[What is the role of compulsory ECT therapy today?]

Electro-convulsive therapy (ECT) has been effective for years, but it arouses opposition among patients and especially in the general public. ECT treatment is limited and compared to other medical treatment it is considered exceptional by the law, regulations and treatment personnel. A question arises as to the position of therapists regarding compulsory ECT treatment. A questionnaire was sent on this subject to all the units utilizing ECT in Israel. Opinions ranged from complete negation of compulsory ECT, to regarding such treatment as possible in cases when the patient is compulsorily hospitalized and/or when the patient's guardian supports this treatment. The authors' opinion is that the Law of Patients' Rights regarding special treatment when the patient is in extreme danger must be followed. The law requires that three physicians agree to the treatment, and compulsory treatment is no longer applicable when the danger passes. ECT treatment is important and imperative in certain conditions, especially conditions endangering patients' lives. In these conditions the law provides the authority to physicians to make decisions regarding treatment.

Ganser syndrome: a review of 15 cases

Using the diagnostic criteria found in the literature, 15 new cases of Ganser syndrome were examined. A relationship was found between specific premorbid personality traits and severity of the syndrome; a high percentage of the sample belonged to an ethnic minority and was suspected of having symptoms of premorbid neurological pathology.

Primary fibromyalgia syndrome--a variant of depressive disorder?

Primary fibromyalgia syndrome (PFS) is a form of connective tissue rheumatism, characterized by diffuse chronic pain in periarticular tissue, for which no organic cause can be identified. The present study examined the personal and family history, clinical and psychodynamic features of 40 PFS patients, and compared them to a matched control group of patients suffering from rheumatoid arthritis. Depression, either in the past or at present, was seen significantly more often among PFS patients that among controls. Dependence and passivity, idealization of family relationships, obsessive-compulsive personality, maladaptive response to loss, and prepain ergomania were the psychodynamic features characteristic of PFS patients. It is suggested that PFS is a well-defined disorder, in which specific premorbid, familial, and psychodynamic characteristics result in a depressive disorder which takes the form of a physical symptom: pain.