Sample records for child psychiatry

  1. The Child and Adolescent Psychiatry Trials Network

    March, John S.; Silva, Susan G.; Compton, Scott; Anthony, Ginger; DeVeaugh-Geiss, Joseph; Califf, Robert; Krishnan, Ranga


    Objective: The current generation of clinical trials in pediatric psychiatry often fails to maximize clinical utility for practicing clinicians, thereby diluting its impact. Method: To attain maximum clinical relevance and acceptability, the Child and Adolescent Psychiatry Trials Network (CAPTN) will transport to pediatric psychiatry the practical…

  2. Classifications in child and adolescent psychiatry

    Squillante , Maria-Vittoria


    The diagnostic approach is essential to medicine. It is one of the binding terms of the doctor-patient relationship. In child psychiatry, the questioning concerning diagnosis and its theoretical background is coupled with the specific nature of the subject being studied. In France infant and juvenile psychiatry is a relatively recent discipline. The following paper discusses the development of child and adolescent psychiatry, taking into account the historical point of view.

  3. Child Psychiatry Curricula in Undergraduate Medical Education

    Sawyer, Michael Gifford; Giesen, Femke; Walter, Garry


    A study to review the amount of time devoted to child psychiatry in undergraduate medical education is conducted. Results conclude that relatively low priority is given to child psychiatry in medical education with suggestions for international teaching standards on the subject.

  4. Administrative issues in child and adult psychiatry training programs.

    Westman, J C


    Child psychiatry training programs have encountered a number of administrative problems resulting from efforts to recognize, without isolating or submerging, the unique aspects of child psychiatry within existing departments of psychiatry. This paper questions the validity of the concept of general psychiatry, which may be responsible for many of these administrative dilemmas. The thesis is advanced that adult and child psychiatry actually represent distinct fields of practice, however, training programs for each should be integrated within departments of psychiatry through both adult and child divisional administrative lines. PMID:688803

  5. Imaging-Genetics Applications in Child Psychiatry

    Pine, Daniel S.; Ernst, Monique; Leibenluft, Ellen


    Objective: To place imaging-genetics research in the context of child psychiatry. Method: A conceptual overview is provided, followed by discussion of specific research examples. Results: Imaging-genetics research is described linking brain function to two specific genes, for the serotonin-reuptake-transporter protein and a monoamine oxidase…

  6. Research in child and adolescent psychiatry in India

    Shastri, Priyavadan Chandrakant; Shastri, Jay P.; Shastri, Dimple


    The primary source for this annotation on child and adolescent psychiatry is Indian Journal of Psychiatry. Articles covering various dimensions of child and adolescent mental health were searched from its electronic data base to discuss relevant articles. Literature was mainly in the form of original research articles, review articles, case reports, editorials, orations and presidential address.

  7. [Child and adolescent psychiatry its problems and foresight].

    Yamazaki, Kosuke


    Accompanying the fall in birth rate, problems pertaining to the child's mind such as school in attendance, bullying, violence in the school, intrafamilial violence, eating disorders, substance abuse, and child abuse have rocketed and diversified, in addition to affecting increasingly lower age groups. The importance of child and adolescent psychiatry has never been more profound, but our country, without a chair in Child and Adolescent Psychiatry in the medical school framework, and lacking recognition of Child and Adolescent Psychiatry as a clinical department has undoubtedly become an underdeveloped country in terms of child and adolescent psychiatric care. The medical schools have been in the process of review and reorganization these past few years. The range of mental science is wide, and despite being a major discipline constituting one of the two arms of medical science together with somatic medicine, it is regarded as a minor existence in our country. This is the time to re-establish mental science, with areas such as child and adolescent psychiatry, geriatric psychiatry, social psychiatry, and crime psychiatry placed on an equal footing with general psychiatry. Turning our eyes on the world, the children are being robbed of their mental health as refugees, through child labor, starvation, and civil war. The demand of this age is true symbiosis, surpassing differences in race, religion, language, and culture, which is probably the indispensable element in the quest for a happy future for the children of this age. PMID:12607920

  8. Family Therapy Training in Child and Adolescent Psychiatry Fellowship Programs

    Rait, Douglas Samuel


    Objective: This study describes the current state of family therapy training in a sample of child and adolescent psychiatry fellowship programs. Method: Child and adolescent psychiatry fellows (N = 66) from seven training programs completed a questionnaire assessing demographics, family therapy training experiences, common models of treatment and…

  9. Child Welfare Training in Child Psychiatry Residency: A Program Director Survey

    Lee, Terry G.; Cox, Julia R.; Walker, Sarah C.


    Objective: This study surveys child psychiatry residency program directors in order to 1) characterize child welfare training experiences for child psychiatry residents; 2) evaluate factors associated with the likelihood of program directors' endorsing the adequacy of their child welfare training; and 3) assess program directors'…

  10. Therapeutic Uses of the WebCam in Child Psychiatry

    Chlebowski, Susan; Fremont, Wanda


    Objective: The authors provide examples for the use of the WebCam as a therapeutic tool in child psychiatry, discussing cases to demonstrate the application of the WebCam, which is most often used in psychiatry training programs during resident supervision and for case presentations. Method: Six cases illustrate the use of the WebCam in individual…

  11. Improving Child and Adolescent Psychiatry Education for Medical Students: An Inter-Organizational Collaborative Action Plan

    Fox, Geraldine S.; Stock, Saundra; Briscoe, Gregory W.; Beck, Gary L.; Horton, Rita; Hunt, Jeffrey I.; Liu, Howard Y.; Rutter, Ashley Partner; Sexson, Sandra; Schlozman, Steven C.; Stubbe, Dorothy E.; Stuber, Margaret L.


    Objective: A new Child and Adolescent Psychiatry in Medical Education (CAPME) Task Force, sponsored by the Association for Directors of Medical Student Education in Psychiatry (ADMSEP), has created an inter-organizational partnership between child and adolescent psychiatry (CAP) educators and medical student educators in psychiatry. This paper…

  12. Primary Supervision: Massachusetts General Hospital's child and adolescent psychiatry seminar

    Jellinek, Michael S.


    In this article, the author describes "Primary Supervision", a seminar he has led for approximately 20 years, which is designed for the entire class of nine first-year residents in Child and Adolescent Psychiatry training at Massachusetts General Hospital. The seminar meets for 1 hour each week throughout the first year. Through 900 hours of…

  13. Child and adolescent psychiatry and family status

    Esbjørn, Barbara Hoff; Levin, Eline; Høyer, Mette;


    BACKGROUND: Much attention has been given to parental separation as a possible risk factor for adverse child development; however, little information is available regarding the family status of children referred to psychiatric facilities. AIMS: To assess the association between psychiatric illness...... children are at increased risk of not living with both biological parents independent of age of the child....

  14. Expanding psychiatry's role in child abuse treatment.

    Green, A H


    Child abuse, a problem that has plagued societies for centuries, has been largely ignored by psychiatrists, the author asserts. He traces the relatively recent interest in the problem of other medical specialists such as pediatricians and radiologists and maintains that it is time for psychiatrists to become more involved. He explains how problems of confidentiality, the patient's lack of motivation for treatment, and other factors have discouraged many psychiatrists from treating child abusers. He demonstrates ways psychiatrists can treat both the abused child and his family if they are willing to use non-traditional services such as home intervention. PMID:90001

  15. What Is Psychiatry?

    Full Text Available ... training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry ... World Psychiatric Association American Association of Child and Adolescent Psychiatry American Association of Community Psychiatrists American Association ...

  16. What Is Psychiatry?

    Full Text Available ... general psychiatry training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry ... More Resources World Psychiatric Association American Association of Child and Adolescent Psychiatry American Association of Community Psychiatrists ...

  17. Musings: What child and adolescent psychiatry means to me

    L. Eugene Arnold


    Full Text Available I have been a grandfather for only 12 years, but for 37 years I have lived a grandparent's dream: people pay me to tell them how to raise their children. This is only one of the many rewards child and adolescent psychiatry has offered me. Table 1 lists some more of them.Probably the greatest satisfaction in child psychiatry is the wide selection of options for specialization: psychotherapy, psychopharmacology, nutrition, biochemistry, genetics, family therapy, parent guidance, custody and visitation advice, epidemiology, disorder specialization, research, consultation, public education and best of all, the chance to integrate it all and play at being a comprehensive physician. The myriad challenges provoke learning and continued development that keep one young at heart and mind. Sometimes I think I should pay to practice child psychiatry.It should be obvious by now to even the casual reader that I enjoy the privilege of being a child and adolescent psychiatrist and that enjoyment manifests in a playful attitude. That playful attitude includes not taking myself too seriously. In fact, I'm proud of my humility! It was earned at the expense of repeated humbling experiences in two ways:Confronting tragic situations that I could not help, where all my education, training, experience and brilliant diagnostic insight seemed useless; and Witnessing real heroism by some parents who struggle with sick children's difficult problems without complaining and with indefatigable hope. They outshine any professional pretensions of mine. By showing me my limitations and forcing me to compare myself to patients and parents (and occasional colleagues of superior moral caliber, child psychiatry has made a better, more honest person of me and for this I'm grateful.On the other hand, there is the mind-blowing exhilaration of watching a child improve after some prescription, potion or psychotherapeutic intervention and being allowed to believe that I had something to

  18. Exposure to Child and Adolescent Psychiatry for Medical Students: Are There Optimal "Teaching Perspectives"?

    Hunt, Jeffrey; Barrett, Rowland; Grapentine, W. Lex; Liguori, Gina; Trivedi, Harsh K.


    Objectives: The ability to develop quality medical student exposures in child and adolescent psychiatry is critical to the professional development of these future physicians and to the growth of recruitment efforts into the field. This study identifies teaching perspectives among child and adolescent psychiatry faculty to determine whether there…

  19. What Is Psychiatry?

    Full Text Available ... general psychiatry training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry Pain medicine Psychosomatic (mind and body) medicine Sleep medicine Some psychiatrists choose additional training ...

  20. Unexpected Death or Suicide by a Child or Adolescent: Improving Responses and Preparedness of Child and Adolescent Psychiatry Trainees

    Sneha, Jadhav; Prakash, Chandra; Vinay, Saranga


    The death of a young patient is a difficult but universal experience in the field of medicine. It is less common in the field of child and adolescent psychiatry. However, when a child or adolescent patient commits suicide, a child and adolescent psychiatry trainee’s response could include shock, denial, disbelief, sadness, sleep difficulties, rumination about patient’s death, fears of litigation, social withdrawal, and a sense of failure. Trainees generally find themselves dealing with the ac...

  1. Using participatory design to develop structured training in child and adolescent psychiatry

    Davis, Deborah J; Ringsted, Charlotte; Bonde, Mie;


    CONTEXT: Learning during residency in child and adolescent psychiatry (CAP) is primarily work-based and has traditionally been opportunistic. There are increasing demands from both postgraduate trainees and medical organisations for structured programmes with defined learning outcomes. OBJECTIVES...

  2. Ethical perspectives on managed care as it relates to child and adolescent psychiatry.

    Geraty, R D; Hendren, R L; Flaa, C J


    Managed health care is providing an increasing influence in the way child and adolescent psychiatry is practiced. The goals of managed care have been to manage price, service, and quality. As external forces are brought to bear on child and adolescent psychiatry, ethical and legal dilemmas are faced. Underlying principles and the impact of society force physicians to reexamine their values and reeducate themselves about legal developments. PMID:1592769

  3. The Differential Impact of Clerk Interest and Participation in a Child and Adolescent Psychiatry Clerkship Rotation upon Psychiatry and Pediatrics Residency Matches

    Hanson, Mark D.; Szatmari, Peter; Eva, Kevin W.


    Objective: The authors evaluated the differential impact of clerk interest and participation in a Child and Adolescent Psychiatry (CAP) clerkship rotation upon psychiatry and pediatrics residency matches. Method: Authors studied clerks from the McMaster University M.D. program graduating years of 2005-2007. Participants were categorized as 1)…

  4. [Psychiatry].

    Guex, Patrice; Conus, Philippe; Pomini, Valentino; Kramer, Ueli; Bonsack, Charles; Eap, Chin


    The novelties in clinical psychiatry are close to somatic medicine adaptation. The clinical staging concept in psychiatry (as in cancerology) is the result of an early intervention strategy in psychotic disorders. A differentiated mode of understanding of the phases of psychiatric disorders allows a prevention oriented approach. Individualized therapeutic programmes in accordance with specific problematics favors the orientation towards focalised follow-ups, for instance CBT programmes on Internet may be proposed to patients motivated and rather autonomous. Others, on the contrary, less accessible to health care should benefit of the support of a mobile team and specific coaching to return to vocational services. Systematic follow-up of the metabolic syndrome, often induced by atypical antipsychotics, belongs to those basic adjustment processes. PMID:21400949

  5. [Major obstacles in the development of child and adolescent psychiatry in Hungary].

    Kalmar, Sandor


    The author ascertains that healthy personality development faces increasingly serious obstacles and consequently the number of children in need of mental healthcare is on the rise. Child and adolescent psychiatry has drawn increasing appreciation, however, it is only formal and deficient in Hungary today and cannot assure optimal mental care according to the principles of evidence-based medicine. The author emphasizes that 75% of the first manifestation of the psychiatric disorders occurs during adolescence and young adulthood. In spite of legal regulation, several deficiencies hinder the development of children into healthy adults. The author analyses the most important obstacles in the development of child and adolescent Psychiatry. The author emphasizes the role of keypersons, describes the situation of and problems faced by Hungarian child psychiatric care. The author lists in detail the most important contradictions, deficiencies and obstacles and outlines suggestions for resolving the present crisis. The author emphasizes (1) the responsibility of institutions, and people dealing with society and children, and the disinterest of competent authorities. (2) The somatic, mental, cultural and spiritual ignorance/illiteracy among parents, teachers, healthcare workers, and the general population partly related to crises among the pedagogues. (3) The lack of holistic approach to treatment of children suffering from mental disorder. (4) The importance and the lack of knowledge concerning central nervous system function in child psychiatry. (5) Application of evidence-based medicine in child and adolescent psychiatry based on understanding the relationship between central nervous system alterations and mental functions. (6) Respecting keypersons' competence limits. (7) Immediate development of inpatient and outpatient child and adolescent psychiatry in the whole country. (8) Reform of child psychiatry board exam. (9) Development of currently missing textbooks and

  6. Managing the ‘unmanageable’: interwar child psychiatry at the Maudsley Hospital, London



    When opened as a post-graduate teaching and research hospital in 1923, the Maudsley made virtually no provision for the treatment of children. Yet its children's department saw sustained growth during the interwar period. This expansion is explored in relation to novel behaviourist hypotheses and the forging of formal links with local government and charitable bodies. The recruitment of psychologists, educators and specialist social workers fostered a multidisciplinary approach through case conferences. This development would structure the theoretical origins of child psychiatry, in particular influencing the role and interpretation of psychoanalytic theory within it. William Moodie and Rosalie Lucas identified learned behaviour tied to social and familial circumstances as the crucial factor for both diagnosis and therapy. The theoretical orientation of child psychiatry and the practical treatment of children represented an area of dynamic change and innovation at a time when adult psychiatry struggled to discover effective treatments or achieve breakthroughs in causal understanding. PMID:19397089

  7. Curricular Adaptations in Inpatient Child Psychiatry for the 21st Century: The Flexner Model Revisited

    Bell, Cathy K.; Guerrero, Anthony; Matsu, Courtenay; Takeshita, Junji; Haning, William; Schultz, Karen


    Objective: The authors describe curricular modifications created in response to the changing culture of medical education, health care systems, academic medicine, and generational differences. The authors propose a model child psychiatry inpatient curriculum that is sustainable within a community teaching hospital in the 21st century. Methods: The…

  8. Training of Child and Adolescent Psychiatry Fellows in Autism and Intellectual Disability

    Marrus, Natasha; Veenstra-VanderWeele, Jeremy; Hellings, Jessica A.; Stigler, Kimberly A.; Szymanski, Ludwik; King, Bryan H.; Carlisle, L. Lee; Cook, Edwin H., Jr.; Pruett, John R., Jr.


    Patients with autism spectrum disorders and intellectual disability can be clinically complex and often have limited access to psychiatric care. Because little is known about post-graduate clinical education in autism spectrum disorder and intellectual disability, we surveyed training directors of child and adolescent psychiatry fellowship…

  9. A Practical Approach to Implementing the Core Competencies in a Child and Adolescent Psychiatry Residency Program

    Dingle, Arden D.; Sexson, Sandra B.


    Objective: The authors describe the development and implementation of the Accreditation Council for Graduate Medical Education's core competencies in a child and adolescent psychiatry residency program. Method: The authors identify the program's organizational approach and participants and detail various strategies and methods of defining,…

  10. Antisocial behaviour in clinically referred boys : Early identification and assessment procedures in child psychiatry

    Enebrink, Pia


    Background: Oppositional and aggressive behaviour in children below twelve years of age is a frequent cause of concern for parents and teachers, and a common reason for referral to child and adolescent psychiatry. Whereas most children outgrow these behaviours, a small subgroup is at risk for developing a persistent antisocial lifestyle. Successfully identifying children at risk could prevent potential human and economic suffering of the child, his/her family, potential vict...

  11. Comparison of the number of supervisors on medical student satisfaction during a child and adolescent psychiatry rotation

    Mascioli, Kelly


    Kelly J Mascioli,1 Catharine J Robertson,1,2 Alan B Douglass1,31Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; 2Department of Psychiatry, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada; 3Royal Ottawa Mental Health Centre, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada Background: Traditionally, third-year medical students are assigned to one supervisor during their 1-week rotation in child and adolescent psychiatry. Howe...

  12. Comparison of the number of supervisors on medical student satisfaction during a child and adolescent psychiatry rotation

    Mascioli KJ; Robertson CJ; Douglass AB


    Kelly J Mascioli,1 Catharine J Robertson,1,2 Alan B Douglass1,31Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; 2Department of Psychiatry, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada; 3Royal Ottawa Mental Health Centre, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada Background: Traditionally, third-year medical students are assigned to one supervisor during their 1-week rotation in child and adolescent psychiatry. However,...


    Scholl, J-M


    Despite its high frequency, bipolarity in childhood is little understood and is often diagnosed only after several years of development, and this during a time when the child's psychosocial future is at stake. A proper diagnosis requires recognition of accurate clinical signs. It is therefore essential to furnish clinicians with precise semiological markers. This paper presents a dimensional semiology for use in anamnesis and in clinical observation of the child. These clinical signs enable the identification of a bipolar manic temperament in the child and/or the identification of various different forms of childhood bipolar and depressive disorder. The relevant differential diagnoses and comorbidities are also presented. PMID:27141653

  14. [Quality characteristics of freedom-restricting coercive measures in child and adolescent psychiatry].

    Schepker, Renate; Steinert, Tilman; Jungmann, Joachim; Bergmann, Frank; Fegert, Jörg M


    Putting into practice legal prescriptions of both children's rights and the personal freedom guaranteed by the German basic constitutional law requires a reflected and sensitive use of freedom-restricting coercive measures. Such measures imply uncertainties and burdens for staff and patients in child and adolescent psychiatry. Using guidelines of psychiatric associations and instructions from three institutions, basic attitudes and quality characteristics of indication, performance, and participation with regard to freedom-restricting coercive measures are described. PMID:17253028

  15. Editorial: Looking beyond the horizon--innovation in child psychology and psychiatry.

    Pasco Fearon, R M


    As readers will no doubt be well aware, the Journal of Child Psychology and Psychiatry dedicates an entire issue, once a year, to state-of-the-art authoritative reviews of research on some of the central issues in our field.(1) I like to think that in doing so we have been quietly undertaking a giant Pavlovian conditioning experiment: every year, as the spring flowers start to blossom (in the northern hemisphere at least), the nucleus accumbens of child psychologists and psychiatrists around the world begin to glow in anticipation of intellectual reward. PMID:26889890

  16. Current state and recent developments of child psychiatry in China

    Zheng, Yi; Zheng, Xixi


    China has a population of 1.3 billion, of which 238 million are children under age 15. The rapid economic development and social reforms that have taken place in recent years all had a great influence on child and adolescent mental health. Though a nationwide prevalence study for child and adolescent mental disorders in China is lacking, several regional studies have shown the prevalence of mental disorders in children to be close to the worldwide prevalence of 20%. This article reviews the c...

  17. Ethnic minority populations and child psychiatry services: An Irish study



    PUBLISHED Background Ethnically, Ireland has diversified greatly over the last twelve years changing from a country of emigration to one of immigration. Blanchardstown, a western suburb of Dublin, is one of the most ethnically diverse areas, with the youngest population in Ireland. Aims and methods This study aimed to examine any differences in referrals, clinical diagnoses and administrative outcomes of immigrants and Irish children referred to Blanchardstown Child and Adolescent...

  18. Concluding the Series on Evidence-Based Practice: The Spread of Excellence in Child and Adolescent Psychiatry

    Hamilton, John D.


    The child and adolescent psychiatry community has been using large systems of information and new technologies to improve its performance.Evidence-based approach is used by practitioners to find and implement feasible therapies and medication. The different procedures involved of evidence-based practice, as used in child and adolescent psychology,…

  19. Comparison of the number of supervisors on medical student satisfaction during a child and adolescent psychiatry rotation

    Mascioli KJ


    Full Text Available Kelly J Mascioli,1 Catharine J Robertson,1,2 Alan B Douglass1,31Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; 2Department of Psychiatry, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada; 3Royal Ottawa Mental Health Centre, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada Background: Traditionally, third-year medical students are assigned to one supervisor during their 1-week rotation in child and adolescent psychiatry. However, the majority of supervisory staff in the Division of Child and Adolescent Psychiatry opted to switch the supervision schedule to one in which some medical students are assigned to two primary supervisors.Objective: The aim of the study was to determine if students assigned to two primary supervisors had greater rotation satisfaction compared with students assigned to one primary supervisor during a 1-week clerkship rotation in child and adolescent psychiatry.Methods: A satisfaction questionnaire was sent to 110 third-year medical students who completed their child and adolescent clerkship rotation. Based on the responses, students were divided into groups depending on their number of supervisors. Questionnaire responses were compared between the groups using independent t-tests.Results: When students who had one primary supervisor were compared to students who had two primary supervisors, the lone item showing a statistically significant difference was regarding improvement of assessment reports/progress notes.Conclusion: The number of supervisors does not significantly affect the satisfaction of students during a 1-week clerkship rotation in child and adolescent psychiatry. Other factors are important in rotation satisfaction.Keywords: medical students, clerkship, child psychiatry

  20. The child and adolescent psychiatry trials network (CAPTN: infrastructure development and lessons learned

    Breland-Noble Alfiee


    Full Text Available Abstract Background In 2003, the National Institute of Mental Health funded the Child and Adolescent Psychiatry Trials Network (CAPTN under the Advanced Center for Services and Intervention Research (ACSIR mechanism. At the time, CAPTN was believed to be both a highly innovative undertaking and a highly speculative one. One reviewer even suggested that CAPTN was "unlikely to succeed, but would be a valuable learning experience for the field." Objective To describe valuable lessons learned in building a clinical research network in pediatric psychiatry, including innovations intended to decrease barriers to research participation. Methods The CAPTN Team has completed construction of the CAPTN network infrastructure, conducted a large, multi-center psychometric study of a novel adverse event reporting tool, and initiated a large antidepressant safety registry and linked pharmacogenomic study focused on severe adverse events. Specific challenges overcome included establishing structures for network organization and governance; recruiting over 150 active CAPTN participants and 15 child psychiatry training programs; developing and implementing procedures for site contracts, regulatory compliance, indemnification and malpractice coverage, human subjects protection training and IRB approval; and constructing an innovative electronic casa report form (eCRF running on a web-based electronic data capture system; and, finally, establishing procedures for audit trail oversight requirements put forward by, among others, the Food and Drug Administration (FDA. Conclusion Given stable funding for network construction and maintenance, our experience demonstrates that judicious use of web-based technologies for profiling investigators, investigator training, and capturing clinical trials data, when coupled to innovative approaches to network governance, data management and site management, can reduce the costs and burden and improve the feasibility of

  1. Epidemiologic Studies in Child and Adolescent Psychiatry: A Review of Methodology

    Onur Burak Dursun


    Full Text Available Childhood psychiatric disorders are estimated to influence about 9 to 21% of relevant age group and interest in this disorders are increasing all over the world. The growing need to child and adolescent mental health leads the task of establishing proposals and policies in this field to become a priority for governments. The first step of such proposals should be determination of prevalence of child and adolescent mental disorders in that country. However, several major methodological problems make it hard to provide accurate prevalence estimates from epidemiological studies. Most common problems are within the fields of sampling, case definition, case ascertainment and data analyses. Such issues increases the costs of studies and hinder to reach large sample sizes. To minimize these problems, investigators have to be careful on choosing the appropriate methodology and diagnostic tools in their studies. Although there are many interviews and questionnaires for screening and diagnosing in child and adolescent psychiatry, only a few of them are suitable for epidemiological research. In parallel with the improvement in all fields of child and adolescent mental health in our country, some of the major screening and diagnosing tools used in prevalence studies in literature have already been translated and validated in Turkish. Most important of this tools for screening purposes are Child Behavior Checklist and Strengths and Difficulties Questionnaire and for diagnosing purposes are Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version and Development and Well-Being Assessment. The aims of this article are to review the methodological problems of epidemiologic studies in child and adolescent psychiatry and to briefly discuss suitable diagnostic tools for extended sampled epidemiologic studies in our country.

  2. Drug monitoring in child and adolescent psychiatry for improved efficacy and safety of psychopharmacotherapy

    Fegert Jörg M


    Full Text Available Abstract Most psychotropic drugs used in the treatment of children and adolescents are applied "off label" with a direct risk of under- or overdosing and a delayed risk of long-term side effects. The selection of doses in paediatric psychiatric patients requires a consideration of pharmacokinetic parameters and the development of central nervous system, and warrants specific studies in children and adolescents. Because these are lacking for most of the psychotropic drugs applied in the Child and Adolescent and Psychiatry, therapeutic drug monitoring (TDM is a valid tool to optimise pharmacotherapy and to enable to adjust the dosage of drugs according to the characteristics of the individual patient. Multi-centre TDM studies enable the identification of age- and development-dependent therapeutic ranges of blood concentrations and facilitate a highly qualified standardized documentation in the child and adolescent health care system. In addition, they will provide data for future research on psychopharmacological treatment in children and adolescents, as a baseline for example for clinically relevant interactions with various co-medications. Therefore, a German-Austrian-Swiss "Competence Network on Therapeutic Drug Monitoring in Child and Adolescent Psychiatry" was founded 1 introducing a comprehensive internet data base for the collection of demographic, safety and efficacy data as well as blood concentrations of psychotropic drugs in children and adolescents.

  3. Editorial: Ingenious designs and causal inference in child psychology and psychiatry.

    Green, Jonathan


    The embryology of behaviour - This title of a book by the great developmental psychologist Arnold Gesell (Gesell, ) continues nicely to encapsulate for me a core endeavour in child psychology and psychiatry; in the use of scientific method to tease out causes and processes within developmental science and psychopathology. This edition of JCPP includes some tremendous examples of the increasing rigour and sophistication with which such questions are being addressed. Particularly encouraging for me, as primarily an interventionist, is the use of well-designed randomized controlled trials (RCTs) for that end. PMID:27090380

  4. MAP as a model for practice-based learning and improvement in child psychiatry training.

    Kataoka, Sheryl H; Podell, Jennifer L; Zima, Bonnie T; Best, Karin; Sidhu, Shawn; Jura, Martha Bates


    Not only is there a growing literature demonstrating the positive outcomes that result from implementing evidence based treatments (EBTs) but also studies that suggest a lack of delivery of these EBTs in "usual care" practices. One way to address this deficit is to improve the quality of psychotherapy teaching for clinicians-in-training. The Accreditation Council for Graduate Medical Education (ACGME) requires all training programs to assess residents in a number of competencies including Practice-Based Learning and Improvements (PBLI). This article describes the piloting of Managing and Adapting Practice (MAP) for child psychiatry fellows, to teach them both EBT and PBLI skills. Eight child psychiatry trainees received 5 full days of MAP training and are delivering MAP in a year-long outpatient teaching clinic. In this setting, MAP is applied to the complex, multiply diagnosed psychiatric patients that present to this clinic. This article describes how MAP tools and resources assist in teaching trainees each of the eight required competency components of PBLI, including identifying deficits in expertise, setting learning goals, performing learning activities, conducting quality improvement methods in practice, incorporating formative feedback, using scientific studies to inform practice, using technology for learning, and participating in patient education. A case example illustrates the use of MAP in teaching PBLI. MAP provides a unique way to teach important quality improvement and practice-based learning skills to trainees while training them in important psychotherapy competence. PMID:24245855

  5. Book review of J. Green & W. Yule (2000). Festschrift for Professor Sir Michael Rutter. Volume I. Research and Innovation on the Road to Modern child Psychiatry. London: Gaskell and the Association for Child Psychology and Psychiatry

    Carr, Alan.


    All of the papers in this Festschrift are clearly written authoritative reviews of the topics they address. Each may be read independently by readers wanting a quick overview of a particular problem. Collectively these essays underline the extraordinary contribution which Professor Sir Michael Rutter has made to the field of child and adolescent psychiatry over the last half a century. peer-reviewed

  6. What Is Psychiatry?

    Full Text Available ... clinics, general and psychiatric hospitals, university medical centers, community agencies, courts and prisons, nursing homes, industry, government, ... of Child and Adolescent Psychiatry American Association of Community Psychiatrists American Association for Geriatric Psychiatry Academy of ...

  7. Assessment of Mental Symptoms and Risk Factors in Children and Adolescents Who Admitted to the Child-Adolescent Psychiatry Clinic

    Yöntem Fidan T.


    Objective: The results of the studies investigating the positive and negative factors which affect the mental health were important for developing protective, new and effective programs in prevention from psychiatric disorders.The aim of this study is to determine the demographic features, symptom distribution of children and adolescents in this region.Methods: 632 child and adolescents who attended to Karadeniz Technical University Child and Adolescent Psychiatry Clinic between 01 January 20...

  8. One-Year Retrospective Analysis of Forensic Cases Referred to Child and Adolescent Psychiatry Outpatient Clinic in the Province of Adiyaman

    Funda Gumustas; Yasemin Yulaf; Sebla Gokce; Sema Saglam; Emel Koyuncu Kutuk


    Purpose: This study’s aim is to investigate child and adolescent cases referred for forensic examination to our child and adolescent psychiatry outpatient clinic. Material and Methods: File informations of 121 cases who referred to Adiyaman University Training and Research Hospital, child psychiatry clinic between 01 June 2012 and 31 May 2013 were reviewed retrospectively. Socio-demographic characteristics of the children and reasons for referral determined. The study was focused on ...

  9. Child Maltreatment Prevention and the Scope of Child and Adolescent Psychiatry.

    Constantino, John N


    Child maltreatment is one of the most deleterious known influences on the mental health and development of children. This article briefly reviews a complement of methods that are ready to incorporate into child and adolescent psychiatric practice, by having been validated either with respect to the prevention of child maltreatment or with respect to adverse outcomes associated with maltreatment (and primarily focused on enhancing the caregiving environment); they are feasible for integration into clinical decision making, and most importantly, can be included in the training of the next generation of clinicians. PMID:26980121

  10. A Model CSMH Curriculum for Child and Adolescent Psychiatry Training Programs.

    Derenne, Jennifer; Martel, Adele


    Child and adolescent psychiatrists (CAP) care for high school students preparing to enter college. They also may continue to see students while on school vacations and may care for college students in various settings (emergency room, inpatient hospital unit, private practice, college student health service, or counseling center). As increasing numbers of students with mental health diagnoses pursue secondary education, CAP need to be knowledgeable about campus systems of care, principles of transition, and privacy and educational laws affecting college students. This article describes an informal needs assessment of general CAP members of the American Academy of Child and Adolescent Psychiatry and details the results of a survey of CAP program directors on training opportunities in college student mental health (CSMH). The authors present a sample curriculum for a clinical rotation in CSMH, as well as providing ideas for core didactic lectures, and proposing the development of online resources to reduce the burden of creating new lectures and standardize experiences among training programs. PMID:25895628

  11. Assessment of Mental Symptoms and Risk Factors in Children and Adolescents Who Admitted to the Child-Adolescent Psychiatry Clinic

    Yöntem Fidan T.


    Full Text Available Objective: The results of the studies investigating the positive and negative factors which affect the mental health were important for developing protective, new and effective programs in prevention from psychiatric disorders.The aim of this study is to determine the demographic features, symptom distribution of children and adolescents in this region.Methods: 632 child and adolescents who attended to Karadeniz Technical University Child and Adolescent Psychiatry Clinic between 01 January 2003 and 30 June 2003 were included the study. The demographic features and first application symptoms were obtained by using interview forms to each child and adolescent and the relation between the demographic features and the first application symptoms were investigated.Results: Of the children and adolescents 63.1% were male and the frequency of the age between 6 and 11 was 40.3% and the frequency of the age between 0-3 years old was the lowest. Irritability, poor school performance, enuresis, encopresis, anxiety, attention deficit-hyperactivity, speech disorders were the most seen symptoms of child and adolescents. Depressive symptoms like crying, unhappiness, suicide attempt were most seen in girls and behavioral symptoms like hyperactivity were seen most in boys (p<0.05. According to age symptoms were specified.Conclusion: In this study, demographic features and symptom distribution between patients who applied to KTU Faculty of Medicine Child and Adolescent Psychiatry Outpatient Clinic and other Child and Adolescent Psychiatry Outpatient Clinics were found similar. In divorced and problematic families, having psychiatric disease of mother-father some specific mental symptoms were found.

  12. Sociodemographic Characteristics and Diagnoses of Individuals Referred to a Child and Adolescent Psychiatry Outpatient Clinic of a University Hospital

    Sevcan Karakoç Demirkaya


    Full Text Available OBJECTIVE: The aim of this study is to evaluate the sociodemographic characteristics, complaints, and diagnoses of individuals who were admitted to a child and adolescent psychiatry outpatient clinic. MATERIALS AND METHODS: Medical charts of the patients who were admitted to the child and adolescent psychiatry unit of Adnan Menderes University between February 1st and July 31st, 2014 were retrospectively studied. RESULTS: The rate of girls and boys from a total of 832 cases who were referred to the child and adolescent psychiatry outpatient clinic in the six month period was 41.8% and 58.2%, respectively. The mean age of the girls and boys was 10.8±4.9 and 8.5±4.7 years, respectively. The most common age range was between 12 and 18 years. The proportion of patients who lived with both parents was 81.1%; however, the proportion of individuals brought in by institutional caregivers was 0.8%. The proportion of consanguineous marriages was 13.7%. The education level of mothers and fathers was mostly a primary school degree (47% and 45.6%, respectively. A positive psychiatric history was present in 13.7% of the mothers and 7.6% of the fathers. Reasons for child psychiatric assessments were as follows: 21.9% for disability report, 13.8% for forensic evaluation, 11.2% for consultation, and 52.9% for general psychiatric evaluation. Referral complaints were irritability/anger (15.7%, attention deficit/hyperactivity (14.8%, delay in speech (10.5%, fear/anxiety (5.9%, and poor school performance (5.7%. The diagnoses were as follows: attention deficit hyperactivity disorder (ADHD (20.6%, other disruptive behaviors (12.4%, and anxiety disorder (10.2%. CONCLUSION: We revealed that the most common referring complaint was irritability/anger and that the most common diagnosis was ADHD in our patient group, which was similar to previous studies. Our results showed that a low parental educational level and a positive history for parental psychopathology were

  13. [Evolution and description of a complete hospitalisation unity in child and teenager psychiatry].

    Richard, Y; Saint-André, S; Porchel, G; Lazartigues, A


    The university department of child and adolescent psychiatry of Brest Hospital (a medium size town of 200,000 inhabitants) has at disposal a 14 in-patient emergency care unit, where young people under 16, mostly in crisis (individual and/or family and/or institutional crisis) are admitted. This unit opens 24h a day throughout the year, and patients with any type of pathology are admitted for a short stay, mainly with no demand for care. After a description of this unit with its modalities of functioning, the authors will report on its activity assessed from sets of data pertinent to the last 8 years. One thousand two hundred and twenty-five admittances were recorded over these 8 years. A very strong increase in the number of hospitalisation over the years (+201.4%) was also noticed. However, the sex-ratio remained quite alike with a majority of boys (55.3%), as well as the average stay duration (15.5 days in 2007). About the age at admittance, one should note that, after the relative stability observed in the first years, the average age has been decreasing regularly for the last 3 years to pass from 13.2 years for girls and 12.7years for boys in 2005 to 12.6 years (girls) and 11.2 years (boys) in 2007. Despite a rise in the number of children under placement in this region (Finistère) between 2001 and 2006, the origin of the admittances has remained quite stable over 8 years: in 2007, 64.9% of the accepted children were living in their family, 24.6% in a foster care and 10.4% in a foster family. The evaluation of this hospitable cohort over several years allowed the authors to highlight various trends such as the explosion of the demand for medical care in both sexes, the rejuvenation of mental disorders, evolution in the motives for admittance with an important increase of psychomotor instability and externalised behavioural problems as well as the occurrence of new demands for care, e.g. the weaning of "on-line" video games or Internet. The growing expansion of

  14. Psychiatric symptoms and service utilization among refugee children referred to a child psychiatry department: a retrospective comparative case note study.

    Vaage, Aina Basilier; Garløv, Ida; Hauff, Edvard; Thomsen, Per Hove


    Refugee children may encounter barriers to accessing mental health services. We conducted a case-control study based on a systematic review of clinic records to compare psychopathology and service utilization in refugee and Norwegian children referred to a child psychiatry department in a county in southern Norway. Sixty-one refugee children were compared with 61 Norwegian-born children matched for gender, age and time of referral to the clinic. There was no significant difference in rates of referral or level of service utilization, which were proportional to the population. Compared with Norwegian children, refugee children were diagnosed more frequently with post-traumatic stress disorder and other affective and emotional disorders, and less often with pervasive developmental disorders and attention deficit hyperactivity disorder. The results are discussed in terms of referral pathways and the need for culturally competent care for refugee children. PMID:17938155

  15. Indications for and use of antidepressants in child and adolescent psychiatry--a cross-sectional survey in Denmark.

    Buhl Sørensen, Christine; Bøhm Jepsen, Ea; Thomsen, Per Hove; Dalsgaard, Søren


    The prescription of antidepressants for children and adolescents is a controversial subject, and it has been documented that the practice has increased in the past decade in Denmark, the UK, and the USA. The aim of this study was to survey the indications for and use of antidepressants in child and adolescent psychiatry. Questionnaires were sent to all Danish child and adolescent psychiatric hospitals, out-patient clinics and privately practising psychiatrists treating children and adolescents under the age of 19 years (31 units in all). A 93.5 % response rate for the total of 382 questionnaires in the survey. The antidepressant serotonin selective re-uptake inhibitors (SSRIs) were the most prominently used agents in treating children and adolescents. The extent of their use represents 8 % of the total sample of individuals under the age of 19 years receiving any kind of psychiatric treatment - 0.03 % of the reference population in Denmark. It is only a surprisingly minor group of children and adolescents that are being treated with antidepressants despite the fact that 10 % of youth under the age of 19 are afflicted with diseases like depression, OCD, anxiety disorder and eating disorders. PMID:12768458

  16. Report of the Psychotherapy Task Force of the American Academy of Child and Adolescent Psychiatry

    Ritvo, Rachel; Al-mateen, Cheryl; Ascherman, Lee; Beardslee, William; Hartmann, Lawrence; Lewis, Owen; Papilsky, Shirley; Sargent, John; Sperling, Eva; Stiener, Gregory; Szigethy, Eva


    In this task force report, the authors define the field of child and adolescent psychotherapy; review the state of the field with respect to advocacy, training, research, and clinical practice; and recommend steps to ensure that psychotherapy remains a core competence of child and adolescent psychiatrists. (The Journal of Psychotherapy Practice and Research 1999; 8:93–102)

  17. What Is Psychiatry?

    Full Text Available ... and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry Pain medicine Psychosomatic (mind and body) medicine ... Psychiatry Academy of Psychosomatic Medicine American Academy of Addiction Psychiatry American Association for Emergency Psychiatry Association of ...

  18. [Cognitive remediation therapy for children: literature data and clinical application in a child and adolescent psychiatry department].

    Doyen, C; Contejean, Y; Risler, V; Asch, M; Amado, I; Launay, C; Redon, P De Bois; Burnouf, I; Kaye, K


    The hypothesis of cerebral plasticity in psychiatric disorders has encouraged clinicians to develop cognitive remediation therapy (CRT), a new therapeutic approach based on attention, memory, planning, and mental flexibility tasks. The first cognitive remediation programs were developed and validated for adults with schizophrenia and were shown to have a positive impact on executive functions as well as on quality of life. In children and adolescents, researchers emphasized the existence of executive dysfunction in neurodevelopmental disorders such as autistic spectrum disorder, attention deficit disorder, and eating disorders. For these disorders, neuropsychological studies suggest that memory, planning, attention and mental flexibility are impaired. Despite the paucity of studies on cognitive remediation (CR) in children, preliminary results have suggested, as in adults with schizophrenia, good compliance and optimization of executive functioning. Consequently, programs dedicated to young subjects were developed in English-speaking countries, and the Department of Child and Adolescent Psychiatry of Sainte Anne Hospital (Paris) developed a new CR program for children with attention deficit disorder, academic problems, or eating disorders. These programs complete the field of CRT proposed by Sainte Anne Hospital's Remediation and Psychosocial Rehabilitation Reference Center, initially designed for adults with schizophrenia. Our team used and adapted validated tools such as Delahunty and Wykes's CRT program (translated and validated in French by Amado and Franck) and Lindvall and Lask's CRT Resource Pack. One program was developed for an adolescent with anorexia nervosa and applied to the subject and her family, but the purpose of this paper is to present a CR approach for children with attention deficit disorder or academic disorder, a 6-month program based on paper-pencil tasks and board and card games. The team was trained in different kinds of cognitive

  19. Mental Health of Immigrant Children: A New Challenge for Child and Adolescent Psychiatry Services in Ireland

    Skokauskas, Norbert; Clarke, Dermot


    Ethnically, Ireland has diversified greatly over the past few years. According to the 2006 census, 419733 foreign nationals live in Ireland. Immigration is one of the one of the most stressful events a child can undergo; it involves profound changes, including a disruption of well-established relationships and acculturation. Since the…

  20. [An inclusive misunderstanding--why noncategorization in special education for people with emotional and social behavior disorders complicates the cooperation with child and adolescent psychiatry].

    Ahrbeck, Bernd; Fickler-Stang, Ulrike


    The welcomed coeducation of children and adolescents with and without disabilities is going into dangerous territory since it has become burdened with a number of illusionary expectations. The constraints applied by real-life and meaningful circumstances should be taken into account, especially for children with emotional and social behavior disorders. Practicable prevention and intervention measurements cannot be generated without profound knowledge about disorders among this heterogeneous group of people. Abandoning all previously relevant terminology («noncategorization»), demanded by some radical inclusion advocates, leads to a situation that is helplessly confronted with its duties but lacks the basic skills and the necessary support stemming from an interdisciplinary dialogue. The contact with child and adolescent psychiatry is threatened to the disadvantage of the profession. PMID:26118813

  1. Evaluation of Consultations Requested from the Departments of Child and Adolescent Psychiatry of Uludağ University Hospital within the Previous Year

    Merve Çolpan


    Full Text Available In­tro­duc­ti­on: Consultation-liaison psychiatry is a field of psychiatry which investigates associations among clinical medicine in general, different fields of specialties and psychic and psychosocial entities. This psychiatric discipline deals with diagnosis, treatment, follow-up of psychiatric, and psychosocial disorders associated with physical diseases. The objective of this study was to review causes of consultations requested from departments of child and adolescent mental health, and diseases (PAMHD, sociodemographic data of the cases, and treatment approaches related to these cases. Materials and Methods: Patient information related to the consultations requested from the department of child and adolescent psychiatry by the clinics of emergency medicine, and other clinics in the Uludag University, Faculty of Medicine (UUFM between January 2012 and January 2013 were retrospectively screened. Results: PAMHD consultations were requested from 0.48% of the cases in the UUFM who referred to the outpatient clinics of pediatric emergency, and 3.25% of the inpatients aged less than18 years. A total of 275 cases (females, 51.5%; and males, 48.5% with a mean age of 13.5±4.23 years were evaluated. Consultations were most often requested from the clinics of pediatric emergency (27%, pediatric hematology (12.5%, and pediatric nephrology (12.5% in decreasing order of frequency. Of the cases, 7.6% had not received any psychiatric diagnosis. Psychiatric diagnoses were mostly adjustment disorder (26.2%, depressive disorder (20.7%, and anxiety disorder (15.3%. Medical treatment was administered to 36% of the evaluated cases. Conclusions: Our study reveals that psychiatric disorders, mainly adjustment disorders and depressions, are frequently seen in patients with physical diseases. Apparently, screening studies performed have revealed annual increases in the number of consultations evaluated. Outcomes of our study emphasized the merit of these

  2. Digital psychiatry.

    Tang, S; Helmeste, D


    The American managed care movement has been viewed as a big experiment and is being watched closely by the rest of the world. In the meanwhile, computer-based information technology (IT) is changing the practice of medicine, much more rapidly than managed care. A New World of digitized knowledge and information has been created. Although literature on IT in psychiatry is largely absent in peer-reviewed psychiatric journals, IT is finding its way into all aspects of medicine, particularly psychiatry. Telepsychiatry programs are becoming very popular. At the same time, medical information sites are flourishing and evolving into a new health-care industry. Patient-physician information asymmetry is decreasing as patients are gaining easy access to medical information hitherto only available to professionals. Thus, psychiatry is facing another paradigm shift, at a time when most attention has been focused on managed care. In this new digital world, knowledge and information are no longer the sole property of professionals. Value will migrate from traditional in-person office-based therapy to digital clinical products, from in-person library search and classroom didactic instruction to interactive on-line searches and distance learning. In this time of value migration, psychiatrists have to determine what their 'distinctive competence' is and where best to add value in the health-care delivery value chain. The authors assess the impact of IT on clinical psychiatry and review how clinical practice, education and research in psychiatry are expected to change in this emerging digital world. PMID:15558872

  3. What Is Psychiatry?

    Full Text Available ... What Is Psychiatry? Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of ... written examination for a state license to practice medicine, and then complete four years of psychiatry residency. ...

  4. Commentary: The devastating effects of ignoring child maltreatment in psychiatry--a commentary on Teicher and Samson 2016.

    van der Kolk, Bessel


    Despite the numerous studies over the past 30 years that have clarified the devastating effects of child maltreatment on mental and physical health, the role of trauma within the caregiving system remains unrecognized both in our diagnostic systems and in our dominant treatment paradigms. Research of people with histories of caregiver abuse and neglect consistently demonstrates problems with concentration, anger, panic, depression, food intake, drugs, and sleep, as well as decreased Heart RateVariability, higher levels of stress hormones, and reduced or impaired immune response. Their relationship between documented brain changes and psychopathology is complex. Traumatic life experiences during childhood and adolescence are far more common than expected. The Centers for Disease Control and Prevention estimates that child maltreatment may be the most costly public health issue in the United States, Eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, serious drug abuse, and domestic violence by three quarters. It would also have a significantly positive effect on workplace performance, and vastly decrease the need for incarceration. The current practice of applying multiple distinct comorbid diagnoses to traumatized children prevents a comprehensive treatment approach. Approaching their problems from a framework of memories of discreet traumatic ignores the fact that the damage affects the brain's neural circuitry and goes well beyond dealing with discrete painful events. Our great challenge is to learn to utilize the brain's neuroplasticity to reorganize defective brain circuits. PMID:26889892

  5. The Antisocial Child, His Family and His Community. The Langley Porter Child Psychiatry Series -- Clinical Approaches to Problems of Childhood, Volume 4.

    Szurek, S.A., Ed.; Berlin, I.N., Ed.

    Eighteen papers consider the antisocial child. The genesis of his behavior is discussed in terms of psychopathic personality trends, acting out, and sexual disorders; emotional factors in the use of authority and the contribution of controls to corrective learning are described. Efforts at psychiatric treatment are reviewed with reference to…

  6. [Sleep psychiatry].

    Chiba, Shigeru


    Sleep disorders are serious issues in modern society. There has been marked scientific interest in sleep for a century, with the discoveries of the electrical activity of the brain (EEG), sleep-wake system, rapid eye movement (REM) sleep, and circadian rhythm system. Additionally, the advent of video-polysomnography in clinical research has revealed some of the consequences of disrupted sleep and sleep deprivation in psychiatric disorders. Decades of clinical research have demonstrated that sleep disorders are intimately tied to not only physical disease (e. g., lifestyle-related disease) but psychiatric illness. According to The International Classification of Sleep Disorders (2005), sleep disorders are classified into 8 major categories: 1) insomnia, 2) sleep-related breathing disorders, 3) hypersomnias of central origin, 4) circadian rhythm sleep disorders, 5) parasomnias, 6) sleep-related movement disorders, 7) isolated symptoms, and 8) other sleep disorders. Several sleep disorders, including obstructive sleep apnea syndrome, restless legs syndrome, periodic limb movement disorder, sleepwalking, REM sleep behavior disorder, and narcolepsy, may be comorbid or possibly mimic numerous psychiatric disorders, and can even occur due to psychiatric pharmacotherapy. Moreover, sleep disorders may exacerbate underlying psychiatric disorders when left untreated. Therefore, psychiatrists should pay attention to the intimate relationship between sleep disorders and psychiatric symptoms. Sleep psychiatry is an academic field focusing on interrelations between sleep medicine and psychiatry. This mini-review summarizes recent findings in sleep psychiatry. Future research on the bidirectional relation between sleep disturbance and psychiatric symptoms will shed light on the pathophysiological view of psychiatric disorders and sleep disorders. PMID:24050022

  7. Transcultural psychiatry

    R Vikash


    Full Text Available During the last half of the century the researchers have placed a great deal of importance on brain behavior relations. This has brought upon a huge body of knowledge but unfortunately at the cost of culture - the true roots of much of our behaviour. This general disregard of cultural factors has not only led to false generalizations but has also blocked the understanding of the real forces that motivate and shape our perceptions, attitudes, and actions. This paper is therefore an attempt to highlight the trajectory of transcultural psychiatry, right from the conceptions of its idea, through flaws in methodology, assessment, treatment and to its future and its limitations.

  8. Child and adolescent psychiatry: which knowledge and skills do primary care physicians need to have? A survey in general practitioners and paediatricians.

    Lempp, Thomas; Heinzel-Gutenbrunner, Monika; Bachmann, Christian


    Primary care physicians (PCPs) play a key role in the initial assessment and management of children and adolescents with mental health problems. However, it is unclear whether current medical education curricula sufficiently equip PCPs for this task. The aim of this study was to investigate, which child and adolescent psychiatry (CAP)-related skills and knowledge PCPs say they require in their daily practice. A questionnaire was generated, employing a modified two-step Delphi approach. Besides socio-demographic items, the questionnaire contained 17 CAP-related knowledge items and 13 CAP-related skills items, which had to be rated by importance in daily practice. The questionnaire was distributed to 348 office-based paediatricians and 500 general practitioners (GPs) in Germany. The overall return rate was 51.3 % (435/848). Regarding CAP-related knowledge, both paediatricians and GPs rated somatoform disorders and obesity as highly important for daily practice. Moreover, paediatricians also deemed regulatory disorders during infancy (e.g. crying, sleep disorders) as important, while GPs assessed knowledge on paediatric depression as relevant. For paediatricians and GPs, the most relevant CAP-related skills were communicating with children and adolescents and their parents. Additionally, paediatricians rated differentiating between non-pathologic and clinically relevant behaviour problems very relevant, while GPs considered basic psychotherapeutic skills essential. The CAP-related knowledge and skills perceived relevant for doctors in primary care differ from the majority of current medical school CAP curricula, which cover mainly typical, epitomic CAP disorders and are predominantly knowledge-oriented. Therefore, medical education in CAP should be amended to reflect the needs of PCPs to improve healthcare for children and adolescents with mental health problems. PMID:26250895

  9. What Is Psychiatry?

    Full Text Available ... Association for Emergency Psychiatry Association of Gay and Lesbian Psychiatrists Resources Explore More Topics Warning Signs of ... APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Terms of Use Copyright Contact © 2016 American Psychiatric ...

  10. Child Wellness and Happiness

    Rettew, David C.


    Wellness and happiness should be considered in the clinical treatment of child and adolescent psychiatry, in addition with thinking about illness. Meanwhile, various studies on child and adolescent psychiatry,which includes an article from the "Journal of Happiness Studies," are discussed.

  11. In the long run...longitudinal studies of psychopathology in children. Committee on Child Psychology. Group for the Advancement of Psychiatry. Report no.143.


    Longitudinal studies are difficult to do well. Too short a study and the results may be meaningless. Too long a study and the subjects cannot be found, money runs out, and research methods become seriously out of date. Despite these problems, there have been some longitudinal studies done that have greatly advanced our understanding of the nature and the treatment of psychopathology in childhood. Without these studies, much less would be known about the clinical course of important disorders, the effects of treatments, and the various risk and protective factors. None of these studies has been perfect. Some longitudinal studies did not focus on quite the right questions, some produced contradictory results, and others produced results that were hard to interpret. What have we learned from the longitudinal studies reviewed in this Group for the Advancement of Psychiatry (GAP) report? Many of the things that we have learned have been surprising--even counterintuitive. Pre- and perinatal insults need not necessarily lead to serious consequences in later life. Premature infants, if raised in nondeprived settings, are not likely to be mentally retarded or learning disabled. Today, of course, premature infants who would not have been kept alive 15 years ago are surviving. Will this advancement led to an untoward outcome? We do not know. New longitudinal studies need to be done. Certain serious illnesses emerging later in childhood may be associated with a greater risk of psychopathology. This risk is true at least for those with asthma. Psychological factors, such as psychological stress, also may lead to exacerbation of asthmatic attacks. Whether other illnesses are associated with a greater risk of psychopathology simply has not been studied adequately. Infant temperamental characteristics can be classified and measured; however, they appear to predict little in terms of later personality development or psychopathology. Although temperamental characteristics measured

  12. Historicizing Indian psychiatry

    Basu, Amit Ranjan


    Our historical endeavour to map Indian psychiatry has largely remained linear, positivistic and evolutionary. Whether it starts from the ancient times or modern, it shows our past as a tale of victory for the western science, without questioning the borrowed paradigm. The use of historical methods for serious enquiry of psychiatry has been ignored. Emergence of a new genre of historicism that is critical of both colonialism and psychiatry as a universal science, has raised hopes to critically...

  13. Historicizing Indian psychiatry.

    Basu, Amit Ranjan


    Our historical endeavour to map Indian psychiatry has largely remained linear, positivistic and evolutionary. Whether it starts from the ancient times or modern, it shows our past as a tale of victory for the western science, without questioning the borrowed paradigm. The use of historical methods for serious enquiry of psychiatry has been ignored. Emergence of a new genre of historicism that is critical of both colonialism and psychiatry as a universal science, has raised hopes to critically review the emergence of psychiatric knowledge. PMID:20711299

  14. Crime and Psychiatry

    Yusuf Matcheswalla


    Full Text Available Psychiatry and crime are linked in certain ways. On one hand, we have criminal offenders with serious psychopathology; and on the other hand, we have psychiatric patients who may commit criminal offences during the influence of a psychiatric disorder. The psychiatrist in practice has to come in contact with the criminal justice system at some point of time in his career. Forensic psychiatry under whose realm these issues reside is a branch yet underdeveloped in India. The present paper reviews the inter-relationship between crime and psychiatry and the factors involved therein.

  15. Annals of General Psychiatry

    Fountoulakis Konstantinos


    Abstract Our regular readers will notice that the title of our journal has changed from Annals of General Hospital Psychiatry (AGHP) to Annals of General Psychiatry (AGP) since January 1st, 2005. This was judged as necessary, in order to be able to serve better the aims of the journal. Our initial thoughts were that including the term 'General Hospital' in the journal's title would help us to launch a journal dedicated to the idea of Psychiatry as a medical specialty. But they were not justif...

  16. What Is Psychiatry?

    Full Text Available ... as a panic attack, frightening hallucinations, thoughts of suicide, or hearing "voices." Or they may be more ... Illness What Is Psychiatry? What Is Mental Illness? Suicide Prevention What is ECT? Ask An Expert Share ...

  17. What Is Psychiatry?

    Full Text Available ... APA Sites APA Publishing APA Learning Center APA Foundation APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental ... Medical Students International APA Sites APA Publishing APA Foundation APA Learning Center APA Annual Meeting Psychiatric News ...

  18. What Is Psychiatry?

    Full Text Available ... Annual Meeting Residents & Medical Students Residents Medical Students Patients & Families Mental Health Disorders/Substance Abuse Find a Psychiatrist Patients & Families What Is Psychiatry? All Topics Resources What ...

  19. What Is Psychiatry?

    Full Text Available ... Meeting Residents & Medical Students Residents Medical Students Patients & Families Mental Health Disorders/Substance Abuse Find a Psychiatrist Patients & Families What Is Psychiatry? All Topics Resources What Is ...

  20. What Is Psychiatry?

    Full Text Available ... become a psychiatrist, a person must complete medical school and take a written examination for a state ... A psychiatrist is a medical doctor (completed medical school and residency) with special training in psychiatry. A ...

  1. What Is Psychiatry?

    Full Text Available ... and insomnia. Hypnotics – used to induce and maintain sleep. Mood stabilizers – used to treat bipolar disorder. Stimulants – ... psychiatry Pain medicine Psychosomatic (mind and body) medicine Sleep medicine Some psychiatrists choose additional training in psychoanalysis ...

  2. What Is Psychiatry?

    Full Text Available ... must complete medical school and take a written examination for a state license to practice medicine, and ... most psychiatrists take a voluntary written and oral examination given by the American Board of Psychiatry and ...

  3. What Is Psychiatry?

    Full Text Available ... Releases Message from the President Reporting on Mental Health Conditions APA Blogs Media Registration - Annual Meeting Advocacy & ... APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents Medical Students International ...

  4. What Is Psychiatry?

    Full Text Available ... Releases Message from the President Reporting on Mental Health Conditions APA Blogs Advocacy & APAPAC APA Sites APA ... APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents Medical Students International ...

  5. What Is Psychiatry?

    Full Text Available ... International Residents & Medical Students Residents Medical Students Patients & Families Mental Health Disorders/Substance Abuse Find a Psychiatrist Patients & Families What Is Psychiatry? All Topics Resources What Is ...

  6. Psychiatry's Turbid Solution

    Richters, John E.; Hinshaw, Stephen P.


    Psychiatry?s generic concept of disorder has long served an important legitimizing function for the broad array of conditions for which individuals seek mental health treatment, regardless of their presumed causes. Wakefield?s proposal to restrict the mental disorder concept to only a subset of these conditions has given rise to concerns about the uncertain consequences of classifying others as non-disorders. In Bergner?s recent counterproposal, this concern is masked in the form of a conspic...

  7. Psychiatry and music

    Nizamie, Shamsul Haque; Tikka, Sai Krishna


    Vocal and/or instrumental sounds combined in such a way as to produce beauty of form, harmony and expression of emotion is music. Brain, mind and music are remarkably related to each other and music has got a strong impact on psychiatry. With the advent of music therapy, as an efficient form of alternative therapy in treating major psychiatric conditions, this impact has been further strengthened. In this review, we deliberate upon the historical aspects of the relationship between psychiatry...

  8. AACAP 2005 Research Forum: Speeding the Adoption of Evidence-Based Practice in Pediatric Psychiatry

    March, John S.; Szatmari, Peter; Bukstein, Oscar; Chrisman, Allan; Kondo, Douglas; Hamilton, John D.; Kremer, Charlotte M. E.; Kratochvil, Christopher J.


    Objectives: At the 2005 Annual Meeting of the American Academy of Child and Adolescent Psychiatry (AACAP), the Academy's Workgroup on Research conducted a Research Forum entitled "Increasing Research Literacy Through the Adoption of Evidence-Based Practice (EBP) in Pediatric Psychiatry." Method: Forum participants focused on speeding the adoption…

  9. Clinical Case Rounds in Child and Adolescent Psychiatry: Enuresis and ADHD in Older Children and an Adolescent Treated with Stimulant Medication: A Case Series

    Williamson, Lloyda B.; Gower, Michael; Ulzen, Thaddeus


    Uncommonly, older children and adolescents can present with a history of enuresis. Resolution of enuresis followed the diagnosis and treatment of Attention Deficit Hyperactivity Disorder (ADHD) in each child in this case series. Subjects were three children with DSM-IV-TR ADHD, who presented with a history of primary nocturnal enuresis (PNE). Our results reveal that a subgroup of children with ADHD plus enuresis, when treated with stimulant medication, demonstrated resolution of enuresis as w...

  10. Psychiatry in Former Socialist Countries: Implications for North Korean Psychiatry

    Park, Young Su; Park, Sang Min; Jun, Jin Yong; Kim, Seog Ju


    Very little information is available regarding psychiatry in North Korea, which is based on the legacy of Soviet psychiatry. This paper reviews the characteristics of psychiatry in former socialist countries and discusses its implications for North Korean psychiatry. Under socialism, psychiatric disorders were attributed primarily to neurophysiologic or neurobiological origins. Psychosocial or psychodynamic etiology was denied or distorted in line with the political ideology of the Communist ...

  11. Training in psychiatry throughout Europe

    Brittlebank, Andrew; Hermans, Marc; Bhugra, Dinesh; Pinto da Costa, Mariana; Rojnic-Kuzman, Martina; Fiorillo, Andrea; Kurimay, Tamas; Hanon, Cecile; WASSERMAN, DANUTA; Gaag, Rutger Jan van der


    Psychiatry is the largest medical specialty in Europe. Despite efforts to bring harmonisation, training in psychiatry in Europe continues to be very diverse. The Union Européenne des Médecins Spécialistes (UEMS) has issued as from 2000 a charter of requirements for the training in psychiatry with an additional European Framework for Competencies in Psychiatry in 2009. Yet these have not been implemented throughout Europe. In this paper, the diversity in training throughout Europe is approache...

  12. SPECT in psychiatry. SPECT in der Psychiatrie

    Barocka, A. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany)); Feistel, H. (Nuklearmedizinische Klinik, Erlangen (Germany)); Ebert, D. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany)); Lungershausen, E. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany))


    This review presents Single Photon Emission Computed Tomography (SPECT) as a powerful tool for clinical use and research in psychiatry. Its focus is on regional cerebral blood flow, measured with technetium labelled HMPAO. In addition, first results with brain receptor imaging, concerning dopamin-D[sub 2] and benzodiazepine receptors, are covered. Due to major improvements in image quality, and impressive number of results has been accumulated in the past three years. The authors caution against using SPECT results as markers for disease entities. A finding like 'hypofrontality' is considered typical of a variety of mental disorders. Clearly both, more experience with SPECT and contributions from psychopathology, are needed. (orig.)

  13. When to Seek Help for Your Child

    ... signs which may indicate that a child and adolescent psychiatric evaluation will be useful. Younger Children Marked fall in ... medical school in general (adult) and child and adolescent psychiatry. Facts ... or educational use without written permission, but cannot be included ...

  14. What Is Psychiatry?

    Full Text Available ... Illness What Is Psychiatry? What Is Mental Illness? Suicide Prevention What is ECT? Ask An Expert Share Your Story Become an APA Member Learn More Explore APA Psychiatrists Residents & Medical Students Patients & Families About APA Newsroom News Releases Psychiatric ...

  15. What Is Psychiatry?

    Full Text Available ... News Releases Message from the President Reporting on Mental Health Conditions APA Blogs Media Registration - Annual Meeting Advocacy & ... Foundation APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents Medical Students International ...

  16. [Sophrology and psychiatry].

    Diehr, Jan


    A relatively new discipline in the field of human sciences, sophrology seeks, through a physical as well as mental approach, to awaken awareness while energising the patient's resources and capacities. In psychiatry, it favours the development of body awareness and the positive activation of the mental structures, for the greater wellbeing of the patient. PMID:27615699

  17. Psychiatry and music.

    Nizamie, Shamsul Haque; Tikka, Sai Krishna


    Vocal and/or instrumental sounds combined in such a way as to produce beauty of form, harmony and expression of emotion is music. Brain, mind and music are remarkably related to each other and music has got a strong impact on psychiatry. With the advent of music therapy, as an efficient form of alternative therapy in treating major psychiatric conditions, this impact has been further strengthened. In this review, we deliberate upon the historical aspects of the relationship between psychiatry and music, neural processing underlying music, music's relation to classical psychology and psychopathology and scientific evidence base for music therapy in major psychiatric disorders. We highlight the role of Indian forms of music and Indian contribution to music therapy. PMID:24891698

  18. What psychiatry means to us

    J.K. Trivedi


    Full Text Available Psychiatry has come up as one of the most dynamic branches of medicine in recent years. There are a lot of controversies regarding concepts, nosology, definitions and treatments in psychiatry, all of which are presently under a strict scanner. Differences are so many that even the meaning of psychiatry varies amongst individual psychiatrists. For us, it is an art to practice psychiatry and give the patient what he needs. Still, it should be practiced with great caution and utmost sincerity towards the patient, based on scientific knowledge and not to be guided by individual conceptions alone. Ethics in psychiatry forms an integral part of its basic concept and meaning, and a tight balance should be maintained between professional advancement and patient benefit. In recent years, the scope of psychiatry has enlarged considerably, with wide ranging influences from Sociology, Anthropology and Philosophy on the one hand, and Neurology and Medicine on the other.

  19. Meditation and Psychiatry

    McGee, Michael


    How might meditation promote wellness and healing from psychiatric illness? How might it contribute to the practice of psychiatry? This review of the literature attempts to answer these questions. Meditation is the consciously willed practice of two actions, attending and abstaining, that all people spontaneously perform to a greater or lesser degree. Psychological health may correlate in part with the degree to which we naturally perform these actions. This review analyzes the nature of medi...

  20. Mumbai Psychiatry: Current Obstacles

    Sanjay V Bagadia


    Full Text Available Mumbai, like any other Metro city, has its own share of contentious issues influencing psychiatric management. These could be old ongoing issues like myths about medications, electroconvulsive therapy and counselling, or newer ones like our stand on homosexuality and crime related to psychosocial factors. A range of these issues is considered in this paper along with some possible solutions. Getting due credit and status for psychiatry as a medical branch is also a challenge we need to address.

  1. Identifying Phronotypes in Psychiatry

    F. AndrewKozel


    Full Text Available Refinements in the methods of diagnosis for psychiatric disorders are critically needed. These new methods should be based on objectively measured brain characteristics that provide clinically useful information. Studying the brain with respect to psychiatric disorders, however, faces numerous challenges. Utilizing techniques learned in other areas of medicine to deal with symptoms that lead to complex disorders can provide insight into improving diagnostic models in psychiatry. Specifically, many areas of medicine use objective measures of an organ’s function or characteristic to guide clinical management of particular subjective complaints. In psychiatry, an objectively measured brain characteristic that provides clinically useful information is proposed to be that person’s “phronotype.” Important requirements to developing phronotypes are discussed. Identifying phronotypes in psychiatry will require a specific investigative approach that must be grounded in rigorous scientific methodology. Successfully developing such markers will have a profound impact on clinical care, clinical research, basic science research, and most importantly the lives of those suffering from these illnesses.


    Doongaji, Dinshaw R


    An overview of psychiatry during the last three decades as practised in a general teaching hospital is presented. Psychiatry as an academic subject has matured tremendously during this period. The empirical treatments of the 1950s and the 1960s which evoke nostalgic memories, have been replaced by modern methods of treatment. However, there is a need to exercise caution against the blind acceptance of new and sophisticated research findings in biological psychiatry. Inspite of the bright futu...

  3. Psychiatry beyond the current paradigm.

    Bracken, Pat


    A series of editorials in this Journal have argued that psychiatry is in the midst of a crisis. The various solutions proposed would all involve a strengthening of psychiatry\\'s identity as essentially \\'applied neuroscience\\'. Although not discounting the importance of the brain sciences and psychopharmacology, we argue that psychiatry needs to move beyond the dominance of the current, technological paradigm. This would be more in keeping with the evidence about how positive outcomes are achieved and could also serve to foster more meaningful collaboration with the growing service user movement.


    Vishal Patill


    Full Text Available Psychiatry in Ayurveda integrates mind, body and soul. The mind-body connection is very important in Ayurveda. Physical imbalances can disturb mental state while mental illness leads to disruption of body functions. In Ayurveda many reference of Manas and treatment of manovikara was available which would be easy to understand and rewarding in the field of treatment, by describing the definition of Manas, its functions, qualities, concept of Manas, classification of mental disorders, treatment of mental illness prevention of mental illnesses, method of examination of mental illness and other important aspects.




    Full Text Available The recent laws on mental health define psychiatric illness as a loss of consciousness and understanding of consequences of self-behavioral acts, evaluated by loss of discernment. As discernment represents the main criteria of responsibility towards personal actions, this study attempts at presenting the ethical issues related to discernment evaluation from the perspective of forensic medicine. We propose a "mint" representation of the content and consequences of one’s own actions as a new criteria of evaluation, taking into account the modern principles of psychology and psychiatry.

  6. SPECT in psychiatry

    This review presents Single Photon Emission Computed Tomography (SPECT) as a powerful tool for clinical use and research in psychiatry. Its focus is on regional cerebral blood flow, measured with technetium labelled HMPAO. In addition, first results with brain receptor imaging, concerning dopamin-D2 and benzodiazepine receptors, are covered. Due to major improvements in image quality, and impressive number of results has been accumulated in the past three years. The authors caution against using SPECT results as markers for disease entities. A finding like 'hypofrontality' is considered typical of a variety of mental disorders. Clearly both, more experience with SPECT and contributions from psychopathology, are needed. (orig.)

  7. [Between neurology and psychiatry].

    Levine, Joseph; Toser, Doron; Zeev, Kaplan


    In this review we will discuss the broad spectrum of possible relationships between the fields of neurology and psychiatry alongside weighing the pros and cons of each alternative relationship. This is in the hope that such discussions will allow an informed decision regarding the construction of future relations between these two areas. The possible connections between the areas are discussed in light of possible relationships that exist between the two groups in the mathematical world with reference to the proposed solutions to the psychophysical mind-body problem. PMID:25095609

  8. Enuresis: A Controversial Problem in Child Psychiatry

    Silberstein, Richard M.


    Discusses the use of an adaptation of the Mowrer device for the treatment of enuretic children, that is, children who involuntarily and unconsciously pass urine in bed while asleep after an arbitrary age limit of 4 years. (Author/RK)

  9. Psychiatry in Korea.

    Park, Jong-Il; Oh, Keun-Young; Chung, Young-Chul


    This paper reports the current status of Korean psychiatry. In 2011, there were 3005 psychiatrists and 75,000 psychiatric beds. There were 84 psychiatric residency-training hospitals in 2011, which produced about 150 psychiatry board-certified doctors annually. As for academic activity, there is the Korean Neuropsychiatric Association, a main association for neuropsychiatry, and 21 other research societies. Psychiatric residency is a 4-year training program, with different objectives for each grade. The Korean health system accepts National Health Insurance. When severely mentally ill patients register as having a mental disorder, they pay only 10% of their total medical costs. Private clinics usually see patients with less severe conditions such as anxiety, mood and eating disorders; general and university hospitals and special mental hospitals often deal with severe conditions such as schizophrenia and bipolar disorder. One great concern is an increasing trend to depend upon pharmacotherapy and neglect the role of psychotherapy. Additionally, conflicts among medical sectors are becoming fierce as other doctors request abolition of the current law that restricts them from prescribing anti-depressants for more than 60 days. The average hospitalization period of all mental care institutions was 166 days in 2010, substantially longer compared with developed countries. To win the heart of the general public, cutting edge research to improve the quality of treatment for mental diseases, reformation of psychiatric residency training programs, public campaigns to increase awareness of mental health value, and timely reflection on policy decisions should be pursued persistently. PMID:23466121

  10. Ethische Herausforderungen der Psychiatrie

    Helmchen H


    Full Text Available Gegenwärtig ungelöste und zukünftige ethische Probleme der Psychiatrie werden durch Fortschritte in den Neurowissenschaften und durch den Wandel des soziokulturellen Kontextes der Psychiatrie bestimmt. Diese Rahmenbedingungen werden durch Hinweise auf die sozialen Folgen verdeutlicht, die sich aus der antipsychiatrischen Bewegung, wirtschaftlichen Krisen und dem demographischen Wandel ebenso wie auch aus der Strenge wissenschaftlicher Methodik oder dem zunehmenden genetischen Wissen für die psychiatrische Versorgung und Forschung ergeben. In solchem Kontext werden ethische Probleme erörtert, die sich zwischen Medizin und Gesellschaft (individuelles Wohl versus Allgemeinwohl oder innerhalb der Medizin (Wohl versus Wille des Patienten oder zwischen Individuum und Institution (Unabhängigkeit ärztlichen Denkens und Sponsoring entwickeln. Beispiele gegenwärtig ungelöster ethischer Probleme werden in der Forschung mit nicht einwilligungsfähigen Patienten, bei placebokontrollierten klinischen Prüfungen und bei industriegesponsorter Forschung gesehen. Zukünftige ethische Herausforderungen werden sich aus dem wachsenden genetischen Wissen, z. B. in der genetischen Voraussage von Risiken (Vermarktung genetischer Tests, pharmakogenetische Individualisierung der Therapie, präsymptomatische Diagnostik, Vertraulichkeit genetischer Daten, aus der pharmakologischen sowie neurotechnischen Veränderung von Hirnfunktionen (Enhancement, Anti-Aging, Aktivierung von Neuroplastizität und Implantation von neuronalem Gewebe oder Mikroelektronik, und nicht zuletzt an den Grenzen zwischen Krankheit und Gesundheit, zwischen Medizin und Wellness ergeben.

  11. Could Diet in Pregnancy Raise Child's Odds for ADHD?

    ... was published Aug. 18 in the Journal of Child Psychology and Psychiatry . SOURCES: Edward Barker, Ph.D., director, ... Park, N.Y.; Aug. 18, 2016, Journal of Child Psychology and Psychiatry HealthDay Copyright (c) 2016 HealthDay . All ...

  12. YouTube and 'psychiatry'.

    Gordon, Robert; Miller, John; Collins, Noel


    YouTube is a video-sharing website that is increasingly used to share and disseminate health-related information, particularly among younger people. There are reports that social media sites, such as YouTube, are being used to communicate an anti-psychiatry message but this has never been confirmed in any published analysis of YouTube clip content. This descriptive study revealed that the representation of 'psychiatry' during summer 2012 was predominantly negative. A subsequent smaller re-analysis suggests that the negative portrayal of 'psychiatry' on YouTube is a stable phenomenon. The significance of this and how it could be addressed are discussed. PMID:26755987

  13. Dimensional Approach in Psychiatry

    Osman Ozdemir


    Full Text Available In psychiatry there is a traditional categorical conception stating that several disorders like schizophrenia and bipolar disorder have distinct etiologies. On the other hand, dimensional approach claims that these entities are actually the same disorder reflecting different clinical aspects of same mental disorder in the course of time. ICD and DSM classifications are based on separate categories of different mental disorders. Howewer, it is quite difficult to consider a mental disorder as a discrete entity that has absolute boundaries from other disorders. There are patients manifesting symptoms of two or more categories but do not fulfill all diagnostic criteria for any mental disorder. Dimensional approach handles the psychopathology as a continuing process and establish the patients to the different ongoing points. According to this view, in fact, multiple diagnosis reflect dimensions of the same disease.

  14. MRI in psychiatry

    Mulert, Christoph [UKE, Hamburg (Germany). Psychiatry Neuroimaging Branch; Shenton, Martha E. (ed.) [Harvard Medical School, Boston, MA (United States). Dept. of Psychiatry and Radiology


    This is the first comprehensive textbook on the use of MRI in psychiatry covering imaging techniques, brain systems and a review of findings in different psychiatric disorders. The book is divided into three sections, the first of which covers in detail all the major MRI-based methodological approaches available today, including fMRI, EEG-fMRI, DTI, and MR spectroscopy. In addition, the role of MRI in imaging genetics and combined brain stimulation and imaging is carefully explained. The second section provides an overview of the different brain systems that are relevant for psychiatric disorders, including the systems for perception, emotion, cognition, and reward. The final part of the book presents the MRI findings that are obtained in all the major psychiatric disorders using the previously discussed techniques. Numerous carefully chosen images support the informative text, making this an ideal reference work for all practitioners and trainees with an interest in this flourishing field.

  15. Nursing interventions in inpatient psychiatry

    Frauenfelder, F.; Muller-Staub, M.; Needham, I.; Achterberg, T. van


    The successful application of the Nursing Interventions Classification (NIC) in inpatient psychiatry depends on whether the classification adequately describes nursing care in this setting. The present study aimed to identify nursing interventions mentioned in journal articles on psychiatric inpatie

  16. History of psychiatry in India

    Nizamie, S.Haque; Goyal, Nishant


    History is a screen through which the past lightens the present and the present brightens the future. Psychiatry by virtue of its ability to deal with human thoughts and emotions and provide a pathway for healthy minds provides an important platform towards being a mentally sound human being and largely the society. This review takes a sneak peek into the foundations of modern psychiatry in India. The description is largely based on the time frame, which provides a better understanding of the...


    Žarkovic Palijan, Tija; Mužinić, Lana; Radeljak, Sanja


    For the past several years a numerous studies in the field of forensic psychiatry confirmed a close relationship between violent offenders and comorbid substance abuse. The comorbid substance abuse in violent offenders was usually unrecognized and misdiagnosed. Furthermore, comorbidity in forensic psychiatry describes the co-occurrence of two or more conditions or psychiatric disorder known in the literature as dual diagnosis and defined by World Health Organization (WHO). In fact, many vi...

  18. Space Psychology and Psychiatry

    Kanas, N.; Manzey, D.


    This book deals with psychological, psychiatric, and psychosocial issues that affect people who live and work in space. Unlike other books that focus on anecdotal reports and ground-based simulation studies, this book emphasizes the findings from psychological research conducted during actual space missions. Both authors have been active in such research. What is presented in this readable text has previously been found only in scientific journal articles. Topics that are discussed include: behavioral adaptation to space; human performance and cognitive effects; crewmember interactions; psychiatric responses; psychological counter-measures related to habitability factors, work-design, selection, training, and in-flight monitoring and support; and the impact of expeditionary missions to Mars and beyond. People finding this book of interest will include: psychology and social science students and professors in universities; medical students and residents in psychiatry and aerospace medicine; human factors workers in space and aviation professions; individuals involved with isolated environments on Earth (e.g., the Antarctic, submarines); aerospace workers in businesses and space agencies such as NASA and ESA; and anyone who is interested in learning the facts about the human side of long-duration space missions. Link:

  19. Nuclear medicine in psychiatry

    In the same way that the symptoms between different diseases in psychiatry overlap, functional brain research frequently shows the same pattern of changes across diagnostic borders; on the other hand, many the other tests, e.g. psychological tests, present the same problem as mentioned above; therefore: The psychiatrist seldom applies to an NM specialist to obtain a diagnosis; instead, a nuclear medicine report will rather confirm, or less frequently exclude, the psychiatrist's diagnosis. Ideally, psychiatric patients should be rescanned after the treatment, and changes in perfusion and/or metabolism discussed between psychiatrist and NM specialist. As shown above, there are few practical applications of nuclear medicine due to low specificity and low spatial resolution, although in the aspect of functional imaging it is still superior to CT/MRI, even in their functional modalities. On the other hand, its investigational potential is still growing, as there is no imaging technique in sight which could replace metabolic and receptor studies, and also because the scope of functional imaging in psychiatric diseases is spreading from its traditional applications, like dementia or depression, towards many poorly investigated fields e.g. hypnosis, suicidal behaviour or sleep disorders. (author)

  20. Psychiatry and movies.

    Damjanović, Aleksandar; Vuković, Olivera; Jovanović, Aleksandar A; Jasović-Gasić, Miroslava


    As one of the most potent and substantial form of mass communication, film exercises a very significant influence upon the perceptions of the audience, especially in relation to mental illness issues, and that perception is very much blurred with populists' misinterpretation and lack of awareness regarding problems faced by persons suffering from mental disorders. Movies such as "Psycho", "One Flew Over Cuckoo's Nest", "Exorcist", despite being valuable in an artistic sense, corroborated and encouraged confusion and undermined the clarity and certainty concerning the fine line separating mental health from mental illness. Modern film makers and movie theoreticians try to overcome these limitations which are often generated by exploitation of stereotypes and myths referring to mentally ill people. This paper defines and discusses the most frequent thematic stereotypes seen in movies which are perpetuating stigmatization of mentally ill people. They are: free-spirited rebel, maniac on a killing spree, seducer, enlightened member of society, narcissistic parasite, beastly person (stereotype of animal sort). Psychiatry and cinematography are linked inseparably not only because they creatively complement each other, but also as an opportunity of mutual influences blending into didactical categories and professional driving forces, benefiting both the filmmakers' and the psychiatrists' professions. PMID:19556954

  1. State of psychiatry in Denmark.

    Bauer, Jeanett; Okkels, Niels; Munk-Jørgensen, Povl


    Danish psychiatry has gone through profound changes over the past two to three decades, reducing inpatient-based treatment and increasing outpatient treatment markedly. The number of patients treated has almost doubled, and the diagnostic profile has broadened, now including a substantial number of common mental disorders, in particular depression and anxiety. Furthermore, 'new' diagnostic groups are represented in the treatment statistics with steeply increasing incidences, e.g. attention deficit hyperactivity disorder (ADHD) and eating disorders, especially in the outpatient part of the statistics. Over the same 30 years, the number of available beds has been reduced by 60-70%; however, as the length of stay of inpatients has been reduced markedly, the departments are still able to treat a high number of patients. The financial budgeting of psychiatry is not increasing equivalently to the somatic specialities, handicapping development in psychiatry. Action has been taken to increase research activity in psychiatry. This is facilitated by an increasing interest among medical students and young graduate physicians attracted by the neuropsychiatric paradigm, rapidly implemented in Danish psychiatry. PMID:22950767

  2. Ethics in psychiatry: a framework



    Defining bioethics as the rational use of dialogue in the formulation, justification, and application of ethical principles, with the aim ofgenerating good practices in research, clinical practice, and advocacy, this paper focuses on methods for bioethical deliberation relevantto psychiatry. Stressing that bioethics fuses the two main ethical traditions in Western thought, the deontological and the teleological, thepaper emphasizes the three conditions that any intervention, ...

  3. State of psychiatry in Denmark

    Bauer, Jeanett Østerby; Okkels, Niels; Munk-Jørgensen, Povl


    statistics. Over the same 30 years, the number of available beds has been reduced by 60-70%; however, as the length of stay of inpatients has been reduced markedly, the departments are still able to treat a high number of patients. The financial budgeting of psychiatry is not increasing equivalently to the...

  4. Historical aspects of Mexican psychiatry.

    Bayardo, Sergio Javier Villaseñor


    Mexican psychiatry initiated since pre-Hispanic times. Historically, treatments were a mixture of magic, science and religion. Ancient Nahuas had their own medical concepts with a holistic view of medicine, considering men and cosmos as a whole. The first psychiatric hospital appeared in 1566 and a more modern psychiatric asylum emerged until 1910. International exchanges of theoretical approaches started in the National University with the visit of Pierre Janet. There were other important figures that influenced Mexican psychiatry, such as Erich Fromm, Henri Ey, Jean Garrabé and Yves Thoret. Regarding Mexican psychiatrists, some of the most important contributors to Mexican psychiatry were José Luis Patiño Rojas, Manuel Guevara Oropeza and Ramón de la Fuente Muñiz. This article includes excerpts from "Clinical Psychiatry", a book by Patiño Rojas where he tries to understand and describe the inner world experienced by patients with schizophrenia; also, the thesis conducted by Guevara Oropeza ("Psychoanalisis"), which is a critical comparison between the theories of Janet and Freud. Finally, we include "The study of consciousness: current status" by Ramón de la Fuente, which leads us through the initial investigations concerning consciousness, its evolution, and the contributions made by psychology, philosophy and neurobiology. PMID:27117799

  5. Training in psychiatry throughout Europe.

    Brittlebank, Andrew; Hermans, Marc; Bhugra, Dinesh; Pinto da Costa, Mariana; Rojnic-Kuzman, Martina; Fiorillo, Andrea; Kurimay, Tamas; Hanon, Cecile; Wasserman, Danuta; van der Gaag, Rutger Jan


    Psychiatry is the largest medical specialty in Europe. Despite efforts to bring harmonisation, training in psychiatry in Europe continues to be very diverse. The Union Européenne des Médecins Spécialistes (UEMS) has issued as from 2000 a charter of requirements for the training in psychiatry with an additional European Framework for Competencies in Psychiatry in 2009. Yet these have not been implemented throughout Europe. In this paper, the diversity in training throughout Europe is approached from different angles: the cultural differences between countries with regards to how mental health care is considered and founded on, the cultural differences between people throughout Europe in all states. The position of psychotherapy is emphasised. What once was the cornerstone of psychiatry as medical specialty seems to have become a neglected area. Seeing the patient with mental health problems within his cultural context is important, but considering him within his family context. The purpose of any training is enabling the trainee to gain the knowledge and acquire the competencies necessary to become a well-equipped professional is the subject of the last paragraph in which trainees consider their position and early career psychiatrists look back to see whether what they were trained in matches with what they need in the working situation. Common standard for training and certification are a necessity within Europe, for the benefit of the profession of psychiatrist but also for patient safety. UEMS is advised to join forces with the Council of National Psychiatric Associations (NPAs) within the EPA and trainings and early career psychiatrist, to discuss with the users what standards should be implemented in all European countries and how a European board examination could ensure professional quality of psychiatrists throughout the continent. PMID:26880078

  6. Secular humanism and "scientific psychiatry".

    Szasz, Thomas


    The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the person is an 'imprisonment,' whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry. PMID:16759353

  7. Secular humanism and "scientific psychiatry"

    Szasz Thomas


    Full Text Available Abstract The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the person is an 'imprisonment,' whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry.

  8. The Two Cultures in Psychiatry.

    Cleghorn, R A


    The division between the two cultures of the literary and scientific worlds is considered, as is the division between the two cultures of humanism and somaticism. The development of psychiatric thought important to this latter dichotomy is described through the Age of Enlightenment, the Romantic Movement and the New Enlightenment. The two cultures of our present literary and scientific milieux are equated with the romanticism and somaticism of the past. The development of two cultures in psychiatry is traced, beginning with Freud's attempt to combine science and romanticism, to the present day where one finds some degree of convergence between the somatic and psychoanalytic approaches. Criteria are presented for a greater union of the two cultures in psychiatry. PMID:20328284

  9. Against Explanatory Minimalism in Psychiatry



    The idea that psychiatry contains, in principle, a series of levels of explanation has been criticized not only as empirically false but also, by Campbell, as unintelligible because it presupposes a discredited pre-Humean view of causation. Campbell’s criticism is based on an interventionist-inspired denial that mechanisms and rational connections underpin physical and mental causation, respectively, and hence underpin levels of explanation. These claims echo some superficially similar remark...

  10. Secular humanism and "scientific psychiatry"

    Szasz Thomas


    Abstract The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of m...

  11. Iranian Medical Students’ Perception of Psychiatry: Before and After a Psychiatry Clerkship

    Homayoun Amini; Ali-Akbar Nejatisafa; Saeed Shoar; Hosein Kaviani; Mehdi Samimi-Ardestani; Amir Shabani; Sara Esmaeili; Yasaman Moghaddam


    Objective We aimed to compare the medical students’ attitude towards psychiatry before and after psychiatry clerkship, and to examine the association of choosing psychiatry as a future career with some personal characteristics. Method In a self-controlled, quasi-experimental study, all of the medical students entering the psychiatry clerkship in three major medical schools of Iran located in Tehran (Tehran, Shahid Beheshti, and Iran University of Medical Sciences) were asked to participate an...

  12. Iranian Medical Students’ Perception of Psychiatry: Before and After a Psychiatry Clerkship

    Homayoun Amini


    Full Text Available Objective: We aimed to compare the medical students’ attitude towards psychiatry before and after psychiatry clerkship, and to examine the association of choosing psychiatry as a future career with some personal characteristics.Method: In a self-controlled, quasi-experimental study, all of the medical students entering the psychiatry clerkship in three major medical schools of Iran located in Tehran (Tehran, Shahid Beheshti, and Iran University of Medical Sciences were asked to participate anonymously in the study on the first and the last 3-days of their psychiatry clerkship. From 346 invited 4th-5th year medical students, 225 (65% completed anonymous self-report questionnaires before and after a 4-week psychiatry clerkship.Results: Positive response to choose psychiatry as a career was seen in 13.3 % and 18.3 % before and after psychiatry rotation, respectively. However, the difference was not statistically significant; about one-quarter of the students were turned on to psychiatry and 25% were discouraged during the clerkship. Individual pair wise comparisons revealed significant improvements only in two out of 13 measured aspects of psychiatry. Seventeen out of 38 (47.7% students who identified psychiatry as the career of choice or strong possibility reported that one of their family members or close friends’ mental illness had an impact on their choice. Those students who considered psychiatry as the strong possibility claimed that they are more interested in humanities (OR = 2.96; 95% CI: 1.17, 7.49, and playing a musical instrument (OR = 2.53; 95% CI: 1.15, 5.57.Conclusion: It may be concluded that exposure to psychiatry clerkship could influence medical students’ opinion about psychiatry positively, or negatively. Personal characteristics and individual interests of students may play an important role in choosing psychiatry as their future

  13. [The most important obstacles of the development of Hungarian psychiatry].

    Kalmár, Sándor


    A quarter of a century ago the change of the political system in Hungary precipitated a serious value-crisis and caused a lot of harmful effects in nurturing and the development of psychiatry. The author establishes that the attack against psychiatry is more intensive than previously but neither the education and health management nor the psychiatric leadership could cope with these difficulties. It can't be denied that the foundation of lifelong mental health begins in the early life years and about 75% of the first Mental Disorder manifests in adolescence and youth. We are not able to ensure the special rights of every child according to the Hungarian Constitution and the Declaration of the Rights of the Child by the United Nations. The large inequalities within the country, the lack of paramount mental education and nurturing, the lack of essential, consistent eternal values, the lack of required psychiatric care system are huge obstacles of the development of healthy individual and leads to self-destructive behaviour and several, serious physical and mental disorders. The purpose of the author is to call psychiatrists' attention to the main obstacles of the development of Hungarian Psychiatric Care System. The main obstacles of the present psychiatric care system: 1. Unclarified notions, confusion of ideas. 2. Somatic, neurologic, mental, cultural-social and spiritual ignorance. 3. Lack of organization in Mental Education and Psychiatric Care System. 4. Value-crisis in our society despite the fact that the "Council of Wise Men" created a "Scale of the Essential Consistent Eternal Values" for the Hungarian Education System in 2008. 5. Lack of mental health prevention both in education system and health care system. There is no teaching of hygiene lessons in the Hungarian schools. 6. Negligence and selfishness among the population. 7. Disinterest among competent authorities. 8. Leaving the most important possibilities out of consideration. The author establishes

  14. Psychiatry Residency Training around the World

    Zisook, Sidney; Balon, Richard; Bjorksten, Karin S.; Everall, Ian; Dunn, Laura; Ganadjian, Krauz; Jin, Hua; Parikh, Sagar; Sciolla, Andres; Sidhartha, Tanuj; Yoo, Tai


    Objective: The authors compare and contrast psychiatry residency training in the United States to that in Canada and selected countries in South America, Europe, and Asia. Method: Nine individuals who are intimately familiar with psychiatry residency training in the United States (primarily chairs, training directors, associate training directors,…

  15. The Holy Grail of Psychiatry

    Nemeroff, Charles B.


    Editor’s Note: “Holy Grail” is a well-known metaphor for the eternal spiritual pursuit for truth and wisdom. It suggests that in order for us to find what no one has found, we must search where few have looked. In 2013, a group led by Helen Mayberg published a groundbreaking paper that sought an answer to one of the most discussed conundrums in psychiatry and neuroscience: Can specific patterns of brain activity indicate how a depressed person will respond to treatment with medication or psyc...

  16. Movies in education of psychiatry residents.

    Jukić, Vlado; Brecić, Petrana; Savić, Aleksandar


    Movies are a complex entity representing simultaneously an art form, a powerful industry, and a social phenomenon. The movie industry has always shown keen interest in physicians and medicine in general, and psychiatry in particular has often been in the spotlight. While there can be positive aspects of interaction of the movies and the psychiatry, stigmatization and negative public perception are also the results we often have to consider. Movies exploit psychiatric topics, at the same time portrayal of mental conditions, psychiatrists, and psychiatry on big screen could be used in different kinds of education in psychiatry. We present our initial experience with introducing movies in education of psychiatry residents in Psychiatric Hospital Vrapce. PMID:20562770

  17. What Psychiatry Means to Me

    Helen Herrman


    Full Text Available Moving in early career from public health physician to psychiatrist gives me a public health view of psychiatry and an interest in pursuing the goals of widening access to community-based services for people with mental disorders and promoting mental health in communities. Training in social medicine in the UK and psychiatry in Australia lead to studies of homelessness in people living with psychotic disorders, the health of family caregivers, assessing quality of life and mental health promotion. Work with the World Health Organization (WHO in the Western Pacific Region and the World Psychiatric Association (WPA worldwide has given me opportunities to work with psychiatrists, mental health workers, service users and others in governments and non-government organisations implementing the recommendations of the World Health Report 2001 in countries with limited resources. My work as WPA Secretary for Publications seeks to improve information exchange in countries irrespective of their wealth. This is an exciting time to be working in a global village with technical capacity to reach into its furthest corners. Psychiatrists supported by WPA can help ensure that vulnerable people and communities and people living with mental disorders are well served in this new environment and no longer left out and left behind.

  18. Against Explanatory Minimalism in Psychiatry.

    Thornton, Tim


    The idea that psychiatry contains, in principle, a series of levels of explanation has been criticized not only as empirically false but also, by Campbell, as unintelligible because it presupposes a discredited pre-Humean view of causation. Campbell's criticism is based on an interventionist-inspired denial that mechanisms and rational connections underpin physical and mental causation, respectively, and hence underpin levels of explanation. These claims echo some superficially similar remarks in Wittgenstein's Zettel. But attention to the context of Wittgenstein's remarks suggests a reason to reject explanatory minimalism in psychiatry and reinstate a Wittgensteinian notion of levels of explanation. Only in a context broader than the one provided by interventionism is that the ascription of propositional attitudes, even in the puzzling case of delusions, justified. Such a view, informed by Wittgenstein, can reconcile the idea that the ascription mental phenomena presupposes a particular level of explanation with the rejection of an a priori claim about its connection to a neurological level of explanation. PMID:26696908

  19. The future of psychiatry as clinical neuroscience.

    Reynolds, Charles F; Lewis, David A; Detre, Thomas; Schatzberg, Alan F; Kupfer, David J


    Psychiatry includes the assessment, treatment, and prevention of complex brain disorders, such as depression, bipolar disorder, anxiety disorders, schizophrenia, developmental disorders (e.g., autism), and neurodegenerative disorders (e.g., Alzheimer dementia). Its core mission is to prevent and alleviate the distress and impairment caused by these disorders, which account for a substantial part of the global burden of illness-related disability. Psychiatry is grounded in clinical neuroscience. Its core mission, now and in the future, is best served within this context because advances in assessment, treatment, and prevention of brain disorders are likely to originate from studies of etiology and pathophysiology based in clinical and translational neuroscience. To ensure its broad public health relevance in the future, psychiatry must also bridge science and service, ensuring that those who need the benefits of its science are also its beneficiaries. To do so effectively, psychiatry as clinical neuroscience must strengthen its partnerships with the disciplines of public health (including epidemiology), community and behavioral health science, and health economics.The authors present a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of psychiatry and identify strategies for strengthening its future and increasing its relevance to public health and the rest of medicine. These strategies encompass new approaches to strengthening the relationship between psychiatry and neurology, financing psychiatry's mission, emphasizing early and sustained multidisciplinary training (research and clinical), bolstering the academic infrastructure, and reorganizing and refinancing mental health services both for preventive intervention and cost-effective chronic disease management. PMID:19318776


    Jakovljević, Miro; Tomić, Zoran; Maslov, Boris; Skoko, Iko


    The mass media has a powerful impact on public attitudes about mental healt and psychiatry. The question of identity of psychiatry as a medical profession as well as of the future of psychiatry has been the subject of much controversial discussion. Psychiatry today has the historical opportunity to shape the future of mental health care, medicine and society. It has gained in scientific and proffesional status by the tremendous increase of knowledge and treatment skills. Psychiatry should bui...

  1. The views of medical students about psychiatry clerkship education

    Varkal, Mihriban Dalkıran; Yüksek, Erhan; Demirel, Ömer Faruk; Çağlar, Nuran; Eliüşük, Nihan; Gökdoğan, Pınar; Özmansur, Elif Nurdan; Emül, Murat


    Objectives: Psychiatry education in medical schools seems to be given little attention and has not been fully integrated into curriculum. In this study our purpose was to get feedback about all phases of psychiatry clerkship from medical students, who completed psychiatry clerkship. Methods: A 31 item questionnaire investigating the views of medical students about psychiatry clerkship and a socio-demographic survey were given to the medical students, who completed psychiatry clerkship and...

  2. A Marxist approach to psychology and psychiatry.

    Nahem, J


    Marxism considers psychology and psychiatry to be young and complex sciences which are powerfully affected by the nature of society. Marxism contributes to these sciences by applying dialectical and historical materialism to their study and development. The Marxist critique of psychology and psychiatry under capitalism identifies the immense harmful effect on them of capitalist class ideology in a number of areas: anti-working class theories, racism, national chauvinism, sexism, theories of fixed evil human nature, and false or one-sided theories. Socialism is held to provide a healthy environment for individual psychological development and to utilize psychology and psychiatry for scientific and humane ends. PMID:7076375

  3. Biological Psychiatry, Research And Industry

    Ajai R. Singh


    Full Text Available In this section, we look at how the biological paradigm shift in psychiatry has been aided and abetted by industry for serving its own needs; which stymies other promising approaches; but which, nonetheless, can serve to advance biomedicine if checks and balances are in place. Industry, Biological Psychiatry And Non-pharmacological Advance The larger issue of benefit to society also concerns us when we realize that industry sponsorship is mainly for potential medications, not for trying to determine whether there may be non-pharmacological interventions that may be equally good, if not better. …a lack of balance in research activities, with a focus mainly on potential medications, is likely to divert talented researchers from the pursuit of profound scientific questions or divert them from the pursuit of questions without market relevance but with an aspect of public good. A company has little incentive to support trials evaluating whether inexpensive, off-patent drugs or whether non-pharmaceutical interventions, could replace their profitable patented drug (Baird, 2003 This is the reason why methods like yoga, psychotherapy, meditation, non-medicated non-mechanised relaxation will not find industry sponsors readily and may never be proved useful apart from anecdotal reporting.In which case to expect industry sponsorship to develop a larger therapeutic armamentarium, especially non-drug based, is wishful thinking. Moreover, non-pharmacological treatment procedures may not get desirable funding. This may not be as much of a problem in other branches of medicine as in psychiatry, wherein non-pharmacological interventions like psychotherapy still hold promise of therapeutic relief.If we do not see rigorous experimental research in psychotherapy or other non-drug modalities to the extent that we should, let us be careful before blaming the researchers for it. Where are the funds? Also, let us note that behind the great thrust towards Biological


    Rubin, Romina; Jauregui, Ricardo


    The changes associated with aging influence the clinical presentation and treatment approach of psychiatric illness. Several psychiatric disorders are common in old age as depression or set of diseases with cognitive impairment requiring geriatric knowledge. In many countries psychiatry of the elderly are called psychogeriatric. Regardless of the name objective of this article is to convey that the psychiatrist who treats patients over 65 years with multiple disorders, with frailty social problems and polypharmacy should have some tools in addition to the thorough understanding of psychiatric illness itself. Teamwork, meet physiological changes of aging and how these affect the response to drugs, atypical presentation of illness and keep in mind the importance of psychosocial and environmental issues both in presentation and in addressing and monitoring of disease. PMID:26650408

  5. Receptor studies in biological psychiatry

    Recent advances in the pharmacological treatment of endogenous psychosis have led to the development of biological studies in psychiatry. Studies on neurotransmitter receptors were reviewed in order to apply positron-emission tomograph (PET) for biological psychiatry. The dopamine (DA) hypothesis for schizophrenia was advanced on the basis of the observed effects of neuroleptics and methamphetamine, and DA(D2) receptor supersensitivity measured by PET and receptor binding in the schizophrenic brain. The clinical potencies of neuroleptics for schizophrenia were correlated with their abilities to inhibit the D2 receptor, and not other receptors. The σ receptor was expected to be a site of antipsychotic action. However, the potency of drugs action on it was not correlated with clinical efficacy. Haloperidol binds with high affinity to the σ receptor, which may mediate acute dystonia, an extrapyramidal side effect of neuroleptics. Behavioral and neurochemical changes induced by methamphetamine treatment were studied as an animal model of schizophrenia, and both a decrease of D2 receptor density and an increase of DA release were detected. The monoamine hypothesis for manic-depressive psychosis was advanced on the basis of the effect of reserpine, monoamine oxidase inhibitor and antidepressants. 3H-clonidine binding sites were increased in platelet membranes of depressive patients, 3H-imipramine binding sites were decreased. The GABAA receptor is the target site for the action of anxiolytics and antiepileptics such as benzodiazepines and barbiturates. Recent developments in molecular biology techniques have revealed the structure of receptor proteins, which are classified into two receptor families, the G-protein coupled type (D2) and the ion-channel type (GABAA). (J.P.N.)

  6. Reflections on psychiatry and international mental health

    Helen Herrman


    Achieving adequate support for mental health in any country requires a unified approach. Strong links between psychiatrists, community leaders and patients and families that are based on negotiation and respect, are vital for progress. When strong partnerships exist, they can contribute to community understanding and advancement of psychiatry. This is the first step towards scaling up good quality care for those living with mental illnesses, preventing illnesses in those at risk, and promoting mental health through work with other community sectors. Partnerships are needed to support education and research in psychiatry, and improvements in quality of care wherever psychiatry is practiced, including primary health and community mental health services, hospitals and private practice. There are important roles for psychiatry in building the strength of organisations that champion the advocacy and support roles of service users and family carers, and encouraging partnerships for mental health promotion in the community.

  7. Neuroimaging in psychiatry: from bench to bedside

    Linden, David E; Fallgatter, Andreas J.


    This perspective considers the present and the future role of different neuroimaging techniques in the field of psychiatry. After identifying shortcomings of the mainly symptom-focussed diagnostic processes and treatment decisions in modern psychiatry, we suggest topics where neuroimaging methods have the potential to help. These include better understanding of the pathophysiology, improved diagnoses, assistance in therapeutic decisions and the supervision of treatment success by direct asses...

  8. Power, change, and 'the culture of psychiatry'

    Rahimi, Sadeq


    It is not uncommon to encounter 'the culture of psychiatry' used as a descriptive or even explanatory concept in discussions of psychiatric practices and services, specifically in research addressing cultural aspects of psychiatry. Drawing on data from research on the role of culture in psychiatric services in the Boston area, this paper critically examines the attribution of a 'culture' to psychiatry, which is prevalent not simply in mainstream psychiatric literature, but also in certain lines of cultural psychiatry, specifically those dedicated to political and anti-racist activism. It is argued that the use of such terminology could be misleading as it implicitly attributes a sense of coherence and agency to what may best be described as a set of related discourses and sociopolitical practices. It is further suggested that, given the implications of using such terminology as 'culture' in our discussions of psychiatry as a social institution, a scientific discourse, or a clinical practice, it would be more fruitful to address the analytic concepts of power, meaning, and the sociopolitical functions of psychiatry instead. PMID:25159045

  9. Formal Training in Women's Issues in Psychiatry: A Survey of Psychiatry Residency Training Directors

    Gold, Liza H.; Epstein, Steven A.


    Objective: The authors describe the availability of formal residency training opportunities in women's issues in psychiatry and explore the potential relationships between the availability of training and characteristics of residency programs. Method: The authors surveyed psychiatry residency training directors to identify program characteristics…

  10. New image of psychiatry, mass media impact and public relations.

    Jakovljević, Miro; Tomić, Zoran; Maslov, Boris; Skoko, Iko


    The mass media has a powerful impact on public attitudes about mental health and psychiatry. The question of identity of psychiatry as a medical profession as well as of the future of psychiatry has been the subject of much controversial discussion. Psychiatry today has the historical opportunity to shape the future of mental health care, medicine and society. It has gained in scientific and professional status by the tremendous increase of knowledge and treatment skills. Psychiatry should build up new transdisciplinary and integrative image of a specialized profession, promote it and make it public. Good public relations are very important for the future of psychiatry. PMID:20562738

  11. Apreciaciones teórico-clínicas sobre la psiquiatría infantil de enlace en un hospital de niños en París Theoretico-clinical Assessment on Child Interconsultation Psychiatry in a Children's Hospital in Paris

    Paola Velásquez1

    Full Text Available Introducción: En este trabajo se presentan algunos elementos teóricos sobre la psiquiatría infantil de enlace y los diferentes modelos de intervención en niños y adolescentes con enfermedades crónicas, que evidencian la importancia de la concepción polifactorial de esta clínica. Método: Primero, se abordó la “parentalización” en relación con los conceptos de enfermedad, muerte, bisexualidad psíquica y representaciones mentales. Segundo, se realizó una correlación teórico-clínica, a partir de la historia de un bebé y de la historia de una preadolescente. Resultados: Es posible intervenir desde los modelos psicoanalítico y del desarrollo, que permiten reflexionar sobre las representaciones mentales de los padres y del equipo cuidador médico y paramédico; sobre el trabajo intersubjetivo y sobre los puentes posibles entre ambos, para permitir la creación de un tercero, contenedor y maleable, en situaciones tan movilizadoras como la enfermedad crónica o el riesgo de muerte. Conclusión: La enfermedad crónica exige un trabajo permanente para replantear la forma y el momento de intervenir. Los modelos de intervención señalados en este documento deben ser flexibles y tener la capacidad de responder a diversos imprevistos.Introduction: In this work, some theoretical elements in child interconsultation psychiatry are presented, as well as various intervention models for children and adolescents suffering from chronic diseases stressing the importance of a multifactorial conception of clinical findings. Method: First, “parentalisation” is addressed in relation to the concepts of sickness, death, psychic bisexuality, and mental representations. Second, a theoretico-clinical correlation based on the history of a baby and of a preadolescent was carried out. Results: Intervention is possible using psychoanalytic and development models that allow considering the mental representations of the parents, and the medical and

  12. Factors associated with group bullying and psychopathology in elementary school students using child-welfare facilities

    Kim JW; Lee K.; Lee YS; DH Han; Min KJ; Song SH; Park GN; Lee JY; Kim JO


    Jun Won Kim,1,2 KounSeok Lee,3 Young Sik Lee,4 Doug Hyun Han,4 Kyung Joon Min,4 Sung Hwan Song,5 Ga Na Park,6 Ju Young Lee,1 Jae Ock Kim5 1Division of Child and Adolescent Psychiatry, Department of Neuropsychiatry, College of Medicine, Seoul National University, Seoul, South Korea; 2Department of Psychiatry, Graduate School, Chung-Ang University, Seoul, South Korea; 3Department of Psychiatry, Samsung Medical Center, Seoul, South Korea; 4Department of Psychiatry, Chung-Ang University, College...

  13. Cultural competency training in psychiatry.

    Qureshi, A; Collazos, F; Ramos, M; Casas, M


    Recent reports indicate that the quality of care provided to immigrant and ethnic minority patients is not at the same level as that provided to majority group patients. Although the European Board of Medical Specialists recognizes awareness of cultural issues as a core component of the psychiatry specialization, few medical schools provide training in cultural issues. Cultural competence represents a comprehensive response to the mental health care needs of immigrant and ethnic minority patients. Cultural competence training involves the development of knowledge, skills, and attitudes that can improve the effectiveness of psychiatric treatment. Cognitive cultural competence involves awareness of the various ways in which culture, immigration status, and race impact psychosocial development, psychopathology, and therapeutic transactions. Technical cultural competence involves the application of cognitive cultural competence, and requires proficiency in intercultural communication, the capacity to develop a therapeutic relationship with a culturally different patient, and the ability to adapt diagnosis and treatment in response to cultural difference. Perhaps the greatest challenge in cultural competence training involves the development of attitudinal competence inasmuch as it requires exploration of cultural and racial preconceptions. Although research is in its infancy, there are increasing indications that cultural competence can improve key aspects of the psychiatric treatment of immigrant and minority group patients. PMID:18371580

  14. PET and SPECT in psychiatry

    Dierckx, Rudi A.J.O. [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Ghent Univ. (Belgium); Otte, Andreas [Univ. of Applied Sciences Offenburg (Germany). Faculty of Electrical Engineering and Information Technology; Vries, Erik F.J. de; Waarde, Aren van (eds.) [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging


    Covers classical psychiatric disorders as well as other subjects such as suicide, sleep, eating disorders, and autism. Emphasis on a multidisciplinary approach. Written by internationally acclaimed experts. PET and SPECT in Psychiatry showcases the combined expertise of renowned authors whose dedication to the investigation of psychiatric disease through nuclear medicine technology has achieved international recognition. The classical psychiatric disorders as well as other subjects - such as suicide, sleep, eating disorders, and autism - are discussed and the latest results in functional neuroimaging are detailed. Most chapters are written jointly by a clinical psychiatrist and a nuclear medicine expert to ensure a multidisciplinary approach. This state of the art compendium will be valuable to all who have an interest in the field of neuroscience, from the psychiatrist and the radiologist/nuclear medicine specialist to the interested general practitioner and cognitive psychologist. It is the first volume of a trilogy on PET and SPECT imaging in the neurosciences; other volumes will focus on PET and SPECT in neurology and PET and SPECT of neurobiological systems.

  15. Workplace Based Assessment in Psychiatry

    Ayse Devrim Basterzi


    Full Text Available Workplace based assessment refers to the assessment of working practices based on what doctors actually do in the workplace, and is predominantly carried out in the workplace itself. Assessment drives learning and it is therefore essential that workplace-based assessment focuses on important attributes rather than what is easiest to assess. Workplacebased assessment is usually competency based. Workplace based assesments may well facilitate and enhance various aspects of educational supervisions, including its structure, frequency and duration etc. The structure and content of workplace based assesments should be monitored to ensure that its benefits are maximised by remaining tailored to individual trainees' needs. Workplace based assesment should be used for formative and summative assessments. Several formative assessment methods have been developed for use in the workplace such as mini clinical evaluation exercise (mini-cex, evidence based journal club assesment and case based discussion, multi source feedback etc. This review discusses the need of workplace based assesments in psychiatry graduate education and introduces some of the work place based assesment methods.

  16. PET and SPECT in psychiatry

    Covers classical psychiatric disorders as well as other subjects such as suicide, sleep, eating disorders, and autism. Emphasis on a multidisciplinary approach. Written by internationally acclaimed experts. PET and SPECT in Psychiatry showcases the combined expertise of renowned authors whose dedication to the investigation of psychiatric disease through nuclear medicine technology has achieved international recognition. The classical psychiatric disorders as well as other subjects - such as suicide, sleep, eating disorders, and autism - are discussed and the latest results in functional neuroimaging are detailed. Most chapters are written jointly by a clinical psychiatrist and a nuclear medicine expert to ensure a multidisciplinary approach. This state of the art compendium will be valuable to all who have an interest in the field of neuroscience, from the psychiatrist and the radiologist/nuclear medicine specialist to the interested general practitioner and cognitive psychologist. It is the first volume of a trilogy on PET and SPECT imaging in the neurosciences; other volumes will focus on PET and SPECT in neurology and PET and SPECT of neurobiological systems.

  17. Psychiatry Today : Biology vs. Psychology.

    Berman, I; Fried, W; Berman, S M; Lengua, J A; Alpert, M


    This research addresses preferences and theoretical leanings of present-day psychiatrists along the continuum defined at one end by biology and at the other by psychology. A questionnaire was devised and sent to 5,702 randomly selected members of the American Psychiatric Association in 1990. The response rate was 307%. The results were analyzed for two groups: psychiatrists with fewer than 15 years of practice since residency and psychiatrists with more than 15 years of practice since graduation. Although the great majority of psychiatrists in both groups equally valued psychology and biology, the senior group attributed a greater importance to psychological methods, whereas the younger group stressed equally the importance of biology and psychology. This suggests that psychiatry has evolved over the years from a predominantly psychological practice to one with a more equal emphasis on psychology and biology. Recent advances in neuroscience may have shifted the pendulum toward a more balanced willingness of clinicians to consider the broad armamentarium of psychosocial and biological treatments. The results point to the need for further conceptualization into the relationship between biology and psychology and its incorporation into the psychiatric residency curriculum. PMID:24442524

  18. My Child Has Been Diagnosed with ADHD - Now What?

    ... trial of specialized and generic programs. Journal of Child Psychology and Psychiatry, 56 , 618-31. Barbaresi, W. J., ... antisocial youth: A meta-analysis. Journal of Abnormal Child Psychology, 34, 527-543. doi:10.1007/s10802-006- ...

  19. History and current condition of Russian psychiatry.

    Krasnov, Valery N; Gurovich, Isaak


    Russian psychiatry has a dramatic history, and until now has been at a transitional stage of development. It is facing problems not only common in world psychiatry, but also specific to eastern Europe, in particular Russia. Starting from the beginning of the 1990s, considerable changes have occurred in psychiatry, especially after 1992 when the law on psychiatric care and guarantees of citizens' rights in its provision was adopted. It became the ideological and legislative basis for reforms. However, there are definite obstacles to structural reforms in psychiatry. They are unfavourable technical conditions in many psychiatric clinics, hypercentralization of psychiatric services, shortage of clinical psychologists and social workers in psychiatry, some difficulties in cooperation between psychiatric and general medical institutions. Economic difficulties in the transition period of Russia's social development prevent the overcoming of these problems. They are being actively discussed and some of them are being gradually solved, e.g. the organization of team work in mental health services, the increasing number of specialists on social work, and the involvement of non-government organizations in psychosocial rehabilitation. PMID:22950772

  20. Gender differences in career paths in psychiatry.

    Krener, P


    Although psychiatry has one of the highest proportions of women entering its residency programs, women have not assumed a proportionate amount of academic or research leadership positions in the field. This literature review identifies three general groups of models that explain disparities between men's and women's careers, but these do not fully account for observed differences in psychiatric practice and academic progression of women in psychiatry. Gender differences in career paths in psychiatry are not only affected by individual traits and choices, but also by economic factors. Theories based on organizational discrimination, and systems and market factors are also reviewed. No single explanatory model accounts for disparities between the careers of men and those of women. Because psychiatric practice patterns may be broadly distributed across labor sectors, more diverse career patterns are possible in psychiatry than in more constrained and traditional fields. Research on gender differences in psychiatry careers must consider not only the individual work style and choice, but also the position of individuals within the organization and the position of those organizations across the labor market. PMID:24435498

  1. Neurology referrals to a liaison psychiatry service.

    Fitzgerald, P


    The objective of the present study was to assess the activity of the Liaison Psychiatry service of Cork University Hospital in relation to all in-patient neurology referrals over a 12-month period. Of 1685 neurology admissions, 106 (6%) were referred to liaison psychiatry for assessment. 91 referrals (86%) met criteria for a psychiatric disorder according to DSM-IV, the commonest being major depression (24%) and somatoform disorder (23%). Patients with multiple sclerosis or epilepsy comprised nearly half of all referrals (48 cases; 45%). Approximately 20% of M.S. in-patients (21 cases) were referred for psychiatric assessment, with the corresponding figure in epilepsy being 25% (18 cases). Although only 106 (6%) neurology in-patients were referred to liaison psychiatry, psychiatric diagnoses were documented in 327 (20%) discharge forms, presumably reflecting previous diagnosis. The above findings indicate that psychiatric illness is common among neurology inpatients screened by liaison psychiatry yet referral rates are relatively low in terms of the overall number of neurology in-patients. Psychiatric disorders were diagnosed in 86% of referrals indicating high concordance between neurologists and liaison psychiatry regarding the presence of a psychiatric disorder.

  2. [Where is going philosophy of psychiatry ?].

    Basso, Elisabetta


    This contribution provides a critical outline of the current trends in the field of "philosophy of psychiatry" by following their developments in the last decade. The first part of the paper focuses on the evolution of this field from a strictly conceptual approach to a perspective more attentive to the social, practical, and clinical dimension of psychiatry. The second part of the paper points out that the need of a mutual commitment of philosophy and psychiatry is perceived according to different ways by the countries involved in this research area. The paper deals especially with the case of France, where the enthusiasm for the "new philosophy of psychiatry" has not had the same impact on the philosophical scene as in the English speaking countries. In conclusion, the paper shows that the field of philosophy of psychiatry stands as a fertile ground for new forms of interaction between the analytic, and the continental philosophical traditions. This interaction takes place, more particularly, as regards such topics as normativity, language, and interpretation. PMID:27550463

  3. Child and Adolescent Psychiatrists' Practices in Assisting Their Adolescent Patients Who Smoke to Quit Smoking

    Price, James H.; Sidani, Jaime E.; Price, Joy A.


    Objective: This national study examined the practices and perceptions of smoking cessation activities among child and adolescent psychiatrists. Method: A random sample of child and adolescent psychiatrists was identified from the membership list of the American Academy of Child and Adolescent Psychiatry and was mailed a valid and reliable 34-item…

  4. Neuroimaging in psychiatry: from bench to bedside

    David E Linden


    Full Text Available This perspective considers the present and the future role of different neuroimaging techniques in the field of psychiatry. After identifying shortcomings of the mainly symptom-focussed diagnostic processes and treatment decisions in modern psychiatry, we suggest topics where neuroimaging methods have the potential to help. These include better understanding of the pathophysiology, improved diagnoses, assistance in therapeutic decisions and the supervision of treatment success by direct assessment of improvement in disease-related brain functions. These different questions are illustrated by examples from neuroimaging studies, with a focus on severe mental and neuropsychiatric illnesses such as schizophrenia, depression and dementia. Despite all reservations addressed in the article, we are optimistic, that neuroimaging has a huge potential with regard to the above-mentioned questions. We expect that neuroimaging will play an increasing role in the future refinement of the diagnostic process and aid in the development of new therapies in the field of psychiatry.

  5. [Practice relevant research in biological psychiatry].

    Meyer-Lindenberg, A


    The practice of psychiatry would be unthinkable without modern psychopharmacology. Drug treatment, especially of severe psychiatric disorders, is often a precondition of community participation, societal reintegration and recovery. Seen in this context it is understandable that biological psychiatry has long been primarily defined by its close interconnection with psychopharmacology and has been perceived this way by practicing physicians. In recent years, however, the concept of what is "biological" has markedly expanded and so has the outreach of this approach into the practice of psychiatry. This article discusses examples showing that biological research methods provide new impulses for individualized medicine, psychotherapy and understanding environmental risks and therefore provide the basis for a preemptive and preventive approach that will be the key to master the challenges posed by the severe burden of mental illness. PMID:26440519

  6. Limitations of the biopsychosocial model in psychiatry

    Benning TB


    Full Text Available Tony B Benning Maple Ridge Mental Health Centre, Maple Ridge, BC, Canada Abstract: A commitment to an integrative, non-reductionist clinical and theoretical perspective in medicine that honors the importance of all relevant domains of knowledge, not just “the biological,” is clearly evident in Engel’s original writings on the biopsychosocial model. And though this model’s influence on modern psychiatry (in clinical as well as educational settings has been significant, a growing body of recent literature is critical of it - charging it with lacking philosophical coherence, insensitivity to patients’ subjective experience, being unfaithful to the general systems theory that Engel claimed it be rooted in, and engendering an undisciplined eclecticism that provides no safeguards against either the dominance or the under-representation of any one of the three domains of bio, psycho, or social. Keywords: critique of biopsychosocial psychiatry, integrative psychiatry, George Engel

  7. Educating psychiatry residents in neuropsychiatry and neuroscience.

    Benjamin, Sheldon


    Neuropsychiatry and psychiatric neuroscience should be part of the general psychiatry curriculum so that graduate psychiatrists will be able to allow their patients the benefit of neuroscientifically informed diagnosis and treatment. Current neurology and neuroscience educational requirements for US psychiatry training are reviewed. The draft milestone requirements for clinical neuroscience training as part of the US Accreditation Council for Graduate Medical Education's Next Accreditation System are also provided. Suggestions for the neuropsychiatric and neuroscience content of psychiatry residency training are made, along with a description of pedagogic methods and resources. Survey data are reviewed indicating agreement by programme directors with the importance of neuroscience training and an increase in the amount of time devoted to this area. Faculty staff development in neuropsychiatry and neuroscience literacy will be needed to provide high quality training in these areas. PMID:23859089

  8. Challenges in conducting psychiatry studies in India

    Saifuddin Kharawala


    Full Text Available A large number of psychiatry studies are conducted in India. Psychiatry studies are complex and present unique challenges in the Indian setting. Ethical issues pertaining to the risk of worsening of illness, use of placebo and validity of informed consents are commonly faced. Site selection can be difficult due to the relative paucity of ICH-GCP (International Conference on Harmonisation - Good Clinical Practice trained psychiatry investigators in India. Recruitment can be challenging due to issues such as strict eligibility criteria, (lack of availability of caregiver, illness-related considerations, etc. Assessment of the consent capacity of patients is not simple, while structured assessments are not commonly employed. As the illness fluctuates, the consent capacity may change, thus requiring continued assessment of consent capacity. Study patients run the risk of worsening of illness and suicide due to exposure to inactive treatments; this risk is counterbalanced by use of appropriate study designs, as well as the indirect psychotherapeutic support received. Psychiatry studies are associated with a high placebo response. This necessitates conduct of placebo-controlled studies despite the attendant difficulties. Also, the high placebo response is often the cause of failed trials. Rating scales are essential for assessment of drug response. Some rating instruments as well as some rater training procedures may not be suitable for the Indian setting. Technological advancements may increase the procedural complexity but improve the quality of ratings. Psychiatry studies present monitors and auditors with unique scenarios too. Utilization of psychiatry specific training and expertise is recommended to ensure successful conduct of these studies in India.

  9. [Evaluating the current status of anthropologic psychiatry].

    Schmidt-Degenhard, M


    Phenomenological psychiatry examines the variety of psychiatric diseases as regular modifications of human feeling tone experience and behaviour, which can be derived approximately from the nature of man as defined philosophically, Interdisciplinary self-conception of phenomenological psychiatry as a science calls for a constant critical dialogue with the philosophy of man and other disciplines of the humanities. The point of departure of phenomenological psychiatry is the mental or affective illness of the individual patient, with which the psychiatrist is acquainted, and reflects in interpersonal encounters in such a way that individual case studies are of central importance in this area of studies. From a methodological point of view two approaches are to be differentiated within the field of research in phenomenological psychiatry: 1. The phenomenological approach is concerned with the analysis of specific patterns of disturbance of the transcendental organisation of psychotic subjectivity. 2. The interpretative approaches are again divided into the so called "Daseinsanalyse" as a hermeneutic access to the inner biography and "Weltanschauung" of the psychiatric patient as well as the attempts of understanding the meaning of psychotic forms of experience. In this context a survey of the current fields of research of phenomenological psychiatry is given which aims at a deeper understanding of the situation of psychiatric patients and which claims to have a strong relevance for therapy. The relevance of such a phenomenological approach for current psychiatry lies in a broadening and sophistication of our experience in clinic and practice. Its main interest lies in the concentration on the patient as an individual and on the existential dimension of forms of mental and emotional diseases. PMID:9445840

  10. Facial Emotion Recognition in Child Psychiatry: A Systematic Review

    Collin, Lisa; Bindra, Jasmeet; Raju, Monika; Gillberg, Christopher; Minnis, Helen


    This review focuses on facial affect (emotion) recognition in children and adolescents with psychiatric disorders other than autism. A systematic search, using PRISMA guidelines, was conducted to identify original articles published prior to October 2011 pertaining to face recognition tasks in case-control studies. Used in the qualitative…

  11. Holistic-medical foundations of American psychiatry: a bicentennial.

    Lipowski, Z J


    American psychiatry has reached its bicentennial. Holistic-medical foundations have been its hallmark, inspiration, and source of preeminence. Incorporated by psychobiology, the American school, they enabled the growth of psychiatry as a medical specialty and scientific discipline and stimulated unparalleled growth of general hospital psychiatry, psychiatric research and teaching, and psychosomatic medicine and liaison psychiatry. Holistic conceptions, a product of a democratic system and the liberal mind, continue to provide the best framework for psychiatry and an antidote to dogma and fanaticism. PMID:7020433

  12. Diversifying Residents' Outpatient Psychiatry Experience: A Contemporary Model for Academic Outpatient Psychiatry Clinics

    Huh, John; Goebert, Deborah A


    A diversified, outpatient experience is an important part of psychiatric training, yet challenging to attain. We describe a multiple, subspecialty psychiatry clinic model for 3rd year psychiatry residents. Evaluation findings based on its initial implementation indicated improved resident supervision, better therapeutic alliance and an overall increase in satisfaction. This model facilitates resident exposure to diverse patients and treatment modalities as well as faculty development of exper...

  13. Cognitive Science and Psychiatry: An Overview

    Dan J Stein


    ABSTRACT Cognitive science is a multidisciplinary field, comprising cognitive psychology, artificial intelligence, linguistics, neuroscience, and anthropology. In recent years, cognitive science has become a predominant paradigm in studies of the mind. This paper reviews work at the emerging interface between cognitive science and psychiatry. It is argued that cognitive science has significant potential as an integrative framework for theorizing and researching psychiatric disorders and...

  14. Psychopathology as the basic science of psychiatry.

    Stanghellini, Giovanni; Broome, Matthew R


    We argue that psychopathology, as the discipline that assesses and makes sense of abnormal human subjectivity, should be at the heart of psychiatry. It should be a basic educational prerequisite in the curriculum for mental health professionals and a key element of the shared intellectual identity of clinicians and researchers in this field. PMID:25179621

  15. Indian Psychiatry and classification of psychiatric disorders

    Jacob, K.S.


    The contribution of Indian psychiatry to classification of mental disorders has been limited and restricted to acute and transient psychosis and to possession disorders. There is a need for leadership in research in order to match diagnosis and management strategies to the Indian context and culture.

  16. Primary care psychiatry: the case for action.

    Shepherd, M.


    Since the introduction of the National Health Service a number of epidemiological enquiries have established the importance of mental disorders in the field of primary care. Examples are provided from the work of the General Practice Research Unit at the Institute of Psychiatry in London. The results furnish a rational basis for collaborative action between research workers, general practitioners and policy makers.

  17. Educational Supervision Appropriate for Psychiatry Trainee's Needs

    Rele, Kiran; Tarrant, C. Jane


    Objective: The authors studied the regularity and content of supervision sessions in one of the U.K. postgraduate psychiatric training schemes (Mid-Trent). Methods: A questionnaire sent to psychiatry trainees assessed the timing and duration of supervision, content and protection of supervision time, and overall quality of supervision. The authors…

  18. Children's Education and Mental Health in Spain during and after the Civil War: Psychiatry, Psychology and "Biological Pedagogy" at the Service of Franco's Regime

    Gomez, Amparo; Canales, Antonio


    This article analyses the child psychiatry and psychology developed during the Spanish Civil War and immediate postwar period. The aim is to demonstrate that, despite the existence of a certain degree of disciplinary continuity in relation to the pre-war period, both disciplines were placed at the service of Francoism. This meant that the…

  19. Biologism in Psychiatry: A Young Man’s Experience of Being Diagnosed with “Pediatric Bipolar Disorder”

    Peter Parry


    Pediatric bipolar disorder is a diagnosis that arose in the mid 1990s in the USA and has mostly remained confined to that nation. In this article a young American man (under a pseudonym) describes his experience of having the diagnosis throughout his adolescent years. His story was conveyed via correspondence and a meeting with the author, an Australian child psychiatrist. The young American’s story reveals several issues that afflict contemporary psychiatry, particularly in the USA, where so...

  20. Cultural psychiatry. Theoretical, clinical, and research issues.

    Lewis-Fernández, R; Kleinman, A


    As a discipline, cultural psychiatry has matured considerably in recent years and the ongoing quality of its theoretical, clinical, and research development holds great promise. The contemporary emphasis on culture as process permits a deeper analysis of the complexities of sociosomatics--the translation of meanings and social relations into bodily experience--and, thus, of the social course of illness. We also are learning a great deal more about cultural processes that affect therapy, including ethnopharmacologic and culturally valid family interventions that are directly relevant to patient care and mental health policy. And an important set of studies is examining the trauma experienced by refugees and immigrants. But at the same time many disquieting findings still point to the limited impact of cultural psychiatry on knowledge creation and clinical application in psychiatry. The failure of the cultural validation of DSM-IV is only the most dismaying. The persistent misdiagnosis of minority patients and the continued presence of racial bias in some treatment recommendations are also disheartening, as is the seeming contempt of many mainstream psychiatrists for culturally defined syndromes and folk healing systems. Widespread inattention to ethnic issues in medical ethics is another source of dismay. It is for these reasons that the culture of psychiatry itself becomes as important as the culture of patients as a topic for research and intervention. Most of the world still suffers from a terrible lack of basic mental health services, including life-saving medications and hospital beds. In the face of these limitations, and because of the increasing multicultural and pluralistic reality of contemporary life, the growing interpretive bridges linking indigenous systems of illness classification and healing to Western nosologies and therapeutic modalities become even more essential and the reluctance of mainstream clinicians to explore folk healing methods more

  1. A Prescription for "Deprescribing" in Psychiatry.

    Gupta, Swapnil; Cahill, John Daniel


    The term "deprescribing," initially coined in geriatric medicine, describes a process of pharmacologic regimen optimization through reduction or cessation of medications for which benefits no longer outweigh risks. Burgeoning rates of polypharmacy, growing appreciation of long-term adverse effects, and a focus on patient-centered practice present specific indications for deprescribing in psychiatry. A strong therapeutic alliance, appropriate timing, and consideration of the meaning of medication for the patient must accompany the following established elements: review of all medications, identification of medications that could be ceased or reduced, collaborative planning of the deprescribing regimen, and provision of review and support to the patient and caregivers. The authors discuss how deprescribing might be adapted for and implemented in psychiatry, identify potential barriers, and make recommendations for future directions. PMID:26975524

  2. Psychiatry 2050: from younger psychiatrists' perspective

    Hassan TM


    Full Text Available Tariq Mahmood Hassan, Wasif Habib, Mir Nadeem Mazhar, Tariq Munshi Department of Psychiatry, Queen's University, Kingston, ON, CanadaThere have been various opinion pieces on predicting the future of psychiatry and addressing its different domains. This editorial addresses the topic from the vantage point of neuroscientific inquiry. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5 however continues with the tradition of its predecessor (DSM 4 text revision [TR], addressing most diagnoses with descriptive phenomenology as opposed to attempting to change diagnoses based on causative phenomenology or response to treatment. Advances in genomics and imaging, with time, will hopefully help shape psychiatric diagnoses and classifications with a primary basis on morphology. This may in turn help improve the recruitment of academic psychiatrists to the field. In doing so, the profession will gain respect amongst its peers in other disciplines of medicine and cement its future.

  3. [Malaise in psychiatry and its history].

    Chebili, S


    The main hypothesis of this paper is the presence of malaise in psychiatry. The malaise has two sides: on one hand, the end of psychiatry hegemony that dominated the theoretical field of psychiatry until the 1990s. The loss of influence of psychoanalysis is due to its inability to be submitted to any kind of assessment. On the other hand, the supremacy of neurosciences. The idea is not to underestimate the importance of neurosciences but rather to affirm that they occupy the whole theoretical field of psychiatry. This is an unusual situation that is specific to our time. Indeed, this monism has succeeded to an epistemological dualism that has existed throughout the history of psychiatry. In this article, we'll try to draw a history of dualism in psychiatry. Firstly, with Pinel, we find a tension between a metaphysical philosophical pole and a physiological one. Pinel's philosophy has something to do with Condillac's ideology as Pinel applies the analytical method to mental diseases. Under Cabanis's influence, the author of the famous Rapports du physique et du moral de l'homme, this ideology is under pressure with physiologism. As a materialist, he gives an essential part to the brain that distributes pieces of information throughout the body because he thinks that mind influences body. Secondly, dualism lies between the doctrine of localizations defended by Gall and the theory of degeneration elaborated by Magnan. Gall, in Anatomie et physiologie du système nerveux en général, seeks to know how bumps or hollows that are found on the skull are shaped. Gall is for the theory of delocalizations. He is the counterpart of Magnan who wrote a work about Les Dégénérés, that takes its part in the physiological trend with the famous theory of degeneration. For him, degeneration means the imperfect state of a subject whose cerebral functions are in a noticeably imperfect state. Thirdly, with Henry Ey, dualism starts to be less important. Indeed, he tends a monist

  4. Indian psychiatry, research and Asian countries.

    Trivedi, J K; Gupta, Pawan Kumar; Saha, Rahul


    Asia has some of the largest conglomerations of human populations and also the fastest growing economies of the world. About 23% of the world's population lives in the South Asian region, and one-fifth of psychiatrically ill patients in the world live in this part of the world. Despite vast cultural, religious, geographical, and political diversities, the factors influencing mental health remain the same throughout this wide region, as highlighted at the recently concluded Asian summit, where the slogan, 'One vision, one identity, one community,' was launched. Thus, the need to strengthen regional cooperation in the field of mental health has always been felt. This article highlights facts about influence of Indian Psychiatry research as well as of some Asian countries in the world psychiatry and vice versa. PMID:21836718

  5. The philosophies of psychiatry: empirical perspectives.

    Ralston, Alan S G


    The past two decades have seen a surge in cross-disciplinary work in philosophy and psychiatry. Much of this work is necessarily abstract whilst those working in the area are aware of the necessity of relating the theoretical and conceptual work to the vagaries of day-to-day practice. But given the diverse methods and aims of philosophy and psychiatry, crossing the 'communication gap' between the two disciplines is easier said than done. In this article different methods of bridging this gap are presented and commented upon. A number of research studies are reviewed with an eye to the potential they display to develop interdisciplinary theory. An empirical approach to philosophy of practice with special attention to ordinary language use is proposed as a fruitful may forward. PMID:22752587

  6. [Philosophy against psychiatry, right up against it].

    Demazeux, Steeves


    Since the early 1990s, there has been a tremendous new interest at the international level for researches at the crossroad between philosophy and psychiatry. This interest has been supported and quite stimulated by the foundation of a dedicated association, as well as by the establishment of a journal and the promotion of a new collection. My aim in this paper is to trace the origins of the so-called "new philosophy of psychiatry" field and to reconstruct its global intellectual dynamics during the past two decades. I try to identify, through the big diversity of the individual contributions, its dominant theoretical orientations but also what may appear as some of its philosophical blind spots. PMID:27550457

  7. [On the cultural history of psychiatry].

    Schott, H


    About 1800, psychiatry was established as a medical discipline with special institutions (madhouses). Therefore, historiography of psychiatry focuses generally on the last 200 years. This contribution will also illustrate aspects of medical and cultural history, which nowadays are mostly supposed to be less important: the premodern concept of melancholy and hypochondria between humoral pathology, demonology, and psychology; the assessment of psychiatric illness as a "creative malady," even complementary to genius; the dialectics of psychiatric therapies between suppression and emancipation, which is especially prominent in the early nineteenth century in regard to "moral treatment" ( psychische Kur in German), a topic stressed vigorously by the "antipsychiatry" movement around 1970; the denunciation of patients and sections of the population by eugenics ( Rassenhygiene in German) and racism (especially toward the Jews) by psychiatrists. Finally, the miraculous mechanisms of mass hysteria of "normal" individuals are questioned. PMID:15340714

  8. Communication interculturelle en psychiatrie: enjeux linguistiques

    Molina, María Eugenia


    Intercultural communication in hospitals has already been the object of many inter-disciplinary studies. In the present article, my analysis will focus on two aspects: first, intercultural communication in psychiatry, and secondly, their linguistic consequences. I am interested in an approach of the «intercultural» notion that strives to identify knowledge and understanding. This is a similar approach in psychiatric consultation during which decoding the subjects’ implications and negotiation...

  9. Setting Up Private Practice in Psychiatry

    Alan De Sousa; Avinash De Sousa


    Setting up a private practice in Mumbai is an onerous task. The present paper looks at the difficulties face by young psychiatrists when starting a private practice in psychiatry. It suggests certain guidelines to be followed to ensure the development of a successful practice. It also suggests methods to gain popularity among patients and society along with the ethics to be followed, knowledge base to be garnered, and the role of using multiple therapies and versatility in private practice.

  10. Genetics of complex traits in psychiatry

    Gelernter, Joel


    Virtually all psychiatric traits are genetically complex. This article discusses the genetics of complex traits in psychiatry. The complexity is accounted for by numerous factors, including multiple risk alleles, epistasis, and epigenetic effects, such as methylation. Risk alleles can individually be common or rare, and can include, for example, single nucleotide polymorphisms (SNPs) and copy number variants (CNV) that are transmitted or are new mutations, and other kinds of variation. Many d...

  11. Initiatives in biological research in Indian psychiatry

    Shrivatava, Amresh


    Biological psychiatry is an exploratory science for mental health. These biological changes provide some explicit insight into the complex area of ‘brain-mind and behavior’. One major achievement of research in biological field is the finding to explain how biological factors cause changes in behavior. In India, we have a clear history of initiatives in research from a biological perspective, which goes back to 1958. In the last 61 years, this field has seen significant evolution, precision a...

  12. Women in academic psychiatry in Canada.

    Penfold, P S


    A comparison of numbers of women psychiatrists with faculty appointments and women residents in Departments of Psychiatry in Canada in 1975 and 1985 showed that the average percentage of women faculty has increased from 11.4% to 14.3% and of women residents from 23.5% to 43.4%. Some departments appeared to be oblivious to the special educational role of women faculty and had not discussed the discrepancy between the numbers of faculty and residents. Only two departments were actively recruiting women faculty. The study also demonstrated a continued concentration of women in the lower ranks. Barriers to recruiting women faculty include lack of academic role models, job advertising not specifically designed to attract women candidates, rigid requirements for appointments, women's lack of access to male corridors of power, pervasive underlying doubts about women's abilities and competence based on cultural stereotypes, female socialization which does not lend itself readily to roles of authority, assertiveness and leadership, and the role strain that ensues when women psychiatrists try to combine career, marriage and motherhood. If women psychiatrists are to fill some of the positions in Departments of Psychiatry, which will fall vacant over the next decade, much more attention must be paid to eliminating or diminishing the multiple obstacles for women who chose a career in academic psychiatry. PMID:3690482

  13. The Third Wave of Biological Psychiatry



    Full Text Available In this article I will argue that we are witnessing at this moment the third wave of biological psychiatry. This framework conceptualizes mental disorders as brain disorders of a special kind that requires a multilevel approach ranging from genes to psychosocial mechanisms. In contrast to earlier biological psychiatry approaches the mental plays a more prominent role in the third wave. This will become apparent by discussing the recent controversy evolving around the recently published DSM-5 and the competing transdiagnostic Research Domain Criteria approach of the National Institute of Mental Health that is build on concepts of cognitive neuroscience. A look at current conceptualizations in biological psychiatry as well as at some discussions in current philosophy of mind on situated cognition, reveals that the thesis, that mental brain disorders are brain disorders has to be qualified with respect to how mental states are constituted and with respect to multilevel explanations of which factors contribute to stable patterns of psychopathological signs and symptoms.

  14. In India, Psychiatry Has Come a Long Way

    Rajesh Parikh


    Full Text Available This Presidential Address of the Bombay Psychiatry Society covers the state of psychiatry in India in 1997. It posits that with the advent of newer brain imaging technologies in India such as computerised tomography, magnetic resonance imaging, single photon emission computerised tomography and brain electrical activity mapping, an era of evidence-based psychiatry in India has arrived. The Address cautions against the dehumanising potential of excessive reliance on technology. The need for a greater emphasis on psychiatry during undergraduate medical education is discussed along with the need to destigmatise psychiatric disorders. Finally, the need to encourage quality research in psychiatric disorders is stressed.

  15. [Perspectives on researches in disaster psychiatry].

    Tomita, Hiroaki


    After experiencing the catastrophic Great East Japan Earthquake and Tsunami disaster in 2011, Tohoku University founded the International Research Institute of Disaster Science (IRIDeS) in April, 2012. IRIDeS, comprising 7 divisions and 36 laboratories with broad areas of specialization, from the humanities to natural sciences, aims to become a global center for the study of disasters and disaster mitigation, learning from and building upon past lessons in disaster management from Japan and around the world. In IRIDeS, the Department of Disaster Psychiatry is in charge of dealing with issues related to disaster psychiatry, including the psychosocial impact of disasters. Now, at more than 2 and a half years after the catastrophic disaster, the psychological impact actually seems to be getting stronger and wider, whereas the memory of the disaster seems to be waning in other areas of the country. In such a situation, where a number of problems need to be resolved, what can/should we do as psychiatrists? On the other hand, other natural disasters, such as storms and floods, have kept hitting Japan, and catastrophes seem to strike somewhere in the world every year. In addition, we need to prepare for the possibility of a Nankai Trough Quake and an earthquake directly hitting the Tokyo area, which may occur sometime in the future. Considering the situation, we need to establish an education system for disaster psychiatry, and proceed with research to collect useful information to prepare for coming disasters. The aim of our department is to integrate multi-faceted basic and clinical research approaches to investigate the following topics: 1) to identify social, psychological, and biological factors involved in the pathophysiology of and recovery from disaster-related mental health problems; 2) to develop systems for disaster prevention, disaster response, and recovery, considering disaster-related psychiatric and psychological issues; 3) to develop useful tools for the

  16. The Task before Psychiatry Today Redux: STSPIR*.

    Singh, Ajai R


    This paper outlines six important tasks for psychiatry today, which can be put in short as: Spread and scale up services;Talk;Science,Psychotherapy;Integrate; andResearch excellence. As an acronym, STSPIR. Spread and scale up services: Spreading mental health services to uncovered areas, and increasing facilities in covered areas:Mental disorders are leading cause of ill health but bottom of health agenda;Patients face widespread discrimination, human rights violations and lack of facilities;Need to stem the brain drain from developing countries;At any given point, 10% of the adult population report having some mental or behavioural disorder;In India, serious mental disorders affect nearly 80 million people, i.e. combined population of the northern top of India, including Punjab, Haryana, Jammu and Kashmir, Uttarakhand and Himachal Pradesh;Combating imbalance between burden of demand and supply of efficient psychiatric services in all countries, especially in developing ones like India, is the first task before psychiatry today. If ever a greater role for activism were needed, this is the field;The need is to scale up effective and cost-effective treatments and preventive interventions for mental disorders.TALK: Speaking to a wider audience about positive contributions of psychiatry:Being aware of, understanding, and countering, the massive anti-psychiatry propaganda online and elsewhere;Giving a firm answer to anti-psychiatry even while understanding its transformation into mental health consumerism and opposition to reckless medicalisation;Defining normality and abnormality;Bringing about greater precision in diagnosis and care;Motivating those helped by psychiatry to speak up;Setting up informative websites and organising programmes to reduce stigma and spread mental health awareness;Setting up regular columns in psychiatry journals around the globe, called 'Patients Speak', or something similar, wherein those who have been helped get a chance to voice their

  17. Training in Tobacco Treatments in Psychiatry: A National Survey of Psychiatry Residency Training Directors

    Prochaska, Judith J.; Fromont, Sebastien C.; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.


    Objective: Nicotine dependence is the most prevalent substance abuse disorder among adult psychiatric patients and is a leading cause of death and disability. This study examines training in tobacco treatment in psychiatry residency programs across the United States. Method: The authors recruited training directors to complete a survey of their…

  18. EPA guidance on improving the image of psychiatry.

    Möller-Leimkühler, A M; Möller, H-J; Maier, W; Gaebel, W; Falkai, P


    This paper explores causes, explanations and consequences of the negative image of psychiatry and develops recommendations for improvement. It is primarily based on a WPA guidance paper on how to combat the stigmatization of psychiatry and psychiatrists and a Medline search on related publications since 2010. Furthermore, focussing on potential causes and explanations, the authors performed a selective literature search regarding additional image-related issues such as mental health literacy and diagnostic and treatment issues. Underestimation of psychiatry results from both unjustified prejudices of the general public, mass media and healthcare professionals and psychiatry's own unfavourable coping with external and internal concerns. Issues related to unjustified devaluation of psychiatry include overestimation of coercion, associative stigma, lack of public knowledge, need to simplify complex mental issues, problem of the continuum between normality and psychopathology, competition with medical and non-medical disciplines and psychopharmacological treatment. Issues related to psychiatry's own contribution to being underestimated include lack of a clear professional identity, lack of biomarkers supporting clinical diagnoses, limited consensus about best treatment options, lack of collaboration with other medical disciplines and low recruitment rates among medical students. Recommendations are proposed for creating and representing a positive self-concept with different components. The negative image of psychiatry is not only due to unfavourable communication with the media, but is basically a problem of self-conceptualization. Much can be improved. However, psychiatry will remain a profession with an exceptional position among the medical disciplines, which should be seen as its specific strength. PMID:26874959

  19. Encompassing Sexual Medicine within Psychiatry: Pros and Cons

    Segraves, Robert Taylor


    Objective: This article examines the positive and negative aspects of psychiatry encompassing sexual medicine within its purview. Methods: MEDLINE searches for the period between 1980 to the present were performed with the terms "psychiatry," "sexual medicine," and "sexual dysfunction." In addition, sexual medicine texts were reviewed for chapters…

  20. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers

    Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina


    Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…

  1. Evaluation of Professional Role Competency during Psychiatry Residency

    Grujich, Nikola N.; Razmy, Ajmal; Zaretsky, Ari; Styra, Rima G.; Sockalingam, Sanjeev


    Objective: The authors sought to determine psychiatry residents' perceptions on the current method of evaluating professional role competency and the use of multi-source feedback (MSF) as an assessment tool. Method: Authors disseminated a structured, anonymous survey to 128 University of Toronto psychiatry residents, evaluating the current mode of…

  2. Academic psychiatry and the pharmaceutical industry.

    Ban, Thomas A


    In the second half of the 19th century new drugs introduced by the pharmaceutical industry helped lead to the establishment of academic departments in psychiatry. Causal treatment of cerebral pellagra by nicotinic acid and cerebral syphilis by penicillin in the first half of the 20th century led to major changes in the diagnostic distribution of psychiatric patients. In the second half of the 20th century with the introduction of a rapidly growing number of psychotropic drugs, pharmacotherapy became the primary form of treatment in mental illness. Psychiatrists today perceive neuropharmacology as one of the basic sciences of psychiatry and psychopharmacology as the bridge between the mode of action and the clinical indications of psychotropic drugs. Pharmacotherapy with psychotropic drugs focused attention on the differential responsiveness to the same drug within the same diagnostic category. Yet, instead of re-evaluating psychiatric nosology and conducting research in psychopathology, a statistical methodology was adopted for the demonstration of therapeutic effectiveness in pharmacologically heterogeneous populations. Employment of consensus-based classifications and psychiatric rating scales in the clinical development of psychotropic drugs led to semi-finished products, which are prescribed indiscriminately. Replacement of single-center clinical trials by multi-center centrally coordinated clinical investigations led to the control of education in pharmacotherapy by the pharmaceutical industry. To separate education from marketing, the identification of the treatment-responsive forms of illness and the delineation of the therapeutic profile of psychotropic drugs are proposed with the employment of a new methodology, the "Composite Diagnostic Evaluation System." It is postulated that development of a pharmacologically valid psychiatric nosology with the employment of a "nosologic matrix" would provide the pharmaceutical industry with the necessary feedback to

  3. Evolutionary Psychiatry and Nosology: Prospects and Limitations

    Luc Faucher


    Full Text Available In this paper, I explain why evolutionary psychiatry is not where the next revolution in psychiatry will come from. I will proceed as follows. Firstly, I will review some of the problems commonly attributed to current nosologies, more specifically to the DSM. One of these problems is the lack of a clear and consensual definition of mental disorder; I will then examine specific attempts to spell out such a definition that use the evolutionary framework. One definition that deserves particular attention (for a number of reasons that I will mention later, is one put forward by Jerome Wakefield. Despite my sympathy for his position, I must indicate a few reasons why I think his attempt might not be able to resolve the problems related to current nosologies. I suggest that it might be wiser for an evolutionary psychiatrist to adopt the more integrative framework of “treatable conditions” (Cosmides and Tooby, 1999. As it is thought that an evolutionary approach can contribute to transforming the way we look at mental disorders, I will provide the reader with a brief sketch of the basic tenets of evolutionary psychology. The picture of the architecture of the human mind that emerges from evolutionary psychology is thought by some to be the crucial backdrop to identifying specific mental disorders and distinguishing them from normal conditions. I will also provide two examples of how evolutionary thinking is supposed to change our thinking about some disorders. Using the case of depression, I will then show what kind of problems evolutionary explanations of particular psychopathologies encounter. In conclusion, I will evaluate where evolutionary thinking leaves us in regard to what I identify as the main problems of our current nosologies. I’ll then argue that the prospects of evolutionary psychiatry are not good.

  4. [Psychiatry in Quebec. Then and now].

    Lalonde, Pierre


    This text narrates the evolution, since the 1960s, of different events that marked the history of psychiatry in the French-Canadian province of Quebec. From his personal experience, the author discusses. The evolution of the Départment de psychiatric de l'Université de Montréal fro where were issued more than 1000 psychiatrists who shaped clinical practice and research developments worthy of mention throughout the years. The evolution of diagnostic noselogy from the DSM-ii, very influenced by psychoanalysis, to the DSM-5 that is more atheortical, but that is still not based on objective data, which remains a challenge to the etiology of mental illness. The psychiatric drugs that we have learned to prescribe in the past 50 years in a more rational way thanks to a better understanding of their action mechanisms. In reality, there has been no discovery of new drug categories; rather it is the way we prescribe medication that evolved. The great adventure of the first textbook of Quebec psychiatry, which was first published in 1980, and is forthcoming in its 4th edition in 2015 in an improved and expanded format. The forthcoming version takes into consideration the developments in psychiatry. The creation of the Young Adults Clinic in 1988, providing treatment and rehabilitation to young adults in the early stages of schizophrenia, as well as psychoeducational support and information to heir family members. Through the years, this clinic had a considerable acknowledgement in Quebec and other French-speaking nations. PMID:26559212

  5. Notes on a Few Issues in the Philosophy of Psychiatry

    Singh Ajai


    Full Text Available The first part called the Preamble tackles: (a the issues of silence and speech, and life and disease; (b whether we need to know some or all of the truth, and how are exact science and philosophical reason related; (c the phenomenon of Why, How, and What; (d how are mind and brain related; (e what is robust eclecticism, empirical/scientific enquiry, replicability/refutability, and the role of diagnosis and medical model in psychiatry; (f bioethics and the four principles of beneficence, non-malfeasance, autonomy, and justice; (g the four concepts of disease, illness, sickness, and disorder; how confusion is confounded by these concepts but clarity is imperative if we want to make sense out of them; and how psychiatry is an interim medical discipline. The second part called The Issues deals with: (a the concepts of nature and nurture; the biological and the psychosocial; and psychiatric disease and brain pathophysiology; (b biology, Freud and the reinvention of psychiatry; (c critics of psychiatry, mind-body problem and paradigm shifts in psychiatry; (d the biological, the psychoanalytic, the psychosocial and the cognitive; (e the issues of clarity, reductionism, and integration; (f what are the fool-proof criteria, which are false leads, and what is the need for questioning assumptions in psychiatry. The third part is called Psychiatric Disorder, Psychiatric Ethics, and Psychiatry Connected Disciplines. It includes topics like (a psychiatric disorder, mental health, and mental phenomena; (b issues in psychiatric ethics; (c social psychiatry, liaison psychiatry, psychosomatic medicine, forensic psychiatry, and neuropsychiatry. The fourth part is called Antipsychiatry, Blunting Creativity, etc. It includes topics like (a antipsychiatry revisited; (b basic arguments of antipsychiatry, Szasz, etc.; (c psychiatric classification and value judgment; (d conformity, labeling, and blunting creativity. The fifth part is called The Role of Philosophy

  6. Positron emission tomography (PET) in psychiatry

    Currently, clinical PET is mainly useful in psychiatry and related areas for differential diagnosis of dementia. In dementia of Alzheimer type reductions of glucose metabolism are found mainly in the temporoparietal assocaiton cortex, in Pick's disease mainly in the frontal cortex, and in Huntington's disease in the striatum. Other demential diseases usually show less toposelective metabolic impairment. In the future, new diagnostic possibilities may arise from analysis of functional stimulation of specific brain areas and from the use of ligands for specific neurotransmitter systems. (orig.)

  7. Hand Held Computing for Psychiatry Residents

    Kennedy, Robert S.


    Residents in Psychiatry are required to keep a continuous log of patient contacts as they progress through their four years of training. These logs are reviewed on a regular basis by the Training Director to insure that the trainees have had a wide variety of patient contacts. Traditionally, the resident logs have been paper based or on cards. These are completed manually and submitted on a regular basis to be reviewed. This is a awkward process for the trainee as well as a lengthy review pro...

  8. What Every Child Needs for Good Mental Health

    ... Teen Eating Disorders Teen Depression and Suicide Teen Self-esteem Feeling Good About Yourself Teen Stress: A Guide to Surviving Stress SOURCES “Facts for Families," America Academy of Child and Adolescent Psychiatry “Children’s and Adolescent’s Mental Health," US Dept. ...

  9. A New Mother-Child Play Activity Program to Decrease Parenting Stress and Improve Child Cognitive Abilities: A Cluster Randomized Controlled Trial

    Yoshiyuki Tachibana; Ai Fukushima; Hitomi Saito; Satoshi Yoneyama; Kazuo Ushida; Susumu Yoneyama; Ryuta Kawashima


    BACKGROUND: We propose a new play activity intervention program for mothers and children. Our interdisciplinary program integrates four fields of child-related sciences: neuroscience, preschool pedagogy, developmental psychology, and child and maternal psychiatry. To determine the effect of this intervention on child and mother psychosocial problems related to parenting stress and on the children's cognitive abilities, we performed a cluster randomized controlled trial. METHODOLOGY/PRINCIPAL ...

  10. Neuroimaging in child and adolescent psychiatric disorders

    Santosh, P. J.


    Neuroimaging in child psychiatry is a rapidly developing field and the number of different techniques being used is increasing rapidly. This review describes the current status of neuroimaging in childhood psychopathology and discusses limitations of the various studies. As yet, no specific and consistent abnormality has been detected in childhood psychiatric disorders. Obsessive compulsive disorder has shown the most consistent findings so far, with orbitofrontal cortex and...

  11. Some origins of cross-cultural psychiatry.

    Raimundo Oda, Ana Maria G; Banzato, Claudio Eduardo M; Dalgalarrondo, Paulo


    The interface between insanity, race and culture was a challenging subject for some of the most influential nineteenth-century alienists. Our paper reviews some of the theoretical and clinical investigations of comparative psychiatry of this period. The idea that insanity was supposedly rare among 'primitive' people, e.g., Africans, American Natives and some Eastern populations, was repeatedly defended by prominent alienists. Associated with this notion, many authors believed that insanity tends to become more prevalent as civilization evolves. According to them, civilization had an unfavourable effect on insanity rates because it demanded a much higher degree of organization and mental production. Moreover, a greater degree of mental excitation would explain why insanity occurs more frequently in Europe than in the East, Africa or South America. Eventually, at the end of the nineteenth century, the coalition of cross-cultural and neuropsychiatry produced a notion that the brain of the 'native' is more simple and crude than that of the civilized, and more vulnerable to the evil effects of civilized life. In conclusion, some ethnocentric bias and racial stereotypes still pervasive in contemporary psychiatry are identified and traced back to their historical origins. PMID:16013118

  12. What kind of science for psychiatry?

    Laurence J Kirmayer


    Full Text Available Psychiatry has invested its hopes in neuroscience as a path to understanding mental disorders and developing more effective treatments and ultimately cures. Recently, the U.S. NIMH has elaborated this vision through a new framework for mental health research, the Research Domain Criteria (RDoC. This framework aims to orient mental health research toward the discovery of underlying neurobiological and biobehavioral mechanisms of mental disorders that will eventually lead to definitive treatments. In this article we consider the rationale of the RDoC and what it reveals about implicit models of mental disorders. As an overall framework for understanding mental disorders, RDoC is impoverished and conceptually flawed. These limitations are not accidental but stem from disciplinary commitments and interests that are at odds with the larger concerns of psychiatry. A multilevel, ecosocial approach to biobhavioral systems is needed both to guide relevant neuroscience research and insure the inclusion of social processes that may be fundamental contributors to psychopathology and recovery.

  13. How new is the new philosophy of psychiatry?

    Denys Damiaan


    Full Text Available Abstract In their recent paper, Natalie Banner and Tim Thornton evaluate seven volumes of the Oxford University Press series “International Perspectives in Philosophy and Psychiatry,” an international book series begun in 2003 focusing on the emerging interdisciplinary field at the interface of philosophy and psychiatry. According to Natalie Banner and Tim Thornton, the series represents a clear indication that the interdisciplinary field of philosophy of psychiatry has been flourishing lately. Philosophers and psychiatrists face a “new philosophy of psychiatry”. However, the optimism which the “new” philosophy of psychiatry celebrates is precisely the exiling of philosophy from the foundations of psychiatry. The 150 year old belief that psychopathology cannot do without philosophical reflection has virtually disappeared from common psychiatric education and daily clinical practice. Though the discipline of psychiatry is particularly suited to contributions from philosophy, the impact of philosophy on psychiatry nowadays remains limited. With some exceptions, philosophical papers are embedded in a philosophical context inscrutable to ordinary psychiatrists. Much current philosophical work is perceived by psychiatrists as negativistic. I would encourage the field of psychiatry to incorporate once again basic philosophical attitudes which render possible true dialogue with philosophy and enrich both disciplines. The views developed here should not discredit the value and importance of Natalie Banner and Tim Thornton’s paper and the excellent series “International Perspectives in Philosophy and Psychiatry.” As Jaspers said “Everybody inclined to disregard philosophy will be overwhelmed by philosophy in an unperceived way”.

  14. Characteristic Features of Severe Child Physical Abuse-A Multi-informant Approach

    Annerbäck, Eva-Maria; Svedin, Carl Göran; Gustafsson, Per


    Minor child physical abuse has decreased in Sweden since 1979, when a law banning corporal punishment of children was passed, but more serious forms have not decreased. The aim of this study was to examine risk and background factors in cases of severe child abuse reported to the police. Files from different agencies (e.g., Social services, Adult and Child psychiatry and Pediatric clinic) for 20 children and 34 caretakers were studied. An accumulation of risk factors was found. It is conclude...

  15. [Interdisciplinarity and psychiatry: is it time not to know?].

    de Menezes, Mardônio Parente; Yasui, Silvio


    This article deals with interdisciplinarity as well as psychiatric and psychosocial care. Throughout the text, a historical account of the constitution and the crisis of scientific knowledge is presented and organized into disciplines. The theoretical difficulty of conceptualizing interdisciplinarity is analyzed and, in the concluding remarks, psychiatry and its relationship to psychosocial care is discussed. The argument is that, because of its history, psychiatry has singularities that differentiate it from other medical specialties and these singularities could initially cause psychiatry to go in the opposite direction in relation to interdisciplinarity. The conclusion is that because of their inherent characteristics psychosocial care services are privileged places for psychiatric training with interdisciplinary characteristics. PMID:23752547

  16. Polish psychiatry in the wake of social changes.

    Herczyńska, Grazyna


    The aim of this paper is to present some characteristic facts concerning the history of psychiatry in Poland. Those facts have been selected as to illustrate the two obvious but not often expressed theses: 1. the history of psychiatry in Poland has been closely linked with the mainstream of Western thought, social and philosophical ideas of the time; 2. development of psychiatry and psychiatric care depend on the political history of the country. The background factor that greatly influenced that development was the partition of Poland between Russia, Prussia and Austria, which lasted well over one hundred years. PMID:19112380

  17. Graphology in German psychiatry (1870-1930).

    Schäfer, Armin


    This article discusses both the use of graphology in German psychiatry (1870-1930) and the use of handwriting in psychiatric experiments. The examination of handwriting was part of an ensemble of diagnostic tools. Although disorders of handwriting seemed to indicate psychic diseases, graphology did not seem the right method to produce valid observations. Nevertheless, psychiatrists began to incorporate the process of writing into research and diagnosis and to make the process of handwriting an experimental field. Emil Kraepelin invented an apparatus - the so-called Writing-Scale - with which he could measure the dynamics of writing in various dimensions and, in particular, the pressure of movements. The experiments produced a huge amount of data, but the psychiatrists were unable to interpret them in a comprehensible way. Although psychiatrists failed to grasp the psychopathology in handwriting, they discovered a systemic behaviour of the organism controlled by feedback. PMID:27160214

  18. Descartes' dogma and damage to Western psychiatry.

    Ventriglio, A; Bhugra, D


    René Descartes described the concept of mind-body dualism in the 16th century. This concept has been called his error but we prefer to call it his dogma because the error was recognised much later. We studied the original writings translated by various scholars. We believe that his dogma has caused tremendous amount of damage to Western psychiatry. This dualism has created boundaries between mind and body but as we know they are inextricably interlinked and influence each other. This has affected clinical practice and has increased the dichotomy between psychiatric services and the physical health care services in the West at least. This dualism has also contributed to stigma against mental illness, the mentally ill and the psychiatric services. We propose that it is time to abandon this mind-body dualism and to look at the whole patient and their illness experiences as is done in some other health care systems such as Ayurveda. PMID:26333032

  19. Antioxidant Vitamins and Their Use in Psychiatry

    Betul Mazlum


    Full Text Available Oxidative stress can be defined as imbalance between prooxidant molecules produced during body metabolism and members of antioxidant system for favor of former. Oxidative stress, which is included in the pathogenesis of cancer, aging, cardiovascular and neurodegenerative disorders, is also considered for pathogenetic mechanisms underlying psychiatric disorders including schizophrenia, mood disorders, attention deficit hyperactivity disorder. Due to important role of antioxidant vitamins in antioxidant defense mechanisms, vitamin supplementation therapies are considered in addition to conventional treatment choices for psychiatric disorders. This paper will attempt to review the biochemical, molecular and genetic data on biological processes related to vitamins A, C and E. Besides, the circumstances under which the antioxidant vitamin supplementation could be used in psychiatry and the factors that should be taken into consideration during these therapies will be discussed.

  20. [Infant psychiatry - more reality than tale].

    Puura, Kaija; Tamminen, Tuula


    In early childhood, the ability of the parent and the child to adapt to each other's needs during early interaction is essential for a healthy mental development.The parent's ability to carry out adequate early interaction may be compromised because of various problems. Positive, shared emotional experiences with the parent can protect the child's mental health. Severe or prolonged problems in baby care, interaction or behavior of the infant may result in the development of a psychic disorder in the infant. Infant psychiatric diagnosis and treatment plan are based on clinical examination of the child and the family and evaluation of the need for support. PMID:27382831

  1. Differences in sexual behavior, health, and history of child abuse among school students who had and had not engaged in sexual activity by the age of 18 years: a cross-sectional study

    Kastbom ÅA; Sydsjö G; Bladh M; Priebe G; Svedin CG


    Åsa A Kastbom,1,2 Gunilla Sydsjö,3 Marie Bladh,3 Gisela Priebe,4,5 Carl Göran Svedin2 1Child and Adolescent Psychiatry, Linköping University Hospital, 2Division of Child and Adolescent Psychiatry and Department of Clinical and Experimental Medicine, Medical Faculty, Linköping University, Linköping, 3Department of Obstetrics and Gynecology, and Department of Clinical and Experimental Medicine, Medical Faculty, Linköping University...

  2. [Medical students and psychiatry. A survey of students' opinion].

    Giberti, F; Corsini, G; Rovida, S


    In the last years research on the didactics of Psychiatry and opinions of medical students on Psychiatry has gained great interest. The authors think that this research could be useful for the improvement of didactics, for better understanding the meanings of professional choice, the identity of psychiatrist and their relationship with colleagues in other medical field. The goal of this research work was a preliminary survey of Genoese University Medical Student's opinions about psychiatry didactics, and choice of specialization. A questionnaire was submitted to all the students who passed Clinical Psychiatry examination in the period from November 1987 to December 1988. The students were divided in two randomized groups: the first group of students (224) was submitted to the questionnaire immediately after Clinical Psychiatry examination; while to the second group of students (66) the questionnaire was mailed. The aim of the questions was to assess the student's opinions on psychiatry, psychoanalysis, psychotherapy, the career they wanted to take up, and the difficulties of studying psychiatry: 69% of the students of the first group and 42% of the students of the second group answered the questionnaire. Female students answered that they preferred psychiatric specialization more than their male colleagues did, but the difference has no statistical importance. In most cases, the students who answered that they have taken into account psychiatry as a choice of specialisation, are more interested in medical specialties (primary care, etc.) than in surgical specialties. Most of the medical students declare some emotional troubles (anxiety, sleeplessness, problem in social relations).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7934737

  3. Innovative methods in teaching psychiatry to medical students

    Antonio Lobo; Concepción de-la Cámara; Ricardo Campos; Tirso Ventura; Carlos Marco; Antonio Campayo; Federico Dourdil; Mari Fé Barcones; Pedro Saz


    Background and Objectives: To test the conjecture that the innovative method to teach psychosomatic psychiatry previously reported will be confirmed as beneficial in the training of medical students in the field of general psychiatry. Methods: The emphasis in this course is placed on the discussion of clinical cases, bed-side clinical teaching, and a research-oriented part. The “Innovative Teaching Plan” (ITP) is intended to train student-leaders to guide small groups (SG) of students. The re...

  4. Towards Community - Reflections on Community Psychiatry, Culture and Alterity

    Ana Neto; Teresa Maia; Pilar Santos Pinto


    Introduction: The constant transformation of  communities  and  its relationship  with mental illness has been studied and debated for the past decades, although it is still not clear how it has been incorporated in clinical practice.Aims: The authors propose to review the relevance to Psychiatry, especially Community Psychiatry, of understanding  communities as well as the methodologies and conceptual frameworks that allow that approach.Methods: Selected and critical review of the literature...

  5. Changing Medical Students’ Attitudes to Psychiatry through Newer Teaching Techniques*

    Ajita Nayak


    The significance of mental health in the entire health scenario has increased. However, the representation of psychiatry in the current MBBS curriculum for undergraduate students in India still remains much less than desirable. Further, stigmatising attitudes lessen these future doctors′ ability to detect and manage patients with psychological problems despite adequate knowledge about psychiatry. Students believe that psychiatrically ill patients are unpredictable and can be dangerous to othe...

  6. [Use of informatics technology in psychiatry].

    Margariti, M; Papadimitriou, G N


    Computer technology dominates our daily lives and has become an integral professional tool in medical practice and by extension, in psychiatry as well. The widespread use of internet technology has taken place with unprecedented speed in the history of human civilization, spreading in a few decades to all countries of the world, offering novel possibilities for transmitting information, and leading to the globalization of knowledge. However, the speed with which computer technology is becoming a part of our lives is accompanied by difficulties in integration. The continued evolution of applications often leads to the impression that to be modern and efficient we have to run continuously after developments, dedicating time and effort that we cannot often afford. At the same time, its widespread use alters the needs of our patients, and our efficiency is constantly judged in a globalized environment which, while offering new possibilities, also has new demands. The initial impression that computer technology is simply a tool that can facilitate the work of those who are willing and able to use it has been replaced by the perception that the practice of medicine, in both clinical and academic level, requires sufficient knowledge of modern technology and the development of relevant skills for ongoing training and following innovative applications. The result of this assumption is the introduction of technology courses in the curricula of medical schools in the country. This article offers a brief description of the uses of information technology in psychiatry. In particular, e-mail is one of the most popular Internet services and there is internationally an increasing pressure from the public to be able to contact their doctor by e-mail. Furthermore, almost all psychiatric journals now have a digital electronic edition, thus increasing the volume of articles published, the ease of accessing the required information, and ultimately the reduction of the time it takes a

  7. Child Abuse

    ... puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical ...

  8. Child Poverty and Child Outcomes.

    Bradshaw, Jonathan


    Reviews the evidence on the prevalence of child poverty in Britain including: (1) how child poverty has changed over the last 20 years; (2) how child poverty in Britain compares with that in other countries; (3) characteristics of poor children; (4) impact of poverty on child well-being; and (5) government attempts to abolish child poverty. (SD)

  9. V. M. Bekhterev in Russian child science, 1900s-1920s : “objective psychology” / “reflexology” as a scientific movement.

    Byford, Andy


    In the early 20th century the child population became a major focus of scientific, professional and public interest. This led to the crystallization of a dynamic field of child science, encompassing developmental and educational psychology, child psychiatry and special education, school hygiene and mental testing, juvenile criminology and the anthropology of childhood. This article discusses the role played in child science by the eminent Russian neurologist and psychiatrist Vladimir Mikhailo...

  10. Brain SPECT in psychiatry: Delusion or reality?

    Aim: The need for functional information is becoming increasingly evident for proper therapeutic approaches to the treatment and follow up of psychiatric diseases. While data on this subject already exists, there is a general lack of consensus about the use of brain SPECT in this domain and also a considerable negative prejudice due to a number of factors including poor quality imaging and unrealistic expectations. Based on a large group of brain SPECT-s performed over the past 3 years we attempted to sort and refine the indications for SPECT in psychiatry. Materials and Methods: High resolution brain SPECT was performed with triple head gamma camera, super-high resolution fan beam collimator and Tc-HMPAO. A comprehensive semiquantitative color, 3D surface as well as multi-thresholded volume display was routinely used and supplemented by automatic realignment in case of longitudinal follow-up. Results: 470 brain SPECT-s done on 432 patients were all referred by psychiatrists or neuro-psychiatrists for a wide spectrum of psychiatric diseases and ranged in age from 7 to 88 years. The most common primary reasons for referral were : attention deficit hyperactive disorder (ADHD); anxiety; obsessive-compulsive disease, depression (refractory, chronic, bipolar ), impulse control problems; oppositional defiance, post traumatic brain injury; seizures, learning difficulties, pervasive development disorders, memory loss and differential of dementia. Among common denominators were long duration of the disease, unresponsiveness to treatment, worsening of clinical status, and presence of multiple conditions at the same time. The multiparametric display used enabled a comprehensive evaluation of the brain volume which included the hemispheric surfaces; the basal ganglia (striatum) and the thalamus, several components of the limbic and paralimbic systems: anterior and posterior cingulate and their respective subdivisions, insula-s and their subdivisions, apical and mesial

  11. Frequency of anemia in chronic psychiatry patients

    Korkmaz S


    Full Text Available Sevda Korkmaz,1 Sevler Yildiz,1 Tuba Korucu,1 Burcu Gundogan,1 Zehra Emine Sunbul,1 Hasan Korkmaz,2 Murad Atmaca1 1Department of Psychiatry, 2Department of Cardiology, Faculty of Medicine, Firat University, Elazig, Turkey Purpose: Anemia could cause psychiatric symptoms such as cognitive function disorders and depression or could deteriorate an existing psychiatric condition when it is untreated. The objective of this study is to scrutinize the frequency of anemia in chronic psychiatric patients and the clinical and sociodemographic factors that could affect this frequency.Methods: All inpatients in our clinic who satisfied the study criteria and received treatment between April 2014 and April 2015 were included in this cross-sectional study. Sociodemographic data for 378 patients included in the study and hemoglobin (Hb and hematocrit values observed during their admission to the hospital were recorded in the forms. Male patients with an Hb level of <13 g/dL and nonpregnant female patients with an Hb level of <12 g/dL were considered as anemic.Findings: Axis 1 diagnoses demonstrated that 172 patients had depressive disorder, 51 patients had bipolar disorder, 54 patients had psychotic disorder, 33 patients had conversion disorder, 19 patients had obsessive-compulsive disorder, 25 patients had generalized anxiety disorder, and 24 patients had other psychiatric conditions. It was also determined that 25.4% of the patients suffered from anemia. Thirty-five percent of females and 10% of males were considered as anemic. The frequency of anemia was the highest among psychotic disorder patients (35%, followed by generalized anxiety disorder patients (32%, and obsessive-compulsive disorder patients (26%. Anemia was diagnosed in 22% of depressive disorder patients, 25% of bipolar disorder patients, and 24% of conversion disorder patients.Results: The prevalence of anemia among chronic psychiatry patients is more frequent than the general population

  12. Russian and Soviet forensic psychiatry: troubled and troubling.

    Healey, Dan


    Russian forensic psychiatry is defined by its troubled and troubling relationship to an unstable state, a state that was not a continuous entity during the modern era. From the mid-nineteenth century, Russia as a nation-state struggled to reform, collapsed, re-constituted itself in a bloody civil war, metastasized into a violent "totalitarian" regime, reformed and stagnated under "mature socialism" and then embraced capitalism and "managed democracy" at the end of the twentieth century. These upheavals had indelible effects on policing and the administration of justice, and on psychiatry's relationship with them. In Russia, physicians specializing in medicine of the mind had to cope with rapid and radical changes of legal and institutional forms, and sometimes, of the state itself. Despite this challenging environment, psychiatrists showed themselves to be active professionals seeking to guide the transformations that inevitably touched their work. In the second half of the nineteenth century debates about the role of psychiatry in criminal justice took place against a backdrop of increasingly alarming terrorist activity, and call for revolution. While German influence, with its preference for hereditarianism, was strong, Russian psychiatry was inclined toward social and environmental explanations of crime. When revolution came in 1917, the new communist regime quickly institutionalized forensic psychiatry. In the aftermath of revolution, the institutionalization of forensic psychiatry "advanced" with each turn of the state's transformation, with profound consequences for practitioners' independence and ethical probity. The abuses of Soviet psychiatry under Stalin and more intensively after his death in the 1960s-80s remain under-researched and key archives are still classified. The return to democracy since the late 1980s has seen mixed results for fresh attempts to reform both the justice system and forensic psychiatric practice. PMID:24128434

  13. [The potential use of ayahuasca in psychiatry].

    Frecska, Ede; Bokor, Petra; Andrassy, Gabor; Kovacs, Attila


    Ayahuasca is a decoctum made of admixture plants containing dimethyltryptamine and harmine. For millennia it has been used as a central element of spiritual, religious, initiation, and other - foremost healing - rituals, originally by the indigenous groups of the Amazon basin and later by the mestizo populations of the region. During the last two decades the brew has raised increased scientific and lay interest about its healing potentials within the framework of Western therapeutic settings. The typical ayahuasca effects consist of strong somatic reactions, vivid visions, relived personal memories, cathartic emotions, and insightful, introspective experiences when the emerging mental contents take different context and get deeper perspectives. The ayahuasca-experience can be exhausting necessitating the presence of an experienced leader for helping participants to pass difficult phases and for maximizing therapeutic benefits. No health damaging adverse effect has been confirmed thus far as result of its well-structured, institutionalized use. The scientific investigation of ayahuasca is hindered by legal issues, methodical problems, and sociocultural preconceptions. The present review outlines the therapeutic potentials of ayahuasca use in psychiatry with its psychobiological and spiritual background. PMID:27390204

  14. [The situation of emergency psychiatry in Germany].

    Pajonk, F-G B


    The impact of psychiatric emergencies for the care of patients in preclinical emergency medicine, in emergency departments and in psychiatric hospitals has been underestimated for a long time. There is still insufficient knowledge and a need for further research. There are, however, sufficient reasons to assume that annually approximately 500,000 patients with a psychiatric emergency receive treatment from a preclinical emergency physician and another 1.5 million in emergency departments in Germany. Further, approximately 500,000 patients are admitted to psychiatric hospitals as an emergency. The most frequent reasons are intoxication, agitation, aggressiveness and suicidal ideation, posing a threat of self-harm to the patient or to other persons and evoking other life-threatening conditions. Emergency psychiatry also plays a role in collective injuries, such as mass disasters, catastrophes and rampage situations. There is some evidence that the number of psychiatric emergencies is increasing. Reasons are, among others, changes in the services provided for inpatient and outpatient treatment, a reduction in stabilizing psychosocial factors and a general increase in the utilization of emergency healthcare services. PMID:26099496

  15. Cyclical swings: The bête noire of psychiatry.

    Decker, Hannah S


    Progress in psychiatry in the West has been retarded by the proclivity of the discipline to swing violently between 2 approaches to viewing mental illness; that is, emphasizing-to the exclusion of the other-the material-somatic vs the psychical-experiential avenues to knowledge. Each time a shift occurs, the leaders of the new dominant approach emotionally denounce the principles and ideas that came before. We can examine this phenomenon historically by looking at Romantic psychiatry, mid-/late-19th century empirical psychiatry, psychoanalysis, and modern biological psychiatry. Looking at the 2 approaches in treatment today, the gold standard of patient care involves combining empirical/psychological care in 1 person (the psychiatrist) or shared between 2 clinicians working intimately with each other (psychiatrist with psychologist or social worker.) Yet as regards psychiatrists, they are discouraged from paying full attention to the psychological side by the way managed care and third-party payment have combined to remunerate them. Finally, how do we account for the intense swings and denunciations in psychiatry? The author speculates on possible explanations but leaves the question open for her readers. PMID:26844651

  16. Psychopathology and its Early Impact on Parenting Behaviors in Mothers: The Interface between Adult and Infant Psychiatry.

    Keren, Miri; Tyano, Sam


    Parenting is, in its essence, the domain where adult mental health and infant's mental and physical health meet in a complex and dynamic interplay. Becoming a parent is a developmental challenge in itself, and often exacerbates an existing mental illness, and in turn, maladaptive parenting impinges on the early parent-infant relationship, and on the infant's socio-emotional development and later functioning. The capacity for mentalization is brought as a bridging concept between adult and infant psychiatry. A few clinical vignettes illustrate the dynamic interplay between very young children's vulnerabilities and needs and their parents' strengths and weaknesses, leading to a complex interaction and often to symptoms in both child and parent. In the light of the compelling data about the impact of parental psychopathology on parenting behaviors and children outcomes, there is an imperative need for a working alliance and on-going communication between child and adult psychiatrists. PMID:26431412

  17. Is Mandatory Prospective Trial Registration Working to Prevent Publication of Unregistered Trials and Selective Outcome Reporting? An Observational Study of Five Psychiatry Journals That Mandate Prospective Clinical Trial Registration.

    Amelia Scott

    Full Text Available To address the bias occurring in the medical literature associated with selective outcome reporting, in 2005, the International Committee of Medical Journal Editors (ICMJE introduced mandatory trial registration guidelines and member journals required prospective registration of trials prior to patient enrolment as a condition of publication. No research has examined whether these guidelines are impacting psychiatry publications. Our objectives were to determine the extent to which articles published in psychiatry journals adhering to ICMJE guidelines were correctly prospectively registered, whether there was evidence of selective outcome reporting and changes to participant numbers, and whether there was a relationship between registration status and source of funding.Any clinical trial (as defined by ICMJE published between 1 January 2009 and 31 July 2013 in the top five psychiatry journals adhering to ICMJE guidelines (The American Journal of Psychiatry, Archives of General Psychiatry/JAMA Psychiatry, Biological Psychiatry, Journal of the American Academy of Child and Adolescent Psychiatry, and The Journal of Clinical Psychiatry and conducted after July 2005 (or 2007 for two journals was included. For each identified trial, where possible we extracted trial registration information, changes to POMs between publication and registry to assess selective outcome reporting, changes to participant numbers, and funding type.Out of 3305 articles, 181 studies were identified as clinical trials requiring registration: 21 (11.6% were deemed unregistered, 61 (33.7% were retrospectively registered, 37 (20.4% had unclear POMs either in the article or the registry and 2 (1.1% were registered in an inaccessible trial registry. Only 60 (33.1% studies were prospectively registered with clearly defined POMs; 17 of these 60 (28.3% showed evidence of selective outcome reporting and 16 (26.7% demonstrated a change in participant numbers of 20% or more; only 26 (14

  18. Godsdienst en psychiatrie: reacties op een geval van doodslag in godsdienstwaanzin

    Belzen, J.A.


    Religion and psychiatry: responses to a case of manslaughter in religious mania

    After having touched upon some modalities of the relationship between religion and psychiatry, a paradox is pointed out in a psychiatry segregated by denomination as was the case in the Netherlands: this type of psychiatry was stated to be different because of its religiou...

  19. PET application in psychiatry and psychopharmacology

    Suhara, Tetsuya [National Inst. of Radiological Sciences, Chiba (Japan)


    In the last few decades diagnostic and research tools in the medical field have made great advances, yet psychiatry has lacked sufficiently sensitive tools to measure the aberration of brain functions. Recently however, the development of Positron emission tomography (PET) techniques has made it possible to measure changes in neurochemical components in mental disorders and the effect of psychoactive drugs in living human brain. Most of the advancement in the psychiatric field has came from the development psychoactive drugs. Brain research involving identification of neurotransmission is largely based on compounds developed in psychopharmacology. Some of these compounds have been radiolabelled and used as radioligands for quantitative examination of neuroreceptors and other aspects of neurotransmission. Using PET, radioligand binding can now be examined in the human brain in vivo. PET techniques also allow examination of an unlabelled drug by examination of its interaction with a radioligand. So one potential of PET in psychiatry is to investigate the mechanism of psychoactive drugs. Antidepressants modulate serotonin transmission by inhibiting serotonin reuptake from the synaptic cleft. High affinity [{sup 3}H]imipramine binding sites in mammalian brain have been labelled to investigate serotonin transporters in living human brain by PET. Cyanoimipramine which is described as a potent serotonin reuptake inhibitor, was labelled with {sup 11}C. In a PET experiment with 6 healthy human subjects, a high accumulation of [{sup 11}C]cyanoimipramine was found in the thalamus and striatum and lowest accumulation was observed in the cerebellum, a region relatively void of serotonin transporters. The thalamus to cerebellum ratio was about 2 at 90 min after the injection of the tracer. Recently, [{sup 11}C]McN5652-X has been introduced as a better tracer for serotonin transporter imaging. Employing [{sup 11}C]McN5652-X in a PET study of 7 healthy human subjects, a high

  20. Haematological toxicity of drugs used in psychiatry.

    Flanagan, Robert J; Dunk, Louisa


    Almost all classes of psychotropic agents have been reported to cause blood dyscrasias. Mechanisms include direct toxic effects upon the bone marrow, the formation of antibodies against haematopoietic precursors or involve peripheral destruction of cells. Agranulocytosis is probably the most important drug-related blood dyscrasia. The mortality from drug-induced agranulocytosis is 5-10% in Western countries. The manifestations of agranulocytosis are secondary to infection. Aggressive treatment with intravenous broad-spectrum antimicrobials and bone marrow stimulants may be required. Of drugs encountered in psychiatry, antipsychotics including clozapine (risk of agranulocytosis approximately 0.8%, predominantly in the first year of treatment) and phenothiazines (chlorpromazine agranulocytosis risk approximately 0.13%), and antiepileptics (notably carbamazepine, neutropenia risk approximately 0.5%) are the most common causes of drug-related neutropenia/agranulocytosis. Drugs known to cause neutropenia should not be used concomitantly with other drugs known to cause this problem. High temperature and other indicators of possible infection should be looked for routinely during treatment. Clozapine is well known as a drug that can cause blood dyscrasias, but olanzapine and other atypicals may also cause similar problems. In addition to genetic factors, there are likely to be dose-related and immunological components to these phenomena. Important lessons have been learnt from the haematological monitoring that is necessary with clozapine and the monitoring has been very successful in preventing deaths related to clozapine-induced agranulocytosis. Continuing research into the mechanisms of drug-induced neutropenia and agranulocytosis may serve to further enhance the safe use not only of clozapine, but also of other agents. PMID:18098216

  1. Conceptualizing the forensic psychiatry report as performative narrative.

    Griffith, Ezra E H; Stankovic, Aleksandra; Baranoski, Madelon


    Forensic psychiatry has evolved into a recognized specialty. Two core competencies, often overlooked but commonplace in forensic psychiatry, are the constructing of forensic reports and the presenting of oral testimony. This article concerns the written forensic report and conceptualizes it as performative writing. We first review the development of the forensic report's structure over the past 30 years or so and then apply constructs from other disciplines as we propose a process for creating narrative forensic reports. Such writing is grounded in the discipline of psychiatry, relies on ethics-based principles of respect for persons and truth-telling, and uses language to tell a story that persuades the legal audience. We examine the impact of voice, pitfalls to avoid, and the concepts of witnessing and labeling, as we describe the process of formulating the narrative through the voice of the forensic expert. PMID:20305072

  2. [Karl Jaspers and the challenges of social psychiatry].

    Jäger, Markus; Lang, Fabian U; Becker, Thomas


    Karl Jaspers, in his book "General Psychopathology", argued for methodological pluralism rather than theoretical dogmatism. He formulated a methodological order of psychopathology with a distinction between "explanation" (objective psychopathology) and "understanding" (subjective psychopathology, psychopathology of meaning). The latter approach focused on patients' subjective experience and biographical issues. Karl Jaspers emphasised social factors in the genesis and course of mental disorders. Following a multiperspective concept, from Jaspers' viewpoint social psychiatry should consider itself of equal importance with biological and psychotherapeutic psychiatry. Therefore, uncritical generalization of one of these perspectives should be avoided. Personalized psychiatry, apart from searching biological markers to tailor treatment should identify psychosocial factors and subjective meaning. Concepts of recovery should not ignore biological foundations in mental disorders. PMID:24858436

  3. [Problem based learning (PBL)--possible adaptation in psychiatry (debate)].

    Adamowski, Tomasz; Frydecka, Dorota; Kiejna, Andrzej


    Teaching psychiatry concerns mainly education of students studying medicine and clinical psychology, but it also concerns professional training the people specializing in psychiatry and in other fields of medicine. Since the requirements that medical professionals are obliged to meet are ever higher, it is essential to provide highest possible quality of teaching and to do so to use the best possible teaching models. One of the modern educational models is Problem Based Learning (PBL). Barrows' and Dreyfus' research as well as development of andragogy had major impact on the introduction of this model of teaching. There are favourable experiences of using PBL in teaching psychiatry reported, especially in the field of psychosomatics. Problem Based Learning gradually becomes a part of modern curricula in Western Europe. For this reason it is worth keeping in mind PBL's principles and knowingly apply them into practice, all the more the reported educational effects of using this method are very promising. PMID:17598426

  4. A Survey of the Interactions between Psychiatry Residency Programs and the Pharmaceutical Industry

    Varley, Christopher K.; Jibson, Michael D.; McCarthy, Mary; Benjamin, Sheldon


    OBJECTIVE: The authors report a survey of the American Association of Directors of Psychiatry Residency Training (AADPRT) on interactions between the pharmaceutical industry and psychiatry residency programs. METHODS: American Association of Directors of Psychiatry Residency Training membership was anonymously surveyed by e-mail and by paper…

  5. Big data are coming to psychiatry: a general introduction.

    Monteith, Scott; Glenn, Tasha; Geddes, John; Bauer, Michael


    Big data are coming to the study of bipolar disorder and all of psychiatry. Data are coming from providers and payers (including EMR, imaging, insurance claims and pharmacy data), from omics (genomic, proteomic, and metabolomic data), and from patients and non-providers (data from smart phone and Internet activities, sensors and monitoring tools). Analysis of the big data will provide unprecedented opportunities for exploration, descriptive observation, hypothesis generation, and prediction, and the results of big data studies will be incorporated into clinical practice. Technical challenges remain in the quality, analysis and management of big data. This paper discusses some of the fundamental opportunities and challenges of big data for psychiatry. PMID:26440506

  6. Psychiatry in 21 st century: The road ahead

    Sayantanava Mitra


    Full Text Available In spite of becoming more humane in its approach with improvements in understanding of mental illnesses over last century, psychiatry still has a long way to go. At this point in time, on one hand the world faces issues like terrorism, wars and global warming; while on the other it is witnessing economic and gender empowerment like never before. With technology providing us with immense opportunities to advance care for the mentally ill, we are closer than ever to finding the holy-grail of psychiatry, and overcoming daunting challenges.

  7. Psychiatry in the East African colonies: a background to confinement.

    Mahone, S


    This article is concerned with the discipline of psychiatry in colonial East Africa as it emerged out of the crime and disorder problem to become an intellectually significant 'East African School' of psychiatry. The process of lunacy certification, in particular, provides a snapshot of the medical and political tensions that existed among the medical establishment, the prison system and the colonial courts, all of whom sought to define collective African behaviour. This historical article utilises archaic terminology, such as 'lunatic' or 'lunacy', as these categories were in use at the time. PMID:16943144

  8. Commentary: the place of performative writing in forensic psychiatry.

    Griffith, Ezra E H; Baranoski, Madelon V


    In this issue of the Journal, Robert Simon has explored the subject of the place that writing should occupy in the professional life of forensic psychiatrists. We have taken the platform so elegantly constructed by this erudite and prolific author and used it to discuss the quotidian and concrete task of writing the customary forensic psychiatry report. We look to other disciplines for mechanisms to analyze the written forensic report: concepts of voice, portraiture, and narrative. We ultimately conclude that preparing these reports is a complex undertaking and that writing with clarity, precision, and artistry in forensic psychiatry should be viewed as a core competency. PMID:17389341

  9. Maurycy Urstein: forgotten Polish contributor to German psychiatry

    Marcinowski, Filip


    Full Text Available Polish psychiatrist Maurycy Urstein (1872–1940 is nowadays almost forgotten. He is not mentioned in the history of Polish psychiatry which only partially may be explained by the fact that his most essential works were published in German language. His scientific oeuvre contains dozens of publications, including four monographs on catatonia. Urstein was an ardent advocate of the autointoxication theory of psychiatric disorders, fierce opponent of psychoanalysis and enthusiast of the use of biological methods of treatment in psychiatry. Both some eccentric views and specific personality probably equally contributed to his almost complete isolation among psychiatrists in the interwar Poland.

  10. Social and Emotional Outcomes of Child Sexual Abuse: A Clinical Sample in Turkey

    Ozbaran, Burcu; Erermis, Serpil; Bukusoglu, Nagehan; Bildik, Tezan; Tamar, Muge; Ercan, Eyyup Sabri; Aydin, Cahide; Cetin, Saniye Korkmaz


    Childhood sexual abuse is a traumatic life event that may cause psychiatric disorders such as posttraumatic stress disorder and depression. During 2003-2004, 20 sexually abused children were referred to the Child and Adolescent Psychiatry Clinic of Ege University in Izmir, Turkey. Two years later, the psychological adjustment of these children (M…