Daniela Amital

Tel Aviv University, Tell Afif, Tel Aviv, Israel

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Publications (43)145.4 Total impact

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    ABSTRACT: Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with systemic comorbidities. Recent data suggests that patients with RA have increased prevalence of the bipolar disorder. The current study investigates the association between RA and bipolar disorder. Methods: A case-control study was conducted as Patients with RA were compared with age- and gender-matched controls regarding the prevalence of bipolar disorder. Pearson χ(2) test was used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services. Results: The study included 11,782 patients with RA and 57,973 age- and gender-matched controls. The prevalence of Bipolar disorder in patients with RA was increased compared with the prevalence in controls (0.6% and 0.4% respectively, p=0.036). However, in a multivariate analysis the association between RA and Bipolar disorder was not significant, whereas smoking is positively correlated with Bipolar disorder (p<0.001). Conclusions: By univariate analysis our data implied that patients with RA have a greater prevalence of bipolar disorder than matched controls. However, our analysis suggests that this association may have been confounded by smoking status. Further research is warranted before making inferences about this association in the level of clinical practice.
    Journal of Affective Disorders 09/2015; 189. DOI:10.1016/j.jad.2015.09.058 · 3.38 Impact Factor
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    ABSTRACT: Patients with autoimmune diseases often present with olfactory impairment. The aim of the study was to assess the olfactory functions of female patients with fibromyalgia (FM) compared with patients with systemic sclerosis (SSc) and with healthy female controls. Olfactory functions were assessed in 24 patients with FM, 20 patients with SSc and 21 age-matched healthy controls. The sense of smell was evaluated using the Sniffin’ Sticks test including the three stages of smell: threshold, discrimination, and identification (TDI) of the different odors. The severity of fibromyalgia was assessed using the fibromyalgia impact questionnaire (FIQ). The short form 36 (SF-36) questionnaire was also completed in order to seek a relationship between the patients perception of quality of life and the different aspects of the smell sense. Depression was evaluated in both FM and SSc patients utilizing the Beck depression inventory-II (BDI-II) questionnaire. Patients with FM had significantly lower TDI smell scores compared with both SSc patients and healthy controls (p
    Immunologic Research 11/2014; 60(2-3). DOI:10.1007/s12026-014-8573-5 · 3.10 Impact Factor
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    ABSTRACT: Over the past years, considerable progress has been made in understanding the pathogenesis of the fibromyatgia syndrome and the evidence based approach to the diagnosis and management has been significantty extended. The purpose of the current project is to develop practicat and evidence based guidetine recommendations for the Israeli health care system. A panet of physicians with clinical and research experience in the fibromyalgia field was convened under the auspices of the Israeli Rheumatology Association. A systematic review was performed on the current literature regarding the diagnosis and treatment of fibromyalgia. Using an interactive discussion procedure, recommendations were reached and expert opinion was introduced where evidence was considered incomplete. The panel recommendations underline the importance of concomitant and integrated medical therapy, such as serotonin and noradrenaline reuptake inhibitor (SNRI) anti-depressants or gamma-aminobutyric acid (GABA) related anti-epileptics, with regular aerobic physical exercise.
    Harefuah 12/2013; 152(12):742-7, 751, 750.
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    ABSTRACT: Little is known about the extent to which a family history of major depression (MD) affects residual depressive symptoms in responder and non-responder patients suffering from MD. Nine hundred eighty-six patients with MD were recruited within the context of a large multicenter project. Information about the family history of MD, as well as about total depressive symptoms and specific depressive clusters, was collected and analyzed. No significant difference was observed in overall depressive symptoms between patients with and those without a family history of MD. However, non-responder patients with a family history of MD showed significantly higher scores in core symptoms as compared with responder patients without a family history of MD. Non-responder MD patients with a positive family history of MD could represent a slightly different sub-group of MD patients with more consistent core depressive symptoms as compared with responder patients without a family history of MD. However, taking into account the retrospective assessment of data, the use of positive or negative family history as a dichotomous indicator of familial loading and the cross-sectional design of the present study, further research is needed to draw more definitive conclusions.
    Comprehensive psychiatry 10/2013; 55(1). DOI:10.1016/j.comppsych.2013.08.002 · 2.25 Impact Factor

  • European Neuropsychopharmacology 10/2013; 23:S334. DOI:10.1016/S0924-977X(13)70525-X · 4.37 Impact Factor
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    Progress in Neuro-Psychopharmacology and Biological Psychiatry 10/2013; 46:70. DOI:10.1016/j.pnpbp.2013.07.001 · 3.69 Impact Factor
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    ABSTRACT: BACKGROUND: Patients with major depression (MD) show reduced social adjustment when compared with healthy controls. However, even among treatment responders, significant differences in social adjustment occur. The main aim of the present work is to study several socio-demographic and clinical variables possibly influencing social adjustment in MD patients who responded to treatment. METHODS: Two hundred and eleven MD patients experiencing a depressive episode who responded to their current treatment were recruited within the context of a large European multicentre project. Our primary outcome measure was the association between 19 socio-demographic and clinical variables and total social adjustment scores, as measured with the Social Adjustment Scale (SAS). Secondary outcome measures included the associations between the same variables and SAS sub-scales, and the associations between these variables and self-esteem, as measured with the Rosenberg Self-Esteem Scale. RESULTS: A co-morbidity with anxiety disorders and the severity of residual depression symptoms were the strongest independent factors associated with poorer social adjustment, in terms of total and most sub-areas' SAS scores. Other variables associated with total and sub-areas' SAS scores were identified as well, although some variations across different areas were observed. LIMITATIONS: The cross-sectional design, the retrospective assessment of data and the lack of a placebo control group. CONCLUSIONS: Our results confirm that a co-morbidity with anxiety disorders and higher residual depression symptoms could reduce social adjustment among responder MD patients. Further longitudinal studies are needed to confirm our results.
    Journal of Affective Disorders 06/2013; 150(3). DOI:10.1016/j.jad.2013.05.021 · 3.38 Impact Factor
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    ABSTRACT: BACKGROUND: Social adjustment is impaired in depressed patients. The difficulty to adjust to social circumstances has been hypothesized to be one of the causes of depression, as well as a consequence of the disorder. Genetic variation in the serotonin transporter gene has been previously associated with social adjustment levels in patients with mood disorders. METHODS: We investigated whether variations on the HTR1A (rs6295) and HTR2A (rs7997012) genes were associated with levels of social adjustment using the Social Adjustment Scale in two samples of depressed patients (total n=156). RESULTS: Patients carrying the GG genotype of the HTR2A-rs7997012 showed better social adjustment in areas of work and family unit bonding. LIMITATIONS: These findings did not survive correction for multiple testing and should be interpreted with caution. CONCLUSION: Our finding is in line with previous observations that have associated the G allele of the HTR2A-rs7997012 with higher rate of antidepressant response. The HTR2A-rs7997012 is worthy of further investigation in studies examining factors that are related to depression course and outcome.
    Journal of Affective Disorders 03/2013; 150(2). DOI:10.1016/j.jad.2013.02.036 · 3.38 Impact Factor
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    ABSTRACT: Treatment resistant depression (TRD) is a significant clinical and public health problem. Among others, neuroplasticity and inflammatory pathways seem to play a crucial role in the pathomechanisms of antidepressant efficacy. The primary aim of this study was to investigate whether a set of single nucleotide polymorphisms (SNPs) within two genes implicated in neuroplasticity and inflammatory processes (the mitogen activated protein kinase 1, MAPK1 (rs3810608, rs6928, rs13515 and rs8136867), and the cyclic AMP responsive element binding protein 1, CREB1 (rs889895, rs6740584, rs2551922 and rs2254137)) was associated with antidepressant treatment resistance (according to two different definitions), in 285 Major Depressive Disorder (MDD) patients. As secondary aims, we investigated the genetic modulation of the same SNPs on response, remission and other clinical features both in MDD patients and in a larger sample including 82 Bipolar Disorder (BD) patients as well. All patients were screened in the context of a European multicenter project. No association between both the investigated genes and treatment resistance and response was found in MDD patients. However, considering remission, higher rates of the CREB1 rs889895 GG genotype were reported in MDD patients. Moreover, MAPK1 rs8136867 AG genotype was found to be associated with remission in the whole sample (MDD and BD). Present results suggest that some genetic polymorphisms in both CREB1 and MAPK1 could be associated with treatment remission. Although further research is needed to draw more definitive conclusions, such results are intriguing since suggest a potential role of two genes implicated in neuroplasticity and inflammatory processes in symptom remission after antidepressant treatment.
    Progress in Neuro-Psychopharmacology and Biological Psychiatry 03/2013; 44. DOI:10.1016/j.pnpbp.2013.03.005 · 3.69 Impact Factor
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    ABSTRACT: Background: Adverse life events are precipitating and maintenance factors for mood and anxiety disorders. However, the impact of such events on clinical features and treatment response is still unclear. Sampling and methods: The aim of this study was to investigate whether specific adverse events (early parental loss and physical abuse) influence clinical features in a sample of 1,336 mood disorder patients, and whether genetic parameters interact with adverse events to influence treatment outcomes in a subsample of 252 subjects. Participants were collected in the context of a European multicenter study and treated with antidepressants at adequate doses for at least 4 weeks. We focused on two genes (BDNF and CREB1) due to prior evidence of association with treatment outcomes in the same sample. Results: Patients with a history of physical abuse had higher suicidal risk (including history of attempts), comorbid panic disorder, posttraumatic stress disorder and alcohol dependence compared to non-abused patients. Experience of early parental loss was a less detrimental type of life stressor. Treatment response was not affected by adverse events. No gene-environment interaction was found with genetic variations, using a corrected significance level. Conclusions: A limitation of the present study is that the subsample is too small for detecting gene-environment interactions. The clinical message of our findings is that mood disorder patients with a history of physical abuse showed a worse clinical profile, characterized by higher comorbid Axis I psychopathology and increased suicidal behavior.
    Psychopathology 02/2013; 46(6). DOI:10.1159/000345358 · 2.08 Impact Factor
  • Renana Milstein · Daniela Amital · Yoav Arnson · Howard Amital ·

    The Israel Medical Association journal: IMAJ 02/2013; 15(2):123-4. · 0.90 Impact Factor
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    ABSTRACT: Co-morbid physical illness has been suggested to play an important role among the factors contributing to treatment resistance in patients with major depressive disorder. In the current study we compared the rate of physical co-morbidity, defined by ICD-10, among a large multicenter sample of 702 patients with major depressive disorder. A total of 356 of the participants were defined as treatment resistant depression (TRD) patients-having failed two or more adequate antidepressant trials. No significant difference was found between TRD and non-TRD participants in the prevalence of any ICD-10 category. This finding suggests that although physical conditions such as diabetes, thyroid dysfunction, hypertension, ischemic heart disease, and peptic diseases are often accompanied by co-morbid MDD, they do not necessarily have an impact on the course of MDD or the likelihood to respond to treatment. Marginally higher rates of co-morbid breast cancer, migraine and glaucoma were found among TRD participants. Possible explanations for these findings and their possible relation to TRD are discussed. http://www.ariel.ac.il/research/apl/publications
    European neuropsychopharmacology: the journal of the European College of Neuropsychopharmacology 10/2012; 23(8). DOI:10.1016/j.euroneuro.2012.09.002 · 4.37 Impact Factor
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    ABSTRACT: Observations that antagonists of the N-methyl-d-aspartate (NMDA) receptor of glutamatergic neurons can mimic symptoms of schizophrenia have raised the hope that NMDA agonists can improve symptoms. On the basis of encouraging results of trials in which NMDA agonists were added to antipsychotics, we conducted an adequately powered randomized controlled trial adding d-serine, an NMDA modulator, to antipsychotics. This study was a 195-patient, multicenter, double-blind, randomized, placebo-controlled, 16-week trial of d-serine 2 g/d as an add-on treatment to antipsychotics. Subjects had DSM-IV schizophrenia or schizoaffective disorder and were inpatients or outpatients stabilized on antipsychotics, with persistent negative symptoms. The primary outcome measures were changes in negative symptoms and cognition as measured by the Scale for the Assessment of Negative Symptoms (SANS) and the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) battery, respectively. The study was performed between 2003 and 2007. Mean total Positive and Negative Syndrome Scale scores at baseline were 75.5. Subjects receiving d-serine and placebo improved in scores on the SANS and MATRICS, but no significant differences were observed between groups: improvement on SANS was 11.4% for d-serine vs 14.8% for placebo, F1,147=1.18, P=.32; and improvement on MATRICS was 6.8% for d-serine vs 6.1% for placebo, F1,125=0.96, P=.39, respectively. d-Serine was well tolerated. This study did not find a significant difference between drug and placebo. However, the results are limited by a relatively large placebo response and somewhat lower-achieved doses than in prior studies. Future studies will administer higher doses and will attempt to affect the NMDA receptor using other mechanisms, such as agonists of the presynaptic metabotropic glutamate 2/3 receptor or glycine reuptake inhibitors. ClinicalTrials.gov identifier: NCT00138775.
    The Journal of Clinical Psychiatry 06/2012; 73(6):e728-34. DOI:10.4088/JCP.11m07031 · 5.50 Impact Factor
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    ABSTRACT: The extent to which a family history of mood disorders and suicide could impact on clinical features of patients suffering from major depression (MD) and bipolar disorder (BD) has received relatively little attention so far. The aim of the present work is, therefore, to assess the clinical implications of the presence of at least one first- and/or second-degree relative with a history of MD, BD and suicide in a large sample of patients with MD or BD. One thousand one hundred and fifty-seven subjects with MD and 686 subjects with BD were recruited within the context of two large projects. The impact of a family history of MD, BD, and suicide-considered both separately and together-on clinical and socio-demographic variables was investigated. A family history of MD, BD, and suicide was more common in BD patients than in MD patients. A positive family history of mood disorders and/or suicide as well as a positive family history of MD and BD separately considered, but not a positive history of suicide alone, were significantly associated with a comorbidity with several anxiety disorders and inversely associated with age of onset. The clinical implications as well as the limitations of our findings are discussed.
    European Archives of Psychiatry and Clinical Neuroscience 05/2012; 263(7). DOI:10.1007/s00406-012-0322-y · 3.53 Impact Factor
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    ABSTRACT: On 4 February 2008, two terrorists armed with suicide bombs arrived atthe open market in the southern Israeli city of Dimona. One detonated his bomb at approximately 10:30 a.m. causing multiple casualties. Short-term emotional effects and acute stress reactions usually appear among survivors after such incidents. To compare the differences in emotions and in disturbances of daily life activities that emerge a couple of days following such an event and to identify patterns of stress development among resilient and low-resilient members of the population in Dimona and in the general population of Israel. A telephone survey of two randomly selected representative samples of adults (428 Israeli residents and 250 Dimona residents) was conducted 2 days afterthe event. A higher prevalence of stress and fear and a lower prevalence of joy were reported among the population of Dimona compared to the general population in Israel (P < 0.05). Differences were also recorded when the population of Dimona was categorized by its personal degree of resilience (P < 0.05). A higher prevalence of disturbances in daily life activities and changes in leisure activity was found in the low-resilient population in Dimona (P < 0.01). This study demonstrates that following a public terror event, self-reported low-resilient subjects have a higher prevalence of disturbances in daily life activities, as well as adverse emotional responses. These differences must be addressed by the relevant social service agencies for immediate public intervention.
    The Israel Medical Association journal: IMAJ 05/2012; 14(5):281-5. · 0.90 Impact Factor
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    ABSTRACT: Vitamin D is increasingly associated with the pathology of cognition and mental illness. Vitamin D receptors have been detected on neurons that regulate behavior. To assess vitamin D serum concentrations in patients with major depression and schizophrenia as compared to healthy controls and to determine if a correlation exists between serum levels of vitamin D and disease activity. We recruited 50 patients with schizophrenia and compared them to 33 patients with major depression and 50 controls with no major psychopathology. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia and the Hamilton Depression scale for depression were administered on the same day the blood samples were drawn. We used LIAISON 25-OH vitamin D (DiaSorin) immunoassay to measure serum concentrations of 25-OH vitamin D. Lower serum vitamin D concentrations were detected among patients with schizophrenia (15.0 +/- 7.3 ng/ml) compared to patients with depression (19.6 +/- 8.3 ng/ml) and to controls (20.2 +/- 7.8 ng/ml, P < 0.05). We found no correlation between disease activity, measured by the PANSS score, and vitamin D levels. Serum vitamin D levels were lower in patients with schizophrenia as compared to patients with depression and to healthy controls. No correlation was found between serum concentration and disease activity. Additional studies are needed to elucidate the role of vitamin D in the autoimmune mechanism and in the pathogenesis of schizophrenia.
    The Israel Medical Association journal: IMAJ 02/2012; 14(2):88-92. · 0.90 Impact Factor
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    ABSTRACT: Autoimmune and rheumatological diseases often come to mind when thinking about gender differences in medicine. While sex ratios vary among the conditions presented herein, female patients are predominantly affected by autoimmune diseases, possibly due to differences in susceptibility, hormonal influences, genetics, and exposure and response to environmental triggers. Where the male incidence is low, the diagnosis of autoimmune disease may be delayed. The clinical and serological differences among the genders are yet to be elucidated. In this chapter, we will discuss the potential biological influences on disease development, with an emphasis on the influence of gender on the clinical presentation, management, and outcomes. The diseases that will be presented are systemic lupus erythematosus (SLE), systemic sclerosis, Sjogren’s syndrome, fibromyalgia, rheumatoid arthritis, and ankylosing spondylitis.
    Sex and Gender Aspects in Clinical Medicine, 01/2012: pages 101-124; , ISBN: 978-0-85729-831-7
  • Ivy Grodman · Dan Buskila · Yoav Arnson · Arie Altaman · Daniela Amital · Howard Amital ·

    The Israel Medical Association journal: IMAJ 12/2011; 13(12):769-72. · 0.90 Impact Factor
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    ABSTRACT: Numerous studies have shown that anxiety and depression are more prevalent among patients suffering from chronic skin disorders. The aims of this study were to assess the prevalences of depression and anxiety in patients suffering from chronic skin disorders, focusing particularly on allergic skin conditions. Additionally, we investigated resilience to disease progression using the Sense of Coherence Scale. A total of 112 consecutive patients without known psychiatric disease were interviewed and asked to complete questionnaires in order to assess psychiatric symptomatology. The following scales were completed: the Mini International Neuropsychiatric Interview; the Hamilton Anxiety Scale (HAS); the Hamilton Depression Rating Scale (HDRS); and the self-administered questionnaire for the Sense of Coherence Scale (SoCS). Rates of anxiety and depression in patients with allergic and non-allergic conditions were considerably higher than those in the general population. This difference was notable in patients with allergic skin diseases, reaching 58.3 and 48.3%, compared with 15.4 and 23.1% for participants with non-allergic conditions, as measured by the HAS and HDRS, respectively (P < 0.05). Statistically significant negative correlations between scores on the SoCS and scores on the HAS (r = -0.45, P < 0.01) and HDRS (r = -0.37, P < 0.01) were observed. Our findings support the hypothesis that rates of anxiety and depression are higher among patients suffering from allergic chronic skin disorders. High SoCS scores may protect against the development of psychiatric illness in patients suffering from allergic skin disease.
    International journal of dermatology 10/2011; 50(10):1217-22. DOI:10.1111/j.1365-4632.2011.04910.x · 1.31 Impact Factor
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    ABSTRACT: Cancer patients often complain about weakness, fatigue, and pain. The aim of this study was to assess the features of the fibromyalgia syndrome (FMS) characteristics in patients with non-metastatic breast cancer. The study group included 40 women whose age ranged from 40 to 70 years with Stages 0-3 breast cancer. The control group included 40 healthy women matched by age. A diagnosis of FMS was established based on medical history, physical examination, and the Fibromyalgia Impact Questionnaire (FIQ). Pain measures and functional factors were evaluated by the Brief Pain Inventory and the Sheehan Questionnaire. Resilience was assessed by Antanovsky's Sense of Coherence Questionnaire. Psychiatric disturbances were tested by the MINI Questionnaire and Hamilton questionnaires for depression and anxiety. The prevalence of chronic pain was higher in the study group. Statistically significant differences were also found between the group regarding pain, fatigue, and functional measures. The prevalence of depressive or anxious mood, measured by the Hamilton questionnaires, was strongly related to FMS characteristics reflected by FIQ scores (r = 0.79 between FIQ and the Hamilton Depression Index and r = 0.75 between FIQ and the Hamilton Anxiety Scale). The sense of coherence measure for these patients demonstrated an inverse correlation with pain, fatigue, and functional capability. Women with breast cancer tend to develop chronic widespread pain syndromes more often than do healthy women.
    Rheumatology International 09/2011; 32(10):3017-23. DOI:10.1007/s00296-011-2104-7 · 1.52 Impact Factor

Publication Stats

436 Citations
145.40 Total Impact Points


  • 2000-2015
    • Tel Aviv University
      • • Sackler Faculty of Medicine
      • • Department of Psychiatry
      Tell Afif, Tel Aviv, Israel
  • 2013
    • Sheba Medical Center
      • Department of Medicine B
      Gan, Tel Aviv, Israel
  • 2007-2013
    • Ness Ziona Mental Health Center
      Wādi Hunein, Central District, Israel