Implementing recovery-oriented interventions with staff in a psychiatric hospital: A mixed-methods study.

WHAT IS KNOWN ON THE SUBJECT?: Recovery-oriented care is a means of providing mental health treatment, focused on the patient's individual needs and active involvement in one's own care. However, this approach presents with challenges, particularly in psychiatric hospitals, which tend to be focused on symptom reduction. WHAT DOES THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study examines the influence of three different recovery-oriented training programmes/interventions (namely, illness management and recovery, peer support, and psychiatric advance directives) on the attitudes and practice of mental health staff (including nurses) in an inpatient setting, using a mixed-methods methodology.

Environment dominates over host genetics in shaping human gut microbiota.

Human gut microbiome composition is shaped by multiple factors but the relative contribution of host genetics remains elusive. Here we examine genotype and microbiome data from 1,046 healthy individuals with several distinct ancestral origins who share a relatively common environment, and demonstrate that the gut microbiome is not significantly associated with genetic ancestry, and that host genetics have a minor role in determining microbiome composition. We show that, by contrast, there are significant similarities in the compositions of the microbiomes of genetically unrelated individuals who share a household, and that over 20% of the inter-person microbiome variability is associated with factors related to diet, drugs and anthropometric measurements.

Perioperative complications of emergent and elective procedures in psychiatric patients.

Background: Patients with psychiatric disorders have an increased risk for morbidity and mortality from other medical conditions.

Methods: Medical records of all the patients undergoing appendectomy (n = 2594) and laparoscopic cholecystectomy (n = 2874) from 2009 to 2014 in one hospital were reviewed. For each patient with a documented psychiatric disorder undergoing surgery, four controls were matched.

A population-based study of premorbid scholastic achievement among patients with psychiatric disorders.

Population-based studies of premorbid cognitive functioning in schizophrenia have found verbal deficits and low IQ scores. It remains unclear, however, whether premorbid deficits are specific to schizophrenia, compared with other psychiatric disorders. Moreover, studies using school-based measures are few and their results inconsistent.

'Not good enough:' Exploring self-criticism's role as a mediator between childhood emotional abuse & adult binge eating.

Empirical studies have identified emotional abuse in childhood (CEA) as a risk factor with long-term implications for psychological problems. Indeed, recent studies indicate it is more prevalent than behavioral forms of abuse, (i.e.

Binge eating & childhood emotional abuse: The mediating role of anger.

Recent studies reveal that childhood emotional abuse (CEA) is the trauma most clearly associated with adult eating pathology. Yet, relatively little is understood about psychological mechanisms linking these distal experiences. Anger's mediational role in the relationship between CEA and adult binge eating (BE) is explored in a community-based sample of 498 adult women (mean age 44).

Pavel Ivanovich Karpov (1873-1932?)--the Russian Prinzhorn: art of the insane in Russia.

The complicated relationship between the discipline of mental health and the arts has barely been studied systematically. Mental hospitals, shelters and prisons--institutions that accommodate the mentally ill--sometimes promote but often discourage and disrupt the patients' artistic creativity and the images created. In psychiatric circles, the recognition of patient art was a long, slow and frustrating process.

Does Specializing in Family Medicine Improve the Detection and Diagnosis of Mental Health Problems?

Background: Approximately half the patients seeking mental health (MH) treatment consult primary care practitioners (PCPs). Previous research indicates that patients often do not receive correct MH diagnoses or appropriate treatment from PCPs. The present study examines whether a specialization in family medicine compared to other or no PCP residency programs enhances physicians' ability to detect, diagnose and treat MH problems.

Cannabis and Alcohol Abuse Among First Psychotic Episode Inpatients.

Background: Psychoactive substance abuse, which includes abuse of alcohol and street drugs, is common among first-episode psychosis patients, but the prevalence of cannabis abuse is particularly high. However, there have been very few reported studies concerning the occurrence of psychoactive substance abuse among first-episode psychotic individuals using standard toxicological testing. We study the prevalence of cannabis and alcohol abuse among first-psychoticepisode inpatients as well as compare the demographic, diagnostic, and psychopathological profiles of substance abusers versus nonusers.

Personalized Nutrition by Prediction of Glycemic Responses.

Elevated postprandial blood glucose levels constitute a global epidemic and a major risk factor for prediabetes and type II diabetes, but existing dietary methods for controlling them have limited efficacy. Here, we continuously monitored week-long glucose levels in an 800-person cohort, measured responses to 46,898 meals, and found high variability in the response to identical meals, suggesting that universal dietary recommendations may have limited utility. We devised a machine-learning algorithm that integrates blood parameters, dietary habits, anthropometrics, physical activity, and gut microbiota measured in this cohort and showed that it accurately predicts personalized postprandial glycemic response to real-life meals.

The time course and characteristics of procedural learning in schizophrenia patients and healthy individuals.

Patients with schizophrenia have deficits in some types of procedural learning. Several mechanisms contribute to this learning in healthy individuals, including statistical and sequence-learning. To find preserved and impaired learning mechanisms in schizophrenia, we studied the time course and characteristics of implicitly introduced sequence-learning (SRT task) in 15 schizophrenia patients (seven mild and eight severe) and nine healthy controls, in short sessions over multiple days (5-22).

Artificial sweeteners induce glucose intolerance by altering the gut microbiota.

Non-caloric artificial sweeteners (NAS) are among the most widely used food additives worldwide, regularly consumed by lean and obese individuals alike. NAS consumption is considered safe and beneficial owing to their low caloric content, yet supporting scientific data remain sparse and controversial. Here we demonstrate that consumption of commonly used NAS formulations drives the development of glucose intolerance through induction of compositional and functional alterations to the intestinal microbiota.

Disordered eating & cultural diversity: a focus on Arab Muslim women in Israel.

Context: A dearth of data concerning eating problems among adult women from minority population groups leaves substantial knowledge gaps and constrains evidence-based interventions.

Objectives: To examine prevalence and predictors of disordered eating behaviors (DEB) among Arab Muslim women in Israel, whose eating behaviors have not been previously examined and to compare with second generation Israeli-born Jews of European heritage.

Design: Community-based study includes sub-samples of Arab Muslims and Israeli-born Jews.

[Stimulating the thought].

Neuropsychiatric disorders are generally accompanied by a change in brain activity (hyperactivity or deficiency compared to normal activity). Therefore, intervention in brain activity may provide treatment for different disorders. In this paper we review various methods of brain stimulation: some that are familiar and have been in use for several years such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS); and others that are new and still being studied but have obtained promising preliminary results such as vagus nerve stimulation (VNS), deep brain stimulation (DBS], magnetic seizure therapy, transcranial direct current stimulation (tDCS] and near-infrared therapy.

Cannabis Withdrawal - A New Diagnostic Category in DSM-5.

Background: Cannabis withdrawal was not formally recognized by the DSM-IV classification but is listed, albeit without diagnostic criteria by ICD-10. The American Psychiatric Association recently has included cannabis withdrawal into DSM-5 classification as part of the "Substance-Related and Addictive Disorders" Section. However, many psychiatrists as well as other medical professionals have very little information, if at all, about the new diagnostic entity.

[Intrinsic motivation: a new direction of understanding and treatment of schizophrenia?].

While diagnosing schizophrenia, clinicians focus on feeling the quality and nature of the internal motivation of patients. This motivational quality was theoretically conceptualized by Self Determination Theory (SDT). In this article we will review some of the basics of this theory, which focuses on motivational variables assessing behavior on an internal-external axis.

Use of unconventional therapies by primary care patients--religious resources vs. complementary or alternative medicine services.

Objectives: The study examines the difference in characteristics between primary care patients who turn to "religious resources for medical purposes" (RRMP) and those who turn to "complementary or alternative medicine" (CAM) services to cope with a physical or mental health problem.

Design And Setting: Data were collected from eight primary care clinics in Israel and included 905 Jewish patients aged 25-75.

Main Outcome Measure: A self-report questionnaire with a battery of validated mental health assessment instruments and two questionnaires regarding use of unconventional therapies (RRMP and CAM services) were administered to the participants.

Hospitalization of patients with schizophrenic and affective disorders in Israel in the aftermath of the structural and rehabilitation reforms.

Background: In the last decade (2001-2010) the Ministry of Health implemented two major inter-related reforms: a 'structural reform' to reduce the number of psychiatric beds and the 'Rehabilitation of the Mentally Disabled in the Community Law', which allocated funds for a variety of residential and vocational programs in the community for these patients. The objective of the present paper was to examine the impact of the two reforms on the hospitalization of schizophrenic and affective disorder patients by tracking the patterns of their inpatient care during the last decade.

Methods: Data on all psychiatric admissions during the period 1990-2011 were extracted from the Israel Psychiatric Case Register to examine changes in the rate of admissions, length of hospitalizations, total inpatient days and tenure in the community.

Trends in the use of rehabilitation services in the community by people with mental disabilities in Israel; the factors involved.

Background: In 2001, the Rehabilitation of the Mentally Disabled Law was implemented, defining a basket of rehabilitation services to which people with mental disabilities are entitled.

Objectives: To describe change over time in the characteristics of applicants to rehabilitation committees, types of referral agencies, and the proportion of those referred who were admitted. To identify factors affecting implementation of decisions to admit people with mental disabilities into different rehabilitation services and predictors of the length of time they remain in the services.

A comparative study of Arab and Jewish patients admitted for psychiatric hospitalization in Jerusalem: the demographic, psychopathologic aspects, and the drug abuse comorbidity.

Background: The influence of ethnicity on different aspects of psychiatric hospitalization is far from clear.

The Aim Of The Study: The main aim of the study was to compare the Arab and the Jewish inpatients, at the time of admission, for the demographic factors, severity of psychotic, and affective psychopathology and comorbid drug abuse rate. POPULATION, METHOD, AND TOOLS: Among 250 consecutively admitted patients in the Jerusalem Mental Health Center-Kfar Shaul Hospital, 202 Jews and 42 Arabs (aged 18-65 years) were examined within 48 hours after admission.

Tachyphylaxis/ tolerance to antidepressive medications: a review.

Tachyphylaxis is the appearance of progressive decrease in response to a given dose after repetitive administration of a pharmacologically or physiologically active substance; the symptoms could appear also during treatment with antidepressants. Although the real frequency of the phenomenon is unclear, it may be as high as 33% during the pharmacological treatment of depression. The review deals with the possible causes and the treatment of the tachyphylaxis following antidepressant treatment.

A comparative study of psychiatric inpatients in a general hospital and a psychiatric hospital in Israel: demographics, psychopathological aspects and drug abuse patterns.

Background: Some specialists and policy makers advocate progression of the mental health reform in Israel by transferring beds from psychiatric to general hospitals.

Objectives: To compare the demographic, diagnostic and psychopathological profiles of psychiatric inpatients hospitalized in psychiatric and general hospitals, as well as their patterns of drug abuse, and to estimate the preparedness of general hospitals for the possible expansion of their psychiatric services.

Methods: Between 2002 and 2006 a total of 250 patients were consecutively admitted to the Jerusalem Mental Health Center-Kfar Shaul Hospital and 220 to the psychiatric department of Sheba Medical Center, a general hospital in central Israel; the patients' ages ranged from 18 to 65.

Dropout from outpatient mental health care: results from the Israel National Health Survey.

Objectives: To examine the dropout rates from outpatient mental health treatment in the general medical and mental health sectors and to identify the predictors of dropout.

Method: The study population was extracted from the Israel National Health Survey. The analysis was related to 12-month service utilization for mental health reasons.