bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Oriental Psychiatric Patients receive Different Dosages of Psychotropic Medication when Compared with Occidentals
Authors: Rosenblat Rebecca , Tang Siu Wa 
Published: April 2017

The literature suggests the possibility of different drug dosage requirements between patients of different ethnic origins. This study thereby attempted to investigate the average dosages of psychotropic medications being prescribed for Orientals versus Occidentals using a retrospective drug history review and an international opinion survey. The retrospective drug history review compared drug dosages for four commonly used psychotropic medications in well matched Oriental and Occidental populations. Data from this review showed that final/maintenance dosages of amitriptyline were significantly lower for Orientals than Occidentals. The opinion survey assessed the responses of psychiatrists in the Orient, as well as in North America, with respect to average dosages prescribed for the two populations; their beliefs in possible variability and causes underlying the variability. Data indicated that significantly lower dosages of chlorpromazine, phenelzine, diazepam, and chlordiazepoxide are being prescribed for Orientals as compared with Occidentals. Beliefs in differences were dependent upon the degree of exposure to Orientals. Suggested etiological factors underlying the variability were usually related to drug metabolism, side effects, and body weight. In both types of studies, Orientals appeared to have lower prescribed dosages than Occidentals. The lower dosages, however, appeared to be a function of the physician's experience in treating the Oriental population.
The Girl who Cried Wolf: Pseudologia Phantastica and Sexual Abuse
Authors: Matas M. , Marriott A. 
Published: April 2017

There has been an explosion of interest recently in sexual abuse and incest, with reported causal links to a wide variety of psychiatric disorders. The integrity of Freud's seduction theory has been challenged by Jeffrey Masson and sexual abuse activists. What is the position of a therapist who finds out that a patient's reports of incest and sexual abuse turn out to be fabrications? These issues are presented and discussed in the context of a brief, illustrative case history. There is also a review of the concept of “pseudologia fantastica”, as well as a brief review of a feminist critique of Freudian theory.
Short-term Economic Change and the Utilization of Mental Health Facilities in a Metropolitan Area*
Authors: Trainor John , Boydell Katherine , Tibshirani Robert 
Published: April 2017

The relationship between economic change and mental disorder has been examined by several investigators over the past century. The purpose of this paper is to explore this basic relationship and determine its direction in a large Metropolitan area. A time series analysis was undertaken to investigate whether or not unemployment and indicators of mental health are related over time. Trends in the following four indicators of mental health were examined:1. Number of admissions to all psychiatric facilities serving Metropolitan Toronto.2. Number of admissions to one provincial psychiatric hospital (Queen Street Mental Health Centre) in Toronto, which serves a chronic population.3. Number of discharges from Queen Street Mental Health Centre.4. Number of admissions plus those assessed and not admitted to Queen Street Mental Health Centre.In order to assess the possible delayed effects of unemployment, correlation analyses were computed for several lag times. “Lag time” is defined here as the time delay between unemployment and its potential effects on mental health indicators. Lag times used were zero, three, six and twelve months. The best equation found was for a six month lag, indicating an inverse relationship; as unemployment increases, admissions and discharges decrease.Results suggest that there are no simple relationships between the dependent and independent variables. Observed trends may be due to much wider exogenous factors such as hospital capacity and changing admission criteria.
The Review Panel Process: Interpretation of the Findings and Recommendations*
Authors: Paredes J. , Ledwidge B. , Beyerstein D. , Cashore J. , Higenbottam J. 
Published: April 2017

In a series of three studies, the present authors and others in this research group have examined the Review Panel process: (a) before the hearing (which patients apply for a hearing?); (b) at the hearing (how do the patients released by the Panel differ from those retained by the Panel and; (c) after the hearing, how are the Panel-released patients faring one and two years after being released by the Panel, compared to patients released by the attending psychiatrist?) In the present paper, the findings of these three studies are summarized and an attempt is made to explain the findings, some of which are surprising (for example, the 35% disagreement between Panel and attending physician with respect to suitability for discharge and the finding that Panel-released patients survive as long in the community as do physician-discharged patients). Based on the findings and the interpretation placed on them, the authors make a series of recommendations with respect to the operation of Panels, the management of defiant involuntary patients and future research in this area.
Psychiatric Disorder and Poor School Performance among Welfare Children in Ontario
Authors: Offord David R. , Boyle Michael H. , Jones Beverly R. 
Published: April 2017

Parental welfare status was found to be a marker for identifying a group of children with an increased prevalence of psychiatric disorder and poor school performance. The marker was particularly strong for psychiatric disorder in young boys and for poor school performance in young girls. For instance, the prevalence rates of psychiatric disorder, in the 6 to 11 age group, for welfare and non-welfare boys, were 40.0% and 13.9%, respectively; and for poor school performance in welfare and non-welfare girls, 27.8% and 6.1%, respectively. The relationship between different measures of psychosocial disadvantage and these child deficits was examined. Multivariate analyses revealed, for example, that parental welfare status made an independent contribution to the prediction of psychiatric disorder and was a more powerful predictor of poor school performance in girls compared to boys. The implications of these and other results are discussed.
Criminalization of the Mentally Ill: Part I. Police Perceptions
Authors: Holley H.L. , Arboleda-Florez J. 
Published: April 2017

This paper reports the findings from Phase I of an ongoing prospective, longitudinal study of mentally ill offenders. The study documents the nature, extent and location of mentally ill offenders in the criminal justice system in Southern Alberta, evaluates mechanisms which are used to identify mentally ill offenders in need of treatment, identifies existing psychiatric services available within the criminal justice system and documents their psychiatric service utilization patterns. A study cohort of 611 was identified at their time of arrest and followed through the justice process from initial detention until final release. Part I on this study focusses on the period of arrest. More specifically, police perceptions of disturbed behaviour are examined. The prevalence of police-identified offenders is reported and police judgments regarding possible causes of disturbed behaviour (that is, mental illness, drugs, alcohol) and recommendations for psychiatric treatment are examined. Discrepancies between official recommendations made by police to a bail magistrate (and recorded on the arrest report) and unofficial recommendations collected as part of the study are explained in terms of differing decision-making models; clinical versus legal. Finally, the importance of police perceptions concerning the presence of mental illness as opposed to substance abuse are identified as important factors which influence the decision to recommend psychiatric examinations.
Psychiatric Consultation-Liaison Services to an Obstetrics and Gynecology Department
Authors: Stewart D.E. , Lippert G.P. 
Published: April 2017

This paper describes the psychiatric consultation-liaison services provided to an Obstetrics and Gynecology Department. Clinical services are provided both by program consultation and by individual inpatient and outpatient referral. Clinical problems in obstetrics and gynecology that result in psychiatric referral are discussed. Research interests which play an important role in the program are described. Educational activities are directed toward ward and clinic staff, undergraduate medical students, residents and the practising specialist. The combination of well articulated consumer requests, interested gynecologists and obstetricians, broadened gynecology residency training objectives, and greater involvement of consultation-liaison psychiatrists suggests a promising future for psychosomatic obstetrics and gynecology.
Faking Sexual Preference
Authors: Kaine Alan , Crim M. , Mersereau Guyon 
Published: April 2017

Erectile assessments of sexual preference have been found quite reliable. Their validity, however, has been questioned with some findings that are at variance with the clinical data. These apparently distorted results could be either false positive or false negative responses. The former may be due to faking, which is the act of feigning a spurious positive response to a non-preferred stimulus, and the latter could be from suppressing, which is producing a spurious negative response to one's natural sexual preference. In this study, phallometric testing with a mercury-in-rubber strain gauge and Model 240 Parks Plethysmograph was used in conjunction with a mid-lumbar pressure sensor. Twenty subjects, half of whom were sex offenders, were tested with visual and audiovisual stimuli depicting male and female models at various ages and degrees of sexual development. Other testing included self-report questionnaires and estimates of age and sexual development. It was found that both groups significantly reduced penile tumescence when instructed to suppress to their stated sexual preference in the audiovisual series. A significant reduction was also obtained in suppressing to the category to which they had a maximum response in the same series. When both groups were instructed to fake to a non-preferred stimulus, the levels of arousal generated were quite variable and not significantly different from those obtained before instruction. Extraneous movement as measured by the lumbar pressure device was markedly greater in our three incest offenders. The meaning of this finding is unclear. Sex offenders as a group were found to be significantly more variable in their responses than controls. In the sex offender group, alcoholics had a significantly lower maximum response, but no such affect of alcohol was found in the control group.
Progrès récents dans l'étude de l'alcoolisme
Authors: Dongier Maurice 
Published: April 2017

The phenomenon of denial of alcohol dependence prevails not only in a majority of alcoholics, but also in the diagnostic and therapeutic behavior of many physicians. The reasons for this neglect of alcohol abuse are reviewed. In particular, value judgments rather than scientific data seem to lead a number of physicians to share the recent views of the U.S. Supreme Court on primary alcoholism: a “willful misconduct” rather than an illness. This dichotomy between primary and secondary alcoholism, simplistic in itself, is part of current attempts to describe a spectrum of alcoholic disorders, some more social, some more biological. The biological underpinnings of abnormal drinking behaviour include various abnormalities of cerebral neurotransmitters: dopaminergic, serotonergic, GABA and endogenous opiate systems among others. These abnormalities are partly genetically determined, pre-existing to alcohol abuse and explaining why “alcoholism runs in families”, and partly secondary to alcohol abuse. Their understanding may open the road to the use of specific pharmacological adjuvants in alcoholism treatment, in conjunction with psychotherapy, rehabilitation and self-help programs.
Metachromatic Leukodystrophy (MLD) in Hospitalized Adult Schizophrenic Patients Resistant to Drug Treatment
Authors: Galbraith D.A. , Gordon B.A., , Feleki V. , Gordon N. , Cooper A.J. 
Published: April 2017

Metachromatic leukodystrophy (MLD) is a rare inherited neurodegenerative disease associated with a defect in the catabolism of sulphatide (galactocerebroside-sulphate) which accumulates in the nervous system. MLD can be diagnosed biochemically by demonstrating deficiency in the activity of the enzyme arylsulphatase A (ASA) and an excess of sulphatide in urine and tissues. Cinically adult MLD may present as a schizophrenic-like psychosis, which typically develops years before the onset of neurologial signs which are not inevitable. Urinary ASA was investigated in 99 chronic hospitalized psychiatric patients (including 77 schizophrenics). Thirteen showed reduced ASA activity. Of the nine who were available for further study, only one evinced reduced ASA activity in other tissues (for example, leukocytes and cultured fibroblasts). However, there was no evidence of sulphatidurea with impaired sulphatide hydrolysis in his intact cultured fibroblasts. Therefore, he tested negative for MLD. This biochemical profile is known as pseudosulphatase deficiency. The possible relationship of pseudosulphatase deficiency to schizophrenic-like conditions is discussed.
Intérêt de l'information médicale au patient institutionnalisé
Authors: Peretti S.C. , Wolf M.A. , Garneau Y. 
Published: April 2017

Medical information given to patients, notably to psychiatric patients, is guided by laws. Before starting any treatment the patient's informed consent is needed. One of the criteria of validity for such a consent is adequate information of the subject. This study shows that certain factors interfere with the institutionalized patient's initial knowledge about medication, hospitalization and illness. It points out that learning is diminished by two factors: the diagnostic of schizophrenia and the length of stay in the hospital. However learning is not changed by severity of symptoms. On the other hand the initial knowledge level is diagnosis independent but altered in case of intense psychiatric symptomatology. Possible explanations of these data are discussed. In conclusion, the importance of the variable of learning capacity is shown in the practice of the informed consent for psychiatric patients. The learning capacity must be taken into account when the patient is informed. Finally, additional research on that subject is indicated particularly concerning the persons disabled by schizophrenia.
Joint Custody: Historical, Legal, and Clinical Perspectives with Emphasis on the Situation in Canada
Authors: Fidler Barbara J. , Saunders Elisabeth , Freedman Elaine , Hood Eric 
Published: April 2017

The search for ways to mitigate the effects of family breakdown on parents and children includes legislative and clinical efforts which to some extent influence each other. In the past year much public interest has been aroused in Canada, and particularly in Ontario, in the issue of legislative changes which would make joint custody the usual or “preferred” legal disposition of custody cases. This paper provides a discussion of the legislated preference, or “rebut-table presumption” of joint custody from a historical, legal and clinical point of view. Definition and elaboration of what joint custody is from the legal and practical perspectives is provided with an emphasis on Canadian laws and practice. The legal rights of the non-custodial parent are explained, and relevant case law is highlighted. The relationship between joint custody, support orders and relitigation rates are elaborated. Following this is a critical overview of the empirical research on joint custody as it relates to the adjustment of children and parent satisfaction is included. It is concluded that while there is little question that shared parenting can be beneficial to children, the enthusiasm of legislators for joint custody has not been supported by empirical data. It is necessary to examine under what circumstances and for which kinds of parents and children joint custody might be beneficial since it is unlikely that one solution will fit the needs of all families and all stages of family life.
The Role of Child Psychiatrists as Consultants to Day Cares
Authors: Weiss Jacqueline , Laroche Catherine 
Published: April 2017

An increasing number of mothers of preschool children in Canada (either by choice or economic necessity) have entered the workforce. It is estimated for example that 58–80% of mothers of preschool children are working. In Canada in 1986, 51.6% of women in the workforce had children under the age of five (1). It is beyond the scope and intent of this paper to discuss the merits (or possible harm) of day care per se. The aim of this paper is to discuss aspects of the quality of day care, and how this might be improved by child psychiatrists being involved in day care centres and in their organization. Few would doubt that the emotional climate and the development of trusting relationships to significant others, in the first year of life, are essential determinants of the healthy personality. Hence the quality of the day care experience of small children is an essential area of study for the child psychiatrist which is as yet insufficiently recognized. This paper discusses what has been learned from the literature and from experience as a consultation-liaison child psychiatrist to a day care centre. A case example illustrates some of the important issues.
Effects of ECT on Prolactin, LH, FSH and Testosterone in Males with Major Depressive Illness*
Authors: Cooper A.J. , Finlayson R. , Velamoor V.R. , Magnus R.V. , Cernovsky Z. 
Published: April 2017

Fourteen males with major depressive illness (DSM-III) received a course of electroconvulsive therapy (ECT). Serum prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone (T), were measured 15 minutes before and 15 minutes after each treatment. The severity of depression was assessed with the Hamilton Rating Scale for Depression (HRSD) two to three days before the first and two to three days following the last treatment. Post-ECT levels of PRL and LH were significantly higher than pre-ECT levels across every treatment. Changes in FSH and testosterone were not significant. There were no relationships between hormone levels (first versus last ECT) and severity of depression, including sexual functioning. It is argued that the relatively greater increases of LH than FSH is due to an acute antidopaminergic action of ECT which acts selectively on the secretion of the former. The blunted testosterone response to the increase of gonadotropins may be due to ECT-induced hyperprolactinemia.
Pensée formelle, opérations logico-discursives et schizophrénie: étude expérimentale d'un cas clinique
Authors: de Bonis Monique , Epelbaum Catherine , Féline André , Grize Jean-Blaise , Hardy Patrick , Somogyi Maria 
Published: April 2017

This study, based on a single case experimental design, examined logical reasoning in a schizophrenic meeting the DSM-III criteria. The quantitative assessment carried out by 32 psychiatrists on a rating scale for logical thinking disorders (nine items, six points) of the retranscribed clinical interview showed 1. that the assessments varied in a statistically significant way according to items and psychiatrists, and that these variations were independent of their degree of experience — the correlations between the different items of the rating scale proved to be weak and not significantly different from zero; and 2. the study of the most contradictory statements carried out by a logician using reasoning analysis procedures concluded that there were in fact logical relationships between the subjects the schizophrenic talked about. The results are discussed in relation to the methodology of assessing formal thought in schizophrenia.
Women as Torture Victims
Authors: Allodi F. , Stiasny S. 
Published: April 2017

This paper reports a retrospective study of the frequency, severity, modalities and mental health consequences of torture in 28 Latin American refugee women in Toronto. The data on these women and a comparison group of male torture victims were retrieved from case records in a hospital outpatient clinic. The results support the hypotheses implicit in the scanty literature available that the frequency and effects of torture in women differ from those found in men. Infernale victims, as in their male counterparts, the severity of the torture was related to the degree of their political involvement. However, torture was more frequently sexual, and its consequences more often affected the women's sexual adaptation.
Screening for Alcoholism in a Psychiatric Hospital
Authors: Dobkin Patricia , Dongier Maurice , Cooper Douglas , Hill Jeanne-Marie 
Published: April 2017

The prevalence of alcoholism is generally underestimated in patients in private practices, general hospitals and psychiatric institutions. Even though the World Health Organization has advocated the concurrent use of laboratory test results and questionnaires for screening, these methods are seldom used together. In this study, patients admitted consecutively to the North Bay Psychiatric Hospital were screened for alcoholism using the Michigan Alcoholism Screening Test (MAST) and gamma-glutamyl-transferase plasma level. Unexpectedly, 56.7% of the entire sample were identified as possible alcoholics; of these, 73.5% were men and 26.5% were women. When rates for men and women were looked at separately, it was found that 66.2% of the men and 40.6% of the women were alcoholic. Participants who tested positive on one or both of the screening tests were offered a more complete evaluation of their drinking behaviour. A diagnosis of alcoholism was confirmed in 88.2% of the patients who agreed to participate further. The question remains whether the high prevalence rates found are a function of the particular sample studied (i.e., patients in a hospital which typically serves a socially disadvantaged sector of the population) or reflects a feature of the general population in this catchment area. A study is currently underway in general hospitals of North Eastern Ontario in an attempt to answer this question.
UK Survey of Psychiatric Services for the Elderly: Direction for Developing Services
Authors: Shulman Kenneth , Arie Tom 
Published: April 2017

As an important step in health care planning for the elderly, a systematic descriptive study of ten psychogeriatric services was undertaken in the United Kingdom. A definite trend emerged of a reduction in the number of hospital beds as community services developed. Health authorities tended to establish a clinical base in general hospitals rather than in mental hospitals. The recent effect of the rapid growth of the private nursing home sector is also described. Some rough guidelines are provided for the basic resources needed to establish a comprehensive service including one assessment bed and one day place per 1,000 elderly persons; the number of long-stay beds depends on the number of places available in the private sector. While the Canadian health care system differs in some fundamental ways from that in the UK, the principles and guidelines derived from the UK experience may be applied to meet the psychiatric needs of the elderly in Canada.