Henry Szor

Survey of patient satisfaction in adult psychiatric outpatient clinics.

A client satisfaction survey was undertaken in two adult psychiatric outpatient clinics. The anonymous self-report questionnaire covering demographic, setting and satisfaction with service variables was endorsed by 203 participants. The mean age of the subjects was 42.5 +/- 19 years, with a small majority (58.6%) of females. Overall satisfaction with psychiatric care was high (79.8%). None of the demographic or setting variables correlated significantly with satisfaction. Psychoeducation was significantly correlated with level of satisfaction with services. These findings further emphasize the importance of psychoeducation by service providers in mental health.

The Loneliness of the Therapist in the Public Outpatient Clinic

The therapists work in a public outpatient clinic is a unique combination as an individual and as a team member. Although the therapist may enjoy working within a team framework, sharing common goals and providing support and supervision, when he feels this environment failing to help or becoming critical, he may begin to experience loneliness. Individual psychotherapy occasionally evinces feelings of loneliness. The therapist has to contend with his patients powerful feelings and try to contain them. We examined issues of loneliness, teamwork, and “burnout” during open meetings with the staff of three outpatient clinics. In addition, 50 questionnaires were sent to the therapists. Thirty-one were answered anonymously. Most of the therapists (80%) reported interest and enjoyment in their work with only 15% reporting tension and feelings of “burnout.” In the Pearson statistic correlation, there was a significant relationship between satisfaction at work and the lack of loneliness (p < 0.01). There was an inverse statistical correlation between satisfaction and “burnout” (p < 0.01) and a connection between staff meetings and not feeling lonely (p < 0.05). We found that the therapist in the outpatient clinic does not feel lonely. The staff meetings and consultations support him as a team member. A disparity was found between feelings felt at the open meetings and those in the questionnaires. Although the therapist is satisfied with his work, problems of overload and the danger of “burnout” are always present. It should be noted that clinic administrators should pay close attention to the entire picture.

Hoarding-What does it mean?

Collecting is a normal phenomenon, in contrast with pathological collecting, or hoarding. Is hoarding a different phenomenon, or an extreme aspect existing on the same spectrum of behavior? How may these phenomena be understood when they are part of everyones repertoire on one hand, but may be symptomatic of a grave disturbance on the other hand. An overview and a discussion of hoarding are presented.

Holocaust survivors hospitalized for life: the Israeli experience.

The Holocaust was the most traumatic experience to occur in the 20th century. The present study aims to assess elderly Holocaust survivors in a long-stay psychiatric setting. Data concerning hospitalized survivors were gathered from medical records, repeated interviews (Structured Clinical Interview for DSM-III [SCID]) with patients, and family interviews. Subjects were all inpatients at Israels largest psychiatric hospital, Abarbanel Mental Health Center. Patients hospitalized in the same setting who did not undergo the Holocaust were the comparison group. Of the centers 670 beds, 74 (11%) are designated for psychogeriatric patients. Forty-four (59.5%) patients in the psychogeriatric section are Holocaust survivors. There were 41 women and three men in our series. Mean age of the group was 76.2 years (range, 54 to 92). The most frequent diagnosis was schizophrenia (22 of 44). Nearly 30% had been hospitalized chronically since the Holocaust. Mean current hospitalization time was 11.2 years (range, 1 to 45). The frequent diagnosis in the comparison group was also schizophrenia (20 of 30), but indexes of chronicity were more favorable. The severity and the chronic, deteriorating course of illness in this subgroup of survivors may be due to the massive life-long psychologic disintegration imposed by the Holocaust.

The Impact of the Gulf War on the Mental Health of Schizophrenic Patients

The Gulf War, which took place during January-February 1991, strongly affected the lives of Israeli civilians. The missiles that landed on the home front were a threat to the entire civilian population, thus differentiating the Gulf War from prior Israeli wars (Danon and Shemer 1991). This was similar to the London blitz during World War II (Scoville 1942).

Screening for Human T-cell Lymphotrophic Virus type-I (HTLV-I) infection in high risk schizophrenic patients

The Mashhadi-Jewish community originating in Iran is a closed and ethnically segregated population with a unique history and a high rate of intra-familial marriage among its members. High infection rate (23%) by Human T-Lymphotrophic Virus type-I (HTLV-I) was found in this population. The known modes of HTLV-I transmission are by sexual intercourse, from mother to child in breast milk, via blood transfusion, and by sharing of needles by parenteral drug users. In the present study we examined the presence of HTLV-I infection in high-risk psychiatric patients of Iranian origin in order to evaluate the infection rate in socially isolated subjects. We screened and examined all (N=42) Iranian-born schizophrenic patients in our center, of whom 17 were Mashhadi subjects (7 females, 10 males, mean age 48.7±13.2 years), and 25 were born in Iran in other cities than Mashhad (12 females, 13 males, mean age 43.2±11.9). Blood samples were tested for HTLV-I antibodies by particle agglutination test. The polymerase chain reaction (PCR) was used to detect HTLV-I proviral DNA sequences from peripheral blood mononuclear cells. One Mashhadi-born Jew (5.9%) was seropositive and PCR-positive for HTLV-I. None of the schizophrenic non-Mashhadi Iranian subjects was positive for HTLV-I by either method. This infection rate in schizophrenic patients of Mashhadi origin is significantly lower than rates reported for the normal Mashhadi community. We suggest that the relative isolation imposed by the stigma associated with mental illness and recurrent psychiatric hospitalizations serve to protect this sub-group from HTLV-I infection.

Maintaining schizophrenic patients on benzodiazepines

The role of benzodiazepines (BZDs) in the treatment of schizophrenia is widely researched since the sixties. Nevertheless the role of BZDs as sole agents for the maintainance phase in pharmacotherapy of schizophrenic patients received little attention. We have conducted a retrospective review of all medical records of ambulatory schizophrenic patients in an out-patient setting receiving only BZD maintainance treatment. Three factors characterized these patients: long duration of illness, few hospitalizations and a relatively low dose response to BZDs.