bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental Illness and Homicide
Authors: Mcknight C.K. , Mohr J.W. , Quinsey R.E. , Erochko J.
Published: April 2017

A homicide study undertaken at the Ontario Hospital, Penetanguishene, yielded 100 cases in which mental illness was present, or considered to be present, at the time of the act. This paper deals with some selected structural data on the total group, leaving dynamic material for intensive investigation of various subgroups.

The 100 patients had killed 110 victims and wounded a further 26. About half of the cases involved homicide within the family. Background information on the patients and some personal and social factors are considered. In terms of diagnosis, more than half were schizophrenics.

The peak in the ages of patients at the time of the offence is in the 30 to 35 year age group, but this differs in the various forms of homicides. Seasonal variations indicate peaks in early spring and fall, with another increase in December in the Christmas period. No specific weekday pattern emerged and the daily pattern suggests an increase in frequency from early morning to late evening. Most of the homicides took place in or close to the residence of offender or victim. Shooting was the most common method of attack. After the act, the majority of offenders made no attempt to escape.

The analysis will be continued in greater detail and with comparative material from the literature. These future papers will be concerned with specific groups, such as matricide, patricide, and wife murder.
En Deca Et Au Dela De L'Inceste Chez L'Adolescente
Authors: Bigras Julien , Bouchard Colette , Coleman-Porter Nancy , Tassé Yolande
Published: April 2017

This work deals with the problem of paternal incest occurring with young daughters at puberty. Only those incestuous relations which lasted at least one year have been the subject of the present research.

1) As far as the family structure is concerned, this study has revealed the incestuous father as a weak, masochistic, passive person who is dominated by his wife. The incestuous seductions of the daughter are experienced by her as making her party to his humiliation by his wife. It is under cover of pity that he turns his erotic desires to his daughter. He either beseeches her understanding and compassion or he uses violence.

He has no control over his home and above all he has no control over himself. The wife holds the reins. The father is incapable of saying no to his incestuous desires.

The mothers of these adolescent girls were described as essentially rejecting, and we noted that there is a parallel between the ego-disorganization of the adolescent girl and the intensity of the mother's rejection.

2) We have found that for the duration of the incestuous relationship, these adolescent girls had not suffered any behavioural or personality disorganization which would have alarmed their environment.

3) It was at the time, and very often on the very day, of the father's departure that these girls broke down.

4) Their disorganization was characterized by a very violent, compulsive acting out, which was for the most part erotic-heterosexual behaviour. Other acting out was observed, such as suicidal attempts, running away from home, auto-mutilation and destructive behaviour. We have given the name of compulsive-masochistic reaction to this type of disorganization.

Two adolescent girls eventually had a more severe reaction. They evolved a frank psychosis.

5) Our main hypothesis, which was confirmed by the analysis of the clinical material, was that the compulsive-masochistic reaction is due to a masochistic father-fixation. In other words, these young girls seek at all costs to perpetuate the incestuous liaison to which they are henceforth irremediably attached. Moreover this father-fixation protects them from a much more radical regression; namely an oral and murderous invasion by the mother.

The psychosis occurs when this father-fixation is no longer possible, that is when the father is annihilated, as much in the mother's eyes as in the daughter's. (“He no longer exists for me”, Lise told us). Then the adolescent girl cannot seek any help in her struggle against the oral, devastating and totally destructive mother with whom she is at grips. The effect is therefore fatal: a collapse of the ego's structure; it is psychosis.
Lack of Differential Effect of Plasma from Schizophrenic Patients and Normal Subjects on Performance of Conditioned Responses in Rats
Authors: Gowdey C. W. , Lovegrove T. D.
Published: April 2017

Reports on the effects of injections of blood fractions from schizophrenic patients into rats have been contradictory. The effects of samples of fresh serum or plasma from a group of chronic male schizophrenic patients and a group of apparently normal subjects have been compared with those of saline on conditioned responses in rats. No significant differences from the pre-injection trials were found with the rat rope-climbing and the conditioned avoidance techniques after any of the injections. Compared to saline, injections of fresh serum or of plasma reduced the responding rate of rats trained on operant schedules. No statistically significant differences could be demonstrated between the effects of the samples from schizophrenic and apparently normal subjects.
In Vivo Metabolism of Chlorpromazine
Authors: Green Donald E. , Forrest Irene S.
Published: April 2017

The present state of our knowledge concerning the metabolism of CPZ in humans is as follows:

Non-polar metabolites — All eight of the postulated metabolites have been reported, with nor-CPZ-SO and bis-nor-CPZ-SO being present in the largest amounts and CPZ and CPZ-SO in lesser amounts.

Moderately polar metabolites — Only CPZ-NO is present in substantial amounts. We have detected two acidic, but non-basic, metabolites by TLC and tentatively identified them as N-β-carboxyethyl derivatives. The concentration of free phenols seems to be very low in fresh urine.

Highly polar metabolites — We have seen at least 15 glucosiduronides and/or sulfates by TLC.

The isolation of representative reference compounds from the highly polar fraction and the determination of their chemical structures will permit the development of analytical techniques for their routine estimation. This information may disclose differences in the metabolic patterns of different patients and may permit the correlating of drug responsiveness with specific metabolic processes.

Obviously, the finding of any anomalous metabolism could have many consequences: it might provide a means of understanding why some patients are drug-responders while others are drug-refractory. Also, vitamins, coenzymes, or other substances which are known to have a role in that particular type of metabolic reaction could be used in an attempt to modify the action of the currently used phenothiazines. Finally, if a certain metabolic pathway is found to lead to either especially high or especially low therapeutic efficacy, medicinal chemists could ‘tailor-make’ a molecule which either facilitates or blocks that particular metabolic sequence in order to improve the clinical usefulness of the phenothiazine ‘tranquillizers’.
Conflict between Treatment and Science on a Research ward Investigating Schizophrenia
Authors: Crandall R. Gordon , Day Harvey , Beckett Peter G. S. , Chen Calvin H. , Brosius Charles , Frohman Charles E. , Gottlieb Jacques S.
Published: April 2017

The biological aspects of schizophrenia have been under study at the Lafayette Clinic since 1956. Previous publications described the isolation of a factor in the plasma of schizophrenic patients. The factor is identified using a chicken-cell lactate-pyruvate (L/P) ratio method. Studies have shown that schizophrenic patients can be significantly differentiated from non-schizophrenic subjects. Work has continued on the identification of the factor and on the regulation of the factor. Attempts are being made at relating behavioural attributes to some aspects of the biochemical measures.

A sizeable population of subjects for these studies has been required, as well as a hospital ward. Northville State Hospital made available an adequate ward and an area sufficient for the research laboratory.

The hospital ward is described. Criteria for the selection of schizophrenic patients are outlined as follows: sex, age, weight, central nervous system factors, intelligence potential, disease factors, drug factors, somatic treatment factors, duration and characteristics of illness.

The selection of control subjects has always posed a problem; and at one stage of investigation, ‘trusties’, obtained through the Michigan State Department of Corrections, were utilized. The management of patients and controls is described.

Discussion deals with the more serious problems encountered in the administration of this ward, including: 1) evidence of friction between staffs of a state hospital and a research clinic; 2) difficulties in obtaining a satisfactory ward physician who could willingly co-operate with both staffs; 3) feelings of nursing staff regarding patient care; 4) the unexpected difficulties encountered in the management of ‘trusties’ used as control subjects; and 5) additional efforts to help the members of the state hospital staff concerned feel that they are definitely essential for the success of the project.
A Comparative Study of Unmarried and Married Mothers Preliminary Report
Authors: Naiman James
Published: April 2017

A preliminary study of a group of white, Protestant, Canadian-born, unmarried mothers was found to have a greater degree of impulsivity and a poorer ability to form stable relationships than a control group of married mothers.
Eye Movements, Attention and Dreaming in Subjects with Lifelong Blindness*
Authors: Amadeo Marco , Gomez Evaristo
Published: April 2017

This study was carried out for two purposes: 1) to determine whether subjects with lifelong blindness will demonstrate increases in REM rate during states of heightened attention; 2) to investigate patterns of eye movements in the sleep of subjects wich lifelong blindness.

REM rates in three subjects were compared under two conditions: rest and states of ‘heightened attention. The latter was secured in the context of a word association test. The results showed a greater than twofold increased in REM rate during attention as compared to rest, lending support to Amadeo & Shagass’ previous findings on normally sighted subjects.

Seven out of eight subjects had REMs during their cyclically recurring EOG sleep Stage 1. The general pattern of electro-oculographic activity during sleep was described; compared to the EOG patterns already described in normally sighted subjects, we found differences in terms of over-all EOG configuration, REM frequency, amplitude and conjugateness.

The relevance of our combined findings to current hypotheses concerning the relationship between REMs and dreaming was discussed.
The Metabolism of Norepinephrine in Depressions: Differences and Effects of Therapies
Authors: Rosenblatt S. , Chanley J. D.
Published: April 2017

The metabolism of infused H3-norepinephrine was studied in twenty psychiatric patients with depression. A difference was found in the metabolism in those patients classified as manic-depressive in that they tended to have a definite increase in the urine in the proportion of those metabolites which retain the amine group as compared to the metabolites which had undergone oxidative deamination (N/O ratio). The main amine metabolite was normetanephrine while the main oxidized metabolite was vanillomandelic acid. Patients diagnosed as reactive depression also tended to have an elevated N/O ratio, but to a lesser degree than the manic-depressives. Those patients with involutional psychosis or schizophrenia with depression did not differ from the normals in the amine metabolism.

E.C.T. appears to be especially effective in those patients with an abnormal amine pattern and it also corrects the disturbance in the metabolism. Chlorpromazine, imipramine, amitriptyline and chlordiazepoxide cause a marked change in the metabolic pattern of norepinephrine.

Evidence is cited which suggests that the altered norepinephrine metabolism may result in an elevation of normetanephrine at synaptic sites which could antagonize the action of sympathetically-released norepinephrine.
Chlorpromazine-Procyclidine Combination, Imipramine and Placebo in Depressive Disorders
Authors: Donald F. Klein
Published: April 2017

Based on the early reports of the successful treatment of depressive states with chlorpromazine, 47 voluntarily hospitalized psychiatric patients referred for drug therapy, were randomly assigned to one of three treatment regimens. Sixteen depressive patients received imipramine, 11 placebo and 20 a combination of chlorpromazine and procyclidine in a six-week, fixed dosage schedule.

On clinical behavioural ratings, both the chlorpromazine-procyclidine combination and imipramine had significantly better therapeutic results than placebo.

These observations are consistent with earlier reports that the treatment of depressive disorders with chlorpromazine may be enhanced by the addition of an antiparkinsonian anticholinergic agent. It appears clear that agitated depressions may be effectively treated with chlorpromazine-procyclidine. Further data is required to evaluate this treatment for retarded depressions.
The Higher they Climb, the Lower they Fall
Authors: Samuel L. Safirstein , Ralph Kaufman M.
Published: April 2017

The opinion that depression is a reaction to a loss is supported. It is suggested that the loss is that of an inflated idealized version of the self which is a necessary aspect of living to the neurotic in order to derive pride, satisfaction and self-esteem. Self-idealization is a process which begins early in childhood in response to basic anxiety and develops on the level of magical, fantasied, wishful thinking. When events of life pierce the armour of self-glorification, the individual falls like a deflated balloon into the depth of despair and self-hate, the clinical expression of which is depression. Depression, through its slowing down of living processes, helps to isolate the individual from his environment and therefore permits the psychic apparatus to devote its energies to reinflate the balloon and restore the premorbid idealized image. Certain therapeutic implications inherent in this point of view are discussed. No claim is made that the suggested dynamic point of view is the exclusive dynamics of depression or that it obtains in all types of depressions.
Organic Brain Disease and Depressive Reactions of Later Life
Authors: Hader Marvin
Published: April 2017

Here reported are six patients with depression of late life and brain syndromes, who responded to an eclectic approach of tranquillizers, antidepressants and psychotherapy, using concepts from Gutheil, Rado and Arieti. Environmental manipulation, use of proprioceptive action self, and discussion of the origins of each depressive episode often helped to ameliorate symptoms and improve the clinical picture. Psychotherapy with these patients may necessarily involve newer but accepted techniques used in specific but different ways.
Propriétés Hypno-Inductrices Du Nitrazépam
Authors: Duguay Robert , Bordeleau Jean-Marc , Tetreault Léon
Published: April 2017

A double-blind comparative study made between nitrazepam 10 and 20 mg. secobarbital 200 mg. and placebo has pointed out the sleep-inductive properties of this 1–4 benzodiazepine derivative. Answers to a questionnaire were controlled by direct observations of the sleep-induction period.

Subjective and objective data prove that nitrazepam 10 and 20 mg. and secobarbital 200 mg. shorten sleep induction. A very high negative correlation was found between the two types of data.

The hypnotic action of nitrazepam was again formed as for quality and duration of sleep. Easiness of awakening and alertness of the subject during the forenoon as well as side effects were also analyzed. The effective and well-tolerated dosage of nitrazepam is 10 mg; awakening and alertness of the subject are affected by a higher dosage.
A Dynamic Thematic-Experiential Approach in the Treatment of Mental Subnormality: A Preliminary Report on an Experiment in Educational Therapy
Authors: Lissak D.
Published: April 2017

In the concise presentation of our program and its preliminary results we do not intend to offer a ‘cure-all’ method. We perceive it rather as an experimental endeavour in educational therapy with the intention of contributing to some of the pressing problems regarding the treatment of mentally subnormal children.

The improvement we observe in our children derived both from measurable data and clinical observation, points out that educational methodology when properly applied in educational therapy with mentally subnormal children — serves a twofold purpose:

1) Exposure to conditions which foster experiencing of primary cognitive functions help the child to develop better intentional and differentiative behaviour and facilitates more meaningful cognitive and functional relationships with the environment. As such it gives the professional worker insight into the basic problem in clinical psychology and special education, namely, the qualitative functional aspect of intelligence.

2) Exposure to the program proves to be a useful way to differentiate among clinical manifestations of different symptomatologies which, at the outset, are clustered around a general and diffuse behavioural and learning dysfunction.
The Selection of Delusional Persecutors
Authors: Sletten Ivan W. , Ballou Susan R.
Published: April 2017

The hypothesis tested in this study was that: The sex of a delusional persecutor will have a relationship to the sex of the most fear-inspiring parent or parent surrogate. Twenty-eight patients with delusions of persecution were evaluated by different interviewers who were unaware of what material to uncover in order to fulfil the hypothesis. It was found that when the father or father surrogate was most fear inspiring, the patient later would develop delusional fears of men only; that when the mother or mother surrogate was most fear inspiring, the patient would develop delusional fears of both men and women, but predominantly of women.

The findings are discussed in relation to cultural studies of delusions, certain aspects of learning theory and the concepts of Freud relating homosexuality to paranoid delusions.
Social Psychiatry and Social Work
Authors: Boehm Werner W.
Published: April 2017

For the purpose of this discussion, ‘social psychiatry’ is defined as an attitude or a perspective; its activity or services is ‘community mental health’. The social work methods, casework, group-work, and community organization, will be considered as contributors to community mental health.

Social work is an ideological forerunner of social psychiatry; the notion of the interdependence of psychic and social factors as determinants of human behaviour. Claims of exclusivity in community mental health made by psychiatry are being questioned by psychiatrists themselves.

Social work can participate in providing community mental health services through its traditional methods regardless of category of client, and in contributing a better understanding of some of the social determinants of mental illness through research. With the chronic mental patient in the realm of rehabilitation and provision, with the ambulatory patient, social work's goal would be rehabilitation and provision, but in addition, there would be secondary prevention. With the ‘mental illness prone’, social work through its traditional methods makes but a minimal contribution, The goal being primarily preventive. Contribution is being made through formal and informal consultative activities with related professions in places where the target population can be reached.

The role of social work can be enhanced if new developments bear fruit. At times society is the patient and the intervention should be directed at the reduction or elimination of the social pathologies and at the malfunctioning of our social systems. Social work thus might intervene in the social structure through the creation of new services and the more effective delivery of these services, the designing of new policies and programs in social welfare, the participation in urban planning and urban renewal and the participation in the creation of change in the ‘culture’ of society.

The problems which remain involved are the functional differentiation among the several mental health professions, the deployment and interrelationships of professional and sub-professional personnel in social welfare and the implication for professional education.

In conclusion the following questions are raised: what societal problems cause what categories of the population to be more prone to mental illness and emotional upheaval. Are we correct in placing under the rubric ‘mental illness’ some of the by-products of our urban highly technological civilization and would interdisciplinary epidemological research coupled with experimental intervention programs be appropriate to obtain answers to questions such as the ones posed above?
Aspirations Maritales et Parentales De Patients Psychiatriques Celibataires*: Enquête préliminaire
Authors: SauçIer Jean-F.
Published: April 2017

Not much being known about psychiatric patients' marital and parental expectations, an investigation has been done in an in-patient service of a general hospital through a questionnaire used previously.

The experimental group is composed of thirty patients, all single, Catholic, from lower social class; fourteen men (35% neurotics and 65% psychotics) and sixteen women (50% neurotics and 50% psychotics); schizophrenia is found in 50% of each sub-group. The control group is composed of 173 subjects, all single, Catholic, from lower social class; 100 men and 73 women whose age is approximately the same.

About the nineteen questions related to the ideal marital relationship, the sick men are significantly different only once from the normals (expecting less often the wife visiting her parents) whereas the sick women have different expectations from the normal women seven times (expecting an older husband, hoping for more frequent company of the husband and expecting less verbal communication between the spouses).

About the nine variables related to intermarriage, the sick men are different four times from the controls (more open to marriage with Protestant French Canadians, with non-French-Canadian Catholics, with recent French immigrants who have no religious practice and with Negro Haitian Catholics). On the other hand, the sick women are different three times from the normals (less open to marriage with Catholic French Canadians, their own ethnic group, and more open to marriage with Protestant French Canadians and with Jewish Canadians).

About the seven questions related to the ideal parental relationship, the sick men always agree with the normals whereas the sick women are three times different from the normals (expecting fewer children, expecting less co-operation from the husband in the care of children, and wishing to teach them more often how to find new ways to live).

Except for the attitudes towards intermarriage, one can observe that the sick women are much more often deviant (ten times against once) than the sick men from the social norms. It seems that this striking difference is related to the greater importance for women of the marital and parental roles; it would seem probable that the sick men give evidence of their deviance in the work and leisure spheres.
Les Psychothérapies Collectives Chez L'Enfant Et L'Adolescent*
Authors: Boulanger J. B.
Published: April 2017

The various group techniques used in the treatment of neurotic children and adolescents are reviewed and discussed under three main categories corresponding to divergent theoretical views on the development of personality and the nature of psychotherapy.

Slavson's group activity and Ginott's group play are defined as orthopedagogic methods meant to repair the frail ego of the child traumatized by frustrations and rejections from the environment.

Moreno's psychodrama centered on role learning is based on a sociological conception of psychic growth. Catharsis through action is a common therapeutic goal pursued by all these approaches. While retaining the instrumental aids introduced by Moreno's school, Lebovici, Anzieu and Boulanger elaborated forms of group psychodrama analytically oriented and devised to foster insight through the interpretation of play.

Group analysis was systematically applied to kindergarten, latency and adolescent patients by Anthony, who labelled his innovations, the ‘small table’, the ‘small room’ and the ‘small circle’ techniques. Boulanger restricts to preadolescents and adolescents verbal group analysis, and suggests group analytic psychodrama for late latency and group psychodrama for drawing and painting for early latency children. The collective fantasies of the group members are interpreted in the here and now of the transference situation.

Group psychoanalysis, adapted to the medium most suited to the age of the patients, is considered by the writer as the appropriate treatment for psychoneurotic children and adolescents. Insight into inner conflicts and transference fantasies is not checked by the intrusion of the therapist in the reality of the environment or by his participation in the acting out — the handicap of family therapy or group activities and orthodox psychodrama. The limitations in conceptualization and verbalization of the young patient, his inferior and dependent status with regard to the adult therapist are more readily overcome in a group of peers than in individual psychotherapeutic encounters. The influence of the process of socialization during these formative years on all aspects of personality development is also greatly enhanced by group psychotherapy.
L'organisation Fonctionnelle De L'enseignement Dans Un HÔPital Psychiatrique
Authors: Grantham Harry
Published: April 2017

The traditional psychiatric institution, when imbued of contemporary psychiatric principles, may become an excellent milieu for theoretical and practical training for each one of the members of the treating staff.

The author reports of an 18 months experience lived both at the university and hospital level, which occurred during the psychiatric teaching reorganization in a traditional psychiatric centre.

After describing the objective pursued in such a postgraduate training for the different health disciplines, the author points out how the psychiatric hospital can meet this challenge. The principles of the theoretical and practical program are briefly described along with the administrative structures of teaching in the hospital milieu. The emphasis set forth in the consultative role of certain teaching committees established according with the principles of a multi-disciplinary approach permits a far more effective comprehensive co-ordination.
Is there a Power Elite in Canadian Psychiatry?
Authors: Coates D. B.
Published: April 2017

This paper poses a number of questions regarding the recent history of psychiatric organization in Canada. Using public documents regarding organizational structure, it was suggested that during the decade 1956–1966, there was considerable evidence of a national shaping of policy regarding psychiatric services by a small but influential group of reformers. For other questions such as the organization and dispensing of research funds, access to more privileged sources would be required. In its organization, Canadian psychiatry is of no greater interest than many other professional organizations. However, because of its critical role at a time when health services generally were in transition, the psychiatric elite played an extremely important part in influencing the restructuring of psychiatric services around private practice, around general hospital and medical integration and the ideology that mental illness is identical with physical illness. The blurring of differences between psychiatry and mental health were discussed briefly and the apparent lack of conflict between bureaucratic and professional roles.
Psychodynamics of the Survivor Syndrome*
Authors: Grauer H.
Published: April 2017

The purpose of this study is to explore some of the psychodynamics of concentration camp survivors. There is growing evidence that in reactions due to extreme environmental stress we are dealing with a condition akin to psychosis or a borderline state. The chronicity of the condition, the clinical symptoms observed and poor response to treatment support the hypothesis that severe trauma results in unmodifiable ego changes. Two related ego alterations are discussed, namely, ego exhaustion and changes in the ego-superego boundary as a result of overwhelming guilt and shame. Ego exhaustion seen here is similar to that encountered in aging. In the aged continued losses and anatomical and physiological decline prevents reparation. Restitution in the concentration camp survivor is difficult because of the continuing ego-superego conflict.

A case is presented and problems encountered in the treatment of survivors are briefly outlined.

Further longitudinal studies and particularly reports of long-term treatment of survivors would help us gain further insight into the problems of massive traumatization.
Canadian Training for Residents from Developing Countries
Authors: Lewis David J.
Published: April 2017

In an effort to explore the relevance of Western methods of training and treatment for foreign residents coming to the McGill training network, a directory follow-up was made of the graduates of 1958–63, and of the two years 1966 and 1967. Results showed that less than one fifth went to a developing country. When the sample was narrowed to those who came from developing countries it was found that one third went home in the earlier period and one quarter in the most recent period. These figures, rough as they are, show that some students do return home but that a great number remain away, probably because of inadequate support.

Further study is needed, and should cover other health specialties as well.
School Refusal with Anxiety: a Review of Sixty-Three Cases
Authors: Smith Stuart L.
Published: April 2017

A review of 63 cases of school refusal with anxiety seen at the Maudsley Hospital, London, England, indicates that the disorder has the following features:

1) peak incidence at age 11 or 12,

2) higher proportion of youngest children in the family,

3) presence of three separate syndromes seems indicated (with some intermixtures), namely,

a) separation anxiety in the younger patients and in those whose difficulties started at a young age,

b) school phobia in the older patients without previous episodes, and

c) depression or withdrawal in some adolescents,

4) excellent prognosis as far as return to school is concerned, although somewhat poorer for patients of age 13 or over.
A Conditioning Test Battery for the Study of Psychopathological Mechanisms and Psychopharmacological Effects
Authors: Ban Thomas A. , Lehmann Heinz E. , Saxena Bishan M.
Published: April 2017

During eight years of systematic experimentation a comprehensive conditioning test procedure has been developed which may be useful for psychiatric clinical research. The procedure consists of seven conditioning techniques employed in eleven testing procedures, each requiring about 30 minutes to complete and measuring a total of 12 experimental variables. With this battery of tests significant differences were found between a normal population and a chronic schizophrenic population. The functional ability to extinguish an autonomic OR was found to be impaired in the schizophrenic group, together with an impairment of ‘integrational’ functions, such as generalization, differentiation and delay — all inhibitory functions. Without exception, the autonomic component of the word association response preceded the verbal one in our schizophrenic group. The first clinical, psychopharmacological application of this battery of tests is in progress.
Brief Communications and Clinical Notes: Schizoid Characteristics in Learning Disabilities
Authors: Hackney I. Mary
Published: April 2017

Three children are reported who were seen for psychological consultation because of academic learning disabilities. These children showed an inability to interpret facial expressions and physical gestures and were developing schizoid characteristics. Questions are raised regarding the implications of these symptoms.
A Comparison of Short-Term Treatment Effects of Intravenous Sodium Amytal-Methedrine and LSD in the Alcoholic
Authors: Johnson F.G.
Published: April 2017

Lysergic acid diethylamide (L.S.D.), given with and without a therapist present, is compared with sodium amylobarbitone-methedrine (S.A.M.), given with á therapist present, as abreactive agents in the treatment of alcoholism. Somatic, cognitive and affective experiences under the different treatment conditions are compared. L.S.D. produced a different quality of response from S.A.M. in many respects, but approximately half the patients in all categories noted a pronounced reduction of tension and depression following the experience. This short-term effect is contrasted with long-term (one year) absence of a significantly greater improvement rate with these drugs than with routine clinic treatment. The significance of these findings is discussed.
Pre-Trial Evaluation of Court Referrals*
Authors: Akhtar Syed Naveed
Published: April 2017

This paper examines the current Canadian laws and psychiatric practice relating to the pre-trial evaluation of court referrals in a mental hospital. The purpose of evaluation is briefly discussed. The issue of fitness to stand trial is examined in detail and psychiatric criteria of unfitness reviewed and illustrated with brief descriptions of clinical cases. It is contended that motivation for defence may be crucial in determining the fitness or unfitness of the accused. Under the present laws a finding of unfitness leads to legal and psychiatric consequences which contain elements of potential injustice to the patient. The recommendations of the Chalke Committee to modify the legal procedure and to remove some of these difficulties are underlined. The paper concludes with a description of the actual process of assessment in the hospital, the writing and submission of psychiatric reports, the fate of such reports and problems commonly encountered in the pre-trial evaluation.
Psychiatry and Abortion*
Authors: Heath David S.
Published: April 2017

Recommendation for abortion on psychiatric grounds is becoming comparatively more frequent; however, except for severe mental retardation, there are no unequivocal psychiatric grounds.

In countries with liberal abortion laws, abortions are recommended for sociomedical reasons much more often than for purely psychiatric reasons, and yet there is little data to enable the psychiatrist to assess these cases objectively and scientifically. He has to rely on his own personal opinion.

It seems that psychiatric illness occurring as a result of therapeutic abortion is uncommon, but it does sometimes occur in women who are less psychologically healthy than normal. However no studies have been carried out on unselected cases.

Studies on women who have been refused abortion show that the risk of suicide is almost nil, but in some circumstances the risk of criminal abortion is high, but again no studies have been done on unselected cases.

The situation in countries with liberal abortion laws is described.

The recent amendment to the Criminal Code of Canada does not change the legal position regarding abortion except for setting up a procedure to examine applications. The Canadian law still does not permit abortion for socio-medical, humanitarian or eugenic reasons.

The role of Canadian psychiatrists in therapeutic abortion is discussed and a brief survey has been carried out on their interpretation of the law.
Early Schizophrenia
Authors: Varsamis John , Adamson John D.
Published: April 2017

This is a report of a phenomenological and descriptive study of forty-four patients seen early in their first hospitalization for schizophrenia.

Most patients had a prodromal phase (median duration 30 months) during which the commonest symptoms were decreased drive and dysphoria. Symptomatology was often similar to that of a reactive depression; there was no instance resembling endogenous depression. A prodromal triad of deterioration in school or work performance, schizoid withdrawal and anergia was identified and this may have some diagnostic use. Twelve of the fifteen patients who exhibited this triad had also experienced disturbed flow of thought.

Some patients experienced increased sexual drive, usually towards the end of the prodromal phase or in early overt psychosis. Some also reported regular fluctuations in symptomatology; these cycles, usually of a few good days and a few bad days, occurred in the prodromal phase and/or early overt psychosis.

The transition to manifest psychosis was usually quite abrupt. An oneirophrenic experience, termed a ‘complex state”, was common either at the beginning of psychosis or soon thereafter. In the ‘complex state” a number of symptoms are experienced together or in such rapid succession that separating them is artificial. Perplexity and emotional arousal, usually dysphoric, are always present, and there is invariably at least one symptom of disturbed perception or delusion. Perceptual disturbances may affect any modality and often more than one; the perceptual alterations may be simple or complex. Disturbances of visual perception were reported more frequently than might have been expected, tending to be associated with good prognosis. Motor blocking, slowing or inco-ordination may occur, and although clouding of consciousness was experienced as part of the complex state, it was not possible to document this satisfactorily.

Delusions usually developed within complex states or more commonly as explanations of them, so that the concept of primary delusion may be invalid.

These findings were further discussed with particular reference to the work of Conrad and Chapman.
Gamma Globulin Levels in Psychiatric Patients
Authors: Hendrie H. C. , Paraskevas F. , Varsamis J.
Published: April 2017

Levels of three classes of immunoglobulins, Ig G, Ig A and Ig M, were determined in a group of carefully selected, drug-free, psychiatric patients. Significant elevation of Ig M occurred in female patients as compared to controls but did not occur in males. This elevation did not appear to be related to schizophrenia. There was also an apparent relationship between severe disorganizing levels of anxiety and increased Ig A values.
The Critical Incident Technique Applied to Postgraduate Training in Psychiatry
Authors: Graham John R. , Winslow Walter W. , Hickey Michael A.
Published: April 2017

The authors describe an interdisciplinary mental health team operating out of the Bernalillo County Mental Health Center in Albuquerque, New Mexico. Psychiatric residents at the University of New Mexico are assigned to teams working in the community. In an attempt to evaluate this educational program a technique describing specific incidents in residents' performance which are judged to be effective or ineffective was used. Everyone had implicit and explicit expectations with the assignment to the treatment team and considerable change took place in the team and the resident. Conflict and breakdown in the usual team function occurred frequently. The lack of role definition and role conflict were serious problems. However, the overall effect was desirable, and this type of program may produce a new and necessary advance in providing services to the population at risk in addition to providing a new educational experience for psychiatric residents.
Role-Playing: A Method of Teaching Interpersonal Skills
Authors: Burra P.
Published: April 2017

A relatively new and increasingly popular method of teaching interpersonal skills has been described. The method has been in operation for the past year in the Department of Psychiatry at Queen's University. Evaluation by forty-five fourth-year medical students of the year 1970–71 points to a very favourable student reaction to this method.
Catecholamine Metabolism in Affective Disorders: Excretion of 3-Methoxy-4-Hydroxymandelic Acid in Depressive States
Authors: Mcnamee H. Brian , Moody J.P. , Naylor G.J.
Published: April 2017

The urinary excretion of the main catecholamine metabolite, 3-methoxy-4-hydroxymandelic acid (VMA), was studied in thirteen patients before, during and after recovery from a depressive illness. The patients were classified independently into two diagnostic groups. Operational definitions of psychotic depression and neurotic depression were made, using diagnostic scales.

Taking the group as a whole there was no significant difference in VMA excretion throughout the periods of study. In four of the patients who showed psychomotor retardation the urinary VMA increased during hospitalization but did not reach statistical significance.

No difference was found in the mean values for VMA excretion in psychotic depressive patients compared with those who were neurotic.
Some Problems in the Evaluation of Women for Therapeutic Abortion
Authors: Werman David S. , Spencer Roger F.
Published: April 2017

Large numbers of patients with unwanted pregnancies are now being seen in areas where the abortion laws have been liberalized. A few frequently occurring psychologic mechanisms noted in these patients are described, and their significance for the consultant is noted.
The Residential Treatment Response of Disturbed Children Using Serial Ratings of Adjustment
Authors: Alderton Harvey R.
Published: April 2017

The response of twenty latency-aged children to residential treatment was measured by serial child-care ratings. Those who did not respond early made no gains during the latter half of hospitalization.

A satisfactory outcome was best predicted by the total rating change within the first six months as a percentage of the treatment interval. Treatment success appeared to depend upon the extent to which the program modified the child's customary defences and behaviour within that period, irrespective of whether this resulted in an increase or reduction in disturbance. Possible reasons for lack of early change are discussed.
A One-Year Trial of Clopenthixol in Chronic Schizophrenia
Authors: Simpson G.M. , Arengo A.D. , Angus J.W.S. , Beckles E.D. , Rochlin D.
Published: April 2017

Fifty-six patients with chronic schizophrenia were maintained on clopenthixol for one year. Significant improvement was noted in 13 of the 18 BPRS items by the end of the study. There was also clinical improvement in approximately 71 per cent of the sample, with 27 per cent showing no change and 2 per cent slightly worse in comparison with their pre-medication condition. A number of side effects and abnormal laboratory results were noted during the first few months of the study, although these generally dropped to normal levels as the study continued. It would appear that clopenthixol is an active antipsychotic medication which maintains its activity over twelve months. One or two patients responded very well to this medication after having failed to react to other neuroleptics. Toxicity was not a problem although laboratory abnormalities were noted early in the study.
Ten-Year Follow-Up of 100 Patients Admitted to a Mental Hospital
Authors: Cahn Charles H.
Published: April 2017

A ten-year follow-up study of 100 patients admitted consecutively to a mental hospital revealed the following information.

The patients used the hospital beds for an average of one year and two months of the ten years, that is, about. one-eighth of the time. The co-operative schizophrenic patients could be kept out of hospital with proper maintenance therapy. Patients admitted with organic psychoses died after an average of one and three-quarter years. Of the ‘functional’ cases nearly a half were alive after ten years, 8 were dead (2 or 3 suicides) and the rest could not be traced.

The patients had an average of 23 physicians but this large number does not appear to have harmed them.

Nearly all patients had some drug therapy, the two most frequently prescribed categories being neuroleptics and antidepressants. About half the patients had occupational and work therapy.

The condition of the 68 survivors was considered to be: ‘recovered’ or ‘much improved’ in 55 per cent; ‘moderately or slightly improved’ in 40 per cent and ‘unimproved or worse’ in 3 per cent. Their last known vocational status was ‘working or self-sufficient’ in 34 per cent, ‘dependent’ upon relatives or government support in 43 per cent and not known in 23 per cent.
A Service of Liaison to the Isolated North: A Proposal for ‘Community Transference’
Authors: Henderson James
Published: April 2017

This is a report of a one-year pilot project of community psychiatric service to three small towns in the northern part of the Province of Ontario. Data acquired in the course of this project are described and an attempt is made to derive from them a more accurate assessment of the mental health requirements of these communities. The concept of ‘community transference’ is advanced to cover the complex of reactive tensions set up in a community by visitors attempting to change deeply-held attitudes to psychiatric disturbance and to alter traditional modes of dealing with these patients. ‘Community transference’ is a theoretical construct which may prove useful in projects where success depends upon modifying community attitudes.
Hospitalized Adolescents and Therapeutic Milieu: Denial of Conflicts versus Normality as Average
Authors: Sendi Ismail B. , Johnson James W.
Published: April 2017

A retrospective clinical and statistical evaluation of the development of a ‘therapeutic milieu’ with a new concept is made. The effectiveness of this milieu for fifty hospitalized adolescents (thirty boys and twenty girls) in the Adolescent Service of Fairlawn Center is studied and reported. The new concept, defined as introduction of ‘normality as average’ standards and as prearranged expectations, have been incorporated into the structural and living system of the adolescent's life. This concept has been introduced as a principle governing the expectations of the therapeutic milieu.

It is suggested that ‘normality as average’ expectations in the therapeutic milieu protects the already prevailing normalized culture of the ward; furthermore, it challenges the adolescent who denies the presence of conflicts. More significantly, ‘normality as average’ expectation reinforces the process of developmental ‘socialization’ which is so necessary for hospitalized adolescents. Five important components required for the stability of a therapeutic milieu for adolescents are categorically discussed. Emphasis has been laid on the staff-patient-staff communication and intradisciplinary communication to prevent the pathological parental attitudes from becoming the anatomy of the attitudes of the staff. It is suggested that equally distributed authority be delegated to all staff dealing with adolescent behaviour in the milieu. The paper reviewed a two-year retrospective study of the conditions of all patients at discharge.

The effectiveness of a ‘normality as average’ expectations in the milieu has been correlated with a gradual and progressive decline in the frequency and the intensity of daily major vandalism.

This paper focuses on the significance of the development of the cognitive process thinking in adolescence. The effect of this thinking of the adolescent and the cognitive approach in the milieu on the patient's syntaxic judgment is emphasized. Such a capability is viewed as being challenging to him, and is used as an avenue of communication to his behavioural confession and his emotional denial.