bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of L.S.D. 25 (D-Lysergic Acid Diethylamide) in the Treatment of the Sexual Perversions
Authors: Ball J. R. , Armstrong Jean J. 
Published: May 2017

1. A method of using L.S.D. 25 in the treatment of sexual perversions is given, using a large dose and single administration, requiring admission for three days. 2. Two illustrative case histories are given.
Considérations Sur L'identité CLinique Et Diagnostique De La Schizophrénie Infantile
Authors: Delage Jean 
Published: May 2017

Since its earliest descriptions, the concept of childhood schizophrenia has changed considerably. Some contemporary clinicians and researchers have made it so broad as to include a wide range of clinical entities which confuse the picture. The author has attempted, in the light of the most prevalent psychopathological theories, to untangle this confusion, and stress the importance of the psychotic nucleus in childhood schizophrenia. Pseudo-neurotic and borderline cases should be carefully assessed and eliminated, as well as hallucinatory conditions found in many organic syndromes. A strict differential diagnosis respecting the essential psychotic components of schizophrenia should help delineate childhood schizophrenia as a separate clinical entity and afford means of re-evaluating the literature on this subject in a more critical light.
Immigration and Ethnic Origin in Mental Illness
Authors: Ward T.F. 
Published: May 2017

A retrospective study of the prevalence of serious mental disease in the southern half of the Canadian province of Saskatchewan was made. The total admissions to the area's Provincial Mental Hospital during the year 1957 were reviewed. A selection was made from the hospital files on the basis of migration and ethnic status. English, German and Ukrainian groups (with a further division into foreign-born and Canadian-born groups) who represented the largest ethnic components of the population were chosen. They were studied to determine the acceptability of four hypotheses. 1. That the ethnic components chosen have different general (social) characteristics on the basis of their derivation from different cultures. 2. That the ethnic components chosen present different forms of mental disease in the community. 3. That the foreign-born and Canadian-born groups have different general (social) characteristics on the basis of derivation from different cultures. 4. That the foreign-born and Canadian-born groups present different forms of mental disease in the community. The Chi square method was used to determine the significance of the groups of factors chosen for each hypothesis. Discussion of the results emphasizes that Hypotheses 3 and 4 should be accepted. The greatest single factor for the acceptance, however, is neither the migrant nor the ethnic status of the individual but rather age. The discussion includes a review of the possible reasons for the great significance of this factor rather than cultural and ecological difficulties mentioned in other papers.
A Survey of Cerebral Tumors Presenting at a Psychiatric Institution
Authors: Mctaggart Andrew N. , Andermann Frederick , Bos Carlo G. 
Published: May 2017

1. A 16 year review is made of the circumstances surrounding the admission of a patient with unsuspected cerebral tumor to an open psychiatric hospital. 2. The incidence of such patients represents 0.2% of admissions. 3. On retrospective analysis, organic mental changes were demonstrated in all cases and frequently were the earliest indication of disturbance. Awareness of the possible nature of these changes led to accurate diagnosis in some cases. 4. The incidence of psychotic or neurotic manifestations were frequent in the patient's pre-tumor history. This incidence was higher than would have been expected in a comparable group of patients admitted to a general or neurological hospital setting. 5. The misinterpretation of psychological mechanisms operating in response to the illness tended to confuse the diagnosis, particularly in the case of the slow growing tumors. 6. Neurological examination was the technique which often raised the suspicion as to the underlying pathology. 7. An integrated approach using previously outlined clinical and laboratory methods would appear to offer the best mode of detection at the present time.
Karl Jaspers: On the Occasion of his Eightieth Birthday
Authors: Pivnicki D. 
Published: May 2017

Jaspers has remained devoted to our discipline throughout his life. Psycho-pathology, the meeting point of clinical psychiatry and psychology, was not only his first major interest but continued to be the nucleus of his entire work. For him, the rigour of scientific method is the touchstone of philosophy. Only a man trained in the filigree of complexities of scientific collecting, classifying and reclassifying and who has not lost himself in it, will be qualified to take the step toward the utmost limits of human experience and the “enlightening of human existence”. Most of the problems and controversies Jaspers brought to light for the first time and attempted to scrutinize are still with us. Very often we gain the impression that some of his ascetic restrictions have forestalled solution. Practical, everyday psychiatrists found Jaspers' abeyance difficult to tolerate and felt his attitude even as an humiliation. Possibly that is the reason that new schools have eagerly attempted to give final answers and that intermittently positive and negative criticisms of his work have been heard. W. Wagner (1957) in one of his notes expressed the feeling that “the shadow produced through Jaspers' way of thinking has become greater in time than the light that his psychopathology has brought into our understanding” …. Is this type of criticism pertinent? Has Jaspers really “dogmatized” psychopathology to the extent of limiting the possibilities of a further development? … The impression prevails that if his works are taken as a scholastic dictum, this may happen: however, this would be entirely against the spirit of his works and would endanger their very meaning. Jaspers tried to open new horizons for us and to increase our awareness in the performance of our daily work by showing how involved it is. Unfortunately, in this endeavour of his Jaspers remains alone. He gave us the example of a scientist and philosopher. He showed us some directions in which to search and to study, but he did not give us precepts which could be adopted as a sure means to extend and concretize his herculean orienting effort. He leaves us in an ambiguous situation. Therefore it is difficult to become a disciple and to follow him on the road of human understanding.
Doctor-Patient Relationship
Authors: Myers J. Martin 
Published: May 2017

Because everything the physician does to or for his patient has a psychological effect on the patient the doctor-patient relationship is his most powerful tool. Three aspects of this relationship are discussed: 1) the voluntary selection of physician by the patient 2) continuity of treatment by the same physician 3) the third party payment of fees for doctor's services. These three considerations may influence the patient's or the doctor's attitude toward the other. A questionnaire was addressed to the 89 members of the staff of the Institute of the Pennsylvania Hospital which includes four heads of departments of psychiatry, two heads of departments of neurology, members of the departments of psychiatry in all five local medical schools, two past presidents of the APA etc. The psychiatric experiences of the 82 who replied ranged from three to 52 years. Three groups were identifiable on the basis of their formal relationship with psychoanalysis. “A” group (26) had no such formal connection; “B” group (30) included 18 members of the American Psychoanalytic Association and eight graduates of psychoanalytic institutes; and “C” group (30) were students of a psychoanalytic institute. Sixty-six of the respondents were certified in psychiatry by either the American Board of Psychiatry and Neurology or its Canadian equivalent. The Tables show the “guestimated” replies to the question “How important do you feel the patient's voluntary selection of a psychiatrist is to the outcome of his treatment in comparison to the assignment of a psychiatrist of comparable training and experience. It would appear that the respondents felt that voluntary selection was most important for the neurotic, slightly less important for the patient with a character disorder and still less so for the schizophrenic and even less again for the patients suffering from an affective disorder. Other questions asked were: “How important to the outcome of treatment do you feel the uninterrupted continuity of doctor-patient relationship is”? This continuity of treatment by one physician was thought to be most important to all patients with the possible exception of those with affective disorders. Another question was; “In what percentage of their cases was a third party involved in payment”? What percentage of these patients benefitted by this and in what way those not benefitted were hindered? An average of 24% of patients enjoyed some form of third party payment, and 38% of these benefitted from this, mostly because without some financial assistance many patients could not get treatment, and it helps the psychiatrist to give better and more thorough treatment. For the percentage who were hindered by third party payment a number of reasons were given. It would, therefore, appear that the method of payment of physician's fees is at least as important to doctor-patient relationship as the voluntary selection of his physician by the patient.
La Dynamique De Groupe Chez Les Residents En Psychiatrie
Authors: Gervais Laurent 
Published: May 2017

For many years group dynamics or group psychotherapy has been used in training of psychiatric residents. An attempt is made to define the specific learning problems facing these residents. The needs of the resident can be met in many ways, but the participation in a group seems to be particularly meaningful. Three stages are described during the group process: 1) The period of euphoria, which coincides with the beginning of the training and only lasts a few months. This is when the resident toys with new words, new concepts and there is a magical connotation to all of this. 2) A depressive period, when the resident begins to ‘feel’ his many difficulties in dealing with patients. He also has to face the many psychiatric ideologies confronting him and he finds it impossible to have a total theoretical grasp of the psychiatric knowledge. This situation creates a good deal of anxiety and it is particularly during this phase that group dynamics can be useful. 3) A period of adaptation. Adaptation is used here as it is put forward by the ego psychologists, that is, as being an active process. Finally an analogy is drawn between the maturation and learning taking place in the psychiatric resident and the adolescent's search for identity and the use of group dynamics as a valuable tool in this on-going process.
The Marihuana Habit: Some Observations of a Small Group of Users*
Authors: Norton W. A. 
Published: May 2017

A sampling of the literature on marihuana has been presented, and a description has been given of some of the attributes of a small group of marihuana smokers in the community. This group is probably not well representative, however, of a largely unknown parent population. While not entirely homogeneous, and while probably harbouring one or two marginally functioning people, this group may be described as composed of still young men and women of quite good intelligence and education, expressing preference for aesthetic, experiential values. For the most part single and without dependants, they support themselves in relatively conventional occupations but lean, less in fact and more in aspiration, towards what one might call artistic and expressive occupations. Current religious attachments are disowned and, instead, they are in search of some philosophy of life, adopting what one might call humanistic principles. They tend to see themselves, as, after all, most social groups do, as enlightened; and they feel united in their rejection or questioning of what they perceive as the contemporary social establishment. Some of them have misgivings about themselves, and are not sure of where they are going. However, the group probably assuages some of these anxieties, and possibly offers quite useful support to some of its less resourceful members. Perhaps, one of the most striking and seemingly paradoxical aspects of the situation is that, despite protestations of extraversion, concern with ‘the real’, and group belongingness, the apparent common denomination of the association lies in the seeking of what are entirely introversive or subjective experiences of an ‘unreal’, transcendental sort, and subsisting mainly in highly individualized phenomena. This consideration at least raises the question of whether the stronger gratification may not lie in membership of the group, rather than simply in indulging the marihuana habit for its own sake. The narcissistic aspects of the group process appear to constitute one important variable underlying the apparent difficulty and delay which these young people meet in establishing an eventual identification of sorts (probably in most cases) with a wider and more representative community.
The Diagnosis of Personality Disorders a Pilot Study
Authors: Standage K.F. 
Published: May 2017

A pilot study was carried out to see what levels of agreement on the diagnosis of the different types of personality disorder, described by Schneider, could be obtained by observers with different amounts of clinical experience. Audio-recordings of eight patients were examined by 10 raters, who represented three levels of experience. Two patients had the same diagnosis made by 80 percent of the raters and these cases seemed best described as “typical”. In all the cases agreement was increased when a second choice diagnosis was permitted. Significantly greater agreement was recorded by clinical clerks than by psychiatrists or psychiatric residents, though this was probably due to their making use of fewer of the types. It seemed probable that some types were less likely than others to be used for a first choice diagnosis. It is recommended that the most typical patients be employed in research in the field of the personality disorders if high diagnostic reliability is required.
Diazepam Addiction a Case Report
Authors: Agrawal Prema 
Published: May 2017

A case of addiction to Diazepam is reported. Severe withdrawal ‘symptoms such as tremulousness, irritability, increased psychomotor activity, generalized muscle cramps, abdominal cramps, photophobia, retro-orbital pains and insomnia are described. Visual hallucinations, illusions, and paranoid features are also present in this case. Detoxification and management were accomplished by gradual withdrawal and the addition of another tranquilizer, anticonvulsant and muscle relaxant. The author reviews other such reports of abuse and addiction in the literature which call for wide recognition of the addictive properties of Diazepam and for restrictions on its indiscriminate prescription by physicians.
Utilization of Emergency Departments for Psychiatric Treatment
Authors: Watson G.D. 
Published: May 2017

A survey of four Edmonton hospital emergency department records for a one month period was carried out to determine the frequency of utilization by patients suffering from psychiatric disorders. Male attenders outnumbered females and the majority of patients fell into the 21 — 50 year age range. Alcohol-related illness was almost three times more frequent in males than females, whereas females were more frequently categorized as suffering “personal distress” or presented as suicide attempts. Overall, seventy-three percent of the patients were discharged; of those admitted, females outnumbered males. The changing pattern of emergency department utilization was compared by examining data from one hospital for the years 1972, 1974 and 1976. During this four-year period the annual number of visits by psychiatric patients increased by almost eighty percent, largely due to dramatic increases in alcohol related problems in males and those described as “personal distress” in females. The establishment of intoxication recovery centres in 1973 paralleled a drop in the proportion of patients admitted to inpatient wards for alcohol-related, street drugs and overdose problems. The results of the present survey are compared to those reported in the relevant literature, and the methodological problems encountered in carrying out a retrospective study of emergency services from clinical records are described.
Factors associated with increased white matter hyperintense lesion (WMHI) load in patients with systemic lupus erythematosus (SLE)
Authors: Shaharir S S , Osman S S , Md Rani S A , Sakthiswary R , Said M S M 
Published: May 2017

Introduction White matter hyperintense (WMHI) lesions are the most common finding in magnetic resonance imaging (MRI) of the brain in patients with systemic lupus erythematosus (SLE). Objective The objective of this article is to determine the clinical factors associated with an increase in WMHI lesion load among SLE patients. Method A total of 83 SLE patients with MRI of the brain from National University of Malaysia Medical Centre were included. The WMHI lesion load was determined using the Scheltens score and Fazekas scale, and their distribution was divided into the deep white matter (DWMHI) and periventricular (PVH) regions. The clinical correlates of WMHI lesions were initially determined using univariate analyses and subsequently multivariable regression analyses were performed to determine the independent factors of increased WMHI lesion load. Results MRI of the brain of 46 patients who had WMHI lesions were compared with 37 patients with normal MRI. We found significant association between the presence of WMHI lesions and age, presence of cerebral infarcts, positive antiphospholipid antibody (aPL), active disease, neuropsychiatric lupus (NPSLE) and disease damage. Age, SLEDAI scores, cerebral infarcts and disease damage were significantly associated with higher DWMHI and PVH Scheltens scores. Meanwhile, patients with active lupus nephritis (LN), lower serum albumin and more severe proteinuria were associated with larger Fazekas WMHI lesions. Multivariable regression analysis revealed that the independent factors associated with presence of WMHI lesions were positive aPL and SLEDAI scores ( p < 0.05). Higher WMHI Scheltens scores in both DWMHI and PVH were associated with presence of cerebral infarct but higher PVH lesion load was significantly associated with active SLE disease. Conclusion Presence of WMHI lesions in SLE was significantly associated with cerebral infarcts, aPL and high general SLE activity, suggesting both inflammation and ischaemia as the underlying pathology of these lesions.
High test positivity and low positive predictive value for colorectal cancer of continued faecal occult blood test screening after negative colonoscopy
Authors: Brown Jeremy P , Wooldrage Kate , Wright Suzanne , Nickerson Claire , Cross Amanda J , Atkin Wendy S 
Published: May 2017

Objectives The English Bowel Cancer Screening Programme offers biennial guaiac faecal occult blood test (gFOBT) screening to 60–74-year-olds. Participants with positive results are referred for follow-up, but many do not have significant findings. If they remain age eligible, these individuals are reinvited for gFOBT screening. We evaluated the performance of repeat screening in this group. Methods We analysed data on programme participants reinvited to gFOBT screening after either previous negative gFOBT ( n = 327,542), or positive gFOBT followed by a diagnostic investigation negative for colorectal cancer (CRC) or adenomas requiring surveillance ( n = 42,280). Outcomes calculated were uptake, test positivity, yield of CRC, and positive predictive value (PPV) of gFOBT for CRC. Results For participants with a previous negative gFOBT, uptake in the subsequent screening round was 87.5%, positivity was 1.3%, yield of CRC was 0.112% of those adequately screened, and the PPV of gFOBT for CRC was 9.1%. After a positive gFOBT and a negative diagnostic investigation, uptake in the repeat screening round was 82.6%, positivity was 11.3%, CRC yield was 0.172% of participants adequately screened, and the PPV of gFOBT for CRC was 1.7%. Conclusion With high positivity and low PPV for CRC, the suitability of routine repeat gFOBT screening in two years among individuals with a previous positive test and a negative diagnostic examination needs to be carefully considered.
Nurses’ contributions to the resolution of ethical dilemmas in practice
Authors: Barlow Nichola Ann , Hargreaves Janet , Gillibrand Warren P 
Published: May 2017

Background: Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. Aims: To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. Design: An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Findings: Four major themes emerged: ‘best for the patient’, ‘accountability’, ‘collaboration and conflict’ and ‘concern for others’. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Discussion: Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing ethical dilemmas and to engage with political and organisational macro- and micro-decision-making. Conclusion: Nurses’ professional relationships are central to nurses’ contributions to the resolution of ethical dilemmas.