A comparison of life events in suicidal and nonsuicidal adolescents and young adults with major depression and borderline personality disorder.

This retrospective study assessed the correlations between various types of stressful life events (SLE) and suicidal adolescents and young adults with major depressive disorder (MDD;22), borderline personality disorder (BPD;18), and nonsuicidal adolescents and young adults with MDD (20) and BPD (20). A community control group of 40 participants was also evaluated. The measurements used were Life Events Checklist, Childhood Sexual Abuse Questionnaire, Suicide Risk Scale, and Beck Depression Inventory. Suicidal participants experienced a greater number of total lifetime negative events compared with nonsuicidal participants, irrespective of diagnosis, including a greater amount of negative life events in the year before the suicide attempt compared with the year before referral in the nonsuicidal group. Participants with MDD reported more lifetime negative events than participants with BPD. Suicidal adolescents did not have more lifetime death-related SLE than nonsuicidal adolescents, but MDD adolescents experienced more lifetime death-related SLE than BPD adolescents. Suicidal BPD participants reported more lifetime sex abuse-related SLE compared with nonsuicidal BPD participants. The complexity of the relationships between SLE and the interplay of both suicidality and underlying psychopathology is discussed with the relevant treatment implications.

Psychologists' and social workers' self-descriptions using DSM-IV psychopathology.

There is limited information on mental health of psychologists and social workers despite their rendering mental health services, so their subjective perception of mental disorder was explored via a self-evaluation survey in which they self-diagnosed the presence of DSM-IV disorders within themselves. The sample of 128 professionals included 63 psychologists and 65 social workers. The presence of Axis I traits was reported by 81.2%, the three most frequent traits being mood, obsessive-compulsive disorder, and eating disorder. Axis II traits were reported by 73.4% of subjects, the three most frequent conditions being narcissistic, avoidant, and obsessive-compulsive personality traits. While a high percentage of subjects reported the presence of either an Axis I or Axis II disorder, the average severity reported was low. More psychologists reported on mood, social phobia, and eating problems than social workers, while the latter reported more on psychotic problems. Psychologists reported more Axis II traits, especially paranoid, narcissistic, and avoidant subtypes. More women than men reported eating problems, while more men reported schizoid and avoidant personality traits. In conclusion, manifestations of subthreshold psychiatric conditions were prominently reported. These findings suggest encouraging mental health care professionals to explore treatment for problems if present.

Psychological guidelines for a medical team debriefing after a stressful event.

Medical and rescue workers are at risk of developing mental syndromes including post-traumatic stress disorder after disasters and it is widely accepted that they should be offered a preventive intervention. The Israel Defense Force Medical Corps has developed psychological guidelines for the medical forces: a medical team debriefing after treating the injured as a preventive intervention for an event that may be experienced as stressful. The main purpose of the debriefing is to investigate the circumstances of the event, analyze the medical team's functioning, and draw the relevant conclusions and the manner of their implementation. The purpose of the guidelines is to enhance mental coping, possibly prevent stress reactions, and help in screening individuals in need of further professional intervention for stress reactions. These guidelines are suitable for similar interventions in other professional teams.

Legal and medical aspects of body dysmorphic disorder.

Body Dysmorphic Disorder (BDD), a preoccupation with an imagined defect in physical appearance has a rich clinical history, but officially appeared with diagnostic criteria only in the DSM-III-R classification system. Prevalence of BDD in plastic and cosmetic dermatology ranges between 7-15% due to the obsession with imagined imperfections. The emotional "defect" causes dissatisfaction with nonpsychiatric medical procedures, and often recourse into legal action. We present a case study of BDD developing after cosmetic surgery and debate whether this is an actual possibility and the legal consequences of this possibility. We question whether surgery was a traumatic event and its relationship to the patient's premorbid "eggshell personality". The difficulty in determining causation of psychiatric disorders for the purpose of deciding issues of compensation is discussed. A practical algorithm is offered in order to avoid litigation and to maintain the legitimate medical ideal of "first do no harm".

Reactivation of combat stress after a family member's enlistment.

Reactivation of traumatic stress syndromes classically occurs in individuals who have recovered from acute stress reactions or from post-traumatic stress disorder. Triggers of traumatic reactivation may resemble the circumstances of the original trauma or may be less specific, connected to life events such as illness or retirement. In Israel, because of the continuous reminders of combat, reactivation of combat stress has been studied closely. A family member's enlistment is a potential trigger for reactivation. This article explores the general meaning of enlistment for family members, and the reactivation that may accompany that enlistment, through the examination of two cases.

Improvement of extrapyramidal symptoms following dehydroepiandrosterone (DHEA) administration in antipsychotic treated schizophrenia patients: a randomized, double-blind placebo controlled trial.

Recent investigation in schizophrenia indicated dehydroepiandrosterone (DHEA) levels to be inversely correlated with extrapyramidal symptomatology (EPS). This study thus investigates the effect of DHEA administration on medication-induced EPS. Inpatients with schizophrenia or schizoaffective disorder were randomized in double-blind fashion to receive either 100 mg DHEA or placebo in addition to a constant dosage of antipsychotic medication. Parkinsonism showed a favorable effect of DHEA with a significant time effect (p < 0.0001), as well as a significant group by time interaction (p < 0.05) and with no change noted on akathisia. Change of DHEA blood levels was negatively associated with change of Parkinsonism (p < 0.05) as well as with change of total EPS ratings (p < 0.05). DHEA appears to demonstrate a significant effect on EPS, with improvement observed particularly in Parkinsonian symptoms.