bluuebunny/crossref_metadata_2025_split huggingface dataset:
Les Phenomenes Mystiques Chez le Malade Psychiatrique
Authors: Duguay Robert , Chaloult Louis , Tétreault Léon 
Published: April 2017

An inquiry about mystical phenomena in psychiatric patients was done in a large French Canadian psychiatric hospital. Four hundred and fifteen patients, taken at random, with functional psychiatric illnesses, were assessed. It was found that 19.28% of this population experienced mystical phenomena. The mystical experience was defined as an unusual psychological state in which a subject had the conviction of being in contact with God or any religious personality of the religion (angels, saints, etc…). The incidence of the mystical phenomena was studied in connection with four parameters: 1. identification characteristics of the patient 2. type of illness 3. sexual life of the patient 4. tendency of the patient to swear Six statistically significant features were identified in mystical patients: these patients have more sexual behavioral symptoms, are more inclined to swear, are more often paranoid schizophrenics with a chronic illness, are not married and have belonged previously to a religious order.
Psychiatric Service to the Juvenile Court a Model
Authors: Chamberlain Clive , Awad George 
Published: April 2017

The interface between psychiatry and the law developed unevenly and the greatest concentration has been in the area of criminal behaviour—family law and juvenile deliquency have been relatively ignored. When developing a clinical service in relation to a Family Court, the lack of literature on the subject became obvious. This paper gives an account of the historical development of the Family Court Clinic in Toronto beginning in 1920 at the time of the appointment of the first full-time Juvenile Court Judge. In terms of the problems and limitations the development of this clinic was typical of similar ventures elsewhere in North America. These problems include insufficient funding and staffing, unrealistic demands for service by the Courts, and incomplete understanding of the operation and needs of Courts on the part of mental health workers. A Family Court Clinic at the Clarke Institute of Psychiatry is offered as an example of a survivor of these and other vicissitudes, with the hope that some of its policies and practices may be useful to those involved in this work. It is felt that several ingredients are responsible for the success of the clinic, among them being attachment to a university clinical setting, a flexible appointment schedule such as evening office hours and the avoidance of a solely diagnostic approach to the work. In the past many clinics have failed because they were chiefly assessment-oriented, offering formulations of the problems but very little in the way of remedies. While unable to provide ongoing treatment for its very large clientele, the clinic operates in such a way as to provide a very broad range of service including a referral policy which treats the process of referral to other services more as a ‘service brokerage’ than the more conventional procedure of a referral letter. This is a much more active involvement which does not cease until the patient has begun receiving a service. Other programs of the clinic in relation to the Juvenile Court are mentioned in the paper and include training programs for judges and other court staff and also research activity. Experience over the past five years with the clinic is discussed in terms of the difficulties encountered in development and the attempts to resolve these. There is a need for clinicians involved in such enterprises to share problems and solutions and to anticipate increasing demands upon psychiatrists for service in relation to family law and family courts.
Frequency and Significance of Minor Organic Signs in Elderly Depressives:
Authors: Cole M. , Hicking T. 
Published: April 2017

Eighty-six elderly depressed patients were followed up for two years. Twenty-nine (34 percent) displayed minor organic signs (partial disorientation to time and/or partial disorientation to place and/or mild impairment of registration or recent memory). Minor organic signs were associated with a significant reduction in discharge rate two years following admission in patients aged 70 years plus. Among those discharged, minor organic signs were associated with a significant decline in living arrangements two years following admission. Coincidentally, minor organic signs identified a group of elderly depressives characterized by older age, depressions of late onset, and few precipitating events.
Patterns in the Delivery of Psychiatric Care in Saskatchewan 1971–72: An Overview of Service Sectors and Patient Volumes
Authors: D'Arcy Carl 
Published: April 2017

For the purpose of examining patterns in the delivery of psychiatric services in the province of Saskatchewan during 1971 and 1972, a research data file was created containing data on all persons who had received medical treatment for explicitly psychiatric disorders: from PSB; from a physician paid on a fee-for-service basis under MCIC; and/or in a provincial general hospital. The resulting data file provides a history of the psychiatric care utilization behaviour of all patients who have been treated for a psychiatric illness in the province during the period January 1st, 1971 to December 31st, 1972, irrespective of the facilities in which this treatment was delivered. This data file, since it has keyed on explicitly psychiatric diagnoses and on diagnoses rather than type of service delivered, will give conservative estimates on the number of patients and patterns of contacts. During the two-year period a total of 123,099 received some form of psychiatric treatment. There were six times as many patients seen by fee-for-service physicians as by the ‘public’ sector. In both sectors the majority of patients were seen on an outpatient basis. Patients in the ‘private’ sector were usually seen by general practitioners. There appear to be two relatively autonomous sectors involved in the delivery of psychiatric care to different population segments. There was also a significant ‘turnover’ in the provincial psychiatric population, with patients receiving treatment in one year but not in the other. The data could be interpreted to suggest that the majority of persons seen for psychiatric reasons by medical practitioners are suffering from relatively minor psychiatric ailments. This raises the whole question of the suitability of the service delivery system and the question of manpower substitution. Alternatively, it could be argued that these data, both the large number of outpatients and the considerable yearly turnover in the provincial psychiatric population, indicate that psychiatric problems are now essentially amenable to treatment.
Supervision of Psychotherapy with Psychiatric Residents: One Model
Authors: Greben Stanley E. 
Published: April 2017

Training of psychiatric residents should include supervised experience in psychotherapy, whatever the mode of practice the psychiatrist-to-be will later choose. individual supervision of psychotherapy on patients seen at least once a week for a year offers the best opportunity for learning in this area. The supervisor has a teaching role which includes showing the resident how to look more objectively and insightfully at the material, serving as a partial model of a professional identity, and giving direct didactic help regarding the subject of psychotherapy. Such an experience leads to growth and development of the resident in his professional role as psychotherapist.
An Approach to the Treatment of an Adolescent with Ulcerative Colitis: Conjoint Therapy of the Parents
Authors: Maclean G. 
Published: April 2017

Summary The pertinent literature on the psychopathology and psychotherapy of individuals with ulcerative colitis is briefly summarized. A particular problem encountered in clinical practice is then described and an approach to its solution is detailed. A 14-year-old, middle-class girl had experienced exacerbations of ulcerative colitis over two years. Without her agreement, she was referred for psychiatric assessment by a gastroenterologist when he found that she was not cooperating with medical treatment, and when she appeared depressed. On assessment, the patient was found to be a silent adolescent whose main symptoms were indicative of immaturity, shyness and anger. This was understood in terms of the overprotective, domineering mother, a protective father and even a protective brother. The therapeutic problem was outlined on referral by her reluctance to take medication, to see doctors or to “let her friends know” of her illness. The patient and the family interactions are described. Confronted by a girl whose denial was of such proportions it became clear that individual psychotherapy could not begin. There was no motivation and no contract to work towards this goal, and there was excessive resistance. With the girl's refusal to become involved in family therapy, it was decided that both parents should review their respective parenting roles in conjoint therapy. This had as its goal the provision of a more stimulating opportunity for the growth and development of the patient. The author describes in detail the assessment and treatment, which was conceptualized as occurring in two stages. Stage one was an attempt at individual therapy and at developing a therapeutic alliance, both of which were unsuccessful. The second stage, conjoint therapy of the parents took place, and provided a more fruitful outcome.
Blindness: Some Psychological and Social Implications
Authors: Keegan David L. , Ash Daniel D.G. , Greenough Timothy 
Published: April 2017

Psychiatry must increase the knowledge of adjustment to various physical disabilities if it is to act in a strong consultant role to medicine and surgery. To this end, the study of one hundred and fourteen adventitiously, declared blind subjects was carried out through structured interviews and psychological and social adjustment measures. The variables were statistically analysed, using the F test, Duncan's Multiple Range test and Canonical Correlation Analysis. The best social function occurred in the youngest age groups, those who had the highest yearly income at the time of maximum life function and who entered rehabilitation. The best psychological and social function was found in those who had given up false hope of regaining vision. The group who had not given up this false hope did poorly on social and psychological adjustment measures and were generally unemployed, coped poorly and did not attend programs in the Canadian National Institute for the Blind (CNIB). The onset of visual loss was found to be the time of greatest crisis, while declaration of blindness in itself led to no particular crisis with associated diminished social or psychological adjustment. Some concern is noted that the CNIB, the major caregiver for the blind, cannot offer assistance at onset because of the legal definition of blindness, and poor service may be furnished by family physicians, ophthalmologists and psychosocial helpers due to lack of understanding, shifting of responsibility and at times, neglect, assuming that the CNIB is assisting when they cannot or are not. More research is needed in all aspects of psychosocial care for the blind. Communicating among helping groups and with the CNIB is imperative if the visually handicapped are to get better psychosocial care.
The Medical Student Therapist Treatment Outcome
Authors: Miles James E. , Mclean Peter D. , Maurice William L. 
Published: April 2017

Summary Sixty inpatients from a psychiatric ward, where senior medical students function as the sole primary physicians, were matched with 60 inpatients from two other wards in the same hospital who had been attended by psychiatric residents and certified psychiatrists. The problem-oriented medical record was used as a basis for treatment evaluation. Ratings by the patient at discharge, and the patient, a significant other and follow-up professional at three months, showed no significant difference in the treatment outcome between the two groups.
Implantation De La Therapie Comportementale En Milieu Psychanalytique
Authors: Lamontagne Yves 
Published: April 2017

In French-speaking Quebec, implantation of behaviour therapy in psychiatric hospitals has been difficult because psychiatrists' training was and still is almost exclusively based on psychoanalytic theory. For this reason, many psychotherapists do not use the knowledge derived from laboratory experiments and only rely on their clinical judgement. Prejudiced by their professional identity, many psychiatrists believe that behaviorists manipulate and control patients, mechanize therapy, deny the importance of interpersonal relationships and only use punitive techniques. After refuting these arguments, the author describes the practical difficulties encountered when implanting behaviour therapy in a psychoanalytic milieu, as well as the advantages of a better understanding between these two schools, which might lead to psychiatry becoming more scientific, more human and closer to daily reality.
Maprotiline — a Double-Blind Study of a New Tetracyclic Antidepressant in Severe Depression
Authors: Molnar G. 
Published: April 2017

A double-blind study was carried out comparing the antidepressant properties of maprotiline (a new tetracyclic antidepressant) and amitriptyline. Twenty-one hospitalized severely depressed patients, selected on the basis of clinical and psychometric criteria, completed the trial period of 28 days. The new drug was found to have an order of effectiveness similar to that of amitriptyline and both drugs were effective in agitated as well as retarded forms of depression. For both, the “day of effect”, intended as the timing of sharp clinical improvement, tended to occur during the second week of treatment. Both drugs were well tolerated by most patients but one of the maprotiline patients presented a generalized rash which resolved after discontinuation of the drug. In conclusion, maprotiline is seen as an interesting addition to the group of major antidepressant drugs.
Psychic Trauma and Traumatic Neurosis
Authors: Maclean G. 
Published: April 2017

In the introduction to a clinical example of a young boy with a traumatic neurosis, this paper reviews the phenomena of psychic trauma. Freud's contribution to the initial description of the phenomena is discussed with consideration of such factors as the “stimulus barrier”, breaks in this “protective shield” and the development of a “traumatic neurosis”. The elaboration of these concepts is followed in their later development in the literature. The clinical example presented by the author is a description of the assessment and treatment of a four-year-old boy who had been mauled by a leopard in a suburban pet store. The presenting complaints at the time of assessment were numerous and of precise onset to the time of the mauling. The boy exhibited disturbance in sleep, clinging, fearful, apprehensive behaviour and marked separation anxiety. All such symptoms appeared as a marked regression in the boy's formerly normal development. The child's course in play therapy is detailed. This highlighted the existence of a number of intrapsychic conflicts involving anger, guilt and the fear of retaliation. The fact that such conflicts predated the traumatic event is postulated to be a determinant of the traumatic process.
Treating the Borderline Patient in Psychotherapy
Authors: Masterson James F. 
Published: April 2017

An attempt has been made to describe the contribution of maternal libidinal availability and withdrawal to the etiology of the borderline syndrome. The mother's vital contribution to normal ego development has been emphasized, and the effects of deficiencies in that contribution to the development of the intrapsychic structure of the borderline — the split ego and the split object relations unit. The latter develops from the internalization of the two major themes of interaction with the mother, produces the lietmotif of the borderline's intrapsychic structure — the rewarding and withdrawing object relations part units. The rewarding part unit becomes allied with the pathological ego to defend against the withdrawing unit, but at the cost of failure to cope with reality. The relationship of these borderline intrapsychic structures to each other and to the therapist's intrapsychic structures, as developed in the therapeutic transference and resistance, is described and illustrated in a clinical example.
Dopamine and Schizophrenia: A Reappraisal in the Light of Clinical Studies with Clozapine
Authors: Nair N. P. V. , Zicherman V. , Schwartz G. 
Published: April 2017

In this paper we review the results of our clinical evaluation of a novel antipsychotic drug, clozapine, and discuss some fundamental issues in the neuropharmacology of schizophrenia, in the light of the results. Nineteen hospitalized chronic schizophrenic patients were treated with clozapine. The drug was administered according to a fixed changing dosage schedule, ranging from 75 mg to 800 mg daily. There was a highly significant improvement as measured by the Brief Psychiatric Rating Scale. At the same time no evidence of Parkinsonism or other extrapyramidal side effects was noted in these patients during the drug administration. For some time now, drug effect on the extrapyramidal system mediated through the nigrostriatal dopaminergic pathway was considered necessary for therapeutic effects in schizophrenic patients. But the recent discovery of the mesolimbic dopaminergic system raises the possibility that the therapeutic action of antipsychotic drugs could be mediated through this pathway without necessarily affecting the nigrostriatal pathway. This is further supported by the fact that these two dopaminergic systems have somewhat different pharmacological properties in relation to DA turnover and DA receptor blockade. The present study clearly demonstrates the antipsychotic property of clozapine. It is equally clear that it induces no extrapyramidal effects. These findings tend to support the hypothesis that clozapine may be selectively blocking dopaminergic receptors in the limbic system. The pharmacological evidence from the literature for this selectivity is presented to support the hypothesis that schizophrenic symptoms are related to excessive dopaminergic activity in the limbic system. In conclusion it can be stated that clozapine represents a significant advance in the investigation of the neuropharmacology and pathophysiology of schizophrenia.
Physical Illness and Length of Psychiatric Hospitalization*
Authors: Allodi F. , Cohen M. 
Published: April 2017

The authors examined physical health in relation to length of psychiatric hospitalization. One hundred and three consecutive patients admitted to an Ontario psychiatric hospital were studied for age, sex, marital status, living arrangements, previous psychiatric hospitalizations, psychiatric diagnosis and length of stay. The patients were classified as physically healthy, with minor or with major illness present. Physical health was found to have a significant association with length of psychiatric hospitalization. Healthy patients tended to stay a shorter period of time (1–3 days) and those with major illness stayed longer (greater than 21 days). As expected, marital status and psychiatric diagnosis were also associated with length of stay; married persons stayed for shorter periods and those with functional and organic psychoses stayed longer. The direct association between physical health and length of hospitalization has not been reported before and, in considering the role of the mental hospital, psychiatrists and administrators should be constantly aware of the physical health needs of psychiatric patients.
Sodium Amytal in the Diagnosis of Chronic Pain*
Authors: Shoichet Roy P. 
Published: April 2017

The diagnosis of chronic pain cases is now an important problem for psychiatrists and many authors have presented strong evidence for the influence of psychological factors in chronic pain conditions. The author is reporting his experience with 75 consecutive out-patient consultations. Many of the patients were foreign-born and had significant language difficulties. The main diagnostic technique described is the use of sodium amytal given intravenously over a 45 minute-period while the patient is examined physically and psychologically; his responses noted during light, midrange and deeper levels of sodium amytal sedation. Most patients fell comfortably into one of the following diagnostic groups: psychogenic regional pain, organic pain, mixed group (organic plus psychogenic regional pain), and malingering. The author suggests that sodium amytal helps to overcome language barriers, reduces the time required for proper assessment and allows the patient and the examiner to appreciate more precisely, the level of pain and the limits of physical performance as well as permitting an effective exploration of important psychodynamic issues.
Flight into Femininity
Authors: Steiner Betty W. , Satterberg John A. , Muir Craig F. 
Published: April 2017

This paper reports on an unusually interesting group of patients who were seen in the Gender Identity Clinic, Clarke Institute of Psychiatry, during the first two years that it was clinically active. (September 1975 to August 31, 1977). The sample consists of 21 male patients, between the ages of 40 and 65, who diagnostically have been transvestites most of their lives. They present with the request for surgical sex reassignment. This request for surgery comes at a period of “middle-age crisis” in their lives. A comparison is made between these older male patients and 27 younger male patients seen in the Clinic who also requested surgery. The findings show that the older group tend to be younger at their age of initial cross-dressing, are more socially introverted than the younger transsexuals, and show greater scholastic ability. The most important finding is the predominantly strong heterosexual orientation in these older men when compared with younger gender disordered males. In certain respects these “older” men are rather typical of normal, heterosexual males. The authors speculate on the findings and suggest that this older male group who request surgical sex reassignment in their middle years, use the desire to “become a woman” as a defence mechanism against an underlying depression. Essentially they are going through the climacteric or “the male menopause”, and should be treated by individual and/or marital therapy (providing the spouse is still living with her husband) together with antidepressant medication, if necessary.
Medical Students' Views of Psychiatry
Authors: Mccormick W.O. , Voineskos G. 
Published: April 2017

Medical students' views of the subjects: Psychiatry, Neurology and Surgery were studied before and after a nine week course which included Psychiatry and Neurology. Surgery was not being taught and was regarded as a control subject. Visual analogue measures of each subject as a career possibility, its importance and its interest were obtained in addition to a ranking for career choice of eight specialties. In addition, students' attitudes to psychiatrists, neurologists and surgeons (as control) were studied using semantic differential scores. The scores on the subjects showed changes favourable to Psychiatry after teaching which were not paralleled in Neurology or Surgery. The semantic differential scores clearly discriminated the three specialists; there were small changes after teaching but the broad differences in attitude to the specialists remained. Some evidence is presented that the more favourable changes towards Psychiatry were related to the quality and intensity of teaching.