage.

Methods: Prospective cohort study (CareAD) during which data on medication prescription were extracted from medical records at regular intervals using standardized extraction procedures.

Results: Patients (n=125) were prescribed a mean of 14.

Quetiapine for elderly non-responsive schizophrenia patients.

Ten elderly chronic schizophrenia patients who were not responding to an atypical antipsychotic were switched to quetiapine. The Brief Psychiatric Rating Scale (BPRS) demonstrated statistically significant improvement after 6 months of quetiapine treatment. Four patients discontinued treatment due to clinical exacerbation or sedation.

A randomized, single-blind, comparison of venlafaxine with paroxetine in elderly patients suffering from resistant depression.

It is estimated that up to 45% of patients with depression do not have an adequate response to a first trial of antidepressant therapy with even higher reported rates for the elderly patients. To compare the efficacy and the tolerability of venlafaxine vs. paroxetine in elderly patients suffering from resistant major depression, who did not respond to at least two previous adequate trials of antidepressants.

Tetrabenazine in the treatment of Huntington's disease.

Tetrabenazine (TBZ), a catecholamine-depleting agent initially developed for the treatment of schizophrenia, when tested for other indications, has proven to be more useful for the treatment of a variety of hyperkinetic movement disorders. These disorders include neurological diseases characterized by abnormal involuntary movements such as chorea associated with Huntington's disease, tics in Tourette's syndrome, dyskinesias and dystonias in tardive dyskinesia, also primary dystonias and myoclonus. This review will include and discuss studies published during the period of 1960-2006 regarding the clinical efficacy and tolerability of TBZ in Huntington's disease (HD).

Quetiapine treatment for behavioural and psychological symptoms of dementia in Alzheimer's disease patients: a 6-week, double-blind, placebo-controlled study.

Setting: Treating elderly patients with Alzheimer's disease (AD) and behavioral and psychological symptoms of dementia (BPSD) is challenging due to the increased risk of iatrogenic movement disorders with old neuroleptics and the seemingly increasing risk of cardiovascular events with newer atypical agents. Quetiapine is an atypical antipsychotic agent that warrants further investigation.

Objectives: To assess tolerability, safety, and clinical benefit of quetiapine in AD patients with BPSD.

The physician-patient relationship in dementia care.

Medical care of patients with dementia often occurs within a physician-patient relationship whose features differ from relationships with patients without dementia. Many basic assumptions of the physician-patient relationship may not completely hold true, and certain aspects of the patient role may be shared by others besides the patient. For example, the entire premise of consent to the patient role may be inapplicable to patients who lack insight into their illness.

Effects of pharmacological therapy on gait and cognitive function in depressed patients.

Objective: To investigate the relationship among affective status, cognitive function, and gait in depressed patients and to evaluate the effects of treatment of depression on gait and cognitive function.

Methods: Nineteen patients recently diagnosed with clinical depression (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) were recruited from a psychiatric outpatient clinic. Evaluation included the Hamilton Depression Rating Scale (HAM-D), the Mini-Mental State Examination, a computerized neuropsychological battery (Mindstreams, NeuroTrax Corp, New York, NY), and Barthel's Index of Instrumental Activities of Daily Living.

Cardiac and cerebrovascular morbidity and mortality associated with antipsychotic medications in elderly psychiatric inpatients.

Objective: To evaluate the rate of adverse medical outcomes for elderly exposed to antipsychotic treatment.

Methods: This was a retrospective evaluation of psychiatric inpatients records. Age, gender, diagnosis, treatment with antipsychotics, and duration of treatment were analyzed.

An alternative model for psychiatric service delivery for people with intellectual disabilities in a vocational rehabilitation center.

The prevalence of mental illness in the intellectually disabled (ID) population is high. Because of their special characteristics, such as involvement of multiple carers (family, social services, protected housing staff, vocational instructors), linguistic limitations and the need for a familiar and steady environment, these patients require special therapeutic consideration. In Israel, as in many other countries, people with ID (PWID) receive psychiatric services from general psychiatric outpatient clinics and hospitals; their treatment is generally not specifically tailored to their needs, and hence often suboptimal.

A pragmatic approach to teaching psychiatry residents the assessment and treatment of religious patients.

Objective: The authors describe a pragmatic and atheoretical frameword for teaching psychiatry residents how to assess and treat religious patients.

Results: The psychiatrist's goals in assessing the religious history are clarified. These goals differ between the assessment and treatment phases.

The immune system and happiness.

Human ability to experience negative and positive emotions has an evolutionary perspective and the presence of feelings designed to influence behavior should thus be reflected in physiological and immune interactions. The complex interactions between the immune system and the central nervous system have been studied extensively in schizophrenia and depression. On the other hand, effects of positive human emotions, especially happiness, on physiological parameters and immunity have received very little attention.

Reduced anticardiolipin antibodies in first episode and chronic schizophrenia.

The objective of this study was to measure anticardiolipin antibodies (aCL) in major psychiatric diseases. In Experiment 1, 96 subjects were evaluated: 20 first episode schizophrenia patients, [SCZ1] 20 chronic schizophrenia patients in acute exacerbation [SCZ2], l9 bipolar patients, 20 schizoeffective patients and 17 healthy age matched controls. In Experiment 2, 97 subjects were studied: 20 first episode schizophrenia patients [SCZ1], 60 chronic schizophrenia patients in acute exacerbation [SCZ2] and 17 healthy matched controls.

Therapist-patient sexual relations: results of a national survey in Israel.

Background: Studies focusing on Patient-Therapist sexual relations have been carried out mainly in the U.S. This study comes to broadly explore this phenomenon in Israel.

Tele-hypnosis in the treatment of adolescent school refusal.

Few studies have presented the use of hypnosis in the treatment of school refusal. These studies haven't approached the problem of self-hypnosis during the stressful morning hours. This paper introduces a therapeutic approach, which utilizes known hypnotic techniques, but rehearses them via the telephone, while the patient is at his/her house or on the way to school and the therapist is at the office.

Intramuscular ziprasidone treatment of acute psychotic agitation in elderly patients with schizophrenia.

Objective: Intramuscular (i.m.) ziprasidone treatment has been shown to be effective and well tolerated in reducing the symptoms of acute psychosis in adults.

Quetiapine versus olanzapine for the treatment of negative symptoms in patients with schizophrenia.

Negative symptoms are considered the most debilitating and refractory aspect of schizophrenia, being associated with poor social, occupational and global outcomes. Conventional antipsychotics have limited efficacy against these symptoms and poor tolerability profiles. Atypical antipsychotics are an alternative treatment, and this 12-week, randomised, flexibly dosed study compared the efficacy, safety and tolerability of quetiapine and olanzapine in this regard.

Donepezil for negative signs in elderly patients with schizophrenia: an add-on, double-blind, crossover, placebo-controlled study.

Objective: Cognitive impairment and negative signs are common in patients with schizophrenia. Up to 35% of elderly patients with schizophrenia fulfill the diagnostic criteria of dementia. Donepezil inhibits cholinesterase, thus enhancing cholinergic neurotransmission.

Psychiatric admissions and hospitalization in Israel: an epidemiologic study of where we stand today and where we are going.

Background: Analysis of the trends in psychiatric admissions and discharges is necessary to correctly plan and distribute resources, especially given the current international climate of "deinstitutionalization." Israel, too, is implementing "reform" in the national psychiatric system - to transfer psychiatric treatment from a hospital to a community setting.

Objectives: To analyze admission and discharge patterns, explore trends in psychiatric hospital length of stay, and compare these characteristics between first-episode and chronic patients, between children, youth and adults, and between hospitals.

Reduced cancer incidence among patients with schizophrenia.

Background: The incidence of cancer in patients with schizophrenia has been conversely reported to be higher, lower, or similar to that in the general population. The effects of lifestyle factors such as excess smoking, exposure to neuroleptic medications, and genetic factors that may influence the incidence of cancer in this group are not clear. The current study was performed to evaluate the frequency of cancer in a large cohort of patients with schizophrenia and to determine the standardized incidence ratios (SIRs) of any malignancy in this group.

Assessing cardiovascular risks of olanzapine treatment: a 6-month study versus haloperidol in schizophrenia patients.

The introduction of second generation antipsychotics (SGA) represents a major advance in the treatment of schizophrenia. Concerns about the metabolic and cardiovascular adverse effects of the SGA have been widely disseminated. The benefits and risks of these drugs have been studied with a focus on particular organ systems.

Elderly psychiatric patients at risk of folic acid deficiency: a case controlled study.

In the elderly, folic acid deficiency may result in psychiatric symptoms or the increases in severity of other organic and non-organic mental diseases. We aimed to characterize elderly, community-dwelling, newly admitted patients to a large urban psychiatric hospital who are suffering from untreated folic acid deficiency in comparison with elderly inpatients who do not suffer from this deficiency. During a 2-year period, all subjects aged 65 years or older admitted to the large psychiatric center were tested for levels of serum folic acid levels.