bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Constructive Use of Envy
Authors: Smith Vivien , Whitfield Margaret 
Published: April 2017

Envy has generally been seen as an undesirable, negative feeling. However, inequality is an inescapable part of life, and envious feelings are a daily experience for most people. The authors feel that envy is a normal human feeling which if acknowledged and accepted may be dealt with constructively. Practical examples and a case history are used to illustrate this thesis.
Is Incest Harmful?
Authors: Henderson James 
Published: April 2017

Classically, incest has been considered from both a psychological and sociological point of view to have harmful consequences. Genetic research, though by no means lacking controversy of its own, generally supports the notion that inbreeding has untoward genetic consequences. The psychodynamics of all three parties to father-daughter incest seem to indicate that people who become involved in incestuous behaviour are often psychologically damaged before the fact, so that if they show subsequent evidence of psychological impairment the incestuous behaviour can be as plausibly viewed as a dysfunctional attempt at solving problems as it can a cause of subsequent psychopathology. Girls involved in the father-daughter incest present in one of half a dozen frequent clinical syndromes. The presentation is influenced by the degree to which the girl may have participated in ongoing incestuous behaviour as opposed to being the presumed victim of an older adult's coercive actions or her own temporary suspension of a behavioural taboo. Research is inconclusive as to the psychological harmfulness of incestuous behaviour, and evidence is reviewed on both sides of this complicated and controversial question. Quite apart from the general issue of the harmful-ness of incest, a number of indicators can be derived from the nature of the incestuous episode and the early response to therapeutic assessment which aid in the clinical forecasting of probable outcome.
Mega-Doses of Behaviour Therapy for Treatment-Resistant Agoraphobics*
Authors: Rapp Morton S. , Thomas Martyn R. , Reyes Eleanor C. 
Published: April 2017

This was a pilot project set up to test the feasibility of effectively and inexpensively treating agoraphobic patients who had not responded to adequate trials of behaviour therapy (and other therapy) in the past. We employed a quantitatively intensive program of exposure therapy, calisthenics and muscular relaxation, and have explained the rationales for the choice of each treatment. The results were gratifying in four of the five patients, with follow-up to three years. This pilot project enabled us to set up a cost-effective treatment for all forms of agoraphobia which is as efficient as other programs described. It has also highlighted the fact that some patients exist who may do poorly on schedules of behaviour therapy which are adequate for some patients, and yet may do well if the amount of treatment is drastically increased.
Psychological Support of Oncology Nurses: A Role for the Liaison Psychiatrist
Authors: Taerk Gary 
Published: April 2017

This paper describes the working of an oncology nurses coping group which functioned under the guidance of a consultation-liaison psychiatrist at the Toronto General Hospital. Nurses were helped to deal more effectively with the many and varied stresses which they face in treating patients with cancer. As a result ward atmosphere, patient care and inter-staff communication improved. The success of the group was due to a number of factors that included the high motivation of the staff the high level of stress on the ward, the support of the head nurse and the consistent relationship of the consulting psychiatrist. A series of cases are presented to illustrate these points.
The Special Patient on the Medical/Surgical Ward
Authors: Friedman Jerry A. 
Published: April 2017

The “special” or favoured patient may play a very important role in the ward milieu. Such patients are discussed in terms of their adaptive function for medical and nursing staff in dealing with feelings of pessimism, anger and guilt. The attitudes of protectiveness and infantilization and staff dissention make the task of the psychiatrist hazardous when consultation is requested. Two clinical examples are discussed: one in which the issue of “specialness” was overlooked, and one in which it was dealt with. The consulting psychiatrist's own reactions of anger and therapeutic nihilism may alert him to such a patient. Intervention must take into account the trust implied in being asked to see a “special” patient and the tremendous emotional investment on the part of the staff. The consultant should use his own reactions to the patient to help staff identify the feelings aroused in them by such patients. Meeting with the staff collectively to share concerns and resolve conflict is productive and should be encouraged.
Cortisol Secretion and DST in Affective Disorders — Methodological Concerns
Authors: Prabhu V. , El-Guebaly N. 
Published: April 2017

In the wake of a large number of studies seeking biological markers for a variety of psychiatric disorders including affective disorders, the enthusiasm over Cortisol Secretion and Dexamethasone Suppression test lead the authors to review critically the data collected so far. The research designs involved, the samples studied and the reliability of the data collected along major variables such as diagnostic criteria, sampling characteristics, procedural differences, length of follow-up and the role of environmental stressors were evaluated. A useful exercise was to compare the literature published in the 50's and 60's with the more recent publications.The potential usefulness of DST as a diagnostic and management tool remains open for scrutiny. Whether the abnormalities in cortisol levels and DST responses evidenced by many researchers are an epiphenomenon or have a diagnostic and management value still remains unclear. From their analysis, the authors point out the lack of well controlled sequential studies using standardized procedures, and large age specific samples. Difficulty arising from the use of various terminologies and criteria for diagnosis of depressive disorders is recognized. The limitations of the use of DST in general clinical practice along with directions for future research are outlined.
Robert Gardiner Hill and the Non-Restraint Movement*
Authors: Jones Kingsley 
Published: April 2017

An account is given of the professional life of Robert Gardiner Hill before and after the publication in 1839 of his lecture on the Total Abolition of Restraint in the Treatment of the Insane. The lecture is summarized and an attempt is made to evaluate his work which has been overshadowed by that of John Connolly. This paper was researched before the author came to North America. A library request to check that no recent work had appeared on the history of the restraint controversy produced two papers published in 1978. One roundly advocates restraint (1) the other acknowledges its widespread practice in Canada (2).
Fathers Absent and Present
Authors: Adams Paul L. 
Published: April 2017

Hindering and obfuscating psychiatric scholarship about the father's role, whether he is present or absent, are several widespread notions and practices — including conceptual, assumptive, attitudinal, methodologic and technical matters. Discussed are eleven barriers to research: patriarchal ideology, preference for studying individual and dyad instead of family systems, preference for considering adults not children, overly rigid definition of parental roles, choosing not longitudinal but onetime cross-sectional study, reasoning about linear cause and effect, focus on attitudes not overt behavior, failure to control for adequate number of variables, neglect of adequate sampling procedures, confusing correlation with causation and an overemphasis on obvious pathology. The father, present or absent, may be salient or insignificant in the life of a child. If salient, the father's role may promote health and growth or may be largely pathogenic. The conclusion holds that an irreducible family unit may consist of only one pair: caretaker/child.
Forensic Psychiatric Assessments in the Northwest Territories
Authors: Seltzer A. , Langford A. 
Published: April 2017

This paper is an analysis of the psychosocial and forensic factors leading to legal referrals to a northern mental health service. It was found, not surprisingly, that most criminal acts were associated with alcoholism, personality disorders, and low socioeconomic status. Young native males figured prominently in both violent and property crimes. Rape offenses and major psychopathology appeared to be more common among Inuit referrals. The influence of rapid culture change and psychosocial and biologic predisposition to the deleterious effects of alcohol were considered relevant criminogenic factors. It was also felt that the high Inuit referral rate might have been related to their willingness to accept consultation and discuss symptoms of mental illness.
Electroconvulsive Therapy: A Canadian Perspective
Authors: Smith W. Edwin , Richman Alex 
Published: April 2017

Recent ECT practices in Canada are reviewed from a historical perspective with respect to specific criticisms. Utilization is decreasing; utilization rates vary widely between Provinces and between regions; disproportionate numbers of females have been receiving ECT; a substantial group of patients diagnosed as neurotic and schizophrenic continue to receive ECT; criteria and guidelines for its use are not consistently applied.Expected rates of ECT used are estimated, based on theory and practice as well as on published data on the epidemiology of affective disorders. Data on actual Canadian usage are reviewed and compared with an estimated minimum ratio of 30–45+ cases per year of non bi-polar depression per 100,000 population requiring ECT. Results show that there may be a substantial number of patients in some Provinces for whom ECT is the best available treatment and who are not receiving it.There is some ethical concern associated with possible under-use of ECT as the best therapy available for certain patient groups. Clinical cases and patterns of care should be reviewed at the hospital level to determine how best to effect improvements in the use of this treatment.
Tourette Syndrome, Atypical Pervasive Developmental Disorder and Ganser Syndrome in a 15-Year-Old, Visually Impaired, Mentally Retarded Boy
Authors: Burd Larry , Kerbeshian Jacob 
Published: April 2017

This is a case report of a 15-year-old visually impaired, mentally retarded male who presents with symptoms consistent with Tourette Syndrome, a Syndrome of approximate answers (Ganser's Syndrome) and Atypical Pervasive Developmental Disorder. The authors feel that this follow-up on the case presented earlier by Parraga and Butterfield raises the possibility of a link between a number of the symptoms of adult schizophrenia, appearing in attenuated form in these two cases, and Tourette Syndrome.
Depressive Illnesses in Children and Adolescents: A Review of Current Concepts
Authors: Mcconville B.J. , Bruce R.T. 
Published: April 2017

Considerable progress has been made in our understanding of depressive illnesses in childhood and adolescence, especially over the last several years.A number of major books on the subject have now appeared, along with a large number of individual papers. This paper attempts to summarize current knowledge, and indicates developmental, age-related and other issues which still require further study.
Clinical and Demographic Correlates of Neuroleptic Response
Authors: Seeman Mary V. 
Published: April 2017

This paper presents evidence that the positive symptoms of schizophrenia respond best to neuroleptics, as do patients with hyperdopaminergic activity (high blink rates, low prolactin levels). Those schizophrenics with defect states, intellectual and neurological impairment, brain atrophy, neuropsychological impairment, and poor school and social premorbid adjustment do not respond as well to dopamine blockers. It has been suggested that this group of schizophrenics do not suffer from a dopamine disturbance. There is also evidence for the relatively superior response of women, especially premenopausal women. This may be due to several factors but appears to be related to estrogen levels, especially since psychotic symptoms appear, in some women, premenstrually and post-partum, when estrogen levels drop. There is now substantial evidence that estrogens antagonize dopamine in the brain.
Autour des décompensations maniaques
Authors: Lavoie Jean-Guy 
Published: April 2017

The author stresses early detection of the premonitory signs of a manic breakdown with a view towards an efficient therapeutic intervention. Some of the most typical signs are described with their corresponding dynamic implication. The manic-depressive's lack of impulse control often forces a member of the patient's circle to take control. After a review of the main personality traits belonging to the manic-depressive patient, the author gives a description of the patient's spouse in whom appear similar and complementary elements of the patient's personality. Finally, some steps are suggested to rationalize treatment. Emphasis is on educational methods combined with lithium therapy within the framework of a therapeutic relationship where the interative dynamic forces are acknowledged.
Patterns of Illness among Individuals Reporting High and Low Stress
Authors: Norman G.R. , Mcfarlane A.H. , Streiner D.L. 
Published: April 2017

This paper reports the results of a prospective study of 428 adults, which was designed to explore the relationship between social stress and health. Individuals in the study were grouped into cohorts based on the number of stressful events experienced in a 12 month period, and the differences in the quantity and quality of health measures among the cohorts in the same time period explored. Individuals under stress experienced considerably more illness (assessed by symptoms reported on a health diary and physician visits) than those not under stress. However the quality of these illness episodes were similar in both groups, as measured by the distribution of problems in organ system/body region and diagnostic categories. A second analysis, examining a subgroup of individuals who went from periods of low to high stress came to similar conclusions. The results suggest that the onset of stressful events is associated with a deterioration of health of a general nature, not associated with particular diseases of body systems.
Private Practice: The First Five Years
Authors: Berger J. 
Published: April 2017

This is a longitudinal study of all patients seen in the first five years of a private psychiatric practice. At the present time, it is believed to be the only known complete study of patients in a typical private practice. The data from 486 patients has been collected and analyzed and some of the results have been compared to those obtained in other studies. Some significant findings emerged. Depression is the single commonest condition and its frequency was similar to that found in other studies. Psychoses were rare. A large category of patients was described as having a Personality Disorder. The implications of these and other findings are discussed. The data are relevant to aspects of clinical psychiatry, to the teaching of psychiatry, and to the financial insurance coverage of medical services.
Suicide Attempters Presenting at an Emergency Department
Authors: Eaton Philip , Reynolds Paul 
Published: April 2017

Seven hundred and forty-seven consecutive cases of deliberate self-injury presenting at the Emergency Department of an inner city hospital were rated on Beck's Medical Lethality Scales, the Intent Scale and Poldinger's Risk Scale. In addition, demographic data were collected on each patient. The results pertaining to the demographic characteristics of the subjects were found to be similar to those reported elsewhere. However, although the overall intent scores were not found to be predictive of the lethality of the method employed, the “objective” circumstances surrounding the attempt were found to be highly related to the risk factor assigned to each patient. The recommendation is made that specific sub-groups of attempters need to be identified and may warrant specialized intervention strategies.
Identity Theory, Functionalism and Intentionality: Three Modes of Psychological Explanation Used in Psychiatry
Authors: Warme Gordon E. 
Published: April 2017

It is argued that there are three modes of psychological explanation that are available and in wide use, but that the three are often unwittingly confounded. These are, identity theory, functionalism and intentionality. Identity theory explains by viewing psychological events as direct products of design, that is, manifestations of brain events. The stance of functionalism is to study psychological events and those past and current stimuli that evoke them. In other words, functionalism studies the way in which psychological events are programmed. Intentionality approaches psychic events as a product of both conscious and unconscious purposes, beliefs, wishes, reasons and meanings, and concludes that it is of considerable worth to treat persons as intentional systems. It is claimed that the demarcation between these explanatory modes is crucial in psychiatric, and especially psychotherapeutic practice and research.
Socialization Scores in Psychiatric Patients and Their Implications for the Diagnosis of Personality Disorders
Authors: Standage Kevin 
Published: April 2017

The distribution scores on the Socialization (So) scale of the California Psychologial Inventory was examined in a series of 83 admissions to a general hospital psychiatric service. The series was divided into groups of low and high scorers (Low So and High So). Low So scorers were younger than high scorers and had a raised mean Neuroticism score. A strong association was found between So scores and the quality of parental care which patients reported receiving from their fathers. Other parental attributes are reported. Patients with a clinical diagnosis of personality disorder were found in the Low So, but not the High So group.
PréSentation D'Un Cas
Authors: Samson Esther , Picard Et Sylvie 
Published: April 2017

Summary A new case of Capgras’ syndrome is presented with a short review on the subject. Since there are many controversies about the etiology of this syndrome, and since some authors explain it with organic factors, others with psychodynamic factors, or a combination of the two, one should be careful with this syndrome to eliminate the presence of organic factors with a meticulous physical examination and appropriate neuropsychological tests. A thorough examination of early interpersonal relations is necessary to verify psychodynamic hypothesis, the most plausible being the splitting of internalized object representations.
Présentation D'Un Cas
Authors: Cournoyer Jocelyne 
Published: April 2017

There is evidence that panic disorder and major depression might share some common neurobiological factors. This would be consistent with the fact that most antidepressant drugs are effective in preventing panic attacks. This is a case report of a 40 year old woman who was suffering from a panic disorder. Following the discontinuation of a long-term lorazepam treatment, she developed severe depressive symptoms. The depressive syndrome improved rapidly with amitriptyline (150 mg/day), but the panic attacks persisted. Twelve weeks later, amitriptyline was replaced by clomipramine (150 mg/day), the dosage of which was increased to 225 mg/day three weeks later. The patient remained anxious with no resolution of her panic attacks. Two weeks later, lithium carbonate (900 mg/day) was added to clomipramine. Sixty hours later, a dramatic improvement was observed. The lithium plasma level was 0.8 mEq/L. Because of some tremors, lithium was discontinued five days later. Within four days, the anxiety as well as the panic attacks reappeared. Lithium carbonate (600 mg/day) was then resumed. Forty-eight hours later, the patient was showing a clinical improvement similar to that observed following the first addition of lithium. She remained symptom free with the maintenance of the drug combination. To date, several reports have confirmed the beneficial effect of adding lithium to a tricyclic antidepressant drug in resistant major depression. However, we believe that the present case reprot is the first one documenting the augmentation of a tricyclic antidepressant drug by lithium in a patient suffering from a panic disorder.
Clinical Aspects and Treatment of Rapid Cycling Mood Disorders
Authors: Levy J. Mark , Remick Ronald A. 
Published: April 2017

Eight female patients with rapid cycling mood disorders (at least four discrete affective episodes per year) were examined from a clinical perspective. Assessment suggested several different etiologies to the rapid cycling pattern in these patients. These included that the rapid mood swings were: a natural expression of the affective disorder, tricyclic induced, a result of frequent medication changes and/or poor medication compliance, and a combination of the aforementioned etiologies. All patients were helped significantly with treatment. Treatment was individualized for each patient's unique illness and possible etiological factors in the rapid cycling. Treatment strategies and guidelines include: i) A psychotherapeutic approach involving the patient and his family which emphasizes the lengthy nature of treatment before expected results; ii) The necessity of rigorous drug adherence, in) The sole use of “high dose” lithium therapy (> 1.2 MEQ/L) in some patients, and the consideration of “high dose” lithium in conjunction with tricyclics, MAO inhibitors or “adjuvant” medication in certain bipolar II patients; iv) The discontinuation of tricyclics in bipolar l rapid cyclers;v) The combination of lithium salts and carbamazepine or the use of carbamazepine alone in selected patients.
Child Psychiatrists in the 90's: Who will want us, who will Need Us
Authors: Rae-Grant Quentin 
Published: April 2017

Child Psychiatry is now a well recognized and established sub-speciality in Canada. It has gone through a period of vigorous and healthy growth. Like psychiatry in general it now faces a number of challenges which provide potential threat but which may lead to better definition of priorities and of its most effective function. Other disciplines, medical and non-medical, increasingly compete for a place on the therapeutic spectrum. Within psychiatry the rhetoric between different schools of thought provides ammunition for those who have no use for any form of psychiatry however it may be provided. The challenge is to develop more effective ways of using the skills of the child psychiatrist within a recognition that the number of practitioners will never approach what would be required to have child psychiatry alone cover the treatment needs of children and adolescents. The field requires the adoption of a more flexible metaphor for training and practice with competence in the different schools of theory and of therapy. Attention needs to be paid to the consumer movement, to the impact of better informed parents and public and to the developing of a parsimonious and selective approach to the use of scarce professional time. The healthy growth of research in child psychiatry is a development long overdue and places the discipline on a scientific rather than a clinical practice base. At a time when funding and the cost of health care are crucial issues the development of a secure knowledge base, efficient methods of service delivery and the integration with other mental health care providers are opportunities and grounds for optimism about the future of the sub-speciality.