Iulian Iancu

Beer Yaakov Ness Ziona Mental Health Center · Yavne Mental Health Center

This study examines the relationship between psychiatrists׳ fear of death and negative emotions toward patients with borderline personality disorder (BPD). A survey (N=120) demonstrated that fear of death is associated with stronger negative attitudes toward BPD patients, after controlling for attitudes toward suicide. Our findings emphasize the im...

Background While electroconvulsive therapy (ECT) has been used for many years, there is insufficient research regarding the indications for continuation/maintenance (C/M)-ECT, its safety and efficacy, and the characteristics of patients with schizophrenia or schizoaffective disorder who receive multiple ECT sessions. The aims of this study were to...

Background Attrition from mental health clinics is afrequent problem and has significant consequences for patients, families andfor the society. It has rarely been researched in Israel. We examined rates of attrition from 5 mentalhealth clinics and its reasons, from the perspective of dropouts and ofdirectors of psychiatric clinics and services. M...

Background Negative attitudes towards patients with borderline personality disorder (BPD) may affect their treatment. We aimed to identify attitudes toward patients with BPD.Methods Clinicians in four psychiatric hospitals in Israel (n¿=¿710; psychiatrists, psychologists, social workers and nurses) were approached and completed questionnaires on at...

Background: Negative attitudes towards patients with borderline personality disorder (BPD) may affect their treatment. We aimed to identify attitudes toward patients with BPD. Methods: Clinicians in four psychiatric hospitals in Israel (n = 710; psychiatrists, psychologists, social workers and nurses) were approached and completed questionnaires on...

Social Anxiety Disorder (SAD) is characterized by fear and avoidance in social situations where one perceives being in danger of scrutiny by others. Low self-esteem' low self-efficacy, high self-criticism and high dependency are additional potential features of SAD, and thus their examination is warranted, as is the elucidation of their inter-relat...

Social Anxiety Disorder (SAD) has been repeatedly shown to be very prevalent in the Western society and is characterized by low self-esteem, pessimism, procrastination and also perfectionism. Very few studies on SAD have been done in the Middle East or in Arab countries, and no study tackled the relationship between social anxiety symptoms and perf...

Social anxiety disorder is a mental condition with anxiety and avoidance in social settings and is frequently accompanied by self-medication with alcohol. Epidemiological studies demonstrate that the risk that patients with social anxiety disorder will develop alcohol dependence is more than two-fold. We will discuss epidemiological research findin...

Objective: The tendency of patients with high levels of anxiety to easily recall threatening stimuli has not been examined in relation to dental anxiety. The current study was aimed to examine the effect of pre-treatment anxiety levels and of information given prior to dentistry surgical procedures on free recall of threatening words. Methods: F...

Subjects with Social Anxiety Disorder (SAD) are characterized by low self-esteem, pessimism, procrastination and also perfectionism.Objectives To examine the link between social anxiety and perfectionism and to evaluate cultural differences on these measures.AimsTo improve our understanding on cultural factors, anxiety disorders and personality fea...

The process of emotion recognition is thought to be negatively biased in social anxiety disorder (SAD). Ways to change this bias are needed. Forty one individuals afflicted with moderate SAD and 39 healthy controls were recruited to participate in this study. All subjects performed a vocal improvisation recognition task and half of them underwent t...

The effects of antidepressant medication on suicide risk remain unclear. This study explores any association between antidepressant medication and suicide attempts leading to hospitalization in adult depressed patients.The medical records of 103 patients admitted after a suicide attempt were examined and compared with those of a matched control gro...

There is growing evidence that individual differences among patients with major depressive disorder (MDD) on psychological and demographic measures may predict the therapeutic response to selective serotonin reuptake inhibitors (SSRIs). In this retrospective chart review, 108 outpatients with current major depressive episodes were treated with cita...

Background Social Anxiety Disorder has been repeatedly shown to be very prevalent in the Western society with prevalence rates of 10% or above. However, very few studies have been performed in the Middle East and in Arab countries. Methods Three hundred Israeli students participated in our study and were administered the Liebowitz Social Anxiety S...

Chronic treatment with selective serotonin reuptake inhibitors (SSRIs) reduces the risk and severity of cardiovascular diseases. SSRIs block the serotonin transporter, thereby inhibiting serotonin (5-HT) uptake into presynaptic neurons as well as into platelets where 5-HT is stored in dense granules. When 5-HT is released in response to agonists it...

Social anxiety disorder (SAD) is characterized by marked anxiety about social or performance situations in which there is a fear of embarassing oneself under scrutiny by others. It is a common disorder with early onset, significant comorbidity and functional impairment. Despite the growing understanding of the condition, information is lacking on e...

Background: A series of epidemiological, clinical and laboratory findings suggest an autoimmune process in schizophrenia and include, among others, high titers of various autoantibodies in the sera of patients. Antiribosomal P antibody is known to exist in systemic lupus erythematosus (SLE) patients with a psychiatric presentation, including psych...

Background: Social Anxiety Disorder (SAD) is characterized by fear and avoidance in social situations where one is exposed to scrutiny by others. It is possible that automatic thoughts either cause the disorder or maintain it, and thus their examination is warranted. Method: 30 SAD subjects diagnosed with the MiniInternational Neuropsychiatric I...

Our aims were (1) to develop 2 inventories for the measurement of cognitive and emotional attitudes toward borderline personality disorder (BPD) patients and their treatment and (2) to use these tools to understand and compare attitudes of psychiatrists, psychologists, and nurses toward BPD patients. Two lists of items referring to cognitive (47 it...

Antidepressant medication treatment has been associated with improvement in negative symptoms in patients with schizophrenia. In this study, we evaluated the efficacy of escitalopram for the treatment of negative symptoms in patients with schizophrenia. Under double-blind conditions, 40 patients with chronic schizophrenia were randomized to add-on...

Impulsivity has been shown to be a major variable in the etiology of suicide and aggression, but has not been researched as much in the schizophrenic population, which is characterized by serious suicide and aggression risks. 68 male schizophrenia patients responded to a battery of measures including the Positive and Negative Syndrome Scale (PANSS)...

The present study aimed to explore the association between stressful life events (LEs) and the development of affective psychopathology. Thirty patients with unipolar disorder and 30 patients with bipolar disorder were compared to 60 matched healthy controls in regard to the rate of stressful LEs. Assessment measures included the Beck Depression In...

According to the current standard of practice in modern medicine, medical decision-making is often forced to comply with stipulations of the insurance provider. In the field of psychiatry, there has been a trend of shortened psychiatric hospitalizations which some have suggested may be due to pressures related to insurance coverage. In Israel, sold...

Blunted, inappropriate affective-social behavior is a hallmark of early schizophrenia, possibly corresponding to reduced ability to recognize and express emotions. It is yet unknown if this affective deficiency relates to disturbed neural sensitivity to facial expressions or to overall face processing. In a previous imaging study, healthy subjects...

Despite the significant progress that has been achieved in the treatment of OCD, 20-30% of patients with OCD are still resistant to treatment. Also, whereas some patients respond very well, others exhibit only partial responses. The treatment of these patients usually requires higher doses and takes longer. In the treatment of resistant cases, it i...

Neurobiological research has shown the potential involvement of serotonergic, dopaminergic and opioid dysfunction in the pathophysiology of pathological gambling. In this review, we present current theories of the neuropathology of pathological gambling, paying particular attention to the role of the neural circuitry underlying motivation, reward,...

Physical activity is an important aspect of good health for everyone, and is even more important for psychiatric patients who usually live an unhealthy lifestyle, and take medications that tend to reinforce the metabolic syndrome. This article presents research dealing with the efficacy of physical activity in treating different psychiatric problem...

This study aims to show that the specific use of sad music in patients with major depressive disorder can circumvent the verbal barrier they typically experience when asked to express their emotions.We examined the effect of four emotionally distinctive types of music (i.e. happiness, fear, anger, and sadness) on 14 hospitalized patients with major...

Providing treatment and support to special-needs populations can decrease psychopathology and suicide rates. Because service in the military is an important socializing force in Israeli society and most Israelis serve, the Israeli Defense Forces (IDF) makes special efforts to identify, treat, and support soldiers with emotional, behavioral, and cog...

Selective serotonin reuptake inhibitors (SSRIs) are currently considered as the first drug of choice in the treatment of panic disorder (PD). The aim of this long-term, naturalistic comparison study was to compare 4 SSRIs with respect to tolerability and treatment outcome of PD. Outcome measures included relapse rates and adverse effects. Two hundr...

Neurobiological research has shown the potential involvement of serotonergic, dopaminergic and opioid dysfunction in the pathophysiology of pathological gambling. In this review, we present current theories of the neuropathology of pathological gambling, paying particular attention to the role of the neural circuitry underlying motivation, reward,...

Self-injurious behaviours (SIBs) are widespread among prisoners and are sometimes classified as potentially calculated acts intended to control others. Access to a psychiatrist may be valued by imprisoned soldiers seeking immediate release from service. The main goal of the study was to assess the effects of a new mental health regulation in the Is...

The Internet provides inexpensive, interesting and comfortable recreation, but sometimes users get hooked. Thus, the computer-internet addiction concept has been proposed as an explanation for uncontrollable and damaging use. Symptoms of addiction could be compared to other addictive behaviors such as pathological gambling, kleptomania, trichotillo...

Schizophrenia patients display an extremely high rate of smoking. Neurosteroids appear to play a possible role in the pathophysiology and management of schizophrenia and have been proposed to be involved in the pathophysiology of nicotine addiction. Although many studies have evaluated blood levels of neurosteroids in schizophrenia patients, only a...

Specific phobia is a very prevalent disorder with high comorbidity rates. The aim of this study was to assess prevalence of specific phobia symptoms in a sample of Israeli young adults. Eight hundred fifty young Israeli soldiers participated in the study. Measures included a questionnaire on specific phobias and a socio-demographic questionnaire. D...

Pathological gambling is classified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition as an impulse-control disorder. In the International Classification of Diseases of the WHO, pathological gambling is coded under the heading of 'Habit and Impulse Disorders'. Pathological gambling is a chronic, progressive disorder, which h...

Affective disorders are a major cause of morbidity and disability among middle-aged and older people. Thus, the prophylaxis of both unipolar depression and bipolar disorder in this patient subpopulation is an important task of psychiatrists and other physicians. Although lithium remains an effective prophylactic and treatment agent in younger indiv...

Social phobia (SP) is a highly prevalent disorder in Western countries, but is rather rare in Eastern societies. Prevalence rates range from 0.5% in Eastern samples up to 16% in Western studies. Its prevalence in Israel, an Asian state characterized by Western culture, has not yet been studied. The present study aimed to assess the prevalence of SP...

This study assessed the beliefs and cognitions of bus-train collision survivors, 7 years following the accident. The sample consisted of 389 young adults who were adolescents at the time of the disaster. The sample was composed of 4 groups who differed in their levels of exposure to traumatic stress. Results indicated that (a) exposure to the traum...

Schizophrenia patients display a high suicidal risk, although this risk is difficult to predict. One of the variables associated with increased suicide risk is smoking. In the present study, we assessed the suicidal risk in schizophrenia patients, smokers and nonsmokers. We also evaluated the impact of various variables such as psychotic symptoms,...

The aim of this naturalistic follow-up study was to examine the effect of pregnancy as a predicting factor of relapse in patients with panic disorder (PD). Eighty-five female patients with PD (between the ages of 20 and 35 years) were included in this study. They were divided into 2 groups based on whether the onset of PD had been during pregnancy...

Eating disorders have been reported to increase in frequency, but it is yet unclear what psychological characteristics increase the proneness toward the development of eating disorders. Alexithymia (AL; a difficulty in awareness to one's emotions) and dissociation proneness are 2 such plausible features. In this study, we evaluated the efficacy of...

Caffeine is considered to be the most commonly used psychoactive drug in the world and about 80% of adult individuals use caffeine-containing foods and beverages. Coffee is a powerful stimulant and its popularity results from this quality. Due to its ubiquitous use and presumably magical effects, caffeine has been suggested as an important factor i...

Brain vesicular monoamine transporter 2 (VMAT2) has a critical role in the regulation of monoaminergic neurotransmission. In our previous study we have found decreased platelet VMAT2 density in healthy habitual smokers. Schizophrenia is associated with high rate of cigarette smoking. In the present study we assessed platelet VMAT2 pharmacodynamic c...

Background: Despite the previously accepted notion that panic disorder (PD) is rare in the elderly, recent data have shown that late-life PD may be more common than previously thought. Paroxetine is a selective serotonergic reuptake inhibitor which has had clear efficacy in the treatment of PD in the general adult population. In this study we aimed...

The assessment of various symptoms in schizophrenia has received much interest, although few studies have compared evaluations by clinicians to those of their patients. Self-report tools may improve service delivery, data collection, and possibly also treatment adherence. We constructed the Positive and Negative Symptoms Questionnaire (PNS-Q), a se...

The threat of the potential spreading of the SARS epidemic caused significant stress to many individuals from non-affected countries. In this study, we investigated whether the SARS threat affected the subjective mood and behavior of Israeli patients with schizophrenia and compared their reactions with those noted in their clinical staff. Subjects...

Background: Recent studies have examined the proper role of benzodiazepine pharmacotherapy in the treatment of Panic Disorder (PD). The purpose of this naturalistic outcome study is to evaluate the possible clinical benefits and safety of paroxetine/ clonazepam combination therapy in the acute treatment phase (weeks 1-16) of PD. We also compare the...

To compare long-term lithium patients who developed renal insufficiency (RI) with those who did not, and to examine what characterized these groups. One hundred fourteen subjects with DSM-IV bipolar, major depressive, or schizoaffective disorder who had been taking lithium for 4 to 30 years from 1968 to 2000 were studied retrospectively. Subjects w...

Kleptomania, defined by DSM-IV as the inability to resist the impulse to steal objects which are not needed for personal use or for their monetary value, may reflect a form of obsessive-compulsive spectrum disorder and/or affective spectrum disorder. Twenty-one kleptomanic patients and 57 first-degree relatives completed a semistructured DSM-IV-bas...

Panic disorder is one of the most common anxiety disorders and has a lifetime prevalence of 3-5%. Panic attacks can begin at any age, but commonly have their onset in early adulthood between the ages of 20 and 40 years. Naturalistic data has shown that panic disorder has a chronic and relapsing course. Panic disorder is reported to be associated wi...

Rumination is a rare and complex disorder to treat. It involves repeated regurgitation, rechewing and reswallowing of food and occurs mainly among infants and mentally retarded children. Among adolescents and adults it is rather rare, but still might cause significant sequelae (depression, other eating disorders and social problems). We provide a d...

This naturalistic open label follow-up study had three objectives: 1) To observe the course of illness in Panic Disorder patients receiving long-term versus intermediate-term paroxetine treatment, 2) To compare the relapse rates and side-effect profile after long-term paroxetine treatment between patients with Panic Disorder and Panic Disorder with...

IntroductionAntidepressant or Antiobsessional?Clomipramine (CMI)Selective Serotonin Reuptake Inhibitors (SSRIs)Drug DosageSide Effects of Antiobsessional MedicationsOnset of Treatment ResponseLong-term ApproachSpecial ConditionsTreatment-resistant OCDSummaryReferences Pharmacotherapy of Obsessive-compulsive Disorder: Accomplishment, Unanswered Ques...

The authors assessed the attitudes of military physicians and mental health officers regarding the phenomenon of malingering. Questionnaires on attitudes regarding malingering and possible cues indicative of deception were sent to 115 general practitioners (GPs) and mental health officers (MHOs) in the Israel Defense Forces (IDF). 91 responses were...

Depression is a common, under-recognized disorder that causes a great burden on the individual, the family and the community. Depressive symptomatology has serious effects on the psychological and medical condition of patients, and also disrupts their well-being and daily activities. The aim of the present study was to investigate the prevalence of...

The current psychiatric literature emphasizes the important risk factors of suicide and parasuicide, which include the following: age, family status, psychopathology, substance abuse, biological markers and so forth. Recently, more emphasis has been placed on the yearly distribution of suicide and parasuicide. This distribution includes parameters...

Selective serotonin reuptake inhibitors (SSRIs) are currently the first-line treatment for panic disorder, although up to 30% of patients either do not respond to SSRIs or withdraw due to adverse events. Reboxetine, a selective norepinephrine reuptake inhibitor (selective NRI), is effective in treating depression and may alleviate depression-relate...

Antiepileptic drugs might be effective in the treatment of patients with Posttraumatic Stress Disorder, a condition with unmet pharmacologic needs. We review the literature on the efficacy and tolerability of antiepileptic drugs in Posttraumatic Stress Disorder, both case reports and open studies, as well as controlled studies if available. The res...

Schizophreniform disorder (SFD) has an unclear diagnostic and prognostic status within the psychotic spectrum. We studied 36 inpatients admitted to our ward between 1983 and 1993 due to SFD. The patients were contacted an average of 12 years after index hospitalization, and we noted the course of their illness, as well as their present diagnosis. O...

The aim of our study was to evaluate the effectiveness of a self-information booklet (SIB) in decreasing anxiety and panic attacks in Panic Disorder (PD) patients. Eighty-four patients attending an outpatient clinic due to panic disorder were randomly chosen to receive paroxetine with/without a friendly-designed brochure. Follow-up was done by a ma...

Obsessive-compulsive disorder (OCD) is a common, chronic, and disabling disorder characterised by obsessions and/or compulsions. These symptoms are ego-dystonic and cause significant distress to patients and their families. Up until the early 1980's, OCD was considered a rare, treatment-refractory, chronic condition, of psychological origin. Since...

Until about thirty years ago, obsessive-compulsive disorder was considered to be a treatment-refractory disorder. Dynamic psychotherapy was of little benefit and several pharmacological treatments were attempted without much success. The introduction of clomipramine (CMI) in the 1960s and of the selective serotonin reuptake inhibitors (SSRIs) in th...

The well-established finding that patients with obsessive-compulsive disorder (OCD) respond to a particular group of drugs – serotonin reuptake inhibitors (SRIs) – which have specific effect on the activity of the serotonergic neurotransmitter system, has changed the outlook for OCD sufferers. Since the early 1980s, several potent SRIs have been st...

To evaluate the prevalence of suicidal behavior in patients with panic disorder (PD) and to study the role of alexithymia (AL), an affect component, as a predictor of suicidal behavior in PD, we compared 42 patients with PD with or without agoraphobia with 24 healthy controls with regards to depression, AL and suicide risk. Only 5% of the PD patien...

Preventive intervention after exposure to traumatic events is a subject of increasing interest among mental health professionals. Psychological debriefing, which aims to reduce the risk of posttraumatic stress disorder and other psychopathological sequelae of traumatic experiences, is an example of such an intervention. The authors review the histo...

An emerging literature suggests that posttraumatic stress disorder (PTSD) patients are at an increased risk for suicide. The objective of this study was: a) to reexamine the relationship between PTSD and suicide by comparing suicide risks of persons with PTSD, to persons with anxiety disorder and to matched controls; and b) to examine the relations...

Up to the early 1980s, obsessive-compulsive disorder (OCD) was considered a treatment-refractory, chronic condition of psychological origins. The management of OCD consisted of dynamic psychotherapy, which was of little benefit, and several pharmacological treatments which had been tried without much success (Salzman and Thaler 1981). However, two...

The objective of this study was to determine the efficacy of pindolol as an augmentor of fluoxetine in treatment-resistant panic disorder (PD). Twenty-five outpatients having PD with or without agoraphobia were included. These patients had not responded to two different trials with antidepressants and an 8-week trial of fluoxetine 20 mg/day. Treatm...

To evaluate the efficacy of pindolol augmentation in treatment-resistant obsessive compulsive disorder (OCD) patients who were unsuccessfully treated with serotonin reuptake inhibitors. Fourteen treatment-resistant OCD patients were treated with paroxetine for 17.4+/-2.1 weeks up to 60 mg/d after they failed at least two other serotonin reuptake in...

Bis in die frühen 8oer Jahre des 20. Jh. hinein hat man Zwangsstörungen als eine behandlungsresistente chronische Erkrankung psychischen Ursprungs angesehen. Die Versorgung von ZwangsstOrungen erfolgte iiber eine dynamische Psychotherapie, die von geringem Nutzen war, und durch verschiedene pharmakologische Behandlungsverfahren, mit denen ohne viel...

Kleptomania is an impulse control disorder and that can be treated with the combination of pharmacotherapy and psychotherapy. The most common drug regimens include antidepressants, especially SSRIs and mood stabilizers. However, the low efficacy rates with these drugs urge research for new treatment regimens. Natrexone, an opioid receptor antagonis...

Although negative affect in general has been widely associated with suicide, the role of specific emotions and affect features in depression and suicidality is unclear. This study examined the potential of three major components of the affect structure as predictors of suicidal behavior. Twenty suicidal depressed (SD) inpatients were compared with...

To compare the efficacy of clomipramine hydrochloride (CMI), a serotonin reuptake inhibitor with the noradrenergic tricyclic antidepressant agent, and desipramine hydrochloride (DMI) for patients with panic disorder (PD). Following a 2-week, single-blind placebo washout phase, 17 PD outpatients completed a 16-week, double-blind, crossover compariso...

Kleptomania is characterized by an irresistible impulse to steal objects not needed for personal use or for their monetary value. Several recent case reports have shown that Serotonin Specific Reuptake Inhibitors (SSRIs) could be effective in the treatment of kleptomania just as it is in other obsessive-compulsive spectrum disorders. We report five...

Labetalol, a combined alpha- and beta-adrenergic blocker is often used to attenuate the transient increases in heart rate and blood pressure that accompany electroconvulsive therapy (ECT). It has been suggested that labetalol should not be administered during ECT without the protection provided by anticholinergic medications, because of its potenti...

This study reexamined the often cited inverse relationship between cholesterol levels and suicidality in major depressive and panic disorder outpatients. The cholesterol levels of 50 depressed and 53 panic disorder psychiatric outpatients with or without agoraphobia were compared. Patients were matched for their suicide history and demographic back...

Posttraumatic stress disorder (PTSD) was associated in the past mainly with combatrelated events. This was reflected in the names given to the disorder, ie, “shell shock,” “soldier's heart,” “combat neurosis,” and “operational fatigue.” Only following the realization that PTSD can be related to all types of traumatic events, including noncombat ass...

We present a patient with gradual development of camptocormia, three years before a non-Hodgkin's lymphoma was diagnosed. Lymphomas are known to produce neuromuscular symptoms through several indirect mechanisms. Recent studies regard camptocormia as a primary disease of the paravertebral muscles. To our knowledge this is the first report associati...

One of the central tenets of the Druze religion is the transmigration of the soul. In rare cases this belief may be related to psychopathology or cause a temporary inability to function normally. We report on 5 Druze patients whose preoccupation with transmigration was the basis of their pathological behavior. These cases illustrate the interaction...

In an open-label study, famotidine was added to the regular neuroleptic regimen of 11 schizophrenic patients for 4 weeks. Each patient was scored weekly with SAPS, SANS, CGI and HAM-D-17 scales. The results suggest that famotidine is indeed effective as an adjunctive drug to neuroleptics in the treatment of schizophrenia.

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Tardive dystonia is a disorder characterized by abnormally sustained posturing associated with the use of dopamine-receptor blocking agents such as antipsychotic drugs. However, the structural pathologic and pathophysiologic features of this disorder are unknown, and no consistently effective pharmacologic treatment is available. Patients with tard...

Resumen En un estudio abierto, se añadió famotidina al régimen neuroléptico regular de 11 pacientes esquizofrénicos durante 4 semanas. Se evaluó a cada paciente semanalmente con las escalas SAPS, SANS, CGI y HAM-D-17. Los resultados indican que la famotidina es verdaderamente efectiva como fármaco adjunto para los neurolépticos en el tratamiento de...