bluuebunny/crossref_metadata_2025 huggingface dataset:
Criminal Behaviour among Schizophrenics
Authors: Chuang Henry T. , Williams Richard , Dalby J. Thomas
Published: April 2017

This study compared the criminal behaviour of schizophrenic patients with a group of hospitalized medical patients who were matched on the basis of age and sex. In addition to the typically employed dependent measure of offense conviction, this study also examined antisocial personality traits, undetected criminal behaviours, criminal charges, and incarceration. No significant differences between the groups were found across offense type (against property, against persons, victimless and motor vehicle violations). Schizophrenic patients, however, were found to be at greater risk for being victims of a violent offense when compared to the control group which seemed to be at a greater risk for becoming victims of non-violent crime.
Childhood and Adolescent Suicide in Manitoba: A Demographic Study
Authors: Thompson Thomas R.
Published: April 2017

All suicides for ages 20 years and younger in Manitoba from 1971 to 1982 were studied for demographic and risk factors. Major demographic findings for Caucasian Manitobans agreed with past studies but native children showed several fold the rates for Caucasian children matched for gender and age. Both native males and rural Caucasian males suicided significantly more frequently at younger ages than their urban counterparts. Significant risk factors and demographic clusters of suicide victims were determined by statistical means and the results discussed in terms of a better understanding of childhood suicide, on a psychodynamic basis.
Two Japanese Families: A Cultural Perspective
Authors: Isomura Theresa , Fine Stuart , Lin Tsung-Yi
Published: April 2017

Some of the difficulties in treating second and third generation Japanese immigrant families are reviewed. An authoritarian, rather concrete approach to symptom relief is expected by, and is effective in, some families. The emphasis placed on academic achievement may lead to particular problems and misunderstandings. Two case examples of very different families are presented to emphasize a flexible therapeutic approach. Particular details of Japanese internment and population movements make the attitudes and behaviors of some families more comprehensible.
General Papers
Authors: Lavoie Richard , Mercier Et Céline
Published: April 2017

A study conducted in a Montreal area psychiatric institution focuses on the impact of chronic patients on in-patients services delivery system. This article shows a disarticulation of the system, from the first to the second line and within the second line.

The authors suggest that when the length of stay is extended beyond a certain time frame, it becomes increasingly difficult to reconcile continuity and complementarity of services: by congesting the system, chronic psychiatric population is decreasing the accessibility of services.
Abdominal Proptosis: A Case Report
Authors: Hardy Joelle-Louise , Coulombe Maurice
Published: April 2017

A case history of abdominal swelling of psychological origin is described. The clinical presentation and psychogenic pathogenesis of the disorder provide a differentiation from pseudocyesis. The psychodynamics of this case are discussed emphasizing the conflict involving strong elements of pre-oedipal aggressivity towards the father image.
The Detection of Psychiatric Morbidity and Associated Factors in Patients with Rheumatoid Arthritis
Authors: Chandarana P.C. , Eals M. , Steingart A.B. , Bellamy N. , Allen S.
Published: April 2017

Eighty-six patients with a confirmed diagnosis of rheumatoid arthritis were surveyed to assess the extent of psychiatric morbidity as indicated by two screening questionnaires, the General Health Questionnaire and the Hospital Anxiety and Depression Scale. In addition to an investigation of the concordance of the screening questionnaires, a description of demographic characteristics and measures of disability were taken. Disability due to arthritis was indicated by measures of years of chronicity, pain, duration of morning stiffness, functional level, active treatment involvement, and presence of coexisting medical problems. The relationship of physical symptoms to level of psychiatric distress was investigated.

Psychiatric cases were identified using recommended cut off scores on results of the screening questionnaires. GHQ cut off scores of 6/7 identified as “cases” 31.8% of the sample. HADS subscale cut off scores of 8/9 identified 21.4% of subjects with “anxiety” and 19.0% with “depression “ scores in the morbid range. Nineteen percent of patients were found to have scores on both tests concurrently in the pathological range.
Some Issues in the Diagnosis of Depression in China*
Authors: Jun-Mian Xu
Published: April 2017

In China, the diagnosis of depression is made much less frequently than in the West, likely because there is a somewhat lower prevalence rate and because of other factors related to culture and to the development of Chinese psychiatry. Some of the relevant factors are: 1) depressed patients often avoid seeking help because of the stigma of mental disorder; 2) many patients seek help from practitioners of Traditional Chinese Medicine; 3) depression is often diagnosed as schizophrenia because of diagnostic criteria that are broader for schizophrenia and narrower for affective disorder than in the West; and 4) somatization is more frequent in China and many depressives receive the label “neurasthenia”.
Hyperactivity and Child Abuse
Authors: Heffron William M. , Martin Catherine A. , Welsh Richard J. , Perry Peggy , Kirby Moore Catherine
Published: April 2017

The role of a child in his/her physical abuse was reviewed with particular attention to hyperactive children. A retrospective analysis of the records of children referred to a university-based hyperactive children's clinic revealed that children both with and without Attention Deficit Disorder (ADD) were more often physically abused than children in the general population. The period prevalence of physical abuse in children with ADD did not differ significantly from that in children without ADD. This suggests that hyperactivity may either contribute to, or result from, physical abuse.
Functional Dysphonia in Adolescence: Two Case Reports*
Authors: Froese Arthur P. , Sims Peter
Published: April 2017

Reports of functional dysphonia in children and adolescents under 16 years of age are few. Approximately a dozen cases have been reported in the English literature over the past 35 years. Most of the articles appear in journals related to the fields of speech, hearing and communication with a few in the Otorhinolaryngologic journals. Published papers in psychiatric journals dealing with voice or speech disorders are virtually nonexistent. In children and adolescents the two most common varieties are the Whispering Syndrome, which occurs predominantly in girls, and the Hysterical High Pitched Voice seen mostly in boys. This paper discusses these two varieties of functional dysphonia and presents a case example of each.
Mood Across the Menstrual Cycle and Number of Menstrual Symptoms Reported: A Cross-Sectional Study*
Authors: Chen Alice W. , Filsinger Erik
Published: April 2017

This study assessed mood among 110 women at three phases of the menstrual cycle and its relationship with the number of reported menstrual symptoms. Women who reported fewer menstrually-related symptoms tended to have generally higher mood scores, but specific depression of mood during menses was found among the subgroup of women who reported fewer menstrual symptoms. Contraceptive pill usage was not related to mood variation across the menstrual cycle. The findings raise questions about the validity of self-reports of menstrually-related symptoms.
A Possible Case of Asperger's Syndrome*
Authors: Munro Alistair
Published: April 2017

Asperger's syndrome is an autistic-like disorder, probably neuropsychiatric in character, which fits with DSM-III criteria for Atypical Pervasive Development Disorder. Because the abnormality is less pervasive than Autistic Disorder, it may be misdiagnosed as Personality Disorder in the adolescent, and the author presents an illustrative case in this respect. The condition is sometimes associated with Tourette's Syndrome, though not in this particular patient. Treatment remains speculative.
Thyroid Hormone Levels in Panic Disorder*
Authors: Yeragani Vikram K. , Rainey John M. , Pohl Robert , Ortiz Aurelio , Weinberg Paula , Gershon Samuel
Published: April 2017

A history of thyroid dysfunction has been reported in patients with phobic disorders. There is also evidence of a blunted TSH response to TRH stimulation in patients with panic disorder. In this study, values of T3, T4 and T7 were compared between 26 patients with panic attacks and 20 normal controls. Patients were diagnosed according to DSM-III criteria and those with a clinical history of thyroid dysfunction were excluded. Patients were not on any medication when the blood samples were drawn. The mean values of T3, T4 and T7 did not significantly differ between the two groups, suggesting no evidence of hypo or hyperthyroidism; however, the variance of distribution of T3, T4 and T7 values was significantly different between the two groups (Fmax values for T3: 2.55, p value < 0.05; T4: 3.15, p value < 0.01; T7: 2.55, p value < 0.05).
Child Psychiatry: One Nation
Authors: Maclean George
Published: April 2017

This essay discusses the position of child psychiatry as a subspecialty in Canada today. Proceeding from a review of a paper written by Dr. Quentin Rae-Grant in 1970 “Adult and Child Psychiatry — One or Two Nations?” the author, using the concept of a nation as a metaphor, explores the evolution of child psychiatry as a subspecialty in Canada. The history of child psychiatry in Canada is reviewed briefly; from its early beginnings to an increased understanding of its uniqueness as a subspecialty, finally through to the formation of the Canadian Academy of Child Psychiatry in 1980. The essay stresses the mutuality of our dependence on the Canadian Psychiatric Association. The author emphasizes our mutual dependence on the greater organizational body of psychiatrists, and encourages a greater participation of child psychiatrists within the Canadian Psychiatric Association. The author also emphasizes the need to have a closer relationship with the Canadian Paediatric Society. In addition, the author discusses in some detail the more complex and controversial relationship between child psychiatry and the Royal College of Physicians and Surgeons of Canada. Finally the author emphasizes the importance of a close working relationship with the American Academy of Child and Adolescent Psychiatry. All of these relationships are emphasized in terms of mutual dependence.
A Rural Child Psychiatry Day Treatment Centre: Systemic Perspective*
Authors: Greenfield Brian
Published: April 2017

The author presents the complexities of directing a DTC (Day Treatment Center) in a rural setting. These complexities are explored from the pespective of system's theory. The various systems contained within the DTC are in dynamic equilibrium with each other as well as with various community groups. Changes in any one system have significant impact on the groups the system impinges on. As an example, the DTC had not functioned well for a period of time prior to the author's arrival. During that period the staff communicated poorly among themselves, resulting in conflicts between the teaching and non-teaching staff. When these conflicts were resolved the well-established incompatibilities and stresses within the system of the non-teaching staff surfaced.

In the process of this conflict resolution the DTC was reorganized. New groups were established to access children at primary and secondary levels of medical prevention. Rapport with other systems in the community improved. Consequently, with better communication between groups of staff and with the community, the treatment of the children could be more effective.
Residential Treatment of Disturbed Delinquents: Description of a Centre and Identification of Therapeutic Factors*
Authors: Harris D.P. , Cote J.E. , Vipond E.M.
Published: April 2017

Residential treatment for disturbed, particularly delinquent, adolescents has been described several decades ago by the founders and leaders of institutions. Theoretical considerations in treatment were prominent. The importance of structured milieu and the control of aggression came to acquire recognition. This study describes a structured centre, known to be effective in treating disturbed delinquents, using data gathered over twelve years of clinical work, observation and research. Factors considered essential in defining this institution are isolated and made compatible with the factors indicated by Rutter in his review of the residential treatment of delinquents. These factors are being used in a further study which compares the effectiveness of different types of facilities for a range of diagnostic categories.
A Case of Mistaken Identity: A Fourth Ventricular Tumor Presenting as School Phobia in a 12 Year Old Boy*
Authors: Blackman Maurice , Wheler G.H.T.
Published: April 2017

A 12 year old boy was diagnosed as having overanxious disorder of childhood and school phobia. He was later found to be suffering from the effects of a cerebral tumor. Surgical removal of the tumor led to alleviation of the anxiety. The authors utilize this case to illustrate some aspects of differential diagnosis in child psychiatry. In particular, they point out the necessity of comprehensive physical examination in child psychiatry inpatient units. The danger of attributing physical symptoms to functional illness purely in the absence of positive physical findings is noted. The importance of utilizing a biopsychosocial diagnostic model in child psychiatry is stressed.
Criteria and Methodology for Assessing Credibility of Sexual Abuse Allegation*
Authors: Wehrspann William H. , Steinhauer Paul D. , Klajner-Diamond Halina
Published: April 2017

This paper will consider three types of interview that are held with sexually abused children. After discussing common problems in technique, it will suggest a methodology designed to help determine a child's credibility and assist in forming and demonstrating a reliable expert opinion for court purposes. Next, it will describe three types of data crucial in investigating allegations of sexual abuse, and will suggest clinical criteria useful in distinguishing true from false allegations. Finally, it will examine the validity of these criteria, comparing them to those of other workers in the field.
Women in Academic Psychiatry in Canada
Authors: Susan Penfold P.
Published: April 2017

A comparison of numbers of women psychiatrists with faculty appointments and women residents in Departments of Psychiatry in Canada in 1975 and 1985 showed that the average percentage of women faculty has increased from 11.4% to 14.3% and of women residents from 23.5% to 43.4%. Some departments appeared to be oblivious to the special educational role of women faculty and had not discussed the discrepancy between the numbers of faculty and residents. Only two departments were actively recruiting women faculty. The study also demonstrated a continued concentration of women in the lower ranks. Barriers to recruiting women faculty include lack of academic role models, job advertising not specifically designed to attract women candidates, rigid requirements for appointments, women's lack of access to male corridors of power, pervasive underlying doubts about women's abilities and competence based on cultural stereotypes, female socialization which does not lend itself readily to roles of authority, assertiveness and leadership, and the role strain that ensues when women psychiatrists try to combine career, marriage and motherhood. If women psychiatrists are to fill some of the positions in Departments of Psychiatry, which will fall vacant over the next decade, much more attention must be paid to eliminating or diminishing the multiple obstacles for women who chose a career in academic psychiatry.
Transsexualism: Syndrome or Symptom?
Authors: Dolan Jeremiah D.
Published: April 2017

The desire to identify with and assume the role of the opposite gender has been present with us since antiquity. Unfortunately, the syndrome of transsexualism as defined by the DSM-III encompasses many individuals who are seeking a gender change perhaps allowing reassignment to take place when not indicated.

This paper reviews the major classifications applied to the condition of transsexualism and a new model of classification for individuals with Gender Dysphoria is outlined.

It will be shown that by subdividing the condition into those with the hypothesized syndrome (primary (true) transsexualism, or the symptom, secondary transsexualism) a better understanding of gender dysphoria is achieved.

By applying this new model of classification, a management/treatment protocol is outlined which is helpful in dealing with the gender dysphoric patient.
Article
Authors: Laperrière Serge , Sirois Et François
Published: April 2017

The article presents the difficulties of the psychiatric consultation with patients having somatic complaints. A model of evaluation and intervention is proposed in which the link between the somatic complaint and the doctor-patient relationship is emphasized. A closer look at the manifest request for consultation often leads to interpreting the consultation as a symptom of the patient's relationship to his doctor. The consultation is often a confrontation with the hidden conflict of the patient embedded in his symptom, but actualized with his referring doctor. The focus is on the patient as the agent of his trouble. A clinical vignette is presented.
Personnalité passive-agressive et personnalité dépendante — état actuel de la question
Authors: Goulet Jean
Published: April 2017

The author makes a critical review of the literature concerning dependant and passive-aggressive personalities. After putting them in a historic perspective, he presents the various etiologic hypotheses. Special attention is given to the clinical and therapeutic aspects.

The author concludes that despite the supposed high incidence of these two personality disorders, the reliability of the diagnoses and the natural history of the disorders remain to be explored in a prospective and systematic manner, before definite conclusions can be drawn regarding therapy.
Narcosuggestion in Chronic Conversion Symptoms Using Combined Intravenous Amobarbital and Methylphenidate
Authors: Hurwitz T.A.
Published: April 2017

Five patients with chronic conversion symptoms were treated with narcoanalysis and narcosuggestion using combined methylphenidate and amobarbital. The combination of methylphenidate and amobarbital proved useful because methylphenidate antagonized sedation and allowed optimal patient cooperation. In four cases recovery of neurological function was obtainedin the first or second interview and subsequently improved with practice and positive feedback. In each instance recovery of neurological function during a narcoanalytic interview confirmed the diagnosis of a conversion reaction. The narcoanalytic interview also confirmed or uncovered important psychopathology and psycho dynamics which permitted more accurate treatment of the underlying psychiatric disorders.
Acute Confusional State with Status Petit Mal as a Withdrawal Syndrome — and Five Year Follow-up
Authors: Hersc Edwin L. , Billings Ronald F.
Published: April 2017

A 55 year old man developed an acute confusional state with grossly impaired short-term memory accompanied by a Status Petit Mai epilepsy pattern on EEG, one to two weeks after abruptly discontinuing a large amount of oxazepam and a smaller amount of alcohol. Both his mental status and EEG pattern normalized markedly after intravenous diazepam. On 5 year follow-up the patient was seizure-free and medication-free without any significant residual cognitive deficit.
Satanism in a Psychiatric Adolescent Population
Authors: Bourget Dominique , Gagnon André , Bradford John M.W.
Published: April 2017

In a university affiliated adolescent psychiatric facility, providing approximately 250 consultations per year, an unsuspectedly high prevalence of preoccupation with “satanism ” was found in referred adolescents.

Interested by the phenomenon, the authors have identified and documented eight cases in an attempt to isolate common characteristics among the cases. Initially a link between the marginal cult belief and general maladjustment was hypothesized, specifically delinquent behaviour. The study confirmed this trend and showed a significant impairment in the social adjustment of these adolescents. One of the most striking findings was the high prevalence of family disruption and parental abuse. Furthermore, a wide range of psychiatric symptoms were found in our subjects.

This study raises concerns over the psychological development of adolescents who are subject to high levels of psychosocial stress. It will hopefully encourage further work in the area of increased susceptibility towards beliefs and indoctrination.
Therapeutic Community: A Canadian Update
Authors: Stauble W.J.
Published: April 2017

Therapeutic Community is forty years old. This paper describes its origins and reviews the more important contributions in the English speaking literature of the last decade. There have been few contributions from Canadians in spite of an upsurge of interest in Group Psychotherapy in the last few years. Some experiences in Toronto are reported.
Pitfalls and Pratfalls in Consultation-Liaison Psychiatry in a General Hospital
Authors: Rowe Cheryl J. , Billings Ronald F. , Pohlman E. Ralph , Silver Ivan L.
Published: April 2017

As Consultation-Liaison Services continue to develop and expand in general hospitals, psychiatrists must be aware of pitfalls and pratfalls inherent in dealing with medical colleagues and other allied health professionals, as well as with the patients. Practical considerations in answering consultation requests are discussed with respect to “hidden agendas” of the consultee, role and expectations of the psychiatrist, and problem referrals. It is only through mutual respect and collaboration that Consultation-Liaison Services can truly be effective.
Case of Atypical Depression
Authors: Minde K. , Burra P. , Persad E. , Dinsdale H. , Brouillette J.
Published: April 2017

This paper reports on a grand round presentation of a psychiatric case history of a young woman who showed frequently changing symptoms compatible with a major depressive disorder. She also presented with auditory hallucinations and grand mal seizures. All her symptoms were refractory to a wide range of pharmacotherapy and ECT.

In the paper, senior clinicians in neurology, psychopharmacology, psychiatry and social work discuss the phenomenology and possible treatment of this clinical picture. They emphasize the dangers associated with single minded psychopharmacological treatment of an atypical depression and delineate the importance of “organic” symptoms in mental disorders. A twelve month follow-up of the case is provided.
Psychopharmacologic Management of Patients with Borderline Personality Disorder
Authors: Links Paul S. , Steiner Meir
Published: April 2017

This paper reviews recent literature on the psychopharmacologic management of borderline personality disorder (BPD) patients and discusses an approach to drug therapy. Five randomized controlled trials have shown positive, but non-specific effects of antipsychotic drugs on the symptoms suffered by BPD patients. There were too few data on other types of drugs to draw any conclusion. We propose that BPD patients be treated on the basis of being in a state or episode of co-existing Axis I disorder.
Inpatient and Day Hospital Treatment of the Borderline: An Integrated Approach
Authors: Eppel Alan B.
Published: April 2017

An integrated treatment approach to the severely ill borderline patient is outlined. Treatment is conceptualized as a process of progression along a continuum of decreasing levels of care. This involves an inpatient, day hospital, and outpatient phase of treatment. During the treatment process, there are many progressions and regressions. The overall goal is to give the patient an increasing sense of separateness, autonomy, and self-reliance.
Symptoms of Depression in a Canadian Urban Sample
Authors: Barnes Gordon E. , Currie Raymond F. , Segall Alexander
Published: April 2017

The prevalence and correlates of symptoms of depression in a Canadian urban sample were examined. A random sample of 524 respondents completed the CES-D scale and a variety of socio demographic questions. In this Sample, 15% of the males and 19% of the females had scores above the depression cut-point of 16 on the CES-D scale. These rates were very similar to results reported in various U.S. centres. Symptoms of depression were most common among the younger, less educated, and those employed in trades and farming. Depression was lowest in the older, more educated, the married and those employed in professional and management roles. Taken as a whole the set of sociodemographic predictors explained 11%) of the variance in symptoms of depression.
The Preventive Utilization of Foster Care
Authors: Steinhauer Paul D.
Published: April 2017

There is a general, but unproven, belief that long-term foster care is inherently unstable and consistently damaging. This paper discusses eight biological, psychological and social factors that the literature considers responsible for the failures of long-term fostering. It then summarizes the clinical picture presented by such failures, pointing out how changes in the nature of children coming into care have necessitated shifts in the type of foster care required to meet their needs. The major part of the paper uses this knowledge to derive seven keys and associated practical strategies for preventing psychological and social deterioration for children in care.
Children's Adjustment during Custody/Access Disputes: Relation to Custody Arrangement, Gender and Age of Child
Authors: Fidler B.J. , Saunders E.B.
Published: April 2017

The adjustment of preschool and latency age children, at the time of a custody/access dispute between their parents, was studied in relation to the children's age, sex and whether they were living with a parent of the same or the opposite-sex. Few adjustment problems were noted; however, older children and boys were more vulnerable. Sex of custodial parent did not predict children's adjustment.
Psychological Aspects of Ultrasound Imaging during Pregnancy
Authors: Villeneuve Claude , Laroche Catherine , Lippman Abby , Marrache Myriam
Published: April 2017

The psychological impact of ultrasound examination on expectant parents is assessed through direct observation, interviews and the administration of a questionnaire to a large group of parents. The examination was a positive and reassuring experience for most parents. Among a wide array of variables that could account for the effects of the exam, the results were the most important. Women viewing their first ultrasound, specially primiparae were more moved. The results did not confirm that there is a traumatic effect when viewing precedes quickening. Contrary to previous reports, fathers were as emotionally involved as the mothers. The presence of the father seemed also to have a beneficial effect on the mother. One-half of parents wanted to know the sex of the fetus before birth. These findings are discussed, along with implications for problems arising from introduction of new technologies during pregnancy.
Auditory Evoked Potential and Psychiatry
Authors: Thivierge Jacques , Julien Yves
Published: April 2017

An adolescent was implied in a car accident in which he suffered a head trauma without any substantial loss of consciousness. The posttraumatic syndrome was characterized by headaches and mental symptoms: nervousness, feelings of depersonalization, impaired memory, difficulty in concentration. Neurological examination and laboratory tests have always been normal but for a large perduring asymmetry at the Cortical Auditory Evoked Response. This finding is commented in the light of a review of the literature and of some neuropsychological findings.
Dyskinésie Tardive: Mise a Jour
Authors: Shriqui Christian L.
Published: April 2017

Tardive Dyskinesia (TD) is a neurological syndrome associated with long-term use of antipsychotic drug treatment (APD). Its significant prevalence (estimated 15–20%) and potential irreversibility are a major concern in psychiatry.

The clinical picture is characterized by involuntary repetitive movements of choreoathetotic and dystonic nature varying in location and intensity. The individual outcome of TD is unpredictable but recent long-term studies give reason for prudent optimism.

All neuroleptics are involved in the disorder, numerous risk factors have been suggested; advancing age is the only one which has a clearly definite role.

Even though several hypotheses have been suggested, the pathophysiology of the disorder remains a mystery.

Informed consent is discussed in this update with regard to the legal implications of the disorder.

Because of lack of effective treatment, prevention of TD is essential. The present treatment of choice is gradual reduction (and ideally discontinuance) of APD treatment when possible.
Peer Review: Empirical Data Base and Practical Implications
Authors: El-Guebaly N.
Published: April 2017

Psychiatrists in the U.S. have raised a host of issues related to their experience with peer review including a concern for the patient's confidentiality, the need to correlate normative standards with local customary practice, the significance of the reviewer's theoretical orientation and training, the optimal documentation required and the impact of peer review on the reimbursement of claims for services rendered. The empirical and experimental evidence relevant to these issues is reviewed. The resulting implications for our clinical freedom and developing quality assurance network are discussed.
Reflections on the Epistemology of Psychiatry
Authors: Yonge Keith A.
Published: April 2017

A re-examination of the theoretical basis of our practice of psychiatry (that is, its epistemology) reveals the insufficiency of the empirical, inductive approach which we have come to regard, too myopically, as the sine qua non of our science. Traditionally in psychiatry, the discipline of philosophy, of which epistemology is one of its major fields of endeavour, has generally come to be regarded as irrelevant or unreliable as a source of true knowledge. But an objective look at our variegated practice of psychiatry — roughly divided into two groups — the biological on the one side and the psychosocial on the other — reveals a glaring lack of integration, cohesion, or synthesis in basic theory. While analysis is the prime modus operandi of science, synthesis is the main objective of philosophy. While we subscribe to various operational theories to explain how our various procedures work, we lack an overarching, unified, general theory to subsume them. Hence we lack a truly holistic concept of the person who is our patient. In this we are much in need of the discipline of philosophy, which promotes clarity of thought, breadth of comprehension, and systematic (logical) reasoning.

Psychiatrists acquire more of this philosophic expertise through collaboration with professional philosophers (epistemologists in particular) and through the introduction into our graduate psychiatric training programs of some specific course content from the literature of philosophy. As a preliminary suggestion for this, an “Annotated Reading List” is appended.
Treatment Resistant Depression: A Clinical Perspective*
Authors: Macewan G. William , Remick Ronald A.
Published: April 2017

One hundred and fourteen patients with a diagnosis of “treatment resistant depression” (TRD) were assessed and treated at a Mood Disorders Clinic. Diagnostically, 52 (45.6%) subjects met criteria for bipolar disorder, 49 (42.9%) for recurrent depression, and 13 (11.4%) patients did not fulfill diagnostic criteria for affective disorder which explained their treatment resistance.

With appropriate, individualized treatment, 59 of 98 (60.2%) patients had complete symptom remission based on clinical and psychometric ratings (initial Ham-D 26.7, final Ham-D 5.9). Eighteen of 98 patients had partial remission (final Ham-D 15.9) with vigorous pharmacological interventions, and 8 subjects exhibited “absolute” TRD (final Ham-D 23.4). The results suggest the value of specialized mood disorder services. The partial and absolute TRD's were more likely to be older, received more Axis II diagnoses, and had previous histories of drug or alcohol abuse.
Eating Attitudes as Related to Demographic and Personality Characteristics: A High School Survey
Authors: Chandarana Praful , Helmes Edward , Benson Nancy
Published: April 2017

A survey of 577 high school students was conducted to assess attitudes toward eating and their relationship to demographic and personality characteristics. Students completed a demographic questionnaire, and Eating Attitude Test (EAT-26) and the Basic Personality Inventory (A-BPI). When a cut-off score of 20 on EAT-26 was applied, overall prevalence of disordered eating attitude was found to be 7.5%. Groups scoring in pathological versus normal ranges showed no significant difference in mean age, socioeconomic status or race. The former group reported significantly shorter height and lower body weight.

Of the subjects, 6.06% reported weight below the 10th percentile. This subgroup did not vary from those above the 10th percentile on sociodemographic and psychopathological variables, nor in prevalence of abnormal eating attitudes.

Analysis of the A-BPI data showed subjects with abnormal eating attitudes had increased psychopathology in several areas, with greater neurotic tendencies, lower self-esteem and higher levels of deviant thinking and behaviour.
Sex Differences in the Phenomenology of Schizophrenic Disorder
Authors: Allan John A. , Hafner R. Julian
Published: April 2017

The content and structure of delusions were compared in 30 women and 30 age-matched men with Shizophrenic Disorder. Men showed an excess of homosexual persecutory delusions and of grandiose delusions involving social status and personal power. Women showed an excess of delusions of fertility and of jealousy, and were more often than men objects rather than subjects in their grandiose delusions. There was an excess of women who reported co-objects of persecution, and who personally knew their persecutors, nearly always men. These differences mirrored aspects of the social environment, especially with regard to sex-role stereotyping.
A Comparison of Voluntary with Remanded Schizophrenics
Authors: Addington Donald , Holley Heather L.
Published: April 2017

In this study two groups of schizophrenic patients are compared on a number of clinical and demographic variables. The first group consists of 52 consecutive admissions to a forensic assessment unit of patients with a diagnosis of schizophrenia. The second is a consectutive series of schizophrenic patients admitted to two open admission units. Significant differences were found between the two groups. Specifically the forensic patients were more often male, single and antisocial as assessed by previous convictions and more often transient or living semi-independently in sheltered accommodation. They were less compliant with treatment. The two groups did not differ with respect to clinical features such as duration of illness and number of hospitalizations. It is concluded that individual patient characteristics may contribute to an outcome of legal involvement among schizophrenics. The implications of this for service delivery and future research on criminalization are discussed.
Utility of the Beck Depression Inventory with Psychiatrically Disturbed Adolescent Outpatients
Authors: Kutcher S.P. , Marton P.
Published: April 2017

Thirty-seven consecutively assessed adolescents were evaluated at two intervals, one week apart, using the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HLDRS). Scores on the two instruments were compared to each other and to the DSM-III clinical diagnosis. High scores on the BDI were not found to be specific to symptoms of patients with a diagnosis of depressive syndrome but rather measured the degree of subjective dysphoria. The severity of dysphoria was found to be greatest in the group with personality disorders and to vary most in this group from one week to the other. Suggestions for an appropriate use of the BDI in an adolescent population are made.
Psychiatry Training and Research
Authors: Gibson Keith , Addington Donald , Brager Nancy , Fauvel Terry , O'malley Kleran
Published: April 2017

There is a growing concern that residents in psychiatric training programs may not be receiving an adequate exposure to the principles of research. This paper examines the need for such exposure and outlines a framework wherein the fundamentals of clinical research could be demonstrated to the resident physician.
The Inability to Name a Child
Authors: Steinberg Paul I. , Aufreiter Johann , Merskey Harold , Mount John , Rae-Grant Quentin
Published: April 2017

A patient, whose presenting complaint is the inability to decide on a name for her child, is presented. A review of the literature on the significance of names is included, and comments are made on panelists from psychoanalytic and phenomenological perspectives. Management of the patient's depression is discussed.
Mourning and Grief as Healing Processes in Psychotherapy
Authors: Olders Henry
Published: April 2017

The argument developed in this paper can be outlined as follows: relationships are vital for growth, for adults and especially for children; to ensure that we work to maintain relationships, evolution provided for pain on separation, which stimulates behaviours designed to restore the relationship.

If the separation is permanent, it is necessary to form other relationships. This requires modifying the attachment to the lost object, a process which involves unlearning of emotional bonds and then learning new bonds to new objects. The process of mourning and the affective state of grief, I believe, assist in this unlearning and new learning.

The stages of mourning involve cognitive learning of the reality of the loss; behaviours associated with mourning, such as searching, embody unlearning by extinction; finally, physiological concomitants of grief may influence unlearning by direct effects on neurotransmitters or neurohormones, such as cortisol, ACTH, or norepinephrine.

Besides losses occasioned by bereavement, life and normal development include many other kinds of losses. Mourning for these losses is as necessary as mourning after a death. Failure to adequately mourn can result in psychopathology or psychosomatic illness. In comparison, appropriate mourning is adaptive, and parallels can be drawn between it and healing in psychotherapy.

The psychoanalytic and psychotherapeutic literature supports the notion that mourning and grief in therapy act to heal. Given that there may be a biological basis for this healing through the effects of mourning on learning, psychotherapists might actively seek to encourage identification of losses and their adequate mourning in therapy. Various approaches are discussed.

Two case reports of mourning occurring in psychotherapy are given, followed by suggestions for research.
An Appraisal of the DSM-III System
Authors: Adamson John
Published: April 2017

DSM-III is a major document in the history of psychiatry. The DSM-III system is here seen as an instrument that promotes the scientific development of psychiatry and the clarity of cummunication among psychiatrists. However a major theme of this review is that reliability does not ensure validity. While making this point it is recognized that the major defects in the DSM-III system result from scientific inadequacies inherent in present day psychiatry.

This review also may be taken as an amplification of the statement in DSM-III-R that it is not a textbook. In particular the data required to arrive at diagnoses in the DSM-III system do not provide sufficient information to arrive at a comprehensive biopsychosocial case formulation, a shortcoming that has relevance for teaching and clinical practice.
Peut-il y avoir une définition médicale de la crise familiale?
Authors: Kahn J.P. , Witkowski P. , Laxenaire M.
Published: April 2017

In our contemporary society, the traditional multi-generational family has to adapt and to organize itself around a smaller nucleus: “The nuclear family”. Nowadays, the management of the crises which accompany significant Life Events (such as birth, marriage, retirement, death…) within this new family-system, is refrained by the lack of “relays” which were previously provided by the “enlarged family”.

In the absence of available relatives (that is, grandparents, cousins, etc…), it is now the Medical System which is addressed with the demand for help.

Using worthy contributions of the systemic theories, the authors analyze the ambiguity of such a request and the paradox underlying it, namely, to take care of a “normal” family crisis. They emphasize two major dangers consisting of the “designation” of an identified patient and the risk of “phagocytosis” of the therapeutic system by the family system.
Attachment Theory and Brief Psychotherapy: Applying Current Research to Clinical Interventions
Authors: West Malcolm , Sheldon Adreenne , Redtfer Linda
Published: April 2017

Recent advances in attachment research provide a framework for defining the content and process of brief psychotherapy with adults. Attachment theory emphasizes a number of issues crucial to therapeutic work. Specifically, attachment relationships are enduring components of a individual's pattern of interpersonal behaviours. Functionally, attachment relationships address security needs. Insecure attachment arises from a representational model based on feared loss of the attachment figure, which predisposes the individual to have little confidence in the attachment figure's availability, responsiveness, and permanence. Behavioural responses to insecure attachment can lead to specific patterns of interpersonal relationships which, in turn, strengthen the representational model. Thus, a relatively stable, self-reinforcing system evolves and results in a consistent inability to experience security within attachment relationships.

In this article, the authors describe the current framework for understanding adult attachment relationships and present clinical vignettes illustrating the saliency of attachment theory to common clinical presentations. The goal of the clinical intervention is defined as increasing the “permeability” of the individual's working model of attachment through affective and cognitive re-assessment of attachment experiences and expectations. Finally, the utility of this approach in evaluating the outcome and effectiveness of psychotherapy is highlighted.
A Prospective Study of Patient Assaults on Nursing Staff in a Psychogeriatric Unit
Authors: Cooper A.J. , Mendonca J.D.
Published: April 2017

A 27 month prospective study concerned with aspects of patient-nurse assaults on the geriatric unit (three wards) of a Canadian provincial mental hospital was conducted. The findings were compared with those for the other wards. The incidence of assaults was approximately the same in both areas (0.24–0.25 assaults/occupied bed/year respectively). In the former, the commonest diagnoses associated with assaultiveness were dementia followed by schizophrenia and in the rest of the hospital, schizophrenia. However, when base rates of assaultiveness were calculated allowing for the disproportionate number of patients with these conditions, mental retardation, and dementia were approximately twice as likely to be related to assaultiveness as schizophrenia; regardless of where the patients were located. In the geriatric unit attacks were more likely when patients were being physically guided or led and during the administration of drugs; elsewhere whilst physical restraints were being applied. In both hospital areas a comparatively small number of patients accounted for a disproportionate number of assaults and a few nurses were attacked repeatedly. The majority of episodes were trivial but in isolated cases personnel were off work for several months. The discussion focuses on the possibility of generalizing results.
Factors Influencing Medical Students' Intentions to Choose Psychiatry as a Career
Authors: Chandarana P.C. , Loncke M. , Conlon P.
Published: April 2017

Information was collected and analyzed to test a theoretical model of the interaction of previously reported correlates of intention to specialize in psychiatry. Ninety-nine first-year medical students completed a four-part questionnaire designed to demonstrate reasons for such an intention. The three main predictors of intention to specialize in this field were shown to be, in order: perception of others ‘views of a psychiatric career, students’ attitude to psychiatry and their willingness to comply with the views of others. Although sociodemographic and personality characteristics also forecast intention to specialize in psychiatry, they did so only by operating through the three main predictors. The implications of these findings in relation to previous findings are discussed.
Electroretinograms (ERGs) in Four Autistic Probands and Six First-Degree Relatives
Authors: Realmuto G. , Purple R. , Knobloch W. , Ritvo E.
Published: April 2017

This pilot study was designed to determine if prior reports of abnormal electroretinograms (ERGs) in autism could be confirmed and, if so, could patterns of family transmission be identified. Abnormal ERG recordings were obtained from six of the 10 subjects tested two of four autistic probands, two of four siblings, and two fathers. No family patterns emerged from our small sample, but the results point to the need to extend this interesting new area or research.
The Effect of Anticonvulsants on the Dexamethasone Suppression Test
Authors: Keitner Gabor I. , Fruzzetti Alan E. , Miller Ivan W. , Norman William H. , Brown Walter A.
Published: April 2017

Rates of non-suppression on the DST were compared in 19 psychiatric inpatients and anticonvulsants and 38 psychiatric inpatients not on anticonvulsants who were matched for age, sex, and diagnosis. Patients on anticonvulsants had a significantly higher rate of nonsuppression.
Parent Satisfaction in a Child Psychiatric Service
Authors: Kotsopoulos Sotiris , Elwood Sandra , Oke Louise
Published: April 2017

The development and use is reported of a client satisfaction questionnaire to be answered by parents of children and adolescents referred to an outpatient psychiatric program. The structure of the questionnaire and the results from a first application are reported. It is suggested that a client satisfaction questionnaire may become an important feedback instrument useful for service planning.
Asperger's Syndrome: A Review of Clinical Features
Authors: Szatmari Peter , Bremner Rebecca , Nagy Joan
Published: April 2017

The term Asperger's Syndrome (AS) refers to a clinical picture characterized by social isolation in combination with odd and eccentric behaviour. While the syndrome has been recognized for some time, diagnostic criteria for the disorder have not yet been established or evaluated. The objective of this paper is to describe some of the clinical features of AS. Twenty-eight children and adolescents with AS were compared to a group of psychiatric outpatients (matched on age and sex) who were also socially impaired. The AS subjects showed a range of social impairments essentially different than those seen in the control group. The sex ratio, family history, and presence of neurologic disease in some AS cases, suggest that the etiology of the disorder is similar to that in autism. The methodological limitations of the study are discussed, and a revised set of diagnostic criteria are proposed for AS.