bluuebunny/crossref_metadata_2025 huggingface dataset:
Schizophrenia and Major Affective Disorder: Forensic Psychiatric Issues
Authors: Kunjukrishnan Reghuvaran , Bradford John M.W.
Published: April 2017

A group of schizophrenic (S) and major affective disorder (MAD) patients assessed in a Forensic Psychiatric Department was studied in depth to test the hypothesis that these patients commit crimes during periods of serious psychiatric disturbance, even if other sociodemographic factors might be contributing to their criminal behavior. The demographic, psychiatric, psychological and legal data were analyzed. The schizophrenic group was overrepresented in this sample compared with the hospitalization pattern for S and MAD patients as a whole. Both groups showed demographic characteristics such as mean age, marital and family status and education and employment, consistent with the diagnoses. S offenders tended to be either chronically ill or paranoid type and MAD offenders the early onset, bipolar type. Both groups showed evidence of serious psychiatric disturbance at the time of assessment and at the time of the alleged offense. S offenders were considered more dangerous based on clinical criteria and showed an increased tendency to assault. About two-thirds of the total group were considered unfit to stand trial at the time of assessment and about three-quarters were considered not fully responsible for the alleged offense from psychiatric viewpoint. These findings confirm the hypothesis that criminal behavior in these seriously ill patients is at least partly due to the psychiatric disturbance itself. The need for psychiatric assessment and treatment of these mentally ill offenders is thus clearly shown.
Post-Stroke Depression: A Critical Review of the Literature*
Authors: Primeau François
Published: April 2017

Because of its physical, psychological, interpersonal and financial repercussions, post-stroke depression is a sensitive issue facing patients, clinicians and society as a whole. The author highlights some difficulties with respect to research methodology, definition, etiology and treatment as reported in the recent scientific literature. Although this review challenges some notions about etiology and rates of post-stroke depression, suggestions are outlined to help prevent, recognize and treat this disorder, the incidence of which is expected to increase because of the demographic trend of our population towards aging.
The Cortical Dementias
Authors: Koranyi Erwin K.
Published: April 2017

A striking accumulation of new technologies and recent diverse research developments open new insight into the nature of primary dementias. The gene of the familial form of Alzheimer's disease was located in the chromosome 21. By further study of the amyloid protein precursor gene, laboratory diagnosis and eventual treatment of Alzheimer's disease may become a reality. This paper reviews and adds perspective to old and new data on the cortical dementias: Alzheimer's disease and Pick's disease.
Lithium, Psychose Maniaco-Depressive et Cycles Biologiques
Authors: Wolf M.A. , Wertenschlag Et N.
Published: April 2017

Lithium is one of the rare substances capable of disturbing the body's “biological clock”. Clinical, biochemical and physiological observations allow us to view the Manic Depressive Illness pathogeny and the mechanism of lithium action in terms of biological rhythm modification.
Bulimia: Independence of Antibulimic and Antidepressant Properties of Desipramine
Authors: Blouin Jane , Blouin Arthur , Perez Edgardo , Barlow Jane
Published: April 2017

The purpose of this study was to identify variables useful for predicting a positive response to the tricyclic antidepressant desipramine, amongst bulimic subjects. Using a randomized double-blind cross-over design, 24 normal weight bulimics completed a 15-week protocol in which they received either desipramine (150 mg/day)for six weeks, no drug for three weeks, followed by placebo for six weeks, or the reverse sequence. At weeks 0, 2, 4, 6, 9, 11, 13, and 15, each subject was assessed using the EDI, SCL-90, POMS and binge records. The DST, Diagnostic Interview Schedule (DIS), and a personal and family medical-psychiatric history questionnaire were administered at initial assessment, while plasma desipramine levels were obtained at weeks 4 and 13. Responders were defined in terms of both binge frequency reduction, and decrease in depressive symptoms.

In the sample of 24 subjects, desipramine was significantly more effective than placebo in reducing the frequency of weekly hinging and vomiting, as well as causing a reduction in the fatigue scale of the POMS. No significant effect of the drug was obtained on the EDI or the SCL-90. In terms of reduction in binge frequency, seven responders were identified; another seven were found to be borderline responders, while 10 were labeled as non-responders. The three groups did not differ in terms of their initial scores on the SCL-90, POMS, DST, DIS results, or psychological subscales of the EDI. However, responders were found to have lower EDI bulimia subscale scores, but a higher frequency of purging episodes than were non-responders. Eight patients were identified as borderline responders with respect to depressive symptoms. They differed from depression non-responders in that they had abnormal DST results, and were more likely to report a family history of depression. These results indicate that the predictors of the antibulimic effect of desipramine in bulimia are independent of its antidepressant properties.
A Patient with Insulinoma Presenting for Psychiatric Assessment
Authors: Steinberg Paul Ian , Mackenzie Robert
Published: April 2017

A case of insulinoma referred for psychiatric assessment illustrates the need for a high index of suspicion of organic mental disorder even in patients who have undergone previous extensive medical investigation. The diagnostic difficulties illustrate the need for persistence and cooperation between specialists in such cases.
Pharmacotherapy of Schizophrenia
Authors: Remington G.
Published: April 2017

Numerous advances in our understanding of schizophrenia and its pharmacotherapy have occurred over the last forty years, reflected in basic research endeavours exploring the pathophysiology of schizophrenia, as well as efforts to establish new medications with a more selective psychotropic action and fewer side effects. Ongoing clinical research has, at the same time, provided valuable information regarding the applicability of the various agents, appropriate dosing, symptom response patterns and side effect profiles. This growth in knowledge also has served to underscore the limitations and drawbacks of currently available drugs, leading to a more cautious approach in their use. Newer technologies, such as positron emission tomography, hold considerable promise in our efforts to further clarify the precise mechanisms mediating schizophrenia, and to establish treatment alternatives.
Tourette Disorder and Bipolar Symptomatology in Childhood and Adolescence
Authors: Kerbeshian Jacob , Burd Larry
Published: April 2017

Three boys with an early history of attention deficit disorder with hyperactivity developed Tourette disorder. At 13, 12 and eight years of age, respectively, each met DSM-III criteria for a manic episode or bipolar disorder. Each of the boys had a family history of affective or affective spectrum disorder. Lithium carbonate in a range of 0.8 to 1.2 meq/L markedly improved their bipolar symptomatology with Tourette symptoms improving in two patients. Further study is suggested to determine the significance of these findings.
Use of Imagery to Describe Functional Abdominal Pain as an Aid to Diagnosis in a Pediatric Population
Authors: Geist R.
Published: April 2017

Abdominal pain is a common presenting complaint among children and adolescents. Although psychological factors may be involved, their role is not clear and a diagnosis of functional pain is often made only after extensive investigations. Specific psychological characteristics have been associated with abdominal pain in children, but little is known about the nature of the pain itself. A retrospective study was undertaken to characterize the subjective experience and description of abdominal pain in patients hospitalized for investigation of abdominal pain.

Thirty subjects with proven inflammatory bowel disease (IBD) and 32 diagnosed as having functional abdominal pain (FAP) were studied. The age, sex distribution, and duration of the pain in these groups were similar. Seven (23%) patients with IBD used imagery to describe their pain in contrast to 25 (78%) of those with FAP (P < 0.01). Neither age nor duration of pain was associated with the use of imagery. The use of imagery was significantly associated with the diagnosis of FAP (P<0.01). A more detailed characterization of the way patients describe abdominal pain might assist in diagnosing its etiology.
Relationship between Psychiatric Illness and Conduct Disorder in Adolescents
Authors: Kutcher S.P. , Marton P. , Korenblum M.
Published: April 2017

Ninety-six psychiatrically ill adolescents admitted to an adolescent inpatient service were systematically assessed to determine the morbidity of conduct disorder (CD), with other Axis I psychiatric disorders. Twenty-six (27%) met DSM-111 criteria for CD in addition to other Axis I disorders. A CD diagnosis was significantly associated with substance abuse, and attention deficit disorder with hyperactivity. Although CD was found in 21 % of depressives it was more commonly found inpatients with psychotic disorders (25 %) and bipolar (42 %) disorders. These findings suggest that CD may be commonly found in a variety of adolescent psychiatric disorders. The implications of this finding for pharmacologic treatment of CD, the clinical assessment of the CD patient, and possible relationships between CD and adolescent psychiatric disorders are discussed.
After Diagnosis, What? Some of the Possible Problems around Diagnostic Assessments
Authors: Konstantareas M.M.
Published: April 2017

Psychopathologies of low frequency of occurrence, such as autistic disorder, constitute a challenge because of the diagnosticians' relatively low familiarity with both the presenting symptoms and, particularly, effective intervention strategies for them. This paper highlights the key potential pitfalls in the assessment of such rare conditions as autism. It then offers some suggestions as to what should be included in a diagnostic assessment of severely and chronically dysfunctional individuals. As well it discusses the need to coordinate the effects of different professionals on behalf of the dysfunctional child and his/her family. Such efforts should take into account the considerable stress and vulnerability of the families across the affected individual's lifespan.
Teaching Child Psychiatry to Medical-Undergraduates
Authors: Macleod R.J. , Steinhauer Paul D.
Published: April 2017

This article describes the findings of a survey of undergraduate curricula in the 16 Canadian medical schools in the areas of growth and development, behavioral sciences, and clinical child psychiatry. It identifies principles upon which such programs may be based and includes issues in integration of child and adult psychiatry.
Meditation and Psychotherapy*
Authors: Craven John L.
Published: April 2017

Meditation has been increasingly recommended as a practice with potential psychotherapeutic benefit. This paper provides a description of meditative practice and discusses selected issues related to the conceptual and technical integration of meditation with modern psychotherapeutic interventions. Evidence suggests that meditation may contribute to psychotherapeutic change and that the disciplines from which meditation arises are in some respects similar to modern psychological formulations, and in other respects are complimentary. It is hoped that improved understanding of meditation will contribute to an increased acceptance and use of these practices as aids to psychotherapeutic change and will facilitate meaningful research regarding meditation.
Le rôle des facteurs subjectifs dans la fidélité à la médication*
Authors: Mercier Céline
Published: April 2017

In 1974, Van Putten was wondering “Why schizophrenic patients refuse to take their medication?” Twenty years later, the entire October 1986 issue of Psychiatric Annals deals with the subject of compliance in the case of maintenance psychotropic drugs. This paper aims to relate the empirical observations made during 152 interviews with chronic psychiatric patients to the broader considerations reported in specialized literature on compliance in the case of psychotropic drugs and of lithium. These two types of data make it possible to explain how the “perceived” advantages and disadvantages of medication go beyond the positive and negative factors objectively recognized and how they intervene in the decision to continue, modify freely or give up the treatment. In conclusion, the author reports studies on the effectiveness of various strategies proposed for increasing compliance.
Studies of the Affective State in Bereaved Children*
Authors: Cheifetz Philip N. , Stavrakakis George , Lester Eva P.
Published: April 2017

The process of bereavement in children ranges from the absence of grief to symptoms of anxiety and conduct disturbances. Some psychoanalytic opinion holds that the absence of grief, associated with lack of cognitive maturity, leads to the development of psychopathology later in life. Other writers describe a mourning response, taking the form of ambivalence, anxiety, and care giving, which may protect against subsequent depression. This paper describes the affective response in 16 children ages four to 17 years, two to three years following the death of a parent, in order to further characterize developmental aspects of the emotional repertoire of bereavement. Only children aged 12 and over were depressed according to the Poznansky Children's Depression Rating Scale and criteria in the DSM-III. Conduct disturbances were observed in the younger children and some of the older children and were correlated with depression in the group as a whole. This suggests that the expression of depressive affect depends on maturation and that the young child may register grief only through anxiety and negativism. Examples of this spectrum of responses are offered in two case vignettes.
Measured Weight Loss and the Dexamethasone Suppression Test*
Authors: Kennedy Sidney H. , Garfinkel Paul E. , Stokl Stephen , Whynot Carrol A.
Published: April 2017

In a prospective study of 28 subjects with major depression, weight was significantly related to nonsuppression in the dexamethasone suppression test (DST) on admission and seven days later. However, changes in weight between these two times did not alter the DST status.
Negative Symptoms in Chronic Non-Schizophrenic Patients*
Authors: De Bosset Farideh , Shaul Sheldon
Published: April 2017

Negative symptoms are mostly associated with schizophrenic illness. This paper discusses the presence of negative symptoms in other chronic psychiatric illnesses. We have observed that logitudinally primary negative symptoms tend to be constant and are precisely symptoms which can define chronicity. They are as unspecific as positive symptoms in mental illness.
Financial and Personal Competence in the Elderly
Authors: Mackay M.J.
Published: April 2017

This paper was prepared for the Professional Standards and Practice Council, chaired by Dr. Werner J. Pankratz. It was approved by the Board of Directors of the Canadian Psychiatric Association on June 3, 1989.
Working in Arctic and Sub-Arctic Conditions: Mental Health Issues
Authors: Cochrane Jeanette J. , Freeman S.J.J.
Published: April 2017

As Canada expands its activities in the North, it becomes necessary to understand the mental, emotional and health consequences of working in harsh, isolated environments.

This paper reviews the pertinent literature and reports on a study, commissioned by Environment Canada, of the working conditions of meteorological technicians in 33 isolated stations who were surveyed by questionnaire. Numerous personal interviews and visits to five Arctic stations were also carried out. GHQ scores of psychological distress were significantly higher than in a Saskatchewan community sample but not higher than in male air transport shift workers in Ontario. Sleep disturbances and anergia were the two most prominent symptoms in our sample. The literature also stressed these symptoms as well as alcoholism and a number of curious cognitive phenomena.

The importance and problems of group functioning are stressed. Our subjects showed fewer problems than the literature would have predicted, but it is generally agreed that there are few, if any, irreversible sequela of life in the North.
An Examination of Mann's Model of Time-Limited Individual Psychotherapy
Authors: Joyce Anthony S. , Piper William E.
Published: April 2017

The present study attempted a sensitive test of the dynamic sequence proposed by Mann for time-limited individual psychotherapy (TLP). Session evaluation ratings were collected from both patient and therapist. Indices were constructed that reflected the consistency of patient ratings, the consistency of therapist ratings, and the congruence between patient and therapist ratings, in each third of TLP. Measures of symptoms and social functioning were employed to differentiate cases of “good” versus “poor” treatment outcome. Therapists' adherence to the TLP technique was assessed by categorizing all interventions in each session. Fourteen patients were treated according to the TLP model. Measures of therapist behaviour indicated that treatments had been conducted in general accordance with Mann's technical recommendations. Measures of consistency and congruence failed to support the proposed TLP dynamic sequence. Analyses of mean evaluation ratings indicated a trend towards more positive evaluations as therapy progressed; “good” outcome cases were significantly more likely to evidence this pattern. Results are discussed in terms of interplay between inductive hypothesis building and empirical verification in the development of theories of psychotherapy.
A Female Sex Offender with Multiple Paraphilias: A Psychologic, Physiologic (Laboratory Sexual Arousal) and Endocrine Case Study
Authors: Cooper A.J. , Swaminath S. , Baxter D. , Poulin C.
Published: April 2017

A 20 year old female pedophile exhibiting multiple paraphilias and who had been both a victim of incest and an active participant, undertook extensive clinical, psychometric, endocrine and laboratory sexual arousal studies. Her psychiatric, psychometric and physiologic arousal profiles showed similarities to those of a sizable proportion of male child molesters, especially incestors. It is suggested that laboratory arousal tests (using the vaginal photoplethysmograph) may have a role in the assessment of some female sex offenders.
Patients with Multiple Admissions in a Psychiatric Record Linkage System
Authors: Woogh Carolyn M.
Published: April 2017

Data from the Kingston Psychiatric Record Linkage System are used to examine the patterns of both inpatient and outpatient service utilization by patients with multiple admissions during a three year period compared with a control group with single admissions. The subgroup with drug and alcohol abuse disorders alone or in combination with a major functional disorder is examined in detail. An index of service utilization, which is based on aggregate inpatient stay and outpatient contacts, is calculated for each patient. Those with multiple admissions tend to be young, poorly educated, living alone and diagnosed with a major functional disorder; however, multiple regression analysis shows that other factors, as yet undetermined, contribute significantly to readmission. Among those with a major functional disorder, the subgroup of patients who also have drug and alcohol abuse disorders is particularly prone to multiple admissions. The need for specific services for patients with dual diagnoses is discussed. Early identification of those types of psychiatric patients who are likely to use services extensively is necessary to allow for planning and implementing of more cost-efficient and effective services.
Prevalence of Psychiatric Disorders and Suicide Attempts in a Prison Population
Authors: Bland Roger C. , Newman Stephen C. , Dyck Ronald J. , Orn Helene
Published: April 2017

A survey was conducted in which 180 randomly selected male prisoners ages 18 to 44 were interviewed using the Diagnostic Interview Schedule and other questionnaires. A comparison was made with 1,006 similarly aged male residents of Edmonton who were interviewed using the same instruments.

Compared to the general population, prisoners were less likely to be married and were less well educated. There was a higher proportion of Native Indians in the prison sample and lower proportions of Oriental and other racial groups. Prisoners were twice as likely to have a lifetime psychiatric disorder compared with the general population, and all individual disorders investigated were more common in the prison population. Six month prevalence showed even greater rates compared with the general population, indicating recent symptoms. The number of individual disorders per prisoner was also higher than for the general population. Lifetime suicide attempts were seven times more frequent in prisoners than in the general population.
Depression Dexamethasone Nonsuppression and Negative Symptoms in Schizophrenia
Authors: Addington Donald , Addington Jean
Published: April 2017

This study compared three measures of depression in schizophrenia and their correlation with the Dexamethasone Suppression Test (DST). The degree of overlap of these three measures with negative symptoms was also examined. The Hamilton Depression Rating Scale (HDRS), the depressive syndrome score of the Present State Examination (PSE), and the Scale for the Assessment of Negative Symptoms (SANS) were administered to 50 acutely ill, hospitalized schizophrenics. Patients were diagnosed using DSM-III criteria for schizophrenia. DSM-III criteria were also used to assess the presence of a major depressive episode. Results were that DST nonsuppression was significantly associated with the presence of a major depressive episode, but not with depressive rating scale scores or with negative symptoms. It is concluded that the DST may be of value in differentiating a depressive syndrome from a negative symptom syndrome in schizophrenia.
Children's Observations of Violence: I. Critical Issues in Child Development and Intervention Planning
Authors: Jaffe Peter G. , Hurley Dermot J. , Wolfe David
Published: April 2017

Children are often the unintended or indirect victims of wife abuse as witnesses of this violence in their family. Current research on these children and a conceptual framework to understand how this violence affects their development are outlined. The implications of this research are discussed in terms of several intervention strategies. The importance of primary prevention programs in school systems is stressed.
Assessment and Treatment of Food Aversion in a Four Year Old Boy: A Multidimensional Approach
Authors: Archer Lynda A. , Szatmari Peter
Published: April 2017

Eating and mealtime problems are common in childhood. They are often stressful not only to the child, but to the entire family. In this case report we describe a multidimensional approach to the assessment and treatment of food aversion in a four year old boy. The integration of psychodynamic, systemic and behavioural concepts in the assessment and treatment is described. In addition we report on preliminary findings from the Children's Eating Behaviour Inventory, a new instrument under development, intended to assess eating and mealtime problems in children.
Relation of Global Ratings of Functioning with Behaviour and Development in Delayed and Disturbed Preschoolers
Authors: Cohen Nancy J. , Kolers Nira , Bradley Susan
Published: April 2017

Ratings on the Global Assessment Scale for Children (GASC) were assessed in relation to a battery of objective developmental and behavioural measures. Children aged three to six years (N=55) attending a day treatment program for developmental delays, language disorders, and behavioural and emotional problems comprised the sample. A battery of tests was administered to the children. Parents and teachers completed standardized questionnaires to measure developmental, behavioural and emotional problems. The results indicated that the GASC score correlated significantly with child developmental level, impulse control, and with teacher ratings of social withdrawal. The GASC was unrelated to ratings of behavioural problems. Ratings on the GASC also were highly consistent over time. These results are discussed with respect to the strengths and limitations of using global ratings with preschool children.
Adolescent Day Program: A Two Year Retrospective Review
Authors: Orchard Janet M. , Macleod Roderick J.
Published: April 2017

The place of a psychiatric day treatment program within the spectrum of necessary treatment options is noted in the literature review. A established day program is described with some characteristics of 97 youths attending the program over a two year period. The authors highlight those characteristics which correlate with benefits derived from program attendance.
A Comparison of Borderline and Schizophrenic Patients for Childhood Life Events and Parent-Child Relationships*
Authors: Byrne C.P. , Velamoor V.R. , Cernovsky Z.Z. , Cortese L. , Losztyn S.
Published: April 2017

Fifteen patients with DSM-III diagnoses of borderline personality disorder and 14 schizophrenics were administered two questionnaires by an interviewer blind to the diagnoses. The questionnaires were the Childhood Life Events and Family Characteristics Questionnaire and the Parental Bonding Instrument. A scale to monitor denial was also included.

Borderlines, when compared with schizophrenics, reported having significantly more childhood sexual and physical abuse, more early separation from their mothers, more paternal criminality, and also more paternal overprotection and less maternal care. When compared with normal population data, they received significantly less care and were significantly more overprotected by both parents.
Family Factors Affecting Adjustment in Japanese Immigrant Housewives*
Authors: Noda Fumitaka , Noda Masako , Clark Campbell
Published: April 2017

Data obtained from 130 questionnaires distributed to immigrant Japanese housewives were analyzed to determine if family factors were associated with poor adjustment, and in particular with depressive symptoms. It was possible to identify women who had no major adjustment problems in adapting to life in Canada (n = 70), transitional adjustment problems (n = 30), late onset adjustment problems (n = 7) and chronic adjustment problems (n = 23). These categories were determined by self-report and validated by symptom identification. Style of marriage, communication with spouse and mother-child interactions were hypothesized to be related to adjustment problems. A 16 item questionnaire was developed to assess the degree to which these factors affected adjustment. The only factor which affected degree of adjustment was communication with the spouse. These results are discussed within the context of traditional hypotheses concerning adaptation to a new culture and the implication for treatment.
Chronic Schizophrenia: A Risk Factor for HIV?
Authors: Seeman M.V. , Lang M. , Rector N.
Published: April 2017

Chronic mental patients may constitute a previously unrecognized high-risk group for the spread of the human immunodeficiency virus. This paper briefly reviews the literature on sexual awareness, sexuality, substance abuse, and schizophrenia, and addresses the problems of implementing sex education programs for chronic mental patients. Although problematic, such preventive programs are urgently needed.
The Optimal Psychiatrist-to-Population Ratio: A Canadian Perspective
Authors: El-Guebaly N. , Beausejour P. , Woodside B. , Smith D. , Kapkin I.
Published: April 2017

A systematic effort is underway to rationalize the planning of physician supply. This paper summarizes the current methodologies available and focuses on the attempts to determine the optimal psychiatrist-to-population ratio in Canada. The impact of several variables influencing this ratio is discussed. An outline of the correlation between target physician supply and requirements of future trainees is presented. While the relevant methodology is rapidly evolving, an improved process of data collection is urgently required. A number of challenges for our profession lay ahead, such as the need for sensitive and reliable measures of the adequacy of psychiatrist and subspecialist supply and public issues arising from the poor geographic distribution of psychiatric manpower.
Are the Monamine Oxidase Inhibitors Facing Extinction?
Authors: O'reilly Richard L.
Published: April 2017

The use of monoamine oxidase inhibitors (MAOIs) in the province of Saskatchewan was compared for two years, 1978 and 1986, using the Saskatchewan Prescription Drug Plan data base. The percentage of the adult population receiving an MAOI decreased from 0.17% in 1978 to 0.07% in 1986. The use of both tricyclic antidepressants and the new generation antidepressants increased during the same period. Physicians appear to have selectively avoided using MAOIs for the elderly. Physicians who are not psychiatrists showed the greatest reduction in their use of the MAOIs. The data indicate an increasing reluctance to prescribe the MAOIs despite the recent resurgence of interest in these agents and the positive literature concerning their safety and efficacy.
Predicting Prognosis by Means of the DSM-III Multiaxial Diagnoses
Authors: Gordon Richard E. , Eisler Robert L. , Gutman E. Michael , Gordon Katherine K.
Published: April 2017

This clinically based retrospective study compares the DSM-III multiaxial characteristics of psychiatric inpatient and outpatient treatment-seekers with those of workmen's compensation and disability payment-seekers. It shows that 1. the groups were significantly different in their DSM-III multiaxial characteristics; 2. multiaxial diagnoses statistically predicted clinical psychiatrists' estimations of disability applicants prognosis for work; and 3. payment-seekers were more likely titan treatment-seekers to have Axis II personality disorders in addition to their Axis I diagnoses.
Low Doses of Clonazepam in the Treatment of Panic Disorder*
Authors: Pols H. , Zandbergen J. , Lousberg H. , Loof C. De , Griez E.
Published: April 2017

In order to assess the efficacy of a high-potency benzodiazepine in the treatment of panic disorder, an open trial was conducted with clonazepam. Clonazepam was administered in relatively low doses and, after four weeks, was shown to be effective in reducing the number of panic attacks and associated features of the disorder.
Validation of the Crisis Triage Rating Scale for Psychiatric Emergencies
Authors: Turner P. M. , Turner T.J.
Published: April 2017

Using a sample of 500 emergency psychiatric patients at Victoria Hospital in London, Ontario, this study replicated part of the research on the Crisis Triage Rating Scale (CTRS) conducted by Bengelsdorf, Levy, Emerson and Barile in 1984. The relationship between the suggested CTRS cut-off score and the decision whether or not to hospitalize the patient was studied, independently of these scores. The relative contribution of each of the subscales (Dangerousness, Support System and Ability to Cooperate) to this decision was also determined. The results of this study suggest that using a cut-off score of 9, the easily administered Crisis Triage Rating Scale could be an additional assessment aid in determining whether patients require emergency hospital admission to a psychiatric unit.
Behaviour Problems of the Mentally Retarded
Authors: Grizenko Natalie , Cvejic Helen , Vida Stephen , Sayegh Liliane
Published: April 2017

The behaviour profiles of 176 mentally retarded individuals from two reception centres and nine group homes were assessed. The correlations between behaviour and age, sex, degree of mental retardation, etiology of mental retardation and medical diagnosis were assessed using the Revised Child Behaviour Profile. The severity of behaviour disturbance did not vary with age or medical diagnosis. The moderately retarded subjects presented with more severe behaviour problems, such as aggression, than the severely mentally retarded subjects. The variable most predictive of behavioural problems was etiology of the disorder. Individuals with Down's syndrome had significantly fewer behaviour disturbances and those with autism and pervasive developmental disorder had significantly more behaviour disturbances than other subjects. A psychiatric disorder was found in 10.2% of the sample. The implications of these findings are discussed with respect to public policy.
The Family of the Asthmatic Child*
Authors: Baron C. , Veilleux P. , Lamarre A.
Published: April 2017

The authors report clinical study of 34 asthmatic children between the ages of ten and 15, followed at a specialized outpatient clinic of a large pediatric hospital in Montreal. Evaluation of the children and their families involved the use of clinical scores with inter-rater agreement. The study found strong associations between certain personality traits and an excessive use of medication, and between personality traits and family structure. Regardless of the severity of their asthma, children with high levels of anxiety and dependence were more likely to live with highly cohesive families and to use greater quantities of cortisone than children with better adapted personality structures. Pathological family settings are known to cause more emotional and behaviour problems in children. We suggest there is a reciprocal influence, and we consider the effects on the family of an early childhood disease that is persistent, worrisome, unpredictable, and necessitates repeated hospitalization. Prospective studies of the high-risk subgroups identified in this study could facilitate early intervention for asthmatic children and their families.
Anabolic-Androgenic Steroids and Psychiatric-Related Effects: A Review*
Authors: Uzych Leo
Published: April 2017

Anabolic-androgenic steroid use may have a wide range of adverse psychiatric and behavioural effects. The available data, however, are often inconsistent and inconclusive concerning possible effects of anabolic-androgenic steroids on libido in men, in women and also the way in which they affect libido differently in males and females. Anabolic-androgenic steroids may both relieve and cause depression. Cessation or diminished use of anabolic-androgenic steroids may also result in depression. More study is required to determine whether or not the disparate data on depression are consistent clinical observations. The level of testosterone appears to be positively associated with “aggression”, particularly in response to provocation! Various psychotic symptoms and manic episodes may be associated with anabolic-androgenic steroids. The possibility of hypomania induced by synthetic androgens must also be considered.
Specificity of Effect in Psychiatric Research*
Authors: Jones Marshall B. , Jones Donald R.
Published: April 2017

In the last ten years the genes responsible for Huntington's disease and several other neurological disorders have been localized to specific chromosomes. Huntington's disease is now known to be caused by a gene on the short arm of chromosome 4. While these advances are welcome, they also pose a problem. All studies to date have been passive observational studies; none has been experimental. Arguably the most successful and significant attributions of cause in neurological history have been achieved by non experimental methods. This realization is somewhat disconcerting, considering that virtually all textbooks in epidemiology insist that true experiments (randomized trials) are the prime means of establishing cause. One cannot help but ask how these unauthorized successes were achieved. What are the principles of investigation that made them possible? In this paper we argue that the recent advances in neurological genetics, along with much else in human genetics, depend heavily on “specificity of effect.” Just what this principle is and how it allows successful attribution of cause is explained. Various applications elsewhere in the medical and behavioural sciences and in psychiatry are discussed.
Schizophrénie: différences selon le sexe*
Authors: Nicole Luc
Published: April 2017

This literature review focuses on the main differences in schizophrenia according to gender. The data are presented as follows: epidemiological data (incidence and age at onset of the illness); data on evolution of the illness; and mortality. Clear conclusions can be drawn and directions for future research are suggested.
Psychogeriatric Hospitalization: Terminable or Interminable?
Authors: Meier H.M.R. , Besir M. , Sylph J.A.
Published: April 2017

This paper takes issue with the stereotype of psychogeriatric patients in the general hospital using beds unnecessarily. With appropriate organization of services involving integrated teamwork, comprehensive patient assessment, early discharge planning and liaison with community resources, a positive outcome and early discharge was achieved with the majority of a group of psychogeriatric patients.
Contacting the Family After a Suicide*
Authors: Brownstein Michael
Published: April 2017

A two-part survey was conducted on psychiatrists' contact with the families of patients who have committed suicide. Families of suicide victims were surveyed to see if they had been contacted and whether they wished to be contacted. In one of the 12 cases, the psychiatrist initiated a contact, and in 11 of the 12 cases, the families wished they had been contacted. Reasons for the discrepancy between what the psychiatrists did and what the families wanted are discussed.
Pyridoxine, Ascorbic Acid and Thiamine in Alzheimer and Comparison Subjects
Authors: Agbayewa M. Oluwafemi , Bruce Vivian M. , Siemens Valerie
Published: April 2017

We compared the intake and functional levels of vitamins B6, C and B1in 15 pairs of Alzheimer's disease and normal subjects. These were similar in both groups, except that B1had lower functional values for the subjects with Alzheimer's disease. This suggests that it is unlikely that B6or C could be used in the treatment of Alzheimer's disease. The role of B1needs further exploration.
Recidivism Among Individuals Detained under a Warrant of the Lieutenant-Governor Living in the Community
Authors: Komer Bill , Math B. , Galbraith Donald
Published: April 2017

This paper reports the findings of a follow-up study of individuals on a warrant of the Lieutenant-Governor in community placement. Of the 32 individuals who had 8.5 years on average of community access, 6.3% had subsequent convictions. A comparison is made between the risk to the community posed by those on warrants and individuals in the general population. The results suggest that those on warrants have functioned relatively well in the community.
The Symptom Structure of Panic Attacks in Depressed and Anxious Patients
Authors: Cox Brian J. , Hasey Gary , Swinson Richard P. , Kuch Klaus , Cooke Robert , Warsh Jerry , Jorna Thecla
Published: April 2017

This study examined the panic symptom profiles of three diagnostic groups: those with panic disorder and no history of major depression; those with panic disorder with a history of major depressive episode but no current depression; and those current major depression with panic disorder. Patients were compared on the frequency of specific panic attack symptoms based on structured interview responses. The symptom profiles of all three groups were significantly correlated. The patients with past and current depressive episodes had the most similar symptom structure.
Utilisation des systèmes experts en psychiatrie
Authors: Ohayon Maurice M.
Published: April 2017

Are expert systems liable to be used as consultants in psychiatry? Most expert systems deal with an over-restricted part of psychiatry and cannot be a real help in everyday care. Moreover, most of them are not actually validated (the comparison between the system's and the expert's conclusions in a few cases is not enough). Another problem is that they reflect the uncertainties of nosographie problems. Validation of such systems needs the careful checking of the logical structure of the underlying nosography, the fitness of the structure's knowledge base and the fitness of the inference engine. Moreover, the naïve use of the system by untrained clinicians is the best means of validation since it provides real life proof of the ability of expert systems to make diagnoses in unselected cases where the need for a common diagnostic reference is clear (for example, epidemiologic, psychopharmacological ornosographic research). Some of the best known expert systems in the field of psychiatry are reviewed and another expert system, Adinfer, is presented. Developed since 1982, Adinfer is a forward-tracking level O system (in its simplified version for micro-computers). The knowledge base is a translation of the DSM-III-R into production rules. The program has been included in several softwares packages and used in many clinical studies, both among psychiatrists and physicians. The program has been validated with 1,141 unselected cases, and with 47 physicians: an 83% agreement rate was found between the system's and the physician's diagnoses, taking into account that the clinicians were asked to give their conclusions according to their usual nosography. Many of the 16% discrepancies were accounted for by the differences in the nosographie classes, since they were found mainly in the “atypical psychotic” and “organic” disorders. A major benefit of expert systems is that they provide a common “expert” in multicentric studies and prevent loose checking of clinical criteria.
Cross-Validating Factors associated with Discharges against Medical Advice
Authors: Dalrymple Andrew J. , Fata Mirella
Published: April 2017

Between six percent and 35% of psychiatric patients discharge themselves from hospital against medical advice (AMA). The discharges may prevent patients from deriving the full benefit of hospitalization and may result in rapid rehospitalization. We examined sociodemographic and clinical characteristics of 195 irregular discharges from a 237 bed psychiatric hospital over a five year period and found that AMA discharges increased over the study period to a peak of 25% in 1986. There was a strong negative correlation between AMA discharge rates and the willingness of physicians to commit patients involuntarily. Multiple discriminant analysis revealed a set of nine variables that accurately classified 78% of cases into regular or irregular discharge categories. Further analysis revealed that there are two distinct subgroups of patients who discharge themselves AMA: those who repeatedly left the hospital AMA in a regular “revolving back door” pattern and those who left AMA only once. The repeat group exceeded the one-time group in terms of prior admissions, appearances before review boards, and percentage of Natives. The repeat group also spent twice as long in hospital, and 27% were readmitted within one-week of the index AMA discharge. Less than three percent of the one-time AMA group was readmitted within a week. These results were cross-validated on a new sample of irregular discharges and matched controls.
Formulation: A Multiperspective Model
Authors: Weerasekera Priyanthy
Published: April 2017

This paper presents a model of formulation that can be used by psychiatrists and other mental health professionals. A review of the literature indicates a need for a more comprehensive approach that can accommodate a variety of perspectives, suggest treatment and can be easily recalled. These issues are addressed by the multiperspective grid presented in this paper.
Teaching Biopsychosocial Integration and Formulation
Authors: Mcdougall Gerald M. , Reade Beth
Published: April 2017

This paper describes the mental processes by which the psychiatrist organizes and integrates data to produce a case formulation. The biopsychosocial formulation uses three perspectives (biological, psychological and social) to view the data and integrates these viewpoints into one broad, complex and dynamic appreciation of the patient. Guidelines for creating and communicating a case formulation are proposed.
Childhood Sexual Abuse, Parental Impairment and the Development of Borderline Personality Disorder
Authors: Links P.S. , Van Reekum R.
Published: April 2017

Childhood sexual abuse in borderline patients made a significant independent contribution to the magnitude of borderline characteristics after controlling for other antecedents and degree of parental impairment. This finding strengthens the etiologic link between childhood sexual abuse and borderline personality.
Effets d'une éducation au traitement neuroleptique chez de jeunes psychotiques
Authors: Goulet Jean , Lalonde Pierre , Lavoie Germain , Jodoin François
Published: April 2017

This study verifies the effect of the neuroleptic treatment teaching module, the French translation of the Medication Management Module produced by the social skills training programs. Twenty patients from an outpatient clinic (with schizophreniform or schizoaffective schizophrenia) were assigned at random to a test group (n = 10)ora control group (n = 10). The pre-test evaluation found that the two groups were the same with regard to 13 significant parameters. The experimenters used French translations of well-known instruments, and the double-blind method was applied to their respective observations throughout the study.

Results were obtained by applying the neuroleptic treatment teaching module three hours per week for two to three months. The post-test evaluation revealed that patients who had been exposed to the education module had an improved understanding of schizophrenia and the medication required to treat it than patients who had not been exposed. The dose of medication prescribed between pre- and post-test evaluations were able to more effectively stabilize patients who had received education than patients who had not. Nevertheless, the education module continues to have no significant effect on the symptomatology (according to the Brief Psychiatric Rating Scale) and final SAS-II social scores of schizophrenics.
Obtaining a Family Psychiatric History: Is it Worth the Effort?
Authors: Remick Ronald A. , Sadovnick Adele D. , Gimbarzevsky Boris , Lam Raymond W. , Zis Athanasios P. , Huggins Marlene J.
Published: April 2017

The purpose of this study was to determine whether, for first-degree relatives of patients presenting to a mood disorders clinic, family history information on psychiatric conditions collected by a psychiatrist and incorporated into the patient's medical records is as informative as that gathered during an interview specifically designed to collect family history data. The study group consisted of 472 first-degree relatives of 78 randomly selected index cases from a large mood disorders genetic database. Family history of psychiatric disorders recorded in regular psychiatric medical records (“clinician history”), and data obtained by a genetic counsellor administering specific family psychiatric history questionnaires to patients and multiple family informants (“family history”) were compared using a kappa statistic. Good agreement between the two methods on the presence or absence of a psychiatric disorder was found among first-degree relatives of index cases, but poor agreement was found with respect to the presence or absence of a specific mood disorder diagnosis(es) in a relative. The results suggest that a clinician-generated family psychiatric history is sensitive to the presence or absence of a psychiatric disorder when compared to a more structured detailed genetic interview. However, for research purposes, a clinician-generated family psychiatric history of a specific mood disorder diagnosis, without supporting collateral information, may not be reliable for use in supporting a mood disorder diagnosis in a patient and/or his relatives.