bluuebunny/crossref_metadata_2025 huggingface dataset:
Overinclusive Thinking in Symptom-Free Schizophrenics
Authors: Payne R.W. , Ancevich Singrida S. , Laverty S.G.
Published: April 2017

1. Three groups of patients who had recovered from their illness, and who showed virtually no symptoms, were tested. Nearly all had received drug treatment for at least a month, and many were still taking drugs. Of the 54 patients, 16 had been diagnosed as schizophrenic, and had been actively deluded in the past. Seventeen had been diagnosed as schizophrenic, but had not been actively deluded. The remaining 21 had not been regarded as schizophrenic.

2. A previous study, testing exactly similar groups prior to treatment, had found the deluded schizophrenics most overinclusive, the non-deluded schizophrenics slightly overinclusive, and the non-schizophrenics normal in this respect. In the present study, there were no significant differences between the three groups on the measure of overinclusion used, the Object Classification Test. Furthermore the subjects were, for all practical purposes, all within the normal range on this measure when compared with previously published data from normal people. It was therefore concluded that overinclusive thinking in schizophrenia is probably a symptom of the illness, and not a permanent personality characteristic of the individuals concerned.

3. Two new tests of overinclusive thinking, both involving the establishment of a perceptual “set”, were tried out to see if they were practicable. The results were negative in that in neither procedure was any set developed.

4. A measure of abnormal retardation was also used, derived from the Object Classification Test. Again, the three groups were not significantly different, nor did they differ from a previously published normal group. This suggests that abnormal retardation, also, is a symptom of the illness of psychotic patients, and not a permanent personality characteristic.
Reactive Psychosis in Adolescence
Authors: Alderton Harvey
Published: April 2017

Two examples of a brief psychotic reaction occurring during adolescence are reported. In spite of symptoms of apparently serious significance the patients made a rapid recovery. The criteria by which such cases of “reactive psychosis in adolescence” may be distinguished from schizophrenia or manic-depressive psychosis are discussed and the value of retaining this separate category considered.
“Conditions Sometimes Mistaken for Mental Defect”
Authors: Gibson Robert
Published: April 2017

Mental defect is a state of both intellectual retardation and social incompetence. In considering the differential diagnosis of mental defect, it becomes necessary to review conditions where only one of these factors may be present. But since intellectual retardation can be simulated by specific defects of visual, auditory and speech functions, it is also necessary to bear these further conditions in mind. Hence in differentiating mental defect, attention must be paid to three separate groups: conditions characterized by intellectual inadequacy alone, specific defects which may simulate intellectual inadequacy, and conditions characterized by social incompetence alone. Conditions characterized by intellectual inadequacy alone include uncomplicated intellectual retardation, dullness, and backwardness. Specific defects impairing visual, auditory and speech functions include congenital blindness, congenital word-blindness, congenital deafness, congenital word-deafness, elective mutism, delayed development of speech and congenital motor aphasia. Where social incompetence is the outstanding feature there is a risk of mistaking for mental defect, behaviour which is primarily delinquent, convulsive or psychotic in character.
Euphemistic Nomenclature in Mental Retardation
Authors: Gibson David
Published: April 2017

A number of new grading systems for the mentally retarded were examined in terms of their potential contribution to diagnosis, prognosis and management. It was concluded that to continue grading the retarded into the traditional Idiot-Imbecile-Moron system was only apparently reactionary in view of the limited universality of the newer grading systems. Current substitute nomenclatures to date suffer from limited predictive potency and are probably little more than disguising euphemisms for a disability which is still essentially repugnant to large sections of the community.
II. Drugs, Dreams and the Experimental Subject
Authors: Whitman Roy M.
Published: April 2017

I have attempted to give a rapid overview of four major studies utilizing REM indicators of dreaming: the first, consisted of the evaluation of the psychological effects of the tranquillizer drugs via standardized collection of five-minute dream samples; the second, consisted of ascertaining the deeper anxieties of the experimental subject when he is undergoing all night monitoring of his dreaming; the third, was the experimental induction of conflict with its subsequent appearance in free associations and dreams; and the fourth, a comparison of dreams as told to the experimenter and to the therapist.
Length of Hospitalization before and after Tranquillizers
Authors: Schnore Morris M. , Kere Ulda
Published: April 2017

Two cohorts of first admission schizophrenics, one group (N=116) before and the other (N=125) after the introduction of tranquillizing drugs, were compared with respect to (a) length of stay in hospital for each admission, and (b) number of readmissions. It was found that a significant decrease in the length of hospitalization for each admission was associated with the introduction of tranquillizers. No significant differences among the two cohorts were found with respect to the number of readmissions. Thus, no evidence was found to support the claim that a decrease in length of hospitalization has resulted in a larger number of readmissions, that is, in a faster turn-over of patients. The difficulties of assigning the decrease in the average length of hospitalization to the direct effects of tranquillizers were discussed.
Ulcerative Colitis — Criteria of a “Psychosomatic” Disease
Authors: Powles William E.
Published: April 2017

Ulcerative colitis is one of a loose group of “psychosomatic” or “psychophysiologic” diseases appearing together in our present official nosological classification. These illnesses share certain common features: the presence of tangible lesions and pathophysiology, the possibility of serious and fatal outcomes, association with certain mental states, and mediating mechanisms outside the voluntary nervous system. This paper is a discussion of the historical steps or criteria necessary to “establish” a disease entity as “psychosomatic”, illustrated by features of ulcerative colitis, the people who suffer from it, and their treatment.

The criteria of a psychosomatic disease, as presented, are: —

1. The association of life stresses with exacerbations of the disease.

2. The finding of generally disturbed personality types associated with sufferers from the disease.

3. Some specificity of personality traits in sufferers from the disease, traits which usually do not fall within any standard psychiatric diagnosis.

4. Some specificity of the type of life stress precipitating attacks of the disease in predisposed people.

5. Establishment of scientifically plausible connections between personality type, specific stress, mental state, and pathophysiologic reaction.

6. Evidence that a specific psychotherapeutic approach contributes to remission, over and above other treatment measures.
L'Encoprésie en Consultation Psychiatrique
Authors: Gauthier Yvon
Published: April 2017

A series of ten cases of encopresis, seen in psychiatric consultation over a period of two years, is reviewed from dynamic and technical aspects. These children were found to react by regression to a traumatic separation from their mothers, over a background of maternal deprivation. A consultation approach, rather than the usual intensive psychotherapy of child and parents, was used in most of these cases, for lack of therapeutic facilities and location of family. The results have been evaluated and were found to be surprisingly better than expected. It is suggested that such an approach (psychiatric interview, social history, and interpretation to the family of specific recommendations) should be used more often before psychotherapy is attempted, thus trying to use better the emotional resources of the family. Some organic factors of this condition are discussed, as well as the role of the paediatrician in the prevention of the illness at critical stages of the child's life: namely, toilet training and birth of a sibling. The timing of the hospitalization of the child is important, and the author suggests it should not occur before the age of four. Close collaboration of the paediatrician and the child psychiatrist is most essential in such cases.
Sheltered Workshops
Authors: Houston Frederick
Published: April 2017

From a mental hospital in England, in 1956, contacts were made with industry to obtain contracts for work to be performed in a hut in the hospital grounds. The manufacturers supplied the material and tools, and a female attendant was appointed as supervisor. Patients were paid for each finished article. The unit was restricted to chronic female patients. Eighty-two patients were studied, 30 of whom had been in hospital for more than a year. Thirty-six of the patients in the project recovered sufficiently to be discharged, of those, 30 who had been hospitalized for more than a year, five were discharged. These five had spent 22, 10, 6 1/2, 4 1/2, and 1 1/2 years respectively in hospital before they went to work in the sheltered workshop. All patients improved.

It was felt that such a project supplies reality testing, resocialization, and a monetary incentive to recovery, and that vocational training was not the main factor here. High morale and prestige of those engaged, as in the Hawthorne experiment, were important. Other industrial units in the hospital, e.g. laundry and sewing room, acted as a control to the experiment.

It is suggested that such an idea be tried more extensively in Canadian mental hospitals, and that scientific measurements be made of changes produced.
Conditioning Techniques in Psychotherapy
Authors: Burnett Alastair , Ryan Edmund
Published: April 2017

Over the last decade more and more articles and books have been published dealing with the application of learning theory and principles in the individual and group psychotherapy of neurotic patients. In this paper, a patient population attending the Day-Care Clinic in the Mental Hospital, St. John's, Newfoundland, is described and the application of a learning theory type of therapy is discussed. These patients came mainly from small, isolated fishing villages or out-ports, located around the coast of Newfoundland. Most of them had gone only as far as Grade VII or VIII in school and were unsophisticated regarding their symptomatology and emotional illness.

Several studies on normal persons living in out-ports had indicated that their performance abilities are much better developed than their verbal-conceptual ones. It was felt, therefore, that patients of this type might benefit from conditioning and supportive therapy rather than from any sophisticated analytic treatment which would require a fair level of education and ability to verbalize.

The results of this type of treatment approach on rural “unsophisticated” patients who have limited formal education suggest that an approach involving conditioning therapy and basic education may be quite useful. Also the results indicate that the emphasis on the psychotherapy of the intelligent urban patient may have resulted in the relative neglect of a fairly large proportion of individuals seeking treatment. It is hoped that a greater interest in these less analytically-exciting patients will result from treatments involving basic learning theory and conditioning principles.
Chronic Anorexia: A Behaviour Problem
Authors: Ayllon T. , Haughton E. , Osmond H. O.
Published: April 2017

The chronic refusal to eat sometimes referred to as chronic anorexia can be effectively controlled through techniques developed in the behavioural laboratory. Contemporary methods used to reinstate normal eating such as persuasion, coaxing, spoon-feeding, insulin injections, tube-feeding, and others, can result in the patient being shaped or conditioned to eat only with assistance.

Based on an experimental investigation of erratic eating in mental patients, the authors present a behavioural model for the identification and treatment of chronic refusal to eat. The syndrome of chronic anorexia is regarded largely as the acquired, learned, behaviour of rejecting food. When food rejection is not followed by social reinforcement it disappears in a relatively short period of time, and normal eating is reinstated.
A Psychiatric Service for University Students
Authors: Schwarz Conrad J.
Published: April 2017

The first Canadian Conference on Student Mental Health has provided the stimulus for this review of the development of a Psychiatric Service for students attending the University of British Columbia, and some of the data obtained for the Winter Session 1962–63 has been presented.

The Psychiatric Service functions as an integral part of the Student Health Service of the University and is staffed by a part-time Consultant Psychiatrist and a full-time Resident. In addition, other Residents in the Department of Psychiatry provide valuable psychotherapy time for the treatment of University students.

It is pointed out that the figure of 1.5% of the student population being seen by the Psychiatric Service must be taken as a low estimate of the incidence of emotional problems among students, since a number of other counselling-type resources are available on the campus.

It would appear that there is an uneven distribution of patients in relation to academic year and faculty or school, with more senior students and those receiving some kind of psychiatric orientation in their courses showing a readier tendency to seek help.

The motivation of students involved in psychiatric treatment is estimated to be fairly high in view of the large percentage of self-referrals and the small percentage of drop-outs, missed appointments and students missing more than one appointment.

The mean number of interviews was 7.8 per student with a mean time of 6.34 hours per student due to the use of less-than-one-hour sessions.

The need to regard hospitalization as a concomitant of out-patient treatment is stressed and the extensive use of the 26-bed campus hospital as a night and as a day facility for the treatment of emotionally disturbed students, is outlined.

Reference is made to the monthly distribution of requests for assessment and some of the factors in the high peaks in October and January are discussed. The low incidence of new referrals during examination times is not felt to be due simply to the students having something on which to focus their anxiety during these times and some of the other possible factors involved are mentioned.
Hypnotherapy of Migraine
Authors: Hanley F. W.
Published: April 2017

Hypnotherapy was used in the successful treatment of six young women with migraine, in whom the attacks were related to unexpressed resentment, usually toward their husbands, without secondary gain. Hypnosis shortened the psychotherapy by increasing rapport and verbalization in the initial phase, facilitating expression of feeling and acquisition of insight in the middle phase, and consolidating self-expression and improving the marital relationship in the later phase. In one case deeper analysis was facilitated.

There were two failures, both in older people in whom the migraine served a need.

It is realized that these cases may not be a representative sample of migraine in the community, but they do indicate the existence of a group which can be helped by hypnotherapy.
LSD in Chronic Alcoholism
Authors: O'Reilly P. O. , Funk A.
Published: April 2017

Since 1959, 68 alcoholics have been treated with LSD. Twenty-six patients reported sobriety in the follow-up period. The nature of the experience appeared to bear an independent relationship to abstinence.
Withdrawal of Long-Term Phenothiazines from Chronically Hospitalized Psychiatric Patients
Authors: Marjerrison G. , Irvine D. , Stewart C. N. , Williams R. , Matheu H. , Demay M.
Published: April 2017

A study was conducted of the effect of substituting placebo medication for active phenothiazine medication under double-blind conditions, in a population of chronically hospitalized psychotic patients who had all been undergoing long-term phenothiazine treatment. Behavioural change was assessed monthly by psychiatric nurses using a ward behaviour inventory, which had been specially constructed to be sensitive to kinds of behaviour likely to affect the clinical prescription of phenothiazines.

At the fifth month of the study, differences were noted between the placebo-substituted group and a control group continuing to receive their originally-prescribed phenothiazine compounds. Significant worsening in the Placebo group did not appear until the fifth monthly rating, and at that time significant improvement in the control (medication unchanged) group also first became evident. These results support the hypothesis that the continued long-term use of phenothiazine compounds in chronically-hospitalized psychotics is effective in the sustained reduction of psychopathological behaviour.

An investigation of trifluoperazine and chlorprothixene within the same double-blind design indicated that both were significantly more effective than placebo in maintaining the behavioural level typical of the prior long-term medication with phenothiazines.

Using the FPN test as one measure of the time course of urinary excretion of some of the phenothiazine metabolites, no relationship was demonstrated in the placebo-substituted group between FPN changes and behavioural worsening. The FPN test, rated blind, was able to discriminate the placebo-substituted group from the group continuing to receive their usual phenothiazines; as a single measure of the time course of urinary excretion of phenothiazine metabolites, however, FPN changes were not related to behavioural worsening within the placebo-substituted group.
Experiments in Time Perception
Authors: Cappon Daniel , Banks Robert
Published: April 2017

Experimentation was carried out to test for a relationship between subjective time perception and ability to make temporal judgements. The performance of 20 depersonalized and derealized patients and 20 controls, was compared on a variety of tests of time judgement administered under normal laboratory conditions and under conditions which have been shown to induce or amplify distortions in subjective temporal experience. The results failed to indicate any reliable relationship between subjective temporal experience and ability to make time judgements. The performance of patients did not differ reliably from that of controls under any of the testing conditions; exposure to distorting conditions did not have a reliable effect on temporal performance and Ss who reported temporal distortions either in their past life or while actually performing the tests of time judgement, failed to perform differently from Ss who did not report distortions.
The Follow-Up of 100 Patients Admitted to a Mental Hospital
Authors: Cahn C. H.
Published: April 2017

This follow-up report of 100 patients admitted to a mental hospital in Montreal showed that 73 patients were discharged, 16 patients died, and 11 patients were still in hospital 15 months after admission. The average duration of stay (first or only) of those who were discharged was 3.6 months; 36 patients who, prior to admission had been last treated at general hospitals with psychiatric in-patient services, stayed an average of only five days longer. Treatments in order of frequency employed were psycho-active drugs, occupational and work therapy, social service referral, psychotherapy, and E.C.T., (usually a combination of treatments was used). Post-discharge follow-up in the hospital After-Care Clinic usually was successful in preventing re-admission of co-operative schizophrenics, but not of manic-depressives and unco-operative schizophrenics.

It is concluded that regardless of what treatment patients receive prior to admission, the great majority do not require prolonged in-patient treatment, and that a modern mental hospital can provide effective treatment and rehabilitation services, not always fully available in general hospitals, even for short-term patients. Further comparative studies are indicated.
A Clinical Formulation of Conditions Conducive to Favourable Change in Psychotherapy.—Part I
Authors: Thomson P. G.
Published: April 2017

This paper is Part I of a three-part presentation attempting to assess, with the use of clinical material, those conditions which seem most to bring about favourable change in patients undergoing psychotherapy.

This includes an attempt to differentiate between two kinds of change. The first is that which occurs under the suggestive influence of the therapist and in which the change comes about as a result of the patient's incorporation of the therapist as a friendly and powerful transference figure.
Skin Pigmentation, A Rare Side Effect of Chlorpromazine
Authors: Ban T. A. , Lehmann H. E.
Published: April 2017

A greyish-brownish-bluish skin discolouration is described in patients who have received chlorpromazine in high dosages for a considerable length of time. Prior to the skin pigmentation an increased melanocytic activity with ocular manifestations appears, which beyond a certain point in some patients leads to exhaustion of melanocytic activity and to deposit of melanin in the dermis. The melanin/chlorpromazine complex is discussed and a hypothetical mechanism of chlorpromazine action is proposed which may lead to the described skin and ocular pathology.
L'Anxiété au Cours de la Formation Psychiatrique
Authors: Bonaccorsi M. T.
Published: April 2017

This paper is concerned with the role and the consequences of anxiety during psychiatric training in relation to three fundamental factors: a) The personality of the resident. b) The clinical and theoretical aspects of psychiatry itself. c) The teaching and training centres.

The psychiatric resident has already made a first decisive choice by becoming a physician. This orientation seems to be determined mainly by unconscious drives as narcissistic, sadistic, voyeuristic impulses, fear of dependency and castration feelings. The medical profession offers ego-syntonic defence mechanisms like reaction-formation, denial or sublimation. Psychiatry introduces a new possibility: The use of the patient's problems as a dress-rehearsal for personal difficulties in an effort of integration. The choice of pre-genital defence mechanisms obscures the therapeutic understanding, becoming anxiety-provoking. The same is true for the exploitation of the patient in order to obtain vicarious satisfactions. The personality of the resident, in terms of level of maturity, is also responsible for the handling and understanding of counter-transference reactions. The positive and negative aspects of counter-transference, its role in anxiety formation, the contribution of the supervisors are discussed and clinical examples are presented in relation to anxiety.

The second factor studied is the clinical and theoretical aspect of psychiatry itself in its interaction with the resident's personality. The emphasis is laid on the premature case-load, the sudden and total investment of the resident's energy and time on mental patients and related theories, the stress caused by the treatment of psychotics in terms of reactivation of early infantile conflicts.

Some criticism is directed towards the policy of training-centres. It is noted that pragmatic needs — such as keeping wards and O.P.D. active — are of paramount importance in the choice of the program. Little time is left for reading and research. The method of teaching relies heavily on seminars, often poorly prepared and given by foreign students with language problems. The approach to the special branches of psychiatry, like psychoanalysis, is rather dogmatic and rigid. The resident is stuffed (often with incomplete notions), but not oriented to a critical and creative mental activity.

The result is the production of standardized psychiatrists. The same holds true for psychoanalytic education, which aims at the formation of a special S.E. (Ferenczi's “S.E. intro-pression”) in order to avoid criticism or secessions.

The sad consequence is the poverty in psychiatric and psychoanalytic research, for, in order to discover something new, one needs a strong, curious and plastic Ego and a tolerant, friendly S.E., able to accept the alteration of the old paternal order.
Notes on Group Psychotherapy with Pedophiles
Authors: Hartman V.
Published: April 2017

Here reported are some of the highlights of a research project completed at the Forensic Clinic, Toronto Psychiatric Hospital. It was aimed at exploring the dynamics of pedophilia and the testing treatment techniques in a context of long-term psychotherapy with chronic pedophiles. Analytically oriented group psychotherapy is seen as the treatment method of choice for unmotivated pedophiles. The group psychotherapeutic sessions are seen as providing the therapeutic attention and interaction necessary for better reality testing, acceptance of responsibility, insight, integrated knowledge about self and the lessening and disappearance of pedophilic urges. In conducting the group, emphasis is placed on the need for flexibility in the therapist. In the integrative phase the therapist must be active, involved, reality-oriented and supportive, to foster ego and the development necessary for the abandonment of compromise devices. Later the therapist's activities are mainly focused on exploring resistances, and there is a gradual change to free group association, to the underlying unconsciously motivated common group themes and to the emphasis on the group as a whole.

The pedophilic act per se is seen as a defensive measure by which the ego establishes homeostasis in time of stress. For pedophiles almost any stress caused by disturbance in object relationships can produce a state of panic. The ego of the pedophile faces tremendous regressive urges toward the recreation of the infantile symbiosis with the mother. Simultaneously there are intense fears of disintegration caused by sadistic rage towards the mother-figure. The unbearable tensions created by these are alleviated by the pedophilic act in those cases where a complex mother-child identification takes place.

The powerful therapeutic effect of the group sessions is seen also as being further strengthened by the symbolic meaning that the group as a whole becomes, viz, assurance of the group members against object loss.

The writer's gratitude to the group members of the Forensic Clinic's group psychotherapy seminar, for their valuable discussions, is herewith acknowledged.
Occupational Accidents: Some Psychosocial Factors in the Accident Syndrome
Authors: Lipinski Edwin , Winslow Walter W. , Powles William E. , Ross W. Donald
Published: April 2017

Accident prevention in industry has been actively promoted by labour and management for many years but only in recent years has the psychological and motivational aspects of accident behaviour been systematically studied. The three ‘E's’, engineering, education and enforcement, have been the bases upon which successful accident-prevention programs have been erected in the past. Our attention is now directed to a fourth ‘E,’ emotions, as we attempt to understand the emotional aspects of accident behaviour, and weave this knowledge into a constructive accident prevention program.

Reference is made to a five-year study conducted by the University of Cincinnati College of Medicine, in the general area of mental health in the industrial setting, with a major emphasis on case-finding and early intervention, secondary prevention. This paper is based on data particularly related to occupational accidents.

The results of the study, in general, corroborate much of the work already done in the area of accident behaviour. Accidents are multi-factorial in origin, each employee has a certain accident potential which is variable and dependent upon many internal and external factors. The severity of interpersonal problems, the employee's satisfactions or dissatisfactions, act together with ever-present dangers in his environment, with chance factors to determine the accident potential of an employee at any given point in time.

Accident behaviour is only one of many job-disruptive types of behaviour. Other types are long-term absences, short-term absences, AWOL, work spoilage, grievances, garnishments, and interpersonal and efficiency problems, to mention a few. Our results show an absence of significant correlation between more than one job-disruptive type of behaviour at any given point in time. It is hypothesized that the employee is either moving from one type of job-disruptive behaviour to another or to the problem-free group.

Attention is also given to preventive measures, dealing with the various levels of prevention — primary, secondary and tertiary.
Treatment of Severely Emotionally Disturbed Children in a Community
Authors: Jensen S. E. , Boden F. K. , Multari G.
Published: April 2017

The paper has discussed the development of treatment services for severely emotionally disturbed children by an outpatient Mental Health Clinic adopting an approach which may be illustrated by such modern key-words as ‘Community Psychiatry’, ‘Total approach’, ‘Therapy in Crisis’ and ‘Family Therapy’.

Basically, the approach we used has included:

1. The setting up of a special educational program for the child in close collaboration with school authorities. The details of such a program will vary with local legislation.

2. A program of intensive psychiatric treatment or play therapy with the child and with the parents individually, and in groups.

3. A program of instruction or counselling the parents in how to meet the special needs and problems in caring for their ‘exceptional’ child. This counselling was conducted on a group basis.

4. The intelligent but aggressive use of all other resources within the community, which might be able and willing to structure themselves to meet the child's needs.

We do not pretend that we have offered ideal therapy. We do want to suggest that the lack of facilities for treatment of this psychiatric category, which exists almost everywhere, gives us no excuse to despair or give up. We submit that it is possible to offer a very real help in these cases by the intelligent and aggressive use of all the resources existing within the Community. The nature of the available facilities will vary but almost everywhere there are resources which are able and willing to structure themselves to meet some of the child's needs, if encouraged to do so. The Community Psychiatric Clinic is in a unique position to encourage and develop this.
The Psychiatric Care of Children in a Teaching Hospital
Authors: Mctaggart A. N.
Published: April 2017

1. An in-patient psychiatric service for children in a general hospital can be maintained on an open setting in conjunction with other medical units.

2. It should be small in size, probably from eight to fourteen children.

3. Maximum age range should not extend beyond twelve years.

4. Sex ratio to be expected is two males to one female.

5. With one aide on the 11 p.m. - 7 a.m. shift, a ratio of one staff to one patient on the remaining two eight-hour shifts is required.

6. All diagnostic categories and degrees of disturbances can be treated providing the milieu of the ward is taken into account.

7. Effective operation requires ample space and a closely coordinated outpatient service.

8. Good inter-departmental relations, particularly between the departments of paediatrics and psychiatry, are essential.

9. Effective communication between staff and children is essential for operation.

10. The unit described can deal with between 75 - 100 children per year.
Communication, Learning and Therapeutic Process in a Children's Psychiatric Hospital
Authors: Alderton Harvey R.
Published: April 2017

Some principles which have appeared to be helpful to the staff in working with children showing serious behavioural difficulties in a children's psychiatric hospital, have been described.

The necessity for dealing with the very disturbed behaviour focuses on the ‘here and now’ interactions characterizing the therapeutic milieu. These principles are intended to help the staff maintain a frame of reference which will facilitate the milieu. These principles are:

1) The child's behaviour may be viewed as an expression of his beliefs.

2) Active confirmation of beliefs is sought.

3) Behaviour should be viewed in interactional and not in structural terms.

4) The frames of reference of staff and children are distinct.

5) The importance of contradictory messages.

6) There is often confusion between the thought and the action.

7) Staff function as behavioural models.

8) Significant communication must be actively maintained.

9) The importance of verbal communication.

10) It is essential to establish a hierarchy of treatment aims.

Communication theory appears to provide the most satisfactory framework within which to examine these principles. Reference is also made to some recent learning theory formulations which focus on the social context of learning.

It is essential, if the psychiatrist is to facilitate therapeutic behaviour by the child-care staff, that he can communicate in a way that has meaning in terms of their actual role.

Early treatment aims consist of avoiding confirming beliefs we wish changed, reflection of feeling, helping to discriminate between thought and feeling, maintaining affective interchange and providing suitable behavioural models.

Methods of facilitating socially desirable responses are very briefly considered. Positive staff responses to the socially appropriate behaviour which even these very seriously disturbed children show, appear likely to be effective provided these are accompanied by congruent staff behaviour.

Some reasons why these principles require constant reaffirmation and reexamination are proposed and comments made on their teaching.
L'Examen En Équipe Des Troubles D'Apprentissage Scolaire
Authors: Houde Laurent , Dubois Thérèse , Lafontaine Raymond , Laframboise Josette , Roussel Denise
Published: April 2017

This paper describes a method for the examination of learning disorders. The examination of a child and his parents is carried out simultaneously by a team including a social worker, a psychiatrist, a specialized educator in remedial teaching, a psychologist and a neurologist. Each specialist examines the child alone but observes the examinations by other team members through a one-way mirror. This procedure favours a more unified and refined comprehensive diagnosis while permitting the use of more specific examination techniques and tests whose limitations can be immediately compensated and complemented by the other team members. Each professional discipline develops means of elucidating more and more definite aspects of the studied learning disorders. Patients can thus obtain more complete services in a single visit to the hospital. In most cases, this examination is sufficient to permit immediate recommendations to the child and his parents for precise and practical therapeutic measures. Also extremely valuable is the enrichment each professional team member derives through observing the work of his co-workers. Repeated confrontation of working methods refines observation skills, widens scientific perspectives, increases mutual understanding and respect, and gives everyone a deeper knowledge of his own specialization.
A Study of Childhood Schizophrenia and Early Infantile Autism: Part I — Description of the Sample
Authors: Ward T. F. , Hoddinott B. A.
Published: April 2017

This group was chosen initially to obtain a survey of the syndrome of childhood schizophrenia. The results of the survey suggested to the investigators that a group selected for rehabilitation should have:

1) An autistic illness without the presence of organic symptoms.

2) The potential for intellectual functioning within the average range.

3) Age below eight years.

4) An intact family group willing to have their child return to them.

5) Residence within reasonable geographic limits.
Outline of a School Psychiatric Service in Montreal
Authors: Cahill Cyril , Sokolyk Dorothy M.
Published: April 2017

For several years a psychiatric consultation service, now involving 1 1/2 days weekly, has been given to Area 5 schools of the Protestant School Board of Greater Montreal, Area 5 having 10,000 children. Treatment is not part of the service, but cases requiring it are generally referred to appropriate physicians or clinics. Prior to actual interviews with the children, data are collected from all suitable sources and intelligence testing is done. The majority of referrals for psychiatric assessment seem warranted. This is illustrated in a Table showing the findings in 18 children from one classroom. Reports from the principals indicate their approval of the service and their wish to see it expanded.
Hyperactivity in Twins
Authors: Lopez Rafael E.
Published: April 2017

A hypothesis was made that hyperactivity as stated by others was not a direct result of brain anoxia produced in pre and post-natal factors, but that they share a common genetic cause.

A comparison between four Mz. and six Dz. sets of twins were made. It was found that all Mz. pairs were male and concordant to hyperactivity. In the Dz. group all pairs were discordant except one male-male combination. Also in the Dz. group hyperactivity was always present in the male partners but for one discordant pair where the syndrome was present in the female.

The importance of genetics as a causative factor was not obviously due to the small amount of hyperactive females studied in this project.
The Prepsychotic Characteristics of Schizophrenic Patients A Comparison with a Non-Psychotic Sibling of the Same Sex
Authors: Hobbs G.E. , Wanklin J.M. , Buck Carol , Egener K.M.
Published: April 2017

In this study we have compared selected aspects of the early life history of ninety-eight schizophrenic patients with those of a sibling of the same sex.

As a group the patients were lower in educational attainment, were more frequently first employed in unskilled labour, and were married less frequently than their siblings. Since these were differences between members of the same family, they suggest that the basic intelligence and/or personality of the individual contributes to the development of schizophrenia over and above the environment in which he is reared. Since the inferiority of the patients' education and first occupation refer to a period of life before the onset of the psychosis, they suggest a primary defect rather than simply a downward social drift of the sick individual.
Validity in Mental Health Surveys
Authors: Leighton Alexander H. , Leighton Dorothea C. , Danley Robert A.
Published: April 2017

In recent years a method of conducting mental health surveys has been developed which relies mainly on interviewing individuals according to a questionnaire. Subjects for the surveys are chosen by statistical techniques so that they will be representative of designated populations regardless of whether or not they have ever had psychiatric treatment. The questionnaires are administered by trained interviewers who as a rule are not psychiatrists; the data are later evaluated by psychiatrists who make a series of ratings on each individual in the survey. Inasmuch as surveys of this type show a very high prevalence of psychiatric disorder in many populations (from 10% to 60%), the question of validity becomes a matter of major importance.

In the present study 123 individuals were examined and rated independently by both the survey technique and by a psychiatrist employing his usual clinical approach. After the psychiatrist had made his independent rating he was allowed to see the survey data and also to re-examine the subject again if he wished. He then made a final rating constituting his best judgment based on all information available.

The degree of agreement is indicated in Tables I to IV. Table I deals with symptom patterns considered without regard to diagnostic implications. Thus, a given individual may have more than one of these symptom patterns. Table II concerns impairment by reason of psychiatric symptoms. Table III deals with a rating as to whether or not the subject is a psychiatric case: ‘A’ means almost certainly a psychiatric disorder of some sort; ‘B’ means probably; ‘C’ means doubtful; and ‘D’ means almost certainly not a psychiatric case. (Note that the group here studied was deliberately weighted with ‘A’ and ‘D’ ratings and hence is not representative of any population.) Table IV summarizes the agreements.

While more work is needed, and studies of this kind should be repeated, the results so far show considerable agreement between the survey and clinical methods. This suggests that the large percentage figures obtained by surveys are properly matters of serious concern and that they have far-reaching implications for the teaching and practice of psychiatry.
Readmission Experiences of a Cohort of Discharges 1953 - 1957
Authors: Bristow M. E. , Harris A. A. , Henderson A. L.
Published: April 2017

The establishment of realistic read-mission rates has always been a problem for the Mental Hospital Administrator. A cohort of discharges from Brandon Hospital for Mental Diseases, discharged in the years 1953–57 inclusive, of 1,113 patients, was followed in the community for five years to establish time specific readmission rates. The results reported indicate the following:

1) Most of the patients lost to the study were lost during the first year of the follow-up.

2) The readmission rate for males during the full five-year period was slightly lower than for females. First admission discharges had lower read-mission rates than readmission discharges.

3) Schizophrenic patients exhibit the highest readmission rates.

4) Almost half the readmissions for the whole five-year period occurred during the first year following discharge.

5) In general, readmission rates declined the longer patients stayed out of hospital.
Treatment of Chronic Schizophrenia with Tri-Iodothyronine
Authors: Simpson George M. , Amuso Dominick
Published: April 2017

The administration of tri-iodothyronine (T3), 200 mcgs. per day, produced minimal behavioural alteration in a group of 30 chronic schizophrenic patients with known thyroid abnormalities. The combination of 100 mcgs. of T3 and 400 mgs. of chlorpromazine for three months had no beneficial effect on these patients. The above results are discussed in relation to other studies. The presence of purple pigmentation in one of the patients on combined T3 and chlorpromazine is also commented upon.
Gilles De La Tourette's Disease
Authors: Chapel James L.
Published: April 2017

A brief history of Tourette's disease dating from Itard in 1825 through Tourette in 1884, Eisenberg in 1959 and to the present day, is reviewed. The syndrome is compared to ‘The Jumping Frenchmen of Maine’, ‘Latah’ and ‘Myriachit’. Two case histories are very briefly outlined and the author's beliefs regarding etiology and dynamics are presented. The statement is made that medication with butyrophenone† is the only known method of treatment which has proven consistently effective in the control of the symptoms of this disorder.
LSD-25 as an Adjunct to Long-Term Psychotherapy
Authors: Pos Robert
Published: April 2017

The author describes his experience with LSD-25 as an adjunct to long-term psychotherapy in 24 patients between September, 1962 and May, 1965, involving a total of 56 LSD-25 sessions for a total duration of 119 1/4 hours. Where therapy blocks developed which could not be overcome, narcoanalysis with or without methylphenidate† was used and if this was not successful LSD-25 was considered. The 24 experimental subjects were almost all suffering from disabling and long-standing psychiatric difficulties. In five out of 24 patients LSD-25 did seem to help the patient to overcome therapeutic blocks successfully; five patients showed only temporary movement and relapsed; 12 patients showed no therapeutic movement whatsoever; in two patients the follow-up was insufficient. There was no stable correlation between the extent of the psychedelic experience and the amount of therapeutic benefit. The events of the LSD-25 sessions could not be predicted on the basis of pre-LSD-25 experience with the patient, nor could the therapeutic outcome of the LSD-25 sessions be predicted on the basis of the session itself, or even on the basis of the first days or weeks following the session. LSD-25 appeared as a sometimes helpful though usually unpredictable treatment variable within the over-all treatment program. When introduced as an adjunct late in the treatment procedure it did not seem to have any untoward psychodynamic effects and no undue increase in suicidal tendencies was noted. The therapist's insight into the patient's dynamics was always increased, though this could far from always be translated into therapeutic benefit.
Disability Evaluation in Psychiatric Illness and the Concept of Hysteria
Authors: Lerner Joseph
Published: April 2017

In the evaluation of disability resulting from hysteria, conversion or psycho-physiological reactions, consideration should be given to the clinical effects resulting from the disturbed, or actual loss of function upon the physiological homeostasis of the patient, as well as his personal activities on a day-to-day basis. While classical forms of major hysteria are less frequent in occurrence in recent years, the etiological basis of the pattern still is clinically significant. Conversion reactions and psychophysiological reactions affecting various body systems continue to be a part of the spectrum of psychiatric illness seen in active practice. While no organic cause for the symptoms is present, the loss of function, when substantial and persistent, equates with the loss of function resulting from actual organic disease. Not all of these reactions occur in the ‘hysterical personality’, and both social and cultural patterns must be taken into account. In evaluating the severity of an impairment (loss of function) resulting from a functional illness, the psychological and physiological homeostasis of the patient is a crucial consideration. Symptoms derived from purely conscious reactions are seldom associated with actual loss of function.
Periodic Catatonia, A Review with Special Reference to Rolv Gjessing*
Authors: Minde Klaus
Published: April 2017

The work of Rolv Gjessing on periodic catatonia is presented. The findings are evaluated in the light of its significance toward a pathogenesis of mental illness. It is stressed that the investigations are impracticable and too costly for general use, especially since most patients seem to improve with generally recognized anti-schizophrenic treatment. It was further pointed out that periodic catatonia is probably a ‘schizophreniform psychosis’ and not related to schizophrenia proper, which enables its metabolic concomitants to serve as a guideline to the investigation of schizophrenia.