bluuebunny/crossref_metadata_2025_split huggingface dataset:
Article
Authors: Streit-Forest Ursula , Goulet Et Marc 
Published: April 2017

In this study a group of 27 victims seen approximately 6 months after the assault was compared to a matched control group. The results show significantly higher scores on two subscales of IPAT (“ego weakness” and “disposition to guilt”) and on 4 scales of the MMPI (“denial”, “hypochondriasis”, “depression” and “conversion hysteria”); also, the victims' social adjustment seems inferior and the frequency of sexual relations has been reduced considerably for them. The following factors have been evaluated in order to test their relation to the adjustment to the assault: rape by a stranger versus someone known, degree of violence, feelings of self-blame, problems during the crisis, predominant thoughts, professional help, social support, stable relationship, allusion to victim's responsibility for rape and conviction or not of the aggressor. Even though most of these variables show a significant simple correlation with adjustment to rape only four among them remain significantly associated when socio-demographic variables, pre-rape psycho-social problems and life stressors are controled; the very subjective variable “predominant thoughts”seems to best explain differences in adjustment. The importance of pre-assault variables and of the subjective reaction to rape is discussed.
Case Reports
Authors: Brooks Simon A. 
Published: April 2017

The etiology of Folie à Deux remains a controversial topic; the relationship between the psychopathology exhibited by the dominant partner and that shown by the submissive one being particularly unclear. Modern etiological theories attempt to reduce the phenomena of Folie à Deux to a procrustean mould, emphasizing in particular the contribution of schizophrenic pathology to the development of the condition. A case is described which raises doubts about the general applicability of this approach.
The Relevance of Infant Psychiatry to the Understanding of Adult Psychopathology
Authors: Minde K. 
Published: April 2017

This paper examines the relevance recent findings in Infant Psychiatry may have for the understanding of adult psychopathology. For example, evidence of both continuity and discontinuity within development is cited as one way in which the continuity of specific psychiatric conditions from childhood to adulthood can be understood. Another example are the aims of Developmental Psychopathologists who examine the mechanisms which underlie developmental transformations and who try to differentiate variations seen in normal individuals from disorders. The paper ends by citing the advantages Infancy as a developmental period has in providing reference points for the understanding of cohesion within development. These are: 1. The rapid rate of change seen in children during this age period. This allows the observation of many developmental transformation and reorganizations. 2. The degree to which infants document how much we can shape our own environment. 3. The pervasive importance interpersonal relationships have for any human activity. 4. The need to understand development and hence change within the context of the environment. 5. The persuasive evidence which suggests that psychological disorders are generally based on real rather than imagined adverse events.
Neuropsychiatry and Child Psychiatry: The Case of the Brainstem Evoked Potential as an Illustration*
Authors: Thivierge Jacques 
Published: April 2017

In child psychiatry one may frequently and reasonably suspect the existence of a neurophysiological abnormality of some kind even though this abnormality is not detectable with readily available technology: in children presenting developmental or acquired aphasia, in some specific learning disabilities, in severe developmental disorders or perhaps in a subgroup of those labeled Attention Deficit Disorder. 1. The importance for us as child psychiatrists to keep in mind the possible role of neurophysiological factors is put into perspective. 2. What Evoked Potentials are is briefly described as well as the basic principles of the technique used in recording them. 3. A review of the literature reveals how the Brainstem Auditory Evoked Responses (BAER) have helped in understanding unknown facets of known diseases (Diabetes, Hyperthyroidism, Bell Palsy, etc….) from this, it is argued that this is reasonable to expect the same usefulness for diagnosis in child psychiatry. 4. An opinion is offered as to how and when a child psychiatrist should make use of this investigation.
What do Children Know about Preventing Sexual Assault? How can Their Awareness be Increased?*
Authors: Sigurdson Eric , Strang Malcolm , Doig Terrie 
Published: April 2017

Recent awareness of the pervasiveness of sexual abuse of children has resulted in a move to implement prevention programs. In conducting these programs the question of effectiveness is frequently asked. In an attempt to answer some of this concern, a questionnaire was developed and tested to determine children's base level of knowledge. The video format prevention program, “Feeling Yes, Feeling No”, available from the National Film Board (Canada) was tested as a method of increasing awareness. A school with a cross section of town and rural children, with differing socioeconomic backgrounds, participated in the study. The study consisted of a pretest of knowledge, a structured video interactive classroom prevention program, and a post-test measure of change. One hundred and thirty-seven students in grades 4, 5, and 6 participated. The program took 4 weeks to complete. When asked about their feelings with regard to the program, 97% of the children stated that they enjoyed it. The results indicated that while most children have a basic level of self-protective knowledge and assertiveness, they can, in a classroom setting, learn significant and additional facts about avoiding sexual assault. Eight of twenty-nine knowledge questions elicited a large change in response, suggesting increased awareness of self-protection. The most significant changes occurred with girls, the same group apparently most at risk.
Children of Parents with Manic-Depressive Illness: A Follow-Up Study*
Authors: Laroche C. , Sheiner R. , Lester E. , Benierakis C. , Marrache M. , Engelsmann F. , Cheifetz P. 
Published: April 2017

Thirty-seven offspring from 21 families with a manic-depressive parent were studied 3 to 7 years following initial evaluation. The study examined both pedigree information and psychosocial variables including parental, marital and overall adjustment, measures of chronicity and severity of parental illness and family assessment measures in rleationship to offspring functioning. Nine of the 37 offspring (24%) received a positive DSM-III diagnosis, which is a similar percentage of positive diagnosis of children as we found previously. The diagnoses clustered in the affective illness spectrum. When the presence of affective traits was considered, there was evidence for continuity of psychopathology in most cases. Associations between offspring psychopathology and both non-specific and specific parental risk factors are discussed.
Eating Disorders: Implications for the 1990's*
Authors: Garfinkel Paul E. , Garner David M. , Goldbloom David S. 
Published: April 2017

In the past decade much has been learned about the clinical features, diagnosis and understanding of people with anorexia nervosa and bulimia nervosa. In order to provide the next level of improvement in our care for these patients, our understanding of certain problems must be addressed by empirical research. Areas which require further study include the definition of high risk groups, the refinement of diagnoses, understanding factors which result in chronicity, determining the complications of chronicity and comparative evaluations of different treatments. These five areas are outlined in this article. Populations at risk for anorexia nervosa and bulimia nervosa may be those who must be thin and achieve according to career choice, those with a particular family and personal psychiatric history; obesity and chronic medical illnesses may be further risks. Improved diagnostic understanding has occurred by the differentiation of bulimic from restricting subtypes of anorexia nervosa. Further work must determine the relationship between the bulimic subtype of anorexia nervosa and bulimia in normal weight women and to further clarify the relationship between eating disorders and affective disorders. A number of factors may result in a chronic illness. These have been described on a variety of levels. The consequences of starvation in altering an individual's thinking, feeling and behaviour do play a role. It is not clear what factors at a neurochemical level contribute to this. Elevated endogenous opiates decreased noradrenergic function and decreased serotonin may be important. Information about the chronic complications is required for clinicians to understand the broad range of difficulties that may develop over time so that clinicians may use this information in planning treatment strategies. Two examples, those of osteoporosis and the pregnant woman with an eating disorder, highlight this problem. Finally, treatment is briefly reviewed in terms of options available and the idea of developing a stepped-care approach to treatment.
Treatment of Heroin Withdrawal with Guanfacine: An Open Clinical Investigation*
Authors: Soler Insa P.A. , Bedate Villar J. , Theohar C. , Yotis A. 
Published: April 2017

The alpha2-adrenoceptor stimulant, guanfacine, was used to treat, under open conditions, heroin addicts who volunteered to withdraw from heroin usage. Thirty-four addicts (29 males, 5 females) aged 17 to 31 years were treated for 5 to 15 days with varying doses of guanfacine (0.03 up to 1.75 mg daily). Efficacy was determined by the “Opiate Withdrawal Checklist” (OWCL), administered several times during the day, and by the Clinical Global Impression (CGI) scale. All symptom categories of the OWCL, except “sleep disturbances” were equally ameliorated by the treatment. According to the CGI, 88% of the cases were judged as having had a very good or good improvement. Tolerability to the medication was judged as good or very good in 94% of the cases.
Computer-Supervised Exposure Treatment for Phobias
Authors: Carr A.C. , Ghosh A. , Marks I.M. 
Published: April 2017

Twenty phobic outpatients were treated by 9 weekly “interviews” at the console of a desk computer. Using a conversational style and multiple choice questions, the computer assessed the symptoms and agreed a hierarchy of self-exposure tasks. Each week the patient was given a diary sheet of tasks to practise daily. At his next visit his progress and motivation were assessed, and if he was succeeding he was encouraged to accept progressively more difficult tasks. This group was compared with a group of 20 patients (matched for age, sex and type of phobia) treated conventionally by a therapist in the preceding year.Progress was measured on standardized scales (both self- and clinician-rated). The two groups showed significant improvement on all the scales, and 75–80% of each group were much improved (scores reduced by 50%). The therapist treated group tended to be more severely ill at entry and to show greater improvement during treatment. Improvement was maintained at 6 month follow-up in both groups.
Le problème psychologique de la chute chez la personne âgée
Authors: Albarède Jean-Louis , Lemdzux André , Vellas Bruno , Groulx Bernard 
Published: April 2017

This article recognizes the high incidence and prevalence of falls in the elderly. Psychological factors can play a definite role as part of the etiology. The fall can be a depressive signal or a cry for help from a demoralized elderly patient. The authors stress the importance of recognizing the depressive syndrome of the elderly. Psychological consequences of the falls are reviewed at three different levels. For the elderly, the consequences are frequently a fear that can lead to a sharp decrease in functional capacity. For the family, the fall can lead to the institutionalization of the elderly or a very restrictive surveillance. For the family physician, the fall is frequently perceived as an emergency that leads to immediate unwarranted admission. A rational approach, with education and guidelines, is proposed and can render this traumatic experience less dramatic at these three different levels.
Canadian Collaborative Study of Tetrahydroaminoacridine (THA) and Lecithin Treatment of Alzheimer's Disease: Effect on Mood
Authors: Vida Stephen , Gauthier Louise , Gauthier Serge 
Published: April 2017

Several lines of evidence have implicated acetylcholine (ACh) as one of the neurotransmitters found to be decreased in Alzheimer's disease (AD). Various methods of cholinergic augmentation have been attempted, with mixed results. Tetrahydroaminoacridine (THA), an acetylcholinesterase inhibitor, is currently being investigated at the McGill Centre for Studies in Aging. Preliminary uncontrolled data from a 10-week clinical trial of THA and lecithin, reported elsewhere, suggest a clinically modest but statistically significant beneficial effect on cognition, although problems exist with side effects, particularly gastrointestinal. Since the suggestion by Janowsky in 1972 that cholinergic neurotransmission may exert an inhibitory or depressant effect on mood, the evidence accumulated in the literature has been inconclusive. We undertook to assess several potential pretreatment correlates of depressive symptoms in AD and to monitor the course of these symptoms during the 10 week treatment period, using the Geriatric Depression Scale (GDS) of Brink and Yesavage. Pretreatment GDS scores were found to correlate with degree of overall disability and dementia as measured by the Rapid Disability Rating Scale (RDRS) and the Mini Mental State Examination (MMS), respectively. GDS scores over the treatment period did not change to a statistically significant degree. The meaning of these results is discussed, particularly with reference to the difficulty of diagnosis and measurement of depression in the setting of dementia.
Viewpoint: Development of Mental Health Services and Psychiatry in Canada: Lessons from the Past: Problems of the Present; and the Future
Authors: Roberts C.A. 
Published: April 2017

The history of mental health services in Canada has been characterized by great frustration for those dedicated to the development of programs to meet the needs of the mentally ill. Acceptance of these services by the public at large has been limited and characterized by suspicion and lack of trust. In recent decades these two trends have contributed to the present situation in which it is difficult to recruit competent, well-motivated clinical staff for our more isolated mental hospitals and there is increasing emphasis on legalistic aspects of individual civil rights, compulsory treatment and related factors with little attention to the patient's entitlement to and need for adequate treatment. It is hypothesized that more understanding and progress may come from an insightful review of the historical development of Canadian Mental Health Services and the goals of organized Psychiatry in Canada than will result from developing a defensive and confrontational attitude towards current events in the field.
Article
Authors: Plante Gilles C. , Huberdeau Lucie , Gagnon-W Et Claire 
Published: April 2017

What happens to deprived children when they grow up? The authors tried to answer this question by initially selecting 34 subjects clearly identified as suffering a deprivation syndrome in their youth. Following theoretical considerations, the authors formulated hypotheses which they attempted to verify by comparing the nine adult subjects available who had suffered deprivation during their youth with whom they were able to establish contact with nine others diagnosed as neurotic (the control group).The authors predicted that the deprived subjects would present more disability as adults than the neurotic ones. They were predicted to be more inclined towards delinquency and depression. It was hypothesized that they would not drift into psychosis, psychosomatic illness or become “young chronics”. We did not expect that they would move very much on the social scale.The authors seized the opportunity to learn more about the satisfaction with the psychiatric interventions experienced during their youth.In this study, the authors used a questionnaire and four scales of the MMPI to compare the two groups. The deprived subjects demonstrated more maladaptation with a strong tendency towards delinquency and possibly depression. They were not mobile on the social scale, and did not drift into psychosomatic illnesses or become “young chronics” but some psychosis was observed among them.In the final discussion, the authors discuss the limitations of the study due to the size of the sample and problems of the methodology, along with ways that this could be strengthened in order to more successfully answer some of the questions raised.
Neuroendocrine Probes as Biological Markers of Affective Disorders: New Directions*
Authors: Brown Gregory M. 
Published: April 2017

Numerous endocrine abnormalities are found in depressive illness and, among these, several have been proposed as useful markers in diagnosis, prediction of treatment response, monitoring treatment outcome or in understanding of etiology. This paper reviews five endocrine systems — the hypothalamic-pituitary-adrenal axis, hypothalamic-pituitary-thyroid axis, growth hormone regulation, prolactin regulation and pineal function, in which such abnormalities have been reported. The dexamethasone suppression test (DST) results are affected by a variety of other diseases and confounding conditions. Furthermore, variability in dexamethasone availability has recently been shown to be an important factor, influencing post-DST cortisol levels. Refined tests, taking into account all these factors, or alternative tests of hypothalamic-pituitary-adrenal function may lead to improved clinical utility. Pineal function is now the focus of considerable investigation. Low nocturnal output of melatonin is found in unipolar and bipolar affective disorder and is normalized by treatment with antidepressant drugs which block re-uptake of noradrenaline. These findings support the hypothesis of noradrenergic abnormality in depression. In seasonal affective disorder there is evidence for a phase delay in the melatonin rhythm which may be a key factor in the seasonal disorder. Effective light therapy causes a phase advance in the abnormal melatonin rhythm. Whether the normalization of the melatonin rhythm is instrumental in producing the antidepressant effect is yet to be determined. There are wide spread neuroendocrine abnormalities in depressive illness. These abnormalities encompass many different pituitary hormones, as well as the pineal. Major theories of affective disorder attribute the mood and visceral changes to disruption in central neurotransmitter regulation or to altered central regulation of body rhythms, or to both. It is thought that disruption of these central systems give rise not only to the mood and visceral changes, but to the accompanying changes in endocrine regulation. Current diagnostic practice is to use clinical history and observation to identify typical forms of depression. Such an approach to diagnosis is less useful in delineating atypical, borderline or sub-clinical affective disorder. For these reasons, the endocrine changes have been proposed as biological markers to be used as clinical aids in diagnosis, prediction of treatment response, monitoring treatment outcome and in understanding etiology. This paper reviews and evaluates published data on five such endocrine measures.
Qui Sont Les Patients Traités en Clinique Externe Avec des Doses Élevées de Neuroleptiques?
Authors: Leblanc Gérard , Cormier Hugues J. , Vaillancourt Sylvie , Gagné Marie-Andrée , Gingras Christian 
Published: April 2017

The use of high doses of neuroleptics (NL) in treatment of chronic psychosis is a controversial subject in the literature. In this context, it is surprising to note the lack of objective data about the prevalence and the consequences concerning this mode of prescription when treating people suffering from severe mental disorders. This study describes the clientele exposed to high doses of NL from an outpatient clinic of a psychiatric hospital. The equivalent of 18 mg or more of haloperidol per day was used as the high dose criterion. Overall, we observed the use of NL in all diagnostic categories and the frequent use of polypharmacy in patients treated with NL. Among the 435 patients receiving NL, 26.4% had high dose prescriptions (two men for every woman). Most of these high dose NL subjects had a diagnosis of schizophrenic disorder (87.9%). Fifty-one of them had been receiving high doses for six months or more and 39 of them agreed to meet our research team. The mean age of these subjects was 37.2 years and the mean dose was 63.5 mg haloperidol equivalent/day. Thirty-five subjects were diagnosed as chronic schizophrenic disorder and four as schizoaffective disorder. Nineteen patients had tardive dyskinesia. In two out of three cases the high dose perscription began during hospitalization and the main reason was presence of severe psychotic symptoms. Significant positive correlations were found between parkinsonian symptoms and negative symptoms of schizophrenia as well as psychosocial dysfunctions on 39 subjects. These findings support the hypothesis that the use of high doses of NL contribute to the negative symptoms and the psychosocial dysfunctions. The implications of these findings relating to assessment and treatment of schizophrenic outpatients are discussed.
Le Problème des Troubles de la Personnalité en Psychiatrie
Authors: Denis Jean-Francois 
Published: April 2017

Psychiatric patients with personality disorders are among the most difficult because of the counter-transferential strain they put on clinicians and the paucity of specific treatment. The author develops the point that personality disorders are not diseases as implied in Axis I disorders, but social illness syndromes which depict systemic problems in which clinicians can be engulfed and entrapped. The difficult patient does not exist in isolation, a victim of his own drives and psyche, but rather is a specific socio-cultural actor living and emerging from a particular environmental context. Personality disorders are considered to be interpersonal patterns in which a person's debilitating behaviour elicits complementary behaviour that reinforces the original behaviour. Within a systems perspective, there is not a disordered personality so much as a disordering system of relationships. As with families and society, healers too become involved in the vicious cycle of personality disorders if they fail to see the manipulative interpersonal devices used by these patients. If clinicians accept too naively the lay person's simplistic belief that personality disorders are diseases to be treated by psychiatrists, they run the risk of fostering inappropriate passivity in patients in the face of life demands. Overindulgence and angry rejection are the two major pitfalls often seen in clinical practice. The approach proposed here may seem conterintuitive in laying stress on the need to actively resist the temptation to take over reponsibility for a patient's life. There is a difference between a behaviour that a patient's illness (Axis I disorder) prevents him from controlling and an impulsive deliberate behaviour stemming from character pathology. It is a logical error to deal with personality disorders in the same manner and with the same conceptual terminology as for depressive and psychotic disorders. Principles of management are detailed and can be summarized as a kind firmness to bring back patients to take on their own responsibilities.