The Israel journal of psychiatry and related sciences, 2016
This manuscript assesses the use of the Child Attachment Interview (CAI) in a sample of Israeli J... more This manuscript assesses the use of the Child Attachment Interview (CAI) in a sample of Israeli Jewish children in middle childhood in order to add to empirical data on this measure. Forty-one children between the ages of 7 and 13 were consecutively recruited to the study. The clinical sample included 29 children diagnosed with anxiety disorder, major depression or ADHD. The Father Focused Referral (FFR) sample included 12 children whose father was unavailable to them. Participants were administered the CAI and coded by certified personnel. 81.4% concordance was found between maternal and paternal secure-insecure attachment classifications in the clinical sample; 100% of the children in the FFR group were classified as insecurely attached to their fathers suggesting convergent validity for the classification of father attachment; 45.4% of the children in the FFR sample were also classified as insecurely attached to their mothers, pointing to the difference that can be found between ...
Sexual abuse has physiological and emotional implications. The purpose of this study is to evalua... more Sexual abuse has physiological and emotional implications. The purpose of this study is to evaluate the neurobiological sequels of childhood sexual trauma by monitoring physiological variables among sexually abused girls and women compared to controls. We assessed posttrauma and traumatic life events of 35 females sexually abused in their childhood (age range 7-51 years) and 25 control females (age range 7-54 years). Electroencephalography, frontalis electromyography, electrodermal activity, and heart rate parameters were recorded while watching sets of pictures representing neutral and trauma-suggestive stimuli. A minority of participants met the Diagnostic and Statistical Manual of Mental Disorders criteria for post-traumatic stress disorder. Abused females displayed significant elevations in heart rate, electromyography, and electroencephalography while viewing allusive stimuli and elevated heart rate while viewing neutral stimuli. The dysfunctional regulation of the physiological stress system associated with child sexual abuse may endanger the victims with various stress and anxiety disorders.
One hundred and six staff members and 150 patients of three psychiatric hospitals in Israel were ... more One hundred and six staff members and 150 patients of three psychiatric hospitals in Israel were administered a smoking habit and attitudes questionnaire. Upon analyzing the data, staff members and patients made up a very high percentage of smokers, 48.1 and 76%, respectively. The staff was not knowledgeable enough about the hazards of smoking. Nurses generously used cigarettes in order to appease the patients. Furthermore, the patients admitted being encouraged to smoke by the staff. According to these findings, a patient hospitalized in the psychiatric hospitals surveyed is significantly exposed to the pro-smoking atmosphere and the hazards of smoking.
Background: The study assessed the prevalence of life events (LE) in adolescents with major depre... more Background: The study assessed the prevalence of life events (LE) in adolescents with major depressive disorder (MDD, n = 19), borderline personality disorder (BPD, n = 20) and matched controls (n = 20). Methods: Assessment measures included: the Child Suicide Potential Scale, the Beck Depression Inventory, the Life Events Checklist, the Childhood Sexual Abuse Questionnaire and the Childhood Trauma Questionnaire. Results: The percentage of negative lifetime LE was significantly higher in both MDD and BPD groups than in the control group, while the opposite was true for the percentage of positive LE. No difference was detected between the groups in the number of negative LE in the year preceding their admission. The MDD group reported more death-related LE than the control group, while the BPD group reported more sexual abuse LE than the control and MDD groups. Conclusions: The present study is a cross-sectional study, and therefore, we cannot draw definite conclusions regarding caus...
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2002
Objective: Most of the data supporting the use of atypical antipsychotics (AA) is based on studie... more Objective: Most of the data supporting the use of atypical antipsychotics (AA) is based on studies in young adult patients. The present study is an open-label naturalistic follow-up study of olanzapine treatment vs. haloperidol for elderly chronic schizophrenia patients. Method: 20 patients (mean age 72.7±5.9 years, mean disease duration 33.1±12.0 years) who met the DSM-IV criteria for schizophrenia were randomly assigned to olanzapine (n=10) or haloperidol (n=10) treatment during acute exacerbation. Primary outcome measure was rating on the Clinical Global Impression (CGI) scale and the Positive and Negative Symptom Scale (PANSS). Results: Between-group differences were computed using analysis of covariance. PANSS Total score decreased from 84 at baseline to 65 after treatment with olanzapine while decreased only from 79 to 74 with haloperidol treatment (F=6.66, P=.02). PANSS Negative subscale decreased from 19 at baseline to 15 with olanzapine treatment while increased (deteriorated) from 18 to 20 with haloperidol treatment (F=23.37, P=.0003). CGI decreased from baseline with both olanzapine and haloperidol treatments (1.1 vs. 0.4) but the decrease in the olanzapine group was significantly greater (F=4.63, P=.05). Mean weight increased in both groups but without statistical difference between groups. Conclusions: In elderly chronic schizophrenia patients, olanzapine treatment is superior to haloperidol in reducing negative symptoms as well as less induction of extrapyramidal symptoms (EPS).
Journal of the American Academy of Child & Adolescent Psychiatry, 1994
Very early onset schizophrenic patients only partially benefit from conventional antipsychotic tr... more Very early onset schizophrenic patients only partially benefit from conventional antipsychotic treatment and are at increased risk for developing tardive dyskinesia (TD). Clozapine, which lacks extrapyramidal side effects including TD, has been proved effective for adult schizophrenic patients who are resistant to other neuroleptics. Clozapine, therefore, may offer an alternative treatment for these patients. The authors report four successful trials of clozapine in children aged 10 to 12 years old with schizophrenia, the youngest group reported on to date, who were unresponsive to conventional neuroleptic treatment.
Journal of the American Academy of Child & Adolescent Psychiatry, 2000
Objective: To report on a brief parent-child group therapy program for children with anxiety diso... more Objective: To report on a brief parent-child group therapy program for children with anxiety disorders. Method: Twenty-four children with an anxiety disorder and their parents participated in a 1 O-session treatment. Children were evaluated at pretreatment (T,), posttreatment (T2), 12-month follow-up (T3), and 36-month followup (T4). Ten children were also assessed on entering a waiting period (To). Results: There were no significant symptomatic changes between To and T,. Anxiety symptoms decreased significantly during the treatment and follow-up periods. Depressive symptoms changed only during the follow-up period. The percentage of children with no current anxiety disorder was 71 % at T2 and 91 % at T4' Children of mothers with an anxiety disorder improved more than children of nonanxious mothers, whereas the anxiety level of anxious mothers remained stable. Conclusions: Brief parent-child group psychotherapy may serve as a time-limited, cost-effective, and efficient intervention.
Journal of the American Academy of Child & Adolescent Psychiatry, 1995
Serotonergic dysregulation in obsessive-compulsive disorder has been repeatedly demonstrated. Rec... more Serotonergic dysregulation in obsessive-compulsive disorder has been repeatedly demonstrated. Recent reports on the emergence of obsessive-compulsive symptoms in patients treated with clozapine support a hyposerotonergic hypothesis of obsessive-compulsive disorder. The authors report the emergence of de novo compulsive symptoms in a drug-naive 8-year-old schizophrenic child, shortly after the initiation of treatment with clothiapine. Clothiapine, an atypical antipsychotic agent, shares with clozapine its strong antiserotonergic properties. It seems that antagonistic activity of atypical neuroleptics at postsynaptic serotonergic receptors might be responsible for the development of iatrogenic obsessive-compulsive symptoms.
The emotional consequences of elective surgery to children and to their parents have not been suf... more The emotional consequences of elective surgery to children and to their parents have not been sufficiently studied. The aim of the present study was to prospectively assess the prevalence and severity of post-traumatic, anxiety and depressive symptoms in this population. Forty children and adolescents consecutively admitted for elective surgery in a general hospital participated in the study. Their parents were also assessed. The assessments were made on the day of admission and surgery, and 1 and 6 months after the surgery. Minor post-traumatic symptoms of the children were noted at the first and second assessments, decreasing significantly at the 6-month assessment. Further, the prevalence of children with elevated post-traumatic symptoms decreased significantly between the first and second assessments. Parents scored highest for anxiety and depression at the first assessment. Their symptoms, however, decreased significantly within 1 month. A significant decrease between the first and second assessments was also noted in the prevalence of parents with elevated anxiety symptoms. At the 1- and 6-month follow-up assessments, there was a significant correlation between the children's symptoms and their parents'. Mild post-traumatic symptoms may accompany paediatric elective surgery and persist for at least 1 month. Parents may also manifest anxiety and depressive symptoms, which may diminish earlier, that is, immediately after the surgery or within 1 month.
This study evaluated symptoms, risk, and protective factors of adolescents from six Israeli schoo... more This study evaluated symptoms, risk, and protective factors of adolescents from six Israeli schools exposed to continuous terrorism. All children in the grades selected at each school (7, 9, and 11) were administered anonymous assessment materials measuring posttraumatic, grief, and dissociative symptoms, as well as traumatic exposure, personal resilience, and family factors. A high number of risk factors increased the likelihood of negative symptoms. Perceived personal resilience served as a protective factor against symptom development, perhaps enforced by ideology. Girls living on the West Bank had less severe posttrauma and were more willing to make personal sacrifices for their country. Proactive interventions aimed at enhancing a child's personal resilience and ability to cope with continuous stress may help protect against later symptomatology following traumatic events. Facing terrorism, political ideology may serve a double edge sword: protecting against symptom development as well as contributing to the toxic cycle of violence.
Journal of Child and Adolescent Psychopharmacology, 2011
In a former study, we reported decreased platelet vesicular monoamine transporter 2 (VMAT2) densi... more In a former study, we reported decreased platelet vesicular monoamine transporter 2 (VMAT2) density (Bmax) in patients with ADHD. The current study aimed at measuring platelet VMAT2 in the disruptive behavior disorders (DBDs) to assess whether this finding is specific to ADHD or generalizable to the broader DBD concept. The study included 13 patients with DBDs aged 10-12 years and 16 healthy volunteers aged 8-17 years. All participants underwent a thorough clinical evaluation using Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version for diagnosis, the Nisonger Child Behavior Rating Form, the Clinical Global Impressions Scale-Severity version, and the DSM-IV ADHD Scale (DAS). The study group's DAS scores did not differ from those of the control group. There was no significant difference between the patients with DBDs and the control group either in VMAT2 density (Bmax) or affinity (Kd) as measured by high-affinity [(3)H]TBZOH binding. We conclude that the formerly reported decreased platelet VMAT2 Bmax in patients with ADHD may be specific to ADHD and not present in DBDs. Larger-scale replication is needed.
Children and adolescents (ages 6-17 years) diagnosed as having an anxiety disorder were compared ... more Children and adolescents (ages 6-17 years) diagnosed as having an anxiety disorder were compared to matched controls on a two-stage serial visual search task in which they identified presence or absence of a unique shape presented with homogeneous distractors. Response time was examined as a function of prior experience with either target, distractor, or both, allowing for a within-subject assessment of latent inhibition (LI: slower responding to a target that was formerly a distractor against a background of distractors that were formerly targets as compared to a novel target with distractors that were formerly targets) and novel pop-out effects (NPO: faster responding to a novel target against a background of familiar former targets as compared to the condition in which both the target and distractors were novel). There were robust LI and NPO effects for both anxious and control children. However, the predicted interaction between diagnosis and LI condition was not obtained. In general, the results suggest that children with diagnosed anxiety disorder do not differ from controls on basic information processing as assessed by this visual search task.
International Journal of Group Psychotherapy, 2010
The use of cognitive-behavioral group psychotherapy in treating childhood anxiety disorders has b... more The use of cognitive-behavioral group psychotherapy in treating childhood anxiety disorders has become widespread. This paper examines the dynamic processes underlying cognitive-behavioral group treatment for children with anxiety disorders and for their parents, with particular focus on the process of separation-individuation. Both children and their parents were empowered through processes of sub-grouping and thus helped to differentiate and separate. We consider this parallel dynamic process an important factor that can enhance cognitive-behavioral treatment.
Human Psychopharmacology: Clinical and Experimental, 2001
Tricyclic antidepressants possess established antienuretic properties. The selective serotonin re... more Tricyclic antidepressants possess established antienuretic properties. The selective serotonin reuptake inhibitors (SSRIs) have similar antidepressant properties to the tricyclic antidepressants and a safer side effect pro®le. The aim of the present study was to evaluate the antienuretic ef®cacy of one SSRI,¯uvoxamine. Nine children aged 9 to 14 years with primary enuresis which was resistant to behavioral therapy participated in the study. All received¯uvoxamine, 75±100 mg per day. In four, the enuresis was the only focus of clinical attention, and ®ve received¯uvoxamine for other primary indications. Enuresis was monitored daily, and mean voiding frequency was compared between three phases: baseline, on treatment and off treatment. Fluvoxamine had no statistically signi®cant effect on enuresis. Fluvoxamine does not seem to possess signi®cant antienuretic properties. We suggest that the combination of serotonergic with anticholinergic activity is a major factor in the antienuretic activity. In the treatment of children or adolescents with obsessive-compulsive disorder and comorbid enuresis, clomipramine may be preferred over SSRIs.
The Israel journal of psychiatry and related sciences, 2016
This manuscript assesses the use of the Child Attachment Interview (CAI) in a sample of Israeli J... more This manuscript assesses the use of the Child Attachment Interview (CAI) in a sample of Israeli Jewish children in middle childhood in order to add to empirical data on this measure. Forty-one children between the ages of 7 and 13 were consecutively recruited to the study. The clinical sample included 29 children diagnosed with anxiety disorder, major depression or ADHD. The Father Focused Referral (FFR) sample included 12 children whose father was unavailable to them. Participants were administered the CAI and coded by certified personnel. 81.4% concordance was found between maternal and paternal secure-insecure attachment classifications in the clinical sample; 100% of the children in the FFR group were classified as insecurely attached to their fathers suggesting convergent validity for the classification of father attachment; 45.4% of the children in the FFR sample were also classified as insecurely attached to their mothers, pointing to the difference that can be found between ...
Sexual abuse has physiological and emotional implications. The purpose of this study is to evalua... more Sexual abuse has physiological and emotional implications. The purpose of this study is to evaluate the neurobiological sequels of childhood sexual trauma by monitoring physiological variables among sexually abused girls and women compared to controls. We assessed posttrauma and traumatic life events of 35 females sexually abused in their childhood (age range 7-51 years) and 25 control females (age range 7-54 years). Electroencephalography, frontalis electromyography, electrodermal activity, and heart rate parameters were recorded while watching sets of pictures representing neutral and trauma-suggestive stimuli. A minority of participants met the Diagnostic and Statistical Manual of Mental Disorders criteria for post-traumatic stress disorder. Abused females displayed significant elevations in heart rate, electromyography, and electroencephalography while viewing allusive stimuli and elevated heart rate while viewing neutral stimuli. The dysfunctional regulation of the physiological stress system associated with child sexual abuse may endanger the victims with various stress and anxiety disorders.
One hundred and six staff members and 150 patients of three psychiatric hospitals in Israel were ... more One hundred and six staff members and 150 patients of three psychiatric hospitals in Israel were administered a smoking habit and attitudes questionnaire. Upon analyzing the data, staff members and patients made up a very high percentage of smokers, 48.1 and 76%, respectively. The staff was not knowledgeable enough about the hazards of smoking. Nurses generously used cigarettes in order to appease the patients. Furthermore, the patients admitted being encouraged to smoke by the staff. According to these findings, a patient hospitalized in the psychiatric hospitals surveyed is significantly exposed to the pro-smoking atmosphere and the hazards of smoking.
Background: The study assessed the prevalence of life events (LE) in adolescents with major depre... more Background: The study assessed the prevalence of life events (LE) in adolescents with major depressive disorder (MDD, n = 19), borderline personality disorder (BPD, n = 20) and matched controls (n = 20). Methods: Assessment measures included: the Child Suicide Potential Scale, the Beck Depression Inventory, the Life Events Checklist, the Childhood Sexual Abuse Questionnaire and the Childhood Trauma Questionnaire. Results: The percentage of negative lifetime LE was significantly higher in both MDD and BPD groups than in the control group, while the opposite was true for the percentage of positive LE. No difference was detected between the groups in the number of negative LE in the year preceding their admission. The MDD group reported more death-related LE than the control group, while the BPD group reported more sexual abuse LE than the control and MDD groups. Conclusions: The present study is a cross-sectional study, and therefore, we cannot draw definite conclusions regarding caus...
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2002
Objective: Most of the data supporting the use of atypical antipsychotics (AA) is based on studie... more Objective: Most of the data supporting the use of atypical antipsychotics (AA) is based on studies in young adult patients. The present study is an open-label naturalistic follow-up study of olanzapine treatment vs. haloperidol for elderly chronic schizophrenia patients. Method: 20 patients (mean age 72.7±5.9 years, mean disease duration 33.1±12.0 years) who met the DSM-IV criteria for schizophrenia were randomly assigned to olanzapine (n=10) or haloperidol (n=10) treatment during acute exacerbation. Primary outcome measure was rating on the Clinical Global Impression (CGI) scale and the Positive and Negative Symptom Scale (PANSS). Results: Between-group differences were computed using analysis of covariance. PANSS Total score decreased from 84 at baseline to 65 after treatment with olanzapine while decreased only from 79 to 74 with haloperidol treatment (F=6.66, P=.02). PANSS Negative subscale decreased from 19 at baseline to 15 with olanzapine treatment while increased (deteriorated) from 18 to 20 with haloperidol treatment (F=23.37, P=.0003). CGI decreased from baseline with both olanzapine and haloperidol treatments (1.1 vs. 0.4) but the decrease in the olanzapine group was significantly greater (F=4.63, P=.05). Mean weight increased in both groups but without statistical difference between groups. Conclusions: In elderly chronic schizophrenia patients, olanzapine treatment is superior to haloperidol in reducing negative symptoms as well as less induction of extrapyramidal symptoms (EPS).
Journal of the American Academy of Child & Adolescent Psychiatry, 1994
Very early onset schizophrenic patients only partially benefit from conventional antipsychotic tr... more Very early onset schizophrenic patients only partially benefit from conventional antipsychotic treatment and are at increased risk for developing tardive dyskinesia (TD). Clozapine, which lacks extrapyramidal side effects including TD, has been proved effective for adult schizophrenic patients who are resistant to other neuroleptics. Clozapine, therefore, may offer an alternative treatment for these patients. The authors report four successful trials of clozapine in children aged 10 to 12 years old with schizophrenia, the youngest group reported on to date, who were unresponsive to conventional neuroleptic treatment.
Journal of the American Academy of Child & Adolescent Psychiatry, 2000
Objective: To report on a brief parent-child group therapy program for children with anxiety diso... more Objective: To report on a brief parent-child group therapy program for children with anxiety disorders. Method: Twenty-four children with an anxiety disorder and their parents participated in a 1 O-session treatment. Children were evaluated at pretreatment (T,), posttreatment (T2), 12-month follow-up (T3), and 36-month followup (T4). Ten children were also assessed on entering a waiting period (To). Results: There were no significant symptomatic changes between To and T,. Anxiety symptoms decreased significantly during the treatment and follow-up periods. Depressive symptoms changed only during the follow-up period. The percentage of children with no current anxiety disorder was 71 % at T2 and 91 % at T4' Children of mothers with an anxiety disorder improved more than children of nonanxious mothers, whereas the anxiety level of anxious mothers remained stable. Conclusions: Brief parent-child group psychotherapy may serve as a time-limited, cost-effective, and efficient intervention.
Journal of the American Academy of Child & Adolescent Psychiatry, 1995
Serotonergic dysregulation in obsessive-compulsive disorder has been repeatedly demonstrated. Rec... more Serotonergic dysregulation in obsessive-compulsive disorder has been repeatedly demonstrated. Recent reports on the emergence of obsessive-compulsive symptoms in patients treated with clozapine support a hyposerotonergic hypothesis of obsessive-compulsive disorder. The authors report the emergence of de novo compulsive symptoms in a drug-naive 8-year-old schizophrenic child, shortly after the initiation of treatment with clothiapine. Clothiapine, an atypical antipsychotic agent, shares with clozapine its strong antiserotonergic properties. It seems that antagonistic activity of atypical neuroleptics at postsynaptic serotonergic receptors might be responsible for the development of iatrogenic obsessive-compulsive symptoms.
The emotional consequences of elective surgery to children and to their parents have not been suf... more The emotional consequences of elective surgery to children and to their parents have not been sufficiently studied. The aim of the present study was to prospectively assess the prevalence and severity of post-traumatic, anxiety and depressive symptoms in this population. Forty children and adolescents consecutively admitted for elective surgery in a general hospital participated in the study. Their parents were also assessed. The assessments were made on the day of admission and surgery, and 1 and 6 months after the surgery. Minor post-traumatic symptoms of the children were noted at the first and second assessments, decreasing significantly at the 6-month assessment. Further, the prevalence of children with elevated post-traumatic symptoms decreased significantly between the first and second assessments. Parents scored highest for anxiety and depression at the first assessment. Their symptoms, however, decreased significantly within 1 month. A significant decrease between the first and second assessments was also noted in the prevalence of parents with elevated anxiety symptoms. At the 1- and 6-month follow-up assessments, there was a significant correlation between the children's symptoms and their parents'. Mild post-traumatic symptoms may accompany paediatric elective surgery and persist for at least 1 month. Parents may also manifest anxiety and depressive symptoms, which may diminish earlier, that is, immediately after the surgery or within 1 month.
This study evaluated symptoms, risk, and protective factors of adolescents from six Israeli schoo... more This study evaluated symptoms, risk, and protective factors of adolescents from six Israeli schools exposed to continuous terrorism. All children in the grades selected at each school (7, 9, and 11) were administered anonymous assessment materials measuring posttraumatic, grief, and dissociative symptoms, as well as traumatic exposure, personal resilience, and family factors. A high number of risk factors increased the likelihood of negative symptoms. Perceived personal resilience served as a protective factor against symptom development, perhaps enforced by ideology. Girls living on the West Bank had less severe posttrauma and were more willing to make personal sacrifices for their country. Proactive interventions aimed at enhancing a child's personal resilience and ability to cope with continuous stress may help protect against later symptomatology following traumatic events. Facing terrorism, political ideology may serve a double edge sword: protecting against symptom development as well as contributing to the toxic cycle of violence.
Journal of Child and Adolescent Psychopharmacology, 2011
In a former study, we reported decreased platelet vesicular monoamine transporter 2 (VMAT2) densi... more In a former study, we reported decreased platelet vesicular monoamine transporter 2 (VMAT2) density (Bmax) in patients with ADHD. The current study aimed at measuring platelet VMAT2 in the disruptive behavior disorders (DBDs) to assess whether this finding is specific to ADHD or generalizable to the broader DBD concept. The study included 13 patients with DBDs aged 10-12 years and 16 healthy volunteers aged 8-17 years. All participants underwent a thorough clinical evaluation using Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version for diagnosis, the Nisonger Child Behavior Rating Form, the Clinical Global Impressions Scale-Severity version, and the DSM-IV ADHD Scale (DAS). The study group's DAS scores did not differ from those of the control group. There was no significant difference between the patients with DBDs and the control group either in VMAT2 density (Bmax) or affinity (Kd) as measured by high-affinity [(3)H]TBZOH binding. We conclude that the formerly reported decreased platelet VMAT2 Bmax in patients with ADHD may be specific to ADHD and not present in DBDs. Larger-scale replication is needed.
Children and adolescents (ages 6-17 years) diagnosed as having an anxiety disorder were compared ... more Children and adolescents (ages 6-17 years) diagnosed as having an anxiety disorder were compared to matched controls on a two-stage serial visual search task in which they identified presence or absence of a unique shape presented with homogeneous distractors. Response time was examined as a function of prior experience with either target, distractor, or both, allowing for a within-subject assessment of latent inhibition (LI: slower responding to a target that was formerly a distractor against a background of distractors that were formerly targets as compared to a novel target with distractors that were formerly targets) and novel pop-out effects (NPO: faster responding to a novel target against a background of familiar former targets as compared to the condition in which both the target and distractors were novel). There were robust LI and NPO effects for both anxious and control children. However, the predicted interaction between diagnosis and LI condition was not obtained. In general, the results suggest that children with diagnosed anxiety disorder do not differ from controls on basic information processing as assessed by this visual search task.
International Journal of Group Psychotherapy, 2010
The use of cognitive-behavioral group psychotherapy in treating childhood anxiety disorders has b... more The use of cognitive-behavioral group psychotherapy in treating childhood anxiety disorders has become widespread. This paper examines the dynamic processes underlying cognitive-behavioral group treatment for children with anxiety disorders and for their parents, with particular focus on the process of separation-individuation. Both children and their parents were empowered through processes of sub-grouping and thus helped to differentiate and separate. We consider this parallel dynamic process an important factor that can enhance cognitive-behavioral treatment.
Human Psychopharmacology: Clinical and Experimental, 2001
Tricyclic antidepressants possess established antienuretic properties. The selective serotonin re... more Tricyclic antidepressants possess established antienuretic properties. The selective serotonin reuptake inhibitors (SSRIs) have similar antidepressant properties to the tricyclic antidepressants and a safer side effect pro®le. The aim of the present study was to evaluate the antienuretic ef®cacy of one SSRI,¯uvoxamine. Nine children aged 9 to 14 years with primary enuresis which was resistant to behavioral therapy participated in the study. All received¯uvoxamine, 75±100 mg per day. In four, the enuresis was the only focus of clinical attention, and ®ve received¯uvoxamine for other primary indications. Enuresis was monitored daily, and mean voiding frequency was compared between three phases: baseline, on treatment and off treatment. Fluvoxamine had no statistically signi®cant effect on enuresis. Fluvoxamine does not seem to possess signi®cant antienuretic properties. We suggest that the combination of serotonergic with anticholinergic activity is a major factor in the antienuretic activity. In the treatment of children or adolescents with obsessive-compulsive disorder and comorbid enuresis, clomipramine may be preferred over SSRIs.
Uploads
Papers by paz toren