bluuebunny/crossref_metadata_2025 huggingface dataset:
The Melancholy Hero—A Link in the Evolution of Medical Psychology
Authors: Smith M. K.
Published: October 2008

The Old English heroic poem “Beowulf” is reviewed with regard to mood disturbance. The poet anticipates many modern concepts concerning the aetiology of depression. In particular, low spirits are attributed in part to failure of self-assertion, and a depression of late onset is portrayed against a coherent constitutional background.
Operant Conditioning of Emotional Responsiveness as a Prerequisite for Behavioural Analysis: A Case Study of an Adolescent School Phobic
Authors: Perkin G. J. , Rowe G. P. , Farmer R. G.
Published: October 2008

The treatment of a school phobic adolescent boy is described. Operant conditioning principles were used to increase the patient&s emotional responsiveness from an initially low level to one at which a productive behavioural analysis could be performed. Additional behaviour therapy techniques used in the treatment, including the method of graded habituation, are described.
Two Features Occasionally Associated with Intravenous Drug Users: A Note
Authors: Bartholomew Allen A.
Published: October 2008

In a population of drug dependent persons who administered their drugs intravenously, two features were occasionally noted. In three cases what has been termed autohaemofetishism was seen and in three cases injection masochism. These two features are considered to be brought about on the basis of classical conditioning.
Antecedents of Schizophrenia: The “Schizoid” Myth?
Authors: Mellsop Graham
Published: October 2008

The origins and usage of the term “schizoid personality” have been briefly traced. The validity of regarding it as a common precursor to schizophrenia has been examined in the light of those published longitudinal studies of adult patients with schizophrenia, on whom information had been collected during their childhood. It was concluded that the evidence linking the schizoid personality with schizophrenia was tenuous and that more adequate studies were necessary to determine the premorbid nature of adult persons who develop schizophrenia.
Adolescence in Revolt: Permissiveness, Betrayal and Integration
Authors: Gold Stanley
Published: October 2008

Western society is aware of a change in the fabric of its moral structure, apparently emanating from the area of adolescence. The politics of permissiveness has led to an exaggerated splitting of the generations, and a realisation that new freedoms have not necessarily brought with them a sense of fulfilment, peace and justification. These phenomena of our age can be approached, using psychological concepts. Community attitudes toward permissiveness are examined. The changes within society are examined in terms of their intrapsychic processes. Permissiveness is seen as the outcome of broken trusts between parent and child. Disenchantment with the parental figures of society, and a failure to identify with them, precipitates regression of sexual and aggressive drives. The lifting of moral taboos discloses an awareness in the young of the basic problem of helplessness and weakness, mystification and confusion. Behind the problems of guilt and depression, lie the difficulties that result in isolation and withdrawal.
Mental Health Services for Youth
Authors: Warren W.
Published: October 2008

This paper discusses some of the mental health problems that occur among Youth, and some of the services that have been set up to deal with them in the United Kingdom. While fairly widespread, they are limited through their rather narrow scope. Some of the difficulties encountered are pointed out, including shortages of trained man-power.

Suggestions are made on what further could be done to widen these services. It is realised, however, that what is applicable to one country is not necessarily so to another. Psychiatric services especially for adolescents are nevertheless spreading. Can Adolescent Psychiatry yet qualify as another sub-specialty in psychiatry?
Youth Unrest and the Psychiatrist in Sri Lanka
Authors: Wijesinghe C. P.
Published: October 2008

Unemployment of educated youth is a major factor leading to youth unrest in Sri Lanka. In addition to an absolute reduction of employment opportunities, the personal aspirations of youth are not consistent with the demands of the labour-market. The historical reasons for this trend are analysed.

The difficulties experienced by less affluent youth who pursue higher education are presented. The nature of psychiatric casualty among this group of students and the therapeutic problems involved are discussed.
Masturbational Madness: An Historical Annotation
Authors: Cade J.F.J.
Published: October 2008

The original admission register of the Royal Park Receiving House was recently brought to the attention of the author. A review of the first full year's admissions (1907–08) revealed two cases of masturbational insanity and one of nymphomania. This remarkable discovery prompted a search of the authoritative literature of the time to discern then current views on aetiology with particular reference to the evils of onanism and the multicausality of G.P.I. The fruits of that investigation are presented.
The Uses of Hypnotically Produced Emotional Responses in Therapy
Authors: Walker Wendy L. , Rippingale Christopher
Published: October 2008

This paper outlines a specialised use of hypnosis as a complement to counselling or interpretive psychotherapy in suitable cases. The techniques capitalise on the ease of manipulating emotions and on the vividness of fantasy experience in hypnosis, to allow patients to learn more adaptive patterns of affective response and to rehearse more adequate repertoires of social behaviour. Implications of the authors' work with a sample of 37 non-psychotic patients is discussed.
Psychiatric Disorders following Road Traffic and Industrial Injuries
Authors: Culpan Roger , Taylor Christine
Published: October 2008

The nature and prognosis of psychoneurotic disorders following accidental injury have long been a source of argument. The present authors have endeavoured to follow up and classify 82 subjects referred by solicitors for psychiatric evaluation following injury.

The subsequent progress of 71 (87%) of the original consecutive sample was successfully obtained. Approximately one-third of the group were disabled by neurotic symptoms which appeared to result from the emotional stress of the accident itself and were thus classified as suffering from true “traumatic neurosis”. These patients improved with the passage of time. About one-half of the group were thought to be unconsciously motivated by the possibility of financial compensation and these patients failed to improve or became worse up until the time of settlement of their claims. The sample also included 5 (6%) frank malingerers; the subjects with “compensation neurosis” invariably denied concern over the outcome of their lawsuits.

Only two of the group received psychiatric treatment following termination of their litigation and only one able-bodied worker was known not to have returned to work by the end of the study. The need for early recognition of the fact that a neurotic disorder is being perpetuated by secondary gain factors is stressed.
Alcoholism and Drug Dependence as Factors in Psychiatric Hospital Admissions
Authors: Kraus J.
Published: October 2008

The study is concerned with alcoholism and drug depedence as causal and as associated factors in psychiatric hospital admissions in New South Wales. During the 1966–1970 period, the only significant increase among first admissions occurred in the 10 to 19 age group: the proportion of admissions with the primary diagnosis of drug dependence increased from 3% to 5%. Among both first and repeated admissions, the proportion with a primary diagnosis of alcoholism (including alcoholic psychosis) was approximately seven times greater than that with drug dependence (15% and 2%, and 20% and 2.9% respectively). The proportion of admissions with a secondary diagnosis of alcoholism was also significantly greater than the proportion with a secondary diagnosis of drug dependence (7.6% and 5.3%); a secondary diagnosis of alcoholism was significantly more common than that of drug dependence in 9 out of 12 psychiatric diagnoses. In both the primary and secondary diagnosis of drug dependence, the most commonly abused drugs were barbiturates (14.5%), followed by amphetamine (5.7%) and opium (2.6%). Significantly more patients with a primary diagnosis of alcoholism than with that of drug dependence had longer periods of hospitalization. The relative ‘severity’ of the problems of alcoholism and drug dependence is discussed in the light of the relevant literature.
Haloperidol and Chlorpromazine: A Double-Blind Cross-Over Trial and Clinical Study in Children and Adolescents
Authors: Lewis P. J. E. , James N. McI.
Published: October 2008

It is possible that the most powerful “drug” in childhood management is the emotionally warm, reality orientated and consistently predictable parent. Such a concept can be exitended to the doctor or any other professional worker who is perceived to have similar qualities by his patients (Balint 1961). Against this, when psychoactive drugs are prescribed for children, one has to evaluate their varying pharmacological effects. This includes placebo and side effects which themselves may have a dynamic interaction and facilitate or retard behavioural changes in the child and attitudes in the parent. Generally child psychiatrists are reluctant to exhibit drugs in the first instance as all too frequently by the time a child is referred there is a history of multiple drug failure. It is believed that for this reason drugs may be underor over-valued and that the indications for their use are not yet well established. Yet it is the clinical experience of most professional workers in this field that drugs exert both powerful and specific effects and should be included in the therpeutic armamentarium.

This study attempts to assess the symptoms, traits and behaviour of a sample of disturbed children over a specified period during which they were given a sequence of psychoactive drugs, a placebo and a no-drug period. An attempt was made at the same time to assess the observable dynamics of the parent-child interaction and the probable relationship this has to the effects of psychoactive drugs.
Methylphenidate in Children—Effect of Dosage
Authors: Werry John S. , Sprague Robert L.
Published: October 2008

A clinical trial in two groups of hyperactive/ aggressive children showed that methylphenidate was superior to placebo for about 2/3 of the children, but that there was little difference in effectiveness between different dosage levels, especially once 0.3 mg/kg is attained. Mild side effects were common at higher dosages. Of a variety of physician, parent, teacher and psychological test and behavioral measures, teacher and physician ratings were the most sensitive to drug effects. No measures including neurological ones discriminated between responders and non-responders. It is concluded that methylphenidate is a useful treatment for hyperactive/aggressive children but that current doses may be too high and side effects more common than stated.
Dilemmas of Aboriginal Marriage in East Arnhem Land, North Australia
Authors: Eastwell H.
Published: October 2008

The Aboriginal group under consideration has complex marriage customs, including a high degree of polygyny. Today, many of the roles within the polygynous family have been made redundant by the introduction of a cash economy. This loss of traditional roles within the family is associated with many cases of psychiatric illness causing moderate or severe social dysfunction. In this preliminary report, no use was made of a matched control group.
The Problem of Cultural Specificity of Mental Illness: The Egyptian Mental Disease and the Zar Ceremony
Authors: El Sendiony M. F.
Published: October 2008

The question posed in the present paper arises from the relationship of psychiatric disorder to culture. This question is: Do we have in Egypt mental sicknesses which are the specific production of the Egyptian cultural setting? After a careful review of the literature supplemented by his own anthropological observations and Egyptian psychiatric reports, the author was able to conclude that the psychopathological manifestations expressed in the RABT and ZAR cult phenomena which reflect in their behaviour the specific cultural content of the victim's society, are simply local varieties of a common disease process to which human beings, as such, are vulnerable.
Youth in a World of Change
Authors: Raphael Beverley
Published: October 2008

Adolescent responses to three areas of life change, or crisis are described. It is proposed that these responses may both reflect and accentuate patterns of response to the adolescent developmental crisis. Twenty-two recently bereaved adolescents showed denial, anger, possibly withdrawal and were often threatened by the new roles into which they were forced by their fathers' deaths, particularly the oedipal aspects of these roles. Of 22 adolescent girls experiencing their first pregnancy, 50% showed evidence of some emotional disorder. They showed also feelings of denial and anger and often prematurely considered they had become “adult” because they were becoming “parents”. Seventeen girls seeking termination of pregnancy were evaluated. Denial, rationalisation and ambivalent feelings were marked. It is concluded that these are areas of important potential for preventive intervention in the form of specific ego support. Such intervention would be aimed at decreasing the incidence of subsequent health impairment in those at risk.
Group Therapy for Married Couples
Authors: Gale Alexandria
Published: October 2008

The use of group therapy with married couples whose destructive relationship is chronic and an accepted way of life is described. Therapeutic forces operating in such groups and the role of the therapist in facilitating changes are assessed.
The Galvanic Skin Response Inhibition Threshold: A Preliminary Study with an Australian Sample
Authors: Byrne D. G. , Tottman V.
Published: October 2008

Galvanic skin response (G.S.R.) inhibition thresholds, giving an index of barbiturate tolerance, were determined for 20 depressive and 10 normal subjects. Barbiturate tolerance was found to effectively differentiate neurotic from psychotic depressives, and both these groups from normal controls. Neurotic depressives generally exhibited high G.S.R. inhibition thresholds relative to normals, while psychotic depressives exhibited low thresholds relative to normals. These results are discussed in terms of previous research on the sedation threshold.

The G.S.R. inhibition threshold was found in some groups, to be systematically influenced by manifest anxiety. However, neither depressive severity nor age influenced barbiturate tolerance. Some potential clinical and experimental uses of the G.S.R. inhibition threshold are discussed.
Psychotherapy in a Large Open Family Group
Authors: Dinnen Anthony , Bell David S.
Published: October 2008

A technique of psychotherapy is reported, using a large open group of theoretically unlimited lifetime. Family and friends are encouraged to attend and new members are added independently of those leaving the group. Various features of such a group are conparable to small group analysis. The group may be used for the exploration and treatment of family psychopathology.

Meetings containing 20 or more members, with several families being represented, are not uncommon. Observers likewise are not limited in number and the group serves a useful teaching and training function as a consequence.

A wide range of patients, including those regarded as unsuitable or too difficult for conventional psychotherapeutic management, may be treated by this technique. Illustrative cases are described.

The purpose of this paper is to describe a technique of group psychotherapy which has been practised over a period of several years and which differs in some important respects from established methods. This technique, the large open family group, has proven itself to be useful in treating a wide range of patients.
Out-Patient Follow-Up of Those who Have Attempted Suicide: Fact or Fantasy?
Authors: Goldney Robert D.
Published: October 2008

46% of patients who had attempted suicide and were referred to the out-patient clinic of the Royal Adelaide Hospital failed to attend. Similar findings have been reported from other centres. Though it is not known why this is so, tentative speculation is possible. Since it has been shown that persons who attempt suicide are more at risk for suiciding in the future, it seems surprising that their non-attendance has not been more fully investigated.
The Infant Development Distress (IDD) Syndrome: A Predictor of Impaired Development?
Authors: Ironside Wallace
Published: October 2008

A group of eight infants with a disorder termed the IDD syndrome and another group of eight matched healthy infants taken into study at the same time have been followed-up for 6.75 years. The follow-up technique and some findings are described. Three IDD syndrome children are still severely disturbed. Three others show recovery from severe developmental disturbance. But one child who was grossly abused after being taken into the study has been well since the third follow-up. The comparison children have not experienced comparable problems.

A qualified affirmative to the question of predictive power is given and discussed.
Abandoning the Mentally ILL
Authors: Barton Russell
Published: October 2008

Mentally ill people have been avoided and abandoned by their families and public authorities for hundreds of years.

Present day abandonment includes the deployment of professionals from patients to paper; the destruction of availability and effectiveness of institutional facilities; the obfuscation of mental illness by captious, sematic criticism; the aspirations of paramedical and paraprofessional groups; and the subordination of the primary purpose of institutions and physicians to other objectives.

The nature of authority is discussed and the need for the treatment of mentally ill people to be based on the art and science of medicine, rather than the pretension and advocacy of the gullible, unqualified or unscrupulous, is noted.
Attempted Suicide in the Perth Statistical Division 1971–1972
Authors: Burvill P. W.
Published: October 2008

A study of attempted suicides in the Perth Statistical Division for 1971–72 has been presented. The average annual rate was 8.5 per 10,000 for males and 20.3 for females. There had been a doubling in rate since 1961, the increase being greater for females than males. Age standardised rates were greater than the Australian born for immigrant males but not for females. There were marked differences in rates between different individual immigrant groups of each sex. Data presented showed a higher rate in aborigines compared with nonaborigines, but many reservations were made regarding the validity of the aboriginal rates.
Juvenile Delinquent Drug abuse in Females: A Clinical Study
Authors: Phillips B. J. , Phillips I. F. , Davidson E. C.
Published: October 2008

Thirty drug taking and thirty non-drug taking delinquent adolescent girls were assessed using a psychiatric interview technique. Differences were observed between the groups on an aggressivepassive-withdrawn dimension. Drug takers were found to be passive and withdrawn whilst control group subjects were found to be more aggressive. These factors were identified within the modal personality of the delinquent girl. The results supported M.M.P.I. studies of the drug taking personality and were seen as an indication of aetiology and its implications for assessment and treatment.
Good Death: Responsible Choice in a Changing Society
Authors: Saclier A. L.
Published: October 2008

Revolutionary advances in social and medical knowledge and technology have radically changed the conditions which precede death for an increasing number of people. The fear of death is being replaced by the dread of too-prolonged life, a feature of which is a widely documented incidence of both pain and physical and mental distress. This situation has produced the accelerating social demand for euthanasia (a painless inducement of death, preferably by medical means) to be legally available to a suffering person earnestly desiring it.

The attitudes of medical workers are ambivalent, trapped as they are between a changing society and intransigent law. Psychiatry, however, and its concern for the whole person, is potentially an ally of those who desire to educate the community to a healthier view of death, even a planned death, as a part of life and a responsible conclusion to it.
Lithium Neurotoxicity
Authors: Johnson Gordon F. S.
Published: October 2008

One of the most alarming and potentially serious complications of Lithium Carbonate therapy is the emergence of central nervous system toxicity. This paper discusses the clinical changes that may occur with illustrative case histories. The role that such factors as serum Lithium levels, sodium balance, organic brain damage, clinical typology, concurrent physical illness and drug interaction play in the genesis of this disorder is discussed. Permanent neurological damage following Lithium poisoning is discussed and guidelines for appropriate use and monitoring of Lithium in psychiatric disorders is outlined.
A Mirror Image Out-Patient Study at a Depot Phenothiazine Clinic
Authors: Marriott Peter , Hiep Albert
Published: October 2008

This Mirror Image Study, at a specialised clinic, has shown a significant reduction in days spent in Hospital.

Individual features of the sample include sex and age difference in the sub-groups for dosage, duration of treatment and anti-Parkinsonian medication.

Preliminary cost-effectiveness analysis has been reported.
Genetics, Drug Dependence and Schizophrenia
Authors: Boyle A. M. , Whitlock F. A.
Published: October 2008

It has been suggested that drug dependence is a substitute for schizophrenia in young patients and that the drug dependence protects them from schizophrenic breakdown. Assuming the correctness of the genetic basis for schizophrenia, it was postulated that persons known to be dependent on heroin would have a higher genetic loading for schizophrenia if the hypothesis was true. An examination of the family backgrounds of 82 drug dependent persons failed to find supporting evidence for the belief that drug dependence is a substitute for schizophrenia in young persons.
An Epidemiological Study of Autistic and Psychotic Children in the Four Eastern States of Australia
Authors: Prior Margot R. , Gajzago Christine C. , Knox Dianne T.
Published: October 2008

Data on general behavioural and etiological characteristics of a sample of 146 autistic and psychotic children from the four eastern states of Australia are presented. Both inter and intra study comparisons are made with reference to a number of factors considered significant in childhood psychosis. The findings accord with those of similar overseas studies on most factors although methodological and diagnostic differences limit the conclusions. A notable finding was that of an excess of “organic” indications in a sub-group of early onset, severely withdrawn “autistic” children suggesting that further neurological and EEG testing of autistic children is desirable.
Family Interaction and Adolescent Suicidal Behaviour: A Preliminary Investigation
Authors: Williams Christopher , Lyons Christina M.
Published: October 2008

While investigators have emphasized the importance of familial relations in the production of suicidal behaviour in adolescence, experimental evaluation of specific family interaction processes has, thus far, been neglected. The aim of the present study was to investigate possible relationships between adolescent suicidal behaviour and total on-going family functioning. Hypotheses were advanced to evaluate the communication, interaction and reinforcement patterns in families. A modified revealed differences technique was employed to elicit standardized segments of interaction which were video-taped and later studied by two indepenent raters. The sample consisted of twelve individually matched, intact family tetrads, six normal (N) and six containing an adolescent female who had exhibited suicidal behaviour (SM).

Results suggest that SM families constitute a malfunctioning system which can be differentiated from that of normal samples. As compared with the N group, SM family interaction evidenced less effective productivity, specificity, and adaptive interaction, and higher rates of conflict and negative reinforcement. Overall findings were discussed in terms of current family theory and their possible relationship to the genesis, maintenance and management of some classes of suicidal behaviour.
Evaluation of an Inpatient Service by Consumer Feedback
Authors: Ahmed M. Basheeruddin , Koltuv Myron
Published: October 2008

Over the past few years, the Sound View-Throgs Neck Community Mental Health Center has conducted a number of studies of client satisfaction with our services. The findings suggest that the majority of clients are generally satisfied with the help they receive. However, the level of satisfaction apparently depends on specific aspects or features of the program being evaluated, as well as the particular unit which is providing the services.

We have used face-to-face, telephone, and mail survey procedures in these studies; and we have sampled both clients who have completed their treatment and those in the early phases of the treatment process.

In one of the studies, the former SVTN-CMHC patients we surveyed had been hospitalized in the inpatient unit located at Bronx Municipal Hospital Center. We randomly selected one hundred patients who had been discharged from the unit during the first six months of 1971. After excluding children under the age of sixteen, patients who were subsequently hospitalized or were too symptomatic to be interviewed, and those living outside New York City, we interviewed twenty-five ex-patients. We asked questions about their feelings related to the need for hospitalization, their present problems, whether hospitalization had helped them, their satisfaction or dissatisfaction with ward life, and their feelings about discharge.

The results indicated that these ex-patients felt at least moderately satisfied with their hospital experience. However, they were relatively dissatisfied with provisions for privacy on the ward, the fact that doctors and other hospital staff were not readily available to them, the doctor's understanding of their problems, and the evening recreation programs.

There was some discrepancy between the ratings, which were mostly favorable, and the comments, which were predominantly unfavorable. There are various possible explanations for this, ranging from the limited validity of rating items in such a study to the possibility that this group of ex-patients were so accustomed to negative experiences that their overall assessments were not significantly influenced by them. There is some possibility that the highly positive ratings may stem from an unexpected source. For approximately half of the sample, the major purpose of hospitalization was to provide the opportunity to get away from their usual surroundings. The in-hospital treatment per se was relatively unimportant to them, and their favorable ratings may be a way of indicating that the hospital simply served as a refuge, which they were seeking.

Since a patient may approach the hospital with, self-defined needs either for treatment or mainly for refuge—it may be worth while to provide alternative programs to meet these different needs. A “refuge” program, for example, may not require an in-hospital environment; and even if it does, the staffing pattern should be different from that of a hospital with a treatment-oriented program.
Community Push: A Community-Oriented Evaluation Programme in a Psychiatric Ward
Authors: Raeburn John M.
Published: October 2008

Evaluation of mental health programmes is a neglected area in New Zealand. This paper describes a community-oriented, experimental programme designed to provide a model for evaluation in the context of an inpatient psychiatric unit. Its primary objective is to improve patient care. This is achieved by emphasizing real-life needs, and dealing with these by a series of clearly specified steps involving goal-setting. Community resources, especially volunteers, are used. A variety of evaluative data are produced and the overall result is a “self-correcting” programme which is appreciated both by patients and staff.
Wider Perspectives in the Behavioural Treatment of Anorexia Nervosa: A Case Study
Authors: Perkin G. J. , Surtees P. G.
Published: October 2008

Hospital-based operant conditioning programmes have been reported as the most effective treatment available for anorexia nervosa. Two refinements of these techniques are outlined and illustrated in this case study. In the first, the external controls on the patient's activities imposed by the operant programme are relaxed in stages as weight increases, allowing the patient to assume progressively more self-control. The second entails re-educative therapy designed to develop adequate covert and behavioural responses for coping with the psycho-social consequences of weight gain and with other environmental stresses.
A Heterosexual Transvestite Club: Psychiatric Aspects
Authors: Buhrich Neil
Published: October 2008

An Australian club for heterosexual transvestites, the Seahorse Club, is described. Emphasis is given to the history and activities of the club and the behaviour of members at club meetings. Indications for referring transvestites requesting medical help to the club are discussed.
Double-Blind Comparison of Clozapine with Chlorpromazine in Acute Schizophrenic Illness
Authors: Chiu Edmond , Burrows Graham , Stevenson James
Published: October 2008

Double Blind comparative trial of a new dibenzodiazepine derivative Clozapine (Leponex) with Chlorpromazine was conducted in the treatment of acute schizophrenic illness over a 6 week period.

Factor Analysis of ratings in 9 matched pairs indicates that Clozapine, at 300 mg. per day, is comparable in efficacy to Chlorpromazine in all factors except “Irritability” for which Clozapine appears to be superior. Illness severity and Global Change ratings in all patients showed that Clozapine is more effective in producing a shift towards improvement at the end of 6 weeks.

Major side effects reported in Clozapine confirmed sedation and hypersalivation as consistent problems and presence of rigidity and tremor (extra-pyramidal) being at variance with other studies.
A Case of Male Childhood Transsexualism and its Management
Authors: Metcalf Sheila , Williams Warwick
Published: October 2008

The syndrome of male childhood transsexualism is described and the case history of a six year old boy is reported. Treatment strategies are explained in detail and the results of ongoing therapy over an 18 month period are presented.
Desire for Attention
Authors: Welford A. T.
Published: October 2008

Seeking of attention appears to be intimately bound up with certain principles of motivation, especially the seeking of observable results of action and of optimum levels of stimulation, variety and challenge, and the relationship between results and the cost of achieving them—a high cost will tend to inhibit action but enhance the value subsequently placed upon what is achieved. These principles can be applied to personal relationships: thus friendship can be regarded as a situation involving facilitative feedback between persons, hostility as involving inhibitory feedback and loneliness as occurring when there is no feedback. Which of these situations occurs appears to depend upon the relationships between the costs and benefits of interaction between the persons concerned. The care of psychiatric or senile patients in the community appears likely to impose demands for attention which are unreasonably severe (“costly”). Any attempt to change community attitudes in the hope of securing greater acceptance of such demands appears to be unrealistic. Substantial benefits could probably be attained in many cases from training in skills, especially social skills, which would enable patients to cope more effectively with the world as it is.
The Psychotherapy of Character Disorder
Authors: Hall Anne
Published: October 2008

Patients suffering from character disorder are often rejected as unsuitable for psychotherapy. Those with anxiety and depression often seek help, and should be assessed for their potential to be helped by a carefully structured long term psychotherapeutic relationship controlled by the therapist to reduce acting out behaviour. The therapist acts throughout as a model for the patient. As the patient develops basic trust in the therapist, identification develops and a major sustained improvement can occur.

The therapy described is current-behaviour orientated and the importance of clear, unambiguous communication, particularly verbal communication, is stressed. The principles of therapy are applicable to all contacts with character-disordered patients. Briefly described is the long term therapy of two patients with hysterical personality disorders and acting-out behaviour, as examples of one type of the wide variety of character disorders that can be treated, and where the nine year follow up was adequate to ensure that improvement was sustained.
Multiproblem Families and Their Psychiatric Significance
Authors: Dax E. Cunningham , Hagger Rona
Published: October 2008

The characteristics of multiproblem families are described, and the investigations in a research project are reported. A note is made of their epidemiological significance.

Reasons are suggested as to why they have received little psychiatric attention. In particular their child upbringing practices, including child rearing and learning disorders, are described. The psychiatry of inadequacy is considered and the validity of the various diagnoses used.

Finally it is suggested that the place of psychiatry in their care should be reconsidered and that a better knowledge of social handicap should be acquired.
Prevalence and Prognosis in Anorexia Nervosa
Authors: Kalucy R. S. , Crisp A. H. , Lacey J. H. , Harding Britta
Published: October 2008

Anorexia nervosa has become a common condition. Treatment regimes are now well defined and outcome criteria can be clearly stated. The achievement of biological maturity is a necessary condition of good outcome. Experience and outcome research with some three hundred and forty patients and their families has furthered knowledge of factors which affect prognosis.
Mental Health Services by and for Aborigines and Islanders: A Follow-Up Report
Authors: Kahn Marvin W. , Kennedy Eva V. , Cawte John
Published: October 2008

The indigenous behavioural health programme for the Aborigine and Islander Community of the Townsville area was belatedly funded and has recently been expanded. An additional group of five behavioural health technicians have been trained to provide broadened services emphasizing alcoholism counselling and community based activities. Evaluation of the programme indicates a considerable increase in the utilization of mental health services by the community as compared to utilization prior to the behavioural health service. Self-referrals account for 40% of the cases. Referrals from the centre's physician and from family account for much of the others. Problems seen are multiple, often both of a personal-emotional and of a social service nature. Alcoholism, family-marital, child-school problems, anxiety and depression were frequent emotional problems. Issues as to whether or not such indigenous programmes should rather deal with social problems or physical health are discussed.
Interpersonal Factors in Suicide Attempts: A Pilot Study in Christchurch
Authors: Adam K. , Bianchi G. , Hawker F. , Nairn L. , Sanford M. , Scarr G.
Published: October 2008

Attempted suicide is a behavioural pattern with complex psychological and sociological determinants, many of which have been extensively studied in recent years. The basic facts of its changing incidence, its demography, and its place within a broader spectrum of self-destructive behaviour are well established but authorities are still divided on many issues related to its aetiology, its function in the individual, and the kinds of services required for its clinical management. (Kessel 1965, Anderson 1974, Weissman 1974, Henderson and Williams 1974).

The study reported here was designed partly to define the characteristics of a group of patients for whom clinical services were being planned and partly as a pilot study to develop a methodology for a more extensive controlled study which we hope to carry out next year. The preliminary findings are sufficiently interesting to report now.
Asthenic Personality, Myth or Reality
Authors: Andrews Gavin , Kiloh L. G. , Kehoe Linda
Published: October 2008

One hundred and seventy five subjects admitted to hospital for neurotic conditions were assessed as to their personality types. Forty seven percent were judged as having personality traits consistent with the diagnosis of asthenic personality disorder. Thirteen of the 138 symptom, life history and psychologial test items examined were found to be associated with the asthenic traits. Condensation of these thirteen items by factor analysis showed that two features—anxiety proneness and inability to cope with stress—together defined the disorder.
Adjustment of Adopted Children and Demographic Profile of Adoptive Parents
Authors: Kraus J.
Published: October 2008

Using 51 manifestations of childhood dysfunction as index of adjustment, the relationship was investigated of 9 demographic characteristics of applicants for adoption to the adjustment of children, when aged 7 to 7 1/2 years, whom they had adopted. ‘Good adjustment’ was associated with the father having at least completed high school, having a non-manual occupation and an above median income. There was a trend for it to be also associated with the mother having at least completed high school, being under 30 years of age, and with the couple's non-committal on (i.e., not outright rejection of) the possibility of adopting a hard to place child. The findings were discussed critically and it was concluded that the study demonstrated the feasibility of establishing objective empirical criteria for the selection of adoption applicants.
Psychological Problems Relating to the Educated Elite in Some Pacific Peoples
Authors: Price J. , Eastwell H. D.
Published: October 2008

The educated elite of many Pacific peoples are exposed both to traditional cultural influences on the one hand and to a Western mode of education and an urban life style on the other. Examples are given of the problems that arise among the Melanesians of Fiji, the Polynesians of Tonga, Western Samoa and the Cook Islands and the Aborigines of Australia from the existence of these two sets of values. Conflict areas include money, property ownership, health care, family boundaries and adoption. The content and form of the conflicts are shaped by the original culture but the basic cause in each case is differential rates of modernization among members of the same ethnic group.
Secondary Premature Ejaculation Due to Semen Sensitivity
Authors: Williams Warwick
Published: October 2008

A case of secondary premature ejaculation due to the patient's emotional reaction to his partner developing a sensitivity to his semen is described. The implications of this and similar case reports for current theories as to the aetiology of premature ejaculation are briefly discussed.
Adverse Psychiatric Reactions to Modern Medication
Authors: Whitlock F. A.
Published: October 2008

‘The trouble about always trying to preserve the health of the body is that it is so difficult to do without destroying the health of the mind.’
Morbid Jealousy — An Unusual Presentation with the Reciprocal Appearance of Psychopathology in Either Spouse
Authors: Turbott John
Published: October 2008

This report concerns a married couple. The husband presented first to a psychiatrist with delusional jealousy. As his jealousy rapidly subsided with treatment his wife developed a florid paranoid psychosis for which she refused therapy. She then actively intervened to prevent her husband's treatment and as his jealousy returned her psychosis remitted. It is suggested that psychopathology may be more common than is suspected in the partners of jealous subjects and that on occasions one partner may be actively provoking jealous behaviour in the other.
Surveillance and Prevention of Non-communicable Diseases (NCDs) in Bangladesh
Authors: Faiz Md Abul
Published: October 2008

DOI = 10.3329/jom.v9i1.1417J MEDICINE 2008; 9 : 1-2
Disability Burden and Economic Loss of Cancer Patients
Authors: Islam Md Ziaul , Jabbar Md Abdul , Farjana Sharmin , Chowdhury Sanjoy Kumar
Published: October 2008

The Descriptive cross sectional study was conducted over the period of 1st July 2006 to 30th June 2007 (one year) to estimate disability burden and economic loss incurred by cancer patients. The study was carried out among 224 cancer patients who attended the National Institute Cancer Research & Hospital (NIRCH). Data was collected by face-to-face interview using a semi-structured questionnaire and systematic random sampling technique. Disability burden of cancer was measured in terms of years of life lived (YLD) and economic loss was estimated by health care expenditure incurred by the cancer patients. Out of all, major part (59.82%) was male while 40.18% was female and most of them were in middle age group (40-49 years) with mean age of 49.18 (SDÂ±14.66) years. Most of the patients (93%) were Muslims and majority (83%) was married. Maximum number of patients (38.39%) had primary level education with a large illiterate segment (27.68%). By occupation, maximum patients were housewives (28.73%) followed by agriculturers (25.50%). The average family size was 4.6 (SDÂ±2.53) and majority (39.28%) was in poor income group ( < Tk.5000). According to primary site, common cancers included cancer of lung (25%) & cervix (16.96%) followed by cancer of breast (13.39%), lymph node & lymphatic (6.70%), larynx (5.36%), oral cavity (5.36%), oesophagus (4.46%), leukemia (4.46%), bone & cartilage (4.02%), stomach (2.68%), skin (2.68%), prostate (1.79%), liver (0.89%), endocrine gland (0.89%) & caner of unknown primary origin (5.36%). Most male cancer patients (73.88%) had smoking habit in contrast to 7.78% female patients, which showed statistical significance (Ï2 test, p < 0.01). Male patients shared more YLDs (64%) than female patients (36%), which was statistically significant (ât' test, p < 0.05). It was emerged that the highest YLD was shared by the active age group (63.8%), middle-income group (40.35%) and by poorly educated patients (69%). Average treatment cost incurred by the cancer patients was TK.5,773.11 (Â±SD272.39) and it was more among the higher income, middle age and educated patients, which were statistically significant (ANOVA, p < 0.01). Male patients shared higher average treatment cost (TK.7,158.65 Â±SD337.76) than their female counterparts (TK.4387.57 Â±SD 207.02) and revealed statistical significance (ât' test, p < 0.01). Ca Lung incurred highest average treatment cost (TK.8,247.86 Â±SD121.43) followed by Ca cervix (TK.7,787.73 Â±SD118.56) and Ca breast (TK.7,183.53 Â±SD104.63). Half of the patients were treated by combination of surgery, chemotherapy & radiotherapy and surgery being most costly (TK.8,574.96 Â±SD 455.23), which was statistically significant (ANOVA, p < 0.01). Key Words: Cancer, Disability burden, YLD, Economic Loss. Â  DOI = 10.3329/jom.v9i1.1418 J MEDICINE 2008; 9 : 3-9
Comparison Between Swenson and Soave-Boley Procedure in the Management of Hirschsprungâs Disease
Authors: Chowdhury ASM Lokman Hossain , Karim Md Shahid , Begum Momotaj , Islam Md Kabirul , Talukder Md Shah Alam , Ehsan Md Toufique
Published: October 2008

Objective: The purpose of study was to compare Swenson & Soave-Boley procedure in the staged operative treatment of Hirschsprung's Disease (HD). Methods : During 16 months of study period, 25 patients of histopathologically confirmed HD were selected for staged operative treatment, following certain inclusion & exclusion criteria & were admitted & operated at DSH; after completion of all stages operation they were followed up & studied under two groups : staged Swenson procedure (Group-A; na=13) & staged Soave-Boley procedure (Group-B, nb=12). They were similar for age, sex, body weight, reselected length of aganglionic segment & postoperative follow up. The level of ganglionosis was assessed from marking biopsy. Preoperative & postoperative observations of Swenson procedure were analyzed & compared with those of Soave-Boley procedure in the staged operative treatment of HD statistically (unpaired ât' test & Ï2 test) Results : For group A (Swenson procedure) the operative time was significantly lesser (unpaired ât' test : P < 0.01) than for the group B (Soave-Boley procedure). First bowel movement after colostomy closure was also significantly lesser in duration in Swenson procedure (Ï2 Â test :P < 0.05). DOI = 10.3329/jom.v9i1.1420 J MEDICINE 2008; 9 : 16-19 Â
The Peri-Operative Fluid Therapy Protocol for A Patient Undergoing A Major Surgical Procedure:
Authors: Khan SA , Yasmin Rubina
Published: October 2008

Surgery does not mean operation only. It is the total evaluation of the patient along with the appropriate and comprehensive management of the specific surgical condition altogether make the surgery an âArt'. As surgeons we are immensely privileged that we are being trusted by people who often have no previous knowledge of us to make decisions on their behalf, carry out necessary measures or action, where someway or other slight lack of vigilance or any negligence at any step in the total process of management may result in various morbidities and might even cost their life. This, on the other hand, imposes a huge responsibility upon the surgeons and that every surgeon must be very vigilant in his all and every step which starts pre-operatively and continues over the subsequent whole management process till the smooth and uneventful post-operative recovery period. It includes, establishment of a normal (or at least near normal) homeostatic status and it's maintenance is highly desirable in the whole peri-operative period. To assess the preoperative volumaeic status of the patient accurately and to replace any existing fluid or electrolyte deficiency as well as any other ongoing losses during the intra or per-operative as well as during the postoperative period, if any, it's proper and appropriate replacement or correction is of fundamental importance for every successful surgery. Â  DOI = 10.3329/jom.v9i1.1427 J MEDICINE 2008; 9 : 50-57
Prevention & Control of Neglected Tropical Diseases : Our Dreams & Achievements
Authors: Khandaker Md Abul Kashem
Published: October 2008

DOI = 10.3329/jom.v9i2.1431Â  J MEDICINE 2008; 9 : 64-65
Diurnal Variation in the Occurrence of Stroke and its Relation with Diabetes Mellitus
Authors: Hoque Mirza Azizul , Islam Shahidul , Islam Md Sirajul , Alam Md Billal , Arif SM , Rahim Abdur , Ur-Rahman Ashraf
Published: October 2008

Objective- To observe diurnal variation in stroke onset and its relation to diabetes mellitus. Methods - A consecutive series of 139 patients with stroke was admitted at a reference hospitals; the time of onset of symptoms were noted. We compared the diurnal variations between stroke onset both in the diabetic and non-diabetic subjects. Results - Time of occurrence of stroke was highest in the second quadrant of the 24 hour clock and lowest in the first quadrant. There was no significant association between time of occurrence of stroke and diabetes mellitus Conclusions - Our study contributes further evidence for a susceptibility stroke event between 6 AM and noon and gives further insights into the possible mechanisms leading to cerebrovascular ischemia. This study also concludes that there is no association between diurnal variation in the occurrence of stroke and diabetes mellitus. Key Words: diurnal variation, stroke onset Â  DOI = 10.3329/jom.v9i2.1434 J MEDICINE 2008; 9 : 75-77