BACKGROUND:The extensive reliance on symptoms for the study of psychotherapy is often criticized. In this study we examined whether the subjective sense of mental pain predicts psychotherapy process and outcome, above and beyond the effect of symptomatic distress.METHODS:Outpatients (n = 53) treated in a psychiatric hospital completed measures of mental pain intensity and tolerance, symptomatic distress, and session climate at pretreatment and posttreatment. Multilevel modeling was utilized to assess the predictive effect of mental pain, while controlling baseline symptomatic distress.RESULTS:Patients with high mental pain at baseline showed significant reductions in distress, while patients with low mental pain showed no significant improvement. Moreover, low mental pain and high mental pain tolerance predicted decreases in session smoothness.CONCLUSIONS:Mental pain can serve as a predictive marker for psychotherapy process and outcome, and complement the reliance on symptomatic distress in psychotherapy research.

Objective In this study, we reexamine the mental pain-suicidality link in adolescence, by focusing on mental pain tolerance as a critical factor in explaining youth suicidal behavior. Method In a series of three studies, participants completed measures of mental pain (tolerance and intensity), emotional regulation, depression, and suicidality. Study 1 included a nonclinical sample of 183 Israeli adolescents. Study 2 included a nonclinical sample of 139 Israeli adolescents, who completed additional measures of self-esteem, optimism, mindfulness, meaning in life, positive affectivity, and life satisfaction. Study 3 included suicidal psychiatric inpatients (N = 24), nonsuicidal psychiatric inpatients (N = 24), and nonclinical adolescents (N = 24). Results In Study 1, mental pain tolerance was significantly associated with depression, suicidality, and emotion-regulation skills. In Study 2, mental pain tolerance was significantly associated with measures of psychological resources. In Study 3, we found that suicidal psychiatric inpatients reported significantly lower levels of mental pain tolerance than nonsuicidal psychiatric inpatients and nonclinical adolescents. No significant group difference was found in the reported intensity of mental pain. Conclusions Findings imply that mental pain tolerance may be a better indicator for suicidal behavior during adolescence than reported pain intensity.

Background: One of the major factors affecting treatment compliance and outcome in patients is the wide range of side effects (SEs) associated with antidepressants. In the present study, we aimed to assess the extent to which Israeli primary care (PC) physicians and psychiatrists discuss the SEs of selective serotonin reuptake inhibitors (SSRIs) with patients prior to the onset of treatment.Methods: A cross-sectional questionnaire survey was conducted among PC physicians (N = 123) and psychiatrists (N = 105). Questionnaires were distributed using a mixed-modality design, combining a web survey and in-person delivery of questionnaires.Results: A significant percentage of our respondents reported that they rarely discuss psychological (60 %) or severe (29 %) SEs of SSRIs. Nearly half (41 %) admitted to avoiding discussion of impact on suicidal ideation. Specialists were noted to discuss and evaluate SEs significantly more than residents, and Psychiatrists more than PC physicians. Specifically, psychiatrists more often discussed the possibility of sexual dysfunction (t (225) = 2.23; p < 0.05) and suicidal ideation (t (225) = 2.11; p < 0.05).Conclusions: It seems that PC physicians and psychiatrists surveyed in this study do not share sufficient information regarding the SEs of SSRIs with their patients at the onset of treatment. In improving this practice, the integration of proper SE management into educational interventions has potential in enhancing compliance and improving expertise and level of care.

Objective: High rates of placebo responses are consistently reported in patients with major depressive disorder. Nonetheless, treating depression with placebo is still ethically controversial and generally prohibited in the clinical setting. In the present study, we assess the acceptability of placebo usage among depressed patients.Method: Ninety-six outpatients with major depressive disorder were matched to 114 healthy controls. After a thorough explanation of the placebo effect, its efficacy and limitations in the treatment of depression, the study participants completed a 32-item self-report questionnaire. The five core questions addressed the attitude and willingness of subjects to be treated with a placebo in the clinical setting.Results: Among study group patients, the majority (56.7%) conveyed consent for placebo treatment if they were to suffer another depressive episode. Both study group and control group expressed high rates of willingness to waive their right to informed consent (55.6% and 50%, respectively), and they did not consider placebo treatment to be a deceit (56%) or to diminish their sense of autonomy (56.7%).Conclusions: Most patients with depression are willing to waive their right to informed consent in order to receive placebo treatment. These findings should encourage further studies of placebo usage and its legitimacy in clinical practice. (C) 2016 Elsevier Inc. All rights reserved.

The aim of this study was to investigate the opinions of healthy students regarding the acceptability of placebo treatment if they were to experience depression. A survey was conducted among 344 students in five academic centers in Israel. After a thorough explanation of the placebo effect, its efficacy and limitations in the treatment of depression, the study participants completed a 32-item self-report questionnaire. Seventy percent (n = 243) of the participants answered that they would agree to treatment with a placebo as a first-line treatment if they were to experience depression in the future. Eighty-eight percent (n = 297) of the subjects did not think that a physician who administered placebos was deceitful. Once aware of the possible benefits and limitations of placebo treatment, most of our study population was willing to accept placebo as a legitimate treatment of depression. Additional studies on the possible use of placebo as an effective, safe, and acceptable form of therapy are warranted.

The aim of this study was to investigate the opinions of healthy students regarding the acceptability of placebo treatment if they were to experience depression. A survey was conducted among 344 students in five academic centers in Israel. After a thorough explanation of the placebo effect, its efficacy and limitations in the treatment of depression, the study participants completed a 32-item self-report questionnaire. Seventy percent (n = 243) of the participants answered that they would agree to treatment with a placebo as a first-line treatment if they were to experience depression in the future. Eighty-eight percent (n = 297) of the subjects did not think that a physician who administered placebos was deceitful. Once aware of the possible benefits and limitations of placebo treatment, most of our study population was willing to accept placebo as a legitimate treatment of depression. Additional studies on the possible use of placebo as an effective, safe, and acceptable form of therapy are warranted.

Web-browsing habits of 143 individuals with psychotic disorders were compared to individuals with non-psychotic disorders (n=118) and healthy volunteers (n=100). The psychotic group created social interactions via Internet use similarly to the control groups. Individuals with schizophrenia benefit from Internet use, as it bypasses some of their social difficulties.