Isr Med Assoc J
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The phenomenon of hair pulling has been recognized for centuries, yet the true prevalence of trichotillomania (TTM) is largely unknown and the topic has been sparsely studied. TTM is classified as an impulse-control disorder despite much debate about its etiology. ⋯ Treatment with anti-addiction drugs seems relevant. Further research is needed to increase our knowledge regarding the etiology of TTM.
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Food allergy is an increasingly prevalent disease in western countries, but an effective form of therapy has not yet been found. A specific active treatment for immunoglobulin E (IgE)-mediated food allergy is currently under study in human clinical trials. Allergen-specific approaches include oral, sublingual and epicutaneous immunotherapy. ⋯ The occurrence of adverse events or reactions during OIT is quite frequent and has been reported in all published studies. Therefore, before this treatment can be used in clinical practice additional studies are needed. Currently, immunotherapy for cow's milk or egg allergies is a novel approach that expands the possibility of an active treatment to improve the quality of life of patients and their families.
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Suicide is universal within the range of human behaviors and is not necessarily related to psychiatric morbidity, though it is considerably more prevalent among psychiatric patients. Considering the limitations of medical knowledge, psychiatrists cope with an unfounded and almost mythical perception of their ability to predict and prevent suicide. We set out to compose a position paper for the Israel Psychiatric Association (IPA) that clarifies expectations from psychiatrists when treating suicidal patients, focusing on risk assessment and boundaries of responsibility, in the era of defensive medicine. ⋯ The IPA Position Paper established the first standard of care concerning expectations from psychiatrists in Israel with regard to knowledge-based assessment of suicide risk, elucidation of the therapist's responsibility to the suicidal psychotic patient (defined by law) compared to patients with preserved reality testing, capacity for choice, and responsibility for their actions. Therapists will be judged for professional performance rather than outcomes and wisdom of hindsight. This paper may provide support for psychiatrists who, with clinical professionalism rather than extenuating considerations of defensive medicine, strive to save the lives of suicidal patients.