bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Removing the Waiting List upon Clinic Intakes
Authors: Brooker B.H. , Joynt M. , Froese A.P.
Published: April 2017

This study reports the results of eliminating the waiting list for a one month period in 1985 upon the referrals made to an out-patient Child and Family Clinic. The Clinic receives most of it's referrals from community physicians and agencies. The study was carried out amidst a background of an increasing number of referrals.

Fifty-nine referrals, mainly families, were received. Among those who were referred and seen, most (58 percent) accepted the offer of a no wait appointment and completed the referral within about one week. A smaller number (17 percent) did not respond to such an offer but later completed the referral. Thus, 76 percent of the referrals overall were completed within 6 months. This was essentially the same as the completion rate for a comparison sample in 1984 (77 percent).

The kinds of problems found among these two groups, as well as among the “non-completers” was analysed. One trend was that cases involving family dysfunction tend to show early or not at all. Overall, the large percentage (60 percent) of families with histories of separation problems as an associated variable, suggested this as a possible explanation for the increasing number of referrals in recent years.
Motives and Intent: A Comparison of Views of Overdose Patients and Their Key Relatives/Friends
Authors: Varadaraj R. , Mendonca J.D. , Rauchenberg P.M.
Published: April 2017

The purpose of the study was to compare the perceptions of patients with those of key relatives or friends as regards motives for self-poisoning and intent to die, in ninety-eight overdose cases. Patients admitted to the accident and emergency department of a district general hospital in the county of Warwickshire, England, were interviewed following their recovery, Their key relatives/friends were also interviewed concerning their views of the emergency. Analysis of the responses of patients and key persons indicated that there was a significant association between the perceptions of the two classes of subjects as regards selection of escape/relief motives, warning prior to the attempt and intention to die. There was also a significant association between patient and relative perceptions of suicidal intent and relief at being alive. The implication of these findings as regards follow-up therapy is discussed.
Clinical Phobias and Avoidant Personality Disorder among Alcoholics Admitted to an Alcoholism Rehabilitation Setting
Authors: Stravynski Ariel , Lamontagne Yves , Lavallée Yvon-Jacques
Published: April 2017

One hundred seventy-three abstinent patients were screened for phobias and avoidant personality disorder. Ninety-six patients were interviewed and diagnosed by two independent assessors who were in agreement on 74% of the diagnoses. In DSM-III terms, over half of the sample (51.4%) met criteria for agoraphobia (8.5%), social phobia (7.8%) and avoidant personality disorder (35.1%). More than 70% of the patients in each diagnostic category were men. For the vast majority of the patients in the sample the disorder preceded the abuse of alcohol which was used by at least 40% of them to relieve their distress in the past. For many it had still a moderating effect on distress at the present but appeared to be mainly used out of “psychological dependence.”
Fatal Overdose with Amantadine
Authors: Cook P.E. , Dermer Stanley W. , Mcgurk Terry
Published: April 2017

The authors describe the first case report in the psychiatric literature of death from an overdose of amantadine hydrochloride used to treat neuroleptic induced extrapyramidal side effects. The pharmacology, adverse reactions and risks of using amantadine are briefly reviewed.
Family Therapy — Where Are We, and Where Are We Going?
Authors: Davidson Simon
Published: April 2017

There has been considerable growth and development in the field of family assessment and therapy over the past thirty years. This management approach provides a useful tool in the assessment, management and treatment of children, adolescents and families with various psychiatric disorders and mental health problems. This paper provides a broad overview and a critical evaluation of the present state of the art, paying particular attention to the integration and present status of clinical practice, theoretical models, research, teaching and training programs. Based on the emerging trends, directions for the future are suggested including an exploration of the integration of different therapeutic modalities. Finally, the practical problems associated with the leaching of these approaches in General Psychiatry Training Programs are addressed.
Cushing's Disease in a Young Woman with Anorexia Nervosa: Pathophysiological Implications
Authors: Katz Jack L. , Weiner Herbert , Kream Jacob , Zumoff Barnett
Published: April 2017

This report describes a 17-year old student who was found to have Cushing's syndrome two years after she had developed anorexia nervosa (AN). The Cushing's syndrome was treated with bilateral resection of enlarged, hyperplastic, non-tumoraus adrenal glands. The diagnosis was further confirmed four years later when, two to three years after new symptoms had appeared, an ACTH secreting pituitary adenoma (that is, Cushing's disease) was found on surgery. The possible mechanism for the development of Cushing's disease in a patient with prior anorexia nervosa, a sequence of events reported once previously, is discussed. It is suggested that increased hypothalamić-pituitary corticotroph stimulation in association with the anorexia nervosa, a now well-established endocrine phenomenon, activated an occult, inactive pituitary basophil adenoma in this patient, eventually resulting in autonomous pituitary overproduction of ACTH by the tumor.
Article
Authors: Streit-Forest Ursula , Goulet Et Marc
Published: April 2017

In this study a group of 27 victims seen approximately 6 months after the assault was compared to a matched control group. The results show significantly higher scores on two subscales of IPAT (“ego weakness” and “disposition to guilt”) and on 4 scales of the MMPI (“denial”, “hypochondriasis”, “depression” and “conversion hysteria”); also, the victims' social adjustment seems inferior and the frequency of sexual relations has been reduced considerably for them.

The following factors have been evaluated in order to test their relation to the adjustment to the assault: rape by a stranger versus someone known, degree of violence, feelings of self-blame, problems during the crisis, predominant thoughts, professional help, social support, stable relationship, allusion to victim's responsibility for rape and conviction or not of the aggressor. Even though most of these variables show a significant simple correlation with adjustment to rape only four among them remain significantly associated when socio-demographic variables, pre-rape psycho-social problems and life stressors are controled; the very subjective variable “predominant thoughts”seems to best explain differences in adjustment.

The importance of pre-assault variables and of the subjective reaction to rape is discussed.
Case Reports
Authors: Brooks Simon A.
Published: April 2017

The etiology of Folie à Deux remains a controversial topic; the relationship between the psychopathology exhibited by the dominant partner and that shown by the submissive one being particularly unclear.

Modern etiological theories attempt to reduce the phenomena of Folie à Deux to a procrustean mould, emphasizing in particular the contribution of schizophrenic pathology to the development of the condition. A case is described which raises doubts about the general applicability of this approach.
Shared Paranoid Disorder Preceded by Cannabis Abuse: Case Report
Authors: Dalby J. Thomas , Duncan Brenda J.
Published: April 2017

A case is presented of a socially isolated married couple who developed a shared paranoid disorder preceded by their cannabis abuse with the wife initiating the delusions. After the couple were separated the wife feared that she would be killed and assaulted her child and mother. Delusions in the pair ceased quickly and a return to cohabitation did not result in relapse in the absence of cannabis abuse.
Free T4 Measurement is Preferred to the T4 Test for Thyroid Evaluation in Lithium Treated Patients
Authors: Kutcher S.P. , Gow S.M.
Published: April 2017

Free T4 (fT4) measurement provides a more sensitive test of thyroid function than the commonly used T4. Recent commercial development of fT4 kit assays has made fT4 assessment widely available. Evaluation of the fT4 Amerlex kit in 26 lithium-treated patients illustrates its utility as a sensitive laboratory test of thyroid function in this group of patients. This finding together with fT4's known superiority over T4 in identifying thyroid dysfunction suggests that fT4 should replace T4 estimations in the routine monitoring of thyroid function in lithium-treated patients.
Assessing the Protective Service Needs of the Impaired Elderly Living in the Community
Authors: Schogt Barbara , Sadavoy Joel
Published: April 2017

The aim of this paper is to define the guidelines for the preparation of reports on protective service needs of the (impaired) elderly living in the community. Such guidelines are of special importance both because they have not been set down in detail, and because of recent moves to establish adult guardianship legislation in various jurisdictions. Three major areas are addressed in detail: a) the definition of an adequate assessment; b) the essential components of each report; and c) who should have responsibility for the assessment process. Medico-legal issues of guardianship are reviewed.
The Relationship between Agoraphobia, Social Phobia and Blood-Injury Phobia in Phobic and Anxious-Depressed Patients
Authors: Bowen Rudradeo C. , Fischer Donald G. , Barrett Peter , D'Arcy Carl
Published: April 2017

This paper reports the results of principal components and stepwise discriminant analyses of anxiety, depression and fear scores for 74 phobic and anxious-depressed psychiatric patients. Factor analysis indicated a coherent agoraphobia factor, with less coherent blood-injury and social phobia factors. Discriminant analysis showed a high degree of correct classification of diagnosed agoraphobic, blood-injury and social phobic patients particularly for agoraphobia. A frequency distribution of the phobia scores indicated an all or nothing quality to agoraphobic fears. The results indicate that agoraphobia is a fairly coherent syndrome, but that more work is needed on the concepts and measurement of blood-injury and social phobias.
Warrants of The Lieutenant Governor*
Authors: Turner R.E.
Published: April 2017

The evaluation of safe custody of ‘insane persons’ and Warrants of the Lieutenant Governor are reviewed, including the present law in the Criminal Code.

Highlights of the draft legislation presented by Mr. Crosbie, former Minister of Justice, June 25, 1986 are presented.
Does Verbal Abuse Leave Deeper Scars: A Study of Children and Parents*
Authors: Ney P.G.
Published: April 2017

This study investigating the effects of verbal abuse on children and their abused parents, tends to support the clinical impression that verbal abuse may have a greater impact for a longer period of time. Although there are very few pure forms of verbal abuse, there are some parents who use verbal abuse but would not hit their children, neglect them, or involve them in sex. Verbal abuse may become an increasingly frequent form of controlling and disciplining children because of the increased awareness of physical abuse and because of the possible declining value of children. Verbal abuse may have a greater impact because the abused child has greater difficulty defending himself from the attack. Because children tend to identify with their parents, the verbal abuse by their parents becomes a way in which they then abuse themselves.
Characteristics of Well Adjusted Adolescents*
Authors: Kashani Javad H. , Rosenberg Tomas , Beck Niels C. , Reid John C. , Battle Eliot F.
Published: April 2017

In a community sample of 150 adolescents 14–16 years old, 25 (16.7%) were found to be well adjusted on the basis of structured interviews with the youths and their parents. The personalities of these subjects were found to be different and their self-concepts better than those of the remaining sample. The well adjusted adolescents described their parents as more caring and reported a larger number of social support systems than did the controls. The direct significance of these findings, as well as more subtle ramifications for the mental health professional, is discussed.
Characteristics of Schizophrenic Patients and the Outcome of Fluphenazine and of Electroconvulsive Treatments*
Authors: Landmark Johan , Joseph Llewellyn , Merskey Harold
Published: April 2017

We examined the outcome with fluphenazine treatment and ECT in a group of 120 patients according to the incidence of psychopathological symptoms, the patients’ status on a variety of sociodemographic and anamnestic variables, and their diagnoses according to 13 systems for diagnosing schizophrenia. All had previously been considered to be schizophrenic patients at least once in hospital settings. The outcome with fluphenazine was better in patients with passivity feelings, auditory hallucinations and other hallucinations and delusions. The outcome with patients who had ECT, as judged from the hospital files, was better in those who were preoccupied with delusions or hallucinations and less successful in those who had been diagnosed as having schizophrenia on the first previous occasion when they had been discharged from the hospital.
The Relevance of Infant Psychiatry to the Understanding of Adult Psychopathology
Authors: Minde K.
Published: April 2017

This paper examines the relevance recent findings in Infant Psychiatry may have for the understanding of adult psychopathology. For example, evidence of both continuity and discontinuity within development is cited as one way in which the continuity of specific psychiatric conditions from childhood to adulthood can be understood. Another example are the aims of Developmental Psychopathologists who examine the mechanisms which underlie developmental transformations and who try to differentiate variations seen in normal individuals from disorders.

The paper ends by citing the advantages Infancy as a developmental period has in providing reference points for the understanding of cohesion within development. These are:

1. The rapid rate of change seen in children during this age period. This allows the observation of many developmental transformation and reorganizations.

2. The degree to which infants document how much we can shape our own environment.

3. The pervasive importance interpersonal relationships have for any human activity.

4. The need to understand development and hence change within the context of the environment.

5. The persuasive evidence which suggests that psychological disorders are generally based on real rather than imagined adverse events.
Neuropsychiatry and Child Psychiatry: The Case of the Brainstem Evoked Potential as an Illustration*
Authors: Thivierge Jacques
Published: April 2017

In child psychiatry one may frequently and reasonably suspect the existence of a neurophysiological abnormality of some kind even though this abnormality is not detectable with readily available technology: in children presenting developmental or acquired aphasia, in some specific learning disabilities, in severe developmental disorders or perhaps in a subgroup of those labeled Attention Deficit Disorder.

1. The importance for us as child psychiatrists to keep in mind the possible role of neurophysiological factors is put into perspective.

2. What Evoked Potentials are is briefly described as well as the basic principles of the technique used in recording them.

3. A review of the literature reveals how the Brainstem Auditory Evoked Responses (BAER) have helped in understanding unknown facets of known diseases (Diabetes, Hyperthyroidism, Bell Palsy, etc….) from this, it is argued that this is reasonable to expect the same usefulness for diagnosis in child psychiatry.

4. An opinion is offered as to how and when a child psychiatrist should make use of this investigation.
What do Children Know about Preventing Sexual Assault? How can Their Awareness be Increased?*
Authors: Sigurdson Eric , Strang Malcolm , Doig Terrie
Published: April 2017

Recent awareness of the pervasiveness of sexual abuse of children has resulted in a move to implement prevention programs. In conducting these programs the question of effectiveness is frequently asked.

In an attempt to answer some of this concern, a questionnaire was developed and tested to determine children's base level of knowledge. The video format prevention program, “Feeling Yes, Feeling No”, available from the National Film Board (Canada) was tested as a method of increasing awareness. A school with a cross section of town and rural children, with differing socioeconomic backgrounds, participated in the study.

The study consisted of a pretest of knowledge, a structured video interactive classroom prevention program, and a post-test measure of change. One hundred and thirty-seven students in grades 4, 5, and 6 participated. The program took 4 weeks to complete.

When asked about their feelings with regard to the program, 97% of the children stated that they enjoyed it. The results indicated that while most children have a basic level of self-protective knowledge and assertiveness, they can, in a classroom setting, learn significant and additional facts about avoiding sexual assault. Eight of twenty-nine knowledge questions elicited a large change in response, suggesting increased awareness of self-protection. The most significant changes occurred with girls, the same group apparently most at risk.
Children of Parents with Manic-Depressive Illness: A Follow-Up Study*
Authors: Laroche C. , Sheiner R. , Lester E. , Benierakis C. , Marrache M. , Engelsmann F. , Cheifetz P.
Published: April 2017

Thirty-seven offspring from 21 families with a manic-depressive parent were studied 3 to 7 years following initial evaluation. The study examined both pedigree information and psychosocial variables including parental, marital and overall adjustment, measures of chronicity and severity of parental illness and family assessment measures in rleationship to offspring functioning.

Nine of the 37 offspring (24%) received a positive DSM-III diagnosis, which is a similar percentage of positive diagnosis of children as we found previously. The diagnoses clustered in the affective illness spectrum. When the presence of affective traits was considered, there was evidence for continuity of psychopathology in most cases. Associations between offspring psychopathology and both non-specific and specific parental risk factors are discussed.
The Psychological Development of a Twin: A Case Study of the Importance of a Symptom*
Authors: Maclean George , Jones Barbara
Published: April 2017

In this paper we focus on the evaluation, assessment, diagnostic conclusions, and individual psychotherapy of a four year old twin who presented with the symptom of encopresis. Of great relevance to this boy is the literature concerning his vulnerability as a twin to develop symptomatology as he starts dealing with separation and individuation issues. Especially relevant are the multiple impacts of attitudes, perceptions and family rearing issues on the psychological development of this twin, and also on the development of this specific symptom choice — encopresis. Incorporating literature with case material, the meaning of the symptom of encopresis to this twin is discussed. The hypothesis defended is that the symptom enabled the twin to attract attention from his somewhat favoured brother, and to promote the process of separation and individuation from his parents and from his twin. It promoted his sense of himself as a separate and unique person in his own right. The child developed a sense of himself despite parental interference. With individual psychotherapy and family therapy, the need for the symptom was neglected.
Eating Disorders: Implications for the 1990's*
Authors: Garfinkel Paul E. , Garner David M. , Goldbloom David S.
Published: April 2017

In the past decade much has been learned about the clinical features, diagnosis and understanding of people with anorexia nervosa and bulimia nervosa. In order to provide the next level of improvement in our care for these patients, our understanding of certain problems must be addressed by empirical research. Areas which require further study include the definition of high risk groups, the refinement of diagnoses, understanding factors which result in chronicity, determining the complications of chronicity and comparative evaluations of different treatments. These five areas are outlined in this article. Populations at risk for anorexia nervosa and bulimia nervosa may be those who must be thin and achieve according to career choice, those with a particular family and personal psychiatric history; obesity and chronic medical illnesses may be further risks. Improved diagnostic understanding has occurred by the differentiation of bulimic from restricting subtypes of anorexia nervosa. Further work must determine the relationship between the bulimic subtype of anorexia nervosa and bulimia in normal weight women and to further clarify the relationship between eating disorders and affective disorders. A number of factors may result in a chronic illness. These have been described on a variety of levels. The consequences of starvation in altering an individual's thinking, feeling and behaviour do play a role. It is not clear what factors at a neurochemical level contribute to this. Elevated endogenous opiates decreased noradrenergic function and decreased serotonin may be important.

Information about the chronic complications is required for clinicians to understand the broad range of difficulties that may develop over time so that clinicians may use this information in planning treatment strategies. Two examples, those of osteoporosis and the pregnant woman with an eating disorder, highlight this problem. Finally, treatment is briefly reviewed in terms of options available and the idea of developing a stepped-care approach to treatment.
The Transfer Syndrome*
Authors: O'reilly Richard
Published: April 2017

Both patients and psychiatric residents are seen to exhibit symptoms as the end of the resident's job rotation approaches and the need arises to transfer the patient's care to a new therapist. These symptoms, collectively known as the “Transfer Syndrome”, are examined. An approach to modify these problems is outlined. Finally, the need for repeated transfers of individual patients between psychiatric residents is reviewed in the light of educational necessities.
Treatment of Heroin Withdrawal with Guanfacine: An Open Clinical Investigation*
Authors: Soler Insa P.A. , Bedate Villar J. , Theohar C. , Yotis A.
Published: April 2017

The alpha2-adrenoceptor stimulant, guanfacine, was used to treat, under open conditions, heroin addicts who volunteered to withdraw from heroin usage. Thirty-four addicts (29 males, 5 females) aged 17 to 31 years were treated for 5 to 15 days with varying doses of guanfacine (0.03 up to 1.75 mg daily). Efficacy was determined by the “Opiate Withdrawal Checklist” (OWCL), administered several times during the day, and by the Clinical Global Impression (CGI) scale.

All symptom categories of the OWCL, except “sleep disturbances” were equally ameliorated by the treatment. According to the CGI, 88% of the cases were judged as having had a very good or good improvement. Tolerability to the medication was judged as good or very good in 94% of the cases.
Patients on Warrants of the Lieutenant Governor in Alberta: A Statistical Summary with Comments on Treatment and Release Procedures
Authors: De St. Croix S. , Dry R. , Webster C.D.
Published: April 2017

Files on all 48 Alberta patients under Warrants of the Lieutenant Governor were reviewed in late 1984, early 1985. Few were on Warrant as a result of unfitness to stand trial and all carried a primary diagnosis involving major mental disorder. More than half were considered paranoidal. Two-thirds of the population had killed someone or attempted to do so. Only eight had not previously been inpatients in psychiatric hospitals. Nearly half of the patients offended against relatives. Close to two-thirds had a previous criminal record. The Alberta Hospital's Forensic Service is described as is the province's Board of Review. Two briefcase studies help portray the system of gradual release. The authors comment on the design of services for this group of patients known to be hard to treat and administer.
The Teaching of Psychiatric Epidemiology in Canadian Psychiatry Residency Programs
Authors: Kates Nicholas , Blum Heather Munroe , Keegan David
Published: April 2017

In an attempt to evaluate the current state of the training residents receive in psychiatric epidemiology in Psychiatry Residency programs, the Canadian Academy of Psychiatric Epidemiology sent a questionnaire to the 16 Canadian Residency Program Directors. Thirteen of the 16 directors (82%) responded. Program directors identified a number of the common components to the training, although there was wide variation in the time allocated and the availability of resources. The biggest single obstacle to the teaching was a perceived lack of interest on the part of the residents.
Evaluation of Psychogeriatric Services
Authors: Cole Martin G.
Published: April 2017

To date, the effectiveness and efficiency of different psychogeriatric services is unknown. In the future, these different services must be evaluated by means of randomized clinical trials.
Psychopathic Adaptations in the Vulnerable Patient
Authors: Dorenbaum David , Silver Daniel
Published: April 2017

The purpose of this paper is to discuss the fluidity of symptoms that a group of psychiatric patients presents during the passage of time. Although clinically recognizable and worthy of attention, this fluctuation makes the illness difficult to conceptualize under a definitive diagnostic category. Such a dilemma is very familiar to the hospital psychiatrist. The authors present a case to illustrate the fluidity of symptoms manifested by a patient throughout the course of her illness. Awareness of the changing clinical presentations may alert us both to reformulate the patient on an ongoing basis, and to identify the different intervention needs at various points in time.
Computer-Supervised Exposure Treatment for Phobias
Authors: Carr A.C. , Ghosh A. , Marks I.M.
Published: April 2017

Twenty phobic outpatients were treated by 9 weekly “interviews” at the console of a desk computer. Using a conversational style and multiple choice questions, the computer assessed the symptoms and agreed a hierarchy of self-exposure tasks. Each week the patient was given a diary sheet of tasks to practise daily. At his next visit his progress and motivation were assessed, and if he was succeeding he was encouraged to accept progressively more difficult tasks. This group was compared with a group of 20 patients (matched for age, sex and type of phobia) treated conventionally by a therapist in the preceding year.

Progress was measured on standardized scales (both self- and clinician-rated). The two groups showed significant improvement on all the scales, and 75–80% of each group were much improved (scores reduced by 50%). The therapist treated group tended to be more severely ill at entry and to show greater improvement during treatment. Improvement was maintained at 6 month follow-up in both groups.
An Experience in Psychiatric Record Linkage
Authors: Woogh Carolyn M.
Published: April 2017

This paper describes a personal experience in setting up a psychiatric record linkage system in an Eastern Ontario city. It discusses the rationale, background and methodology of the Kingston Psychiatric Record Linkage System and includes a detailed description of the practical issues encountered in its establishment and operation. The issues include funding, cooperation of local facilities, system start-up, operating costs, and data collection, linkage, entry, processing, storage and analysis. The limitations and uses of this system are discussed. Potential problems such as financial support and reliance on others have been resolved and the system has been functioning remarkably well since 1984. Published reports from other record linkage systems do not include such mundane details which would have been useful to know before planning this project. It is hoped that this paper will be beneficial to others who are interested in record linkage.
Myotonic Dystrophy of Steinert: Are Anxiety and Depression Necessarily Concomittants?
Authors: Cuthill John , Gattereau Antoine , Viguié Francis
Published: April 2017

Anxio-depressive symptomatology was not found in a small group of thirteen myotonic dystrophy (“Steinert's disease”) patients. This contradicts previously published reports which document a moderately severe affective disorder in this disease as well as showing a beneficial clinical response to “imipramine” and “lithium carbonate”. Methodologic and interpretative difference may explain the discordance between the studies.
Case Report of Hepatotoxicity Associated with Maprotiline
Authors: Weinstein R.P. , Gosselin J.Y.
Published: April 2017

A patient with unipolar affective disorder developed elevations in her liver enzymes shortly after initiation of therapy with maprotiline. The enzyme levels rapidly returned to normal after cessation of the drug with no residual liver disease.
A Psychiatric Consultation-Liaison Service in a Community Hospital
Authors: Porter Jean
Published: April 2017

The development of a multidiscipline Psychiatric Consultation-Liaison Service in a 628 bed community hospital is outlined showing its organization and benefits. Specific aspects of the role of each discipline, as well as the process of functioning on a multidiscipline team, are discussed, emphasizing the roles of the psychiatric clinical nurse specialist and psychiatric occupational therapist. Data obtained from 623 patients seen over two years is presented, showing trends similar to other published studies. The effectiveness of the multidiscipline team in allowing the one psychiatrist to significantly increase the number of patients seen in the second year and to become more precise in using the specific skills of the psychiatrist and other team members at the highest possible level of expertise, to meet each type of patient need, is brought into focus.
Treatment of the Borderline Patient, Relationship Management
Authors: Dawson David F.
Published: April 2017

The author suggests that not the borderline syndrome itself but many of the worst behaviours of borderline patients are essentially iatrogenic. To do no harm should be the primary goal of any therapist encountering a patient exhibiting borderline features. Management of the patient-therapist relationship is paramount and may be in itself the most effective and safe treatment for both crisis situations and longer therapy. A conceptual model borrowing from and bridging self psychology and interpersonal theory is described. This model leads to a reframing or new interpretation of borderline symptoms and therapists’ reactions. Realtionship management guidelines and specific interventions are suggested.
La stimulation preconsclente et consciente de l'imaginaire erotique
Authors: Borgeat François , Rezanowicz Thaddeus , Chaloult Louis
Published: April 2017

La possibilité de stimuler l'imaginaire erotique par l'association de relaxation et de suggestions érotiques conscientes ou préconscientes a été évaluée. Cette étude a été entreprise à la suite du succès d'une procédure semblable dans la stimulation de la fonction imaginaire chez les alexithymiques. Trente sujets féminins, répartis en trois groupes, ont pratiqué la relaxation quotidiennement pendant deux semaines incluant trois séances avec mesures psychologiques. Pendant la deuxième semaine, des suggestions érotiques, préconscientes pour un groupe et conscientes pour un second, ont été ajoutées. Le troisième groupe (contrôle) n'a reçu que de la relaxation. Les résultats ont montré une augmentation de l'excitation sexuelle subjective et de l'imagerie erotique pendant les séances avec suggestions érotiques. Les activités sexuelles et le désir ont augmenté dans les deux groupes expérimentaux. Il n'y a pas eu de différences entre les effets des suggestions conscientes et préconscientes. Les éventuelles applications cliniques d'une telle procédure sont discutées.
Working with Facially Disfigured Children: A Challenge in Prevention
Authors: Lefebvre Arlette M. , Arndt Erika M.
Published: April 2017

This paper reviews the growing literature on the psychology of appearance and outlines prevention principles for working with facially disfigured children, based on 15 years of psychiatric consultation to a major pediatric craniofacial team.
Child Sexual Abuse: Its Impact and Treatment
Authors: Vargo B. , Stavrakaki C. , Ellis J. , Williams E.
Published: April 2017

Sexual victimization of children is a relatively new area of enquiry and initial studies have been directed towards identification and etiology. It is only recently that treatment issues are beginning to be addressed. This paper first reviews the literature on the direct and indirect effects of sexual abuse on the child victim, and outlines five key issues in treatment. The major foci in treatment to date are described and a number of existing models, which have been devised to address these treatment issues, are briefly summarized.
Behavioural and Developmental Gains Made in a Therapeutic Preschool and an Integrated Day Care Program: A Pilot Study
Authors: Bradley Susan J. , Kolers Nira , Cohen Nancy
Published: April 2017

The outcomes after 8 months treatment for mildly delayed, behaviorally disordered preschoolers in a therapeutic preschool were compared with outcomes for similar children integrated into daycare centres on measures of development, language and behaviour. The results provide a measure of the gains achievable in a well resourced and specialized program.
Morbidity and Mortality of Certified Adolescent Psychiatric Patients
Authors: Stein B.A. , Tanzer L.
Published: April 2017

Recent legislation has placed greater restrictions on the involuntary hospitalization and treatment of psychiatric patients. A follow-up study was done on adolescent psychiatric patients who were certified during their hospital stay. The rate of certification was 8.5%. Their functioning was compared with that of a control group of voluntarily admitted adolescents. The two main reasons for certification were suicidal behaviour and psychotic symptoms. The majority of patients required further hospital treatment during the five year period after discharge. Few patients were found to be functioning in a successful independent fashion at the time of follow-up and certified patients required much more long-term social assistance. Five patients (22% of those certified) committed suicide and the combination of personality disorder and major depression was of particular importance in predicting suicide.
The Use and Misuse of Psychotropic Prescribing for Elderly Psychiatric Patients
Authors: Ancill R.J. , Embury G.D. , Macewan G.W. , Kennedy J.S.
Published: April 2017

The presenting problems and pre-admission diagnoses of 100 consecutive admissions to a geriatric psychiatry inpatient assessment unit were assessed in a retrospective survey and the use of psychotropic medication examined. Although post-admission diagnoses showed a high proportion of depressive illness amongst the patients, depression was infrequently diagnosed prior to admission and antidepressants infrequently used. The majority of these elderly patients were referred with a diagnosis of dementia and ‘behaviour problems’. These were treated prior to admission with neuroleptics or benzodiazepines in line with prescribing habits in this population reported elsewhere in North America. Attention is drawn to the significant incidence of major depression in these patients and the excellent response to treatment, both with chemotherapy or with electrotherapy. Attention is also drawn to the pre-admission prescribing of psychotropic drugs which are likely to lead to problems when used in the elderly and likely to result in significant iatrogenic disorders.
Development of a Suicide Screening Instrument for Use in a Remand Centre Setting*
Authors: Arboleda-Florez J. , Holley H.L.
Published: April 2017

In penal settings it is important to be able to quickly discriminate which kinds of self-destructive behaviours carry a larger suicide potential and which inmates present a greater suicide risk. This paper is a preliminary report of the first phase of a suicide research project conducted at the Calgary Remand Centre, Calgary, Alberta which has entailed the development of a tool for screening potentially suicidal inmates. The Suicide Checklist was designed for use by the nursing staff of the Centre to provide a screening process which would be: (a) reliable; (b) valid (within the broad constraints and difficulties inherent in any attempt to predict dangerousness to self); (c) standardized; (d) quick and feasible to implement; and (e) a combination of clinical and past history variables. This paper identifies some of the issues which have surrounded the development of this tool and presents findings from an initial reliability study.
Homosexual Panic: A Review of its Concept
Authors: Chuang Henry T. , Addington Donald
Published: April 2017

This paper traces the origin of the term “homosexual panic” when it was first described in 1920 to the Freudian bisexual theory of sexual development and the concepts of repressed and latent homosexuality, and questions the appropriateness of this term when used to diagnose as well as to describe different situations. Concerns are raised especially when dealing with conditions ranging from violent behaviour to outright psychotic episodes. Homosexual panic is also compared with pseudohomosexuality, and finally correlated with society's homophobic attitudes.
The Unseen Tears of Children: A Chinese Boy who Vomited for 14 Months
Authors: Wong Chung Kwong
Published: April 2017

A Chinese boy in Hong Kong who vomited for 14 months after his father had gone abroad to work is reported. Despite the very obvious predicament and sadness, more than 30 doctors had failed to understand the patient. In their search for a disease to explain the symptom, they trapped both themselves and the patient in the symptom of vomiting. It is argued that this patient should have been understood not from the angle of the traditional medical model. Neither was the psychoanalytical model useful. Rather the communication model of hysteria is much more practical; the vomiting can be construed as the unseen tears of a boy entrenched helplessly in his predicament. These unseen and unrecognized tears had cost the patient 14 months of precious life.
The Effectiveness of a Child Psychiatric Unit: A Follow-up Study
Authors: Ney Philip G. , Robert R. , Hanton Bruce R. , Brindad Emma S.
Published: April 2017

This follow-up study to determine the effectiveness of a child psychiatric unit found evidence to support a program emphasizing a predetermined period of hospitalization. Most measures of family satisfaction, behaviour and social function improved significantly. The unit appears to treat older children as well as those less than 9, children from fighting families as well as those with less fighting, and sexually abused children as well as physically abused children. The program includes: 2 weeks of preadmission evaluations, 5 weeks hospitalization and 5 weeks of follow-up, placement decisions made before admission, primary responsibility for front line staff and treatment programs composed of various combinations of techniques from a list of 65 possible techniques.
Relationship of Adverse Drug Reactions to Length of Hospital-Stay in Genetically Subgrouped Schizophrenics
Authors: Galdi Joe , Bonato Roland R.
Published: April 2017

The emergence of depression, parkinsonism, and akathisia after neuroleptic therapy was associated with increased length of hospital-stay in schizophrenics with affective heredity only. In schizophrenics with schizophrenic heredity, increased length of hospital-stay was associated with residual hallucinations and apathy. In the former patients, findings were theoretically attributed to a putative biogenetic abnormality sensitive to the effects of neuroleptic drugs.
Les interventions pharmacologiques chez les déficients mentaux agites
Authors: Sidoun Paul , Hillel Jean , Grunberg Frédéric , Elie Robert
Published: April 2017

Aggressive behavior of mental retardates is a frequent problem which semiological description is very polymorphic. Some psychiatric etiologies are listed, and then the different aspects of idiopathic aggressive behavior are described. These aspects give guidelines for more specific treatments which are further reviewed. Preferential indications and side effects are described for each in a way to suggest a therapeutic strategy. At the end, legal aspects involved are briefly exposed.
Le problème psychologique de la chute chez la personne âgée
Authors: Albarède Jean-Louis , Lemdzux André , Vellas Bruno , Groulx Bernard
Published: April 2017

This article recognizes the high incidence and prevalence of falls in the elderly. Psychological factors can play a definite role as part of the etiology. The fall can be a depressive signal or a cry for help from a demoralized elderly patient. The authors stress the importance of recognizing the depressive syndrome of the elderly.

Psychological consequences of the falls are reviewed at three different levels. For the elderly, the consequences are frequently a fear that can lead to a sharp decrease in functional capacity. For the family, the fall can lead to the institutionalization of the elderly or a very restrictive surveillance. For the family physician, the fall is frequently perceived as an emergency that leads to immediate unwarranted admission.

A rational approach, with education and guidelines, is proposed and can render this traumatic experience less dramatic at these three different levels.
Short-Term Group Therapy with Depressed Adolescent Outpatients
Authors: Fine Stuart , Gilbert Merv , Schmidt Lauren , Haley Glenn , Maxwell Anne , Forth Adele
Published: April 2017

A selected review of the literature about short-term therapy and social skills as they may apply to depressed adolescents is presented. Two forms of group therapy are described. These are social skills and a traditional discussion group format. Some of the difficulties in establishing and evaluating a group therapy program are outlined.
Treatment of Lithium Induced Tremor with Atenolol
Authors: Davé Mahendra
Published: April 2017

This is the first report on the successful treatment of one patient with lithium induced tremor with hydrophilic atenolol, which is a relatively selective beta 1 adrenergic receptor blocker. Atenolol's advantages over lipophilic beta blockers in the treatment of lithium induced tremor are discussed.
Canadian Collaborative Study of Tetrahydroaminoacridine (THA) and Lecithin Treatment of Alzheimer's Disease: Effect on Mood
Authors: Vida Stephen , Gauthier Louise , Gauthier Serge
Published: April 2017

Several lines of evidence have implicated acetylcholine (ACh) as one of the neurotransmitters found to be decreased in Alzheimer's disease (AD). Various methods of cholinergic augmentation have been attempted, with mixed results.

Tetrahydroaminoacridine (THA), an acetylcholinesterase inhibitor, is currently being investigated at the McGill Centre for Studies in Aging. Preliminary uncontrolled data from a 10-week clinical trial of THA and lecithin, reported elsewhere, suggest a clinically modest but statistically significant beneficial effect on cognition, although problems exist with side effects, particularly gastrointestinal.

Since the suggestion by Janowsky in 1972 that cholinergic neurotransmission may exert an inhibitory or depressant effect on mood, the evidence accumulated in the literature has been inconclusive. We undertook to assess several potential pretreatment correlates of depressive symptoms in AD and to monitor the course of these symptoms during the 10 week treatment period, using the Geriatric Depression Scale (GDS) of Brink and Yesavage. Pretreatment GDS scores were found to correlate with degree of overall disability and dementia as measured by the Rapid Disability Rating Scale (RDRS) and the Mini Mental State Examination (MMS), respectively. GDS scores over the treatment period did not change to a statistically significant degree. The meaning of these results is discussed, particularly with reference to the difficulty of diagnosis and measurement of depression in the setting of dementia.
Training Residents to Care for the Mentally III
Authors: Kates Nick , Cook Peter , Denson John , Low James
Published: April 2017

Recent changes in Royal College training requirements have highlighted the need for residency programs to be able to offer challenging and worthwhile experiences to their trainees in caring for the chronically mentally ill. This training should bring them into contact with patients at each stage of their illness and recovery and expose them to the different settings in which treatment or management takes place. Postgraduate programs face many problems in organizing this teaching that arise from the nature and course of long-term psychiatric illnesses, the organization of residency training programs, attitudes and preconceptions of residents and teachers and competing time demands. The authors review these problems, identify specific goals for the training and suggest strategies for achieving these goals. Expectations of postgraduate programs, clinical placements, supervisors and residents themselves are outlined.
Consultations psychiatriques dans un hôpital général (III): positions du consultant
Authors: Sirois François
Published: April 2017

Various clinical situations are described to illustrate the specific psychological assumptions toward which the psychiatric consultant is drawn in the course of daily liaison work in the general hospital. The purpose is to stress the usefulness and relevance of hitherto known models of consultation and models of patient-doctor relationships.
The Independence of Hyperactivity from Conduct Disorder: Methodological Considerations
Authors: Blouin Arthur G. , Conners C. Keith , Seidel William T. , Blouin Jane
Published: April 2017

It has been claimed that the childhood behavioural factors “hyperactivity” and “conduct disorder” are highly correlated. The fact that hyperactive symptoms load heavily on the conduct disorder factor has also been used to support the notion that hyperactivity is not an independent behavioural dimension. The present study employs a large sample of combined clinic and normal children to demonstrate that both of these observations are artifacts of methodological technique. When factor score coefficients are used to interpret factors, the hyperactive symptoms do not load on the conduct disorder factor. If factor scores are defined by the use of unit weights, as in previous studies, then the inter-correlation between the hyperactive and conduct disorder factors is high. The use of factor score coefficients to define factors, on the other hand, produces uncorrelated factors. The results support the idea that hyperactivity and conduct disorder are independent behavioural dimensions.