bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic Abortion and Psychiatric Disturbance in Canadian Women
Authors: Greenglass Esther R.
Published: April 2017

The majority of one hundred and eighty-eight women interviewed after having legal, therapeutic abortions did not experience psychiatric disturbance. While women with a psychiatric history were more likely than their more mentally healthy counterparts to experience some psychiatric disturbance afterwards, the majority of those with psychiatric problems in the past appeared to be coping reasonably well afterwards. It was pointed out that factors and circumstances other than the abortion itself, but occurring around the same time, may constitute reasons for the subsequent appearance of psychiatric disturbance, such as suicide attempts. Finally, the grounds for legal abortion in Canada were questioned — particularly the artificial practice of compartmentalizing and labeling reasons for abortion as psychiatric and non-psychiatric. While such practices may facilitate the decision-making processes involved in reviewing applications for abortion, they do not take account of the full range of human and social need.
Suicide and Prevention Centres
Authors: Eastwood M.R. , Brill Linda , Brown J.H.
Published: April 2017

Suicide and parasuicide rates have been underestimated in the past although there is evidence to show that the individuals in the official statistics are representative of the suicidal population as a whole. Both medical and non-medical agencies are involved in suicide prevention and while their effectiveness is uncertain their efforts should be judged by the same criteria with the whole spectrum ideation taken into account.
Continuous Observation — Part I
Authors: Phillips Michael , Peacocke Judy , Hermanstyne Lance , Rosales Ausa , Rowe Michelle , Smith Pat , Steele Carole , Weaver Rae
Published: April 2017

This study sought to identify the type of patient who receives continuous observation, the reasons for which continuous observation was prescribed and to evaluate the therapeutic benefit to the patient.
Patterns in the Delivery of Psychiatric Care in Saskatchewan 1971–1972 (II): Types of Contacts and Some Patient Career Characteristics
Authors: D'arcy Carl
Published: April 2017

A previous paper dealt with an overview of service sectors and patient volumes (2), whereas this one concentrates on types of contacts and some patient career characteristics. Analysis of a comprehensive psychiatric care utilization data file for Saskatchewan for the 1971–1972 period shows that ‘public’ sector patients were hospitalized for a greater average length of time than were ‘private’ sector patients. This may reflect differences in the styles of practice, exigencies of the demand for hospital beds in the ‘private’ as opposed to the ‘public’ sector and/or intrinsic differences in the nature of the problem treated in each sector.

Some interesting facts regarding patterns of contact were uncovered. The bimodal nature of the ‘psychiatric population’ was further evident from the data which show that the majority of patients used relatively few services whereas a few used a large number of services. This suggests that the majority of the people seen for psychiatric reasons by medical practitioners were suffering from relatively minor psychiatric disorders. Heavy users of services were much more likely to have had some ‘public’ or University Hospital-based contact. Conversely, light users were predominantly private sector patients. In the ‘public’ sector, those who had had some inpatient treatment were consistently higher users of all services.

It is evident that psychiatrists held a dominant position in this community-oriented public sector, having seen a large number of patients, but having had a low average rate of services per patient. In contrast, community nurses saw relatively few patients but saw them very often. This no doubt reflects their role in providing ‘maintenance’ services to chronic patients in approved homes in the community.

In the ‘private’ sector, 69 percent of the services were delivered by GPs and 23 percent by psychiatrists. Patients seen by psychiatrists were more likely to have had ‘public’ sector activity than were those seen only by GPs; also once in the ‘public’ sector, they were likelier to have had inpatient as well as outpatient treatment. This suggests a ‘sifting’ of the more ‘difficult’ patients through the private specialist sector into the public sector.
Patterns in the Delivery of Psychiatric Care in Saskatchewan 1971–1972: Part III: Patient Socio-Demographic and Medical Characteristics
Authors: D'Arcy Carl
Published: April 2017

This paper is one of several examining he variety of patterns in the delivery of psychiatric health care in the Province of Saskatchewan during 1971 and 1972. Previous papers dealt with an overview of service sectors, patient volumes, types of contacts and some patients career characteristics. This paper deals with sociodemographic and medical characteristics of patients treated in the various sectors of the psychiatric care delivery system in Saskatchewan.

The private and public psychiatric care delivery systems deal with essentially separate psychiatric populations. These differ in volume, in type of psychiatric disorder, in socio-demographic characteristics and in patient career characteristics. The “private” sector saw proportionately more females in the 20-39 year age group, whereas the public sector saw proportionately more males and females in the 0-19 year age category. The “private” sector also treated more people in rural, village and town areas whereas the public sector appeared to be more city-based. General practitioners were more active in rural and small towns, while psychiatrists tended to be more active in the larger urban areas. This reflects the general practitioner's role as a primary health care source. The vast majority of private sector patients were seen for neurotic and psychosomatic disorders. The public sector patients included those treated for the more intractable schizophrenic, organic, affective, and neurotic depression diagnoses.

Comparative data on both the private and public sectors show considerable increases in the volume of services being delivered. Previous data demonstrate a relatively strong relationship between availability of psychiatric services and utilization rates within a region. It would appear that the presence of a psychiatric inpatient facility serves an educative function and increases the volume of general practitioner treatment for psychiatric problems.

The present data indicate that the majority of persons seen for psychiatric reasons by medical practitioners in Saskatchewan suffer from relatively minor psychiatric ailments. Therefore, we must question the suitability of the present service delivery system. Is there a need to screen out “medical problems” from “problems of living” which may be better treated by non-medically-oriented counselling services, thus freeing some of the medically-skilled manpower to focus on better and more comprehensive care for the more intractable mental disorders?
Dynamic Patterns for Failure in College Students: Some Further Reflections on Success Neurosis
Authors: Frank Hallie
Published: April 2017

Several distinctive dynamic constellations associated with success neurosis are delineated in university students. It appears that success neurosis does not lend itself to any singular dynamic formulation. The traditional explanation based on oedipal competition is limited in its applicability. Pre-oedipal factors appear to assume greater magnitude than has previously been recognized. Dynamic explanations can be fruitfully subdivided into two categories, depending upon whether guilt or aggression is the critical etiological determinant for failure.
On Being Therapeutic
Authors: Greben Stanley E.
Published: April 2017

Psychotherapy is both an art and a science. The art deserves as careful study as does the science.

In this paper the author puts forward the view that the effectiveness of psychotherapy is dependent to a marked degree upon certain innate characteristics of the therapist: these include his character structure, his personal values, and his spontaneous personality style.

In order to explore this thesis, the author examines what has been written about some successful and well-known psychotherapists, by their patients, their colleagues, and their friends. He concludes that these therapists strongly evidenced the following characteristics: empathy and concern, caring and protectiveness, warmth, therapeutic force-fulness, expectation of improvement, freedom from despair, reliability, friendliness and respectfulness.

It is felt that such factors in the therapist must be taken into account in order to achieve a view of psychotherapy which is not reductionistic.
Two New Cases of XYY Chromosome Complement: And a Review of the Literature
Authors: Hoffman Brian F.
Published: April 2017

Two cases with XYY chromosome complement are presented and compared with 153 cases described in the literature.

Some patients with abnormalities of personality development and manifest psychopathology may have sex chromosome abnormalities and should be studied further for the interaction of genetic and environmental factors in personality development. In particular, tall, schizoid impulsive men with a history of criminality, arson or sexual offences should be screened for this particular genetic configuration. Because of the biased manner by which most of the cases are found, it is not yet known whether an XYY genotype results in a characteristic phenotype. What is needed is a genetic study of a normal population and a prospective study of newborns with various genotypes which would, unfortunately, create complex research and ethical problems.
L'adaptation Psycho-Sociale Des Malades Mentaux Chroniques Dans un Centre de Sante Mentale Communautaire
Authors: Gascon Louis , Thibaudeau Marie-France , Jean Richard ST.
Published: April 2017

The results of this study which lasted 27 months corroborate the approach advocated by the centre dealing with an underprivileged population of chronic patients. Indeed, our patients, in spite of the chronic character of their problem, have shown a continual improvement concerning their psychosocial adaptation, a better utilization and a more open perception of their environment.

Nevertheless, we have the feeling that the approach taken by the centre begins, after two years, to reach a plateau and this requires a major modification of the strategies of treatment. This change is needed in order to utilize more efficiently the non-psychiatric resources of the catchment area and to limit the involvement of the regular staff of the clinic.
Types of Disorders and Demographic Variables in A Canadian Child Psychiatry Population
Authors: Beitchman Joseph , Bell Kathy , Simeon Susan
Published: April 2017

The value and extent of epidemiologic investigations of adult psychopathology is contrasted with the paucity of similar data in child psychiatry. Some findings from American and British sources on the epidemiology of childhood psychopathology are noted but it is not known whether these findings would also be true in the Canadian setting, and what little Canadian data are available are not readily comparable with much of these foreign data.

Using both the D.S.M.II diagnostic schema and the child's symptoms as the definition of type of disorder, the relationship between type of disorder and demographic variables among 96 children attending a Canadian Regional Treatment Centre was investigated.

The results indicate that, in general, the relationship between type of disorder and age is consistent with reports from American and other foreign studies. No significant associations between social class and type of disorder could be discerned.

The analysis of sex and type of disorder produced somewhat contradictory results. Using symptom data, the possibility of changing patterns of symptom expression (toward increased proportion of externalizing symptoms) among girls is raised. If the reference point is diagnosis rather than symptom type, the results are more consistent with expected notions of neurotic disturbances being more common among girls, and conduct problems being more common among boys, but the possibility of sex stereotyping on the part of the diagnosing physician cannot be ruled out.

Finally, it is suggested that population studies are needed to investigate further the relationships between childhood psychopathology and demographic variables.
Group Pharmacotherapy for Withdrawn Schizophrenic Patients*
Authors: Payn Stephen B.
Published: April 2017

A method is described in which regressed schizophrenic patients on maintenance doses of neuroleptics receive their prescriptions in a group setting. Guided by the therapist, they learn to experience the give-and-take of interpersonal relationships. The result is a shift from the patients' preoccupation with themselves towards an interest in other people. While only a few patients have improved sufficiently to be able to work, the group experience has helped most participants by leading them towards involvement with other people.
Psychiatric Aspects of Geriatric Crisis Intervention
Authors: Grauer H. , Frank D.
Published: April 2017

Data on 64 geriatric patients treated by the Psychiatric Crisis Team at the Jewish General Hospital were reviewed. A control group of non-geriatric patients was selected at random for comparison.

The average age of the geriatric group was 69.4 years compared to 33 in the control group. Women predominated in the geriatric group. Precipitating factors were more easily delineated in the geriatric group. Physical illness, loss of a close relative and relocation were the most common precipitating events in the geriatric group. Depression, psychotic and neurotic, was the predominant diagnosis in the older group and schizophrenic psychosis in the control group. Compared to the control group, the geriatric patients were discharged sooner and were more easily managed. Only two geriatric patients required institutionalization.

The study supports the value of prompt and comprehensive geriatric crisis intervention.
Suicidal Behaviour in Halifax, Nova Scotia
Authors: Hirsch Solomon , Lowman Margaret , Perry Roland
Published: April 2017

A brief report of suicide statistics — completed suicides, attempts with lethal intent (a new category), and other attempts — is presented. The highest risk group in Halifax County is the male from late adolescence to early middle life.

Statistics from Canada and Nova Scotia reveal a marked increase in the rate of completed suicides in the young adult male during the past twenty years.

It is noteworthy that completed suicides and attempts with lethal intent frequently occur in persons with no clear evidence of significant depressive illness and that many patients with severe depressive illness are never seriously suicidal.

Many persons and some families have a pattern of reacting to stress and/or psychiatric illness with suicidal behaviour. There is often little correlation between the seriousness of the stress and/ or illness and the seriousness, of the suicidal behaviour.

Most suicide's were considered to be not preventable by ordinary techniques of management. Various patterns of behaviour relevant to preventability are described.

A brief description of reactions of physicians and nurses to suicidal behaviour is given. There is a negative reaction of both groups to suicidal attempts which are not serious, particularly to repeaters; and this reaction is much stronger in nurses than in physicians.

There is also a brief description of unusual complications of suicidal attempts and of the very high medical costs of caring for those who make attempts.
Consistency in the Diagnosis of the Functional Psychoses*
Authors: Amara I.B.
Published: April 2017

A review of the case books of 868 patients who had been admitted into a psychiatric hospital from January 1, 1970, to December 31, 1973, was carried out for consistency in the pattern of diagnosis by the same or different psychiatrists. Of these, 16.5% had a revision in diagnosis. The pertinent literature was reviewed. The possible factors that contribute to the observed inconsistency in diagnosis in this and other investigations are discussed. It is concluded that the problems as reflected in the significant change in diagnosis in this study are multifactorial. It is suggested that these problems may be related to the unknown etiology of the functional psychoses and the absence of identifiable specific lesions.
Psychiatric Services in China
Authors: Allodi F. , Dukszta J.
Published: April 2017

Reportedly, the People's Republic of China has made great progress in health care services, particularly at preventive, primary and community levels. Information on their psychiatric services is still scarce. A group of 12 health professionals visited the country for three weeks in July 1977. This paper provides a description and an analysis of the network of mental health services using a sample of one mental hospital, six general hospitals and a number of health units in cities, factories and communes. The basic principles of policy and administration are those of a collective socialism with strong central guidelines and considerable local administrative initiative. Admissions to the mental hospital in Shanghai reveal that 83% are young acute schizophrenic cases and very few are neurotic or non-psychotic. This distribution stands in great contrast with admissions to mental hospitals in the West, as is the case in Canada, where schizophrenics represent only 12% of all first admissions to mental hospitals and non-psychotic or minor conditions amount to two-thirds. An impressionistic survey of Chinese traditional medicine rooms in general hospitals revealed that a good proportion of their cases (60-70%) are diagnosed as suffering from minor organic or vague organic conditions without evidence of organic pathology and which in the West would be considered as neurotic or psychosomatic conditions. Outside the institutions, in the communes of the rural and urban areas behavioural, interpersonal and family problems are not defined specifically as mental health problems, but handled within the moral and political ideology prevalent in the country. None of the general hospitals visited had a psychiatric unit, but every patient in every hospital or health unit in the cities and countryside received a combination of traditional Chinese medicine (herbal preparations, acupuncture and moxibustion) besides the Western or modern type of treatment.

Officially mental illness is not considered a major problem and it is given very low priority in medical school curricula or in the planning of health services. It is concluded that psychiatric services in China are concerned primarily with cases of psychosis and severe neurosis, that neuroses are viewed as general health problems, and personality and behaviour disorders are considered social or community matters.
An Introduction to Holistic Primal Therapy*
Authors: Verny Tom
Published: April 2017

Holistic primal therapy is a comprehensive system of therapy where the therapist, while establishing a relationship of trust and mutual respect, acts as a catalyst for regression, the dismantling of defenses and the intensification of feelings. He or she acts as a transference object for the patient but also serves as a model of an ideal parent and normal adult. Through his own vitality he re-energizes the patient and helps him to overcome therapeutic impasse by focusing and integrating. Holistic primal therapy represents an important addition to the existing psychiatric modalities of treatment and suitable candidates should no longer be denied access to it.
Effects of Antianxiety Agents on Relaxation Training: A Preliminary Investigation*
Authors: Kazarian Shahe S. , Tekatch Gordon M. , Ifabumuyi Omatayo I. , Deinum E.J.L. , Merskey Harold
Published: April 2017

The purpose of this preliminary study was to investigate the effects of certain antianxiety agents, that is, minor tranquilizers, sedatives, and hypnotics, on relaxation training. Twelve inpatients and two outpatients were referred to group relaxation training because of tension-anxiety complaints and underwent three training sessions. Results for those patients who were not having any psychotropic medication (Relaxation Only group) were compared with results for those who were receiving anxiolytic drugs (Medication-Relaxation group). Patients in the second group were on antianxiety medication prior to and during relaxation training. Self-report measures indicate that the Relaxation Only group benefited more from relaxation training and showed more treatment generalization effects. The results are interpreted as lending some support to the view that antianxiety drugs may have an interfering effect on relaxation training. Implications and limitations of the study are discussed.
Operant Management of the Behavioural Sequelae of Wilson's Disease: A Case Report*
Authors: Jarrett F.J. , Gauthier Janel , Oliver R.D.
Published: April 2017

An approach to the management of the behavioural manifestations of Wilson's Disease by operant technique is outlined. There was considerable improvement in the patient's ability to perform autonomously on this program. When the contingencies were changed the patient's behaviour deteriorated markedly, thereby suggesting that improvement in behaviour was not due to medication alone.
Basic Principles in Custody Assessments*
Authors: Awad George A.
Published: April 2017

The paper discusses some of the principles of custody assessments in divorce proceedings. It is felt that such assessments should be undertaken only upon the request of the judge or both lawyers. The assessment should be extensive and should include collecting and collating all available data obtained through interviews or letters. The report should include historical material, the formulation, and the reasons for the recommendations. Clinically, the important issue is to decide under whose care the child's growth and development is enhanced. Factors that help in this decision include the emotional ties between the parent and the child, the capacity of each parent to provide physically and emotionally, the preference of the child, and the need for continuity. The psychiatric and moral “fitness” of parents is critically reviewed. It is maintained that no parent should be given an inherent preference in custody rulings. Finally, it is argued that access should be expected after divorce and should be changed or eliminated only under strict conditions.
Current Utilization of Day Hospitalization*
Authors: Azim Hassan F.A. , Weiden Theodore D. , Ratcliffe William D. , Nutter Richard W. , Dyck Ronald J. , Howarth Brian G.
Published: April 2017

The present study examined characteristics of comparable samples of patients admitted to nonaffiliated day and full-time psychiatric hospitals. Moreover, the influence of the day hospital program on symptomatology and social functioning was assessed. In general, the results indicated that day patients were of higher socioeconomic status and had fewer previous hospitalizations in comparison to 24-hour patients. While fewer day patients were diagnosed as psychotic, they did obtain higher scores of social inadequacy, depression and social introversion. Participation in the day hospital program was generally found to be related to decreased psychopathology, increased self-esteem and social role activities, and symptom relief. However, patients suffering from functional psychoses were found to demonstrate improvement below the average of the patient sample. These results were discussed in relation to previous research.
Ecg Changes in Pure Imipramine Overdose as Function of Plasma Level*
Authors: Reed K. , Mckim H.R.
Published: April 2017

ECG changes occur with therapeutic doses of tricyclic antidepressants and cardiovascular conduction alteration is the lethal effect in overdoses on these drugs.

These ECG changes depend on the plasma level and metabolism of the particular antidepressant. Information about the relative toxicity and metabolism characteristics can be obtained by studying overdoses if the attempt simply involves one tricyclic and no other drug ingestion. Such a case report involving a known quantity of imipramine is presented.

The early toxic signs leading to cardiac arrest and the recovery from coma are discussed. The ECG along with corresponding plasma levels of imipramine and its metabolite desmethylimipramine are given as a function of time after ingestion. The relative toxicity of these metabolites and the use of anticholinesterase in the acute management is considered.
Am I What I Wear?
Authors: Seeman Mary V.
Published: April 2017

For the borderline patient, clothes confer the possibility of stepping out of a shakily held sense of self and of temporarily becoming another person. With this possibility, which is enhanced by current day permissiveness in styles of dress, come many clothes-related symptoms. Identity conflicts and transitional crises are expressed by these symptoms, as illustrated by the case examples.
“The ‘Impossible’ Child,” The Difficult Child, and other Assorted Delinquents: Etiology, Characteristics and Incidence
Authors: Warren Marguerite Q.
Published: April 2017

The evidence is very strong and persuasive that if serious juvenile delinquents are identified as having reached Level 4, a differential treatment program can be identified for them which will increase their chances of avoiding further law violation behaviour. Looking at both I-level growth and further delinquent behaviour, less is known about how to bring about change in the Power-oriented youths than in other I-level groups. This group is perhaps the most deserving of the label “Impossible Child.” Continuing attempts to treat the Power-oriented offender in experimental programs is extremely important because this group includes the most serious offenders (the most felony-type crimes and the most assaultive crimes). More research is also needed on the treatment of the Passive Conformist group. We need to know more about the reasons for the short-term success and the long-term failure. Although this subtype does not commit as serious crimes as the other I3 subtypes, there is some evidence that there is a persistence to the offence behaviour which continues into adulthood, producing highly recidivistic individuals.
Case Reports
Authors: Bogopolsky Yann , Cormier Bruno M.
Published: April 2017

The displacement of roles in an incestuous family is described. As the daughters grew up, the mother abandoned early her rôle as a mother and nurturing, protective figure. She became one of them, playing the rôle of oldest daughter who, however, had passed the age of being the object of the incestuous wishes of the father (her husband). For his part, the father ignored her as a wife and in many ways this abandonment was a confirmation that she was no longer playing her rôle as spouse. On the other hand, the husband was unable to be a mature, responsible father who could take care of the affective needs of the family, so he gradually looked to his oldest daughter for a love relationship. In doing so he was himself abdicating as a father, perceiving himself as in his daughter's peer group. The second daughter, a pre-pubertal girl, out of jealousy and self-defence, assumed the rôle of ‘guardian’ of her older sister in trying to stop the relationship with the father and eventually refusing the advances he made to her. In the end, she revealed the ‘affair’ that took place between the father and the oldest daughter to the mother. The many changes in family relationships described, arising out of the incestuous relationship, shows that the disturbance in rôles leads in the end to the destruction of the family. Whereas there might have been many reasons to justify incest taboos for millenia past, in contemporary society the major reason justifying this taboo is that tolerance of it leads in fact to the destruction of the nuclear family, which is still, despite many changes, the key group of society.
The Syndrome of Inappropriate Secretion of Antidiuretic Hormone (Siadh): An Overview
Authors: Jose C.J. , Mehta S. , Perez-Cruet J.
Published: April 2017

We have reviewed 14 cases of water intoxication in psychiatric patients. In these cases the possibility of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was suspected or diagnosed. The SIADH should be suspected in psychotic patients who drink water excessively, develop seizures, disorientation and deterioration of mental status.
Overview: Certification Examination: The Canadian Certification Examination in Psychiatry: I: Historical Notes
Authors: Lowy F.H. , Jones R.O.
Published: April 2017

There has been much criticism of the format and process of the certification examination in psychiatry, and some of this is based on lack of information regarding the history of the specialty certification procedures, the Royal College of Physicians and Surgeons and the Board of Examiners. In this first of three reports the history of the Royal College as the certifying organization is traced, and the relevant College structures are briefly described, including the Specialty Committee on Psychiatry which is instrumental in appointing the clinical examiners. The clinical examiners since 1965 are identified.
The Canadian Certification Examination in Psychiatry: III: Towards Better Certification Techniques
Authors: Lowy F.H. , Prosen H.
Published: April 2017

Although there has been much criticism of specialty certification examinations there is general agreement that they are an important safeguard of competence in medical specialties where the consumer cannot judge this. The Canadian Royal College has made strenuous attempts to improve certification techniques but these have not been heretofore widely reported.

This paper reports on the rationale for the replacement of the essay examination by multiple choice questionnaires, the problems associated with MCQ, and the efforts made to improve the fairness, validity and reliability of the clinical (oral) examination. These efforts have been in the areas of selection of examiners, training for examiners, standardization of marking and the conduct of the examination. A description is given of the conduct of the examination and what the examiners look for in the candidate's performance. The development and increasing importance of the In-Training Evaluation are discussed. The publication of A Resident's Guide to Psychiatric Education with multinational participation advances the possibility of future reciprocity in psychiatric examinations conducted in several English speaking countries.
The Analysis of a Case of Dysmorfophobia (Psychopathology and Psychodynamics)
Authors: Philippopoulos George Spyros
Published: April 2017

A case history is presented of a 16 year old adopted girl, diagnosed as having dysmorfophobia and successfully treated by psychoanalytically-oriented psychotherapy, during which time much material for discussion and interpretation was provided by the patient's dreams.

The psychodynamics of the case are explored. In this case, dysmorfophobia is seen as a façade covering up the patient's unconscious urge to yield to sexual temptation.

Clinically, the case may be seen and classified as follows: It may be a syndrome or a cluster of symptoms that do not currently exist in the standard psychiatric nomenclature. The diagnosis of a personality trait disorder in a not yet fully structured personality might be a second alternative diagnosis. The author, however, is inclined to consider the case as a “transitional” or “potential” emotional disturbance, in accordance with Edward Glover's views (4).
Psychosomatic Illness Concept and Psychotherapy among the Akan of Ghana
Authors: Brautigam Walter , Osei Yaw
Published: April 2017

The example of the Akan in Ghana shows that western medicine has no psychotherapeutic alternative to offer the so-called “developing countries”. The traditional healing methods existing in such countries must be preserved and researched in order to maintain them at least at their present standard (9). This task, as well as that of developing these methods over the coming decades to keep pace with the cultural development process, is one that devolves upon the young scientists and doctors of such countries. This in turn requires further study of socialization values and norms, the potential resultant conflicts, the psychotherapeutic conflict-solving processes designed to obviate them and the forces at work in such psychotherapy.
The Mother Tongue in Psychotherapy
Authors: Carlson Richard J.
Published: April 2017

The psychotherapy of three women with neurotic and adaptational problems was conducted using their mother tongue, German, and emphasis is placed on the facilitation of the therapeutic process by this method. It is felt that transference may be readily formed, there is less resistance to examining conflict areas, and the use of the acquired language as a defense against anxiety can be avoided.

Several other authors have noted similar effects of therapy in the mother tongue. Various aspects of the literature are discussed, particularly focusing on the affective and cognitive differences between the primary and acquired languages as they may influence the psychotherapy.
General Papers
Authors: Gauthier Yvon
Published: April 2017

This paper summarizes the results of a longitudinal study on young asthmatic children and particularly on the mother-child relationship in this illness: At both observation times— 14 to 30 months and 4 to 6 years — the majority of the children appeared to be developing in a very adequate manner, both in the area of autonomy and opposition. Similarly, in most situations, the mothers appeared quite adequate in the face of their child's illness, and mother-child relationships, generally, seemed harmonious. However, a certain vulnerability in the area of opposition was more marked in a few cases, more frequently between 4–6 years than between 14–30 months.

The author attempts a brief history of the development of the concept of the “bad mother” who has become a scapegoat not only in childhood asthma but also in many illnesses encountered in child psychiatry. In questioning the role which may have been played by dynamic theories in this evolution, psychoanalytic writings are reviewed (for example, S. Freud, M. Klein, Spitz, Brody) and it is hypothesized that psychoanalytic theory has had more of a catalytic than a causal influence in relation with a strong tendency in our culture to the eclosion of negative attitudes toward the mother in her relationship with her child. The emphasis placed by North American culture on the nuclear family, the hypertrophy of the maternal function coupled with a paternal role much reduced in time, as well as the almost complete disappearance of maternal substitutes, have all probably greatly influenced the development of this concept of the “bad mother”. The author notes however, that happily, in recent years some child development theories insist on the concept of mother-child interaction and on the mutual role that mother and child have on one another in their exchanges. A review is made of the work of Sander, Bowlby, Schaffer, Lewis and Rosenblum which demonstrates this new trend.

The author also studies the question of vulnerability within parent-child relationships, leading to the appearance of child psychopathology, and discusses the development of methods which could help in its early detection. Recent attempts in this direction are reviewed, particularly those of Broussard, Gray et al., Lézine. The importance of Thomas and Chess’ work is particularly underlined, which emphasizes the specific interaction between the temperamental characteristics of the child and the parents’ specific responses to them, at all levels of development. More recent studies by Brazelton et al. and by Korner are also reviewed, suggesting a very early interaction between mother and child. The author concludes by briefly developing the preventive implications of these works and stressing the importance of closely following the efforts made at pre- and post-natal levels which may have much influence in the early prevention of psychopathology in parent-child relationships.
Beginning Psychoanalysis of a 16 Year Old Autistic Girl: The First Three Months
Authors: Eyre Dean P.
Published: April 2017

This clinical report attempts to show some aspects of the first three months of analysis with a 16 year old autistic girl with some conceptualization of the technical difficulties of instituting psychoanalysis with such a patient, as well as some conceptualizations of the material itself.
Psychiatric Consultations in a Canadian General Hospital
Authors: Taylor Graeme , Doody Kenneth
Published: April 2017

This paper reports a survey of psychiatric referral patterns on the inpatient wards of a Canadian general hospital over a 5-year period. The results demonstrate the useful contributions which psychiatric consultants can make to the care of physically ill patients. The most frequent consultation requests were for assistance with diagnostic problems and the management of depression or other psychopathology accompanying physical illness. The majority of consultation patients, 69.4%, had concurrent physical and psychiatric diagnoses and could be managed collaboratively on the services from which they were referred. Only 6.64% of the referred patients were transferred to a psychiatric ward, which reflected the philosophy of the consultation-liaison service to treat the psychiatric problems of the physically ill in the medical setting. The findings from the survey are compared with reports from general hospitals in Britain and the United States where the underutilization of psychiatric consultation services has been well demonstrated. Factors influencing the referral process, including liaison activities, are discussed and the limitations of consultation-liaison psychiatry, acknowledged. Changes in medical and nursing education are suggested to promote the wider practice of comprehensive patient care.
Psychiatric Implications of the Mitral Valve Prolapse Syndrome (MVPS)
Authors: Flannery John G. , Szmuilowicz J.
Published: April 2017

The mitral valve prolapse syndrome (MVPS) is an infrequent outcome of mitral valve prolapse, a common and usually benign structural abnormality. Psychiatric patients often present with symptoms indistinguishable from MVPS, knowledge of which is thus essential for differential diagnosis. Even when prolapse of the mitral valve is detected, the symptoms may be variously determined by both physical and emotional factors. Four illustrative case histories are presented.
Studies of the Psychosocial Adjustment of the Hearing-Impaired: I. Adolescents and their Families a Pilot Study
Authors: Maclean George , Becker Sheila
Published: April 2017

There is a general pessimistic view found in the literature that defends a hypothesis that the consequences of a severe hearing impairment on psychosocial development are many and severe. This pilot study of 20 adolescents who had experienced a profound hearing impairment from birth had the purpose of clarifying this issue. The findings of the study were not compatible with such pessimism. It is concluded that the teaching of an oral means of communication which facilitates education within a mainstreamed system, is compatible with good psychosocial adjustment. To confirm this optimism and to delineate the variables in good development, further study employing comparison groups is needed.
Therapeutic Milieu: A Dynamic Approach
Authors: Slonim Rodney , Nelken Moleyn , Leszcz Mayer
Published: April 2017

This paper deals with the establishment of a therapeutic milieu in an acute care general hospital setting. The rationale and structure are defined, and dynamic considerations are elaborated. Conclusions are drawn from our experience suggesting that the therapeutic milieu is a viable and a more effective treatment delivery system than that provided by conventional inpatient units.
The Man who became Angry Once: A Study of Overcontrolled Hostility
Authors: Arnold Larry , Fleming Russell , Bell Valerie
Published: April 2017

Recent developments in the study of violent behaviour have led social scientists to examine the concept of Overcontrolled Hostility. This case report describes the history of an overcontrolled individual who was examined in a Maximum Security Hospital after having shot his wife. The presentation of this case includes a brief theoretical perspective, as well as the results of psychiatric and psychological examinations.
Depression and Loss: A Theme in Robert Burton's “Anatomy of Melancholy” (1621)
Authors: Brink Andrew
Published: April 2017

Robert Burton's Anatomy of Melancholy (1621) can hardly be thought of as a modern study in psychiatry, but it contains more elements of modern theory than have been recognized. Attempts to recommend the book to modern readers have missed the point that Burton, more clearly than other seventeenth century writers on melancholy, sees traumatic loss of attachment figures, status symbols and personal health as predisposing to mood disorders. In this he strongly anticipates such work as that of John Bowlby in Attachment and Loss (1969, 1973). Burton's theory is divided between the humoural physiological theory descending from Galen and the observation that loss is a frequent precursor of melancholy. He cannot reconcile the two, writing a book only poised on the verge of modernity. The Anatomy of Melancholy nevertheless very fully discusses etiological “hunches” which have found verification in recent studies of traumatic loss.
Teaching Psychotherapy: Learning Objectives in Individual Psychotherapy
Authors: Waiters W.W. , Rubenstein J.S. , Bellissimo A.
Published: April 2017

This paper constitutes an initial attempt to establish specific end-point objectives for the teaching (and learning) of individual psychotherapy skills. A working framework for teaching psychotherapy, which includes intrapsychic as well as interactional phenomena, is articulated. The framework also tries to achieve an integration of basic concepts of psychotherapy and specific skills for clinical practice. It draws on concepts derived from communication theory, psychoanalytic theory, adaptational theory (ego theory), learning theory, and transactional theory.

In presenting these objectives three classes of skills are articulated: perceptual, conceptual, and executive. The end-point objectives are described for the following categories: 1) therapeutic stance, 2) history and mental status, 3) models and concepts, 4) communication channels, 5) patient's affect, 6) therapist's affect, 7) acceptance of affect, 8) interpretation, 9) transactions and 10) reinforcement and adaptation.

This framework is truly eclectic in nature and effects a healthy compromise between the technique oriented “ABC's of psychotherapy” school and proponents of the view that psychotherapy is an art that cannot be taught. By drawing from more than one model it encourages the student to recognize early the distinction between theoretical formulation and ideological commitment in psychotherapy. It presents these objectives in the form of an instrument that can, with continuous refinement and testing, be used to evaluate student's progress in a psychotherapy training program.
Evaluation of Lithium Response: Psychometric Findings
Authors: Ananth J. , Engelsmann F. , Kiriakos R.
Published: April 2017

Fifty-nine lithium treated patients were administered the MMPI test to differentiate the responders from the non-responders. The non-responders obtained higher scores on the Psychopathic Deviate, Paranoid and Mania Scales while the responders obtained higher scores on the Hypochondriasis, Psychasthenia and Social Introversion scales. Further work with pre- and post-treatment MMPI administration may provide additional and more definitive results.
Genetic Factors in Obsessive-Compulsive Neurosis? : A Rare Case of Discordant Monozygotic Twins
Authors: Hoaken Paul C.S. , Schnurr Rosina
Published: April 2017

There has been considerable interest in the strength of genetic predisposition to obsessive-compulsive neurosis in spite of the tendency in North America to view this disorder as entirely psychogenic. Both American and British papers have remarked on the rarity of the coincidence of obsessive-compulsive neurosis and the occurrence of MZ twins. An analysis of published reports indicates that, of those cases for which both zygosity and diagnosis can be firmly established, ten are concordant and only four discordant. Errors in previous studies that disqualify them from serious consideration include: failure of the investigators to establish zygosity with some degree of certainty; failure to distinguish between obsessive-compulsive neurosis and a mixed neurosis; and a tendency to confuse obsessive-compulsive neurosis with obsessive-compulsive personality or “obsessive traits”.

MZ female twins discordant for obsessive-compulsive neurosis are presented and their life histories are discussed. Although the twins were very similar in early childhood, their personality characteristics diverged remarkably, beginning at age 11, with the result that the symptomatic twin became shy, sensitive, cautious, conservative, and religious; whereas her asymptomatic sister became outgoing, confident, and adventuresome. The findings on psychiatric examination and on detailed psychological testing indicate that the obsessive-compulsive neurosis in the affected twin was clearly a psychogenic disorder.
Acculturation and Mental Disorder in the Inuit
Authors: Seltzer Allan
Published: April 2017

The phenomenon of acculturation stress is described with particular reference to the subsequent development of the transitional role conflict. The adolescent and young adult male Eskimo is especially susceptible to the anxiety generated by the process of acculturation and it is the interaction of this external stress with the bio-psycho-social characteristics of the individual within his ecological group, that may lead to an increased incidence of mental disorder. The clinical picture that develops will depend on the complex interaction of this psychosocial stressor and the level of ego development and its accompanying defence and coping strategies. We see how the development of manifest psychopathology in two young Inuit males was intimately associated with the stresses of acculturation acting upon personalities characterized by a low self-esteem and negative self-image, feelings of emasculation and a state of anomie. Coping and defensive strategies exhibited both similarities (drugs, alcohol, withdrawal, acting out) and differences (psychosis versus dissociation). The value of modified supportive therapy with continuity of care aimed at increasing self-esteem through sublimation, identification, reduction of dependency and encouragement of growth and autonomy is described, as are measures aimed at primary prevention.
Social Responsiveness toward Mental Patients: The General Public and Others
Authors: Page Stewart
Published: April 2017

The present study investigated the social responsiveness of the general public, and of psychiatric hospital staff, using Mil-gram's (1969) lost-letter technique. The public did not return fewer (or more) letters believed to be addressed to mental patients. Highest return rates were observed when personal costs to the finder were negligible. Psychiatric staff returned significantly fewer letters than did the general public. Other research, and implications of the findings, are outlined.
Sleep and Depression: A Case Study of EEG Sleep Prior to Relapse
Authors: Cairns J. , Waldron J. , Maclean A. W. , Knowles J.B.
Published: April 2017

By chance, we were able to record for five consecutive nights the sleep of a 61-year-old woman before each of two successive depressive episodes. In this patient, marked changes in EEG sleep (notably a decline in “sleep efficiency”) preceded both episodes. These changes are considered to be of predictive, but not of etiological, significance.