Gil Zalsman

• MD, MHA, BSc
• Professor (Full) at Tel Aviv University

Background Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally. Methods We identified suicide data from official pu...

Objectives In the next decades, many countries will become ‘ageing societies’. This combined with the current high rates of suicide in later life suggests that many older adults may die by suicide before clinical trials can be conducted to demonstrate the best approaches to prevent late-life suicide. Methods A New Zealand (NZ) ‘expert panel’ has r...

Background and Goals Suicide attempts occur mostly during adolescence and are much more frequent in females than in males, although males tend to commit suicide more often than females. This study aims to examine the association between female gender, gender conflict, depression, stress and suicide attempts in adolescent girls. Methods Participant...

The purpose of the current study was to explore whether depression symptoms mediate the relationships between perceptions of social support from three sources; namely parents, teachers, and peers, and non-suicidal self-injury (NSSI) and suicidal ideation. We also tested the interactions between the different sources of support. Focusing on the Arab...

Objectives: The COVID-19 pandemic and aligned social and physical distancing regulations increase the sense of uncertainty, intensifying the risk for psychopathology globally. Anxiety disorders are associated with intolerance to uncertainty. In this review we describe brain circuits and sensorimotor pathways involved in human reactions to uncertain...

Several lines of evidence indicate that immune-inflammatory alterations are widely observed in various mental disorders. Genetic syndromes with high risk of psychiatric disorders may constitute a model for studies investigating this phenomenon. One of such genetically determined neurodevelopmental disorders is the Prader–Willi syndrome (PWS). There...

Background A COVID-19 pandemic-related rise in suicide rates has been predicted due to social isolation, fear, uncertainty, economic turndown and grief. Detecting an increase in suicide rates is difficult in the absence of real-time data. Alternative data sources for such trends in psychopathology and suicidal behavior must be sought. Methods Data...

The COVID-19 pandemic brought about a global crisis, with profound implications on public mental health. The current review focuses on the impact of the pandemic on the mental health of mothers and their infants during pregnancy and shortly after delivery. Literature shows that in similar disaster situations, mothers’ stress reaction and mental hea...

Introduction Depression and anxiety have been associated with type 2 diabetes mellitus and metabolic syndrome, major causes of cardiovascular morbidity and mortality. The effect of antidepressants in this association is unknown. This study aimed to examine the association between adherence to selective serotonin receptor inhibitors (SSRIs) and all-...

Summary Background The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. Methods We sourced real-time s...

Suicide research involves a difficult ethical challenge: how to keep participants' safe without compromising their privacy. This challenge becomes even more difficult in contemporary research that relies on data from anonymous users of web-based crowdsourcing platforms (e.g., Amazon's Mechanical Turk). To address this ethical challenge, a consortiu...

Objective Deliberate self-harm (DSH) is a major health concern among adolescents, and is often associated with the need for inpatient psychiatric hospitalization. The aim of this study was to identify clinical and demographic characteristics associated with DSH behavior among adolescents admitted to an acute psychiatric inpatient unit. Method We r...

The existence of physical disorders and disabilities has been associated with suicidal behaviour among adults. Though relatively less often studied in children and adolescents, a growing body of evidence supports a similar link in this population as well. This text describes recent studies on suicidality among young patients with diabetes mellitus,...

The coronavirus (COVID-19) pandemic presents us with unusual challenges to the global health system and economics. The pandemic may not have an immediate impact on suicide rates, however, given that it is likely to result in a confluence of risk factors for suicide and economic crisis, it is highly possibly that it will lead to increases in suicide...

Introduction: The spread of epidemics resulting in many deaths has been known since the dawn of civilization, for example, the typhus and smallpox epidemics and the plague. Early in the previous century there was an outbreak of the Spanish Flue and towards the end of the 60's, the AIDS epidemic (HIV). Since the start of the current century, severa...

Introduction: In January 2020, the World Health Organization (WHO) declared an international emergency due to the outbreak of COVID-19. In March 2020 the WHO announced that the epidemic could be characterized as a pandemic. Subsequently, the WHO acknowledged the importance of providing support to the medical teams, realizing the enormous burden an...

Methylphenidate (MPH) is a common and effective treatment for attention deficit hyperactivity disorder (ADHD), but little is known about the relationship between early childhood intake of MPH and onset of antidepressant treatment during adolescence. The study aimed to examine whether adherence to MPH during early childhood predicts the initiation o...

Background: Depression and anxiety are common in cancer and antidepressants (AD) are efficacious treatment. The relationship between AD adherence and mortality in cancer is unclear. This study aimed to evaluate the association between adherence to AD and all-cause mortality in a population-based cohort of patients with cancer. Materials and metho...

Background: There is an ongoing debate on the effectiveness of suicidal behavior prevention measures in the military. The association of three widely used tools with severe suicide attempts was assessed in this setting. Methods: Thirty-nine Israeli soldiers (59% males), mean age 19 yrs., who attempted suicide during military service were divided...

Introduction: Approximately a million people a year worldwide die by committing suicide. In Israel about 500 die by committing suicide. It is the leading cause of death in youngsters below the age of 24. More than half of them have met with their primary care physician (PCP) in the month prior to suicide. Suicide is more common in males and attemp...

The study explored hypothesized mediation of social interaction skills between executive functions and social engagement among adolescents diagnosed with schizophrenia. Participants (N = 92; 62% boys; age = 16.8) were assessed four weeks after hospitalization using previously validated scales. A regression mediation analysis followed by Structural...

Objectives: Suicidality during hospitalization is a common phenomenon with potential devastating consequences. We attempted to identify risk factors for in-hospital suicidality in a high risk group of adolescent inpatients hospitalized for suicidal behaviors (SB). Methods: The database of a tertiary adolescent psychiatric ward was screened for pati...

Background and objectives: Prior studies of residual cognitive deficits in abstinent substance-use disorder (SUD) patients, exhibited conflicting reports and a substantial patient selection bias. The aim of this study was to test the cognitive function of a sample of chronic abstinent SUD patients in a therapeutic-community. Methods: The IntegNe...

The current study explores the therapeutic potential of Cannabidiol (CBD), a compound in the Cannabis plant, using both sexes of 2 “depressive-like” genetic models, Wistar Kyoto (WKY) and Flinders Sensitive Line (FSL) rats. Rats ingested CBD (30 mg/kg) orally. In the saccharin preference test, following a previous report of a pro-hedonic effect of...

Introduction: It is supposed that both antidepressants and psychotherapies work in a manner consistent with cognitive theories of depression when changing negative affective and cognitive distortions. This study evaluated changes in cognitive distortions (i.e., systematic misinterpretations of new information) and affectivity in adolescent major de...

Our traditional names for psychotropic medication classes lead to unnecessary confusion. As clinicians, we have grown comfortable with idiosyncratic names of psychotropic medications and have forgotten how unclear and misleading they can be. For example, evidence shows that serotonin reuptake inhibitors help in pediatric anxiety disorders, but a pa...

Background and purpose: Cannabidiolic acid methyl ester (HU-580) was recently shown to reduce stress-induced anxiety-like behavior in rats. The aim of this study was to examine the antidepressant effect of HU-580 in two different rat models of depression. Experimental approach: Using the forced swim test (FST), we evaluated the effect of HU-580...

This chapter will present the two suicide facilitating processes (dissociation and habituation) and their relationship to suicidal behaviour. Nearly all empirical research deals with the causes and factors of suicide, with the understanding that not everyone who is considered at risk will actually turn to suicidal behaviour. Suicide facilitating fa...

Post stroke depression is common and pervasive. In the general population, there has been some controversy that antidepressant (AD) medication is associated with premature mortality. Data is still lacking regarding the association between adherence to antidepressants (AD) and all-cause mortality. In this retrospective analysis of a population-based...

Introduction The purpose of this study was to evaluate the relationship between adherence to antidepressants (AD) and all-cause mortality in a population-based cohort of patients with Parkinson's Disease (PD). Methods From a database of more than 4 million people, 8553 patients with PD who purchased an AD at least once between the years 2008–2011...

The current study explored the relationship between non-suicidal self-injuries (NSSI) and students' perceptions of school among adolescents. A sample of 594 high-school students (54.4% male; mean age 14.96) completed validated self-reported measures. Students were divided into three groups: repetitive-NSSI (more than 6 occasions), occasional-NSSI (...

The Neuroscience‐based Nomenclature (NbN) for psychotropic drugs was developed as an alternative to the current Anatomical Therapeutic Chemical (ATC) indication‐based classification in order to provide more precise designations for this drug class. The ATC nomenclature for psychotherapeutics is limited in that it fails to specify either pharmacolog...

Child maltreatment and abuse represent the most adverse and stressful challenges that confront children in all societies that have been studied. These stressful events probably serve as pathogenic processes for the developing brain. Genetic polymorphisms have been found to interact with environmental adverse factors and result in psychopathology. N...

Community and nationwide surveys on adolescent suicidal behaviors using clinical interviews are not abundant. Rates of self-reported suicide attempts in community samples vary greatly between 1 and 20 %. In general, adolescent and parental agreement in child psychiatry practice is low, and their agreement with regard to suicidal behavior is unknown...

While there is an abundance of research pertaining to the development of anxiety disorders, there is still a dearth of knowledge regarding the development of anxiety in the general population. The objective of this study was to longitudinally explore the development of mathematics anxiety among normative middle-school students, and to identify the...

Objective: There is a lack of evidence-based diagnostic paradigms and personalized interventions for preschoolers with ADHD. This study aimed to evaluate the performance of preschoolers diagnosed with ADHD on a continuous performance test (CPT) before and after a single methylphenidate (MPH) challenge. Method: The Test of Variables of Attention (TO...

Objective: Suicide is the leading cause of death among Israeli youths but data on causes are scarce. This study used psychological autopsies of 70 Israeli school students who committed suicide during 2004-2011, attempting to determine the causes. Methods: Four narratives of the self were identified (qualitative analysis) and compared (quantitati...

Objectives: Abnormal brain connectivity has been described in depressive disorder. However, these studies are correlational or cross-sectional and their design does not examine causal relationships. We aimed to investigate structural connectivity in a genetic rat model of depression. Methods: Using diffusion tensor imaging (DTI), we reconstructe...

Background: Little is known about the role of insight and satisfaction with life in adolescent suicidal behavior. Aims: The objective of this study was to examine the relationship between suicide risk, insight, and satisfaction with life among adolescents with mental disorders. Method: A total of 30 adolescents were evaluated using self-report meas...

Background and objectives: This study aimed to examine the rates of cigarette smoking, alcohol and cannabis use among patients with pervasive developmental disorder (PDD), in order to determine whether they are relatively protected from developing substance-related addictive behaviors. Methods: This case-control study included 85 patients diagno...

Background: Many countries are developing suicide prevention strategies for which up-to-date, high-quality evidence is required. We present updated evidence for the effectiveness of suicide prevention interventions since 2005. Methods: We searched PubMed and the Cochrane Library using multiple terms related to suicide prevention for studies publ...

Objective: Despite the growing use of antidepressants and the potential grave consequences of inadequate treatment, little is known about the impact of adherence to antidepressant treatment on mortality in the general population. The objective of this study was to evaluate the association between adherence to antidepressants and all-cause mortalit...

Objectives: Until recently, it was believed that attention deficit and hyperactivity disorder (ADHD) are outgrown by the end of adolescence and the beginning of adulthood. The purpose of this review is to describe the characteristics of the disease in adults, depict comorbidities that accompany it, and expand the scope over methods of diagnosis an...

Background: Accumulating evidence suggests that cannabidiol (CBD) may be an effective and safe anxiolytic agent and potentially also an antidepressant. Aim: The objective of this study was to further examine these properties of CBD using the 'depressive-like' Wistar-Kyoto (WKY) rat, focusing on the drug's effect on anhedonia-like behaviors. Met...

Objective This study presents an initial evaluation of the psychometric properties of the Dynamic Occupation Assessment of Executive Function (DOAEF), a new tool designed to assess adolescents’ executive function (EF) in daily situations and offering two levels of mediation through the administration process. Method In the preliminary study, we te...

Early stressful life events predict depression and anxiety in carriers of specific polymorphisms and alter brain responses but brain structural phenotypes are largely unknown. We studied the interaction between short-term stress during specific time-windows and emotion-regulation using a genetic animal model of depression, the Wistar-Kyoto (WKY) ra...

Purpose: In this study we aimed to examine the outcome of children's severe psychiatric disorders from preschool into later childhood and adolescence. Method: Forty preschool children (28 boys and 12 girls) treated in a tertiary referral mental health center, evaluated at admission and 5.5 ± 1.2 years thereafter. Results: Seven (58.3%) childre...

In the Israel Defense Forces (IDF) as well as in most armies throughout the world, the leading cause of death during peace-time is suicide. This study examines emotional regulation of mental pain as a contributor to suicidal ideation in soldiers. One hundred sixty-eight IDF soldiers (aged 18-21years, 59% males) completed the following self-report q...

Impaired adherence is common among patients using antidepressant drugs (ADs). However, few studies investigated the role of age and gender in adherence to AD and finding conflict. This study aimed to determine how gender and age impact adherence to AD in a large-scale cohort. We conducted a historical cohort study (N = 310,994 individuals) that cla...

The objective of this study was to determine the long-term hematological and biochemical side effects of valproic acid (VPA) in psychiatric adolescent inpatients. A retrospective naturalistic study design was used. Participants were psychiatric inpatients treated with VPA, alone or in combination with other medications. Electronic medical files wer...

Adolescent suicidal behavior poses a major global public health concern as it is highly prevalent and associated with mortality and morbidity worldwide. Substanceuse disorders are also an issue of increasing concern among adolescents and have been shown to increase the risk for suicidal behaviors. In this review we address emerging issues in the re...

Adolescents with mental disorders are at increased risk for being overweight or obese, and subsequently developing metabolic syndrome. However, data regarding risk factors for weight gain during psychiatric hospitalization of adolescents are limited and inconsistent. The aim of this study was to investigate the sociodemographic, clinical, and pharm...

Background The use of antidepressant drugs in patients with ischaemic heart disease (IHD) has been debated owing to scarcity of data and conflicting results regarding the effect of these drugs on mortality. Aims To evaluate the association between adherence to antidepressant therapy and all-cause mortality in a population-based cohort of patients w...

Few studies have focused on the research of male suicidality. The World Health Organization estimated in 2012 the global male: female suicidality ratio to be 1:9. Some of the most often researched factors in relation to suicidality are mental health problems and especially depression. Other factors that are being suggested as possible contributors...

To study the impact of chronic, life-threatening stressors in the form of daily missile attacks, for five consecutive years, on pregnancy outcomes. Charts of deliveries from two neighboring towns in the south of Israel, covering the years 2000 and 2003-2008, were reviewed retrospectively. One city had been exposed to missile attacks, while the othe...

Objective: The aim of this pilot study was to compare the occurrence of post-traumatic stress disorder (PTSD) symptoms, major depression disorder (MDD)-related symptoms, and negative mood regulation capacities among Israeli Jewish and Arab children and their parents, all of whom had been exposed to recurrent missiles attacks during the Second Leba...

Background: Suicide is the leading cause of soldier death in the Israeli Defense Forces (IDF) in peace time. Suicide attempt (SA) and non-suicidal self-injury (NSSI) are risk factors for death by suicide in civilian studies and therefore their predictive value needs to be determined in the military. Methods: All army screening, psychometric and dem...

Objective The purpose of the current study was to assess the associations of illness perception-related variables with satisfaction with life (SwL) among adolescents with mental disorders. Methods Insight into mental disorder (SAI-E), Internalized stigma of mental illness (ISMI) and Multidimensional Students’ Life Satisfaction Scale (MSLSS) were a...

PURPOSE: While several studies have demonstrated an inverse association between religiosity and self-injurious thoughts and behaviors in Christian adolescents, the results are equivocal [1]. To date, no study has examined this relationship in a Jewish adolescent cohort. We therefore sought to evaluate whether religiosity is a protective factor agai...

Adolescence is a period of profound neurophysiological, behavioral, cognitive and psychological changes, but not much is known about the underlying molecular neural mechanisms. The aim of this study was to systematically analyze expression levels of the genes forming serotonergic and dopaminergic synapses during adolescence. We analyzed the mRNA ex...

Antipsychotic medications (APs) are a well-established pharmacological treatment in adults with serious mental health problems. However, many adult mental health disorders have their origins and onset in childhood or adolescence. The understanding that neuropsychiatric conditions of childhood are in part biologically determined, led to an increase...

Purpose: Few studies have investigated the association between religiosity and self-injurious thoughts and behaviors specifically in adolescents, yielding inconsistent results. To date, no study has examined this relationship in a Jewish adolescent cohort. Methods: Self-injurious thoughts and behaviors, as well as depression, were assessed in a...

PURPOSE: Few studies have investigated the association between religiosity and self-injurious thoughts and behaviors specifically in adolescents, yielding inconsistent results. To date, no study has examined this relationship in a Jewish adolescent cohort. METHODS: Self-injurious thoughts and behaviors, as well as depression, were assessed in...

Background: Mother-daughter relationship was the focus of studies on the development of eating disorders (ED) for many years. This study aimed to examine the association between the father-daughter relationship and ED and depressive symptoms. Methods: Fifty-three women diagnosed with ED were compared to a psychiatric control group (n=26) and to...

Objective: The purpose of this study was to determine if the known side effects of lithium in adults may be generalized to younger patients with psychiatric disorders. Methods: A retrospective naturalistic study design was used. Data were collected from the database of a tertiary pediatric medical center covering the years 1994-2010. Included we...

22q11.2 deletion syndrome (22q11.2DS) is a common neurogenetic syndrome associated with high rates of psychosis. The aims of the present study were to identify the unique temperament traits that characterize children with 22q11.2DS compared to children with Williams syndrome (WS) and typically developing (TD) controls, and to examine temperamental...

PURPOSE: Few studies have investigated the association between religiosity and self-injurious thoughts and behaviors specifically in adolescents, yielding inconsistent results. To date, no study has examined this relationship in a Jewish adolescent cohort. METHODS: Self-injurious thoughts and behaviors, as well as depression, were assessed in a nat...

This study used path-analysis to examine the assumption that the presence of mental pain in adults mediates the relationship between self-destruction, number of losses experienced in one's life, and suicidal tendency. Fifty suicidal inpatients, 50 non-suicidal inpatients and 50 healthy volunteers were assessed for self-destruction, losses experienc...

Data is progressively and robustly accumulating regarding the biological basis of autism. Autism spectrum disorders (ASD) are currently considered a group of neurodevelopmental disorders with onset very early in life and a complex, heterogeneous, multifactorial aetiology. A comprehensive search of the last five years of the Medline database was con...

Establishing a psychiatric diagnosis and assessing suicidal tendencies is often a challenging task particularly in the early stages of an illness. Cognitive impairments characterize different psychiatric entities, but there is no known specific cognitive deficit profile that could help the clinician in achieving the diagnostic task. This study's ai...

Background: The use of physical restraints or a seclusion room for the treatment of adolescents in a psychiatric inpatient setting raises ethical dilemmas. We investigated the attitudes of adolescents towards these two means of confinement. Method: We used a structured questionnaire to collect data on the attitudes of 50 adolescent patients, hos...

Marked gender differences have been identified in cigarette smoking. In this study, we aimed to identify the gender-specific emotional and behavioral disorders among adolescent smokers and their consequent utilization of mental health services. We performed a nationwide survey study of an Israeli representative sample of 906 adolescents and their m...

Background / Purpose: Gene (G) by environment (E) by timing (T) interaction hypothesis was assessed using an animal model of depression, the WKY rat, by a DTI analysis. At this stage we assessed males only. Main conclusion: We found a few areas that showed G x E x T interaction.

Objective: The purpose of this study was to evaluate the association between polymorphisms in two serotonin pathway genes and the clinical response to citalopram among children and adolescents with depression and/or anxiety disorders. Methods: Eighty-three children and adolescents with depression and/or anxiety disorders were treated with citalo...

The purpose of this discussion is to explore academics’ views on the use of reliability as a vital element to clinical trials and research. The main research question guiding this investigation is “How do academics approach the understanding of reliability as a resource in their courses and research studies?” There have been several recent attempts...

To assess the impact of lithium treatment alone or combined with other medications on TSH levels and WBC count in hospitalized bipolar and non-bipolar children, adolescents and young adults using data extracted from electronic medical records.Method The study investigated serum TSH and WBC count in lithium treated hospitalized youth, aged 12–24 yea...

Every year, suicide is among the top 20 leading causes of death globally for all ages. Unfortunately, suicide is difficult to prevent, in large part because the prevalence of risk factors is high among the general population. In this review, clinical and psychological risk factors are examined and methods for suicide prevention are discussed. Preve...

Schizophrenia in children and adolescents is a rare and serious representation of adult schizophrenia that indicates phenotypic and neurobiological continuity with the adult version of the illness. Epidemiological, genetic, cognitive and imaging findings support the centrality of the neuro-developmental model in the etiology of the disease. The dia...

Suicide is the third leading cause of death in adolescence in the United States. In addition, nonfatal forms of suicidal behavior are the most common reasons for the psychiatric hospitalization of adolescents in many countries (Center for Disease Control 1994). About 1600 youngsters, age 15–19, committed suicide in the United States in 2001; 3.4 mi...

Unlabelled: Suicide is a major public health problem in the WHO European Region accounting for over 150,000 deaths per year. Suicidal crisis: Acute intervention should start immediately in order to keep the patient alive. Diagnosis: An underlying psychiatric disorder is present in up to 90% of people who completed suicide. Comorbidity with depre...

The role of the meaning of given names has been noted in psychotherapy as well as in everyday life. This study aimed to investigate the possible association between the nature of given names of children and attention deficit hyperactivity disorder (ADHD) diagnosis. A total of 134 given names of children and adolescent patients diagnosed as having A...

In this study, we aimed to evaluate the utilization of mental health services by adolescent smokers, the presence of untreated mental disorders in this young population and the associated emotional and behavioral difficulties. We performed a nationwide survey study of an Israeli representative sample of 906 adolescents and their mothers. Mental dis...

Unlabelled: There is relatively little research addressing parent-adolescent agreement as regards to reporting on adolescent suicidal behavior in general and their behavioral and emotional difficulties in particular. The objective of this study was to compare maternal and adolescents' reports on behavioral and emotional difficulties among adolesce...