bluuebunny/crossref_metadata_2025 huggingface dataset:
The Angry Parent in Family-Oriented Therapy
Authors: Menzies M. Albert
Published: April 2017

This paper is directed to the problem of parental hostility in its various forms and degrees. Hostility is defined as a destructive, negative feeling, variously described as anger, resentment, hatred and rejection. Both open and hidden forms of expression are considered, with hidden anger seen as the more damaging one. Hostility is viewed as a defensive reaction to a real or imagined threat; the hostile parent feels unable to cope with the challenge presented by the child because of multiple etiological factors coming to bear on the parent. Treatment is discussed on the basis of ventilation and acknowledgment of the hostility, with the parent being helped to accept it as a natural human reaction in the face of a challenge which is seen as both overwhelming and inescapable. The second phase of treatment is a study of the general and specific factors which impair the feeling of adequacy of the parent in dealing with this particular child. With resolution of enough of these factors, the parent is helped to feel sufficiently confident with the child so that the hostile reaction is not necessary. Then, at last, the child who has been deprived of parental love can have it once again and the vicious cycle of mutual hostility between parent and child can be replaced by a new cycle of interaction which is based to a much greater degree on mutual love and understanding.
The Speech and Language Abilities of Emotionally Disturbed Children
Authors: Weber Jack L.
Published: April 2017

The speech and language disorders of these severely disturbed children can be divided into two categories which relate to the type of psychiatric disturbance. The autistic-schizophrenic children used bizarre forms of language or did not use communicative language at all. The non-autistic-schizophrenic, the neurotic, the primary behaviour disorder, and the minimally brain-damaged children as a group, had similar speech and language problems to normal children but of a more severe and frequent nature. Their problems were predominantly in the areas of speech and language development, articulation, rate of speech and fluency. The children with primary behaviour disorders had the more severe speech and language problems.
Psychiatric Problems of University Students
Authors: Boyce R.M. , Barnes D.S.
Published: April 2017

Student patients were investigated by use of the questionnaire method and clinical observation during the years 1962–4.

Questionnaire results revealed that patients, significantly more often than a group of controls, had attended one or more universities prior to the University of Western Ontario, had no extra-curricular activity, had not fulfilled their father's wishes in regard to course, smoked, smoked more than 20 cigarettes a day, were not abstainers, had chronic or recurring illness, had changed courses, lived in a room or apartment, were either the first or last child, slept six hours or less, had changed in weight by 10 lb. in the preceding three months, and had no faith preference or affiliation.

Depression was most commonly encountered. A relatively high number of students in English and post-graduate students were seen. Two groups of ill students who were friends or intimates to a degree were encountered and the presence of ill teachers or other leading figures as a focus in these groups was described. Increased academic competition served as a stress for some. Disturbed family inter-relationships and current social expectations were among factors which appeared to favour the development of illness.
Assessing the need for Psychiatric Care
Authors: Richman Alex
Published: April 2017

This paper reviews the methodology employed in assessing the extent and characteristics of persons needing psychiatric care. Surveys of the need for physicians' care for any type of disorder (as well as psychiatric) are characterized by problems associated with:

a) Diagnostic process

b) Social factors in attending physicians

c) The natural history of the disorder

d) Definitions of impairment, disability and handicap

e) Clinical insignificance of some statistically significant factors.

Case-finding in psychiatry has additional problems associated with the use of symptom questionnaires; the criterion of work limitation; and the question of past versus present disability. Determination of the type of psychiatrists' care required is also of paramount importance.

One should not equate symptoms with illness; nor symptoms with a need for psychiatrists' care. Community surveys have not yet been able to provide valid estimates of the nature or extent of psychiatrists' care required.
Clinical note on the Possible use of Clomiphene Citrate in Recurrent Psychosis
Authors: Cookson B. A.
Published: April 2017

Clomiphene citrate is a drug which may induce ovulation in anovulatory women. Its use in women with recurrent psychoses is suggested by the observation that such women frequently display menstrual irregularities such as amenorrhoea or anovulatory cycles during their disturbed phases.

The author has investigated the use of this drug in three women with recurrent psychoses who were studied for a minimum of 30 months prior to testing. Each of these women showed menstrual irregularities and had a psychosis with an abrupt onset in the second half of the menstrual cycle. In each case a beneficial behavioural change commenced during the latter half of the first menstrual cycle regulated by clomiphene.

Patient B. W., prior to the use of clomiphene, had a well-established periodic catatonia which occurred approximately every 37 days; during the half-year that she received cyclical clomiphene therapy there was a radical alteration in the pattern of her illness followed by a disappearance of its major features. J.W. a schizophrenic, and A.C. a manic-depressive, both emerged from prolonged withdrawn states when menstrual function was restored with clomiphene.

The tendency of recurrent psychoses to remit spontaneously makes the author cautious in advancing his claim that clomiphene citrate is an effective therapeutic agent in this type of malady. If the work is confirmed it will have importance not only therapeutically but also theoretically.
Memory Dysfunction: A Prognostic Indicator in Geriatric Patients*
Authors: Kral V. A. , Müller H.
Published: April 2017

The results of a five-year survey of 696 aged patients of a mental hospital are presented. It was found that patients suffering from organic brain disease with an amnestic syndrome (malignant senescent forgetfulness) as the leading psychopathological sign, have a significantly higher death rate and a significantly shorter survival time than patients of the same age with preserved memory function or the ‘benign’ type of forgetfulness, but suffering from functional psychoses, even if the latter had been hospitalized for much longer periods of time than the former. It was, furthermore, found that the presence of an amnestic syndrome is a highly significant prognostic indicator of the general health of the individual. Some theoretical implications of these findings are discussed.
Private Practice and Psychiatry Today
Authors: Davidson George A.
Published: April 2017

The advantages and disadvantages of the private practice of psychiatry have been discussed.

The changing times and the training for private practice of psychiatry have been considered.

The aims in treatment and how the patient's needs are best met are mentioned.

Finally, a look at ourselves and how psychiatrists can best function in meeting the needs in the community is considered.
Capgras' Syndrome: the Illusion of Doubles
Authors: Bankier Robert G.
Published: April 2017

The Capgras illusion is a rare symptom occurring in patients suffering from a psychotic illness having strong paranoid features. The patient misidentifies a close relative and believes instead that a double of the relative has been created. A brief review of the literature is given, followed by a detailed account of one unusual case recently observed by the author. The various theories concerning the ætiology of the symptom are discussed.
Group and Family Therapy Abnormalities in Siblings of Schizophrenic Children
Authors: Havelkova Milada
Published: April 2017

In 209 families with schizophrenic children, 18 families with more than one abnormal child were found. Among the parents of this group there was a high incidence of marital discord, schizoid personalities and different forms of schizophrenia. Among the siblings mental defect, speech delay, and schizophrenia were found. Because of the high incidence of the children in this group functioning on a mentally defective level, special attention was paid to the problem of the intellectual function of all family members. Twenty-four (40%) of the 60 children in these 18 families studied presented a picture of intellectual defects along with schizophrenic process. In three (5%) mental defect was found without typical symptoms of childhood schizophrenia. None of the parents were found to be mentally defective and only one was found to be of borderline intelligence. Twenty (55%) parents were of normal intelligence and 15 (42%) were bright normal to superior, while the corresponding figures for the children were 22 (36.6%) and six (10%). There were only four children whose intellectual function improved while there were 16 who deteriorated considerably.

There was an unexplained finding of an unusually high number of twins among the 18 families. We found five pairs of twins. Two pairs were monozygotic, concordant for schizophrenia. Two pairs were dizygotic, discordant for schizophrenia. One of the fifth pair died early; the second was mentally defective.
Suicide: A Critical Review of the Literature
Authors: Adam Kenneth Stuart
Published: April 2017

A review of the literature on suicide with particular emphasis on its research aspects has been completed. Demographic studies have given some information about the circumstances surrounding suicide, but have been criticized for their incomplete data, the validity of their statistics, and their failure to explain individual suicide. Psychodynamic studies have relied heavily on the dynamics of depression to explain suicide and generally have failed to explain suicidal behaviour in other dynamic constellations. Clinical studies searching for reliable indicators of suicide have encountered many methodological problems making conclusions uncertain, thus limiting practical application of the findings. An important neglected area of study is felt to be the phenomenology and developmental psychology of suicidal ideation. Some of the sparse literature in this area is reviewed and its significance in terms of object relations theory is discussed. The hypothesis that the suicidal impulse is a variant of normal psychological development with important determinants in early childhood is proposed. This proposal is discussed in terms of its implications for future research.
Quelques Considerations Sur Le Taux Eleve De Schizophrenie Dans Un Type De Communaute Canadienne — Francaise
Authors: Murphy H. B. M. , Lemieux Marcel
Published: April 2017

A mental health survey of fourteen rural Quebec and Ontario communities of various cultural backgrounds, revealed that the active prevalence of schizophrenia in the three traditional French-Canadian communities chosen was much higher than in any of the remainder, Careful re-examination of the data indicated that the difference was genuine, not deriving from diagnostic bias or cultural outlook of the investigators, from the age structure or socio-economical level of the communities, or from differences in use of psychiatric services. The excess of cases, however, proved to lie almost wholly in the female half of the population, and further analysis showed that the disorder struck especially at young unmarried women and at middle-aged married ones, the younger married group being relatively free.

Sociological investigations suggest that one of the factors contributing to the observed excess of schizophrenia is a discrepancy between the actual and the nominal roles occupied by women in the traditional communities. Other factors may be the greater tolerance of dependency which the latter show, the greater clarity with which they enforce their concept of the sick role, and their greater intolerance of other forms of deviancy.
The Nature of the Psychotic State
Authors: Powles William E. , Burk E. David
Published: April 2017

We have drawn on a number of sources in discussing the shared nature of various psychotic states, with a debt particularly to the psychoanalytic and cybernetic points of view.

Clinical psychiatry does have some problems with its classifications of states of illness. At present there seems to be some disagreement between the point of view which sees all psychiatric illnesses in mutually exclusive syndromes, and the point of view which sees mental health and equilibrium as existing along a continuum. Psychotic states occupy one end of such a continuum or spectrum: they are far enough removed from normality that the two are mutually exclusive, and they differ quantitatively and qualitatively from neurotic states.

The concept of psychosis appears to have operational value. We must however disentangle several kinds of definitions or we have semantic chaos. Socially, insanity is defined as behaviour beyond the social norm and carrying with it certain connotations of danger to the social fabric. Clinically, the diagnosis of psychosis implies a serious disorganization of mental health or adaptation with a guarded prognosis and requiring special drastic treatment methods. Psychopathologically how can the psychotic state be defined?

We have devoted some space to the discussion of the concept of the cognitive and executive ego, since psychosis is seen primarily as a disordered ego state. The nature of this disorder appears to be that of a rupturing or disarticulating of certain fundamental organizations of memory, which have been welded together into the primordium of the ego. In architectural language we might call these foundations, in computer language programs, in cybernetic language guidance systems, and in everyday language, character. The nature of the bonds and energies which hold such collections of experience together as guidance systems is not understood. We must assume that it has a neurophysiological substrate. Both under conditions of extreme psychic stress and of bra:n-tissue disturbance these fundamental operating patterns are disrupted, resulting in certain characteristic symptoms of hallucinosis, extremely severe affective change, and disorders of thought and logic. This model his some implications for treatment, particularly for psychotherapeutic treatment, including the management of ‘organic’ psychoses. There are, further, certain interesting contradictions between the social, clinical and psychopathological frames of reference which we have touched on only briefly.
The Chronic Patient in the Community A Two-Year Follow Up of 338 Chronic Patients
Authors: Herjanic M. , Stewart A. , Hales R. C.
Published: April 2017

Three hundred and thirty-eight chronic psychiatric patients were followed up for two years after their discharge. Information was available on all but four patients. During the twenty-four month follow-up period, 11% had died and 25% required readmission. The source of support and living arrangements for the whole group were discussed, and the opinions about the outcome by the informant, psychiatrist, and social worker, were compared, The opinions correlated remarkably well. Characteristics of community care deemed important by the investigators were discussed briefly.
A Blind Comparative Trial of Nortriptyline and Isocarboxazid in Depressed Outpatients*
Authors: Hays P. , Steinert Jack
Published: April 2017

Nortriptyline and isocarboxazid were blindly compared in a trial on psychotically depressed outpatients. Response was roughly equal in each group; some clinical prognostic guides, noted in a previous trial, were confirmed.
Article
Authors: Gauthier Yvon , Drapeau Pierre , Leclaire Françoise , Fortin Claire , Forget Gérard
Published: April 2017

This study of the diagnosis, ego functions and degree of affective deficiency in the encopretic child shows that although the problem remains complex these children can be subdivided into two main categories: neurotics and those suffering from ego disorders. The neurological and intellectual equipment of the latter group is below that of the neurotic children, and they show a marked tendency to an exaggerated or deficient motor control. Family troubles also contribute to the condition which in the case of these children appears to be due to developmental arrest, evident also in other areas.

As to neurotics, the study of their dynamics reveals depressive elements related to separation or threatened separation. The traumatic aspect is often more symbolic than real. Repressed aggressivity appears as an important feature of this category of encopretic children.

Ego-disturbed children present significantly higher indications of affective deficiency, especially due to family environment. It seems that this factor of affective deficiency overlaps diagnostic categories and in some cases appears to be related to serious marital problems of the parents.

This study does not show why such children have ‘chosen’ to become encopretic. It only gives some indications as to the type of family environment where the symptom develops, and identifies certain precipitating conditions. It also appears that the majority of parents will tolerate such a condition for a long time without seeking advice. This confirms the importance of family environment in the development of the symptom, and indicates that further research should concentrate on the study of original mother-child relationships, inasmuch as they influence sphincter control, and also on the whole family network, which seems to be frequently implicated in the child's symptomatology.
Amplitude-Averaged A-Scan Echoencephalography of a Mental Hospital Population
Authors: White D.N. , Clark J.M.
Published: April 2017

Two surveys of the population of the local mental hospital were carried out by the Amplitude-Averaging technique for A-scan echoencephalography. A total of twelve cases appeared to have shifted cerebral midline structures. Of these, ten were investigated further and four were thought to be cases of false positive error in patients with marked enlargement of the ventricular system from various causes.

The remaining six cases were thought to be correctly diagnosed by echoencephalography though this was proven in only three patients. Of the six patients believed to have displaced midlines, most if not all were due to unilateral atrophic disease rather than to space-occupying lesions.

The technique would not seem to be economically valuable for the investigation of resident mental hospital patients.
Le Coupable Est-Il un Malade?
Authors: Chevalier François
Published: April 2017

This paper reviews both English and Canadian law governing the concept of insanity in relation to criminal offences. The prevailing legal doctrine and jurisprudence show that both our penal system and our present judicial way of thinking are outdated and do not take into account the progress of the science of psychiatry.

The contention is that our criminal law should be revised and should recognize that the antisocial behaviour of an individual is, in many instances, the result of an abnormal mental condition which renders him incapable of judging whether or not his actions are criminal, and consequently it is suggested that such behaviour should not be dealt with by sentencing the person to prison but by commitment to a psychiatric institution.
Child Murder by A Depressed Mother: A Case Report*
Authors: Rodenburg Martin
Published: April 2017

There is a risk that children may be killed by parents suffering from a severe depressive illness. This risk becomes grave when the patient is actively suicidal.

A case has been presented in detail in an attempt to illustrate some of the factors previously reviewed. Many features of the patient's personality seem to fit. the characteristics outlined by other authors. Here, however, the aggressive impulses were not directed primarily toward the child, but the daughter had become part of an increasing conflict situation which the patient attempted to solve by destroying her.

It is a sad fact that this tragedy might have been prevented if both the husband and the patient had been aware of the early symptoms and the homicidal risk involved.
Psychiatric Patients in the General Hospital Casualty Service
Authors: Harvey Michael L. , Brown James H.
Published: April 2017

Data are presented regarding the psychiatric patients seen in the Casualty-Emergency Service of the Winnipeg General Hospital during a fifteen-day period, and this group is compared with the general casualty intake, and to a lesser extent with the population of the area served.

The psychiatric patients had a higher proportion of:

1) admissions to hospital

2) females

3) persons aged 40 - 49

4) persons divorced or legally separated

5) newcomers to the Province

6) visits between 2:00 a.m. and 6:00 a.m.

In the psychiatric group there was a preponderance of women among those diagnosed as neurotic and of men among those diagnosed as alcoholic. These findings are discussed and compared with those in the literature.
Effectiveness of Ward Meetings
Authors: Shamsie S. J. , Clark J. E.
Published: April 2017

A study was undertaken to investigate the reasons for dissatisfaction with ward meetings on the part of the staff who attend them. The research situation was a children's unit of a large psychiatric hospital. The study was carried out by giving a questionnaire to all the ward staff including the chief-of-service for each ward.

The findings indicated that in general the meetings were not well defined in terms of their goals, and it was felt that changes were necessary for all meetings. At the same time the staff thought the meetings were worthwhile, though the majority felt they were not conclusive in solving ward problems.
Institutional Transference and Disengagement: A Study of an Outpatient Clinic
Authors: Sampath H. M. , Kingstone E. , Dhindsa B.
Published: April 2017

This paper describes an outpatient clinic where many of the patients are chronic attenders who resist all attempts at discharge. Their dependency needs and the difficulty of one-to-one treatment are outlined. On the one hand there is the almost insatiable demand for magical medications, and on the other the frustration of the therapists trying to deal with this situation. To circumvent these difficulties, the concept of institutional transference was fostered by a policy of disengagement. As a result a flexible therapeutic set up was evolved allowing for the fulfillment of dependency needs and the maintenance of satisfactory morale, not only among the patients but also among the entire treatment staff. The clinic, instead of being viewed as merely a place for difficult and incurable patients, is now seen as a useful alternative in the treatment armamentarium of the outpatient department.
Migration of Canadian Physicians to Psychiatry in the United States
Authors: Powles William E. , Gysbertsen Johanna B. , Robertson John F.
Published: April 2017

The brain drain — the contemporary striking pattern of migration of skilled professions — is, according to Grubel and Scott, “… an international transfer of resources … completely unrecorded in any official balance-of-payments statistics.” They emphasize the necessity of estimating a net brain drain for a country such as Canada. Canada has, in fact, benefited from the migration of economists. This study examines these questions for psychiatrists: how many Canadians have settled in the United States, how many have come to Canada from other countries and what is the net benefit or loss to Canada?

It is estimated that 550 Canadian psychiatrists were working in the United States in 1969. This was more than half the number of psychiatrists (1,095) then working in Canada. In turn, 444 of Canada's psychiatrists were immigrants and only five were from the United States. The estimated net brain drain to Canada is thus a loss of about 100 psychiatrists.
Maintenance Methadone Treatment of drug Dependency
Authors: Cassidy W. J.
Published: April 2017

An assessment is presented of a treatment program for narcotics dependency which involves the daily oral administration of methadone to act as a blocking agent by virtue of tolerance to all opiates. In every parameter, except holding a job, there was appreciable overall improvement from the time of admission to the methadone program, to its termination, and even in the most difficult parameter of abstinence approximately two-thirds of the patients were virtually abstinent and most of the rest had used heroin only intermittently or periodically. Only five out of thirty-two patients voluntarily stopped taking the methadone in spite of frequent though tolerable side effects.
What is a Sasquatch — or, the Problematics of Reality Testing
Authors: Jilek-Aall Louise M.
Published: April 2017

This investigation indicates that it is more difficult for people living in the isolation of remote areas and surrounded by dark forests and mountains to distinguish hearsay, fantasy, imagination and reality than it is for those who walk through illuminated city streets amidst noisy neighbours. A lonely Euro-Canadian farmer when asked about Sasquatches said, “When it is daylight I don't believe in them but at night when I am alone in the mountains or in the bush they could be real.”

It is also obvious that formal education is an important factor in determining whether a person has unwavering belief in mythology, and the higher the level of formal education the less a person believes in these phenomena.
Sex Differences in the Performance of School Children
Authors: Lester Eva P. , Dudek Stephanie , Muir Roy C.
Published: April 2017

Marked and consistent differences in academic performance between boys and girls were found in a longitudinal study of young school-age children. Performance, measured by objective tests administered by a psychologist, was higher in girls in all grades (Grade I to Grade V). However, tests of intelligence, perceptual maturity and conceptual ability showed no sex-linked differences — the only tests favouring the girls were those of motor ability. To explain the better academic performance of female children, personality attributes were considered (C.P.I.). Statistically significant differences were found in three personality dimensions: girls were found to be obedient and dependent, sober-minded and quiet, practical and realistic. In contrast the boys were found to be assertive and independent, excitable and happy-go-lucky, sensitive and free thinking. The significance of these findings is discussed in terms of academic achievement and also in terms of culturally-determined sex-typing of young children.
Psychiatric Services: Organization of a Psychiatric Ambulatory Care Service in a General Hospital
Authors: Watters W.W. , Goodman A. , Molnar J.G.
Published: April 2017

A psychiatric ambulatory care service in a general hospital which has attempted to incorporate in the program design many of the modern concepts of community psychiatry is described. There is indication that the theoretical orientation of such a program must be discriminatingly eclectic and that the general systems approach, in addition to being operationally useful, offers a framework within which different behavioural models can be accommodated.

The value of program monitoring to provide ongoing feedback to the administrators of such programs and to provide a data base for studies of outcome and cost effectiveness is emphasized.
Test-Retest Performance in Chronic Schizophrenia on the Verdun Conditioning Program
Authors: Ananth J. V. , Ban T. A. , Lehmann H. E.
Published: April 2017

Test-retest stability of the VCP was studied in sixty chronic schizophrenic patients. While no significant correlation between the first and the second test was revealed on any of the eleven individual functions tested, the correlation between the first and second test was found to be significant for the battery as a whole. Since there was also a significant correlation between the first and second test for the integrational functional system in contrast to the autonomic and skeletomuscular functional systems, the integrational functional system may be of greater importance in the characterization of psychiatric patients than the autonomic and the skeletomuscular functional systems.
Dream Content Analysis of Male Schizoprhenic Patients
Authors: Kramer Milton , Trinder John , Roth Thomas
Published: April 2017

This study explored two hypotheses — that the dream report content of groups are different from each other; and that with significant psychological change in a group there will be significant alteration in their dream report content. This study supported the first hypothesis — different groups do indeed have different dream report content (male paranoid schizophrenics compared to male college students); but did not support the second hypothesis — that with significant psychological change, dream report content altered (male paranoid schizophrenics before treatment and after improvement). The failure to support the second hypothesis may be related to the small number of content items compared and to the psychological states of the patients not being sufficiently different.

It was possible to extract from the dream reports some areas of concern for the male paranoid schizophrenic patient, which suggested an avoidance of and a withdrawal from bodily concerns and interpersonal relationships. If there are before and after differences in dream report content they may be mostly related to the increase of active activities relative to passive ones following improvement and to a decrease in negative statements in the dream reports.
Some Polarizations in Behaviour Therapy and Clinical Psychiatry
Authors: Firth S.T.
Published: April 2017

In the literature dealing with the relationship of behavioural therapy to other forms of psychotherapy the psychiatric practitioner is faced with a number of apparently dichotomous positions. The general psychiatrist whose practice usually calls for an eclectic approach has to come to terms with these apparently antithetical approaches. With this in mind, three different but related polarities are discussed — behaviourism versus psychodynamics; integration versus segregation; and autonomy versus control.
Instrumental Control of Autonomic Responses with the Use of a Cognitive Strategy
Authors: Corson J.A. , Bouchard C. , Scherer M.W. , Amit Z. , Hisey L.G. , Cleghorn R.G. , Golden M.
Published: April 2017

The technique included some unusual features. Instructions were written specifically for the patient in order to attach motivational significance to the signalling stimulus, to be compatible with his conceptualization of the problem and to instruct him in the use of a specific cognitive strategy to gain control of the biological process. Before instrumental control training per se the patient was instructed concerning progressive relaxation, and the relaxation process was eventually used as the cognitive strategy in the control sessions.

Treatment was completed in 10 weeks, and follow-up over a period of 15 months shows no relapse in terms of perspiration or social behaviour.
Lactate Infusion in the Treatment of ‘Free-Floating’ Anxiety
Authors: Bonn J.A. , Harrison Jean , Rees Linford
Published: April 2017

This paper reports on the successful use of bi-weekly intravenous infusions of sodium lactate in alleviating symptoms in 33 patients suffering from intractable anxiety. Data is presented showing differential physiological and biochemical reactions to lactate, sodium chloride, and calcium infusions, as well as significant declines in self-rated anxiety for patients treated with lactate infusions for three weeks. Follow-up three and six weeks later suggests that these psychological changes may be relatively stable. The relevance of these results for a behavioural technique is suggested.
Sucide Prevention: Review and Evaluation
Authors: Singh A.N. , Brown J.H.
Published: April 2017

The interdependence of suicide prevention and crisis intervention is discussed and the development of telephone crisis-intervention/suicide-prevention services is described. Studies of the effectiveness of various types of services are reviewed and discussed and suggestions made for future research.
Long-Acting Phenothiazines in the Prevention of Relapse of Schizophrenic Patients
Authors: Denham John , Adamson Leslie
Published: April 2017

The development of the depot fluphenazine preparations has been a major advance in the drug treatment of schizophrenia, ensuring continuous medication and stimulating the development of adequate community care services, resulting in significant reduction of relapse and readmission.

This report compares the incidence of readmissions and the duration of hospital stay in a group of chronic schizophrenic patients who had first received oral medication and then long-acting injectable fluphenazine enanthate and decanoate over identical periods of time. A percentage of 93.3 of the subjects were maintained on continuous treatment for twelve to forty months. The readmission rate was reduced from 191 to 50, and the time spent in hospital from 8,713 to 1,335 days.
On Maybe Becoming a Psychotherapist, Perhaps
Authors: Book Howard E.
Published: April 2017

Learning the art of psychotherapy can be an anxiety-provoking endeavour. These anxieties are engendered by the loss of the medical model, with attendant feelings of anger, doubt and alienation, and by the development of a psychodynamic model which facilitates the rising into consciousness of the resident's own warded-off wishes. Transient overidentification with the patient, inability to handle silences and counter-transference feelings of anger, lust or envy are other phenomena which stimulate anxiety in the neophyte therapist. The conflictual dual role of the supervisor, as seen by the resident, is one other source of anxiety.

It is necessary for the resident to deal with and, hopefully, work through these stresses so that he may learn and practise psychotherapy in a non-constricted, non-distorted manner.
Auditory Discrimination during Rem and Non-Rem Sleep in Women before and after Delivery
Authors: Poitras R. , Thorkildsen A. , Gagnon M.A. , Naiman J.
Published: April 2017

Pregnant and postpartum women were presented with auditory stimuli, of from 10 to 70 decibels, of baby's cries, a woman's voice saying “baby is crying” and a speech noise during stage 2, stage REM and slow-wave stages of sleep. The subjects were awakened with increasing difficulty in the above-given order of stages, and with increasing facility going from speech noise to human voice to baby's cry, in that order. There was an overall lowering of awakening threshold after delivery. All the differences found were statistically significant, except that the difference between the voice saying “baby is crying” and the tape-recorded baby's cry was not significant.

The theoretical implications of these findings are discussed.
Problems of Treatment of Anorexia Nervosa
Authors: Moldofsky H. , Garfinkel P. E.
Published: April 2017

An effective treatment program involves measures for correction of both the malnutrition and the psychological disturbance in patients with anorexia nervosa. A novel approach to re-feeding, using motivational incentives in a controlled hospital setting, has been useful in the restoration of weight. The difficulty in maintenance of desirable weight after leaving hospital might be related to continuing disturbances in family relationships and to perceptual distortions. Treatment to prevent recurrence of symptoms should involve efforts to improve family communications and relationships, and correcting the patient's faulty perceptions. Both the disturbance in recognition of satiety and overestimation of the width of her trunk are reflected in limitation in caloric intake and relentless pursuit of thinness. Attention to correcting these perceptual disturbances might allow the patient to realize an accurate and acceptable sense of self, and to tolerate fears involving physical and psychological aspects of sexual maturation.
The Processes of Psychiatric Residency Training: Part II. Trainees who Drop Out
Authors: Garfinkel Paul E. , Steiner Betty W. , Hunter R. C. A.
Published: April 2017

Fifteen percent of physicians who began psychiatric residencies at the University of Toronto over a six-year period dropped out. Data were analysed in an effort to determine what factors were related to these resignations. Background data could not differentiate drop-outs from the rest of their cohorts. Drop-outs were rated equal to the non drop-outs by supervisors after one year of training; but after two years of training the remaining were rated to have poorer capabilities for psychiatry. Drop-outs were also more likely to spend their first year in training in a mental hospital. These findings are discussed and recommendations are made for reducing the number of competent residents resigning from training.
Diagnostic Practice in a Psychiatric Unit
Authors: Meikle Stewart , Gerritse Richard , Pearce Keith
Published: April 2017

This study takes the view that although psychiatric diagnosis has frequently been criticized as being deficient in terms of both reliability and validity, as long as it remains in use as a classification scheme its limitation should continue to be investigated. In line with this approach the present investigation examined three questions: What are the frequencies of major diagnostic groupings on admission to hospital? Do these frequencies change by the time discharge arrives? Are there differences in the stability of initial diagnosis for the various diagnostic sub-groupings? It was found that the most frequently used admitting diagnoses in order were: affective psychoses, neuroses and schizophrenia. Both personality disorders and other psychoses were relatively rarely used. In general the same ranking also held on discharge. However some diagnoses applied on admission appeared much more stable than others. For example 80 percent of those patients initially diagnosed as schizophrenic remained so classified on discharge. In contrast the equivalent figure for diagnoses listed under ‘other conditions’ was 46 percent.

Although practitioners often talk as though diagnosis is a meaningless ritual, in fact the present study suggests a differential degree to selection and consideration in their application of psychiatric categories.
Role of a Nurse on a Psychiatric Consultation Service
Authors: Moreau Diane , Kahn Pamela , Lal Samarthji
Published: April 2017

A psychiatric nurse on a psychiatric consultation service in a general hospital plays both a diagnostic and therapeutic role, and also provides a teaching service to nursing personnel in other departments. This paper focuses on these functions and how they apply in a specific psychiatric setting. The role of the psychiatric nurse also illustrates the use of para-medical staff in the delivery of psychiatric care. The addition of a psychiatric nurse as a regular member of a psychiatric consultation service in a general hospital is of value both for the consultation service and for the non-psychiatric nursing staff.
A Metabolic Basis for Drug Dependence
Authors: Doust J. W. Lovett
Published: April 2017

In man, incessant, compulsive sexual activity may follow an increase in brain serotonin simultaneously with a decrease in brain noradrenalin. In animals a similar compulsive aphrodisiac effect on behaviour can occur with the use of an antiserotonin drug permitting a relative increase in noradrenalin.

Five commonly used drugs of dependence, including morphine, have been shown to increase brain serotonin, thus disturbing the ratio of this monoamine, to noradrenalin.

It is argued that drug dependence is a phenomenon of learning and that this learning depends upon stimulation of the reward system of the lateral hypothalamus, medial forebrain bundle and midbrain reticular formation. Drug dependence could follow if the balance of brain serotonin and noradrenalin were seriously disturbed by the drug in either direction. It is suggested that normalization of this metabolic balance might be a logical goal for treatment in drug addiction.
Explorations in Co-Psychotherapy
Authors: Watterson Donald , Collinson Sara
Published: April 2017

Publications regarding the joint psychotherapy of individual patients or couples describe a variety of therapist-pairings, many styles of treatment approach, and an increasing interest, in the last two decades, in a treatment tool which impresses workers as having particular therapeutic effect with both research and training potential.

The pairings of therapists show many permutations by profession, previous experience, and relatedness. In this ongoing study the partners are a male psychoanalytically trained psychiatrist and a female social psychology graduate. The style used has been referred to as multiple therapy although the term co-psychotherapy is less ambiguous and more specific.

Patients seen in private practice readily accepted the joint participation of the junior partner, no matter whether they were already underway in psychotherapy or were newly referred.

Co-psychotherapy appears to be more effective than single-handed psychotherapy, especially in the treatment of psychotic and borderline patients.

When one member of a therapeutic pair is a trainee, co-psychotherapy offers an apprenticeship in psychotherapy by direct and intense immersion. Its value as part of psychotherapy training would seem to warrant more extensive deployment.
Infanticide: Some Medicolegal Considerations
Authors: Arboleda-Florez Julio
Published: April 2017

This paper presents some legal and medical-psychiatric considerations relating to the offence of infanticide. The history of this offence in the Criminal Code of Canada is reviewed. Highlights in the literature of post-partum psychosis are presented, and it is contended that the offence of infanticide as a separate entity is unnecessary and discriminatory. It is felt that it should be abolished and that Section 16 of the Criminal Code is sufficient to deal with the cases of infanticide resulting from post-partum psychosis.
Intensive Individual Psychotherapy of Adolescents: The Dilemmas and the Delights
Authors: Kline Carl
Published: April 2017

Intensive psychotherapy with adolescents requires, first of all, a therapist with extensive training in child, adult, and family psychotherapy. The therapist must be imaginative, flexible, and mature in judgement. Versatility in the use of therapeutic techniques allows variation in keeping with the psychological needs of the patient. Therapy of the adolescent must be as changeable as the adolescent himself, but always based upon sound psychoanalytic principles.

Anna Freud (2) has stated that, “The role of the therapist is to keep him [the patient] from getting sicker while he is growing up.” It is also the therapist's role to help the adolescent to grow out of his childhood, not to free him from it. With all of this, and a little luck, the therapist can play an exciting role in the ‘all O.K.’ termination of adolescent therapy.
Comparison of Depression Inventories in a Clinical Population
Authors: Schnurr Rosina , Hoaken P.C.S. , Jarrett F.J.
Published: April 2017

Using a general hospital psychiatric population (CN =158) the following psychometric measures of depression were assessed: Minnesota Multiphasic Personality Inventory, D. Scale; Hamilton Rating Scale for Depression; Beck Inventory for Measuring Depression; Wechsler Depression Rating Scale; and Zung Self-Rating Depression Scale. The patients were grouped according to diagnoses in The Diagnostic and Statistical Manual of Mental Disorders (DSM II): Depressive Neurosis; Severe Depression (Manic-Depressive, Depressed and Psychotic Depressive Reaction); Schizophrenia and Organic Brain Syndrome; Personality Disorder; and Neuroses other than Depressive (mainly anxiety). A group comprising those who attempted suicide was also formed from the above groups. All the measures correlated well with one another. Younger patients tended to score higher on the Zung SDS and the Beck. Females scored higher on the D Scale (MMPI) and males scored higher on the Beck. The group of suicidal patients were predominantly young females. The Hamilton and the D Scale differentiated the groups clinically. These two scales and the Wechsler may be the inventories of choice, expecially since the Hamilton and Wechsler have the advantage of being completed by a psychiatrist.
Treatment of Drug-Induced Psychosis with Diphenylhydantoin†
Authors: Ifabumuyi O. I. , Jeffries J. J.
Published: April 2017

This paper introduces an alternative to the major tranquilizers in the treatment of acute psychotic breakdown following multiple drug abuse. All the patients described had been taking hallucinogenic drugs for over five years. Only three of several successfully treated cases are described. Two of these cases were followed by EEG recordings, which did not show any localized epileptiform activity. The response to diphenylhydantoin is described both clinically and as recorded by EEG. An initial two-week period is necessary in order that the effects of the drugs can be demonstrated clinically or on EEG tracing. It cannot be concluded from this that the antiepileptic drugs are the drugs of choice in drug-induced psychosis; but, diphenylhydantoin has shown dramatic effectiveness in these previously refractory cases. In view of the response, some abnormal cerebral discharge from an as yet undiscovered locus may be involved in the pathogenesis of drug-induced hallucinations.
A Case of Homosexuality Treated by in Vivo Desensitization and Assertive Training
Authors: Latimer Paul
Published: April 2017

Sexual deviation is not a unitary condition, amenable to a single treatment approach. Deviant sexual arousal has been overemphasized while inadequate attention has been given to associated behavioural problems such as deficient heterosexual arousal, deficient heterosexual skills and gender role deviation.

A client with homosexual arousal and requesting aversion therapy was treated successfully and rapidly using in vivo desensitization and assertive training. The treatment is described and the importance of the behavioural analysis in directing the course of therapy is stressed.