bluuebunny/crossref_metadata_2025_split huggingface dataset:
The DSM-III in Canada: A Survey
Authors: Junek R.W. 
Published: April 2017

A survey of the membership of the Canadian Psychiatric Association (CPA) was completed for the Scientific Council to discover, first, the reaction of the members to the Diagnostic and Statistical Manual, Third Edition (DSM-III) and second, the support given to the CPA Policy of not endorsing a particular classification system. A total of 26.3% responded. It was noted that 66.6% had studied the DSM-III in detail. Whereas the ICD-9 and DSM-II were the most used systems in the past (28.5% and 25.9% respectively), first choice systems for the future were DSM-III, 42.0% and ICD-9, 16.3%. Furthermore, the DSM-III was recommended to be used as the sole system to various associations, (Statistics Canada, Royal College, Medical Council of Canada and Postgraduate Programs) 45.9% to 51.4%, depending on which association (vs. 8.7% to 13.4% for the ICD-9). Of those responding to the question, 70.8% had a favourable impression of the DSM-III and a similar percentage wanted an ICD-10 which would incorporate features of the DSM-III. A survey of directors of postgraduate psychiatric training programs gave similar results. A total of 54.8% of the members supported changing the CPA “non-endorsement” policy. As well, 39.7% voted to maintain the policy and 5.5% did not respond. The survey provides information for the CPA in its consideration of policy about the use of classification systems. Should the policy be changed, and one system endorsed, the DSM-III receives the most support.
Today's Resident — Tomorrow's Psychiatrist*
Authors: Leichner Pierre , Harper Dan 
Published: April 2017

A survey of 201 Psychiatry residents in Canada was conducted to obtain the opinions of today's residents on a number of controversial issues which may reflect their development as tomorrow's psychiatrist. Generally, this group of residents felt that an internship and training in Neurology and Internal Medicine should be a requirement for residents. Research, psychoanalysis and personal therapy were seen as non-essential assets to the training of a psychiatrist. These residents also showed a definite willingness to learn about the treatment of the seriously mentally ill and the chronic patient by making a rotation in a mental hospital a requirement during their training. The majority felt strongly that their professional identity was primarily that of a physician and were most supportive of a biopsychosocial model as basic to both practice and research in Psychiatry. They acknowledged that role diffusion was a problem in Psychiatry. They saw themselves as different from psychologists, social workers and psychiatric nurses in their ability to develop a differential diagnosis, to arrive at a diagnosis, to prescribe chemotherapy, to decide the necessity for admission, to act as therapeutic team leaders and bear the final medicolegal responsibility. Practising psychotherapy was not seen as a differentiating factor. These results would seem to indicate that most of these future psychiatrists are developing their interest in a direction compatible with the predictions of educators who see tomorrow's psychiatrist as more of a psychobi-ologist. Their role definition is very much in keeping with the recommendations of administrators in view of the manpower shortage. However, before rejoicing at this apparent trend one must remember that once out of training psychiatrists may drift towards endeavours that are more rewarding ideologically and financially. Fee schedules and working environments need to be changed in order to support this change in focus. Another concern is that this direction may weaken the psychological basis of our profession.
Studies in Hysteria
Authors: Guze Samuel B. 
Published: April 2017

This paper describes how the idea of substituting “Briquet Syndrome” for “Hysteria” developed. It emphasizes the need to base the diagnosis firmly on clinical features and also the value of differentiating “polysymptomatic” forms (Briquet Syndrome) from “conversion” symptoms (unexplained neurological symptoms). Other studies have shown that there is a preponderance of Briquet's Syndrome in women, and that female relatives of patients have an increased prevalence of Briquet's Syndrome, while male relatives have an increased prevalence of antisocial personality and of alcoholism. Conversely, a study of female relatives of a male prison population reveals a high prevalence of Briquet's Syndrome amongst them. It is suggested that the association between Briquet's Syndrome and antisocial personality may explain many clinical and epidemiologic observations.
The Assessment of Depression in Normal Adolescents — A Comparison Study
Authors: Yanchyshyn Gordon W. , Robbins Douglas R. 
Published: April 2017

This pilot study addressed two questions. The first was whether the combination of an observer scale (Hamilton Rating Scale) and a self-rating scale (Carroll Self-Rating Scale, modelled after the Hamilton) can make a valid distinction between the frequency and severity of depressive symptomatology in adolescents not referred for treatment, and psychiatric inpatients. The second was whether Major Depressive Disorder (MDD) could be recognized and diagnosed in “non-patient” adolescents using this interview and rating scale approach. The median Hamilton and Carroll scores of the school students differed significantly from those of the in-patients, though the scores alone did not correspond with the presence or absence of MDD. Only 1 of the 26 (3.8%) tenth grade “students interviewed appeared to have MDD, compared with 9 of 33 (27%) adolescent inpatients studied previously with the same methodology. The strength and limitations of this interview and assessment approach are discussed.
Story Telling: A Creative Therapeutic Technique
Authors: Stirtzinger Ruth M. 
Published: April 2017

This paper describes the “mutual story telling” therapy as it is used to aid the young child Joshua in finding healthy ways of dealing with conflicts that cause disruptions in his home and school life. In this therapeutic process, Joshua's stories illustrate growth in ability to integrate good and bad parts of himself, to acknowledge his own anger and to express it without fear of annihilation; to feel the ego strength necessary to allow him to explore his external world.
Psychodynamic Aspects of Occupational Stress
Authors: Wasylenki Donald A. 
Published: April 2017

Freud described work as that which attaches the individual most firmly to reality. Many patients present to psychiatrists with disturbances in the capacity to work. This paper reviews common psychodynamic constellations in such patients in the belief that depth psychological approaches should complement recent person-environment fit considerations. Work inhibitions may arise from repressed aggression and/or sexuality displaced onto occupational tasks. Fear of success may be rooted in both oedipal and pre-oedipal conflicts. Work compulsion may evince attempts to appease a harsh super-ego. Chronic job dissatisfaction often arises from maladaptive attempts to regulate self-esteem. More importantly however, these disturbances frequently arise from interacting dynamic factors which must be carefully attended to by clinicians.
Depression and its Treatment in Alcoholics: A Review
Authors: O'sullivan Karl 
Published: April 2017

The relationship between Affective Disorder and Alcoholism is complex and has been studied extensively. Increased rates of depression are reported in alcoholics and in families of alcoholics. Some studies report that drinking behaviour may be influenced by the coexistence of depressive disorder while others indicate that depressed mood has little impact on the course and treatment of alcoholism. Some people who are depressed turn to alcohol as a form of self-medication and many of these have positive results from it, both due to the pharmacological effects of the drug and the self-limiting nature of most depressive episodes. Those with more severe depression, however, are less likely to benefit in this way. Excessive alcohol taken under such circumstances results in diminishing returns; alcohol becomes more of a contributor to the problem than a solution to it. There is no convincing evidence that drugs including anti-depressants and lithium are effective in the treatment of depressed alcoholics, except for those minority of patients where the diagnosis of primary affective disorder can be established. In such cases the indications for lithium and anti-depressant usage are similar as for non alcoholics with affective disorder. Decisions about the choice of treatment to be offered the alcoholic must be made as quickly and as accurately as possible and can only be done after a careful assessment, which may include hospitalization. It is worth noting that the pharmacologically induced depression of heavy drinking and the depression associated with the withdrawal phase may be clinically similar to the depression of primary affective disorder.
Article
Authors: Hodgins Sheilagh , HÉBert Et Jacques 
Published: April 2017

The study presented here aims to gather descriptive information which would be useful to the development of research hypotheses, policies, and treatment programmes for persons suffering from mental illness who commit crimes. The project tracked a cohort of 225 persons for the seven to nine years after they had been judged unfit to stand trial or not guilty by reason of insanity. A comparison is made here between the cases treated in a maximum security hospital and those treated in other hospitals. The population studied is characterised principally by its misery. The majority are individuals who have been diagnosed as psychotic, who have few, if any, personal or social resources and who live on the edge of society. Thirty-six percent of these cases were treated in a security hospital. Of all the variables studied, only a few distinguished these cases: the place and type of crime of which they were initially accused, the length of out-patient treatment, the type of residence once released from hospital, and the occupation. Questions are raised with respect to appropriate treatments for such persons.
Diet and Monoamine Oxidase Inhibitors: A Re-Examination
Authors: Sullivan Elizabeth A. , Shulman Kenneth I. 
Published: April 2017

Monoamine oxidase inhibitors (MAOIs) are attracting renewed attention as effective antidepressants for refractory depressions, particularly among the elderly. However, widespread fears concerning the interactions of MAOIs with tyramine-containing foods have led to the development of long and complicated diets. These diets have served as an obstacle to the ready use of MAOIs, yet very little systematic or critical review of the basis for food restriction has been undertaken. An international survey of MAOI diets was conducted and from the diets collected, foods were categorized according to frequency of restriction on the diet lists. On the basis of this survey and a critical review of the literature it was determined that only four foods clearly warrant absolute prohibition: aged cheese, pickled fish (herring), concentrated yeast extracts and broad bean pods. While there is insufficient evidence to prohibit alcohol completely (even chianti wine) true moderation must apply. It is suggested that a radically simplified diet should be investigated on a prospective basis.
An Assessment Approach to Couples with Sexual Problems
Authors: Watters W.W. , Askwith J. , Cohen M. , Lamont J.A. 
Published: April 2017

We have described the assessment approach to couples with sexual complaints used in the McMaster Human Sexuality Clinic. Our approach takes into account a number of individual factors including intrapersonal and biological ones as well as issues of sexual socialization, gender role socialization and sexual orientation. Couple factors include relationship factors as well as factors dealing with sexual behaviours, attitudes and responses. In our view, the issues of sexual socialization and gender role socialization needs special emphasis in assessing such couples. We stress as well that the dichotomy between organic and functional is a misleading one and that for each individual and couple, any biological factors and the many supra-biological factors listed above, must be prioritized in terms of their role in symptom production. Such apriority list can then be used to map out treatment strategies.
Marital Adjustment and Fatherhood
Authors: Robson B. , Mandel D. 
Published: April 2017

This paper examines the relationship between marital stability and fathers’ bonding to their first born infants. Current literature reports on the significant and unique influence of the father on his developing infant (1–7) and the influence of the father on the mother-infant bond (8,9). Some authors (10–12) suggest that prematurity, the type of delivery, or a father's presence or absence at the birth, influences his engrossment or bonding and later caretaking behaviour. However, little attention has been given to other factors such as the father's personality, education, previous experience with child care or his relationship with his spouse. Similarily, there is a paucity of research on the effect of the birth of the infant on the marital bond. Einzig (13), Wente and Crockenberg (14) and Dyer (15) suggest that the transition to parenthood is a crisis in the family life and can lead to disruption in the husband-wife relationship. With the apparent increase in family instability in the last decade as marked by the rising divorce rate (16), it seems crucial to explore what correlation, if any, exists between marital condition and a father's relationship to his newborn infant.
Psychopathology in the Offspring of Parents with Bipolar Affective Disorders
Authors: Laroche C. , Cheifetz P. , Lester E.P. , Schibuk L. , Ditommaso E. , Engelsmann F. 
Published: April 2017

Thirty-nine children from intact families with a manic-depressive parent were evaluated by a semi-structured clinical interview and a number of rating scales for the presence or absence of psychopathology. This sample represents a larger one than in an earlier study, which showed minimal offspring psychopathology compared with reports of other investigators. The current study also examines the inter-relationships between the presence or absence of offspring psychopathology with both genetic loading and a number of psychosocial variables including measures of parental marital adjustment, severity and chronicity of proband parent illness and early exposure of children to parental illness. Nine of the thirty-nine children, (23%) received a positive DSM-III diagnosis, with depression of the dysthymic type being the most common. There was no significant correlation between genetic loading and offspring psychopathology. However, there were significant associations between children with psychopathology and paternal marital dissatisfaction and the age and chronicity of illness of the proband parent as compared with the children with no psychopathology.
Is There an Obsessive Psychosis? Aetiological and Prognostic Factors of an Atypical Form of Obsessive-Compulsive Neurosis
Authors: Solyom L. , Dinicola V.F. , Phil M. , Sookman D. , Luchins D. 
Published: April 2017

The study explores whether an atypical form of obsessional illness can be delineated and separated from the conventional form of obsessive-compulsive neurosis (OCN). From a group of 45 obsessive patients, 8 were selected on the basis of 3 criteria: (a) presence of a severely debilitating main obsessive symptom; (b) bordering on the delusional; (c) no schizophrenic symptoms. Assessment and outcome measures included the Psychiatric Questionnaire, the Leyton Obsessional Inventory, Fear Survey Schedule, and IPAT Self-Analysis Form. Self-assessment forms allowed patients to make social adjustment and neurotic symptom ratings. In a multi-modal approach, patients were assigned to behavioural and pharmacological treatments on the basis of severity. Reassessment took place after 50 sessions of therapy. Results of analysis of variance statistics indicated that the atypical group had a more malignant form of illness, with more varied and severe obsessions. A poorer prognosis for the atypical group was indicated by: greater social maladjustment, poor employment records, illness of longer duration showing no remissions despite more courses of treatment, and poor response to treatment throughout. The atypical group manifested fewer characteristic features of OCN (example: fewer precipitating events). On the other hand, schizophrenia was not imputed, although delusion-like experiences in the atypical group suggest a psychotic form of illness. The term “obsessive psychosis” suggested by Strauss (1) and recently investigated by Weiss et al (2), and Robinson et al (3) is proposed for our atypical group. Results are compared with those of other investigators. It is concluded that the delineation of a subgroup of obsessional illness is desirable for research and therapy, since a form of atypical obsessional illness or obsessive psychosis can be differentiated on aetiological, phenomenological and prognostic factors.
Premenstrual Syndromes: Past and Future Research Strategies
Authors: Rubinow David R. , Hoban Christine , Roy-Byrne Peter , Grover Gay N. , Post Robert M. 
Published: April 2017

Premenstrual Syndrome remains a poorly understood controversial disorder largely because of the errors in design found in research into this subject. The first task is to clearly define the entity to be studied. It is necessary to look at the nature, intensity and time of occurrence of symptoms in relation to menstruation. One must further differentiate the appearance of symptoms premenstrually from the premenstrual exacerbation of symptoms present throughout the menstrual cycle. Research has clearly shown the superiority of prospective versus retrospective data in establishing a linkage between symptoms and menstruation. Premenstrual Syndrome research offers a unique opportunity to study classical psychiatric disorders. A relationship appears to exist between this syndrome and major affective disorders. Studies of the appearance or exacerbation of mood disturbances in relation to the menstrual cycle may inform us about the development, course and vicissitudes of psychiatric illness.
Violence and Youth
Authors: Shamsie S. Jalal 
Published: April 2017

Violence is looked at from ethological, biological and anthropological points of view. The family is examined to determine the roots of violence. Various prospective studies are reviewed to assess the role of temperament, social, familial and economic factors facilitating the development of antisocial and violent behaviour in the youth. There is also a look at the violence committed by groups, nations or governments in the name of God, flag or a just cause. The role that mental health professionals could play in preventing the development of violent behaviour is discussed.
Multiple Attempters of Suicide Presenting at an Emergency Department
Authors: Reynolds Paul , Eaton Philip 
Published: April 2017

As part of a study involving seven hundred and forty-seven (747) consecutive cases of self-injury presenting at the emergency department of an inner city hospital, data pertaining to a multiple attempt group of ninety-nine subjects were compared with the data pertaining to first attempters. All subjects were rated on Beck's Lethality Scales, Intent Scale and Hopelessness Scale. In addition, a standard interview was conducted to provide psychosocial information. Of the total suicide attempt population, 14% can be considered chronic. The multiple attempters were found to show more chronicity in their symptomatology, poorer coping histories, a positive family history of suicidal behaviour and a positive history of alcohol and drug abuse, all at a statistically significant level compared with first-time attempters. The multiple attempters also tend to show higher lethality and depression ratings, less impulsiveness and are significantly more often admitted to the in-patient unit following the attempt, than first attempters. Their intent scores were significantly related to their sense of hopelessness, which may be a reflection of their basic feelings of inadequacy. It was concluded that the multiple or “chronic” attempter differed sufficiently from the first-time attempter to warrant special intervention strategies.
The Benefit of Lithium Carbonate Adjunct in Refractory Depression — Fact or Fiction?
Authors: Kantor David , Mcnevin Stephen , Leichner Pierre , Harper Dan , Krenn Marlene 
Published: April 2017

Our group attempted to validate previous claims of rapid success with lithium carbonate adjunct therapy in antidepressant-resistant depression. Seven depressed patients volunteered for a study of placebo controlled, double-blind design. During their treatment on general hospital psychiatric wards, these patients received antidepressant medication for a period of at least 21 days. While continuing to receive antidepresant medication after the 21 day period, four of the patients then received lithium carbonate, and three received placebo. This combination pharmacological therapy continued for a 48 hour period. After this time, six of the seven patients showed no significant improvement. The remaining patient, who had received lithium carbonate, improved markedly over the 48 hour period. However, this patient relapsed within one week. A review of the two most extensive studies claiming significant results with the lithium carbonate adjunct therapy was performed. We feel that they, as presented, leave serious doubt as to the validity of their conclusions. We conclude that on the basis of our work up to this point in time and the analysis of previous reports claiming otherwise, no valid evidence exists for a consistent therapeutic effect of lithium carbonate adjunct in antidepressant-resistant depression. It was also found that methodologic contamination necessitated the exclusion of an additional six patients from the double-blind trial. We conclude that in order to objectively examine the rapidly expanding field of biological psychiatry, teaching of clinical staff in basic research procedure should be stressed as apart of routine ward orientation.
Impact of Removing the Waiting List upon Clinic Intakes
Authors: Brooker B.H. , Joynt M. , Froese A.P. 
Published: April 2017

This study reports the results of eliminating the waiting list for a one month period in 1985 upon the referrals made to an out-patient Child and Family Clinic. The Clinic receives most of it's referrals from community physicians and agencies. The study was carried out amidst a background of an increasing number of referrals. Fifty-nine referrals, mainly families, were received. Among those who were referred and seen, most (58 percent) accepted the offer of a no wait appointment and completed the referral within about one week. A smaller number (17 percent) did not respond to such an offer but later completed the referral. Thus, 76 percent of the referrals overall were completed within 6 months. This was essentially the same as the completion rate for a comparison sample in 1984 (77 percent). The kinds of problems found among these two groups, as well as among the “non-completers” was analysed. One trend was that cases involving family dysfunction tend to show early or not at all. Overall, the large percentage (60 percent) of families with histories of separation problems as an associated variable, suggested this as a possible explanation for the increasing number of referrals in recent years.