bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity in Mental Health Surveys
Authors: Leighton Alexander H. , Leighton Dorothea C. , Danley Robert A. 
Published: April 2017

In recent years a method of conducting mental health surveys has been developed which relies mainly on interviewing individuals according to a questionnaire. Subjects for the surveys are chosen by statistical techniques so that they will be representative of designated populations regardless of whether or not they have ever had psychiatric treatment. The questionnaires are administered by trained interviewers who as a rule are not psychiatrists; the data are later evaluated by psychiatrists who make a series of ratings on each individual in the survey. Inasmuch as surveys of this type show a very high prevalence of psychiatric disorder in many populations (from 10% to 60%), the question of validity becomes a matter of major importance. In the present study 123 individuals were examined and rated independently by both the survey technique and by a psychiatrist employing his usual clinical approach. After the psychiatrist had made his independent rating he was allowed to see the survey data and also to re-examine the subject again if he wished. He then made a final rating constituting his best judgment based on all information available. The degree of agreement is indicated in Tables I to IV. Table I deals with symptom patterns considered without regard to diagnostic implications. Thus, a given individual may have more than one of these symptom patterns. Table II concerns impairment by reason of psychiatric symptoms. Table III deals with a rating as to whether or not the subject is a psychiatric case: ‘A’ means almost certainly a psychiatric disorder of some sort; ‘B’ means probably; ‘C’ means doubtful; and ‘D’ means almost certainly not a psychiatric case. (Note that the group here studied was deliberately weighted with ‘A’ and ‘D’ ratings and hence is not representative of any population.) Table IV summarizes the agreements. While more work is needed, and studies of this kind should be repeated, the results so far show considerable agreement between the survey and clinical methods. This suggests that the large percentage figures obtained by surveys are properly matters of serious concern and that they have far-reaching implications for the teaching and practice of psychiatry.
Readmission Experiences of a Cohort of Discharges 1953 - 1957
Authors: Bristow M. E. , Harris A. A. , Henderson A. L. 
Published: April 2017

The establishment of realistic read-mission rates has always been a problem for the Mental Hospital Administrator. A cohort of discharges from Brandon Hospital for Mental Diseases, discharged in the years 1953–57 inclusive, of 1,113 patients, was followed in the community for five years to establish time specific readmission rates. The results reported indicate the following: 1) Most of the patients lost to the study were lost during the first year of the follow-up. 2) The readmission rate for males during the full five-year period was slightly lower than for females. First admission discharges had lower read-mission rates than readmission discharges. 3) Schizophrenic patients exhibit the highest readmission rates. 4) Almost half the readmissions for the whole five-year period occurred during the first year following discharge. 5) In general, readmission rates declined the longer patients stayed out of hospital.
Some Social Attitudes to Personality with Implications for Psychotherapy
Authors: Hanley F. W. 
Published: April 2017

The patient and the psychiatrist often have different belief systems about personality and its functions. The one held by the patient is derived at least in part, from the values and attitudes toward people of a business-dominated society. Examples of several attitudes are discussed. First, that everyone should be able to solve his own personal and interpersonal problems without assistance. This exaggerated and narrow individualism leads to increasing alienation, reluctance to enter therapy and difficulty in the establishment of a therapeutic relationship. Second, the notion that will power is an entity which can influence and control thoughts, feelings and behaviour leads to much useless effort on the part of the patient. Third, emotions are considered inferior to reason and are distrusted, making the psychiatrist's work of helping patients to recognize and accept their feelings much more difficult. Many self-attitudes are derived from commercial values and the view of human beings as commodities. The belief system derived from business is materialistic, mechanical, limiting and anti-humanistic. The belief system held by the psychiatrist is humanistic and oriented toward a full-valued, integrated individual. These opposing systems may interfere with communication and hence with therapy. The psychiatrist is not always free from the harmful assumptions held by the patient.
The Role of Punishment in the In-Patient Treatment of Psychiatrically Disturbed Children
Authors: Alderton Harvey R. 
Published: April 2017

The role of punishment in the psychiatric in-patient treatment of non-psychotic latency-age children with behaviour disorders is discussed. Punishment is defined as the removal of previously existing positive reinforcers or the administration of aversive stimuli. Ways in which appropriate social behaviour may be acquired are briefly considered. These include reinforcement of desirable responses, non-reinforcement of undesirable responses, reinforcement of incompatible responses and imitative learning. The reported effects of punishment on behaviour are reviewed and the psychological functions necessary before punishment can have the intended effects considered. For seriously disturbed children punishment is ineffective as a treatment technique. It reinforces pathological perceptions of self and adults even if it successfully suppresses behaviour. The frame of reference of the seriously disturbed child contraindicates the removal of positive reinforcers and verbal as well as physical aversive stimuli. Controls and punishments must be clearly distinguished. Controls continue only as long as the behaviour towards which they are directed. They do not include the deliberate establishment of an unpleasant state by the adult as a result of particular behaviour. Control techniques such as removal from a group may be necessary but when possible should be avoided in favour of techniques less likely to be misinterpreted. Avoidance of punishment in treatment makes even more important explicit expectations and provision of realistic controls. Natural laws may result in unpleasant experiences as an unavoidable result of certain behaviour. By definition such results can never be imposed by the adult. Treatment considerations may necessitate that the child be protected from the results of his actions. Avoidance of punishment requires a higher staff/child ratio, more mature and better trained staff. Sometimes children have previously been deterred from serious community acting out only by punishment. Should the therapeutic endeavours outlined not prevent such behaviour, treatment in a closed setting without punishment is indicated, not the use of punishment in an open centre.
Treatment of a Case of School Phobia by Reciprocal Inhibition
Authors: Chapel James L. 
Published: April 2017

Behaviour therapy by reciprocal inhibition was undertaken on a moderately severe case of school phobia in an 11-year-old boy after an adequate trial of conventional therapy had failed to bring about lasting improvement. A fairly accurate estimate of expended therapy time follows: First admission to day-school (January 1964): Five initial sessions (30 minutes each) of relaxation by hypnosis. Eighteen sessions (20–30 minutes each) of reciprocal inhibition therapy, presenting an average of four hierarchies per session. Second admission to day-school (September 1964): Fifteen sessions (20–30 minutes each) of reciprocal inhibition therapy, presenting an average of seven hierarchies per session. This form of therapy was undertaken as a learning experience by the author and its very good results are in no way meant to imply that one approach is superior to another. Rather, this paper was prepared as a plea for tolerance on the part of all who concern themselves with the treatment of emotionally disturbed persons.
The Diagnosis and Treatment of Borderline Schizophrenia in Adolescence
Authors: Katz Philip 
Published: April 2017

It is necessary to establish the presence or absence of a borderline schizophrenic reaction early, for it is of great importance in deciding on the treatment program for the patient. Its presence is suspected if there are symptoms that indicate that the patient is developing a thought disorder, and/or a disturbance of affect of schizophrenic type, and/or is beginning to detach from reality. It is also suspected if there is a persistence of such symptoms as disturbances of judgment, poor empathy and understanding of others, an absence of enjoyment, periods of seclusiveness, or sexual and philosophical preoccupations. Mixtures of the neuroses, with free-floating anxiety often indicates an underlying schizophrenic process. In the treatment of a patient with a borderline schizophrenic reaction, the prime focus should be on the prevention of a psychosis. The child should be protected against severe stresses, which may involve some environmental manipulation. Anxiety has a deteriorating effect and tranquillizers may have to be used. Supportive psychotherapy is of great value. It is essential that the relationship with the therapist be a positive one. The therapist should be a real person who offers the adolescent patient someone with whom to identify. One strengthens useful defences and lessens the need for the other defences by reducing the ego's needs for those defences, e.g. by reality testing the fantasied threats, by offering a less punitive and less rigid superego, and by manipulating the environment to reduce stress. It is often helpful to orient the patient towards pleasurable experiences which have an ego-strengthening effect. Here then, in the handling of the defences and in the management of anxiety, can be seen a major difference in the treatment of patients with a borderline schizophrenic reaction, from the treatment of patients with psycho-neuroses or personality disorders. Failure to recognize the presence of an underlying schizophrenic process may lead to the choice of the wrong treatment program for the patient, with a resultant worsening of his condition and the onset of a psychosis.
Toxic Psychosis Due to Antiparkinsonian Drugs
Authors: Warnes H. 
Published: April 2017

Nine cases of transient toxic-delirious reactions during combined antipsychotic-antiparkinsonism treatment have been described. A few days prior to the onset of the reaction, all patients had been placed on an antiparkinsonian drug. Three clinical phases were observed: an autonomic stage (sympathicotonic signs: mydriasis, dry mouth, anorexia, excitement, disorientation, insomnia, severe constipation); a strio-thalamic phase (dyskinesias, visual and tactile hallucinations) and a post-delirious state (increased sleep and integration). The pathogenic factors which play a role in this atropine-like toxic condition, such as age, individual susceptibility, drug response per se and the influence of rapid dose changes were briefly discussed.
Studies on the Autonomic Psychophysiology of Lipid Mobilization
Authors: Cleghorn John M. , Peterfy G. , Pinter E. J. , Pattee C. J. 
Published: April 2017

Infusion of adrenaline or noradrenaline in man gives rise to increases in plasma free fatty acid level through its indirect action on adipose tissue. Many kinds of psychological stresses have been shown to produce elevated plasma FFA levels. The present work aims to delineate some of the psychological and neurohumoral factors which mediate the external stress which leads to fat mobilization.In 18 subjects FFA increase following stress was found to be due to a primary increase in FFA production rather than to diminished use. The effect of emotional stress on this phenomenon was found to be significantly less in the presence of beta adrenergic blockade (propanolol). Thus it was concluded that, a) the adipokinetic mechanism of short-term emotional arousal depends on endogenous catecholamine and, b) FFA mobilization under these circumstances is an indirect measure of catecholamine activity.In two groups of 20 and 24 subjects levels of anxiety and three kinds of hostility were measured from unprompted verbalizations while blood was drawn for FFA determinations. FFA levels were found repeatedly to be positively and significantly correlated with anxiety levels, but not with hostility levels. Maximum FFA levels were found to develop 15 minutes after experimental stress. Even when greater amounts of hostility were provoked by stress interviews, no association between hostility and FFA level was found. The changes in FFA level in REM sleep were also found to be correlated positively and significantly with anxiety levels in 20 dream reports.Further studies were done on nine subjects from whom blood was drawn for plasma free fatty acid determinations while they were asked under hypnosis to assume alternately a passive and an active approach to a task. In experiments in which the subject was instructed to be passive or active, much greater fat mobilization resulted than in experiments in which he was given no suggestion. The passive attitude stimulated somewhat more anxiety. With the suggestion to be passive and no suggestion, anxiety and FFA ceased to co-vary in the time lag relationship described above.The significance of these findings for our beginning understanding of psycho-physiological mechanisms in diabetes mellitus, coronary disease and obesity were mentioned.
Psychiatrie Sociale versus Psychiatrie Communautaire
Authors: Lazure Denis 
Published: April 2017

The author briefly describes the historical factors in Europe and also in North America which have promoted the development of a type of psychiatry sometimes designated as ‘social psychiatry’ or more often ‘community psychiatry’. The term ‘community psychiatry’ can be misleading and its increasing use implies, in the mind of many, a value judgment by which a greater prestige is attached to such a category of psychiatric service, in contrast to the hospital psychiatric service. This is an unfortunate consequence; for this reason and others explained in this paper, the author advocates relinquishing the term ‘community psychiatry’ and replacing it with ‘social psychiatry’. Theoretical and practical considerations on the respective roles of the State and of the community in organizing and maintaining psychiatric services are discussed. The author reflects on a misconception often observed in North America, according to which a so-called community service becomes synonymous with a private service, i.e., not operated and not entirely financed by the Government. The role of the Government and more particularly of the various pressure groups which can influence decisionmaking on social issues, is presented as being of fundamental importance in social psychiatry. Furthermore this paper underlines certain dangers which stem from the current tendency to consider hospital treatment as being a last resort measure; e.g. the massive discharge of patients towards so-called community resources which is often accompanied by a deprivation of adequate care which the hospital milieu was providing to those patients. Finally, a fair distribution of personnel giving treatment throughout all the areas of a given country appears to be a basic prerequisite to any national program of social psychiatry.
Stress Reactions Resulting from the Relocation of an aged Population
Authors: Kral V. A. , Grad B. , Berenson J. 
Published: April 2017

Fifty-four subjects from 64 to 94 years of age were investigated for their stress reactions following their relocation from one site to another. Forty of them, 16 men and 24 women, were psychiatrically normal, while the remainder (eight men and six women) were suffering from a psychosis, which in all cases, except one, was of organic type. There was no statistically significant difference between the ages of the men and women, and of the normals and psychotics. The same was true in the case of the body weight, except that the men weighed more than the women. Plasma corticoid (PC) levels were determined two to nine days before relocation and eight to 17 days afterwards. One-third of the subjects made no complaints in regard to their health within four months of relocation (NC 33%), while the rest either reported symptoms for which there did not appear to be any apparent organic cause (WS 43%) or presented organic signs (OS 24%). Most of the complaints in the WS category were related to the abdomen, while most of those in the OS group were either due to respiratory infections or cardiovascular conditions. The relative percentage of persons falling into these three categories was essentially similar in normal men and in normal women and in psychotic men and psychotic women. However, the psychotics had a significantly higher incidence of OS persons and a significantly lower number of NC subjects than did the normals, while the incidence of WS was essentially the same in these two groups. Following relocation the PC levels increased in normal men, but decreased in normal women. Furthermore, a greater PC increase was observed in men of the OS group than in those of the WS category, who in turn showed a greater increase than the NC males. This was not observed in the women. Men in each of the NC, WS and OS categories had higher PC levels than women of the same category, and psychotics higher than normals. Twenty-five per cent of the normal men died within the first six months of relocation but none of the normal women, a statistically significant difference. Within 23 months of relocation reliably more psychotics died than normals. In conclusion, normal aged men appeared to suffer more from the relocation than normal aged women, and psychotic aged persons more than psychiatrically normal subjects of the same age.
Psychothérapie Brève En Période De Crise: Notes préliminaires
Authors: Saucier Jean-François 
Published: April 2017

Drawing our inspiration from the work of Levy (3) and from a brief research made in Notre-Dame Hospital, we present a schema of a crisis oriented therapy in six weekly sessions. First session: the patient is informed about our brief and intensive program of therapy. He is then invited to give a detailed account of his recent crisis in order to relive it intensively in the presence of an understanding therapist. Tranquillizing medication is then prescribed. Second session: the therapist conducts a deep exploration of the patient's fear of losing control over his impulses: a clear distinction is made between thought and action. Then an investigation is made about the patient's milieu, in order to measure its pathogenic potential. If information is not satisfactory, an investigation should be made immediately at the patient's home, because the background information is essential. Third session: a complete exploration is made about the preceding crises and particularly the warning symptoms so as to find a common pattern and to help the patient recognize the onset of a crisis. The therapist makes then his first interpretation, comparing the many crises and noticing certain links between them. Finally, the patient is invited to make some plans for the future to be discussed in following sessions. Fourth session: the therapist explores deeply the factors, conscious and unconscious, responsible for the crises. If he feels he has obtained a reasonable confirmation of one of his hypotheses, he gives then a dynamic interpretation but in general (not direct) and without insisting if the patient evades it. The last part of the session is given to concrete problems of readaptation. Fifth session: an enquiry is done about a few current situations which are distressing for the patient, the therapist tries to discover with the patient the means to transform these situations and he helps the patient ‘rehearse’ his new behaviour for the next time he will have to face it. Finally the therapist tries to detect the effects of his dynamic interpretation: if the patient has gained insight, then he could state it more directly. Sixth session: a general review is made of the affects of medication, interpretations and ‘rehearsals’. The essential is to communicate to the patient an experimental mentality in his interpersonal relations, so he could try many techniques to improve difficult situations. The session is terminated by a discussion about concrete plans of reorganization. A follow-up appointment is given in two months. These notes present a very sketchy attempt to integrate three techniques: psychiatric treatment, Freudian psychodynamics and learning theory in a crisi situation. Now it remains to test the precise conditions in which this technique will be successful.
Alterations of Sleep Pattern in Psychiatric Disorder
Authors: Ward J. A. 
Published: April 2017

Summary and Conclusions A survey of the sleep pattern change of 87 women patients admitted to an acute psychiatric ward of the Ontario Hospital, Toronto was reported. An alteration of sleep pattern is common to all psychiatric diagnostic categories and the specific symptoms of Evening Insomnia, Morning Insomnia, Frequent Wakening, Light Sleep, Sleep during the Day and Shortening of the total Sleep time is common to all of them. Evening insomnia, light sleep and shortness of sleep are related to the estimated severity of depression while evening insomnia alone was related to the estimated anxiety level. A total increase in sleep symptoms is related significantly to both the estimated depth of depression and the estimated height of anxiety. Shortening of the sleep time and evening insomnia are significantly increased in suicidal patients although changes in the quantity of dreams and increases of nightmares was not. The total sleep symptom score failed to achieve a level of significance. A change in the quantity of dreaming was related to the diagnosis of depression, especially psychotic depression, but not to depression depth, anxiety level, suicidal tendencies or age. Nightmares increased with a diagnosis of psychotic or neurotic depression, with the estimated level of depression but not with the estimated anxiety level or suicidal tendency. Nightmares significantly decrease with age. The factors of anxiety and depressive affect, suicidal tendencies and other like parameters may promise a more significant relationship to sleep disorder than the diagnostic category. The recall of dreams appears to be of more importance for the diagnostic categorization of depressive states than other sleep symptoms.