bluuebunny/crossref_metadata_2025 huggingface dataset:
The Validity of Commitment Certificates in British Columbia
Authors: Paredes J. , Kanachowski A. , Ledwidge B. , Stoutenburg K. , Beyerstein D.
Published: April 2017

This study surveyed the content of committal forms completed at two B. C. hospitals. A profile of 50 patients at a provincial mental hospital and 50 patients on the ward of a general hospital was obtained by comparing the two groups on a number of demographic and psychiatric history variables. The medical certificates of the patients were then assessed for the inclusion of information required by the B. C. Mental Health Act. Of the 198 forms rated (two per patient), 137 (69.2%) were in compliance with the requirements of the B. C. Mental Health Act. Although a larger number of valid forms was scored for the psychiatric hospital, this difference was not significant. A total of 50 patients had a legally valid combination of medical certificates. Much of the problem associated with the invalid forms was related to the vague and confused wording of the Mental Health Act. It is suggested that a clearer definition of committal criteria and a rewording of the medical certificate may aid physicians in completing commitment documentation.
Appraising the Quality of Drug-Evaluation Research: I. A Method of Meta-Analysis for Acute Treatment Medications
Authors: King Paul R.
Published: April 2017

The present paper focuses on drug-evaluation research, and describes a method of meta-analysis for evaluating the methodological quality of a body of research focusing on the study of an acute treatment medication. An illustrative application of this procedure to research evaluating lithium treatment for acute mania revealed general problems with diagnostic reliability and the reliability of the dependent variable, and a tendency to ignore the statistical power aspects of determining sample size. The implications of this are discussed in terms of a need to further clarify lithium's role in treating this disorder.
The Social Complications of Chronic Alcohol Abuse: Relative Influence of Family History and Severity of Alcohol Dependence
Authors: Schachter Debbie Carol , Negrete Juan C. , Ansari Essam Al
Published: April 2017

Alcoholics with a family history of the disease are said to present more severe consequences than alcoholics without such a history. This study examined the frequency distribution of severe alcohol dependence and police arrests for public drunkenness across samples of alcoholics with (n = 77) and without (n = 37) a family history of alcoholism. Both the percentage of subjects presenting severe dependence and the history of police arrests were greater in the positive family history group, but these differences did not reach conventional levels of statistical significance. However, results of logistic regression analyses demonstrate that male sex, younger age and, above all, severity of alcohol dependence, are better correlates of the occurrence of police arrests than is the subject's family history of alcoholism. The picture presented by this sample of outpatient alcoholics appears to qualify some currently held assumptions of the influence of family history on the phenomenology of alcoholism.
Interrater Reliability of the Blessed Dementia Scale
Authors: Cole Martin G.
Published: April 2017

This study examined the interrater reliability of the Blessed Dementia Scale. On consecutive days, two raters, working independently, interviewed each of the caretakers of 47 demented subjects. Interrater reliability of total scale scores was determined by calculation of the Pearson correlation coefficient (r), the intra-classcorrelation coefficient (ICC), and the limits of agreement (Ð ± 2 s). By all three methods of calculation, the interrater reliability of the Blessed Dementia Scale was low.
Effect of Combined Androgen Blockade with an LHRH Agonist and Flutamide in One Severe Case of Male Exhibitionism
Authors: Rousseau Louis , Couture Marcel , Dupont André , Labrie Fernand , Couture Normande
Published: April 2017

A severe exhibitionist has been treated with the combination of an LHRH agonist and the antiandrogen flutamide in order to maximize androgen blocking and to control his severe deviant behaviour. The results obtained show that the androgen blockade ended his exhibitionistic behaviour and markedly decreased his sexual fantasies and activities, especially masturbation, without significant side effects.
On the Usefulness of the DSM-III-R versus the DSM-III for Child Psychiatrists
Authors: Mcconville Brian J. , Steichen-Asch Paule
Published: April 2017

The purpose of this paper is to compare and contrast the disorders of infancy, childhood and adolescence in the DSM-III-R with those of its predecessor, the DSM-III. Design features of the child psychiatry sections of the DSM-III-R are described, with comparisons of reliability and validity assessments in the two classifications. Categorical and dimensional systems of psychiatric nosology are described; the DSM-III-R has features of both systems. To be most useful for child psychiatrists in ordinary clinical practice, DSM-III-R symptom criteria should be available in a standardized but brief fashion to ensure adequate data gathering from both child and parent. This avoids problems inherent in lengthy standardized interviews based on DSM-III-R criteria; although these interviews are excellent for research purposes, clinicians tend to avoid them as clinically constraining. The commonly used alternate of clinicians' overall evaluations is of uncertain reliability and validity, since it is unclear whether all symptoms have been asked for. A symptom checklist approach is therefore suggested as an intermediate procedure to ensure that appropriate questions are asked from the parent and child, while allowing fuller exploration by the clinician. This approach also indicates parent-child variance, and allows for rank ordering of diagnoses which may indicate priorities for treatment of child psychiatric disorders. Overall, the DSM-III-R is a positive step towards more adequate diagnosis and treatment for child and adolescent psychiatric disorders, which will lead to further improvement in the future DSM-IV.
Health Care Utilization for Emotional Problems: Results from a Community Survey
Authors: Bland Roger C. , Newman Stephen C. , Orn Helene
Published: April 2017

A survey was conducted in which 865 randomly selected adult household residents of Edmonton, Alberta were interviewed to obtain information about health care in the preceding year. Eighty percent of the sample had seen a family physician, and eight percent of visits to family physicians involved a mental or emotional problem. Thirteen percent of the sample received professional help for a mental or emotional problem from some type of caregiver. The most frequently consulted professional was the family physician (eight percent of the sample), followed by psychologists and psychiatrists (each seeing two percent of the sample). Family physicians accounted for the greatest number of consultations for mental or emotional problems (41 %), followed by psychologists (16%), social workers (12%) and psychiatrists (nine percent). Women were 27% more likely to seek a consultation than men, and consultation rates were highest in the group ranging in age from 35 to 44 years. There was also a strong relationship between having recent psychiatric symptoms and having had a consultation in the past year.
Psychiatric Epidemiology in Quebec: An Overview
Authors: Kovess Vivianne , Valla Jean-Pierre , Tousignant Michel
Published: April 2017

This paper reviews the development of psychiatric epidemiology in Quebec from 1960 to the present. The research in this area is divided into three periods: 1960 to 1980, 1980 to 1985, and 1985 onward. Child psychiatric epidemiology is addressed separately. The authors conclude that psychiatric epidemiology has been an active area of research in Quebec and will likely be even more so in the future given the increasing interest in the field.
Intersubjective Processes in Psychotherapy
Authors: Frayn Douglas H.
Published: April 2017

An intersubjective field is created by the interplay between the subjective inner worlds of the patient and therapist. The study of intersubjective processes has been based loosely on the paradigm of infant and caregiver interactions with subsequent empathic appreciation of each others' subjective realities. This approach is not necessarily dependent on an acceptance of a self-psychology model. Dyadic interactional dynamics can be explored and understood using different theoretical models. It may be therapeutic to be able to communicate and clarify significant moments of shared mutuality and affects, which when put into words often uncover previously repetitive and frustrating misunderstandings and expectations.
Gender Identity Disorder and Psychosexual Problems in Children and Adolescents
Authors: Bradley Susan J. , Zucker Kenneth J.
Published: April 2017

This article provides a selected overview of the literature on gender identity disorder and psychosexual problems in children and adolescents, with a focus on diagnosis, clinical course, etiology, and treatment.
Evaluation of the Effectiveness of a Psychodynamically Oriented Day Treatment Program for Children with Behaviour Problems: A Pilot Study
Authors: Grizenko Natalie , Sayegh Liliane
Published: April 2017

Twenty-three consecutive admissions to a psychodynamically oriented day treatment program were assessed using a pre-/post-test design. Discharge scores revealed a significant improvement on all standardized scales for behaviour (p < .0001), academics (p < .05), personality measures (p < . 0001) and family measures (p < .05). Parents reported a significantly greater behavioural improvement than both teachers and primary therapists (p < .0001). Although all children showed improvement, parents reported significantly lower improvement rates (p < 0.05) for children with conduct disorder compared with attention deficit disorder, oppositional defiant disorder and depression. Teachers found that younger boys (aged six to nine) showed a significantly greater improvement (p < .05) than older boys (aged ten to 12) in total behaviour score and externalizing subscores of the Revised Child Behavior Profile. At discharge 87% of children were reintegrated into regular school; only 17% were attending regular school at admission.
Anorexia Resulting from Fear of Vomiting in Four Adolescent Girls
Authors: Manassis Katharina , Kalman Eva
Published: April 2017

Four adolescent girls were referred for psychiatric assessment because of suspected anorexia nervosa. Although all of them had lost at least 15% of their body weight, investigation showed that they did not meet the criteria for anorexia nervosa. In all cases, refusal to eat resulted from fear of vomiting following a viral illness and not from a desire to lose weight. Their family configurations and personal histories showed many similarities, including constricted range of affect and a notable lack of anger. With counseling and, in one case, psychotropic medication, the patients recovered promptly.
A Mandatory Clinical Clerkship in Child Psychiatry: A Description and Evaluation
Authors: Fine S. , Thomas J. , Krell R.
Published: April 2017

We describe a mandatory clinical clerkship in which students spend one day a week for six weeks assessing and treating a child and family and participate in seminars on common child psychiatric syndromes and their treatments, In two of three settings, two students were assigned to each child and family and in the third setting, one student was assigned. We assessed their satisfaction by a mailed survey and found each student seemed to be satisfied with his/her own experience. The administrative advantages of having two students for each family are outlined. Also a rank order of preference of seminar content was assessed. Seminars on depression, conduct disorders, attention deficit disorders and family assessment were most appreciated.
The New York Longitudinal Study (NYLS): The Young Adult Periods
Authors: Chess Stella , Thomas Alexander
Published: April 2017

This paper focuses on the findings and analyses, both qualitative and quantitative, of the young adult periods; early adult life (EAL) or ages 18 to 24, and young adult life (YAL) or ages 25 to 30. A summary is given of the sample and methods used in the study. Complexities of the life paths of the 133 subjects are traced, and the adolescent findings are discussed. In this middle class sample, the YAL period was found qualitatively to demand greater resolution of goals, life patterns and self-sufficiency than earlier periods.
Morbidité Psychiatrique Chez Les Patients Hospitalisés Pour le SIDA: Expérience dans un Hôpital au Québec*
Authors: Fabian José Luis
Published: April 2017

Neuropsychiatric complications in AIDS patients are common and have been reported in many recent articles. The author reviewed the medical charts of 80 patients admitted for AIDS between April 1984 and April 1988 to determine the frequency and nature of psychiatric complications in these patients and to compare these with recent reports made by other authors. The most frequent complications requiring psychiatric intervention seem to be organic mental disorders and adjustment disorders. Practical conclusions are drawn.
Psychiatric Ethics and Ethical Psychiatry*
Authors: Paredes Jaime , Beyerstein Dale , Ledwidge Barry , Kogan Claudio
Published: April 2017

This paper critically examines the code of ethics that applies to practising psychiatrists. The code performs the functions for which it was designed admirably well. It does not, however, resolve moral dilemmas (i. e., complex situations in which any course of action compromises certain ethical principles). In these cases, the psychiatrist must turn to wider moral theory (i. e., psychiatric ethics) for guidance.
Trainee Safety in Psychiatric Units and Facilities*
Authors: Moscovitch A. , Chaimowitz G.A. , Patterson P.G.R.
Published: April 2017

This position statement was prepared by the Professional Standards and Practice Council, chaired by Dr. Paul C.R. Patterson, and approved by the Board of Directors of the Canadian Psychiatric Association on March 31, 1990.
Consistency and Change in Personality Characteristics and Affect from Middle to Late Adolescence
Authors: Stein B.A. , Golombek H. , Marton P. , Korenblum M.
Published: April 2017

Non clinical adolescents in a longitudinal study were examined at ages 16 and 18 to see whether or not there were changes in personality functioning, attitudes and affect over time, and whether or not these were related to each other. Personality functioning remained fairly consistent at both ages, with marked personality problems occurring in about one out of seven. As a group, the older adolescents demonstrated more anxiety and depression, as well as changes in certain attitudes such as more curiosity and interest in people. For individual adolescents it was found that there was considerable predictability of affect and attitudes at age 18 from the presentation at age 16. Furthermore, a relative increase in the amount of anger in middle adolescence was a predictor of personality problems in late adolescence.
Screening for Alcoholism in a Psychiatric Hospital
Authors: Dobkin Patricia , Dongier Maurice , Cooper Douglas , Hill Jeanne-Marie
Published: April 2017

The prevalence of alcoholism is generally underestimated in patients in private practices, general hospitals and psychiatric institutions. Even though the World Health Organization has advocated the concurrent use of laboratory test results and questionnaires for screening, these methods are seldom used together. In this study, patients admitted consecutively to the North Bay Psychiatric Hospital were screened for alcoholism using the Michigan Alcoholism Screening Test (MAST) and gamma-glutamyl-transferase plasma level. Unexpectedly, 56.7% of the entire sample were identified as possible alcoholics; of these, 73.5% were men and 26.5% were women. When rates for men and women were looked at separately, it was found that 66.2% of the men and 40.6% of the women were alcoholic.

Participants who tested positive on one or both of the screening tests were offered a more complete evaluation of their drinking behaviour. A diagnosis of alcoholism was confirmed in 88.2% of the patients who agreed to participate further. The question remains whether the high prevalence rates found are a function of the particular sample studied (i.e., patients in a hospital which typically serves a socially disadvantaged sector of the population) or reflects a feature of the general population in this catchment area. A study is currently underway in general hospitals of North Eastern Ontario in an attempt to answer this question.
Heterogeneity in Responses to Cancer. Part I: Psychiatric Symptoms
Authors: Johnstone Beverly G.M. , Silberfeld Michel , Chapman Judy-Anne , Phoenix Candice , Sturgeon Jeremy F.G. , Till James E. , Sutcliffe Simon B.
Published: April 2017

Heterogeneity in psychiatric responses to disease specific diagnosis is demonstrated for two groups of cancer patients who are comparable in prognosis and treatment intensity. Implications of this heterogeneity are drawn for etiological study and for planning psychiatric interventions.
A Comprehensive and Practical Quality Assurance Program for Community Mental Health Services
Authors: Eppel Alan B. , Fuyarchuk Claudette , Phelps David , Phelan Anna Tersigni
Published: April 2017

The authors desribe the implementation of a comprehensive quality assurance program, within a multi-disciplinary, multi-program mental health clinic. The quality assurance program is reviewed in relation to measures of structure, process and outcome.
Multiple Sclerosis and Affective Disorders
Authors: Garland E. Jane , Zis A.P.
Published: April 2017

Affective disorders occurring in association with multiple sclerosis have been attributed both to the psychosocial impact of a chronic disabling illness and to the structural lesions of cerebral demyelination. A review of research evidence suggests that while there is a correlation between chronic depressive symptoms and both progressive disability and lack of social support, acute major depressive and manic episodes may be psychiatric manifestations of demyelinating lesions and may be the initial presenting symptoms of multiple sclerosis. Anti-inflammatory agents may be required in the management of acute psychiatric symptoms despite the fact that these agents have a propensity to precipitate psychotic episodes. Two case reports are presented to illustrate the clinical challenge of distinguishing between organic and functional affective illness in patients with multiple sclerosis. The interplay between biological and psychological aspects of multiple sclerosis in precipitating affective disorders is discussed, with implications for patient assessment and management.
A Case of Obsessive-Compulsive Disorder Related to AIDS: Psychopharmacologic Treatment
Authors: Schechter Janet B. , Myers Michael F. , Solyom Leslie
Published: April 2017

It is well known that delusions, obsessions and phobic reactions may centre on items which are of current topical interest. We report a case of obsessive-compulsive disorder manifested primarily by intrusive thoughts about AIDS. The patient eventually responded to an unusual combination of medications.
UK Survey of Psychiatric Services for the Elderly: Direction for Developing Services
Authors: Shulman Kenneth , Arie Tom
Published: April 2017

As an important step in health care planning for the elderly, a systematic descriptive study of ten psychogeriatric services was undertaken in the United Kingdom. A definite trend emerged of a reduction in the number of hospital beds as community services developed. Health authorities tended to establish a clinical base in general hospitals rather than in mental hospitals. The recent effect of the rapid growth of the private nursing home sector is also described.

Some rough guidelines are provided for the basic resources needed to establish a comprehensive service including one assessment bed and one day place per 1,000 elderly persons; the number of long-stay beds depends on the number of places available in the private sector. While the Canadian health care system differs in some fundamental ways from that in the UK, the principles and guidelines derived from the UK experience may be applied to meet the psychiatric needs of the elderly in Canada.
Patients who Reoffend while on Warrants of the Lieutenant-Governor
Authors: Phillips Michael S. , Dickie B.
Published: April 2017

Occasionally, psychiatric patients detained in institutions against their will or residing in the community under legal restraints elope and commit serious offenses. The authors looked at the frequency with which this occurred with patients on warrants of the Lieutenant-Governor in Ontario. Using the files of the Ontario Lieutenant-Governor's Board of Review, they examined the records and isolated such recorded incidents over a 16 year period. In spite of the limitations identified by the authors, their findings indicate a lower than expected occurrence. As well, they point to the risk management implications of certain diagnostic groups being treated in a less than secure setting.
Homophobia Among Psychiatric Residents, Family Practice Residents and Psychiatric Faculty
Authors: Chaimowitz G.A.
Published: April 2017

As the number of AIDS cases has continued to increase, psychiatric research has focused on the victims of this disease. Little has been written about the caregivers and the impact that their attitudes have on patients. There have been a few studies measuring attitudes of health care providers to homosexuals and AIDS patients, but to the best of our knowledge, none have looked at the attitudes of psychiatrists or residents in psychiatry.

Psychiatric residents, family practice residents and psychiatric faculty in a medium-sized Canadian medical school completed a questionnaire measuring attitudes toward homosexuals. We report on the results of this questionnaire and comment on the impact of the attitudes of health care professionals on the quality of patient care.
Aspects Cliniques et Neurobiologiques de L'Administration à Long Terme des Psychotropes*
Authors: Bourin Michel , Bradwejn Jacques
Published: April 2017

In neuroleptic therapy for psychotic illnesses, clinical improvement occurs much later than central dopamine blockade, and its time course varies widely among patients. A hypothesis explaining neuroleptic-responsive illness cannot be explained by dopamine blockade alone. Nevertheless, experimental data suggest that this mechanism may be a step in the therapeutic process for schizophrenia. Explanations are suggested for the time lag in therapeutic response for neuroleptics, including the hypothesis of delayed inactivation of mid-brain dopamine neurones.

Chronic benzodiazepine treatment elicits adaptive responses in the CNS that are manifested as functional tolerance and physical dependence. Possible mechanisms involved in such a profound alteration of neuronal functioning are suggested. Down regulation of benzodiazepine receptors has been shown to be related to functional tolerance under certain conditions.

The effect of repeated treatment with antidepressants is compatible with the hypothesis that changes in central monoamine transmission are involved in the activity of these drugs. Beta-adrenergic receptors are desensitized and their density is decreased; alpha-2 adrenoreceptors sensitivity is reduced, and post-synaptic serotoninergic receptors sensitivity is increased. It remains to be clarified whether some of the changes have larger role than others or whether they all contribute to the psychotropic drug activity in the therapeutic process.
Outcomes of Admission to a Psychogeriatric Service
Authors: Rockwood Kenneth , Stolee Paul , Brahim Asad
Published: April 2017

There is an increasing demand in Canada for improved care of elderly patients with psychiatric disorders. We report one year's experience, with a one year follow-up, of 130 consecutive admissions to the psychogeriatric service at Alberta Hospital, Edmonton. Approximately one-half of the patients came from the community and one-half from long term care institutions; 38% were admitted via an acute care hospital. The median age was 76 years (range from 43 to 92). Aggression (45%) and wandering (29%) were the most common problems. Dementia was diagnosed in 58% and depression in 19% of patients; 17% had medical problems which precipitated or exacerbated the presenting symptoms. The median length of stay was 92 days (range from one to 365 days); patients admitted from long term care facilities were hospitalized for a longer period of time than those admitted from the community. The mortality rate was 16% in the hospital and five percent at one year follow-up. Approximately one-half of the patients were discharged back to their original residence. These results suggest that even very severely disturbed behaviour can be managed successfully and that a close link between medical diagnostic and treatment services is important. Innovations between these services and long term care facilities may reduce the need for prolonged hospitalization.
Psychiatry in the Canadian Correctional Service
Authors: Green Christopher M. , Menzies Robin P.D. , Naismith Laurence J.
Published: April 2017

This paper traces the development of psychiatric services for offenders suffering from mental disorders within the Correctional Service of Canada from the 19th century to the present day. The major milestone in the development of these services was the report to the Solicitor General of Canada in 1972 entitled “The General Programme for the Development of Psychiatric Services in Federal Correctional Services in Canada (Chalke Report). The report resulted in the development of the regional psychiatric centres, which remain the cornerstone of psychiatric services within the Canadian federal correctional system. Based on the authors' own experiences working at Corrections Canada, the paper endeavours to explore the psychiatric services now being offered and the difficulties remaining.
Schizophrenia with Secondary Transsexualism*
Authors: Caldwell Cary , Keshavan Matcheri S.
Published: April 2017

We describe a patient with schizophrenia who developed transsexualism. The emergence of transsexualism and the patient's improvement paralleled those of the schizophrenic illness. The relationship between the diagnosis of the primary psychiatric illness in transsexualism has implications for prognosis and appropriate management.
The Occupational Stress of Judges
Authors: Rogers Joy M. , Freeman Stanley J.J. , Lesage Patrick
Published: April 2017

This paper reports the results of what is believed to be the first systematic survey of the Canadian judiciary about work-related stress. County and District Court judges from four provinces who were attending an educational event on two successive years (N=104) reported in writing, anonymously, their perceptions of the most stressful aspects of being a judge. A similar survey of their spouses (N = 48) added another perspective to the findings. The overwhelming majority of respondents reported aspects of the work itself (for example, sentencing, child custody cases, judgements, decision-making, and jury trials) as being their primary source of occupational stress. This is not in keeping with the results of most studies, which find that workers view job factors such as role conflict, employer/employee relationships, and career decisions as being more stressful than the actual work they perform. Qualitative material from individual and group interviews suggests that additional preparation and training for the bench and mechanisms for reducing isolation and improving communication might alleviate the stress experienced by judges, while helping them to cope more effectively with their increasingly complex and difficult roles.
Pilot Study of Anxiety and Depression in Prepubertal Children
Authors: Stavrakaki Chrissoula , Williams Esther Caplan , Walker Selena , Roberts Nasreen , Kotsopoulos Sotiris
Published: April 2017

Early detection of anxiety and depression is important because of the relationship between these disorders, suicide and other problems (i.e. social, phobias, learning problems). This study screened prepubertal students in a school setting for symptoms of anxiety and depression using self-report measures (Revised Children's Manifest Anxiety Scale and the Children's Depression Inventory). Controls and children who scored high on measures of anxiety or depression or both were interviewed with their parents and were tested using the Diagnostic Interview for Children and Adolescents (computer version) and the Peabody Individual Achievement Test. Initial results indicated that anxiety is more prevalent in prepubertal children than depression. The correlation between different diagnostic measurements used in this project was calculated. A correlation was found between low scores of self-esteem and high scores of anxiety and depression on self-reports. It is concluded that self-report measures are good screening tools.
La judiciarisation du traitement du malade psychiatrique inapte qui refuse catégoriquement de consentir
Authors: Cournoyer Jocelyne , Monette Yvan
Published: April 2017

Psychiatrists in particular face a cliinical, legal and social dilemma in treating their patients who are likely to categorically oppose treatment. This article illustrates this dilemma in the context of Quebec's Bill 145, resulting in the care of psychiatric patients being increasinly referred to the courts. After presenting this legislation and a case, the authors illustrate the impact of this legislation in light of their own experience and similar legislation in the United States. The mechanisms proposed by Bill 145 have proved costly in several respects as well as cumbersome and ineffecive. The authors propose the establishment of an administrative tribunal as an alternative to the current recourse to the courts.
Electrical Dosage and Efficacy in Electroconvulsive Therapy
Authors: Enns Murray
Published: April 2017

The traditional view is that the elicitation of a series of generalized cerebral seizures is the essential requirement for efficacious electroconvulsive therapy (ECT). This theory is the basis of many recent recommendations that the minimum electrical dose required to elicit generalized seizures should be used. Evidence challenging this theory is reviewed, which suggests a role for supra-threshold electrical stimulation in ECT. Hypotheses to explain these findings are examined, and recommendations are made.
Using Meta-Analysis in Psychiatric Research
Authors: Streiner David L.
Published: April 2017

Meta-analysis is a technique for summarizing the results of many studies which can allow reviewers in a particular field to arrive at a synthesis of the various findings in a more objective manner than relying on expert opinion and combine the results of these studies to arrive at an overall estimate of the magnitude of the effect of a treatment, to determine if the evidence favours its effectiveness. The technique consists of determining an effect size or odds ratio for each study and combining them, taking into account the fact that studies with large samples should exert more influence than those with small samples. However, the procedure is not mechanical. The reviewer must make a series of decisions regarding the studies to be included or excluded, the weight to place on the methodological rigour of the trials, the results from each study to be used, how to handle differences in the magnitude of the results across studies, how to derive the best overall estimate of the effect across studies, and how to determine the precision of that estimate. Each of these decisions can affect both the quality of the review and the nature of the findings.
Sleep Disturbance in Depression Reconsidered
Authors: Southmayd Stephen E. , Cairns James , David Michela M.
Published: April 2017

The well documented observation of a characteristic sleep disturbance in depression has been accorded a good deal of significance. Several current hypotheses regarding the etiology of depression, are based on these findings. However, a review of the descriptive studies shows that care has not generally been taken either to restrict or objectively measure daytime sleep. Evidence is presented suggesting that daytime sleep may occur in depressed patients more frequently than commonly thought and that, in normal subjects, daytime napping can result in nocturnal sleep changes similar to those seen in depressed patients. A model is proposed in which the nocturnal sleep disturbance in depression reflects the occurrence, during the daytime, of frank slow wave sleep or periods of larqe amplitude, slow wave EEG activity as a consequence of a dampening of the circadian rhythm of sleep propensity.
Assessment of Premenstrual Complaint using the Premenstrual Assessment Form: Comparison of Two Populations
Authors: Yuk Vivienne J. , Cumming Ceinwen E. , Fox Eugene E. , Cumming David C.
Published: April 2017

The Premenstrual Assessment Form (PAF) provides frequencies of diagnoses for subjects meeting the criteria for typological classifications which are similar in New York and Edmonton, suggesting that the instrument is stable in assessing premenstrual complaint. However, the frequency with which an unselected population meet the criteria suggests that more strict criteria and/or a “severity index” would be appropriate. It seems likely that a modified form of the PAF could fulfil some of the intentions of its originators.
Adolescent Female Firesetters
Authors: Saunders Elisabeth B. , Awad George A.
Published: April 2017

A retrospective study of the charts of 13 female adolescent firesetters revealed severe family and individual pathology. The parents had a history of separation, violence, alcohol and/or drug abuse, and inability to take care of the children. The girls had a long history of serious behavioural problems. Four girls had set one fire, six had set several fires within a period of a few days, three had a long-standing history of setting fires. The girls showed a lack of remorse or concern for their behaviours.
Hypothèses actuelles sur le mécanisme d'action centrale des benzodiazépines
Authors: Bouchard L-P. , Llorca P.M. , Wolf M.A.
Published: April 2017

Les benzodiazépines (BZD) produisent leurs effets cliniques en se liant à des récepteurs spécifiques du système nerveux central. Le récepteur BZD fait partie d'un complexe supramoléculaire qui possède également des sites allostériques pour les barbituriques et le GABA. En facilitant l'unité de couplage GABA-canal à CL-, les BZD potentialisent l'inhibition neuronale. Les recherches actuelles visent à préciser le fonctionnement moléculaire des récepteurs et à identifier leurs ligands endogènes.
Seasonal Affective Disorder Presenting as Chronic Fatigue Syndrome
Authors: Lam Raymond W.
Published: April 2017

Although operational criteria have been recently proposed to better define chronic fatigue syndrome (CFS), it remains a controversial diagnosis. There are many overlapping symptoms between CFS and major depression. The author presents two patients with seasonal affective disorder, who responded to phototherapy and had previously been diagnosed as CFS. Because of the consequences of treatment, seasonal and non seasonal depression need to be ruled out in patients with chronic fatigue symptoms.
Group Therapy in a Forensic Setting
Authors: Stein Eleanor , Jennifer D. Brown
Published: April 2017

Mentally ill offenders are especially difficult patients to rehabilitate. Although group therapy is a universal method of treating these patients, their ability to benefit from group therapy has not been proven. The authors studied a group of patients held on Warrants of the Lieutenant Governor to assess their personality characteristics and their ability to develop group dynamics which are beneficial in other patient populations. The findings were that forensic patients have personality characteristics which preclude the development of these therapeutic dynamics.
Fluoxetine Potentiation by Buspirone: Three Case Histories
Authors: Bakish David
Published: April 2017

The potentiation of fluoxetine by buspirone is described in three cases of treatment-resistant depression. All three patients improved markedly with very few side-effects from the medication. The possibility of synergy between drugs that affect serotonin reuptake inhibition, 5HT1A receptors and 5HT2 receptors is discussed.
The Effects of Cyproterone Acetate on Sleeping and Waking Penile Erections in Pedophiles: Possible Implications for Treatment*
Authors: Cooper A.J. , Cernovovsky Z.
Published: April 2017

This study reports the short term effects in five pedophiles of the antiandrogenic drug cyproterone acetate (CPA) on nocturnal penile tumescence (NPT); penile responses to erotic stimuli in the laboratory; and sex hormones (testosterone, LH, FSH and prolactin). During the administration of CPA, NPT, laboratory arousal and hormone measures (except prolactin) all decreased. Waking laboratory measures were influenced less and were more variable (one subject showed greater arousal) than NPT measures. The changes in NPT closely paralleled the reduction in testosterone. The results are discussed with reference to the known psychoneuroendrocrinology of sleeping and waking erections.
Triiodothyronine Potentiation of Fluoxetine in Depressed Patients*
Authors: Joffe Russell T.
Published: April 2017

Triiodothyronine (T3) has been shown to augment the therapeutic effect of tricyclic antidepressants as well as monoamine oxidase inhibitors. In this report, three cases of T3 potentiation of the antidepressant effect of fluoxetine are described. The results suggest that T3 augmentation may be effective with a wide range of antidepressants.
The Measurement of Expressed Emotion: A Review*
Authors: Kazarian Shahe S.
Published: April 2017

Expressed emotion refers to the affective attitudes and behaviours (i.e., criticism, hostility and emotional over-involvement) of relatives toward a family member with a psychiatric illness. In this article, the Camberwell Family Interview, the standard method used to assess expressed emotion, and alternative approaches to the measurement of expressed emotion are reviewed. While there is a reasonable correspondence between ratings derived from the Camberwell interview and the less arduous alternative methods, the association is not perfect. In addition, the conceptual similarities and prognostic utility of these measures require replication and further exploration. Of the alternative assessment methods available the use of the Five Minute Speech Sample or the Level of Expressed Emotion Scale as screening devices is recommended.
Guidelines for a Non Sexist (Gender-Sensitive) Doctor-Patient Relationship*
Authors: Bishop Joan
Published: April 2017

The following guidelines have been adapted from the Canadian Psychological Association's Guidelines on Therapy and Counselling with Women (1) and have undergone revisions and additions to make them suitable for both male and female patients and useful for physicians. The guidelines were approved by the Board of Directors of the Canadian Psychiatric Association October 4, 1991.
Psychiatric Emergency Services in a Canadian City: II. Clinical Characteristics and Patients' Disposition
Authors: Oyewumi L.K. , Odejide O. , Kazarian S.S.
Published: April 2017

The clinical characteristics of patients seen at the psychiatric emergency facilities in a Canadian city and the determinants of decisions regarding their treatment were investigated. A total of 544 patients who sought psychiatric emergency services from the three hospitals in Saskatoon during a three month period were studied. Cognitive disturbance, past psychiatric history, previous psychiatric hospitalization and diagnoses of substance use disorders, affective disorders, anxiety disorders and schizophrenic disorders were associated with psychiatric emergencies. Psychiatric diagnoses and availability of social support were significantly associated with disposition. The implications of these findings for psychiatric emergency services are discussed.
You Drive Me Crazy: A Case Report of Acute Psychosis and Neurocysticercosis*
Authors: Shriqui Christian L. , Milette Pierre C.
Published: April 2017

Cysticercosis is a parasitic disease endemic in several developing countries where people consume raw or insufficiently cooked pork. The authors present a clinical picture of an organic psychosis in a 24 year old female with CNS cysticercosis. The neuroradiologic follow-up of this patient pre and post treatment with praziquantel is presented. The implications of this case with regard to the pathophysiology of schizophrenia and schizophrenia-like psychoses is discussed.
Agoraphobia: What Westphal Really Said*
Authors: Kuch Klaus , Swinson Richard P.
Published: April 2017

In 1872 Westphal described a series of patients who experienced unexpected and situational panic attacks in squares, empty streets, on bridges and in crowds. They suffered from anticipatory anxiety and a fear of sudden incapacitation. The symptoms of agoraphobia have not changed appreciably in well over a century.
When the System is the Problem, Don't Blame the Patient: Problems Inherent in the Interdisciplinary Inpatient Team
Authors: Butterill Dale , O'hanlon Jacinta , Book Howard
Published: April 2017

Organizational theory used in conjunction with the transference/countertransference paradigm enables members of the interdisciplinary team to look at treatment problems from two perspectives and to intervene at the appropriate level. Common problems of the team are poorly defined accountability, a lack of leadership, communication breakdowns, and boundary violations. Suggested interventions are education of team members about organizational theory, open discussion of contentious issues, and reinforcement of boundaries. The dynamics of the team are important and a team can benefit from self-examination through organizational theory.
A Study of Competence to Consent to Treatment in a Psychiatric Hospital*
Authors: Hoffman B. F. , Srinivasan J.
Published: April 2017

Sixty patients admitted to an acute treatment ward in a provincial psychiatric, hospital were assessed for their competence to consent to psychiatric treatment. A semi-structured interview was used to determine whether they met none, some or all of the four necessary criteria for competence outlined in the Mental Health Act of Ontario. Only 21 of the 60 patients (37%) met all four criteria necessary for a patient to be considered competent to make their own decisions regarding psychiatric treatment. The study outlines the major difficulties in the assessment of competence to consent to psychiatric treatment. Our findings suggest that 74% of patients found incompetent using the current definition in the MHA (Ontario) would fail almost any reasonable test. The implications of these findings are discussed.
The Pharmacoepidemiology of Treatment-Refractory Schizophrenia*
Authors: Collins Evan J. , Hogan Thomas P. , Awad A.G.
Published: April 2017

Treatment-refractory schizophrenia is a major clinical problem for which there is relatively little scientific information, and no consensus has been reached on approaches to treatment. The pharmacotherapy used for 103 patients with a diagnosis of schizophrenia or schizoaffective disorder at one psychiatric hospital was examined. Data were gathered on neuroleptic choice and dose, the use of adjunctive treatments and serum neuroleptic levels. The daily neuroleptic dose was compared with that of random samples of patients receiving outpatient maintenance treatment, and short-stay patients receiving acute treatment. The patients in our sample received high doses of neuroleptics despite a persistent lack of response to treatment, and despite the fact that these were in excess of the recommended maximum beneficial dose. The appropriateness of this therapy is discussed.
Emploi du système d'aide au diagnostic Adinfer dans une étude sur la plainte somatique en médecine générale*
Authors: Ohayon M. , Caulet M. , Bosc M.
Published: April 2017

Somatic complaints are very common in general medical practice. They are not identified as psychic disorders and are treated symptomatically. We explore two kind of problems: 1. methodological problems such as the instruments to use to examine somatic complaints (it is evident that a checklist does not give the best results with suggestible patients); and 2. the relationships between somatic complaints and psychic disorders such as anxiety, depression and somatoform disorders. Psychiatric nosology is by no means clear and includes many diagnoses from “hysteria” to “hypochondria” or “psychosomatic”, “somatization”. In this study, we compare the symptoms collected by general practitioners, and their clinical diagnoses to those obtained by an automatic DSM-III diagnostic program. Adinfer was modified so that three DSM decision trees were systematically scanned: depressive, anxiety and somatoform disorders. This allows for an epidemiological study of somatic complaints and their relationship to depression and anxiety. The subjects' score on rating scales for anxiety and depression are compared with the diagnoses made by the expert system. We discuss the significance of somatic symptoms, the DSM classes and the value of expert systems in epidemiological studies.
Child Psychiatry and Early Intervention: I. The Aggregate Burden of Suffering*
Authors: Beitchman J.H. , Inglis Alison , Schachter Debbie
Published: April 2017

This paper discusses the need to estimate the costs of an illness to properly allocate intervention resources for the various psychiatric disorders of childhood. Disorders that require the most community resources should be given the highest priority for early intervention programs. Factors to consider for estimating disorders which are most costly are discussed here: the incidence of the disorder, its severity, whether it is episodic or stable, and its impact on the individual, family and the community. These factors contribute to the aggregate burden of suffering caused by a disorder.
Abduction during Custody and Access Disputes*
Authors: Cole W.A. , Bradford J.M.
Published: April 2017

In recent years abductions during divorce custody and access disputes have received greater attention from both the lay and medical press. However, little has been written on the psychopathology of the abductors or the impact on children of being kidnapped by a parent. In this study 20 cases of abduction, involving 20 parents and 37 children, were examined after the children had been located and returned to the custodial parent. Characteristics of the abduction and psychopathology seen in the children are compared to those of a control population. The outcome of assessments conducted by the family court clinic after the abductions are profiled.
Encephalitis Associated with Herpes Zoster: A Case Report and Review*
Authors: Mckenna K.F. , Warneke L.B.
Published: April 2017

This paper describes the case of a patient with a history of affective disorder who developed encephalitis associated with herpes zoster which presented as a delirium with prominent manic symptoms. Published reports of encephalitis following herpes zoster infections are reviewed. The diagnosis of herpes zoster-associated encephalitis should be suspected in individuals with changes in his or her mental state, an abnormal electroencephalogram and an abnormal cerebrospinal fluid examination which closely follow a cutaneous herpes zoster lesion.