bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chinese Approach to Mental Health Service
Authors: Leung Sophia M.R. , Miller Milton H. , Leung S. Wah 
Published: April 2017

This paper reviews the health care approaches in the People's Republic of China where life style, political leadership, grass roots health programs and patriotic zeal are a unified endeavour. Certain assumptions underlying North American health practices come into particular focus. Specifically, the Chinese experiences raise doubt about the value of a professionally oriented emphasis in health care and deny the worth of health programs which are not woven into the social, economic, political and ethical activities of society. How effective can our free standing groups of health professionals be in practising prevention, in enlisting public involvement in their own health care and in helping to co-ordinate needed public, private and governmental joint endeavours required for the enhancement of people's health? The Chinese maintain that the key to all health and mental health care advances is social and economic reform, grass roots programs and most importantly, a self-reliance strategy with an intense personal motivation to produce change in one's way of life. Professional responsibility worthy of public trust would be achieved only insofar as professional efforts facilitate these three areas of development. Material for this presentation is drawn from a total of six recent visits to the People's Republic of China and from personal discussions with' representatives of several delegations of health leaders during their Vancouver visits. Programs in the Shanghai Mental Hospital are described along with some reference to an interview with Dr. George Hatem (Ma Hai Teh), the distinguished physician who directed the programs which resulted in the virtual eradication of veneral diseases.
The Link Between Hysterectomy and Depression
Authors: Turpin Theodore J. , Heath David S. 
Published: April 2017

This paper reviews the current literature on the possible link between hysterectomy and depression. Psychological hypotheses for such a link are discussed. The literature is divided fairly evenly into those papers which support a definite association between hysterectomy and post-operative depression and those which refute any such link. A summary of these papers is given with a critical discussion of the various methodologies and operational definitions used. No clear-cut association can be found on review of these studies, but in those papers which do suggest an association, the risk factors of a history of pre-operative depression, no organic uterine pathology and hysterectomy in young women of child bearing age are common to most. The point is made that depression occurring after hysterectomy is more likely to be associated with the social and psychological consequences of organ removal than with the operative procedure itself, and therefore, one may not expect the condition to become clinically obvious for anywhere from six months to two years post-operatively. The authors conclude that care should be taken in performing hysterectomy where the indications are equivocal, especially if the above alleged risk factors are present. A plea is made for more research in this area to determine whether hysterectomy is a factor in the etiology of depression in some women, and if so, which women are at risk.
Manic Depressive Illness in Adolescence and Childhood: Review and Case Report
Authors: Coll Patrick G. , Bland Roger 
Published: April 2017

The literature on this topic from its inception by Kraepelin is reviewed. While Kraepelin and the French school always recognized juvenile mania, the Anglo-American school has no such unanimity of opinion. Less than 100 cases are described in the world literature. In Canada affective psychoses are rarely diagnosed under age 10 and of all affective psychoses admitted to institutions less than 5% are under age 20. The differences between child and adult mania are outlined.It is proposed that manic-depressive illness occurs in children but is not diagnosed more often because of its dissimilar presentation to the adult form and doubts about its existence in childhood.The case history of a 14 year old boy who presented in a hypomanic state is described. There was a strong family history of affective disorder. Both his parents and his half-sister were already on lithium for manic-depressive illness.
Role of Psychiatry in the Phenomenon of Cults
Authors: Levine Saul V. 
Published: April 2017

Summary Religious cults and particularly their attraction for young people are receiving increased attention. There is currently considerable controversy about the role of governmental bodies in understanding and regulating cults and their effect on members. Regardless of their effect on the members of the cult or movement, particularly new members who are often adolescents, membership in a cult produces severe familial tensions. The cult members often develop opinions and modes of behaviour so diametrically different from their families of origin that psychiatrists are often consulted with the view to understand, treat and correct what is seen as behavioural aberration by the families. The phenomenon of religious cults does not seem to be of a passing nature and it is therefore imperative that psychiatrists have as comprehensive and clear a knowledge of the concepts and activities of cults, their seeming effects on young people and their families, and some of the reactions they have caused in society.
Relationship between Abortion and Child Abuse
Authors: Ney Philip 
Published: April 2017

SummaryAlthough permissive abortion has been advocated on the grounds it will reduce the prevalence of child abuse and infanticide, there is no evidence to prove it has. There is a growing concern that it may have contributed to the problem. This article outlines eight possible methods whereby an increasing rate of abortion will lead to an increasing rate of abuse. There is evidence that an abortion results in depression which hinders mother-infant bonding in a subsequent pregnancy. An abortion of the first pregnancy may interrupt the developing bonding mechanism and interfere with the ability to bond to the next infant. If the hypothesis is correct, medicine by endorsing abortion on request may be jeopardizing the safety and care of a large number of children.
Family Studies and Changing Concepts of Personality Development
Authors: Lidz Theodore 
Published: April 2017

Summary Many of the most significant changes in concepts of personality development and maldevelopment derive simply from belated appreciation that the child grows up in a family; and that the child requires considerable positive input from those who raise him to grow into a reasonably integrated person. Only recently have psychiatrists and psychoanalysts begun to focus on the influence of the family transactions throughout the formative years. The paper briefly presents the requisites a family must provide to assure the integrated development of its offspring and groups them under four headings: the parental nurturant functions that change with each phase of the offspring's development; the influence of the dynamic organization of the family on the offspring's intrapsychic structure, affecting self-boundaries, gender identity, superego directives, and so forth; conveying through family transactions the basic social roles and societal institutions to the child; transmitting the instrumental techniques of the culture, and particularly its language with its system of meanings and logic upon which virtually all ego functioning depends. The paper considers the evidence that the “choice of the neurosis” — or more correctly, the choice of the psychiatric syndrome — does not depend only upon fixation at various phases of pre-genital development, but also, and perhaps primarily, upon the panphasic influence of the intrafamilial environment. It is of particular importance to recognize that there is a very direct relationship between the family transactions, the separation-individuation process, boundary formation, the attainment of various degrees of object constancy, problems of splitting, superego directives, and what can be conscious and what need be repressed into the unconscious. The failure to recognize the import of the family has interfered with the formation of an integrated developmental theory that can unite various aspects of the developmental process that have remained more or less isolated from one another — drive theory, object relations, ego psychology, separation-individuation, and cognitive development. Finally the question is raised if in providing guidance to parents we have been amiss in not focusing on such matters as who the parents are, how they relate to one another as well as to the child, the values they communicate by their behaviour — matters that are fundamental and to which almost all else is secondary, but about which relatively little has been said or taught.
Type a Behaviour Pattern: Relationship to Coronary Heart Disease, Personality and Life Adjustment
Authors: Keegan David L. , Sinha Bhirov N. , Merriman John E. , Shipley Carol 
Published: April 2017

Sixty male subjects, all under age 60, taken consecutively from a cardiologist's referral practice were studied in terms of A Behaviour pattern using the Rosenman-Friedman Stress Interview. Subsequently they all underwent personality, temperament and life stress assessment by questionnaire using the MMPI, Thurstone Temperament Schedule, Holmes-Rahe Schedule of Recent Experience, Rosenman Life Satisfaction Questionnaire and a number of demographic measures. They were examined medically and divided into coronary heart disease (CHD) and non-coronary heart disease (NCHD) groups. There were many more A Behaviour subjects reflecting the sampling bias from the cardiologist's practice. There were significantly more A subjects found in the group with CHD than in the NCHD group. A Behaviour subjects were more dissatisfied with their marriages and attainment of life goals and preferred respect and recognition to love and affection. The A Behaviour subjects were considered more open, self-critical, dissatisfied and passive than the non-A cohorts as interpreted from the L, K and Mf scales of the MMPI. The finding of an association between A Behaviour and CHD validates the research of others. The greater dissatisfaction in certain areas of the A subjects’ lives fits in with other research evidence and is discussed in this vein. The passive, aesthetic interests of A subjects although difficult to explain in the light of the contrasting behaviour style, is discussed with reference to earlier psychoanalytic theories. The lack of psychopathology and personality differences in A subjects points up the difficulty of recognizing the A pattern using personality tests and points to the need of improved behavioural measures.
Intellectuality and Emotionality in Psychiatric Residents
Authors: Paris Joel 
Published: April 2017

The fully trained psychiatrist must be able to integrate vast amounts of phenomenological data as well as to empathically share feeling states inpatients. Beginning psychiatric residents often lean either towards intellectuality or towards emotionality, tendencies which potentially reinforce splitting within the profession. Cognitive styles may correlate with neurophysiological indicators, such as hemispheric dominance and the augmenting-reducing dimension. There may also be sex differences in cognition; if so, they would have to be taken into account as more women enter psychiatric training. A theoretical understanding of individual differences in students provides a basis for the pedagogical correction of biases. Overly intellectual residents may be organically or psychodynamically oriented. In either case they favour theory over concrete experience, and there are difficulties in mobilizing their empathic capacities. Identification with empathic teachers and a focus in supervision on the perception and integration of more stimuli, especially nonverbal cues, are important correctives. Overly emotional residents identify excessively with their patients and tend to have problems with boundaries. An augmenting tendency, leading to stimulus overload, can be controlled by teaching residents how to structure and set limits. Identification with the supervisor is aided by clear boundaries in the supervisory relationship. In both cases the resident's strengths must not be denigrated while correcting his weaknesses. Examples of learning problems in both kinds of residents are given, with discussion of supervisory pitfalls.
A Survey of Referral Problems to a Psychiatric Preschool Program: Patient Characteristics and Therapeutic Considerations
Authors: Beitchman Joseph H. , Murray Charles , Minty Gillian 
Published: April 2017

This study provides a detailed account of the nature of referral problems found in a consecutive series of 90 cases admitted to a psychiatric preschool treatment program. The characteristics of the sample, including age, sex, and ordinal position of the children are described. The type of presenting problems and such features of the child as speech and language function and intelligence are included as well. The characteristics of the parents are also included, such as their social class and their marital and psychiatric status.These results are understood in the context of a developmental-interactional frame of reference, such that four categories of problems can be identified: 1) those children with organic/constitutional difficulties; 2) those children with mild developmental difficulties that put them in conflict with their parents’ or teachers’ expectations; 3) those children whose problems are reactive to family conflict and marriage breakdown; and 4) those marginally coping parents who decompensate when their preschooler reactivates unresolved internal conflicts of their own, which are then projected onto the child who becomes the identified patient.The nature and details of the treatment program are described with particular reference to the four categories of problems identified. The unique advantage of a program such as this, and the difficulties providing service and continuity of care for these children and families are highlighted. The importance of an integrated and comprehensive approach which coordinates the educational, social and psychiatric services is emphasized if preventive psychiatry is to retain its meaning and fulfill its mandate.
Cults and Mental Health: Clinical Conclusions
Authors: Levine Saul V. 
Published: April 2017

The field of cults and their relation to psychological and psychiatric disorder is reft with rhetoric and opinion. There has been a particular dearth of documentation and substantiated data supporting psychiatric opinion. As a result of considerable research, clinical work, and an extensive literature review, certain conclusions or strongly suggested positions are enunciated. An attempt is made to substantiate each of the ten assertions based on existing data, in the hope that they will clarify the muddy area, make clinical positions and interventions more soundly based, and inspire debate and heuristic efforts.
Exorcism and Possession in Psychotherapy Practice
Authors: Henderson James 
Published: April 2017

There has been an evolution in the layman's concept of mental disorder. Medieval belief in possession by demons and witches gave way to a 19th century medical model and more recently classical psychoanalytic formulations. Concurrently professional helping endeavour has moved increasingly from a more traditionally medical to psychotherapeutic process, and from a classical psychotherapeutic process wherein the therapist remained to a degree unresponsive and detached to a more modern emphasis on such qualities as empathy, sensitivity, reliability, and optimism as ingredients of successful psychotherapeutic practice. Freud's account of Haizmann's demonological neurosis usefully formulates the possession concept in psychological terms. However, recent developments in psychotherapeutic practice argue for a validity in the possession model of psychological distress. The possessing forces of object relations psychology are of course not the possessing demons and witches of medieval times but the possessing good and bad objects of early intrapsychic life set up through processes of introjection and incorporation in response to frustration in the early infant-mother relationship. Points of similarity in this comparison should not obscure features of contrast — there is no place for histrionic manipulation nor for a moralistic attitude in the practice of psychotherapy. A case is described to illustrate these points.
Comparison of Pimozide and Chlorpromazine in Acute Schizophrenia
Authors: Pecknold J.C. , Mcclure D.J. , Allan T. , Wrzesinski L. 
Published: April 2017

A four week double-blind study comparing pimozide and chlorpromazine was designed to test the hypothesis that pimozide, a powerful dopamine receptor blocker, is more effective in the treatment of acute schizophrenia than chlorpromazine. Twenty patients, 13 males and 7 females ranging in age from 21 to 53 years (mean age 33 years) admitted to St. Mary's Hospital with acute schizophrenia were placed on the study. They were treated on an individual titrated dosage of either chlorpromazine 300 mg to 2100 mg, or pimozide 10 to 70 mg. The results revealed that on the Brief Psychiatric Rating Scale, the chlorpromazine group significantly improved after one week, whereas the pimozide group showed no statistical improvement until the third week. By the end of the study no significant differences were apparent between the two groups. In the Clinical Global Impression Scale, a significant difference between the two groups was found at week 4 showing a greater improvement in the chlorpromazine group. In terms of adverse reactions, the chlorpromazine group had significantly fewer extrapyramidal symptoms than the pimozide group (Simpson and Angus Scale) and in addition 15 adverse reactions were noted for the pimozide group as compared with 8 for the chlorpromazine group. This study shows that chlorpromazine has an earlier onset of action than pimozide in the acute schizophrenic patient despite the fact that it has a weaker effect on the dopamine receptor than has pimozide. In view of this finding, the dopamine theory of schizophrenia should be critically re-examined.
Agoraphobia
Authors: Rapp Morton S. , Thomas Martyn R. 
Published: April 2017

The authors focus on the nature of agoraphobia and on treatments for it. A variety of myths about agoraphobia are examined such as those concerning the patient's childhood, sexual development, and marital history, and the conclusion is that none of these helps in understanding the nature of the condition. The recent notion that agoraphobia is merely a form of endogenous depression is refuted. Of the four traditional languages of psychiatry, the medical and behavioural models are currently more in vogue than the genetic or psychoanalytic, but there are limitations in all models. It is shown why the behavioural therapies for agoraphobia may not be as universally helpful as implied by the recent research literature. The apparent success of both pharmacotherapy and behaviour therapy leaves models of agoraphobia which are at variance with each other, and the authors suggest possible lines of research which might resolve the contradiction.
Insomnia: II. Assessment and Treatment of Chronic Insomnia*
Authors: Cleghorn J.M. , Bellissimo A. , Kaplan R.D. , Szatmari P. 
Published: April 2017

Evidence for non-pharmacological effects of hypnotics on sleep is presented. This suggests that behavioural variables may be involved in the regulation of sleep onset in insomnia. Chronic ‘true’ insomnia is described in terms of precipitating events: fixed behavioural patterns which perpetuate it and the disordered timing of electrophysiological and hormonal events. Specific behavioural factors relevant to an individual patient's insomnia must be identified. The factors are: (i) the patient's expectations of the experience of going to sleep and his / her belief that he can or cannot control the onset of sleep, (ii) the patients’ personal theory of the cause of the problem, (iii) what the patient says to himself privately about the problem, (iv) the presence of stimuli in the sleep setting which arouse the patients including objects, persons and behavioural rituals. Treatment requires that patients be taught special skills, individually tailored to the specific behavioural variables found to perpetuate their insomnia. Non specific ‘placebo’ effects are also involved as is the case with drug administration. Patients who fail to respond to treatment may have a masked disturbance of circadian rhythms. This recent observation requires the addition of new approaches to assessment and treatment.
Les suicides et les tentatives de suicide reliés à la prestation de soins médicaux: étude des poursuites judiciaires intentées au Québec entre 1968 et 1977*
Authors: Deschamps Pierre 
Published: April 2017

This study analyzes 39 malpractice suits based on suicide attempts of hospital patients in Quebec between the years 1968 and 1977. Both the age and sex of the victims, as well as the pathology involved, the site of occurrence, the technique used and the foreseeability of the event are examined. The study discusses the two main criteria that are used by the courts to determine liability for such occurrences, that is the foreseeability of the attempt and the possibility of its prevention. This is followed by an outline of the different factors that are considered by the courts in determining liability, such as the nature of the illness, the behavior of the patient, the site of hospitalization and the type of surveillance prescribed and exercised. This analysis illustrates the difficulty in predicting the behavior of suicidal patients. In addition, as demonstrated, it is often impossible to prevent these patients from committing suicide. In conclusion, it is important to recognize the difficulties facing those who do decide to sue, difficulties stemming from the requirement of proving fault on the part of the doctor or the hospital staff in either not foreseeing the event or in not prescribing appropriate measures so as to prevent its occurrence.
On Direct Patient Participation in the Cost of Their Psychiatric Care.
Authors: El-Guebaly N. , Prosen H. , Bebchuk W. 
Published: April 2017

A review of the relation between insurance and psychiatric services addresses the economic concerns involved. Under third-party reimbursement, a range of predictability and stability of treatment costs is observed; overall cost benefit and effectiveness for a variety of therapeutic procedures is demonstrated and socio-cultural factors play a role in the users demand behaviour. The cost of medical care is a small percentage of the system's total cost and judicious use of psychiatric consultation reduces medical and surgical expenditures. Inherent difficulties for the profession exist in a universal health care scheme. The acceptability of psychological impairment and the confidentiality dilemma are among the issues reviewed. Further attention must be paid to the therapist's fee, behaviour and income needs A traditional defensiveness regarding these matters should be overcome through a peer review process in order to further delineate responsible financial norms of psychiatric practice. The “laissez-faire” attitude observed in most of our training programs towards financial matters must be addressed in order to participate effectively in the ongoing sociopolitical dialogue on the funding of healthcare.