[Depersonalization after withdrawal from cannabis usage].

The phenomenon of depersonalization during cannabis usage (intoxication) is commonly known. However, its appearance after drug stoppage is relatively unknown. This article reviews the literature on depersonalization after cannabis withdrawal and discusses three representing cases demonstrating the severity of the problem. Clinical features are described as well as effects on functioning and the long-term nature of this disorder. The treatment approach in each case is also presented.

The enigma of Lenin's (1870-1924) malady.

The health of heads of states is not always handled in the same way as an incapacitating disability in ordinary professionals. Instead of suspension of responsibilities, the health status of political leaders is concealed, especially when the illness is perceived as stigmatizing, such as organic mental impairment or sexual disorder. The objective of the present paper is to analyse the malady of Lenin (1870-1924) in the light of relevant and new medical information. It is hoped that this will accentuate the need for transparency when the health of a statesman is concerned.

Reassessing "Jacob's case": a serial killer re-examined after ten years.

The current study re-examines an exceptional case of a serial killer incarcerated since a decade ago. "Jacob" is the first serial killer apprehended in Israel. His known actions were committed during the eighties of the last century, and continued for eleven years. The victims were elderly individuals, including both his parents. Shortly after incarceration he became overtly schizophrenic and underwent five hospitalisations. The case is re-examined in view of changes, both in the perpetrator's diagnosis and criminal legislation. Was Jacob doomed to become a serial killer, or could his fate be avoided through early professional intervention? Were the killings presenting symptoms of a psychotic or pre-psychotic phase? Should he be eligible for a retrial? What would have been his position with the current law in view of the new 300A(a) clause ("Reduced Punishment") of the Israeli Criminal Code? Could he ever be released back to the community? These are some of the questions to be addressed.

[Cyclic psychosis associated with the menstrual cycle].

Cyclic psychosis associated with the menstrual cycle is an uncommon disorder, not included under the accepted definitions of functional psychoses. We present three female adolescents who developed an acute psychosis a few days before menstruation, which resolved completely upon bleeding or several days later, only to reappear in the same form in subsequent cycles. The clinical presentation was not in line with that of the typical functional psychoses. An extensive medical work-up did not show any significant disturbances, with the exception of anovulatory cycles in one youngster. Psychotropic treatment had no effect on the course of the psychosis. Treatment with progesterone in the second half of the cycle in one case, and with a combined progesterone/estrogen contraceptive agent in another, resulted in full recovery within several cycles. The third girl showed a spontaneous remission within four cycles. Remission continued in all cases after discontinuation of the hormonal treatment, and with no need to reintroduce any psychotropic agent, for a period of 2-4 years. We discuss several possible etiologic mechanisms for cyclic psychosis associated with the menstrual cycle, including it being a cycloid non-specific affective disorder, and its association with a temporary functional hypothalamic-pituitary dysfunction, and with anovulation. We also discuss the role of psychotropic and hormonal treatment in this disorder.

[Cerebral and physical risks associated with cannabis use].

This article summarize the results of research studies that indicate that the accepting, permissive approach to cannabis use is not justified. After theoretical introduction and a discussion of the forms currently available, we review research and epidemiological surveys demoting the effects of cannabis on various body systems. The deleterious effects associated with cannabis use and its derivatives are discussed.

[Enigma of Lenin's illness].

A difficult problem that arises periodically involves the physical and psychological problems of political leaders. Unlike the ordinary person, where the presence of physical or psychiatric disability that interferes with functioning will be revealed and will result in suspension from work responsibilities (e.g. pilot, bus driver, physician), the situation is different with regard to political leaders. Concerning the latter, the information may remain concealed because it is conceived of as stigmatizing, e.g., mental illness, and sexual disorder. The result of hiding such information is that sick leaders may continue to hold their positions of vast power in spite of their disability. Examples of world leaders who suffered from sustained disability as a result of incapacitating neurological or psychiatric illnesses, physical problems or medication effects include Woodrow Wilson, Franklin Roosevelt, Dwight Eisenhower, Winston Churchill and Conrad Adenauer. In the present article we will discuss in detail Lenins severe illness--whose differential diagnosis and real facts were kept hidden from the public--and the consequences of this cover-up.

Death, bereavement and traumatic loss in Israel: a historical and cultural perspective.

In the present article, we focus on the experience of bereavement and traumatic loss in Israel and examine the main influences that continue to shape them. For the Jewish population the main features are: religious aspects stemming from Jewish tradition and its variants; the secular and contemporary traditions, the ethos of the Israeli state, and the influence of the struggle to reestablish the Jewish people in its homeland. In an increasingly multicultural society, significant changes are occurring. A series of vignettes of grief and mourning illustrate current issues and practices among religious, secular, kibbutz, Russian and Ethiopian segments of society. The remainder of the article discusses emerging patterns of response to bereavement that are socially constructed and historically situated. We follow the variations in these patterns, from shifting forms of memorialization on the collective level to changes in expressive mood on the individual level, which are mediated by the cultural mosaic of the society. Mental health professionals would benefit from an understanding of the multifaceted fabric of beliefs and cultural-specific customs that shape the mourning rituals and their meanings for the bereaved.

[Chapters in the history of psychiatry in Israel and its surroundings: B). The Asfouriyeh hospital for the insane in Lebanon].

This is the second of a series of articles dealing with the history of psychiatry in Eretz-Israel and its surroundings. After a brief survey of the Ottoman medicine and Islamic hospitals, this article presents a short description of the treatment for mentally ill patients in the Ottoman Empire. We describe the historical background and the establishment of the Asfouriyeh hospital for the insane in Lebanon towards the end of 19th century, as well as other mental hospitals in this land. We outline some similarities in initiative and administration during the foundation of Ezrath-Nashim hospital in Jerusalem at that time.

The misidentification of Clerambault's and Kandinsky-Clerambault's syndromes.

Eponymic terms or eponyms are labels describing phenomena that reflect the name(s) of the person(s) who first described the phenomena. Using a similar term to describe different forms of pathology leads to a muddle. In this paper, we describe "Clerambault's syndrome" and "Kandinsky-Clerambault's syndrome" and discuss and clarify the confusion surrounding these different syndromes.

[Cannabis--a drug with dangerous implications for mental health].

Accepting and forgiving attitudes to the use of cannabis in its various forms, such as marijuana or hashish, are not justified, as they may result in dangerous mental health consequences. A theoretical framework for this opinion is provided, including information on the various forms of cannabis available. Case studies presented exemplify possible complications resulting from use of cannabis or its derivatives.

Medical confidentiality in the new Israeli Patients' Rights Act (1996): does it add or detract?

Medical confidentiality is dealt with in various laws in Israel. The 1996 Israel Patient's Rights Act approaches the subject of confidentiality in an extensive and fairly detailed manner which includes several innovations in relation to previous laws. This article will review the old and the new legislations on confidentiality, and will analyze and discuss the implications and potential problems for psychiatric clinical practice. The new Act will also be examined in light of the World Health Organization guidelines on Mental Health Care Laws.