bluuebunny/crossref_metadata_2025 huggingface dataset:
Tardive Dyskinesia: a Five Year Follow-Up*
Authors: Fornazzari X. , Grossman H. , Thornton J. , Seeman M.V.
Published: April 2017

A group of chronic schizophrenic patients receiving prolonged treatment with neuroleptics was assessed in 1978 at an outpatient clinic to determine the prevalence of Tardive Dyskinesia. Those with TD were reassessed after two and five years with regard to change in TD severity. The Smith scale was used every time and, on the last assessment, the AIMS scale and videotaped interviews were added. Because of the high attrition rate, results, though interesting, cannot be generalized.
True Hallucinations in Non-Psychotic States*
Authors: Andrade Chittaranjan , Srinath Shoba , Andrade A. Chitra
Published: April 2017

While hallucinations are known to occur as conversion symptoms in non-psychotic psychiatric states such as hysteria and grief, there is a lack of distinction between true and pseudo-hallucinations in such cases. We discuss the rationale which has necessitated this distinction, affirm that true hallucinations can occur in non-psychotic states, discuss the characteristics of such hallucinations, and postulate certain factors which may lead to hallucinations in non-psychotic states being judged as “true.”
Split Body and Self: An Unusual Case of Misidentification*
Authors: Silva J. Arturo , Leong Gregory B. , Luong My Thi
Published: April 2017

Following a head injury, a 27 year old female developed a chronic misidentification delusion that incorporated her transient neurological symptoms. Her presentation was consistent with the syndrome of reverse subjective doubles. A discussion of the syndrome of reverse subjective doubles follows.
Borderline Traits among Community Alcoholics and Problem-Drinkers: Rural-Urban Differences
Authors: Tousignant Michel , Kovess Viviane
Published: April 2017

This study analyzed the borderline traits of a sample of community alcoholics drawn from a rural and a metropolitan area of the province of Quebec. The Diagnostic Interview Schedule and other questions from the Diagnostic Interview for Borderlines were administered. About one-third of the sample of alcoholics showed a high number of borderline traits, a proportion similar to that found in institutionalized samples elsewhere. The borderline alcoholics tended to be younger and they all came from the urban area. This result suggests that alcoholics are probably better tolerated in rural areas and are less likely to adopt a pathological behaviour.
The Psychology of Women: A Psychoanalytic Review*
Authors: Small Fern E.
Published: April 2017

Freud's psychoanalytic views of female development emphasized the importance of penis envy and the Oedipus complex. Resolution of the Oedipus complex resulted in a “neurotic” solution, a “masculinity complex ” or a normal feminine attitude involving acceptance of anatomic inferiority, passivity, masochism and narcissism. Modern psychoanalytic views have rejected or reformulated many of these theories. Penis envy is seen as a normal phase of development which is resolved in most women. Women have been found to develop strong, albeit different, super ego structures. The female character triad has been questioned and the role of environmental factors emphasized. Efforts continue to develop a comprehensive well-integrated view of female psychology.
Comparative Plasma Levels of Doxepin and Desipramine in the Elderly*
Authors: Gosselin Caroline , Ancill Raymond J.
Published: April 2017

Although tricyclic antidepressants remain a principal mode of treatment of depression in the elderly, concomitant medical illness in this subgroup creates particular concern regarding the safety of these drugs. Doxepin has gained favour for use in the geriatric population due to claims of low cardiovascular side effects. This perceived safety has been questioned, however, since few investigators have actually reviewed plasma levels.

A recent finding of interest revealed that two patients on 150 mg of doxepin daily with assured compliance had undetectable levels of doxepin or desmethyldoxepin in their plasma. Aprospective study was consequently undertaken to compare oral doses and plasma levels of doxepin with desipramine as a standard reference compound. Data was collected for 19 females (12 on doxepin, seven on desipramine) and 12 males (five on doxepin, seven on desipramine) with a mean age of 76. Eight patients on doxepin showed undetectable plasma levels as compared with none on desipramine. This is a highly significant difference.

Although the therapeutic plasma range for doxepin remains controversial, it is unlikely that patients can respond to levels of zero. The authors recommend routine monitoring of doxepin levels in the elderly and question poor bioavailability or absorption of this tricyclic antidepressant in some patients.
Passing the Oral Examination for Specialist Qualification in Psychiatry: Part II*
Authors: Kline Stephen A. , Fleming Sandford
Published: April 2017

The nature of the relationship between candidates and their examiners is explored, and suggestions made as to how candidates might comport themselves during the oral examinations. In addition, the authors describe some of the organizing principles for responding to questions during the question and answer portion of the examination.
A Call for Primary Prevention: Reality or Utopia*
Authors: Toews John , El-Guebaly Nady
Published: April 2017

The efficacy of primary prevention of mental disorders has been debated over the years. The debate is complicated by ideology, semantic confusion, methodological difficulties and a paucity of good evaluative studies. This paper reviews newer concepts of primary prevention and mental health promotion, methodological issues, model programs, and inherent ethical concerns. Further evaluative studies and an increased contribution of psychiatrists to the primary prevention debate are recommended as necessary steps in further evolution of the field.
An Integrated Approach to Family Therapy Training for Psychiatric Residents
Authors: Guttman Herta , Feldman Ronald , Braverman Shirley
Published: April 2017

Unlike nonmedical family therapists, psychiatric family therapists are able to evaluate and treat both the biological and psychosocial components of a problem. They can integrate knowledge of biology, psychopharmacology and individual psychodynamics with family systems theory and family therapy skills.

A family therapy training program is presented as a model which prepares psychiatric residents for this unique role. This model emphasizes the importance of having psychiatrists as family therapy teachers, the use of both systems and psychodynamic perspectives in teaching about families, and the principle of presenting concepts and interventive techniques at successively greater levels of difficulty. Illustrative examples are presented. A minimum of two years of family therapy training and supervision is recommended during a four year residency program.
The Incidence of Abnormal Dexamethasone Suppression in Schizophrenia: A Review and a Meta-Analytic Comparison with the Incidence in Normal Controls
Authors: Yeragani Vikram K.
Published: April 2017

Studies on dexamethasone suppression test (DST) and schizophrenia are reviewed and the incidence of nonsuppression in the group of studies on schizophrenic patients is compared to that in the group of studies on normal controls from a previous review article. The incidence of nonsuppression in schizophrenic patients (26.4%) is significantly higher than that in normal controls (5.0%). There may be a subgroup of schizophrenic patients with an increase in cholinergic functioning. The variance of the nonsuppression rates of DST were also significantly higher in patients with schizophrenia compared to normal controls. This may be due to a heterogeneity of mechanisms that is responsible for the DST non-supressionor due to the heterogeneous nature of the diagnosis of schizophrenia. The possible mechanisms of abnormal and varied DST results in schizophrenia are discussed.
The Ward Milieu and its Effect on the Behaviour of Psychogeriatric Patients
Authors: Minde Regina , Haynes Evangeline , Rodenburg Martin
Published: April 2017

Research relating environment and behaviour indicates that relatively minor changes in the environment, such as restructuring a dayroom, can result in significantly improved psychosocial functioning in psychogeriatric patients. A project introducing multiple changes designed to improve the quality of life on a geriatric ward in a provincial mental hospital is described and discussed in the light of that research and suggestions are made regarding its replication under more rigorous experimental conditions.
Separation Experiences in Childhood and Adult Marital Quality
Authors: Truant G.S. , Herscovitch J. , Donaldson L.A. , Lohrenz J.G.
Published: April 2017

A relational model of the influence of childhood relationships on adult marital quality is proposed and tested in a family medical centre and a psychiatric outpatient population by a questionnaire of separation experiences, the Parental Bonding Instrument and the Locke-Wallace Short Marital Adjustment Test. This paper presents results from a psychiatric outpatient population that correspond with previously reported results on the family medical centre patients. The paper also presents data from both populations on the association of childhood separation experiences with adult marital quality. The presence or absence of self-reported childhood separation experiences was not associated with variations of marital quality in either population. The variation in other aspects of separation experiences similarly was not associated with marital quality. The association between representations of childhood experience and adult marital quality, found in a previous study of the family medical centre patients, was not found in the psychiatric outpatient population. The possible reasons for these findings are discussed.
Psychological Factors in Irritable Bowel Syndrome
Authors: Toner Brenda B. , Garfinkel Paul E. , Jeejeebhoy Khursheed N.
Published: April 2017

This paper describes the prevalence and incidence of psychiatric disorders in IBS patients using a standardized psychiatric interview, and proposes a psychological model for investigating one aspect of IBS. Forty-four IBS patients and 28 nonclinical participants received a psychiatric interview (Diagnostic Interview Schedule) and completed the Lie Scale of the Eysenck Personality Inventory (L-EPI). Results indicated that a significant percentage (59%) of the IBS group met DSM-III criteria for a psychiatric disorder within the last year, far more than occurred in the matched nonclinical comparison group. Relative to the comparison group, the IBS group also had significantly higher lie scores on the EPI indicating a response style of social desirability. On the basis of these findings, together with earlier work by Latimer's group, a conceptual model was formulated on the notion that some IBS patients may have a self-schema (i.e. knowledge of self, stored in memory) characterized by social desirability. We suggest that the construct of self-schema may be helpful in differentiating IBS from psychiatric groups both conceptually and therapeutically.
Problems in the Treatment of Premenstrual Syndrome
Authors: Robinson Gail Erlick , Garfinkel Paul E.
Published: April 2017

Three categories of treatments for premenstrual syndrome (PMS) have been proposed: those designed to correct the cause of the disorder; those designed for symptom relief; and those aimed at eliminating the menstrual cycle. Many of these recommendations are based on poor research with loose definitions of the disorder and uncontrolled open trials. This paper reviews the literature on treatment methods with emphasis on recent random, placebo controlled, double-blind studies. The most effective current management of PMS is a conservative one including accurate diagnosis, stress control, sensible levels of diet and exercise and perhaps the use of alprazolam in the premenstrual period. Other approaches such as the use of mefenamic acid and evening oil of primrose remain unproven. Progesterone has been proven uneffective. Further research is required into the value of antidepressant medication.
A Psychiatric Fellowship in the United States
Authors: Swenson J.R. , Lam R.W. , Morehouse R.L.
Published: April 2017

The development of subspecialty fields in psychiatry will likely motivate many new graduates of Canadian psychiatric residency programs to seek additional fellowship training. There is little information to guide psychiatric residents interested in arranging a fellowship year. This article discusses the experience of three Canadian psychiatrists who recently completed a fellowship year in a well known academic centre in the United States. The reasons for considering an additional year of training are discussed. The practical aspects of finding and funding a fellowship year are also addressed. The individual experiences of the authors as fellows in consultation-liaison psychiatry, psychopharmacology and psychobiology, and sleep disorders medicine are described. Finally, personal stresses which appeared to be commonly experienced by psychiatric fellows are explored.
Validation of the Alexithymia Construct: A Measurement-Based Approach
Authors: Taylor Graeme J. , Bagby R. Michael , Ryan David P. , Parker James D.A.
Published: April 2017

Alexithymia is a hypothetical personality construct that has been associated with a variety of medical and psychiatric disorders. This article reviews a program of research evaluating the validity of the construct using a measurement-based, construct validation approach. For this purpose the Toronto Alexithymia Scale (TAS) was developed. In a series of studies the TAS demonstrated internal consistency, good test-retest reliability, and a stable factor structure theoretically congruent with the alexithymia construct. In separate tests of construct validity, the TAS correlated in a theoretically meaningful fashion with measures of other constructs. Criterion validity was supported by a study in which the TAS was able to discriminate between behavioural medicine out-patients designated as alexithymic and those designated as nonalexithymic on the basis of objectively rated structured interviews. In a normal adult sample, TAS scores were not related to sociodemographic variables or intelligence. These results provide considerable empirical support for the validity of the alexithymia construct. In addition, the TAS appears to be a psychometrically sound measure of alexithymia that may prove useful in testing the construct with psychiatric and medical patient populations.
Effet anti-koro d'un antidépresseur tricyclique
Authors: Turnier Luc , Chouinard Guy
Published: April 2017

The authors are reporting a case of koro syndrome which was associated with major depression. Koro syndrome is a rare disease which manifests itself with a severe anxiety associated with the fear of having the penis shrinking and disappearing in the abdomen. The case reported was treated with trimipramine, a tricyclic antidepressant, at a dose of 150 mg/day associated with bromazepam, a benzodiazepine, In addition, the patient received psychotherapy, which allowed him to deal with the situation and to eliminate guilt feelings. It is hypothesized that the tricyclic antidepressant, by treating the depression, had a curative effect on the koro syndrome.
Evaluation of Clonidine Suppression of Opiate Withdrawal Reactions: A Multidisciplinary Approach
Authors: Cuthill J.D. , Beroniade V. , Salvatori V.A. , Viguié F.
Published: April 2017

The purpose of this open, uncontrolled study in a group of confirmed heroin addicts of both sexes was to determine whether clonidine by itself suppresses opiate withdrawal reactions, its maximal effective dosage range, the time of maximal effect, duration of its effectiveness and the extent of cardiovascular side effects. After a washout phase of opium residues, clonidine was administered for eight days and its effects were closely monitored and recorded. Even during the first 24 hour period, when clonidine was administered alone in a high dosage, it suppressed the signs and symptoms of opiate withdrawal reactions. The maximum effect was attained within three days. Thereafter, it maintained improvement until natural resolution of the reactions. Side effects were limited to some small but statistically significant cardiovascular changes. Illicit drug use during the treatment period indicated that drug related behaviour is only slightly affected by clonidine. The drug is thus effective in the acute withdrawal phase but does not replace the important psychosocial management needed to achieve long term drug abstinence.
La Doctrine du Consentement Libre et Éclairé: Ses Fondements Éthiques, Juridiques et ses Applications dans la Recherche et la Pratique de la Psychiatrie
Authors: Grunberg Frédéric
Published: April 2017

This article briefly examines the ethical and legal foundations for the doctrine of informed consent in medical research and pratice. The doctrine is based upon the importance of respecting the individual's autonomy and his right to self-determination.

The article also reviews the development of the doctrine of informed consent based on its recent application. The authors cite the Nuremburg Code and the Helsinki Declarations and particularly the media denunciation of several scandals in the United States during the late 1960s, when Henri Beecher's name figured prominently.

The effects of informed consent in psychiatry are examined specifically, as well as the consequences for psychiatric research, on subjects who are able to give their consent, as well as those who are unable to do so.

As for its effects on clinical practice, the paper discusses the right of the hospitalized patient to refuse treatment, and informed consent and the risks for patients treated with neuroleptics of developing tardive dyskinesia. The authors conclude that in psychotherapy the concept of informed consent cannot be taken for granted.
The Relevance of a Systemic Model for the Study and Treatment of Anorexia Nervosa in Adolescents*
Authors: Martin Freda E.
Published: April 2017

A systems model describing interactions between social, familial, intrapsychic and physiological levels in anorexia nervosa is described. The role of escalating positive cycles in producing severe pathology is emphasized. The general relevance of the model for understanding different clinical pictures and for focusing treatment interventions and further research is outlined.
Feeding Disorders in Infancy: Classification and Treatment Considerations
Authors: Wittenberg Jean-V.P.
Published: April 2017

This paper critically discusses conceptualizations of failure to thrive as an organic and nonorganic dichotomy. Research findings are used to refute this type of categorization. Instead, an approach which recognizes both organic and nonorganic influences and consequences of the syndrome are suggested. Physical, psychological and interpersonal systems and their interactions are explored. Potential contributions of the psychiatrist in the context of a multidisciplinary team approach to treatment are described.
Treatment Outcome for Children and Adolescents with Conversion Disorder
Authors: Turgay Atilla
Published: April 2017

This paper describes the clinical impressions of conversion disorders developed after long term in-depth clinical work with 137 children and adolescents and their families. Almost half of the 89 patients who were directly treated and followed by the author through an integrative child and family therapy approach recovered less than two weeks after the initiation of the treatment. Only three out of 89 patients required longer than four weeks for recovery. The rest responded well to the therapy and recovered with two to four weeks of treatment. Factors associated with positive treatment outcome are: younger age of patient, healthy personality characteristics, lack of psychopathology, insight and treatment compliance, healthy family functioning, acceptance by the family of the psychological nature of the illness, positive feelings towards the child and the family by the staff, lack of internal conflict and inflexible neurotic defences, and early therapeutic interventions. It was found that child and adolescent patients with conversion disorders responded quite well to an integrative, condensed treatment approach.
Trends in Treatment Admissions for Cocaine and Other Drug Abusers*
Authors: Smart Reginald G. , Adlaf Edward M.
Published: April 2017

This paper examines the proportion of drug abusers who report cocaine abuse as their primary problem at a Toronto clinic. In addition, characteristics of cocaine abusers are compared with those of alcohol and cannabis abusers. There is a significant increase in the proportion of drug abusers seeking treatment for cocaine use relative to other drugs, and a dramatic increase in their absolute numbers. Differences in age, marital status and socioeconomic status among cocaine, alcohol, and cannabis abusers are also noted.
Psychopathology in Sturge-Weber Syndrome*
Authors: Lee Sing
Published: April 2017

Sturge-Weber syndrome is a rare congenital disease which can impair a child's brain functions and psychosocial development. Its psychiatric aspects have been ignored in the literature. Two male Chinese patients who presented with paranoid disorders and one female Chinese patient who presented with depressive pseudodementia are described. Biological and psychosocial aspects of pathogenesis are discussed, especially in the light of a “shame-humiliation model” of paranoid processes, since shame and humiliation are engrained in Chinese culture. These case descriptions suggest an overlooked association of Sturge-Weber syndrome with psychopathology and have important implications for the prevention and treatment of such potentially crippling psychiatric complications in subjects with this syndrome as well as other visible physical handicaps.
Regional Cerebral Glucose Metabolism in Major Depressive Disorder
Authors: Hurwitz T.A. , Clark C. , Murphy E. , Klonoff H. , Martin W.R.W. , Pate B.D.
Published: April 2017

Six subjects with DSM-III defined unipolar major depressive disorder had positron emission tomography scans using 18F-2-fluoro-2-deoxy-D-glucose (2FDG) before and after treatment with imipramine. Their 12 scans were compared to the scans of six controls matched for age. Significant reductions in metabolism for subjects in the depressed group were found on scans for both the anterior and right frontal regions. Significant reductions in metabolism occurred more often in the right hemisphere than the left. No significant changes in metabolism could be attributed to imipramine. In addition, absolute metabolic rates were not related to the degree of depression pre- and post-treatment. The findings suggest that hypometabolism in the frontal cortex and right hemisphere may occur in major depressive disorders.
A Perspective on the Thyroid and Depression*
Authors: Joffe Russell T.
Published: April 2017

There is extensive literature documenting an association between abnormalities of the hypothalamic-pituitary-thyroid axis and disorders of mood. However, the specific abnormality in thyroid functioning associated with primary affective disorder remains poorly understood. Various aspects of the relationship between thyroid functioning and affective illness are reviewed. Particular attention is paid to psychiatric symptoms and clinical thyroid disorders as well as abnormalities of basal thyroid hormone levels in depression and the use of thyroid hormones in the treatment of depressive illness. Current hypotheses regarding the association between altered thyroid functioning and depressive illness are critically reviewed.
Psychopharmacology Training in Psychiatric Residency Programs: The Canadian Scene
Authors: Awad A. George , Darby Padraig L. , Garfinkel Paul E.
Published: April 2017

A survey among psychiatric residents about their satisfaction with and concerns about their training in psychopharmacology was conducted. One hundred and seventy responders (61%) from ten post-graduate psychiatric programs in Canada completed the questionnaire. The questionnaire assessed the residents' satisfaction with the training they had received over the previous six months as well as over their entire residency period. The questionnaire enquired specifically about the quantity and quality of supervision in the use of different medications for different therapeutic purposes. It also looked at the quality of supervision of drug therapies within hospital services, inpatient, outpatient, consultation and emergency services. Residents also were asked about coverage of specific topics and ranked different methods of learning. The survey uncovered a number of deficiencies mostly related to the teaching of basic psychopharmacology, integration of psychopharmacological and psychosocial issues and the lack of teaching of clinical appraisal of recent advances. Factors that may have contributed to the development of such deficiencies as well as specific recommendations are discussed.
Delusion of Fetal Duplication in a Capgras Patient
Authors: Silva J. Arturo , Leong Gregory B. , Longhitano Maria , Botello Timothy E.
Published: April 2017

A case of Capgras syndrome in a pregnant patient is described. In addition to perceiving living family members as impostors, she believed that there was a double or twin of her fetus. She conceptualized her “twins” differently than the way she viewed doubles of family members. Her fetus may represent the youngest “person” to have been duplicated. The relationship of Capgras syndrome to misidentification phenomena is discussed.
The Use of Sodium Amytal in Psychogenic Psychosis
Authors: Steiner Warren
Published: April 2017

A case of psychogenic psychosis is presented. The effective use of sodium amytal as an aid in diagnosis and in treatment is described.
Patient Assaults on Psychiatric Residents: The Canadian Experience
Authors: Chaimowitz G.A. , Moscovitch A.
Published: April 2017

There have been fairly limited reports in the literature of assaults on residents in psychiatric facilities. Assaults on residents and staff tend to be underreported and, for a variety of reasons, not adequately dealt with by the administration. For this reason, security in psychiatric facilities may be lacking in many instances. In order to prepare a position paper of guidelines specifying minimum security requirements for psychiatric facilities in Canada, the Residents' Section of the Canadian Psychiatric Association gathered data on this issue from psychiatric residents. We present the results of a questionnaire sent to all psychiatric residents who are members of the Canadian Psychiatric Association.

Results indicate that 40.2% of residents have been assaulted at least once. We present some interesting findings that relate to the residents' perception of their training and the appropriateness of the facilities for assessing patients. Requests for improved security were made by 36.9% of the residents, but only 22.9% of this group found the response by acceptable. Some of the residents' explanations for the assaults suggest interesting dynamics. These and other findings suggest an urgent need to address this issue.
A Review of the Psychopharmacology of Panic Disorder: Individual Differences and Non Specific Factors
Authors: Cox Brian J. , Swinson Richard P. , Endler Norman S.
Published: April 2017

This paper critically examines the pharmacological provocation and treatment of panic disorder. An analysis of research findings on how panic attacks are induced indicates that there are psychological and non specific factors that may mediate biochemical etiological models, and these individual differences need to be investigated further. This has important implications for the psychopharmacological management of panic. A review of studies on treating panic disorder with imipramine and alprazolam emphasizes the importance of several non specific factors that include the role of self-directed in vivo exposure and changes in dysphoria and self-efficacy (subjective beliefs regarding personal compentency) in predicting outcome. It is recommended that any treatment of panic-related disorders include self-directed, in vivo exposure.
Efficacy of Routine Admission Urinalyses in Psychiatric Hospitals
Authors: Berber Mark J. , Mcfeely Neil
Published: April 2017

The clinical efficacy of routine admission urinalyses was evaluated in 515 patients admitted to a psychiatric hospital. Two staff psychistrists reviewed the patients' charts to determine which test resulted in diagnostic or therapeutic management changes. Abnormalities were found in 40 (7.8%) of the cases, but only four (0.8%) of the routine urinalyses affected patient therapy. It is concluded that routine admission urinalysis has very little impact on the care of psychiatric patients and that there is little justification for ordering this test on all patients admitted to psychiatric hospitals.
Primary and Secondary Depression: A Review
Authors: Costello Charles G. , Scott Carol B.
Published: April 2017

The literature on the distinction between primary and secondary depression is reviewed. The research data indicate that less severe, non life-threatening suicidal thoughts and behaviours occur more often in patients with secondary depression than in those with primary depression and that the prognosis for secondary depression after somatic forms of therapy is poorer than that for primary depression. The data also suggest that secondary depressives, unlike primary depressives, suffer from chronic dysphoria.

It is concluded that, because the available evidence suggests that there are no qualitative differences between the episodes of primary and secondary depression, future research should concentrate on investigating the characteristics of different groups of patients with secondary depression rather than on comparisons between primary and secondary depression in general.
Who Misses Appointments? An Empirical Analysis
Authors: Campbell Barry , Staley Douglas , Matas Manuel
Published: April 2017

Patient noncompliance is a major problem in clinical practice. In order to better understand this issue, 236 appointments at an outpatient psychiatry clinic of a large urban general hospital were examined. Five variables significantly discriminated patients who kept their appointments from patients who did not. Patients who were younger, had a history of missed appointments, were scheduled to see a resident physician, had a routine appointment and lived a distance from the hospital, were at greater risk of missing their appointment. This information helps to identify patients at high risk of nonattendance and allows clinicians to plan schedules and appointments more efficiently.
Mortality in a Cohort of Patients with Schizophrenia: A Record Linkage Study*
Authors: Newman Stephen C. , Bland Roger C.
Published: April 2017

A retrospective study of mortality was conducted in which 3,623 patients with schizophrenia receiving treatment in Alberta between 1976 and 1985 were followed to the end of 1985. Vital status was determined by record linkage to the Statistics Canada Mortality Data Base. There were 301 deaths in the cohort, 97 of which were due to suicide. For all causes of death combined, the risk of mortality was approximately double that of the Alberta population; for suicide, risk was increased by a factor of 20. Mortality from circulatory, respiratory, digestive and genitourinary diseases was also greater than expected. It is estimated that those who suffer from schizophrenia have a life expectancy which is approximately 20% shorter than that of the general population. This study confirms earlier research demonstrating an increased risk of mortality associated with schizophrenia, and extends those findings to specific causes of death.
Validation of the Five Minute Speech Sample in Measuring Expressed Emotion*
Authors: Malla Ashok K. , Razarian Shahe S. , Barnes Susan , Cole John D.
Published: April 2017

The relationship of the Five Minute Speech Sample (FMSS) to the Camberwell Family Interview and its coding system were evaluated. The Camberwell Family Interview and the FMSS were administered to twenty-three relatives of patients diagnosed with schizophrenia. Overall, the results supported the utility of the FMSS and its coding system as a brief screening device for measuring expressed emotion.
Deceptions in Psychotherapy: Case Report and Considerations
Authors: Billig Nathan
Published: April 2017

Deliberate deception by a patient in psychotherapy is a deviation from a fundamental requirement of the patient-therapist relationship. When deceptions are discovered or admitted, it is crucial to analyze them for their value in understanding conflicts, transference relationships, and current stresses. These issues are illustrated with a case involving an elaborate deception carried out over several months by a patient in psychotherapy.
Fluoxetine in Panic Disorder
Authors: Solyom Leslie , Solyom Carol , Ledwidge Barry
Published: April 2017

This paper presents the cases of two patients who suffered from panic disorder with agoraphobia and depression. One had been refractory to alprazolam and tricyclics and to behaviour therapy; she had responded to phenelzine, but due to a weight gain of 50 lbs, had discontinued treatment and she relapsed. The second patient, who also suffered from post-traumatic stress disorder, did not respond to alprazolam, imipramine or to phenelzine, but gained weight (33 lbs) on phenelzine. Both patients responded to fluoxetine 80 mg per day without concomitant weight gain.
Pattern of Substance Abuse in Psychiatric Inpatients
Authors: Toner Brenda B. , Shugar Gerald , Campbell Beverly , Di Gasbarro Ines
Published: April 2017

This study examined the pattern of substance abuse in a sample of 114 psychiatric inpatients using a standardized diagnostic interview. As predicted, psychiatric inpatients reported a significantly higher rate of substance abuse than a randomly selected community sample. Approximately three-quarters of the inpatients abused at least one substance. Almost one-half of the patient sample reported abusing more than one substance. These findings emphasize the need to screen psychiatric inpatients for substance abuse using a standardized diagnostic instrument and to develop treatment programs for substance abuse in psychiatric patients.
Diagnostic Utility of the Beck Depression Inventory with Adolescent Psychiatric Outpatients and Inpatients
Authors: Marton P. , Churchard M. , Kutcher S. , Korenblum M.
Published: April 2017

The utility of the Beck Depression Inventory (BDI) for differentiating adolescents with depressive disorders from adolescents with non affective psychiatric disorders was examined using a sample of 93 psychiatric outpatients and 26 inpatients. The Diagnostic Interview for Children and Adolescents (DICA) was administered to establish the patients' diagnosis. Psychiatric diagnoses were made by experienced clinicians who used all available information on the patient. The BDI scores discriminated between patients with depressive disorders and patients with non affective psychiatric disorders. This differentiation was true for boys and girls, outpatients and inpatients. The classification accuracy of the instrument was 75% at thresholds of 11 and 16 on the scale. The results indicate that the BDI is a useful instrument for screening for depression in adolescents, and can also be used in conjunction with other tests. However, the BDI by itself is inadequate to establish a diagnosis of depression.
Regional Metabolism in Microsmic Patients with Schizophrenia
Authors: Clark Campbell , Kopala Lili , Hurwitz Trevor , Li David
Published: April 2017

The cerebral glucose metabolism of eight patients with schizophrenia and an olfactory agnosia was compared with that of eight normosmic patients with schizophrenia and eight normal controls. Since all patients were scanned while on their current medication regimen, the duration and dosage of the medication of the two patient groups were compared. Similarly, duration and dosage were correlated with absolute regional metabolic rates. No significant effects were found in these analyses. The patients with schizophrenia had significantly lower rates of frontal metabolism than the normal controls. However, the patients with schizophrenia and an olfactory agnosia had a lower right basal ganglia and thalamic metabolism than the normosmic patients with schizophrenia.
Photophilic and Photophobic Behaviour in Patients with Schizophrenia and Depression
Authors: Gerbaldo Hector , Thaker Gunvant
Published: April 2017

The authors Interviewed 32 patients (25 with an RDC diagnosis of schizophrenia and seven with schizoaffective disorder) consecutively admitted to a psychiatric outpatient clinic. Ten patients had a history of photophilic behaviour with sun-gazing, while 20 patients showed no unusual behaviour related to light. Two patients who had depressive symptoms at the time of interview had a history of photophobic behaviour. Sixteen patients and 12 controls were tested for their threshold for discomfort of high intensity light; the thresholds were significantly higher in the patients with schizophrenia (especially in those with history of sun gazing). The implications of these findings for clinical practice and research are discussed.
Autism: Its Primary Psychological and Neurological Deficit
Authors: Fotheringham John B.
Published: April 2017

Autism is a perplexing condition because of its unique presenting signs and high degree of variability. Evidence is presented that the basic underlying information processing disorder is a dysfunction of the appreciation of the emotional significance of incoming stimuli and attaching motivational value to the stimuli. It is proposed that this dysfunction occurs when the amygdaloid nucleus and/or its connections are disrupted, resulting in the variability of the presentation of this syndrome among individuals. Herpes simplex encephalitis sometimes results in signs of autism. The virus has a predilection to attack specific areas of the brain, which provides information on the probable underlying neurological dysfunction in autism.
Fluoxetine Treatment of Obsessive-Compulsive Disorder
Authors: Solyom Leslie , Solyom Carol , Ledwidge Barry
Published: April 2017

Two patients suffering from severe obsessive-compulsive disorder which had proven refractory to clomipramine and/or phenelzine treatment were successfully treated with fluoxetine, a new drug with a strong serotonin uptake inhibiting action. Outcome of treatment was measured on psychometric tests including the Leyton Obsessive Inventory, Hopkins Symptom Checklist-90, Beck Depression Inventory, and daily self-reports of the duration and degree of discomfort of their most severe obsessions. The delay in responding to fluoxetine, the continuing improvement even after one year on the drug, and the prompt relapse with abrupt withdrawal of treatment were noted.
Repeated Use of Psychiatric Emergency Services by Children
Authors: Cole W. , Turgay A. , Mouldey G.
Published: April 2017

In this study, the repeat utilization of child psychiatric emergency services was examined. There are patients who use psychiatric emergency services repeatedly, and these patients represent a significant proportion of child psychiatric emergencies seen in emergency rooms. Repeat patients were more likely to threaten to harm others, have a diagnosis of adjustment disorder, conduct or oppositional disorder and be under the care of a child welfare agency. They were significantly more likely than the one-time patients to be less compliant with outpatient follow-up, admitted to hospital more often, needed more social support and had greater difficulty remaining in a residential treatment setting. Intervention in the emergency room did not appear to change the way they used emergency services.
Self-Report of Family Histories of Learning Difficulties
Authors: Schachter Debbie Carol , Pless Barry , Bruck Maggie
Published: April 2017

Self-reports of learning difficulties by parents of reading disabled children may be inflated because of recall bias. A retrospective study of the association between specific reading disabilities and familial reports of learning difficulties indicated the relative odds of being reading disabled for those whose relatives reported learning difficulties compared with children whose relatives did not report learning difficulties was statistically significant if fathers or siblings reported learning difficulties. No significant association was found between mothers' self-reports of learning difficulties and a diagnosis of specific learning disabilities in their children. The results support the association between specific reading disabilities and self-reported histories of academic problems in the father or siblings, but not in mothers of learning disabled children. The results suggest that reports of learning difficulties among mothers of reading disabled children may be inflated because of recall bias.
Le jeu pathologique: une revue de la littérature*
Authors: Filteau Marie-Josée , Baruch Philippe , Vincent Pierre
Published: April 2017

This paper summarizes the current literature on pathological gambling. Interest in gambling has been present in every society but treated as an object of sociopolitical or literary interest. It is only from the beginning of this century that psychiatry began to look at pathological gambling, first with Freud and his writing on Dostoïevsky then with other theories like the learning theory, studies on substance dépendance, the links with affective syndromes and the psychobiological studies. These studies are presented and discussed. Finally, the authors offer some guidelines for an approach to a pathological gambler.
Psychiatric Disorders in Prisoners Referred for Assessment: A Preliminary Study
Authors: Fido Abdullahi A. , Razik M. Abdel , Mizra Iman , Frcp M.F. El-Islam,
Published: April 2017

The psychiatric profile of a consecutive series of 69 men and women prisoners referred for assessment over a nine month period was examined. Thirty-six point two percent had a major psychiatric disorder and a further 53.6% had a minor psychiatric illness. One-third of the sample had a previous criminal record, and approximately one-half had past psychiatric contacts. Schizophrenic patients with active symptoms appear to be more likely to commit violent offenses. Often prisoners who committed murder, nine were patients with schizophrenia. Almost all the psychotic patients had active symptoms at the time that they committed their offenses. The most probable reason for the commission of their crime was psychosis. Some underlying psychosocial factors are also discussed. Ways of minimizing the vulnerability and victimization of individuals with serious mental disorders are suggested. Because this was a highly selective sample, the results should be viewed with some caution. More research is needed to determine the criminal behaviour of the mentally ill in general, and schizophrenics in particular.
A Critical Review of the Role of Childhood Sexual Abuse in the Etiology of Borderline Personality Disorder*
Authors: Paris Joel , Zweig-Frank Hallie
Published: April 2017

A number of recent reports have indicated that there is a high incidence of sexual abuse during childhood among patients with borderline personality disorder. Although these findings are important, a simple association between abuse and the disorder is an oversimplification. Community studies of the long term effects of abuse indicate that the parameters of abuse are crucial to the patient's outcome. In addition, correlations have been found between sexual abuse during childhood and factors related to the family environment. A multifactorial model of the etiology of borderline personality disorder is proposed in which biological vulnerability, psychological factors and social influences are considered along with their interactions.
An Audit of Substance Use Disorders on a General Hospital Psychiatric Unit
Authors: Barral M.V. , Standage K.
Published: April 2017

This study found that one-fifth of patients admitted to a general hospital psychiatric unit meet the diagnostic criteria for abuse of, or dependence on, psychoactive substances other than alcohol. Many of the substances involved are prescribed medications. Dependence on benzodiazepines and other sedatives was the most common substance use disorder among patients with a variety of other psychiatric diagnoses. We are also concerned by the extent of reported abuse of analgesic compounds and feel it is necessary to modify our initial diagnostic assessments so that patients with these disorders can be recognized at an early stage and managed appropriately.
The Use of Laboratory Tests in a Psychiatric Hospital*
Authors: Rapp Morton S. , Bibr Jindrich , Campbell Keith
Published: April 2017

Little attention has been paid to the use of laboratory tests in psychiatric hospitals. This paper reviews studies of the use and abuse of laboratory tests in general medicine. It examines five different sets of test results performed over a three month period at a mid-sized psychiatric hospital. The paper concludes that, on the whole, the laboratory was used efficiently and effectively. However, some testing patterns need to be re-evaluated.
Familial Transmission of Speech and Language Impairment: A Preliminary Investigation
Authors: Beitchman J.H. , Hood Jane , Inglis Alison
Published: April 2017

The familial transmission of speech and language disorders was investigated using a community sample of five year old children with speech and/or language impairment and a control group with normal language skills. The results indicated a significantly higher prevalence rate of language-related problems in families of speech and language impaired children than in normal language controls. Girls with speech/language impairments had more affected relatives than boys, suggesting that girls with this type of family history are at a greater risk of developing speech or language related problems. The pattern of transmission of speech and language disorders was also compared with published reports of the family histories of stuttering and reading disabilities, and with reports of cognitive and linguistic deficits among families of autistic individuals. The findings are discussed in relation to the theory of an underlying neurolinguistic diathesis common to these various disabilities.
Bibliotherapy: The Use of Books in Psychiatric Treatment*
Authors: Katz Gilda , Watt John A.
Published: April 2017

The guided use of selected books as an adjunct to treatment is applicable to patients in all stages of life and with a variety of problems. This paper describes the authors' experience using books as an adjunct to therapy with psychiatric patients. The authors define the term, review the literature, and set out the objectives of bibliotherapy. The paper presents some principles to follow when assigning books, and examples of books used for common problems. Finally, examples are given of bibliotherapy in action at two Ontario hospitals, and some future directions are suggested.
Cultural Variations in Attitudes toward Menstruation*
Authors: Chandra Prabha S. , Chaturvedi Santosh K.
Published: April 2017

Attitudes towards menstruation play an important role in the perception of menstrual distress. The influence of cultural and Social factors was studied in a group of 48 Indian women using the Menstrual Attitudes Questionnaire (modified version). Women over 25 years of age were significantly more likely to consider menstruation as being “natural”. No other significant relationships were found between menstrual attitudes and demographic variables. The menstrual attitudes of Indian and American college women (from a previous study) were also compared.