bluuebunny/crossref_metadata_2025 huggingface dataset:
Some Social Attitudes to Personality with Implications for Psychotherapy
Authors: Hanley F. W.
Published: April 2017

The patient and the psychiatrist often have different belief systems about personality and its functions. The one held by the patient is derived at least in part, from the values and attitudes toward people of a business-dominated society. Examples of several attitudes are discussed. First, that everyone should be able to solve his own personal and interpersonal problems without assistance. This exaggerated and narrow individualism leads to increasing alienation, reluctance to enter therapy and difficulty in the establishment of a therapeutic relationship. Second, the notion that will power is an entity which can influence and control thoughts, feelings and behaviour leads to much useless effort on the part of the patient. Third, emotions are considered inferior to reason and are distrusted, making the psychiatrist's work of helping patients to recognize and accept their feelings much more difficult. Many self-attitudes are derived from commercial values and the view of human beings as commodities.

The belief system derived from business is materialistic, mechanical, limiting and anti-humanistic. The belief system held by the psychiatrist is humanistic and oriented toward a full-valued, integrated individual. These opposing systems may interfere with communication and hence with therapy. The psychiatrist is not always free from the harmful assumptions held by the patient.
Clinical Guides to the Assessment and Treatment of Depressed Patients
Authors: Wilner Saul
Published: April 2017

The main thesis of this presentation is the contention that in the clinical assessment of a depressed patient one must use not only the relatively coarse criteria of changes of mood and affect, psychomotor retardation, diurnal variation, sleep disturbance, etc. but also the finer criteria centering around his object relationships (2). These latter can be seen in the doctor/patient relationship even in the first interview. A most crucial criterion revolves around how, and to what extent, the patient reaches out towards, or withdraws from, the doctor. The use of these criteria clarifies the indications and contraindications for psychoanalysis, psychotherapy, drugs or E.C.T. in the depressed patient.
A Revalidation of a Depression Rating Instrument the British Hospital Progress Test
Authors: Gerald J. Sarwer-Foner , Sanders Sidney , Gomez E. , Amadeo Marco
Published: April 2017

The BHPT is an inexpensive, easily administered rating instrument for the severity of depressive illnesses. It was administered to 31 patients diagnosed as suffering from one of the depressive group of illnesses, and to 36 non-depressed patients as controls. Weighted scores gave excellent discriminations between the two classes and re-testing measured recovery from depression. The BHPT is thus an excellent rating instrument, useful in clinical and psychopharmacological research and in the psychiatric training programs.
Conditional Reflex Studies in Depression
Authors: Ban T. A. , Choi S. M. , Lehmann H. E. , Adamo Evelyn
Published: April 2017

A conditional reflex test procedure was described which enabled us to reveal and measure the characteristic differences among neurotic, endogenous and schizophrenic depressions. The differences found among the depressive groups were expressed in conditional and unconditional reflex variables. The revealed changes direct attention to the possible pathophysiological basis of the different depressive conditions. This is suggested by the behavioural conditioning method but can only be proven through neurophysiological experiments.
The Role of Punishment in the In-Patient Treatment of Psychiatrically Disturbed Children
Authors: Alderton Harvey R.
Published: April 2017

The role of punishment in the psychiatric in-patient treatment of non-psychotic latency-age children with behaviour disorders is discussed. Punishment is defined as the removal of previously existing positive reinforcers or the administration of aversive stimuli.

Ways in which appropriate social behaviour may be acquired are briefly considered. These include reinforcement of desirable responses, non-reinforcement of undesirable responses, reinforcement of incompatible responses and imitative learning.

The reported effects of punishment on behaviour are reviewed and the psychological functions necessary before punishment can have the intended effects considered. For seriously disturbed children punishment is ineffective as a treatment technique. It reinforces pathological perceptions of self and adults even if it successfully suppresses behaviour. The frame of reference of the seriously disturbed child contraindicates the removal of positive reinforcers and verbal as well as physical aversive stimuli.

Controls and punishments must be clearly distinguished. Controls continue only as long as the behaviour towards which they are directed. They do not include the deliberate establishment of an unpleasant state by the adult as a result of particular behaviour. Control techniques such as removal from a group may be necessary but when possible should be avoided in favour of techniques less likely to be misinterpreted. Avoidance of punishment in treatment makes even more important explicit expectations and provision of realistic controls.

Natural laws may result in unpleasant experiences as an unavoidable result of certain behaviour. By definition such results can never be imposed by the adult. Treatment considerations may necessitate that the child be protected from the results of his actions.

Avoidance of punishment requires a higher staff/child ratio, more mature and better trained staff. Sometimes children have previously been deterred from serious community acting out only by punishment. Should the therapeutic endeavours outlined not prevent such behaviour, treatment in a closed setting without punishment is indicated, not the use of punishment in an open centre.
Treatment of a Case of School Phobia by Reciprocal Inhibition
Authors: Chapel James L.
Published: April 2017

Behaviour therapy by reciprocal inhibition was undertaken on a moderately severe case of school phobia in an 11-year-old boy after an adequate trial of conventional therapy had failed to bring about lasting improvement. A fairly accurate estimate of expended therapy time follows:

First admission to day-school (January 1964):

Five initial sessions (30 minutes each) of relaxation by hypnosis.

Eighteen sessions (20–30 minutes each) of reciprocal inhibition therapy, presenting an average of four hierarchies per session.

Second admission to day-school (September 1964):

Fifteen sessions (20–30 minutes each) of reciprocal inhibition therapy, presenting an average of seven hierarchies per session.

This form of therapy was undertaken as a learning experience by the author and its very good results are in no way meant to imply that one approach is superior to another. Rather, this paper was prepared as a plea for tolerance on the part of all who concern themselves with the treatment of emotionally disturbed persons.
The Diagnosis and Treatment of Borderline Schizophrenia in Adolescence
Authors: Katz Philip
Published: April 2017

It is necessary to establish the presence or absence of a borderline schizophrenic reaction early, for it is of great importance in deciding on the treatment program for the patient. Its presence is suspected if there are symptoms that indicate that the patient is developing a thought disorder, and/or a disturbance of affect of schizophrenic type, and/or is beginning to detach from reality. It is also suspected if there is a persistence of such symptoms as disturbances of judgment, poor empathy and understanding of others, an absence of enjoyment, periods of seclusiveness, or sexual and philosophical preoccupations. Mixtures of the neuroses, with free-floating anxiety often indicates an underlying schizophrenic process.

In the treatment of a patient with a borderline schizophrenic reaction, the prime focus should be on the prevention of a psychosis. The child should be protected against severe stresses, which may involve some environmental manipulation. Anxiety has a deteriorating effect and tranquillizers may have to be used.

Supportive psychotherapy is of great value. It is essential that the relationship with the therapist be a positive one. The therapist should be a real person who offers the adolescent patient someone with whom to identify. One strengthens useful defences and lessens the need for the other defences by reducing the ego's needs for those defences, e.g. by reality testing the fantasied threats, by offering a less punitive and less rigid superego, and by manipulating the environment to reduce stress. It is often helpful to orient the patient towards pleasurable experiences which have an ego-strengthening effect.

Here then, in the handling of the defences and in the management of anxiety, can be seen a major difference in the treatment of patients with a borderline schizophrenic reaction, from the treatment of patients with psycho-neuroses or personality disorders. Failure to recognize the presence of an underlying schizophrenic process may lead to the choice of the wrong treatment program for the patient, with a resultant worsening of his condition and the onset of a psychosis.
Toxic Psychosis Due to Antiparkinsonian Drugs
Authors: Warnes H.
Published: April 2017

Nine cases of transient toxic-delirious reactions during combined antipsychotic-antiparkinsonism treatment have been described. A few days prior to the onset of the reaction, all patients had been placed on an antiparkinsonian drug.

Three clinical phases were observed: an autonomic stage (sympathicotonic signs: mydriasis, dry mouth, anorexia, excitement, disorientation, insomnia, severe constipation); a strio-thalamic phase (dyskinesias, visual and tactile hallucinations) and a post-delirious state (increased sleep and integration).

The pathogenic factors which play a role in this atropine-like toxic condition, such as age, individual susceptibility, drug response per se and the influence of rapid dose changes were briefly discussed.
Studies on the Autonomic Psychophysiology of Lipid Mobilization
Authors: Cleghorn John M. , Peterfy G. , Pinter E. J. , Pattee C. J.
Published: April 2017

Infusion of adrenaline or noradrenaline in man gives rise to increases in plasma free fatty acid level through its indirect action on adipose tissue. Many kinds of psychological stresses have been shown to produce elevated plasma FFA levels. The present work aims to delineate some of the psychological and neurohumoral factors which mediate the external stress which leads to fat mobilization.

In 18 subjects FFA increase following stress was found to be due to a primary increase in FFA production rather than to diminished use. The effect of emotional stress on this phenomenon was found to be significantly less in the presence of beta adrenergic blockade (propanolol). Thus it was concluded that, a) the adipokinetic mechanism of short-term emotional arousal depends on endogenous catecholamine and, b) FFA mobilization under these circumstances is an indirect measure of catecholamine activity.

In two groups of 20 and 24 subjects levels of anxiety and three kinds of hostility were measured from unprompted verbalizations while blood was drawn for FFA determinations. FFA levels were found repeatedly to be positively and significantly correlated with anxiety levels, but not with hostility levels. Maximum FFA levels were found to develop 15 minutes after experimental stress. Even when greater amounts of hostility were provoked by stress interviews, no association between hostility and FFA level was found. The changes in FFA level in REM sleep were also found to be correlated positively and significantly with anxiety levels in 20 dream reports.

Further studies were done on nine subjects from whom blood was drawn for plasma free fatty acid determinations while they were asked under hypnosis to assume alternately a passive and an active approach to a task. In experiments in which the subject was instructed to be passive or active, much greater fat mobilization resulted than in experiments in which he was given no suggestion. The passive attitude stimulated somewhat more anxiety. With the suggestion to be passive and no suggestion, anxiety and FFA ceased to co-vary in the time lag relationship described above.

The significance of these findings for our beginning understanding of psycho-physiological mechanisms in diabetes mellitus, coronary disease and obesity were mentioned.
Psychiatrie Sociale versus Psychiatrie Communautaire
Authors: Lazure Denis
Published: April 2017

The author briefly describes the historical factors in Europe and also in North America which have promoted the development of a type of psychiatry sometimes designated as ‘social psychiatry’ or more often ‘community psychiatry’.

The term ‘community psychiatry’ can be misleading and its increasing use implies, in the mind of many, a value judgment by which a greater prestige is attached to such a category of psychiatric service, in contrast to the hospital psychiatric service. This is an unfortunate consequence; for this reason and others explained in this paper, the author advocates relinquishing the term ‘community psychiatry’ and replacing it with ‘social psychiatry’.

Theoretical and practical considerations on the respective roles of the State and of the community in organizing and maintaining psychiatric services are discussed. The author reflects on a misconception often observed in North America, according to which a so-called community service becomes synonymous with a private service, i.e., not operated and not entirely financed by the Government.

The role of the Government and more particularly of the various pressure groups which can influence decisionmaking on social issues, is presented as being of fundamental importance in social psychiatry.

Furthermore this paper underlines certain dangers which stem from the current tendency to consider hospital treatment as being a last resort measure; e.g. the massive discharge of patients towards so-called community resources which is often accompanied by a deprivation of adequate care which the hospital milieu was providing to those patients.

Finally, a fair distribution of personnel giving treatment throughout all the areas of a given country appears to be a basic prerequisite to any national program of social psychiatry.
Some Notes on Preventive Psychiatry
Authors: Leighton Alexander H.
Published: April 2017

An epidemiological approach is described in detail giving main emphasis to the functional state of a whole environmental system. Criteria were established by which communities were judged in terms of their socio-cultural integration. A high correlation between the prevalence of psychiatric disorders and extremes of disintegration was found. By inducing in one community — the Road — patterns of social functioning including group action and local leadership, changes in the situation and attitudes of the people were promoted. On a re-survey after one decade the prevalence of psychiatric disorders turned out to be much lower than the initial survey.
Stress Reactions Resulting from the Relocation of an aged Population
Authors: Kral V. A. , Grad B. , Berenson J.
Published: April 2017

Fifty-four subjects from 64 to 94 years of age were investigated for their stress reactions following their relocation from one site to another. Forty of them, 16 men and 24 women, were psychiatrically normal, while the remainder (eight men and six women) were suffering from a psychosis, which in all cases, except one, was of organic type.

There was no statistically significant difference between the ages of the men and women, and of the normals and psychotics. The same was true in the case of the body weight, except that the men weighed more than the women. Plasma corticoid (PC) levels were determined two to nine days before relocation and eight to 17 days afterwards.

One-third of the subjects made no complaints in regard to their health within four months of relocation (NC 33%), while the rest either reported symptoms for which there did not appear to be any apparent organic cause (WS 43%) or presented organic signs (OS 24%). Most of the complaints in the WS category were related to the abdomen, while most of those in the OS group were either due to respiratory infections or cardiovascular conditions. The relative percentage of persons falling into these three categories was essentially similar in normal men and in normal women and in psychotic men and psychotic women. However, the psychotics had a significantly higher incidence of OS persons and a significantly lower number of NC subjects than did the normals, while the incidence of WS was essentially the same in these two groups.

Following relocation the PC levels increased in normal men, but decreased in normal women. Furthermore, a greater PC increase was observed in men of the OS group than in those of the WS category, who in turn showed a greater increase than the NC males. This was not observed in the women. Men in each of the NC, WS and OS categories had higher PC levels than women of the same category, and psychotics higher than normals.

Twenty-five per cent of the normal men died within the first six months of relocation but none of the normal women, a statistically significant difference. Within 23 months of relocation reliably more psychotics died than normals.

In conclusion, normal aged men appeared to suffer more from the relocation than normal aged women, and psychotic aged persons more than psychiatrically normal subjects of the same age.
Psychothérapie Brève En Période De Crise: Notes préliminaires
Authors: Saucier Jean-François
Published: April 2017

Drawing our inspiration from the work of Levy (3) and from a brief research made in Notre-Dame Hospital, we present a schema of a crisis oriented therapy in six weekly sessions.

First session: the patient is informed about our brief and intensive program of therapy. He is then invited to give a detailed account of his recent crisis in order to relive it intensively in the presence of an understanding therapist. Tranquillizing medication is then prescribed.

Second session: the therapist conducts a deep exploration of the patient's fear of losing control over his impulses: a clear distinction is made between thought and action. Then an investigation is made about the patient's milieu, in order to measure its pathogenic potential. If information is not satisfactory, an investigation should be made immediately at the patient's home, because the background information is essential.

Third session: a complete exploration is made about the preceding crises and particularly the warning symptoms so as to find a common pattern and to help the patient recognize the onset of a crisis. The therapist makes then his first interpretation, comparing the many crises and noticing certain links between them. Finally, the patient is invited to make some plans for the future to be discussed in following sessions.

Fourth session: the therapist explores deeply the factors, conscious and unconscious, responsible for the crises. If he feels he has obtained a reasonable confirmation of one of his hypotheses, he gives then a dynamic interpretation but in general (not direct) and without insisting if the patient evades it. The last part of the session is given to concrete problems of readaptation.

Fifth session: an enquiry is done about a few current situations which are distressing for the patient, the therapist tries to discover with the patient the means to transform these situations and he helps the patient ‘rehearse’ his new behaviour for the next time he will have to face it. Finally the therapist tries to detect the effects of his dynamic interpretation: if the patient has gained insight, then he could state it more directly.

Sixth session: a general review is made of the affects of medication, interpretations and ‘rehearsals’. The essential is to communicate to the patient an experimental mentality in his interpersonal relations, so he could try many techniques to improve difficult situations. The session is terminated by a discussion about concrete plans of reorganization. A follow-up appointment is given in two months.

These notes present a very sketchy attempt to integrate three techniques: psychiatric treatment, Freudian psychodynamics and learning theory in a crisi situation. Now it remains to test the precise conditions in which this technique will be successful.
Alterations of Sleep Pattern in Psychiatric Disorder
Authors: Ward J. A.
Published: April 2017

Summary and Conclusions

A survey of the sleep pattern change of 87 women patients admitted to an acute psychiatric ward of the Ontario Hospital, Toronto was reported. An alteration of sleep pattern is common to all psychiatric diagnostic categories and the specific symptoms of Evening Insomnia, Morning Insomnia, Frequent Wakening, Light Sleep, Sleep during the Day and Shortening of the total Sleep time is common to all of them. Evening insomnia, light sleep and shortness of sleep are related to the estimated severity of depression while evening insomnia alone was related to the estimated anxiety level. A total increase in sleep symptoms is related significantly to both the estimated depth of depression and the estimated height of anxiety. Shortening of the sleep time and evening insomnia are significantly increased in suicidal patients although changes in the quantity of dreams and increases of nightmares was not. The total sleep symptom score failed to achieve a level of significance. A change in the quantity of dreaming was related to the diagnosis of depression, especially psychotic depression, but not to depression depth, anxiety level, suicidal tendencies or age. Nightmares increased with a diagnosis of psychotic or neurotic depression, with the estimated level of depression but not with the estimated anxiety level or suicidal tendency. Nightmares significantly decrease with age. The factors of anxiety and depressive affect, suicidal tendencies and other like parameters may promise a more significant relationship to sleep disorder than the diagnostic category. The recall of dreams appears to be of more importance for the diagnostic categorization of depressive states than other sleep symptoms.
Analyse Statistique Et Psychodynamique De La Population Canadienne-Française Qui Consulte En Pédopsychiatrie: Étude Préliminaire
Authors: Mackay Jacques , Bigras Julien , Melvyn Carla , Bélair Claudette
Published: April 2017

In this retrospective study covering the total number of patients assessed in the Psychiatric Out-Patient Clinic of St. Justine's Hospital during a period of three months, the authors have accumulated a wide range of data and presented their significant findings concerning both the specifications of the group under study and the manner in which the professional staff had been dealing with the cases. A positive association was found between pathology in the milieu and pathology in the children. A lack of information about fathers was noted. Differences between girls and boys in terms of incidence and types of pathology appeared significant. The authors have been impressed with the high proportion of their cases which had been previously placed in foster homes. It was noted that the type of patients who had been in foster homes presented not so much a more severe pathology but on the whole a ‘noisier’ type of manifestation. Other interesting observations were made on adopted children and on the groups with working and non-working mothers. Some comparisons between the diagnosis and prognoses established by the team, and a study of the relationship between the recommendations made and those carried out, brought about an increased awareness of our own level of efficiency. A survey of the recommendations made for the less talented children indicated a bias in favour of the more talented group.
A Survey of Postgraduate Psychiatric Education in Canada, 1966–1967
Authors: Hunter R. C. A. , Frayn D. H.
Published: April 2017

Our Canadian programs produce about 100 psychiatrists a year and are likely to do so for the next three or four. There are approximately 4,400 medical students in the country at present (5). If we use Funkenstein's figure of 10% of medical students and Clarke and Fish's figure of 11.4% of residents opting for psychiatry it means an indigenous pool of 400 students or 100 a year (4). This number can be increased by foreign medical graduates, reduction in Certification and Fellowship failures, reducing the brain-drain, and inducing Canadian graduates to return home. The country-needs another 785 psychiatrists immediately to attain a 1:10,000 ratio of psychiatrists to population. At the present rates of psychiatrist production and population growth the manpower picture would improve only very slowly. It appears that the capacity of present training programs is not adequate to meet national requirements even if enough trainees were available to fill them. The time is ripe for imaginative and novel solutions to this problem.
Sex Chromosome Mosaicism Associated with a Psychiatric Problem
Authors: Worling R. V.
Published: April 2017

This 65 year old separated female patient with borderline intelligence and a lifelong history of difficulty in interpersonal relationships is presented as illustrative of the association of a psychiatric problem with a chromosomal abnormality — specifically the rare mosaic female chromosome pattern— 46 XX – 47 XXX. The case also illustrates the difficulties one might encounter in chromosomal investigation of such a patient in a general hospital setting where admission is voluntary, as against the ‘captive’ populations of mental hospitals where most of this type of investigation is undertaken.
A Two-Year Clinical Experience with Lithium
Authors: Furlong F. Wayne , Hendrie Hugh , Luby Elliot D.
Published: April 2017

A two year clinical experience with lithium has been described. Our results can be summarized as follows:

Effect on active mania

Over seventy per cent of the manic patients in this study were controllable with lithium alone.

An additional twenty per cent with severe mania had to be stabilized by haloperidol, but were maintained by lithium once the acute phase subsided.

When a patient maintained on lithium shows prodromal symptoms of hypomania an increase in the dose of lithium is often, and for some patients regularly, an effective control for the incipient manic attack.

Some patients required periodic treatment for residual depression. Decreasing the dose of lithium, and adding an anti-depressant has been found to be effective, even in some cases where an antidepressant alone had previously failed to prevent repeated depressions. Merely decreasing the dose of lithium was not found to be effective.

Those who relapsed completely tended to be more hostile and suspicious, and in the authors' experience, ultimately showed schizophrenic features.

One relapse, especially when subsequent to the patient's discontinuing his own medication, does not mean that the patient cannot thereafter, be stabilized on lithium. One relapse should not be taken to mean ultimate failure, when a decrease in severity or frequency of attacks would be a worthwhile goal.
Sensitivity to a Phenothiazine (Butaperazine)
Authors: Simpson G. M. , Laska E.
Published: April 2017

A second study of butaperazine on twenty-two patients compared to a previous group of twenty-four patients revealed rather similar results. Twenty of the subjects were involved in both studies, with an eleven-week period off medication in between the two treatment regimes.

In the first study matched groups received different dose levels, there being no physician's choice of treatment. In the second study twenty of the same patients were subjected to treatment with the same drug, according to a six-week scheme, which was laid down beforehand and then followed by a six-week treatment at the doctor's discretion. Despite marked differences in the dose levels between the two studies, no great differences in improvement were shown with, if anything, improvement being greater in the first study. There was a marked increase in acute dystonic reactions in the patients who received large amounts of starting medication, but no great difference in the amount of extra-pyramidal system disturbance. However, in the second study it was noted that extrapyramidal disturbance appeared earlier, at a lower dose level, was more difficult to control and, indeed, was felt to interfere with behavioural improvement. A hypothesis that sensitization to butaperazine occurred was put forth to explain the discrepancy and was supported by the introduction of a formula for an index of sensitivity.
Consultation and Evaluation
Authors: Lipowski Z. J. , Ramsay R. A. , Villard H. P.
Published: April 2017

This paper describes the experience of providing on-the-spot psychiatric consultations to medical and surgical clinics. Data on the first 100 referred patients are presented, patterns of referral and outcome of the consultations discussed. The following postulates are offered.

The presence of psychiatric consultants in the medical and surgical clinics is desirable in the interest of more efficient care of patients with psychiatric disorders, who reportedly comprise at least half of clinic populations.

The aim of the consultant in this setting should be to facilitate better management of psychiatric problems by the non-psychiatrists and to prevent, as far as possible, automatic and often belated, referrals to the psychiatric clinic.

Proper use of psychiatric consultants should be stressed to the medical students and residents.

More attention should be devoted to the improvement of the techniques of psychiatric consultations to increase their still inadequate efficacy.

Consultants should be members of an organized pyschiatric consultation service which would ensure their optimum performance. We predict that the future introduction of comprehensive medical care will make such a service an economic necessity in every general hospital.
Le Service D'évaluation, Dispositif De Psychiatrie Communautaire
Authors: Doucet Pierre
Published: April 2017

Community psychiatry, the third psychiatric revolution, is viewed as a new task for psychiatrists. We have to make our community benefit from all the recent psychiatric discoveries. Existing psychiatric facilities have to be reorganized to fulfil this role. This has been done at the Institut Albert-Prévost by the inauguration in 1967 of the evaluation service. This service receives all requests made to the Institut Albert-Prévost, evaluates them and directs the patiént to the appropriate facility. In its first year of existence this service received 13,332 appeals and made 4,841 contacts, evaluating individually 897 patients. From this experience the different roles of the service are described. They are for the patients: information, selection and treatment. For the staff they are: teaching, research, and inter-professional relationship. The addition of this service has brought to our attention the most needed improvements in our structure at the present time, which are the increase of outpatient facilities and the addition of new services to the inpatient service. Also a training program for general practitioners seems to be necessary. Finally, even if it is obvious that our services are to be developed quantitatively, this should not be done at the cost of diminution in quality.
De La Genèse De La Consulation Psychiatrique à L'Hôpital Général
Authors: Lepage Antoine , Aird Georges , Briones Luis , Villard Henri-Paul
Published: April 2017

The authors started a new psychiatric unit in a general hospital which had not benefited from psychiatric services before their arrival. They chose as their first target the consultation service, and in working with other physicians they were surprised that, on many occasions, they were not consulted about patients who needed their services but, instead, they were asked to see patients who did not need their services to a significant degree. They began then to question the reasons for the referrals and this paper is an attempt to describe the unconscious or hidden reasons that were not explicitly expressed in the consultation, be it verbal or written, but which motivated the referring physician to ask for the help of the psychiatrist. Briefly, it was discovered that the psychiatric consultation was asked for after a crisis had developed between the referring physician and his patient, and the paper examines the dynamic origins of the crisis, its development and its resolution. The authors feel that their findings might also be applied to patients in the outpatient department and they expand upon the role of the psychiatrist in the general hospital.
Defence-Disrupting Therapy*
Authors: Barker E. T. , Mason M. H. , Wilson J.
Published: April 2017

Although its exact effects are uncertain and the best patterns of dosage and frequency have yet to be ascertained, a combination of scopolamine and methedrine given intramuscularly appears to have some value as a means of rendering young, physically healthy, mentally ill offenders more accessible to treatment when they are participating in an intensive therapeutic community program. It offers a form of control of the psychopathic patient which is superior to heavy doses of tranquillizers or seclusion. In all phases of its employment its effects on the group seem cohesive, providing a focus for concerned and helpful activities.
Méthodologie Pour Une Etude Biochimique De La Schizophrénie*
Authors: Bury Jacques A.
Published: April 2017

All the hypotheses concerning the basic problems of schizophrenia have been disproved, challenged or simply never corroborated. We tried to find the reasons.

The first step in any research seems to be the definition of its object, but there is no definition of schizophrenia.

The influence of the organogenesis versus psychogenesis dispute and of the personal convictions of searchers is inevitable and very often unconscious; it is felt at all the levels of research. The interference of other personal factors is also controversial at the research team level and notably regarding the importance of the illness concerned.

Bleuler spoke about “the group of schizophrenias”, but all the studies are carried out as if, behind the diversity of the clinical description there was one single and constant organic substratum. The limitations which this idea engenders are discussed. The emphasis is on the interest in studying acute beginning forms. Various etiopathogenetic hypotheses are taken into consideration when choosing methodology; it is the least limitating hypothesis which must be the deciding factor, namely that there are, in schizophrenia, some social-psychological and some organic factors, but the presence of only one factor of any kind is sufficient. The methodological conclusions are: the value of longitudinal studies compared with sectional studies, the importance of setting up homogeneous sub-groups for at least one additional datum over that of schizophrenia and the interest of repeating the tests recommended by different schools on the same subjects.

For reasons of facility, most studies deal with chronic patients, and various criteria of selection are shown. Consequences of ‘institutionalization' in a mental hospital (secondary alienation) are also looked at from the point of view of the body: it seems to us that chronicity gradually changes a person into ‘another man’, biologically speaking. The peculiarities of diets in mental hospitals were at the beginning of many contradictions and mistakes in those studies; the part of other independent variables is taken into consideration; such as the level of physical activity, stress and chemical treatments. The problem of control groups for the sectional studies is shown.

Throughout the text, examples are given of repercussions on some studies of the methodological problems raised.
Canadian Psychiatry: A Problem of Priorities
Authors: Weil R. J.
Published: April 2017

I have now come to the end of a very-subjective exposition of contemporary psychiatry, emphasizing especially the Canadian scene. I have attempted to highlight the present status of psychiatry, its increasing interests and ‘expending competencies’ and the inherent hazards of the latter, especially in terms of ‘professional identity diffusion’. I have touched on psychiatry's relationship with medicine and suggested a consolidation of psychiatry on a clinical basis, as well as close affiliation with the behavioural sciences and with the public health profession. Finally, I have set forth for your consideration some ‘priorities for Canadian psychiatry’.
Approche Psychopathologique D'un Cas D'infanticide*
Authors: Gosselin J.-Y. , Bury J. A.
Published: April 2017

This paper relates the case of a twenty-year-old woman who was hospitalized after an acute psychotic reaction suddenly appeared in the immediate postpartum period of her first pregnancy. Her baby daughter died when nine days old; asphyxiation by talcum powder sprinkled by the mother during a short period of confusion or dissociative reactions.

To facilitate a better dynamic approach the main events surrounding the infanticide are reported in detail. Among the hypotheses mentioned in the introduction, the double identification suggested by Arieti seems the most appropriate: He assumed that the new mother must have a double identification; first with her child, to develop a nurturing orientation and second, with her mother to make her feel capable of nurturing.

In this study the identification is with the agressive mother rather than with the nurturing one and there is no adequate identification with the baby.

This paper discusses a specific type of infanticide; the ‘acutely psychotic filicide' committed under the influence of delirium.
The Therapeutic Contract with Adolescents
Authors: Golombek Harvey
Published: April 2017

In this paper the contract commonly established with adults in adult psychiatry is described. Reference is made to the expectations psychiatrists have for themselves and for their patients in the psychiatric contract. Excerpts of an assessment interview held with a teenage patient are given in order to demonstrate some of the attitudes the teenager may bring to his meeting with the psychiatrist. An elaboration of the attitudes commonly held by teenagers as they come to see the psychiatrist is given. The therapeutic attitudes and specific terms of contract found helpful in establishing an effective “Therapeutic Contract With Adolescents” are outlined.
Phenothiazine Treatment and Electrocardiographic Abnormalities
Authors: Lapierre Y. D. , Lapointe L. , Bordeleau J. M. , Tetreault L.
Published: April 2017

We have received the literature on ECG. abnormalities found in patients treated with phenothiazines. A survey of 106 electrocardiograms of patients receiving thioridazine as the only neuroleptic has been made. Fifty-nine patients (55.6%) had ECG. abnormalities considered ‘specific' to thioridazine. No statistically significant correlation could be made on the one hand with the sex of the patient, his age, duration of treatment, dosage level, use of antiparkinsonian medication and on the other hand the presence or absence of ECG. abnormalities. It is suggested that the ECG. abnormalities represent a disturbance in many patients with a particular susceptibility to the drug which is unpredictable at present.
Hysteria—Multiple Manifestations of Semantic Confusion
Authors: Cleghorn R. A.
Published: April 2017

‘Hysteria' is a term with confusing uses covering a variety of conditions often with little or no functional relationship. Some salient historical aspects of the term are reviewed. The three listed categories of so-called hysterical reaction are: Dysmnesic and Conversion Reactions and Hysterical Personality. The first is discussed in summary form; the second and third in greater detail.

Dysmnesic reactions such as amnesia, fugue, twilight and trance states and multiple personality are explained on the basis of gross dissociation. Somnambulism, once included here, has now been shown to be associated with gross EEG. changes, and suggests that modern neurophysiological techniques may yet contribute factual data on the nature of presently obscure cerebral events.

Conversion reactions still remain explicable only in psychological terms, such as suggested by Freud. Present-day views include a wide range of interpersonal events as causal. The tacit association of conversion symptoms with the hysterical personality is no longer tenable. Such symptoms occur in many diagnostic categories. Organic brain disease may favour a predilection to the formation of conversion symptoms. Pain, as a common conversion phenomenon, should be labelled ‘psychogenic regional pain’, as suggested by Walters, but never ‘hysterical’. While conversion may be part of a communication process and often symbolic, it is not necessarily restricted to somatic motor and sensory systems. Certain symptoms, mediated in part or totally by autonomic pathways, may be symbolic or include conversion reactions in their chain of events. The psycho- or physiodynamics of conversion remain obscure.

Attempts to hew a syndrome out of the coincidence of multiple conversion symptoms in women with so-called hysterical personalities are unjustified and becloud thinking about the events involved.

The type of personality called ‘hysterical' or ‘histrionic' is only related to the dysmnesic or conversion categories by the semantic misdemeanor of confused usage of the word hysteria. It impies a person with childlike egocentricity and affective lability, on which is superimposed the more adult skills of melodrama and coquettishness. The psychodynamics of such personalities is discussed and a comparison made to Harlow's parent-deprived monkeys. The common difficulties in sexual relationships are commented on.
Toward a Medical Understanding of Marihuana
Authors: Schwarz Conrad J.
Published: April 2017

This paper is based on a review of the English language medical literature over the past 35 years on Indian Hemp, with direct reference being made to the more significant articles published during that time. The paucity of direct experimental observation is noted and the difficulties in experimental studies are highlighted by descriptions of the wide variations in the potency of Indian Hemp derivatives. Specific references are provided for the wide range of observations made in relation to acute and chronic physical and psychological effects, personal characteristics of the users and possible factors in causation. It is concluded that marihuana is a poorly defined intoxicant which varies in potency, deteriorates with time and whose chemical composition is largely unknown at present. There are wide variations in human response and the state of intoxication itself carries with it varying degrees of unpleasant physical and psychological experiences. The association between hashish and, to a lesser extent, marihuana and short-term and long-term complications is discussed in relation to complex variables, of which the drug is but one factor.
A Tissue Culture Study of Morphine Dependence on the Mammalian CNS
Authors: Ghadirian A.
Published: April 2017

The addicting influence of morphine sulfate on the nervous tissue of new-born rabbits and puppies was studied by using the tissue culture technique. Certain low concentrations of morphine seemed to stimulate the growth of the cells as mitosis and proliferation increased. Nerve cells subjected to morphine sulfate developed increasing tolerance and physical dependence, which was tested through the processes of exposure to higher concentrations of morphine sulfate, withdrawal and reintroduction of this drug to the tissue cultures.

Symbols in Figures

MS: morphine sulfate DIV: days in vitro T.T.: number of test tubes RMS: reintroduction of morphine sulfate
Chronic Perchlorethylene Poisoning*
Authors: Gold Judith Hammerling
Published: April 2017

A case of a forty-seven year-old male with a three-year history of daily prolonged exposure to perchlorethylene has been reported. Acute symptoms included nausea, vomiting, dizziness, staggering gait and disorientation followed by deep sleep. Chronic symptoms were fatigue, irritability, lability of mood, inappropriate affect, mild disorientation, difficulty with recent memory and perserverative stammering speech, which remained over a twelve-month follow-up period despite lack of further exposure.

The literature on perchlorethylene intoxication was reviewed and a marked similarity of the patient's symptoms to those described by other authors was noted. This case differed in the length of exposure and the persistence of symptoms a year after exposure had ceased.
Nicotinic Acid in the Prevention and Treatment of Methionine-Induced Exacerbation of Psychopathology in Schizophrenics
Authors: Ananth J. V. , Ban T. A. , Lehmann H. E. , Bennett J.
Published: April 2017

In this placebo-controlled crossover study nicotinic acid, in a fixed dosage of 3000 mg. a day, produced statistically significant improvement in chronic hospitalized schizophrenic patients. We were able to reproduce the clinical observations and the results of previous workers; that is, the exacerbation of psychopathological symptoms by the combined administration of methionine and tranylcypromine. Nicotinic acid failed to prevent by prior administration or to relieve by subsequent administration, the methionine-tranylcypromine-induced exacerbation of psychopathology. This might have been due to the inadequate dosage of nicotinic acid given but the possibility of a toxic psychosis due to the metabolite, methionine sulfoximine, must be seriously considered.
Kachigumi: A Collective Delusion among the Japanese and Their Descendants in Brazil*
Authors: Kumasaka Y. , Saito H.
Published: April 2017

In August 1945 the Second World War ended. The end of the war precipitated a sharp division of the 300,000 Japanese community in Brazil over its outcome, and a large majority believed that Japan had won the war and they came into conflict with the minority who acknowledged the defeat of Japan. The ensuing bitter conflict within the Japanese community in Brazil continued over several years and eventually led to the assassination of more than fifteen community leaders. As time passed, a majority of these victory-believers came to grasp the reality, but there are still remnants of fanatic victory-believers who shut themselves off completely from other Japanese. A chronological account of the event is reported in this paper from the perspective of the process of acculturation of Japanese immigrants to Brazilian culture.
Successful Treatment of ‘Drinamyl’ Addicts and Associated Personality Changes
Authors: Kraft Tom
Published: April 2017

This paper seeks to evaluate the personality of two young ‘Drinamyl’ addicts before and after a course of treatment which aimed at removing social anxiety by systematic desensitization. Attention has been focused on the personality alteration which followed their treatment, and the argument is put forward that this change may have been a major contribution toward their recovery. The addictive drug taken by these patients is treated as being of secondary importance, and emphasis has been placed on the underlying personality difficulties which were conducive to their addiction. The patients were given several personality tests before and after treatment and the considerable differences are in accord with the clinical findings.
The Children's Pathology Index as a Predictor of Follow-Up Adjustment
Authors: Alderton Harvey R.
Published: April 2017

The adjustment of 16 boys treated in hospital for acting out behaviour disorders was studied. The discharge Factor I score was 157 or more in Group I (8 subjects) and 156 or below in Group II (8 subjects). As predicted, Group I boys showed significantly fewer antisocial difficulties following discharge. A low Factor I score also predicted hyperkinetic symptoms but at a much lower level of confidence and Factor III (destructive behaviour) predicted antisocial difficulties but less effectively than Factor I (disturbed behaviour towards adults). No advantage was gained by using other than the Factor I rating and it is concluded that this score based on only 10 categories helps to identify boys who on discharge will have continuing serious antisocial difficulties.