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Sample records for adult psychiatry department

  1. 48,XXYY in a General Adult Psychiatry Department

    OpenAIRE

    Santos, NB; Trancas, B; Pinto, P; Lopes, B.; Gamito, A; S. Almeida; Ferreira, B.; Luengo, A; Vieira, C; Martinho, J.; Pereira, B.; Cardoso, G

    2010-01-01

    The 48,XXYY syndrome is a distinct clinical and genetic entity, with an incidence of 1:17,000 to 1:50,000 newborns. Patients often access mental healthcare services due to behavior problems, such as aggressiveness and impulsiveness, and are frequently intellectually disabled. We report a case of a patient with 48,XXYY syndrome treated in a general adult psychiatry department. A 23-year-old man was frequently admitted to our inpatient psychiatric unit (14 admissions in five years) due to...

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

    Science.gov (United States)

    Westman, J C

    1978-01-01

    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

  3. [Psychiatry].

    Science.gov (United States)

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

    2011-01-19

    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

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

    Science.gov (United States)

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

    2015-04-01

    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

  5. What Is Psychiatry?

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    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 ...

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

    Science.gov (United States)

    Keren, Miri; Tyano, Sam

    2015-01-01

    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

  7. Off-label drug use in Psychiatry Outpatient Department: A prospective study at a Tertiary Care Teaching Hospital

    Science.gov (United States)

    Kharadi, Darshan; Patel, Kamlesh; Rana, Devang; Patel, Varsha

    2015-01-01

    Introduction: Off-label drug prescribing is very common in Psychiatry. US-Food and Drug Administration has defined off-label drug as “use of drugs for the indication, dosage form, regimen, patient or other use constraint not mentioned in the approved labeling.” Objective: The objective was to evaluate off-label drug use in patients attending Outpatient Department of Psychiatry. Materials and Methods: One year prospective, cross sectional study was conducted on patients attending Psychiatry Outpatient Department. Demographic data, clinical history, and complete prescription were noted in the predesigned proforma and prescriptions were analyzed for off-label drug use as per British National Formulary-2011. Result: A total of 250 patients were enrolled with mean age 40.36 ± 12.3 years. Most common diagnosis was major depressive disorder 101 (40.4%). A total of 980 drugs (mean 3.68 ± 1.42) were prescribed out of which 387 (39.5%) were off-label. Of 250 patients, 198 (79.2%) received at least one off-label drug. Psychopharmacological agents most frequently used in off-label manner were clonazepam 31 (12.4%), lorazepam 30 (12%), and trihexyphenidyl HCl 25 (10%). Prevalence of off-label use of these three drugs was significantly higher than other off-label drugs (P < 0.0001, P < 0.0001 and P < 0.0001 respectively). Inappropriate indication was the most common category of off-label use. There was positive and significant correlation between off-label prescribing and number of drugs (r = 0.722, P ≤ 0.000). Off-label prescribing was statistically significantly higher in 21–40 year age group, but no difference was seen in any co-morbid condition or in between any psychiatric disorder. Conclusion: Off-label drugs use is common in psychiatric OPD in our setup. Clonazepam, lorazepam, and trihexyphenidyl HCl were the most frequently used drugs in off-label manner. PMID:25767363

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

    Science.gov (United States)

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

    2007-09-01

    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

  9. What Is Psychiatry?

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    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 ...

  10. What Is Psychiatry?

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    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 ...

  11. What Is Psychiatry?

    Medline Plus

    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 ...

  12. ADHD-related symptoms among adults in out-patient psychiatry and female prison inmates as compared with the general population

    OpenAIRE

    Edvinsson, Dan; Bingefors, Kerstin; Lindström, Eva; Lewander, Tommy

    2010-01-01

    Objective To compare the prevalence of symptoms consistent with attention deficit hyperactivity disorder (ADHD) and related problems in adults in the general population, out-patient psychiatry (where females are in majority), and female convicts. Method A questionnaire based on the DSM-IV criteria of ADHD, reported childhood symptoms, reading and spelling problems, difficulties and suffering, and general assessment of functioning (GAF) was distributed to samples of the general population, ope...

  13. Autismo: una mirada desde la psiquiatría de adultos Autism: an adult psychiatry perspective

    Directory of Open Access Journals (Sweden)

    María Elisa Irarrázaval O.

    2005-03-01

    Full Text Available . Los Trastornos del Espectro Autista (TEA agrupan diversos cuadros clínicos que se caracterizan por presentar alteraciones del desarrollo con deficiencias en las áreas de comunicación, conducta e interacción social. Su prevalencia ha presentado un importante aumento desde 4 a 5 por 10.000 hasta 10 por 10.000 niños. Las manifestaciones clínicas son características según cada etapa evolutiva y, tanto la adaptabilidad al medio, como el pronóstico final van a depender del desarrollo intelectual alcanzado y de la rehabilitación psicosocial temprana. El pronóstico de vida es igual al de la población general y los autistas adultos presentan generalmente cuadros de agitación psicomotora y de adaptación, tanto depresivos como ansiosos. El origen de las TEA es neurobiológico, se remonta a etapas tempranas del desarrollo fetal o infantil y está relacionado con factores genéticos complejos. El abordaje psicofarmacológico es inespecífico y va dirigido a corregir las alteraciones conductuales que priman en cada casoAutism Spectrum Disorders (ASD are severe developmental diseases marked by significant impairment in social, behavioral, and communicative functioning. Their prevalence has increased from earlier estimates of 4 to 5 per 10.000 to about 10 per 10.000. Symptoms are age specific. Intellectual development and early psychosocial rehabilitation are the most important prognostic factors. Life expectancy is similar to that of the general population. In adult life, comorbidity with anxiety disorders or depression and aggression toward self and others may appear. The assumption is that ASDs are of neurobiological origin beginning before birth or in very early child development and involve complex genetic factors. The psychopharmacotherapy of autistic disorders involves treating behavioral symptoms

  14. Digital psychiatry.

    Science.gov (United States)

    Tang, S; Helmeste, D

    2000-02-01

    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

  15. Pattern of prescription and drug use in psychiatry out patient department of private practitioners of Central India

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    Chetna A. Shamkuwar

    2013-12-01

    Conclusions: Anti-anxiety drug (benzodiazepines was the most frequently prescribed class of psychotropic drugs in various psychiatry disorders. The prescribing prevalence of Alprazolam with different brand names was more than that of other benzodiazepines. The combination of different psychotropic drugs were also prescribed. [Int J Basic Clin Pharmacol 2013; 2(6.000: 777-782

  16. What Is Psychiatry?

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    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. ...

  17. [Sleep psychiatry].

    Science.gov (United States)

    Chiba, Shigeru

    2013-01-01

    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

  18. Transcultural psychiatry

    Directory of Open Access Journals (Sweden)

    R Vikash

    2008-01-01

    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.

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

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    Merve Çolpan

    2013-12-01

    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

  20. State of psychiatry in Denmark

    DEFF Research Database (Denmark)

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

    2012-01-01

    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...

  1. State of psychiatry in Denmark.

    Science.gov (United States)

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

    2012-08-01

    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. What Is Psychiatry?

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    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 ...

  3. What Is Psychiatry?

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    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 ...

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

    Science.gov (United States)

    EVANS, BONNIE; RAHMAN, SHAHINA; JONES, EDGAR

    2009-01-01

    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

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

    Science.gov (United States)

    Singh, Ajai R

    2014-01-01

    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

  6. Historicizing Indian psychiatry

    OpenAIRE

    Basu, Amit Ranjan

    2005-01-01

    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...

  7. Emergency Department and Older Adult Motor Vehicle Collisions

    Directory of Open Access Journals (Sweden)

    Lotfipour, Shahram

    2013-11-01

    Full Text Available In 2009, the Center for Disease Control and Prevention reported there were 33 million licensed drivers 65 years and older in the U.S. This represents a 23 percent increase from 1999, number that is predicted to double by 2030. Although, motor vehicle collisions (MVC-related to emergency department (ED visits for older adults are lower per capita than for younger adults, the older-adults MVCs require more resources, such as additional diagnostic imaging and increased odds of admission. Addressing the specific needs of older-adults could lead to better outcomes yet not enough research currently exists. It is important to continue training emergency physicians to treat the increasing older-patient population, but its also imperative we increase our injury prevention and screening methodology. We review research findings from the article: Emergency Department Visits by Older Adults for Motor Vehicle Collisions: A Five-year national study, with commentary on current recommendation and policies for the growing older-adult driving population. [West J Emerg Med.2013;14(6:582–584.

  8. A CLINICAL AUDIT OF REFERRALS TO THE PSYCHIATRY DEPARTMENT FROM OTHER SPECIALTIES: A STUDY FROM CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Ajagallay

    2014-03-01

    Full Text Available INTRODUCTION: The rate of psychiatric referrals is reported to be high in hospitalized patients in different studies in developing countries. A high prevalence rate of psychiatric disorders is reported among many outpatient departments. For the quality and effectiveness of the various healthcare services, the active role of the psychiatric services in a general hospital cannot be neglected. OBJECTIVE: To evaluate the pattern of psychiatric referrals from various specialities and to study different psychological conditions affecting physical disorders. MATERIAL AND METHODS: The study was conducted at Chirayu medical college and hospital over a period of one year. It was a retrospective evaluation based study. There were 215 referrals recorded, inclusive of inpatient referrals only and diagnosis was made based on ICD-10 classification. RESULTS: Among the 215 referrals, age range of the subjects was 5-75 years with a mean age of 47±12 years. The most common reasons for referral were disorientation and altered sensorium (34% followed by irrelevant talks (32%. The most common psychiatric diagnosis made was delirium (30.6% followed by psychotic spectrum disorders (11.6%. Department wise referrals were mostly from medical units (40% followed by surgical units (11%. No psychiatric diagnosis was made in 42 cases (20%. CONCLUSION: Early diagnosis and intervention of psychiatric disorders in those having physical illnesses definitely hastens recovery and reduces morbidity and the period of stay at a hospital

  9. Emergency Department Utilization by Older Adults: a Descriptive Study

    Science.gov (United States)

    Latham, Lesley P.; Ackroyd-Stolarz, Stacy

    2014-01-01

    Background Emergency Departments (EDs) are playing an increasingly important role in the care of older adults. Characterizing ED usage will facilitate the planning for care delivery more suited to the complex health needs of this population. Methods In this retrospective cross-sectional study, administrative and clinical data were extracted from four study sites. Visits for patients aged 65 years or older were characterized using standard descriptive statistics. Results We analyzed 34,454 ED visits by older adults, accounting for 21.8% of the total ED visits for our study time period. Overall, 74.2% of patient visits were triaged as urgent or emergent. Almost half (49.8%) of visits involved diagnostic imaging, 62.1% involved lab work, and 30.8% involved consultation with hospital services. The most common ED diagnoses were symptom- or injury-related (25.0%, 17.1%. respectively). Length of stay increased with age group (Mann-Whitney U; p < .0001), as did the proportion of visits involving diagnostic testing and consultation (χ2; p < .0001). Approximately 20% of older adults in our study population were admitted to hospital following their ED visit. Conclusions Older adults have distinct patterns of ED use. ED resource use intensity increases with age. These patterns may be used to target future interventions involving alternative care for older adults. PMID:25452824

  10. Historicizing Indian psychiatry.

    Science.gov (United States)

    Basu, Amit Ranjan

    2005-04-01

    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

  11. Crime and Psychiatry

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    Yusuf Matcheswalla

    2015-01-01

    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.

  12. Annals of General Psychiatry

    OpenAIRE

    Fountoulakis Konstantinos

    2005-01-01

    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...

  13. Informed Consent in Adult Psychiatry

    Directory of Open Access Journals (Sweden)

    Ahmed Bait Amer

    2013-07-01

    Full Text Available This article addresses some of the groundwork of informed consent in people with mental illness whose decision-making capacity has obviously been compromised. This article examines four crucial aspects in particular, namely: i the main elements of informed consent; ii difficulties pertaining to psychiatric illnesses; iii the effect of psychiatric disorders on the patient’s capability; iv how to assess situations in which consents may not be required.

  14. Genetic diagnosis in clinical psychiatry: A case report of a woman with a 47, XXX karyotype and Fragile X syndrome

    OpenAIRE

    Vandersteen, Anthony M.; David Moore; Celia Donaghue; Neil MacFarlane; Dragana Josifova

    2009-01-01

    Background and Objectives: A recent report highlighted the importance of considering a chromosomal abnormality in the differential diagnosis of adult clinical psychiatry. This case report illustrates the importance of considering Fragile X syndrome, an X-linked genetic disorder associated with psychiatric morbidities. Methods: A 45 years old woman was referred to the clinical genetics department by her psychiatrist for investigation of her gross obesity, hyperphagia, learning difficulties and...

  15. What Is Psychiatry?

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    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 ...

  16. What Is Psychiatry?

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    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 ...

  17. What Is Psychiatry?

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    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 ...

  18. What Is Psychiatry?

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  19. What Is Psychiatry?

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    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 ...

  20. What Is Psychiatry?

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    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 ...

  1. What Is Psychiatry?

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    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 ...

  2. What Is Psychiatry?

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    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 ...

  3. What Is Psychiatry?

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    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 ...

  4. What Is Psychiatry?

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    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 ...

  5. Psychiatry's Turbid Solution

    OpenAIRE

    Richters, John E.; Hinshaw, Stephen P.

    1997-01-01

    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...

  6. Psychiatry and music

    OpenAIRE

    Nizamie, Shamsul Haque; Tikka, Sai Krishna

    2014-01-01

    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...

  7. Observational study to assess prescription cost and its relation to the socioeconomic status of the patients in psychiatry outpatient department in a tertiary care hospital

    OpenAIRE

    Sumit G. Goyal; Dnyaneshwar G. Kurle; Balwant D. Samant

    2016-01-01

    Background: To analyse the cost of prescriptions and to determine the relationship between socioeconomic status of the patients and the cost of prescriptions. Methods: A prospective, observational study was conducted in psychiatry OPD of a tertiary care hospital from August 2007 to January 2008. 300 patients of either sex and irrespective of age suffering from mental disorders were included. Information about the socioeconomic status of the patient was analysed on the basis of Kuppuswami's...

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

    Science.gov (United States)

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

    2006-01-01

    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…

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

    OpenAIRE

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

    2014-01-01

    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 ...

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

    Science.gov (United States)

    Yamazaki, Kosuke

    2002-01-01

    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

  11. Training in psychiatry throughout Europe

    OpenAIRE

    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

    2016-01-01

    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

    Energy Technology Data Exchange (ETDEWEB)

    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))

    1993-08-13

    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. What Is Psychiatry?

    Medline Plus

    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 ...

  14. What Is Psychiatry?

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    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 ...

  15. [Sophrology and psychiatry].

    Science.gov (United States)

    Diehr, Jan

    2016-01-01

    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

  16. DESCRIPTION OF THE PSYCHOTHERAPEUTIC PROGRAM IN DEPARTMENT OF DEVELOPMENTAL, PSYCHOTIC AND GERIATRIC PSYCHIATRY OF MEDICAL UNIVERSITY OF GDANSK [OPIS PROGRAMU PSYCHOTERAPEUTYCZNEGO W KLINICE PSYCHIATRII ROZWOJOWEJ, ZABURZEN PSYCHOTYCZNYCH I WIEKU PODESZŁEGO GDANSKIEGO UNIWERSYTETU MEDYCZNEGO

    Directory of Open Access Journals (Sweden)

    Motak, Ewa

    2013-07-01

    Full Text Available The subject of the article is description of work of psychotherapists on the ward of Department of Developmental, Psychotic and Geriatric Psychiatry of Medical University of Gdansk. The group of patientsconsists of people diagnosed with different mental disorders, most of them are hospitalized for schizophrenia. The average duration of treatment is 6 weeks. The main form of treatment for patients is pharmacotherapy, psychotherapy is an additional method to help them. The psychotherapy is mainly focused on group rehabilitation, which aims to improve social relation, to give a sense of satisfaction from their achievements and sense of cooperation with therapeutic group. To each results were used elements of group therapy, therapeuticcommunity meetings, Jacobson relaxation method and psychoeducation addressed to the patients suffering from schizophrenia.

  17. Women in academic psychiatry in Canada.

    Science.gov (United States)

    Penfold, P S

    1987-11-01

    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

  18. Psychiatry and music.

    Science.gov (United States)

    Nizamie, Shamsul Haque; Tikka, Sai Krishna

    2014-04-01

    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

  19. What psychiatry means to us

    Directory of Open Access Journals (Sweden)

    J.K. Trivedi

    2006-03-01

    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.

  20. Meditation and Psychiatry

    OpenAIRE

    McGee, Michael

    2008-01-01

    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...

  1. Mumbai Psychiatry: Current Obstacles

    Directory of Open Access Journals (Sweden)

    Sanjay V Bagadia

    2015-01-01

    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.

  2. Effect of changing journal clubs from traditional method to evidence-based method on psychiatry residents

    OpenAIRE

    Dadgarmoghaddam, Maliheh; Faridhoseini,Farhad; Ali SAGHEBI; Khadem-Rezaiyan, Majid; Moharari, Fatemeh

    2016-01-01

    Farhad Faridhosseini,1 Ali Saghebi,2 Majid Khadem-Rezaiyan,3 Fatemeh Moharari,2 Maliheh Dadgarmoghaddam3 1Psychiatry and Behavioral Sciences Research Center, 2Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, 3Community Medicine, Faculty of Medicine, Mahhad University of Medical Sciences, Mashhad, Iran Introduction: Journal club is a valuable educational tool in the medical field. This method follows different goals. This study aims to investigate the effect on psy...

  3. Identifying Phronotypes in Psychiatry

    Directory of Open Access Journals (Sweden)

    F. AndrewKozel

    2010-10-01

    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.

  4. PSYCHIATRY-PAST, PRESENT & FUTURE

    OpenAIRE

    Doongaji, Dinshaw R

    1997-01-01

    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...

  5. Psychiatry beyond the current paradigm.

    LENUS (Irish Health Repository)

    Bracken, Pat

    2012-12-01

    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.

  6. Assessment of the priority target group of mental health service networks within a nation-wide reform of adult psychiatry in Belgium

    OpenAIRE

    Lorant, Vincent; Grard, Adeline; Van Audenhove, Chantal; Helmer, Eva; Vanderhaegen, Joke; Nicaise, Pablo

    2016-01-01

    Background Belgium is currently implementing a nation-wide reform of mental health care delivery based on service networks. These networks are supposed to strengthen the community-based supply of care, reduce the resort to hospitals, and improve the continuity of care. They are also intended to supply comprehensive care to all adult mental health users. It is unclear, however, if one single model of network can target the needs of the whole adult population with mental health problems. Method...

  7. Psychiatry 2050: from younger psychiatrists' perspective

    Directory of Open Access Journals (Sweden)

    Hassan TM

    2014-05-01

    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.

  8. PSYCHIATRY IN AYURVEDA

    Directory of Open Access Journals (Sweden)

    Vishal Patill

    2015-03-01

    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.

  9. BIOETHICS AND FORENSIC PSYCHIATRY

    Directory of Open Access Journals (Sweden)

    Călin SCRIPCARU

    2016-03-01

    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.

  10. SPECT in psychiatry

    International Nuclear Information System (INIS)

    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.)

  11. [Between neurology and psychiatry].

    Science.gov (United States)

    Levine, Joseph; Toser, Doron; Zeev, Kaplan

    2014-06-01

    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

  12. Treatment of adults with attention-deficit/hyperactivity disorder

    OpenAIRE

    Hechtman, Lily

    2008-01-01

    Dusan Kolar, Amanda Keller, Maria Golfinopoulos, Lucy Cumyn, Cassidy Syer, Lily HechtmanDepartment of Psychiatry, Montreal Children’s Hospital, McGill University, Montreal, CanadaAbstract: This review focuses on the treatment of attention deficit hyperactivity disorder (ADHD) in adults. It briefly addresses prevalence, diagnostic and differential diagnostic issues specific to adults. Stimulant medication, non-stimulant medication, and psychosocial treatments are thoroughly reviewed....

  13. Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit/hyperactivity disorder. American Academy of Child and Adolescent Psychiatry.

    Science.gov (United States)

    Dulcan, M

    1997-10-01

    These practice parameters review the literature on children, adolescents, and adults with attention-deficit/hyperactivity disorder (ADHD). There are three types of ADHD: predominantly inattentive, predominantly hyperactive-impulsive, and combined. Together, they occur in as many as 10% of boys and 5% of girls of elementary school age. Prevalence declines with age, although up to 65% of hyperactive children are still symptomatic as adults. Frequency in adults is estimated to be 2% to 7%. Assessment includes clinical interviews and standardized rating scales from parents and teachers. Testing of intelligence and academic achievement usually are required. Comorbidity is common. The cornerstones of treatment are support and education of parents, appropriate school placement, and pharmacology. The primary medications are psychostimulants, but antidepressants and alpha-adrenergic agonists are used in special circumstances. Other treatments such as behavior modification, school consultation, family therapy, and group therapy address remaining symptoms. PMID:9334567

  14. 追踪方法学在精神科高风险攻击行为患者防范中的应用%Application of tracking methodology in prevention of high-risk aggressive behaviors of psychiatry department

    Institute of Scientific and Technical Information of China (English)

    李会芹

    2015-01-01

    目的::观察追踪方法学在精神科高风险攻击行为患者防范中的应用效果。方法:运用《高风险患者入院评估表》、《攻击行为评估表》,按照追踪方法学的基本步骤,对攻击行为护理防范流程进行失效风险评估及根本原因分析,并制定安全管理持续改进措施。结果:运用追踪方法学对高风险攻击行为患者进行护理质量改进后,使患者的攻击行为发生率下降到历年最低(30.7%),减少了患者和医务人员受伤频率及严重度。结论:追踪方法学在精神科攻击行为防范中具有积极作用。%Objective:To observe application effects of tracking methodology in prevention of high-risk aggressive behaviors of psychiatry department. Methods:Using admission assessment form of high risk patients and aggressive behavior scale, and according to the basis steps of tracking methodology, the failure risks during the aggressive behavior nursing and prevention procedures were eval-uated and their basic reasons were analyzed. Moreover, the continuous improvement measures for safety management were formulated. Results:After the application of tracking methodology to improve the nursing quality for the high-risk patients, the occurring rate of the aggressive behaviors was reduced to the lowest in all these years (30. 7%), and the frequency and severity degree of the patients' and medical staffs' injuries were reduced. Conclusions:The tracking methodology in the aggressive behavior prevention of psychiatry department makes positive and sure effects.

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

    OpenAIRE

    Mascioli, Kelly

    2016-01-01

    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...

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

    OpenAIRE

    Mascioli KJ; Robertson CJ; Douglass AB

    2016-01-01

    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,...

  17. Psychiatry in Korea.

    Science.gov (United States)

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

    2013-04-01

    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

  18. Ethische Herausforderungen der Psychiatrie

    Directory of Open Access Journals (Sweden)

    Helmchen H

    2005-01-01

    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.

  19. Family Burden in Families from the Psychoeducation Group of the Department of Psychiatry of the Universidad de Antioquia who have a family member diagnosed with Bipolar Disorder Carga familiar en familias antioqueñas del Grupo Psicoeducativo del Departamento de Psiquiatría de la Universidad de Antioquia que tienen un miembro diagnosticado con trastorno afectivo bipolar*

    OpenAIRE

    Elizabeth Gómez González; Catalina Londoño; María Victoria Builes Correa; Mauricio Bedoya Hernández; Jenny García Valencia; Carlos López-Jaramillo

    2011-01-01

    Objective: To determine family burden in a group of families from the psychoeducation group of the Department of Psychiatry of the Universidad de Antioquia who have a family member diagnosed with bipolar disorder. Method: Family burden was measured in 50 caregivers of people diagnosed with Bipolar Disorder using the “Escala de Carga Familiar (ECF)”, which is a Spanish adaptation of the Psychosocial Functioning Scale. Statistic processing and analysis was done with SPSS Version 17 ...

  20. Head injuries in accident and emergency departments. How different are children from adults?

    OpenAIRE

    Brookes, M; MacMillan, R.; Cully, S; E. Anderson; S. Murray; Mendelow, A D; Jennett, B

    1990-01-01

    STUDY OBJECTIVE--The aim of the study was to examine the differences between child and adult patients attending accident and emergency departments after recent head injuries. DESIGN AND SETTING--A retrospective survey based on existing case records from 23 Scottish accident and emergency departments for 1985 was compared with prospective data from one hospital over 9 months in 1984. PATIENTS--3838 children under 15 and 4775 adults attended hospital with head injuries during the period analyse...

  1. YouTube and 'psychiatry'.

    Science.gov (United States)

    Gordon, Robert; Miller, John; Collins, Noel

    2015-12-01

    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

  2. [Perspectives on researches in disaster psychiatry].

    Science.gov (United States)

    Tomita, Hiroaki

    2014-01-01

    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

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

    Science.gov (United States)

    Lalonde, Pierre

    2015-01-01

    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

  4. Dimensional Approach in Psychiatry

    Directory of Open Access Journals (Sweden)

    Osman Ozdemir

    2012-09-01

    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.

  5. MRI in psychiatry

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-01

    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.

  6. Nursing interventions in inpatient psychiatry

    NARCIS (Netherlands)

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

    2013-01-01

    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

  7. History of psychiatry in India

    OpenAIRE

    Nizamie, S.Haque; Goyal, Nishant

    2010-01-01

    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...

  8. PSYCHIATRIC COMORBIDITY IN FORENSIC PSYCHIATRY

    OpenAIRE

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

    2009-01-01

    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...

  9. Space Psychology and Psychiatry

    Science.gov (United States)

    Kanas, N.; Manzey, D.

    2003-09-01

    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: http://www.wkap.nl/prod/b/1-4020-1341-8

  10. Nuclear medicine in psychiatry

    International Nuclear Information System (INIS)

    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)

  11. Psychiatry and movies.

    Science.gov (United States)

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

    2009-06-01

    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

  12. Academic psychiatry and the pharmaceutical industry.

    Science.gov (United States)

    Ban, Thomas A

    2006-05-01

    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

  13. The Child and Adolescent Psychiatry Trials Network

    Science.gov (United States)

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

    2004-01-01

    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…

  14. The Introduction of Western Psychiatry into Korea (II) Psychiatric Education in Korea during the Forced Japanese Annexation of Korea (1910-1945)

    OpenAIRE

    CHUNG Wonyong,; LEE NaMi; RHI Bou-yong

    2006-01-01

    In the second report in our series on the historical investigation on the introduction of western psychiatry into Korea, authors deal with the status of psychiatric education during the Japanese forced annexation of Korea. The first lecture on psychiatry in Korea under the title "Mental Diseases" was held in Dae-han-eui-won around 1910. In 1913, the Department of Psychiatry branched off from the Department of Internal Medicine of Chosen-sotoku-fu-iing, the Colonial Governmental Clinic, the su...

  15. Care of the Older Adult in the Emergency Department: Nurses Views of the Pressing Issues

    Science.gov (United States)

    Boltz, Marie; Parke, Belinda; Shuluk, Joseph; Capezuti, Elizabeth; Galvin, James E.

    2013-01-01

    Purpose: The purpose of the study was to describe nurses' views of the issues to be addressed to improve care of the older adult in the emergency department (ED). Design and Methods: An exploratory content analysis examined the qualitative responses of 527 registered nurses from 49U.S. hospitals who completed the Geriatric Institutional Profile.…

  16. Neuropsychological effects of antiepileptic drugs (carbamazepine versus valproate) in adult males with epilepsy

    OpenAIRE

    Shehata, Ghaydaa A; Bateh, Abd El-aziz M; Hamed, Sherifa A; et al

    2009-01-01

    Ghaydaa A Shehata,1 Abd El-aziz M Bateh,2 Sherifa A Hamed,1 Tarek A Rageh,1 Yaser B Elsorogy11Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Egypt; 2Department of Psychology, Faculty of Arts, Banha University, EgyptPurpose: To evaluate the effect of antiepileptic drugs (AEDs) on cognition and behavior in adult epileptic males controlled on treatment with conventional antiepileptic medications. Methods: Cognitive, mood, behavior and personality traits were asse...

  17. An audit in general adult psychiatry service.

    LENUS (Irish Health Repository)

    Udumaga, E

    2010-04-01

    The aim of this study is to evaluate the standards of lithium monitoring using the local prescribing guidelines in patients attending the lithium clinic of Galway University Hospitals (GUH). The laboratory records of 116 out of 142 patients who met the inclusion criteria were examined to identify the frequency of testing for serum lithium level, thyroid function tests and renal function tests. Only about one third of the patients met all the recommended standards in these three areas revealing poor standard of lithium monitoring. Lithium monitoring standards could be improved through the involvement of multidisciplinary team and a more detailed patient education system.

  18. Ethics in psychiatry: a framework

    OpenAIRE

    LOLAS, FERNANDO

    2006-01-01

    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, ...

  19. Historical aspects of Mexican psychiatry.

    Science.gov (United States)

    Bayardo, Sergio Javier Villaseñor

    2016-04-01

    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

  20. Training in psychiatry throughout Europe.

    Science.gov (United States)

    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

    2016-03-01

    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

  1. The Supreme Court of Canada Ruling on Physician-Assisted Death: Implications for Psychiatry in Canada.

    Science.gov (United States)

    Duffy, Olivia Anne

    2015-12-01

    On February 6, 2015, the Supreme Court of Canada ruled that the prohibition of physician-assisted death (PAD) was unconstitutional for a competent adult person who "clearly consents to the termination of life" and has a "grievous and irremediable (including an illness, disease, or disability) condition that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition." The radically subjective nature of this ruling raises important questions about who will be involved and how this practice might be regulated. This paper aims to stimulate discussion about psychiatry's role in this heretofore illegal practice and to explore how psychiatry might become involved in end-of-life care in a meaningful, patient-centred way. First, I will review existing international legislation and professional regulatory standards regarding psychiatry and PAD. Second, I will discuss important challenges psychiatry might face regarding capacity assessment, the notion of rational suicide, and the assessment of suffering. PMID:26720829

  2. Problem-solving strategies in psychiatry: differences between experts and novices in diagnostic accuracy and reasoning

    OpenAIRE

    Gabriel A; Violato C

    2013-01-01

    Adel Gabriel,1,2 Claudio Violato21Departments of Psychiatry, University of Calgary, Calgary; 2Medical Education, Community Health Sciences, University of Calgary Calgary, CanadaBackground: The purpose of this study was to examine and compare diagnostic success and its relationship with the diagnostic reasoning process between novices and experts in psychiatry.Methods: Nine volunteers, comprising five expert psychiatrists and four clinical clerks, completed a think-aloud protocol while attempt...

  3. Secular humanism and "scientific psychiatry".

    Science.gov (United States)

    Szasz, Thomas

    2006-01-01

    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

  4. Secular humanism and "scientific psychiatry"

    Directory of Open Access Journals (Sweden)

    Szasz Thomas

    2006-04-01

    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.

  5. The Two Cultures in Psychiatry.

    Science.gov (United States)

    Cleghorn, R A

    1965-07-10

    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

  6. Against Explanatory Minimalism in Psychiatry

    OpenAIRE

    THORNTON, TIM

    2015-01-01

    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...

  7. Secular humanism and "scientific psychiatry"

    OpenAIRE

    Szasz Thomas

    2006-01-01

    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...

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

    OpenAIRE

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

    2013-01-01

    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...

  9. Delirium, a ‘confusing’ condition in general hospitals: The experience of a Consultation–Liaison Psychiatry Unit in Greece

    OpenAIRE

    Panagiota Goulia; Christos Mantas; Thomas Hyphantis

    2009-01-01

    Panagiota Goulia, Christos Mantas, Thomas HyphantisConsultation-Liaison Psychiatry Unit, Department of Psychiatry, Medical School, University of Ioannina, Ioannina, GreeceBackground/aims: A plethora of studies showed that delirium is common in hospitalized populations. We aimed to examine the characteristics of delirium patients referred to our Consultation–Liaison Psychiatry Unit (CLPU).Methods: Our CLPU database was used to obtain data of all referred patients admitted to our hosp...

  10. Physicians’ “compliance with treatment” in the context of consultation-liaison psychiatry: The role of “triangle” relationships and projective identification

    OpenAIRE

    Hyphantis, Thomas

    2008-01-01

    Thomas N Hyphantis1, Konstantinos I Arvanitakis21Consultation-Liaison Psychiatric Unit, Department of Psychiatry,Medical School, University of Ioannina, Ioannina, Greece; 2Department of Philosophy and Department of Psychiatry, McGill University Health Centre, Montreal, CanadaAbstract: Transference and countertransference issues arising in the context of consultation-liaison (C-L) psychiatry could be more complex than originally assumed since they include reactions evoked within the frame of a...

  11. Classifications in child and adolescent psychiatry

    OpenAIRE

    Squillante , Maria-Vittoria

    2014-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Homayoun Amini

    2013-03-01

    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. Adult ADHD and comorbid depression: A consensus-derived diagnostic algorithm for ADHD

    OpenAIRE

    Binder, Carin

    2009-01-01

    Diane McIntosh1, Stan Kutcher2, Carin Binder3, Anthony Levitt4, Angelo Fallu5, Michael Rosenbluth61Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; 2Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; 3Medical and Government Affairs, Janssen-Ortho Inc, Toronto, Ontario, Canada; 4Department of Psychiatry, Sunnybrook and Women’s Health Sciences Centre, Toronto, Ontario, Canada; 5Psychiatry, Clinique Woodward, Sher...

  14. [What place is there for psychotherapy in public psychiatry?].

    Science.gov (United States)

    Kramer, U; Ambresin, G; de Roten, Y; Fassassi, S; Hedjal, A; Herrera, F; Kolly, S; Pomini, V; Preisig, M; Despland, J-N

    2010-09-22

    The question of the place of psychotherapy in psychiatric public care is posed in this article. We will address this question first by presenting two clinical and research programmes which were implemented in a clinical psychiatric unit, section Karl Jaspers (Service of General Psychiatry) of the Department of Psychiatry CHUV, in Lausanne with the collaboration of the University Institute of Psychotherapy. The first one puts forward psychodynamic psychotherapy of depressed inpatients; the clinical programme and the research questions on efficacy of this treatment are discussed. The second focuses on the early treatment of patients with Borderline Personality Disorder, in particular in its research question on the effect of the motive-oriented therapeutic relationship in this process. We conclude by underlining the convergences of the two programmes. PMID:20963958

  15. Child Psychiatry Curricula in Undergraduate Medical Education

    Science.gov (United States)

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

    2008-01-01

    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.

  16. Psychiatry Residency Training around the World

    Science.gov (United States)

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

    2007-01-01

    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,…

  17. The Holy Grail of Psychiatry

    OpenAIRE

    Nemeroff, Charles B.

    2015-01-01

    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...

  18. Movies in education of psychiatry residents.

    Science.gov (United States)

    Jukić, Vlado; Brecić, Petrana; Savić, Aleksandar

    2010-06-01

    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

  19. Determinants of medication adherence among adults with type 2 diabetes mellitus in three Malaysian public health clinics: a cross-sectional study

    OpenAIRE

    Chew, Boon-How; Hassan, Noor-Hasliza; Sherina, Mohd-Sidik

    2015-01-01

    Boon-How Chew,1 Noor-Hasliza Hassan,2 Mohd-Sidik Sherina3 1Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 2Klinik Kesihatan Dengkil, Ministry of Health, 3Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia Abstract: Medication adherence (MA) in adults with type 2 diabetes mellitus (T2D) is associated with improved disease control (glycated hemoglobin, blood pressure, and lipid pro...

  20. Genetic diagnosis in clinical psychiatry: A case report of a woman with a 47, XXX karyotype and Fragile X syndrome

    Directory of Open Access Journals (Sweden)

    Anthony M. Vandersteen

    2009-03-01

    Full Text Available Background and Objectives: A recent report highlighted the importance of considering a chromosomal abnormality in the differential diagnosis of adult clinical psychiatry. This case report illustrates the importance of considering Fragile X syndrome, an X-linked genetic disorder associated with psychiatric morbidities. Methods: A 45 years old woman was referred to the clinical genetics department by her psychiatrist for investigation of her gross obesity, hyperphagia, learning difficulties and affective disorder. Results: Cytogenetic analysis revealed a 47,XXX karyotype. Molecular testing identified an expansion of approximately 580 repeats in the FRAXA gene carried on two of her three copies of the X chromosome. Clinical evaluation revealed features consistent with the Prader-Willi like phenotype of Fragile X syndrome. Conclusions: It is important to consider molecular and cytogenetic testing in patients with dysmorphic features, complex neuro-behavioural profile and/or psychotic disorders in order to establish a causative diagnosis, provide adequate counselling and initiate cascade screening where applicable.

  1. What Psychiatry Means to Me

    Directory of Open Access Journals (Sweden)

    Helen Herrman

    2007-01-01

    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.

  2. Against Explanatory Minimalism in Psychiatry.

    Science.gov (United States)

    Thornton, Tim

    2015-01-01

    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

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

    Science.gov (United States)

    Pajonk, F-G B

    2015-09-01

    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

  4. Ohio Department of Education, Office of Career-Technical & Adult Education District Program Performance Review--Executive Summary, FY04

    Science.gov (United States)

    Anstaett, Dwight

    2004-01-01

    In the fall of 2004, the Ohio Department of Education's (ODE) Office of Career- Technical and Adult Education conducted a comprehensive program performance review of all career-technical education programs offered within Ohio Department of Youth Services (ODYS) Institutions. The unique nature of career-technical education delivery within a…

  5. A Comparison of Medical and Psychobehavioral Emergency Department Visits Made by Adults with Intellectual Disabilities

    Science.gov (United States)

    Lunsky, Yona; Balogh, Rob; Khodaverdian, Alin; Elliott, Deborah; Jaskulski, Christine; Morris, Susan

    2012-01-01

    Study Objective. We describe and contrast medical to psychobehavioral emergency visits made by a cohort of adults with intellectual disabilities. Methods. This was a study of 221 patients with intellectual disabilities who visited the emergency department because of a psychobehavioral or medical emergency. Patient profiles are described and logistic regression was used to assess predictors of psychobehavioral emergencies in this group, including age, residence, psychiatric diagnosis, cognitive level, and life events. Results. Ninety-eight individuals had medical emergencies and 123 individuals presented with psychobehavioral emergencies. The most common medical issue was injury and the most common psychobehavioral issue was aggression. In the multivariate analysis, life events (odds ratio (OR) 0.28; 95% confidence interval (CI) 0.10 to 0.75), psychiatric diagnosis (OR 2.35; 95% CI 1.12 to 4.95), and age group (OR 4.97; 95% CI 1.28 to 19.38) were associated with psychobehavioral emergencies. Psychobehavioral emergencies were more likely to result in admission and caregivers reported lower rates of satisfaction with these visits. Conclusion. Emergency departments would benefit from greater understanding of the different types of presentations made by adults with intellectual disabilities, given the unique presentations and outcomes associated with them. PMID:23056948

  6. Frequency of anemia in chronic psychiatry patients

    Directory of Open Access Journals (Sweden)

    Korkmaz S

    2015-10-01

    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

  7. The future of psychiatry as clinical neuroscience.

    Science.gov (United States)

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

    2009-04-01

    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

  8. NEW IMAGE OF PSYCHIATRY, MASS MEDIA IMPACT AND PUBLIC RELATIONS

    OpenAIRE

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

    2010-01-01

    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...

  9. The views of medical students about psychiatry clerkship education

    OpenAIRE

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

    2012-01-01

    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...

  10. A Marxist approach to psychology and psychiatry.

    Science.gov (United States)

    Nahem, J

    1982-01-01

    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

  11. Biological Psychiatry, Research And Industry

    Directory of Open Access Journals (Sweden)

    Ajai R. Singh

    2007-01-01

    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

  12. [IMPACT OF AGING IN PSYCHIATRY].

    Science.gov (United States)

    Rubin, Romina; Jauregui, Ricardo

    2015-01-01

    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

  13. Treatment of adults with attention-deficit/hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Dusan Kolar

    2008-03-01

    Full Text Available Dusan Kolar, Amanda Keller, Maria Golfinopoulos, Lucy Cumyn, Cassidy Syer, Lily HechtmanDepartment of Psychiatry, Montreal Children’s Hospital, McGill University, Montreal, CanadaAbstract: This review focuses on the treatment of attention deficit hyperactivity disorder (ADHD in adults. It briefly addresses prevalence, diagnostic and differential diagnostic issues specific to adults. Stimulant medication, non-stimulant medication, and psychosocial treatments are thoroughly reviewed. For each class of medication possible mechanism of action, efficacy and side effects are summarized. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, stimulant medications are most effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.Keywords: adult ADHD, medication, stimulants, cognitive-behavioral therapy

  14. Treatment of adults with attention-deficit/hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Dusan Kolar

    2008-04-01

    Full Text Available Dusan Kolar, Amanda Keller, Maria Golfinopoulos, Lucy Cumyn, Cassidy Syer, Lily HechtmanDepartment of Psychiatry, Montreal Children’s Hospital, McGill University, Montreal, CanadaAbstract: This review focuses on the treatment of attention deficit hyperactivity disorder (ADHD in adults. It briefly addresses prevalence, diagnostic and differential diagnostic issues specific to adults. Stimulant medication, non-stimulant medication, and psychosocial treatments are thoroughly reviewed. For each class of medication possible mechanism of action, efficacy and side effects are summarized. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, stimulant medications are most effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.Keywords: adult ADHD, medication, stimulants, cognitive-behavioral therapy

  15. Receptor studies in biological psychiatry

    International Nuclear Information System (INIS)

    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.)

  16. Reflections on psychiatry and international mental health

    Directory of Open Access Journals (Sweden)

    Helen Herrman

    2013-01-01

    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.

  17. Do characteristics of seriously injured older adults differ from those of their younger counterparts in the emergency department?

    OpenAIRE

    Aköz, Ayhan; IŞIK, Memet; ŞAHİN, Hüseyin; EMET, Mücahit

    2013-01-01

    To analyze the injury characteristics of younger and older adult trauma victims. Materials and methods: This was a prospective, cross-sectional, observational, and single-center study including both younger adult and geriatric trauma patients. The relationships between the age groups and the number of consultations in the emergency department (ED) were compared with analysis of covariance after adjusting for Injury Severity Score (ISS). Results: The data consisted of 779 patients, 131 (16.8...

  18. Etiology and Clinical Characterization of Respiratory Virus Infections in Adult Patients Attending an Emergency Department in Beijing

    OpenAIRE

    Yu, Xiaoyan; Lu, Roujian; Wang, Zhong; Zhu, Na; Wang, Wen; Julian, Druce; Chris, Birch; Lv, Jianxin; Tan, Wenjie

    2012-01-01

    Background Acute respiratory tract infections (ARTIs) represent a serious global health burden. To date, few reports have addressed the prevalence of respiratory viruses (RVs) in adults with ARTIs attending an emergency department (ED). Therefore, the potential impact of respiratory virus infections on such patients remains unknown. Methodology/Principal Findings To determine the epidemiological and clinical profiles of common and recently discovered respiratory viruses in adults with ARTIs a...

  19. Neuroimaging in psychiatry: from bench to bedside

    OpenAIRE

    Linden, David E; Fallgatter, Andreas J.

    2009-01-01

    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...

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

    Science.gov (United States)

    Rahimi, Sadeq

    2014-12-01

    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

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

    Science.gov (United States)

    Gold, Liza H.; Epstein, Steven A.

    2006-01-01

    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…

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

    Science.gov (United States)

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

    2010-06-01

    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

  3. Cultural competency training in psychiatry.

    Science.gov (United States)

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

    2008-01-01

    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

  4. PET and SPECT in psychiatry

    Energy Technology Data Exchange (ETDEWEB)

    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

    2014-09-01

    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.

  5. Workplace Based Assessment in Psychiatry

    Directory of Open Access Journals (Sweden)

    Ayse Devrim Basterzi

    2009-11-01

    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.

  6. PET and SPECT in psychiatry

    International Nuclear Information System (INIS)

    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.

  7. Psychiatry Today : Biology vs. Psychology.

    Science.gov (United States)

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

    1995-06-01

    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

  8. Acute bacterial gastroenteritis: a study of adult patients with positive stool cultures treated in the emergency department

    OpenAIRE

    Chan, S.; Ng, K; Lyon, D.; Cheung, W; Cheng, A.; Rainer, T

    2003-01-01

    Objectives: To investigate the presenting clinical features of acute bacterial gastroenteritis in adult patients treated as outpatients in the emergency department (ED), and the pathogens responsible in this setting and population; and to identify the frequency with which positive stool culture result changes management.

  9. History and current condition of Russian psychiatry.

    Science.gov (United States)

    Krasnov, Valery N; Gurovich, Isaak

    2012-08-01

    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

  10. Gender differences in career paths in psychiatry.

    Science.gov (United States)

    Krener, P

    1994-03-01

    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

  11. Neurology referrals to a liaison psychiatry service.

    LENUS (Irish Health Repository)

    Fitzgerald, P

    2012-02-03

    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.

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

    Science.gov (United States)

    Basso, Elisabetta

    2016-12-01

    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

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

    Directory of Open Access Journals (Sweden)

    L. Eugene Arnold

    2008-01-01

    has been to participate in research on nutritional aspects of child psychiatry. Equally gratifying is to participate in efforts to make such interest and research respectable. The implicit double standard about drugs and psychosocial treatments on the one hand and nutrition and other complementary considerations on the other seems to make many intelligent colleagues reluctant to acknowledge any interest in this area. The discovery of closet nutritionists after boldly speaking out on the subject has been a repeated joy.The experience of observing nature's healing power, coupled with the interest in research, has led me to a great interest in placebo/Hawthorne effect. I'm fascinated by the fact that this no-risk treatment can produce an improvement, depending on the disorder, that is a tenth to twice as much as active medication. For example, if an antidepressant has a 60% response rate and placebo 40% response rate, then the pharmacological effect is 20% response, the difference. In this case, the placebo effect is twice as strong as the pharmacological effect and when you give an antidepressant, 2/3 of the effect is placebo. This is why witch doctors, shamans and charlatans thrive: in the example given, they can be 2/3 as effective as the most expert allopathic psychiatrist. We need to understand this effect better: how much of it is real improvement, how much statistical regression to the mean, how much rater expectation, etc.? Mastery of placebo effect for the good of our patients is particularly important in child psychiatry because children are subject to two sets of expectations: their own and their parents'; and they are probably more sensitive to the expectation matrix than adults are. We should strive to be good witch doctors as well as good psychotherapy technicians, pharmacologists and nutrition experts. I can proudly (and humbly say that I've become the best witch doctor I can be.And that's what child and adolescent psychiatry means to me.

  14. Neuroimaging in psychiatry: from bench to bedside

    Directory of Open Access Journals (Sweden)

    David E Linden

    2009-12-01

    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.

  15. [Practice relevant research in biological psychiatry].

    Science.gov (United States)

    Meyer-Lindenberg, A

    2015-11-01

    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

  16. Limitations of the biopsychosocial model in psychiatry

    Directory of Open Access Journals (Sweden)

    Benning TB

    2015-05-01

    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

  17. Educating psychiatry residents in neuropsychiatry and neuroscience.

    Science.gov (United States)

    Benjamin, Sheldon

    2013-06-01

    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

  18. Challenges in conducting psychiatry studies in India

    Directory of Open Access Journals (Sweden)

    Saifuddin Kharawala

    2011-01-01

    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.

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

    Science.gov (United States)

    Schmidt-Degenhard, M

    1997-10-01

    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

  20. Effect of changing journal clubs from traditional method to evidence-based method on psychiatry residents

    Directory of Open Access Journals (Sweden)

    Faridhosseini F

    2016-08-01

    Full Text Available Farhad Faridhosseini,1 Ali Saghebi,2 Majid Khadem-Rezaiyan,3 Fatemeh Moharari,2 Maliheh Dadgarmoghaddam3 1Psychiatry and Behavioral Sciences Research Center, 2Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, 3Community Medicine, Faculty of Medicine, Mahhad University of Medical Sciences, Mashhad, Iran Introduction: Journal club is a valuable educational tool in the medical field. This method follows different goals. This study aims to investigate the effect on psychiatry residents of changing journal clubs from the traditional method to the evidence-based method. Method: This study was conducted using a before–after design. First- and second-year residents of psychiatry were included in the study. First, the status quo was evaluated by standardized questionnaire regarding the effect of journal club. Then, ten sessions were held to familiarize the residents with the concept of journal club. After that, evidence-based journal club sessions were held. The questionnaire was given to the residents again after the final session. Data were analyzed through descriptive statistics (frequency and percentage frequency, mean and standard deviation, and analytic statistics (paired t-test using SPSS 22. Results: Of a total of 20 first- and second-year residents of psychiatry, the data of 18 residents were finally analyzed. Most of the subjects (17 [93.7%] were females. The mean overall score before and after the intervention was 1.83±0.45 and 2.85±0.57, respectively, which showed a significant increase (P<0.001. Conclusion: Moving toward evidence-based journal clubs seems like an appropriate measure to reach the goals set by this educational tool. Keywords: journal club, evidence-based, residents, education method

  1. Sleep hygiene use in a psychiatry outpatient setting.

    LENUS (Irish Health Repository)

    Lyne, J

    2012-02-01

    Non-pharmacological measures are recommended prior to use of hypnotics in the latest NICE guidance. This study investigated if non-pharmacological measures are utilised prior to hypnotic prescribing in a general adult psychiatry outpatient setting, and further reviewed patient\\'s sleep quality following implementation of sleep hygiene education. Interviews were conducted with 85 patients, and poor adherence with NICE guidance was found among the 74 (87%) patients previously prescribed a hypnotic. Just five (6.8%) patients recalled use of non-pharmacological measures prior to hypnotic prescription, 47 (63.5%) indicated non-pharmacological measures had not been discussed, while a further 22 (29.7%) could not remember. Improvement in Pittsburgh Sleep Quality Index scores following implementation of sleep hygiene education was also noted (P = 0.03). These findings suggest that increased awareness of sleep hygiene education for clinicians may be beneficial.

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

    Science.gov (United States)

    Lipowski, Z J

    1981-07-01

    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

  3. Safety and tolerability of flexible dosages of prolonged-release OROS methylphenidate in adults with attention-deficit/hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Jan K Buitelaar

    2009-08-01

    Full Text Available Jan K Buitelaar1, J Antoni Ramos-Quiroga2, Miguel Casas2, J J Sandra Kooij3, Asko Niemelä4, Eric Konofal5, Joachim Dejonckheere6, Bradford H Challis7, Rossella Medori81Department of Psychiatry, University Medical Center, St. Radboud and Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands; 2Department of Psychiatry, Hospital Universitari Vall d’Hebron and Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; 3PsyQ, Psycho-Medical Programs, Program Adult ADHD, Den Haag, The Netherlands; 4Oulu University Hospital, Department of Psychiatry, Oulu, Finland; 5Groupe Hospitalier Pitie-Salpetriere, Paris, France; 6SGS Life Sciences, Mechelen, Belgium; 7Johnson & Johnson Pharmaceutical Research and Development, Titusville, NJ, USA; 8Janssen-Cilag EMEA, Neuss, GermanyAbstract: The osmotic release oral system (OROS methylphenidate formulation is a prolonged-release medication for the treatment of attention-deficit/hyperactivity disorder (ADHD in children, adolescents, and adults. We conducted a seven-week open-label extension of a double-blind study to assess the safety and tolerability of OROS methylphenidate in a flexible dose regimen (18–90 mg daily for the treatment of adults diagnosed with ADHD (N = 370. Medication was adjusted to optimize efficacy and tolerability for each patient. Adverse events, vital signs, and laboratory parameters were assessed. Most patients (337; 91% completed the seven-week treatment and the final dispensed dose was 18 mg (8%, 36 mg (29%, 54 mg (34%, 72 mg (20%, or 90 mg (9%. Adverse events were reported in 253 (68% patients and most were mild or moderate in severity; most frequently reported included headache (17%, decreased appetite (13%, and insomnia (11%. Adverse events were rarely serious (<1%; 2/370. Small mean increases in systolic and diastolic blood pressure (both 2.4 mmHg and pulse (3.2 bpm were observed. Body weight decreased

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

    OpenAIRE

    Huh, John; Goebert, Deborah A

    2010-01-01

    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...

  5. Cognitive Science and Psychiatry: An Overview

    OpenAIRE

    Dan J Stein

    1992-01-01

    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...

  6. Psychopathology as the basic science of psychiatry.

    Science.gov (United States)

    Stanghellini, Giovanni; Broome, Matthew R

    2014-09-01

    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

  7. Indian Psychiatry and classification of psychiatric disorders

    OpenAIRE

    Jacob, K.S.

    2010-01-01

    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.

  8. Primary care psychiatry: the case for action.

    OpenAIRE

    Shepherd, M.

    1991-01-01

    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.

  9. Educational Supervision Appropriate for Psychiatry Trainee's Needs

    Science.gov (United States)

    Rele, Kiran; Tarrant, C. Jane

    2010-01-01

    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…

  10. Imaging-Genetics Applications in Child Psychiatry

    Science.gov (United States)

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

    2010-01-01

    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…

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

    Directory of Open Access Journals (Sweden)

    Mascioli KJ

    2016-04-01

    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

  12. Nursing phenomena in inpatient psychiatry

    NARCIS (Netherlands)

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

    2011-01-01

    Little is known about the question if the nursing diagnosis classification of North American Nursing Association-International (NANDA-I) describes the adult inpatient psychiatric nursing care. The present study aimed to identify nursing phenomena mentioned in journal articles about the psychiatric i

  13. Attitudes toward technology-based health information among adult emergency department patients with drug or alcohol misuse☆,☆☆

    OpenAIRE

    Choo, Esther K.; Ranney, Megan L.; Wong, Zerlina; Mello, Michael J

    2012-01-01

    Technology-based screening and interventions are emerging solutions to the challenge of addressing substance use in the emergency department (ED). A standardized questionnaire of adult patients at a large-volume, urban, academic ED assessed interest in, and potential barriers to, technology-based substance use information. Questionnaire topics included substance use, access to technology, preferences for health information, and perceived barriers to technology interventions. Among the 430 par...

  14. Neuropathological research at the "Deutsche Forschungsanstalt fuer Psychiatrie" (German Institute for Psychiatric Research) in Munich (Kaiser-Wilhelm-Institute). Scientific utilization of children's organs from the "Kinderfachabteilungen" (Children's Special Departments) at Bavarian State Hospitals.

    Science.gov (United States)

    Steger, Florian

    2006-09-01

    During National Socialism, the politically motivated interest in psychiatric genetic research lead to the founding of research departments specialized in pathological-anatomical brain research, the two Kaiser Wilhelm-Institutes (KWI) in Berlin and Munich. The latter was indirectly provided with brain material by Bavarian State Hospitals, to three of which "Kinderfachabteilungen" (Special Pediatric Units) were affiliated. As children became victims of the systematically conducted child "euthanasia" in these Special Pediatric Units, this paper will address the question whether and to which extent the organs from victims of child "euthanasia" were used for (neuro-) pathological research at the KWI in Munich. By means of case studies and medical histories (with focus on the situation in Kaufbeuren-Irsee), I will argue that pediatric departments on a regular base delivered slide preparations, that the child "euthanasia" conduced in these departments systematically contributed to neuropathological research and that slide preparations from victims of child "euthanasia" were used in scientific publications after 1945. PMID:16887759

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

    Science.gov (United States)

    Kalmar, Sandor

    2016-06-01

    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

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

    Science.gov (United States)

    Lewis-Fernández, R; Kleinman, A

    1995-09-01

    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

  17. An Innovative Use of Case Conference to Teach Future Educators in Addiction Psychiatry.

    Science.gov (United States)

    Muvvala, Srinivas B; Marienfeld, Carla; Encandela, John; Petrakis, Ismene; Edens, Ellen Lockard

    2016-06-01

    Objective An innovative course was developed for fellows enrolled in the Yale School of Medicine Addiction Psychiatry program to educate them in key principles of adult learning, apply these principles in a case conference presentation, and to improve skills in providing and receiving feedback. Methods An initial training module on educational skills was followed by individual mentorship to prepare a case presentation. A feedback module provided space to learn and practice skills in feedback delivery. Results The program showed positive results and improved confidence levels of the participants in presenting and providing/receiving feedback. Conclusions Implementing a course designed to improve teaching and feedback skills is feasible in a 1-year Addiction Psychiatry fellowship. PMID:27001311

  18. [Intermixture of politics and science in the GDR. The investigation of deaths at the Department of Neurology and Psychiatry at Leipzig University under Müller-Hegemann in 1963].

    Science.gov (United States)

    Steinberg, H; Weber, M M

    2011-10-01

    This study presents archival sources that shed light on a topic still being discussed by psychiatrists in East Germany: the death of two patients at the Leipzig Department that occurred in 1960 and 1962 under the directorship of Dietfried Müller-Hegemann. These fatalities were supposed to have been induced by obsolete psychotropic drugs and were associated with Ivan Pavlov's hypnotherapy. The incidents were investigated both by highest administrative bodies and the General State Prosecutor of the former GDR. Archival sources suggest that lower party organs and the ministerial administration tried to make use of the proceedings to bring about the downfall of the head of the Leipzig Department, who had become ideologically suspicious. However, the official General State Prosecutor's investigation ascertained that both Müller-Hegemann and Christa Kohler, head of the psychotherapeutic ward, were not to be held responsible. Although the SED Central Committee at first tried to influence the outcome on the basis of ideological reservations made by the university party organisation, it finally accepted and confirmed the judgment of the General State Prosecutor. Hence, in this case, the highest party bodies followed arguments that were the result of an independent investigation and were not influenced by an individual bias or ideological motives. PMID:21347994

  19. A Prescription for "Deprescribing" in Psychiatry.

    Science.gov (United States)

    Gupta, Swapnil; Cahill, John Daniel

    2016-08-01

    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

  20. [Malaise in psychiatry and its history].

    Science.gov (United States)

    Chebili, S

    2016-04-01

    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

  1. Indian psychiatry, research and Asian countries.

    Science.gov (United States)

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

    2010-01-01

    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

  2. The philosophies of psychiatry: empirical perspectives.

    Science.gov (United States)

    Ralston, Alan S G

    2013-08-01

    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

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

    Science.gov (United States)

    Demazeux, Steeves

    2016-12-01

    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

  4. [On the cultural history of psychiatry].

    Science.gov (United States)

    Schott, H

    2004-08-01

    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

  5. Emergency Department Visits for Drug-Related Suicide Attempts Involving Antidepressants by Adolescents and Young Adults: 2004 to 2008. The DAWN Report

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration, 2011

    2011-01-01

    In 2008, adolescents made 23,124 visits to the emergency department (ED) for drug-related suicide attempts, and young adults made 38,036 such visits; of these visits, 23.0 percent (5,312 visits) among adolescents and 17.6 percent (6,700 visits) among young adults involved antidepressants. Among ED visits for suicide attempts involving…

  6. Communication interculturelle en psychiatrie: enjeux linguistiques

    OpenAIRE

    Molina, María Eugenia

    2010-01-01

    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...

  7. Setting Up Private Practice in Psychiatry

    OpenAIRE

    Alan De Sousa; Avinash De Sousa

    2015-01-01

    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.

  8. Genetics of complex traits in psychiatry

    OpenAIRE

    Gelernter, Joel

    2014-01-01

    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...

  9. Initiatives in biological research in Indian psychiatry

    OpenAIRE

    Shrivatava, Amresh

    2010-01-01

    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...

  10. The Third Wave of Biological Psychiatry

    Directory of Open Access Journals (Sweden)

    HenrikWalter

    2013-09-01

    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.

  11. In India, Psychiatry Has Come a Long Way

    Directory of Open Access Journals (Sweden)

    Rajesh Parikh

    2015-01-01

    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.

  12. Estrutura fatorial do questionário de morbidade psiquiátrica de adultos aplicado em amostras populacionais de cidades brasileiras The factor structure of the adult psychiatry morbidity questionnaire (QMPA in a community sample of Brazilian cities

    Directory of Open Access Journals (Sweden)

    Sérgio Baxter Andreoli

    1994-08-01

    psychiatric disorders. It has been applied to the study of the Factorial Structure of a Brazilian screening questionnaire, the Adult Psychiatric Morbidity Questionnaire (QMPA. The questionnaire is made up of 45 yes/no items for the identification of psychiatric symptons and the use of psychiatric services and psychotropic drugs. The questionnaire was applied to 6.470 subjects over 15 years old in representative samples from three urban areas: Brasília, Porto Alegre and S. Paulo. Seven factors were found to explain 42.7% of the total variance: Anxiety/Somatization (eigenvalue=3.81, 10.9%; Irritability/Depression (eigenvalue =2.41, 6.9%; Cognitive Impairment (eigenvalue = 2.01, 5.8%; Alcoholism (eigenvalue =1.90, 5.4%; Mood Elation (eigenvalue = 1.62, 4.6%; Hallucinatory/ Delusional Disorders (eigenvalue = 1.60, 4.6%; and Drug/Therapies (eigenvalue = 1.60, 4.5%. A similar pattern of results was found when the analysis was carried out in the three places. It is suggested, on the banis of these findings, that some questions should be modified and some excluded in any future version of the questionnaire.

  13. [Academic presentation of neurology and psychiatry of Keijo Imperial University at annual meetings].

    Science.gov (United States)

    Kanekawa, Hideo

    2012-01-01

    The origin of Keijo Imperial University, Medical School, Psychiatry course, and presentation at the Annual Meetings of the Japanese Society of Psychiatry and Neurology and The Japanese Society of Psychiatry and Neurology were investigated from its establishment to 1945. Keijo was the name used for the capital city of Korea, Seoul, when Korea was under Japanese rule. We believe the Keijo Imperial University evolved out of the Governor-General of Korea Hospital and Keijo Medical Professional School. The first Professor at the University was Shinji Suitsu, who studied under Shuzo Kure. He visited Shizuoka prefecture when he collaborated in Kure's "Actual situation and statistical observation on home custody of mental patients" (1918). This was confirmed by photographic materials from this time. The year after the visit to Shizuoka, Suitsu was sent to the Korean Peninsula. In 1913, Suitsu established the Department of Psychiatry at the Governor-General of Korea Hospital, and the institution had 500 tsubo (approximately 1,650 m2) of land within Keijo (Seoul), with floor space of 160 tsubo (approximately 528 m2) and 24 beds. Treatments were performed by Suitsu, an assistant, and 8-9 nurses. The number of hospitalized patients was 30-50 patients per year. Cells had floor heating. Keijo Imperial University was established in 1924, and was called Jodai. In 1925, Suitsu retired from his Professorship of Psychiatry at Keijo Medical Professional School. Suitsu was from Kyoto Imperial University, and had studied abroad. In 1925, Suitsu's father-in-law, and a long-time friend of Shuzo Kure, Seiji Yamane, passed away. The professor who took up the position after Suitsu was Kiyoji Kubo, who was originally supposed to go to Hokkaido Imperial University. When the medical school was established at Keijo Imperial University in 1926, Kubo was offered a professorship there. Jodai was under the jurisdiction of the Governor-General of Korea, and not the Ministry of Education. Later

  14. The Introduction of Western Psychiatry into Korea (II Psychiatric Education in Korea during the Forced Japanese Annexation of Korea (1910-1945

    Directory of Open Access Journals (Sweden)

    CHUNG Wonyong,

    2006-12-01

    Full Text Available In the second report in our series on the historical investigation on the introduction of western psychiatry into Korea, authors deal with the status of psychiatric education during the Japanese forced annexation of Korea. The first lecture on psychiatry in Korea under the title "Mental Diseases" was held in Dae-han-eui-won around 1910. In 1913, the Department of Psychiatry branched off from the Department of Internal Medicine of Chosen-sotoku-fu-iing, the Colonial Governmental Clinic, the successor of Dae-han-eui-won. The chairman, Professor Suiju Sinji; and the Korean assistant Sim Ho-seop administered the psychiatric ward with 35 beds. Since 1913, an Australian missionary psychiatrist, Dr. McLaren began to teach neurology and psychiatry at Severance Union Medical College and established a Department of Psychiatry in 1923. Dr. McLaren was a faithful Christian and open minded toward Oriental religious thought such as in Buddhism and Taoism. He devoted himself to the humanitarian care of mentally ill patients and served there until 1937 when he had to leave the land due to Japanese persecution. His disciple, Dr. Lee Jung Cheol succeeded the chair of the Psychiatric Department of Severance Medical College and served until 1939. In 1916, Keijo(Seoul Medical College was established and in 1928, Keijo Teikoku Daigaku(Imperial University. From 1929 to 1941, the Department of Neurology and Psychiatry of Keijo Imperial University grew under the chairmanship of Professor Kubo Kioji followed by Professor Watanabe until 1945. Many assistants including a few Koreans were gathered to the Department for training and research. The main textbook used for the psychiatric education for medical students in Korea was on Kraepelinian German Psychiatry translated and edited by Japanese psychiatrists. Lectures and clerkships for Neurology and Psychiatry were allocated generally in the curriculum for senior students for weekly 1-3 hours. Postgraduate professional

  15. [Adolescence: viewpoints from adolescent psychiatry].

    Science.gov (United States)

    Bürgin, D; von Klitzing, K

    1994-05-01

    Adolescence is a phase of human development which is marked by a high vulnerability due to the ongoing psycho-physiological transformations. The regulation of the self-esteem is especially in danger in youngsters who went into adolescence with a marked burden of conflicts or who lived in families with disturbed intrafamilial dynamics. To be present as a partner and not to find the solutions for the adolescents' conflicts, to accept their questioning of what is established and to recognize their movements of reconciliation are the quite complex demands put on to the world of the adults. Adolescents urge us to a review of our own adolescence, to a balancing of hate and love, openness and rigidity, and to dialectic movements between disintegration and reintegration as well as between the generations. Any help, be it on the physical, the social or the psychic level, should be directed toward a restitution of the intrapsychic, intrafamilial or intergenerational balance; sociocultural factors have also always to be respected. The helpers--especially in a culture with rapid change--are often confronted with their own adolescence, which took place a generation before and mostly under totally different conditions. PMID:8016759

  16. The Supreme Court of Canada Ruling on Physician-Assisted Death: Implications for Psychiatry in Canada

    Science.gov (United States)

    Duffy, Olivia Anne

    2015-01-01

    On February 6, 2015, the Supreme Court of Canada ruled that the prohibition of physician-assisted death (PAD) was unconstitutional for a competent adult person who “clearly consents to the termination of life” and has a “grievous and irremediable (including an illness, disease, or disability) condition that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”1 The radically subjective nature of this ruling raises important questions about who will be involved and how this practice might be regulated. This paper aims to stimulate discussion about psychiatry’s role in this heretofore illegal practice and to explore how psychiatry might become involved in end-of-life care in a meaningful, patient-centred way. First, I will review existing international legislation and professional regulatory standards regarding psychiatry and PAD. Second, I will discuss important challenges psychiatry might face regarding capacity assessment, the notion of rational suicide, and the assessment of suffering. PMID:26720829

  17. EPA guidance on improving the image of psychiatry.

    Science.gov (United States)

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

    2016-03-01

    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

  18. Encompassing Sexual Medicine within Psychiatry: Pros and Cons

    Science.gov (United States)

    Segraves, Robert Taylor

    2010-01-01

    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…

  19. Research in child and adolescent psychiatry in India

    OpenAIRE

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

    2010-01-01

    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.

  20. Therapeutic Uses of the WebCam in Child Psychiatry

    Science.gov (United States)

    Chlebowski, Susan; Fremont, Wanda

    2011-01-01

    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…

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

    Science.gov (United States)

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

    2011-01-01

    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…

  2. Evaluation of Professional Role Competency during Psychiatry Residency

    Science.gov (United States)

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

    2012-01-01

    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…

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

    Science.gov (United States)

    Rait, Douglas Samuel

    2012-01-01

    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…

  4. Evolutionary Psychiatry and Nosology: Prospects and Limitations

    Directory of Open Access Journals (Sweden)

    Luc Faucher

    2012-11-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Singh Ajai

    2009-01-01

    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

    International Nuclear Information System (INIS)

    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

    OpenAIRE

    Kennedy, Robert S.

    1999-01-01

    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. Factors associated with hospital admissions and repeat emergency department visits for adults with asthma

    OpenAIRE

    Adams, R; B. Smith; Ruffin, R

    2000-01-01

    BACKGROUND—A small proportion of patients with asthma account for a disproportionate number of acute health service events. To identify whether factors other than severity and low socioeconomic status were associated with this disproportionate use, a prospective study was undertaken to examine management and psychosocial factors associated with increased risk for admission to hospital with asthma and repeat visits to the emergency department over a 12month period.
METHODS...

  9. Some origins of cross-cultural psychiatry.

    Science.gov (United States)

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

    2005-06-01

    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

  10. What kind of science for psychiatry?

    Directory of Open Access Journals (Sweden)

    Laurence J Kirmayer

    2014-06-01

    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.

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

    Science.gov (United States)

    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.

    2012-01-01

    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. Screening for alcohol and drug use disorders among adults in primary care: a review

    Directory of Open Access Journals (Sweden)

    Pilowsky DJ

    2012-04-01

    Full Text Available Daniel J Pilowsky1, Li-Tzy Wu21Departments of Epidemiology and Psychiatry, Columbia University, and the New York State Psychiatric Institute, New York City, NY, 2Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USABackground: The Patient Protection and Affordable Care Act of 2010 supports integration of substance abuse interventions and treatments into the mainstream health care system. Thus, effective screening and intervention for substance use disorders in health care settings is a priority.Objective: This paper reviews the prevalence of alcohol and drug use disorders (abuse or dependence in primary care settings and emergency departments, as well as current screening tools and brief interventions.Methods: MEDLINE was searched using the following keywords: alcohol use, alcohol use disorder, drug use, drug use disorder, screening, primary care, and emergency departments. Using the related-articles link, additional articles were screened for inclusion. This review focuses on alcohol and drug use and related disorders among adults in primary care settings.Conclusion: Screening, brief intervention, and referral for treatment are feasible and effective in primary care settings, provided that funding for screening is available, along with brief interventions and treatment facilities to which patients can be referred and treated promptly.Keywords: brief intervention, emergency departments

  13. Characteristics of Older Adults Admitted to Hospital versus Those Discharged Home, in Emergency Department Patients Referred to Internal Medicine

    Science.gov (United States)

    Hominick, Kathryn; McLeod, Victoria; Rockwood, Kenneth

    2016-01-01

    Background Frail older adults present to the Emergency Department (ED) with complex medical, functional, and social needs. When these needs can be addressed promptly, discharge is possible, and when they cannot, hospital admission is required. We evaluated the care needs of frail older adults in the ED who were consulted to internal medicine and seen by a geriatrician to determine, under current practices, which factors were associated with hospitalization and which allowed discharge. Methods We preformed a chart-based, exploratory study. Data were abstracted from consultation records and ED charts. All cases had a standard Comprehensive Geriatric Assessment (CGA which records a Clinical Frailty Scale (CFA) and allows calculation of a Frailty Index (FI). Results Of 100 consecutive patients, 2 died in the ED, 75 were admitted, and 23 were discharged, including one urgent placement. Compared with discharged patients (0.39 ± SD 0.16), those admitted had a higher mean FI-CGA (0.48 ± 0.13; p < .01). Greater mobility dependence (2% in discharged vs. 32% in admitted; p < .05) was notable. Conclusions Discharge decisions require assessment of medical, functional, and social problems. Ill, frail patients often can be discharged home when social and nursing support can be provided. The degree of frailty, impaired mobility, and likely delirium must be taken into account when planning for their care. PMID:27076860

  14. How new is the new philosophy of psychiatry?

    Directory of Open Access Journals (Sweden)

    Denys Damiaan

    2007-10-01

    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”.

  15. The HIV-Infected Adult Patient In The Emergency Department, The Changing Landscape Of Disease.

    Science.gov (United States)

    Gutteridge, David L; Egan, Daniel J

    2016-02-01

    The care of the HIV-infected patient in the emergency department has changed since the development of highly active antiretroviral therapy. This therapy has resulted in longer life expectancies and increased quality of life for HIV-infected patients, and in cases of treatment compliance and success, virtual elimination of AIDS-associated opportunistic infections. As a result, the emergency clinician is now more often confronted with adverse events related to medication and the diseases associated with aging and chronic disease. This issue focuses on the differences in evaluation of HIV patients on long-term therapy and patients with medication noncompliance and low CD4 counts, as well as recognition of life-threatening and rare opportunistic infections. Disease processes related to the effect of longstanding HIV infection, even with good control, on many organ systems are addressed. PMID:26760316

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

    Science.gov (United States)

    de Menezes, Mardônio Parente; Yasui, Silvio

    2013-06-01

    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

  17. Polish psychiatry in the wake of social changes.

    Science.gov (United States)

    Herczyńska, Grazyna

    2003-06-01

    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

  18. The influence of childhood abuse, adult life events, and affective temperaments on the well-being of the general, nonclinical adult population

    OpenAIRE

    Kanai Y.; Takaesu Y; Nakai Y; Ichiki M; Sato M.; Matsumoto Y; Ishikawa J; Ono Y; Murakoshi A; Tanabe H; Kusumi I; Inoue T.

    2016-01-01

    Yoshiaki Kanai,1,2 Yoshikazu Takaesu,1 Yukiei Nakai,3 Masahiko Ichiki,1 Mitsuhiko Sato,1 Yasunori Matsumoto,1 Jun Ishikawa,1 Yasuyuki Ono,1 Akiko Murakoshi,1 Hajime Tanabe,4 Ichiro Kusumi,3 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, 2Department of Palliative Medicine, The University of Tokyo Hospital, Tokyo, 3Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, 4Department of Clinical Human Sciences, Graduate School of Humanities and So...

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

    Science.gov (United States)

    Schäfer, Armin

    2016-09-01

    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

  20. Descartes' dogma and damage to Western psychiatry.

    Science.gov (United States)

    Ventriglio, A; Bhugra, D

    2015-10-01

    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

  1. Antioxidant Vitamins and Their Use in Psychiatry

    Directory of Open Access Journals (Sweden)

    Betul Mazlum

    2012-12-01

    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.

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

    Science.gov (United States)

    Giberti, F; Corsini, G; Rovida, S

    1994-06-01

    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

    OpenAIRE

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

    2015-01-01

    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

    OpenAIRE

    Ana Neto; Teresa Maia; Pilar Santos Pinto

    2015-01-01

    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*

    OpenAIRE

    Ajita Nayak

    2015-01-01

    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. The police, social services and psychiatry cooperation in Denmark—A new model of working practice between governmental sectors. A description of the concept, process, practice and experience

    DEFF Research Database (Denmark)

    Sestoft, Dorthe; Rasmussen, Mikael Flemming; Vitus, Kathrine;

    2014-01-01

    In 2004 a new model of working practice between three public sectors, the local Police Department, Social Services and Psychiatry/Mental Health Services (PSP) was introduced in the municipality of Frederiksberg, Denmark. The aim of this cooperation was to enhance support to vulnerable citizens, w...

  7. [Use of informatics technology in psychiatry].

    Science.gov (United States)

    Margariti, M; Papadimitriou, G N

    2012-01-01

    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

  8. Brain SPECT in psychiatry: Delusion or reality?

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    Healey, Dan

    2014-01-01

    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

  10. Prevalence of Exposure to Risk Factors for Violence among Young Adults Seen in an Inner-City Emergency Department

    Directory of Open Access Journals (Sweden)

    Abigail Hankin

    2013-08-01

    Full Text Available Introduction: To assess the prevalence of risk factors for violent injury among young adults treated at an urban emergency department (ED.Methods: This study is a cross-sectional analysis of data collected as part of a longitudinal study. Enrollment took place in an urban ED in a Level 1 trauma center, June through December 2010. All patients aged 18–24 years were eligible. Patients were excluded if they were incarcerated, critically ill, or unable to read English. Study participants completed a 10-minute multiple-choice questionnaire using previously validated scales: a aggression, b perceived likelihood of violence, c recent violent behavior, d peer behavior, and e community exposure to violence.Results: 403 eligible patients were approached, of whom 365 (90.1% consented to participate. Average age was 21.1 (95% confidence interval: 20.9, 21.3 years, and participants were 57.2% female, 85.7% African American, and 82.2% were educated at the high school level or beyond. Among study participants, rates of high-risk exposure to individual risk factors ranged from 7.4% (recent violent behavior to 24.5% (exposure to community violence, with 32.3% of patients showing high exposure to at least one risk factor. When comparing participants by ethnicity, no significant differences were found between White, African-American, and Hispanic participants. Males and females differed significantly only on 1 of the scales – community violence, (20.4% of males vs. 30.3% of females, p¼0.03. Selfreported hostile/aggressive feelings were independently associated with initial presentation for injury associated complaint after controlling for age, sex, and race (odds ratio 3.48 (1.49-8.13.Conclusion: Over 30% of young adults presenting to an urban ED reported high exposure to risk factors for violent injury. The high prevalence of these risk factors among ED patients highlights the potential benefit of a survey instrument to identify youth who might benefit from

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

    Science.gov (United States)

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

    2016-06-01

    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

  12. Cyclical swings: The bête noire of psychiatry.

    Science.gov (United States)

    Decker, Hannah S

    2016-02-01

    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

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

    OpenAIRE

    Belzen, J.A.

    1996-01-01

    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...

  14. PET application in psychiatry and psychopharmacology

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-07-01

    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

  15. Haematological toxicity of drugs used in psychiatry.

    Science.gov (United States)

    Flanagan, Robert J; Dunk, Louisa

    2008-01-01

    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

  16. Conceptualizing the forensic psychiatry report as performative narrative.

    Science.gov (United States)

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

    2010-01-01

    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

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

    Science.gov (United States)

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

    2015-01-01

    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

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

    Science.gov (United States)

    Adamowski, Tomasz; Frydecka, Dorota; Kiejna, Andrzej

    2007-01-01

    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

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

    Science.gov (United States)

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

    2005-01-01

    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…

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

    Science.gov (United States)

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

    2015-12-01

    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

  1. Psychiatry in 21 st century: The road ahead

    Directory of Open Access Journals (Sweden)

    Sayantanava Mitra

    2014-01-01

    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.

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

    Science.gov (United States)

    Mahone, S

    2006-08-01

    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

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

    Science.gov (United States)

    Griffith, Ezra E H; Baranoski, Madelon V

    2007-01-01

    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

  4. Maurycy Urstein: forgotten Polish contributor to German psychiatry

    Directory of Open Access Journals (Sweden)

    Marcinowski, Filip

    2014-02-01

    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.

  5. Symptoms of Poststroke Depression among Stroke Survivors: An Appraisal of Psychiatry Needs and Care during Physiotherapy Rehabilitation

    Science.gov (United States)

    Ibeneme, Sam Chidi; Anyachukwu, Canice Chukwudi; Nwosu, Akachukwu; Ibeneme, Georgian Chiaka; Bakare, Muideen; Fortwengel, Gerhard

    2016-01-01

    Purpose. To identify stroke survivors with symptoms of poststroke depression and the extent of psychiatry needs and care they have received while on physiotherapy rehabilitation. Participants. Fifty stroke survivors (22 females and 28 males) at the outpatient unit of Physiotherapy Department, University of Nigeria Teaching Hospital, Enugu, who gave their informed consent, were randomly selected. Their age range and mean age were 26–66 years and 54.76 ± 8.79 years, respectively. Method. A multiple case study of 50 stroke survivors for symptoms of poststroke depression was done with Beck's Depression Inventory, mini mental status examination tool, and Modified Motor Assessment Scale. The tests were performed independently by the participants except otherwise stated and scored on a scale of 0–6. Data were analyzed using Z-test for proportional significance and chi-square test for determining relationship between variables, at p < 0.05. Results. Twenty-one (42.0%) stroke survivors had symptoms of PSD, which was significantly dependent on duration of stroke (χ2 = 21.680, df = 6, and p = 0.001), yet none of the participants had a psychiatry review. Conclusions. Symptoms of PSD may be common in cold compared to new cases of stroke and may need psychiatry care while on physiotherapy rehabilitation.

  6. Consulting Psychiatry within an Integrated Primary Care Model

    OpenAIRE

    Schreiter, Elizabeth A. Zeidler; Pandhi, Nancy; Fondow, Meghan D. M.; Thomas, Chantelle; Vonk, Jantina; Reardon, Claudia L; Serrano, Neftali

    2013-01-01

    After implementation of an integrated consulting psychiatry model and psychology services within primary care at a federally qualified health center, patients have increased access to needed mental health services, and primary care clinicians receive the support and collaboration needed to meet the psychiatric needs of the population.

  7. Psychiatry Trainees' Training and Experience in Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Eyal, Roy; O'Connor, Mary J.

    2011-01-01

    Background/Objective: Alcohol is a teratogen. Fetal alcohol spectrum disorders (FASDs) affect about 1% of live births, causing severe impairment. Individuals affected by FASDs are overrepresented in psychiatric settings. This study reports on the education and experience of psychiatry trainees in approaching FASDs. Method: Data were collected from…

  8. Implementing Interpersonal Psychotherapy in a Psychiatry Residency Training Program

    Science.gov (United States)

    Lichtmacher, Jonathan; Eisendrath, Stuart J.; Haller, Ellen

    2006-01-01

    Objective: Interpersonal psychotherapy (IPT) for depression is a brief, well researched treatment for acute major depression. This article describes the implementation of IPT as an evidence-based treatment for depression in a psychiatry residency program. Method: The authors tracked the implementation process over 5 years as interpersonal…

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

    Science.gov (United States)

    Jellinek, Michael S.

    2007-01-01

    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…

  10. Education and Training in Psychiatry in the U.K.

    Science.gov (United States)

    Carney, Stuart; Bhugra, Dinesh K.

    2013-01-01

    Background/Objective: Recent training and education changes have raised important issues in delivery of psychiatric education at all levels. In this article, the authors describe the current status of mental health education in the training of all doctors and postgraduate training and education in psychiatry in the U.K. Method: The authors explore…

  11. Postgraduate training in psychiatry in India with focus on mumbai.

    Science.gov (United States)

    Patel, Ramesh R

    2015-01-01

    The present article traces the formation of the Indian Psychiatric Society and the progress of post-graduate training in psychiatry in India in general and Mumbai in particular. It covers the standard of psychiatric education, the goals and recommendations for improvisation of residency programmes, and the future of post-graduate psychiatric training. PMID:25838723

  12. Emergency Psychiatry and the Family: The Decision to Admit.

    Science.gov (United States)

    Perlmutter, Richard A.

    1986-01-01

    Awareness of interpersonal forces upon mental health clinicians is crucial to allow mature balancing of the many factors involved in the decision-making process. An integration of family and systems thinking into the practice of emergency psychiatry can enhance comfort and effectiveness in many difficult crisis situations. (Author/BL)

  13. Reduced brain resting-state network specificity in infants compared with adults

    Directory of Open Access Journals (Sweden)

    Wylie KP

    2014-07-01

    Full Text Available Korey P Wylie,1,* Donald C Rojas,1,* Randal G Ross,1 Sharon K Hunter,1 Keeran Maharajh,1 Marc-Andre Cornier,2 Jason R Tregellas1,3 1Department of Psychiatry, 2Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; 3Denver Veterans Affairs Medical Center, Denver, CO, USA *These authors contributed equally to this work Purpose: Infant resting-state networks do not exhibit the same connectivity patterns as those of young children and adults. Current theories of brain development emphasize developmental progression in regional and network specialization. We compared infant and adult functional connectivity, predicting that infants would exhibit less regional specificity and greater internetwork communication compared with adults.Patients and methods: Functional magnetic resonance imaging at rest was acquired in 12 healthy, term infants and 17 adults. Resting-state networks were extracted, using independent components analysis, and the resulting components were then compared between the adult and infant groups.Results: Adults exhibited stronger connectivity in the posterior cingulate cortex node of the default mode network, but infants had higher connectivity in medial prefrontal cortex/anterior cingulate cortex than adults. Adult connectivity was typically higher than infant connectivity within structures previously associated with the various networks, whereas infant connectivity was frequently higher outside of these structures. Internetwork communication was significantly higher in infants than in adults.Conclusion: We interpret these findings as consistent with evidence suggesting that resting-state network development is associated with increasing spatial specificity, possibly reflecting the corresponding functional specialization of regions and their interconnections through experience. Keywords: functional connectivity magnetic resonance imaging

  14. Advances and perspectives in mental health: is psychiatry being stigmatized?

    Science.gov (United States)

    Montenegro, R

    2011-01-01

    The specialty of Psychiatry and the interdisciplinary work performed by psychiatrists in conjunction with other scientific and humanistic disciplines is being affected by some facts which lead to its stigmatization. There are both internal and external risks that are affecting the profession. Among the internal ones we may mention the different diagnostic criteria used by psychiatrists and the differences between treatments--as there is a wide variety of treatment options. Besides, the practice of psychiatry may differ enormously, according to the perspective--biological, psychological, social, cultural, and so on--of each psychiatrist. The internal inconsistencies give rise to some of the external risks psychiatry and psychiatrists have to face: patients' discontent or even mistrust, the intrusion of other professions in the field of psychiatry and the negative image psychiatry has among the public. Just as it occurred in many other places before, the passing of a new mental health law in Argentina has proved to be an occasion for deep debate. The passing of this law has caused big controversy, especially among professional associations, private mental health services, NGOs which represent users and their families, trade unions which represent health workers, political and economic decision makers, etc. In Argentina, the debate of ideas has always been rich. Even when political parties were forbidden, there were discussions taking place among groups which supported psychoanalytic and psychodynamic approaches. There are many who demonize the developments made in the field of psychiatry and they also campaign against such developments. They catch the public's attention and they convince legislators, thus spreading the idea that psychiatry may be dangerous. As a consequence, for example, the new law gives similar status to psychiatrists and psychologists when it states that the decision to confine a patient into hospital "should be signed by two professionals, one of

  15. The molecular turn in psychiatry: a philosophical analysis.

    Science.gov (United States)

    Rudnick, Abraham

    2002-06-01

    Biological psychiatry has been dominated by a psychopharmacologically-driven neurotransmitter dysfunction paradigm. The objective of this paper is to explore a reductionist assumption underlying this paradigm, and to suggest an improvement on it. The methods used are conceptual analysis with a comparative approach, particularly using illustrations from the history of both biological psychiatry and molecular biology. The results are that complete reduction to physicochemical explanations is not fruitful, at least in the initial stages of research in the medical and life sciences, and that an appropriate (non-reducible) integrative principle--addressing a property of the whole system under study--is required for each domain of research. This is illustrated in Pauling's use of a topological integrative principle for the discovery of the functioning of proteins and in Watson and Crick's use of the notion of a genetic code as an integrative principle for the discovery of the structure of genes. The neurotransmitter dysfunction paradigm addresses single molecules and their neural pathways, yet their interactions within the CNS as a whole seem most pertinent to mental disorders such as schizophrenia. The lack within biological psychiatry of an integrative principle addressing a property of the CNS as a whole may be responsible for the empirical failure of orthomolecular psychiatry, as well as for the central role that serendipity has played in the study of mental disorders, which is dominated by the neurotransmitter paradigm. The conclusion is that research in biological psychiatry may benefit from using, at least initially, some integrative principle(s) addressing a property of the CNS as a whole, such as connectionism or a hierarchical notion. PMID:12187435

  16. Students' Perceptions of Questioning Strategies in an Adult EFL Classroom in the English Department at the College of Basic Education in Kuwait

    OpenAIRE

    Badria Al-Hajji; Hanan Taqi; Khaled Shuqair

    2014-01-01

    This aim of this paper is to study the students’ perceptions and evaluation of teacher questioning skills in adult EFL classrooms of the English Department, the College of Basic Education at the Public Authority of Applied Education in Kuwait.  For the purpose of the study, the following research questions were examined: (1)  What is the students’ perception of the levels and types of questions posed by the instructor? (2)   What is the students’ perception of the instructor’s attending behav...

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

    Science.gov (United States)

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

    2011-01-01

    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)…

  18. Can lab data be used to reduce abdominal computed tomography (CT) usage in young adults presenting to the emergency department with nontraumatic abdominal pain?

    Science.gov (United States)

    Scheinfeld, Meir H; Mahadevia, Soham; Stein, Evan G; Freeman, Katherine; Rozenblit, Alla M

    2010-09-01

    We sought to determine whether laboratory parameters could be found, predictive of a negative abdominal CT scan in young adults with nontraumatic abdominal pain. Following institutional review board approval, we evaluated CT reports of 522 patients, aged 21-35 years old, who presented to the Emergency Department with nontraumatic abdominal pain. Bivariate analyses relating ten laboratory parameters to whether the CT detected a cause for abdominal pain were conducted. A multivariate logistic regression model was then derived, with all variables in the final model significant at p meeting inclusion criteria, 45% had a cause for pain demonstrated by CT. Predictors of a negative CT in men were normal hematocrit and negative urine blood (p = 0.045, p = 0.016, respectively), and in women normal hematocrit, granulocyte percent, and alkaline phosphatase (p = 0.023, p = 0.039, p sufficient to offer reassurance that a CT is not necessary in a young adult patient with nontraumatic abdominal pain. Alternative strategies should be considered to decrease the use of CT, and its associated radiation exposure, in young adults with nontraumatic abdominal pain. PMID:20306104

  19. Serum 25-hydroxyvitamin D predicts cognitive performance in adults

    Directory of Open Access Journals (Sweden)

    Darwish H

    2015-08-01

    Full Text Available Hala Darwish,1 Pia Zeinoun,2 Husam Ghusn,3,4 Brigitte Khoury,2 Hani Tamim,5 Samia J Khoury6 1Hariri School of Nursing, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; 2Psychiatry Department, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; 3Internal Medicine Department, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; 4Geriatrics Department, Ain Wazein Hospital, El Chouf, Lebanon; 5Clinical Research Institute, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; 6Neurology Department, Faculty of Medicine, American University of Beirut, Beirut, Lebanon Background: Vitamin D is an endogenous hormone known to regulate calcium levels in the body and plays a role in cognitive performance. Studies have shown an association between vitamin D deficiency and cognitive impairment in older adults. Lebanon has a high 25-hydroxyvitamin D (25(OHD deficiency prevalence across all age groups. Methods: In this cross-sectional study, we explored the cognitive performance and serum 25(OHD levels using an electrochemoluminescent immunoassay in 254 older (>60 years as well as younger (30–60 years adults. Subjects’ characteristics, including age, years of education, wearing of veil, alcohol consumption, smoking, and physical exercise, were collected. Participants were screened for depression prior to cognitive screening using the Montreal Cognitive Assessment Arabic version. Visuospatial memory was tested using the Rey Complex Figure Test and Recognition Trial, and speed of processing was assessed using the Symbol Digit Modalities test. Results: Pearson’s correlation and stepwise linear regression analyses showed that a low vitamin D level was associated with greater risk of cognitive impairment in older as well as younger adults. Conclusion: These findings suggest that correction of vitamin D needs to be explored as an intervention to prevent cognitive impairment. Prospective

  20. Perceived barriers to mental health care and goal setting among depressed, community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Mark I Weinberger

    2009-05-01

    Full Text Available Mark I Weinberger1, Camila Mateo2, Jo Anne Sirey11Department of Psychiatry, Weill Cornell Medical College, White Plains, NY, USA; 2College of Public Health and Health Professions, University of Florida, Gainesville, FL, USAObjective: Older adults are particularly vulnerable to the deleterious effects of depression and tend to underutilize mental health services. The current study aims to characterize the perceived barriers to care and goal setting in a sample of depressed, community-dwelling older adults. Methods: We report on the association among perceived barriers to care, goal setting and accepting a mental health referral using a subset of data from a larger study. The Patient Health Questionnaire (PHQ-9 was used to assess depressive symptoms. Results: Forty-seven participants completed the study (Mean age = 82, SD = 7.8, 85% female. Accessing and paying for mental health treatment were the barriers most frequently cited by participants. Clinical improvement and improved socialization were most cited goals. In bivariate associations, participants who set goals (χ2 = 5.41, p = 0.02 and reported a logistic barrier (χ2 = 5.30, p = 0.02 were more likely to accept a mental health referral.Conclusion: Perceived barriers to care and goal setting appear to be central to accepting a mental health referral among community dwelling older, depressed adults. Developing interventions that can be used to increase mental health service utilization of older adults is necessary. Keywords: depression, older adults, community, perceived barriers to care

  1. Gender differences in the practice patterns of forensic psychiatry experts.

    Science.gov (United States)

    Price, Marilyn; Recupero, Patricia R; Strong, David R; Gutheil, Thomas G

    2004-01-01

    In the past 25 years, the number of female forensic psychiatrists has increased dramatically. To assess whether there are gender differences in the practice patterns of forensic psychiatry experts, members of the American Academy of Psychiatry and the Law were surveyed during an annual business meeting. Women in the sample were shown to perform fewer categories of evaluation than men. Women were less likely than men to do criminal work, civil commitment/involuntary medication evaluations, and testamentary capacity evaluations, but there was no significant difference in the percentage of those performing some personal injury/disability/fitness for duty, custody, sexual harassment, or malpractice evaluations. Gender was not a significant factor in determining hourly rate. When subjects were asked to comment on whether they thought that gender was a factor in the selection of a forensic expert, 80 percent of the women, but only 41 percent of the men, believed that gender was a consideration. PMID:15515912

  2. [Ambiguity in Eric Kandel's neuroscientific basis of psychiatry].

    Science.gov (United States)

    Glas, G

    2006-01-01

    The philosophical principles underlying the work of Eric Kandel are investigated on the basis of his innovative paper entitled 'A new intellectual framework for psychiatry' (Kandel 1998). A careful analysis of the concepts involved reveals some ambiguity in Kandel's proposition in the mind-body debate. On the one hand Kandel uses formulations that are compatible with (classical) psychophysical identity theories; on the other hand he expresses views that actually have more in common with non-eliminative physicalism (or epiphenomenalism). In addition, he weakens his position by using misleading metaphors an analogies. This can lead to what is known as the 'mereological fallacy'. The final part of the article examines what this ambiguity tells us about Kandel's views on psychotherapy and the social justification for psychiatry. Kandel's approach can lead to a pointless narrowing down of the psychiatrist's normative role and to an over-restrictive attitude to psychotherapy. PMID:17151995

  3. Commentary on "Conceptions of modern psychiatry": from attachment to intersubjectivity.

    Science.gov (United States)

    Allen, Jon G

    2012-01-01

    I am honored and humbled by the invitation to comment on the wisdom of a true giant in the history of psychiatry, Harry Stack Sullivan. Resonating with the prescience of his thought as any contemporary reader would, I am astonished by its pertinence to current concerns. Four domains of resonance strike me: the role of neurobiology in psychiatry, the social origins of mind in attachment relationships, the contribution of self-hate to suicide and, perhaps most important for clinicians, the intersubjective process of diagnostic understanding and treatment. As an expression of admiration for the timelessness of Sullivan's essay and appreciation for all we have learned from him, my comments merely explicate how some of his thoughts are playing out in contemporary theory and research. PMID:22397539

  4. A Thorn in the Flesh? Forensic Inpatients in General Psychiatry

    DEFF Research Database (Denmark)

    Møllerhøj, Jette; Stølan, Liv Os; Brandt-Christensen, Anne Mette

    2016-01-01

    provide sufficient mental health care. PRACTICE IMPLICATIONS: Nationwide training and teaching as well as knowledge exchange between specialized forensic psychiatry and general psychiatry are recommended. Further exploration is needed on patient perspectives and on avenues to increase efficiency and......, bottlenecks, poor information exchange, lack of knowledge and competences, complex psychopathology, and a vague and therefore uncomfortable task of nursing leads to a focus on criminal offenses rather than mental disorders and an increased risk of brutalization and stigmatization in nursing practices. Members...... of staff identify the care of mentally disordered offenders in general psychiatric units as either "a parking space" or a very difficult or frightening course, where staff members tend to behave like pleasers in order to avoid risks of conflict or physical violence. Either way, it seems hard to...

  5. [Definition of mental illness and discoursive strategies in psychiatry].

    Science.gov (United States)

    Hartman, J

    1998-01-01

    Defining mental illness was presented in the article both as a matter of medical knowledge and a political issue. This latter aspect cannot be successfully dealt with by psychiatry itself, since it is a branch of medicine, nevertheless bioethics offers here its competences and possibilities. The presentation of some elements of traditional strategies in defining mental illness introduces a draft of such a project of the definition procedure, which reinforces the constantly threatened (by the decrease of sovereignity) social and legal status of psychiatry, and--on the other hand--enables us to support the evidently handicapped status of psychiatric patients. This solitary definition strategy, which support both psychiatric circles and patients, assumes that a popular modern tendency to deny the very reality of the mental illness is to be avoided. The definition of mental illness proposed in the article is pragmatic in character and is based on a definition of mental illness as a kind of spiritual disorder. PMID:10816967

  6. ["I do the right thing only against payment": A critique of pay for performance in psychiatry].

    Science.gov (United States)

    Maio, G

    2015-11-01

    This paper takes a critical look at pay for performance (P4P) as a model for introducing new incentives in psychiatry. This model is to be seen as a tool of commercialism, and such a restructuring of psychiatry represents a wide-reaching political maneuver which actively introduces economical parameters into the field and will have a great impact on psychiatry. P4P starts with the false premise that medicine has to be structured like industry. This premise is false because psychiatry has to do with relationships to patients, and not with the production of a product. Therefore, it is essential to reflect critically upon the premises and consequences of P4P for psychiatry. Only this critical reflection can help psychiatry to keep its identity as a humane service for suffering people. PMID:26429196

  7. The neurology-psychiatry divide: a thought experiment

    OpenAIRE

    Reilly, Thomas

    2015-01-01

    Diseases of the brain are generally classified as either neurological or psychiatric. However, these two groups of illnesses cannot be readily separated on the basis of pathophysiology or symptomatology. It is difficult to rationally explain to someone with no prior frame of reference why we have the split between neurological and psychiatric illness. This demonstrates that the division is untenable, which has implications for training in both psychiatry and neurology.

  8. Maurycy Urstein: forgotten Polish contributor to German psychiatry

    OpenAIRE

    Marcinowski, Filip

    2014-01-01

    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 bi...

  9. Psychiatry Training in Canadian Family Medicine Residency Programs

    OpenAIRE

    Kates, Nick; Toews, John; Leichner, Pierre

    1985-01-01

    Family physicians may spend up to 50% of their time diagnosing and managing mental disorders and emotional problems, but this is not always reflected in the training they receive. This study of the teaching of psychiatry in the 16 family medicine residency programs in Canada showed that although the majority of program directors are reasonably satisfied with the current training, they see room for improvement—particularly in finding psychiatrists with a better understanding of family practice...

  10. The Impact of Psychiatric Patient Boarding in Emergency Departments

    Directory of Open Access Journals (Sweden)

    B. A. Nicks

    2012-01-01

    Full Text Available Objectives. Studies have demonstrated the adverse effects of emergency department (ED boarding. This study examines the impact of resource utilization, throughput, and financial impact for psychiatric patients awaiting inpatient placement. Methods. The authors retrospectively studied all psychiatric and non-psychiatric adult admissions in an Academic Medical Center ED (>68,000 adult visits from January 2007-2008. The main outcomes were ED length of stay (LOS and associated reimbursement. Results. 1,438 patients were consulted to psychiatry with 505 (35.1% requiring inpatient psychiatric care management. The mean psychiatric patient age was 42.5 years (SD 13.1 years, with 2.7 times more women than men. ED LOS was significantly longer for psychiatric admissions (1089 min, CI (1039–1140 versus 340 min, CI (304–375; <0.001 when compared to non-psychiatric admissions. The financial impact of psychiatric boarding accounted for a direct loss of ($1,198 compared to non-psychiatric admissions. Factoring the loss of bed turnover for waiting patients and opportunity cost due to loss of those patients, psychiatric patient boarding cost the department $2,264 per patient. Conclusions. Psychiatric patients awaiting inpatient placement remain in the ED 3.2 times longer than non-psychiatric patients, preventing 2.2 bed turnovers (additional patients per psychiatric patient, and decreasing financial revenue.

  11. European consensus statement on diagnosis and treatment of adult ADHD: the European Network adult ADHD

    LENUS (Irish Health Repository)

    Kooij, Sandra JJ

    2010-09-03

    Abstract Background Attention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persists into adulthood in the majority of cases. The evidence on persistence poses several difficulties for adult psychiatry considering the lack of expertise for diagnostic assessment, limited treatment options and patient facilities across Europe. Methods The European Network Adult ADHD, founded in 2003, aims to increase awareness of this disorder and improve knowledge and patient care for adults with ADHD across Europe. This Consensus Statement is one of the actions taken by the European Network Adult ADHD in order to support the clinician with research evidence and clinical experience from 18 European countries in which ADHD in adults is recognised and treated. Results Besides information on the genetics and neurobiology of ADHD, three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3) How should ADHD in adults be effectively treated? Conclusions ADHD often presents as an impairing lifelong condition in adults, yet it is currently underdiagnosed and treated in many European countries, leading to ineffective treatment and higher costs of illness. Expertise in diagnostic assessment and treatment of ADHD in adults must increase in psychiatry. Instruments for screening and diagnosis of ADHD in adults are available and appropriate treatments exist, although more research is needed in this age group.

  12. Level of training and experience in physicians performing interhospital transfers of adult patients in the internal medicine department

    DEFF Research Database (Denmark)

    Hallas, P; Folkestad, L; Brabrand, M

    2009-01-01

    offered by 24.0% of departments. When presented with cases of interhospital transfers of critically ill patients, 77.3% of the responders stated that their department would not follow guidelines when performing the transfer. CONCLUSIONS: The gap between recommended professional standards and current...... responded (response rate 94.4%). Of the 84 hospitals, 75 (89.3%) indicated that they perform interhospital transfers. Most transfers were performed by interns (61.3%) or senior house officers (10.7%) with only a few months' experience in their current speciality. Training in interhospital transfer was...

  13. Happiness and health in psychiatry: what are their implications?

    Directory of Open Access Journals (Sweden)

    Leonardo Machado

    2015-08-01

    Full Text Available Background Happiness is a lasting state and is associated with the absence of negative emotions, the presence of positive emotions, life satisfaction, social engagement and objectives in life. Researchers have demonstrated the benefits of happiness in many aspects of life, but few studies have been conducted within psychiatry.Objectives To develop a critical literature review of studies on happiness and health in order to bring some further and useful information to psychiatry updating the article “Happiness: a review” published in 2007 in Revista de Psiquiatria Clínica.Methods Computational searching was undertaken of digital data basis (PubMed and SciELO using the keywords “happiness” and “health”. One hundred twenty-seven papers published between 2004 and 2014 were found, but only 76 had the keywords in the title or abstract and with this were selected.Results Personality traits, such as self-direction; being married; being involved in physical and leisure activities; higher educational backgrounds and intelligence quotient; religiosity, volunteering and altruism; good physical and mental health; were positively related to happiness.Discussion Analysis of the concept of happiness and its associated emotions may be more complex than describing the symptoms of psychiatric disorders. Despite this, the study of happiness brings several positive implications for psychiatry.

  14. The Troubled History of Psychiatry's Quest for Specificity.

    Science.gov (United States)

    Horwitz, Allan V; Grob, Gerald N

    2016-08-01

    Over the course of the nineteenth century, medical disciplines replaced holistic conceptions of body and mind with specific diagnoses that were unrelated to the qualities and circumstances of the individuals who harbored them. Despite periodic attempts from the late nineteenth through the mid-twentieth centuries to implement diagnostic systems based on the principle of specificity, psychiatric diagnoses remained undifferentiated, overlapping, and capacious. The need for medical legitimacy, compatibility with a biomedical model, and conditions that third parties would reimburse led psychiatry to replace the psychodynamically oriented DSM-I and DSM-II with the radically empiricist DSM-III in 1980. This manual emphasized explicit measurement, symptom-based entities, and homogeneous categories that were compatible with the specific disorders embraced in the rest of medicine. Yet the diagnostic system that the DSM-III launched was incongruent with the underlying nature of the continuous, fluid, and intersecting conditions with which psychiatry deals. The widespread institutionalization of the specific diagnostic system in psychiatric practice, however, prevented any thoroughgoing revisions when the DSM-5 was published in 2013. The result is an impasse between psychiatry's classificatory system and the need for scientific progress in understanding the causes of and treatments for mental disorders. PMID:27127255

  15. Impact of clerkship in the attitudes toward psychiatry among Portuguese medical students

    OpenAIRE

    Almeida José C; Xavier Miguel

    2010-01-01

    Abstract Background Given the shortage of human resources and the launching of a new Mental Health Plan, recruitment of psychiatrists is currently a major concern in Portugal, as well as in several other countries. Medical students' attitude toward psychiatry has been pointed as a predictor of recruitment. This study aims to evaluate the medical students' perception of psychiatry before and after a clerkship, and the impact on their intention to pursue psychiatry as a future specialty option....

  16. The naturalization of psychiatry in Indonesia and its interaction with indigenous therapeutics

    OpenAIRE

    Nathan Porath

    2008-01-01

    Psychiatry developed as a modern branch of medical knowledge in Western societies and arrived in Southeast Asia in the late nineteenth century. Dutch colonialism brought psychiatry and psychology to the Dutch East Indies as part of the development of European therapeutics in that part of the empire. During the twentieth century, psychiatry was naturalized in Indonesia (and other Southeast Asian countries) and integrated into the national health care system. In the post-independence period, mo...

  17. Persian Translation of Perception of Psychiatry Survey Questionnaire and Evaluation of its Psychometric Properties

    OpenAIRE

    Valentin Artounian; Behnam Shariati; Homayoun Amini; Alireza Salimi; Ali-Akbar Nejatisafa

    2012-01-01

    Objective: Test the psychometric properties of the Persian version of the Perception of Psychiatry Survey questionnaire , which is being used in a large multi-site international study, of which we were part. This instrument was designed to measure the attitudes of medical educators to psychiatry.Methods: We used World Health Organization guideline as the methodological model for Persian translation. The Persian version of Perception of Psychiatry Survey questionnaire was administered to a con...

  18. The influence of childhood abuse, adult life events, and affective temperaments on the well-being of the general, nonclinical adult population

    Directory of Open Access Journals (Sweden)

    Kanai Y

    2016-04-01

    Full Text Available Yoshiaki Kanai,1,2 Yoshikazu Takaesu,1 Yukiei Nakai,3 Masahiko Ichiki,1 Mitsuhiko Sato,1 Yasunori Matsumoto,1 Jun Ishikawa,1 Yasuyuki Ono,1 Akiko Murakoshi,1 Hajime Tanabe,4 Ichiro Kusumi,3 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, 2Department of Palliative Medicine, The University of Tokyo Hospital, Tokyo, 3Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, 4Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan Background: Previous studies have shown the effects of childhood abuse, life events, and temperaments on well-being (positive affect and ill-being (negative affect. We hypothesized that childhood abuse, affective temperaments, and adult life events interact with one another and influence positive and negative affects in the general adult population and tested this hypothesis using structural equation modeling. Methods: A total of 415 participants from the general, nonclinical adult population were studied using the following self-administered questionnaires: the Subjective Well-Being Inventory (SUBI; Life Experiences Survey (LES; Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A; and the Child Abuse and Trauma Scale (CATS. The data were analyzed with single and multiple regression analyses and structural equation modeling (Mplus. Results: Childhood abuse indirectly predicted the worsening of positive and negative affects through cyclothymic, anxious, and irritable temperaments as measured by the TEMPS-A in the structural equation model. The cyclothymic, anxious, and irritable temperaments directly worsened the positive and negative affects and the negative appraisal of life events that occurred during the past year, while the hyperthymic temperament had the opposite effects. Limitations: The subjects of this study were nonclinical volunteers. The findings might not

  19. Working towards a new psychiatry - neuroscience, technology and the DSM-5

    OpenAIRE

    Alam Sabina; Patel Jigisha; Giordano James

    2012-01-01

    Abstract This Editorial introduces the thematic series on 'Toward a New Psychiatry: Philosophical and Ethical Issues in Classification, Diagnosis and Care' http://www.biomedcentral.com/series/newpsychiatry.

  20. Capillary refill time is a predictor of short-term mortality for adult patients admitted to a medical department

    DEFF Research Database (Denmark)

    Mrgan, Monija; Rytter, Dorte; Brabrand, Mikkel

    2014-01-01

    relationship between CRT (using two existing definitions and as a continuous variable) and short-term mortality. METHODS: We included all acutely admitted adult patients to a medical admission unit. We measured CRT, blood pressure, pulse, temperature and peripheral oxygen saturation. We presented the data...... descriptively. Difference between continuous data was analysed using Wilcoxon Rank Sum Test and categorical data using χ(2) test. The primary endpoint was 1-day all-cause mortality. RESULTS: 3046 patients were enrolled and CRT was measured on 1935. In univariate analyses, we found increasing all-cause 1-day...... mortality with all definitions of CRT. Performing multivariable analysis, controlling for age, sex, mean blood pressure, pulse, temperature and peripheral oxygen saturation, we found increasing CRT as a continuous variable and according to the Schriger and Baraff definition to be associated with increased...

  1. Problem-solving strategies in psychiatry: differences between experts and novices in diagnostic accuracy and reasoning

    Directory of Open Access Journals (Sweden)

    Gabriel A

    2013-01-01

    Full Text Available Adel Gabriel,1,2 Claudio Violato21Departments of Psychiatry, University of Calgary, Calgary; 2Medical Education, Community Health Sciences, University of Calgary Calgary, CanadaBackground: The purpose of this study was to examine and compare diagnostic success and its relationship with the diagnostic reasoning process between novices and experts in psychiatry.Methods: Nine volunteers, comprising five expert psychiatrists and four clinical clerks, completed a think-aloud protocol while attempting to make a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of a selected case with both Axis I and Axis III diagnoses.Results: Expert psychiatrists made significantly more successful diagnoses for both the primary psychiatric and medical diagnoses than clinical clerks. Expert psychiatrists also gave fewer differential options. Analyzing the think-aloud protocols, expert psychiatrists were much more organized, made fewer mistakes, and utilized significantly less time to access their knowledge than clinical clerks. Both novices and experts seemed to use the hypothetic-deductive and scheme-inductive approaches to diagnosis. However, experts utilized hypothetic-deductive approaches significantly more often than novices.Conclusion: The hypothetic-deductive diagnostic strategy was utilized more than the scheme-inductive approach by both expert psychiatrists and clinical clerks. However, a specific relationship between diagnostic reasoning and diagnostic success could not be identified in this small pilot study. The author recommends a larger study that would include a detailed analysis of the think-aloud protocols.Keywords: diagnostic reasoning, knowledge structure, psychiatric diagnosis, hypothetic-deductive, scheme-inductive

  2. Impact of clerkship in the attitudes toward psychiatry among Portuguese medical students

    Directory of Open Access Journals (Sweden)

    Almeida José C

    2010-08-01

    Full Text Available Abstract Background Given the shortage of human resources and the launching of a new Mental Health Plan, recruitment of psychiatrists is currently a major concern in Portugal, as well as in several other countries. Medical students' attitude toward psychiatry has been pointed as a predictor of recruitment. This study aims to evaluate the medical students' perception of psychiatry before and after a clerkship, and the impact on their intention to pursue psychiatry as a future specialty option. Methods Two self-report questionnaires were administered to all 6th year students in a medical school in Lisbon, before and after a 4-weeks full-time psychiatric clerkship, in order to evaluate attitudes toward psychiatry and intention to follow psychiatry in the future. Statistical analysis included Wilcoxon and Chi-square tests. Results 153 students (60.8% female filled in both questionnaires (no dropouts. After the clerkship, there was a significant improvement regarding the overall merits of psychiatry, efficacy, role definition and functioning of psychiatrists, use of legal powers to hospitalize patients and specific medical school factors. There was also a significant increase of students decided or considering the possibility to take a residency in psychiatry. However, perceptions of low prestige and negative pressure from family and peers regarding a future choice of psychiatry remained unchanged in about one-third of the students. Conclusions The results indicate clearly that the clerkship had a favorable overall impact on the student attitude towards psychiatry, as well as in the number of students considering a future career in psychiatry. Attitudes toward psychiatry seems a promising outcome indicator of the clerkship's quality, but further research is needed in order to assess its reliability as a sound predictor of recruitment.

  3. Prevalence and correlates of HIV risk among adolescents and young adults reporting drug use: Data from an urban Emergency Department in the U.S

    Science.gov (United States)

    Bonar, Erin E.; Whiteside, Lauren K.; Walton, Maureen A.; Zimmerman, Marc A.; Booth, Brenda M.; Blow, Frederic C.; Cunningham, Rebecca

    2014-01-01

    Adolescents and young adults who use substances are at particularly high risk for contracting Human Immunodeficiency Virus (HIV). The Emergency Department (ED) is a critical location for HIV prevention for at-risk youth. To inform future interventions in the ED, this study identifies correlates of HIV risk behaviors among substance using youth seeking ED care. Among 600 14-24-year-olds with past 6-month drug use, bivariate correlates of HIV risk included: older age, female gender, depressive symptoms, alcohol use, marijuana use, other drug use, and dating, peer, and community violence. Regression analyses indicated that older age, marijuana use, and dating violence were positively related to HIV risk. Results suggest HIV prevention efforts for youth in the urban ED should address marijuana use and dating violence as well as sexual risk behaviors. PMID:25126024

  4. Viral Respiratory Tract Infections in Adult Patients Attending Outpatient and Emergency Departments, Taiwan, 2012-2013: A PCR/Electrospray Ionization Mass Spectrometry Study.

    Science.gov (United States)

    Shih, Hsin-I; Wang, Hsuan-Chen; Su, Ih-Jen; Hsu, Hsiang-Chin; Wang, Jen-Ren; Sun, Hsiao Fang Sunny; Chou, Chien-Hsuan; Ko, Wen-Chien; Hsieh, Ming-I; Wu, Chi-Jung

    2015-09-01

    Viral etiologies of respiratory tract infections (RTIs) have been less studied in adult than in pediatric populations. Furthermore, the ability of PCR/electrospray ionization mass spectrometry (PCR/ESI-MS) to detect enteroviruses and rhinoviruses in respiratory samples has not been well evaluated. We sought to use PCR/ESI-MS to comprehensively investigate the viral epidemiology of adult RTIs, including testing for rhinoviruses and enteroviruses. Nasopharyngeal or throat swabs from 267 adults with acute RTIs (212 upper RTIs and 55 lower RTIs) who visited a local clinic or the outpatient or emergency departments of a medical center in Taiwan between October 2012 and June 2013 were tested for respiratory viruses by both virus isolation and PCR/ESI-MS. Throat swabs from 15 patients with bacterial infections and 27 individuals without active infections were included as control samples. Respiratory viruses were found in 23.6%, 47.2%, and 47.9% of the 267 cases by virus isolation, PCR/ESI-MS, and both methods, respectively. When both methods were used, the influenza A virus (24.3%) and rhinoviruses (9.4%) were the most frequently identified viruses, whereas human coronaviruses, human metapneumovirus (hMPV), enteroviruses, adenoviruses, respiratory syncytial virus, and parainfluenza viruses were identified in small proportions of cases (old age, and immunosuppression were independently associated with lower RTIs. In conclusion, PCR/ESI-MS improved the diagnostic yield for viral RTIs. Non-influenza respiratory virus infections were associated with patients with comorbidities and with lower RTIs. Additional studies that delineate the clinical need for including non-influenza respiratory viruses in the diagnostic work-up in these populations are warranted. PMID:26402811

  5. Empirical evidence on the use and effectiveness of telepsychiatry via videoconferencing: implications for forensic and correctional psychiatry.

    Science.gov (United States)

    Antonacci, Diana J; Bloch, Richard M; Saeed, Sy Atezaz; Yildirim, Yilmaz; Talley, Jessica

    2008-01-01

    A growing body of literature now suggests that use of telepsychiatry to provide mental health services has the potential to solve the workforce shortage problem that directly affects access to care, especially in remote and underserved areas. Live interactive two-way audio-video communication-videoconferencing-is the modality most applicable to psychiatry and has become synonymous with telepsychiatry involving patient care, distance education, and administration. This article reviews empirical evidence on the use and effectiveness of videoconferencing in providing diagnostic and treatment services in mental health settings that serve child, adolescent, and adult populations. Descriptive reports, case studies, research articles, and randomized controlled trials related to clinical outcomes were identified and reviewed independently by two authors. Articles related to cost-effectiveness, technological issues, or legal or ethical aspects of telepsychiatry were excluded. The review of the evidence broadly covers mental health service provision in all settings, including forensic settings. Given the sparse literature on telepsychiatry in forensic settings, we discuss implications for mental health care across settings and populations and comment on future directions and potential uses in forensic or correctional psychiatry. PMID:18548519

  6. Clinical Skills Verification in General Psychiatry: Recommendations of the ABPN Task Force on Rater Training

    Science.gov (United States)

    Jibson, Michael D.; Broquet, Karen E.; Anzia, Joan Meyer; Beresin, Eugene V.; Hunt, Jeffrey I.; Kaye, David; Rao, Nyapati Raghu; Rostain, Anthony Leon; Sexson, Sandra B.; Summers, Richard F.

    2012-01-01

    Objective: The American Board of Psychiatry and Neurology (ABPN) announced in 2007 that general psychiatry training programs must conduct Clinical Skills Verification (CSV), consisting of observed clinical interviews and case presentations during residency, as one requirement to establish graduates' eligibility to sit for the written certification…

  7. Integrating Neuroscience Knowledge and Neuropsychiatric Skills Into Psychiatry: The Way Forward.

    Science.gov (United States)

    Schildkrout, Barbara; Benjamin, Sheldon; Lauterbach, Margo D

    2016-05-01

    Increasing the integration of neuroscience knowledge and neuropsychiatric skills into general psychiatric practice would facilitate expanded approaches to diagnosis, formulation, and treatment while positioning practitioners to utilize findings from emerging brain research. There is growing consensus that the field of psychiatry would benefit from more familiarity with neuroscience and neuropsychiatry. Yet there remain numerous factors impeding the integration of these domains of knowledge into general psychiatry.The authors make recommendations to move the field forward, focusing on the need for advocacy by psychiatry and medical organizations and changes in psychiatry education at all levels. For individual psychiatrists, the recommendations target obstacles to attaining expanded neuroscience and neuropsychiatry education and barriers stemming from widely held, often unspoken beliefs. For the system of psychiatric care, recommendations address the conceptual and physical separation of psychiatry from medicine, overemphasis on the Diagnostic and Statistical Manual of Mental Disorders and on psychopharmacology, and different systems in medicine and psychiatry for handling reimbursement and patient records. For psychiatry residency training, recommendations focus on expanding neuroscience/neuropsychiatry faculty and integrating neuroscience education throughout the curriculum.Psychiatry traditionally concerns itself with helping individuals construct meaningful life narratives. Brain function is one of the fundamental determinants of individuality. It is now possible for psychiatrists to integrate knowledge of neuroscience into understanding the whole person by asking, What person has this brain? How does this brain make this person unique? How does this brain make this disorder unique? What treatment will help this disorder in this person with this brain? PMID:26630604

  8. Telemedicine for Peer-to-Peer Psychiatry Learning between U.K. and Somaliland Medical Students

    Science.gov (United States)

    Keynejad, Roxanne; Ali, Faisal R.; Finlayson, Alexander E. T.; Handuleh, Jibriil; Adam, Gudon; Bowen, Jordan S. T.; Leather, Andrew; Little, Simon J.; Whitwell, Susannah

    2013-01-01

    Objective: The proportion of U.K. medical students applying for psychiatry training continues to decline, whereas, in Somaliland, there are no public-sector psychiatrists. This pilot study assessed the usefulness and feasibility of online, instant messenger, peer-to-peer exchange for psychiatry education between cultures. Method: Twenty medical…

  9. Training Researchers in Cultural Psychiatry: The McGill-CIHR Strategic Training Program

    Science.gov (United States)

    Kirmayer, Laurence J.; Rousseau, Cecile; Corin, Ellen; Groleau, Danielle

    2008-01-01

    Objectives: The authors aim to summarize the pedagogical approaches and curriculum used in the training of researchers in cultural psychiatry at the Division of Social and Transcultural Psychiatry at McGill University. Method: We reviewed available published and unpublished reports on the history and development of the McGill cultural psychiatry…

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

    Science.gov (United States)

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

    2007-01-01

    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…

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

    Science.gov (United States)

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

    2013-01-01

    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'…

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

    Science.gov (United States)

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

    2008-01-01

    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…

  13. Assessment of Psychopharmacology on the American Board of Psychiatry and Neurology Examinations

    Science.gov (United States)

    Juul, Dorthea; Winstead, Daniel K.; Sheiber, Stephen C.

    2005-01-01

    OBJECTIVE: To report the assessment of psychopharmacology on the certification and recertification exams in general psychiatry and in the subspecialties administered by the American Board of Psychiatry and Neurology (ABPN). METHODS: The ABPN's core competencies for psychiatrists were reviewed. The number of items addressing psychopharmacology or…

  14. Challenges of creating synergy between global mental health and cultural psychiatry

    NARCIS (Netherlands)

    J.T.V.M. de Jong

    2014-01-01

    This article addresses four major challenges for efforts to create synergy between the global mental health movement and cultural psychiatry. First, although they appear to share domains of mutual interest, the worlds of global mental health and cultural psychiatry have distinct lineages. Expanding

  15. Audit of an inpatient liaison psychiatry consultation service.

    LENUS (Irish Health Repository)

    Lyne, John

    2012-02-01

    PURPOSE: The purpose of this paper is to examine an audit that was performed of all patients referred to a liaison psychiatry inpatient consultation service which sought to establish a baseline for demographics, type of referral, and management of referrals, with a view to introducing improved evidence-based treatments. It also aims to examine timeliness of response to referrals benchmarked against published standards. DESIGN\\/METHODOLOGY\\/APPROACH: All inpatient referrals to a liaison psychiatry service were recorded over a six-month period, including demographics, diagnosis, management and timeliness of response to referrals. The data were retrospectively analysed and compared against international standards. FINDINGS: A total of 172 referrals were received in the six months. Commonest referral reasons included assessments regarding depressive disorders (23.8 per cent), delirium\\/other cognitive disorders (19.2 per cent), alcohol-related disorders (18.6 per cent), anxiety disorders (14.5 per cent), and risk management (12.2 per cent). Evidence-based practices were not utilised effectively for a number of different types of presentations. A total of 40.1 per cent of referrals were seen on the same day, 75.4 per cent by the end of the next day, and 93.4 per cent by the end of the following day. PRACTICAL IMPLICATIONS: Use of a hospital protocol for management of delirium may improve outcomes for these patients. Evidence-based techniques, such as brief intervention therapies, may be beneficial for referrals involving alcohol dependence. Referrals were seen reasonably quickly, but there is room for improvement when compared with published standards. ORIGINALITY\\/VALUE: This paper provides valuable information for those involved in management of liaison psychiatry consultation services, providing ideas for development and implementation of evidence based practices.

  16. Assessment of an undergraduate psychiatry course in an African setting

    Directory of Open Access Journals (Sweden)

    Leuvennink Johan

    2008-04-01

    Full Text Available Abstract Background International reports recommend the improvement in the amount and quality of training for mental health workers in low and middle income countries. The Scotland-Malawi Mental Health Education Project (SMMHEP has been established to support the teaching of psychiatry to medical students in the University of Malawi. While anecdotally supportive medical educational initiatives appear of value, little quantitative evidence exists to demonstrate whether such initiatives can deliver comparable educational standards. This study aimed to assess the effectiveness of an undergraduate psychiatry course given by UK psychiatrists in Malawi by studying University of Malawi and Edinburgh University medical students' performance on an MCQ examination paper. Methods An undergraduate psychiatry course followed by an MCQ exam was delivered by the SMMHEP to 57 Malawi medical students. This same MCQ exam was given to 71 Edinburgh University medical students who subsequently sat their own Edinburgh University examination. Results There were no significant differences between Edinburgh students' performance on the Malawi exam and their own Edinburgh University exam. (p = 0.65. This would suggest that the Malawi exam is a comparable standard to the Edinburgh exam. Malawi students marks ranged from 52.4%–84.6%. Importantly 84.4% of Malawi students scored above 60% on their exam which would equate to a hypothetical pass by UK university standards. Conclusion The support of an undergraduate course in an African setting by high income country specialists can attain a high percentage pass rate by UK standards. Although didactic teaching has been surpassed by more novel educational methods, in resource poor countries it remains an effective and cost effective method of gaining an important educational standard.

  17. Neurology Didactic Curricula for Psychiatry Residents: A Review of the Literature and a Survey of Program Directors

    Science.gov (United States)

    Reardon, Claudia L.; Walaszek, Art

    2012-01-01

    Objective: Minimal literature exists on neurology didactic instruction offered to psychiatry residents, and there is no model neurology didactic curriculum offered for psychiatry residency programs. The authors sought to describe the current state of neurology didactic training in psychiatry residencies. Methods: The authors electronically…

  18. Nuclear death: an unprecedented challenge to psychiatry and religion

    International Nuclear Information System (INIS)

    The growing danger of a nuclear holocaust has intensified two aspects of the human predicament that concern both religion and psychiatry: the inevitability of death and the disastrous consequences of the characteristic termed pride by theologians and narcissism by psychiatrists. For the first time, humans have power to exterminate themselves and death threatens all ages equally. Pride of power causes leaders to exaggerate their ability to control nuclear weapons; moral pride leads to demonizing enemies. The author considers implications for psychiatrists and clergy, with special reference to preventing a nuclear holocaust

  19. [Consultation-liaison psychiatry: strategy for care, opportunity for training].

    Science.gov (United States)

    Gogliani, Andrea; Canuto, Alessandra; Zeppegno, Patrizia; Torre, Eugenio

    2014-02-12

    The liaison psychiatry defines itself as way to comprehend the psychological aspects in any situation of care, and in particular in the context of somatic care. The identification of the psychic processes, which can influence the diagnosis and the outcome of a somatic disease, is essential to adequately and globally take care of the individual. At the same time, training in the Help relationship allows to identify the difficulties of nursing, which is very often source of exhaustion and burn-out. PMID:24620465

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

    Science.gov (United States)

    Kalmár, Sándor

    2015-06-01

    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

  1. Mind-body and the future of psychiatry.

    Science.gov (United States)

    Wallace, E R

    1990-02-01

    Philosophical perspectives are deeply relevant to psychiatric theorization, investigation, and practice. There is no better instance of this than the perennially vexing mind-body problem. This essay eschews reductionist, dualist, and identity-theory attempts to resolve this problem, and offers an ontology--"monistic dual-aspect interactionism"--for the biopsychosocial model. The profound clinical, scientific, and moral consequences of positions on the mind-body relation are examined. I prescribe a radically biological cure for psychiatry's--and all medicine's--chronic dogmatism and fragmentation. PMID:2187043

  2. The phenomenological method in qualitative psychology and psychiatry

    Directory of Open Access Journals (Sweden)

    Magnus Englander

    2016-03-01

    Full Text Available This article will closely examine the phenomenological method as applied to qualitative inquiry in psychology and psychiatry. In a critical comparison between Amedeo Giorgi's and Larry Davidson's qualitatively methods, conclusions were drawn with regard to how different kinds of qualitative inquiry are possible while remaining faithful to Husserlian philosophical foundations. Utilizing Lester Embree's recent articulation of how Husserl's method of the epochē can be disclosed as specific to a discipline, varieties of these two qualitative methods were seen in their relation to the original scientific aim instigated by the developer.

  3. The phenomenological method in qualitative psychology and psychiatry

    Science.gov (United States)

    Englander, Magnus

    2016-01-01

    This article will closely examine the phenomenological method as applied to qualitative inquiry in psychology and psychiatry. In a critical comparison between Amedeo Giorgi's and Larry Davidson's qualitatively methods, conclusions were drawn with regard to how different kinds of qualitative inquiry are possible while remaining faithful to Husserlian philosophical foundations. Utilizing Lester Embree's recent articulation of how Husserl's method of the epochē can be disclosed as specific to a discipline, varieties of these two qualitative methods were seen in their relation to the original scientific aim instigated by the developer. PMID:26968361

  4. Nuclear death: an unprecedented challenge to psychiatry and religion

    Energy Technology Data Exchange (ETDEWEB)

    Frank, J.D.

    1984-11-01

    The growing danger of a nuclear holocaust has intensified two aspects of the human predicament that concern both religion and psychiatry: the inevitability of death and the disastrous consequences of the characteristic termed pride by theologians and narcissism by psychiatrists. For the first time, humans have power to exterminate themselves and death threatens all ages equally. Pride of power causes leaders to exaggerate their ability to control nuclear weapons; moral pride leads to demonizing enemies. The author considers implications for psychiatrists and clergy, with special reference to preventing a nuclear holocaust.

  5. Sturge–Weber syndrome: neurology-psychiatry interface

    OpenAIRE

    Gadit, Amin A Muhammad

    2011-01-01

    This is a case of a 22-year-old male who was born with a port-wine stain on right side of his face, developed seizures at the age of 2, was not able to complete formal education in a school. MRI revealed intracranial calcification and left-sided brain atrophy. He had diagnosis of Sturge–Weber syndrome. Since the time of adolescence, he developed psychiatric problems and hence was treated with psychotropic medications. This case remains under the domain of psychiatry as well as neurology and c...

  6. [Concepts of anthroposophic psychiatry and their contribution to understanding schizophrenia].

    Science.gov (United States)

    Andres, K

    1992-01-01

    A concept of central importance in alternative forms of psychiatry, namely the concept of the etheric body, is elaborated in reference to disturbed body sensations of schizophrenic patients. In the non-orthodox approach the etheric body, i.e. a spatial organisation of forces active in the organism that is perceived only under specific circumstances, is a mediating medium between body and soul. The concept of the etheric body proves to be associated with both, the still unsolved body-mind-problem and the problem of conceptualising psychic energy. Schizophrenia is interpreted as a disorder in which the connections between body, etheric body and mind have come loose. PMID:1287703

  7. Is mental disease just brain disease? The limits to biological psychiatry.

    Science.gov (United States)

    McLaren, N

    1992-06-01

    As a process of rational enquiry into an empirical field, psychiatry must submit itself to the same discipline as other areas of science. Effectively, it must show that its fundamental premises are both internally and externally consistent, and that its methods of investigation satisfy prevailing criteria of scientific methodology. When psychoanalytic psychology (and hence all psychodynamic models) and behaviourism were analysed from these points of view, they were found wanting. To date, there has been little or no meta-analysis of the third great school of psychiatric theorizing, biological psychiatry. A preliminary analysis establishes sharp limits to the notion that biological psychiatry is the "wave of the future". Like psychoanalysis and behaviourism, it cannot form the basis of a general theory of psychiatry. Since it lacks an adequate theoretical framework, the inescapable conclusion is that psychiatry is nothing more than protoscience. PMID:1642619

  8. Comments on "cyclical swings" by Professor Hannah Decker: The underappreciated "solid center" of psychiatry.

    Science.gov (United States)

    Pies, Ronald W

    2016-02-01

    The history of psychiatry is characterized by some deep ideological and conceptual divisions, as adumbrated in Professor Hannah Decker's essay. However, the schism between "biological" and "psychosocial" models of mental illness and its treatment represents extreme positions among some psychiatrists-not the model propounded by academic psychiatry or its affiliated professional organizations. Indeed, the "biopsycho-social model" (BPSM) developed by Dr. George L. Engel has been, and remains, the foundational model for academic psychiatry, notwithstanding malign market forces that have undermined the BPSM's use in clinical practice. The BPSM is integrally related to "centralizing" and integrative trends in American psychiatry that may be traced to Franz Alexander, Karl Jaspers, and Engel himself, among others. This "Alexandrian-Jaspersian-Engelian" tradition is explored in relation to Professor Decker's "cyclical swing" model of psychiatry's history. (PsycINFO Database Record PMID:26844653

  9. Experiences of health care transition voiced by young adults with type 1 diabetes: a qualitative study

    Directory of Open Access Journals (Sweden)

    Garvey KC

    2014-10-01

    Full Text Available Katharine C Garvey,1,5 Margaret G Beste,2 Donna Luff,3,5 Astrid Atakov-Castillo,2 Howard A Wolpert,2,5 Marilyn D Ritholz4–61Division of Endocrinology, Boston Children’s Hospital, Boston, MA, USA; 2Adult Section, Joslin Diabetes Center, Boston, MA, USA; 3Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, MA, USA; 4Behavioral and Mental Health Unit, Joslin Diabetes Center, Boston, MA, USA; 5Harvard Medical School, Boston, MA, USA; 6Department of Psychiatry, Boston Children's Hospital, Boston, MA, USAObjective: This qualitative study aimed to explore the experience of transition from pediatric to adult diabetes care reported by posttransition emerging adults with type 1 diabetes (T1D, with a focus on preparation for the actual transfer in care.Methods: Twenty-six T1D emerging adults (mean age 26.2±2.5 years receiving adult diabetes care at a single center participated in five focus groups stratified by two levels of current glycemic control. A multidisciplinary team coded transcripts and conducted thematic analysis.Results: Four key themes on the process of transfer to adult care emerged from a thematic analysis: 1 nonpurposeful transition (patients reported a lack of transition preparation by pediatric providers for the transfer to adult diabetes care; 2 vulnerability in the college years (patients conveyed periods of loss to follow-up during college and described health risks and diabetes management challenges specific to the college years that were inadequately addressed by pediatric or adult providers; 3 unexpected differences between pediatric and adult health care systems (patients were surprised by the different feel of adult diabetes care, especially with regards to an increased focus on diabetes complications; and 4 patients’ wish list for improving the transition process (patients recommended enhanced pediatric transition counseling, implementation of adult clinic orientation programs, and peer

  10. Nocturnal emergency department visits, duration of symptoms and risk of hospitalisation among adults with asthma exacerbations: a multicentre observational study

    Science.gov (United States)

    Yasuda, Hideto; Hagiwara, Yusuke; Watase, Hiroko; Hasegawa, Kohei

    2016-01-01

    Objectives We sought to compare the characteristics of patients with asthma presenting to the emergency department (ED) during the night-time with those of patients presenting at other times of the day, and to determine whether the time of ED presentation is associated with the risk of hospitalisation. Design and setting A multicentre chart review study of 23 EDs across Japan. Participants Patients aged 18–54 years with a history of physician-diagnosed asthma, presented to the ED between January 2009 and December 2011 Outcome measures The outcome of interest was hospitalisation, including admissions to an observation unit, inpatient unit and intensive care unit. Results Among the 1354 patients (30.1% in the night-time group vs 69.9% in the other time group) included in this study, the median age was 34 years and ∼40% were male. Overall 145 patients (10.7%) were hospitalised. Patients in the night-time group were more likely to have a shorter duration of symptoms (≤3 hours) before ED presentation than those in the other time group (25.9% in night-time vs 13.4% in other times; p0.05). Similarly, the risk of hospitalisation did not differ between the two groups (11.3% in night-time vs 10.5% in other times; p=0.65). In a multivariable model adjusting for potential confounders, the risk of hospitalisation in the night-time group was not statistically different from the other time group (OR, 1.10; 95% CI 0.74 to 1.61; p=0.63). Conclusions This multicentre study in Japan demonstrated no significant difference in the risk of hospitalisations according to the time of ED presentation. PMID:27519919

  11. Financial management challenges for general hospital psychiatry 2001.

    Science.gov (United States)

    Goldberg, R J

    2001-01-01

    Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need to develop new compensation models with more of an emphasis on revenue collection and overhead management. Programs which cannot master these areas are likely to go out of business. For academic programs, incentive systems must address not only clinical productivity, but academic and teaching output as well. General hospital programs will need to develop increased sophistication in differential cost accounting in order to be able to advocate for their patients and program in the current management climate. Clinical leaders will need the skills (ranging from actuarial to negotiations) to be at the table with contract development, since those decisions are inseparable from clinical care issues. Strategic planning needs to consider the value of improving integration with primary care, along with the ability to understand the advantages and disadvantages of risk-sharing models. Psychiatry leaders need to define and develop useful reports shared with clinical division leadership to track progress and identify problems and opportunities. Leaders should be responsible for a strategy for developing appropriate information system architecture and infrastructure. Finally, it is hoped that some leaders will emerge who can further our needs to address inequities in mental health fee schedules and parity issues which affect our program viability. PMID:11313073

  12. Jung, spirits and madness: lessons for cultural psychiatry.

    Science.gov (United States)

    Koss-Chioino, Joan D

    2003-06-01

    An understanding of the nature and meaning of 'dissociative,' 'altered' or unusual states ultimately turns on the meaning and definition of consciousness. The view of consciousness from the discipline of psychiatry is largely based on a biomedically endorsed, culturally specific perspective of 'normal' consciousness as an integrated pattern of quotidian relationships with the 'observable' physical world. This perspective underlies the nosology for mental disorders, particularly psychoses, suggesting irreconcilable difference in cognition and affect of persons with these diagnostic labels. This article reviews some theories of Carl Gustav Jung regarding the structure and content of human consciousness and their relationship to aspects of 'dementia praecox' or 'schizophrenia.' It traces the origin and development of these ideas in part to Jung's early contact with, and intense interest in spiritualists and spirits, to later influences comprised of his own altered states (dreams and fantasies) and his involvement with patients diagnosed as schizophrenic. Data on current Spiritist beliefs and healing practices focused on 'madness' (i.e. most often diagnosed as schizophrenia in mental health settings), are described to explore parallels with Jung's ideas on the structure and dynamics of the psyche. These parallels are of special interest because the experience of spirits is ubiquitous, not well explained and often rejected as meaningful by psychiatrists and clinical psychologists. Jung, however, offers a cogent explanation of spirit phenomena as manifestations of the unconscious. A concluding section suggests contributions to cultural psychiatry by Jung. PMID:12940643

  13. Text mining applications in psychiatry: a systematic literature review.

    Science.gov (United States)

    Abbe, Adeline; Grouin, Cyril; Zweigenbaum, Pierre; Falissard, Bruno

    2016-06-01

    The expansion of biomedical literature is creating the need for efficient tools to keep pace with increasing volumes of information. Text mining (TM) approaches are becoming essential to facilitate the automated extraction of useful biomedical information from unstructured text. We reviewed the applications of TM in psychiatry, and explored its advantages and limitations. A systematic review of the literature was carried out using the CINAHL, Medline, EMBASE, PsycINFO and Cochrane databases. In this review, 1103 papers were screened, and 38 were included as applications of TM in psychiatric research. Using TM and content analysis, we identified four major areas of application: (1) Psychopathology (i.e. observational studies focusing on mental illnesses) (2) the Patient perspective (i.e. patients' thoughts and opinions), (3) Medical records (i.e. safety issues, quality of care and description of treatments), and (4) Medical literature (i.e. identification of new scientific information in the literature). The information sources were qualitative studies, Internet postings, medical records and biomedical literature. Our work demonstrates that TM can contribute to complex research tasks in psychiatry. We discuss the benefits, limits, and further applications of this tool in the future. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26184780

  14. Locked doors in acute inpatient psychiatry: a literature review.

    Science.gov (United States)

    van der Merwe, M; Bowers, L; Jones, J; Simpson, A; Haglund, K

    2009-04-01

    Many acute inpatient psychiatric wards in the UK are permanently locked, although this is contrary to the current Mental Health Act Code of Practice. To conduct a literature review of empirical articles concerning locked doors in acute psychiatric inpatient wards, an extensive literature search was performed in SAGE Journals Online, EBM Reviews, British Nursing Index, CINAHL, EMBASE Psychiatry, International Bibliography of the Social Sciences, Ovid MEDLINE, PsycINFO and Google, using the search terms 'open$', 'close$', '$lock$', 'door', 'ward', 'hospital', 'psychiatr', 'mental health', 'inpatient' and 'asylum'. A total of 11 empirical papers were included in the review. Both staff and patients reported advantages (e.g. preventing illegal substances from entering the ward and preventing patients from absconding and harming themselves or others) and disadvantages (e.g. making patients feel depressed, confined and creating extra work for staff) regarding locked doors. Locked wards were associated with increased patient aggression, poorer satisfaction with treatment and more severe symptoms. The limited literature available showed the urgent need for research to determine the real effects of locked doors in inpatient psychiatry. PMID:19291159

  15. Therapeutic Misconception in Psychiatry Research: A Systematic Review.

    Science.gov (United States)

    Thong, Ivan Sk; Foo, Meng Yee; Sum, Min Yi; Capps, Benjamin; Lee, Tih-Shih; Ho, Calvin; Sim, Kang

    2016-02-29

    Therapeutic misconception (TM) denotes the phenomenon in which research subjects conflate research purpose, protocols and procedures with clinical treatment. We examined the prevalence, contributory factors, clinical associations, impact, and collated solutions on TM within psychiatric research, and made suggestions going ahead. Literature search for relevant empirical research papers was conducted until February 2015. Eighty-eight reports were extracted, of which 31 were selected, summarised into different headings for discussion of implications and collated solutions of TM. We found variable and high rates of TM (ranging from 12.5% to 86%) in some psychiatry research populations. Contributory factors to TM included perceived medical roles of researchers, media, research setting and subject factors. Greater TM in affective, neurodevelopmental and psychotic spectrum conditions were associated with demographic variables (such as lower education, increased age), clinical factors (such as poor insight, cognitive deficits, increased symptoms, poorer self-rated quality of health), and social functioning (such as decreased independence). Inattention to TM may lead to frustration, negative impression and abandonment of participation in psychiatry research. Strategies such as the employment of a neutral educator during the informed consent process and education modules may be effective in addressing TM. Further research is warranted to examine the different TM facets, specific clinical correlates and more effective management strategies. PMID:26792036

  16. Application of functional near-infrared spectroscopy in psychiatry.

    Science.gov (United States)

    Ehlis, Ann-Christine; Schneider, Sabrina; Dresler, Thomas; Fallgatter, Andreas J

    2014-01-15

    Two decades ago, the introduction of functional near-infrared spectroscopy (fNIRS) into the field of neuroscience created new opportunities for investigating neural processes within the human cerebral cortex. Since then, fNIRS has been increasingly used to conduct functional activation studies in different neuropsychiatric disorders, most prominently schizophrenic illnesses, affective disorders and developmental syndromes, such as attention-deficit/hyperactivity disorder as well as normal and pathological aging. This review article provides a comprehensive overview of state of the art fNIRS research in psychiatry covering a wide range of applications, including studies on the phenomenological characterization of psychiatric disorders, descriptions of life-time developmental aspects, treatment effects, and genetic influences on neuroimaging data. Finally, methodological shortcomings as well as current research perspectives and promising future applications of fNIRS in psychiatry are discussed. We conclude that fNIRS is a valid addition to the range of neuroscientific methods available to assess neural mechanisms underlying neuropsychiatric disorders. Future research should particularly focus on expanding the presently used activation paradigms and cortical regions of interest, while additionally fostering technical and methodological advances particularly concerning the identification and removal of extracranial influences on fNIRS data as well as systematic artifact correction. Eventually, fNIRS might be a useful tool in practical psychiatric settings involving both diagnostics and the complementary treatment of psychological disorders using, for example, neurofeedback applications. PMID:23578578

  17. The history of modern psychiatry in India, 1858-1947.

    Science.gov (United States)

    Mills, J

    2001-12-01

    This article presents an introduction to the history of Indian psychiatry. It suggests that this history can be divided into four main periods, 1795 to 1857, 1858 to 1914, 1914 to 1947 and 1947 to the present day. The focus of the piece is on the periods 1858-1914 and 1914-1947, as it traces the main trends and developments of the colonial era and argues that the foundations of modern psychiatry in India were laid down in the period of British rule. A brief consideration of the post-Independence period suggests that the patterns established in the years of British rule have continued to influence the psychiatric system of modern India. Research for these conclusions is based on extensive archival work in Indian mental health institutions and in Indian records offices, as well as work conducted at the National Library of Scotland in Edinburgh and at the India Office Library, the Wellcome Institute Library and the London School of Hygiene and Tropical Medicine. PMID:11951867

  18. Placebo eff ects in psychiatry: mediators and moderators.

    Science.gov (United States)

    Weimer, Katja; Colloca, Luana; Enck, Paul

    2015-03-01

    A strong placebo response in psychiatric disorders has been noted for the past 50 years and various attempts have been made to identify predictors of it, by use of meta-analyses of randomised controlled trials and laboratory studies. We reviewed 31 meta-analyses and systematic reviews of more than 500 randomised placebo-controlled trials across psychiatry (depression, schizophrenia, mania, attention-deficit hyperactivity disorder, autism, psychosis, binge-eating disorder, and addiction) for factors identified to be associated with increased placebo response. Of 20 factors discussed, only three were often linked to high placebo responses: low baseline severity of symptoms, more recent trials, and unbalanced randomisation (more patients randomly assigned to drug than placebo). Randomised controlled trials in non-drug therapy have not added further predictors, and laboratory studies with psychological, brain, and genetic approaches have not been successful in identifying predictors of placebo responses. This comprehensive Review suggests that predictors of the placebo response are still to be discovered, the response probably has more than one mediator, and that different and distinct moderators are probably what cause the placebo response within psychiatry and beyond. PMID:25815249

  19. [The role of psychiatry in the Brazilian psychiatric reform].

    Science.gov (United States)

    Serpa Junior, Octavio Domont de

    2011-12-01

    Psychiatry emerged just over two hundred years ago as a special branch of medicine offering institutional care for the insane, since it encompassed the fields of medicine, natural history (biology) and philosophy (humanities). It appeared at a time marked by the transition with the exclusion apparatus of the marginalized people of the Old Regime and by epistemic pluralism. In this article, the contribution that psychiatry can make today - just over two centuries and some important conceptual and institutional rearrangements later - is discussed. It is well established in the academic world and socially legitimized, albeit at another moment of transition, in which new paradigms of care are established placing importance on the contextual and intersubjective situation of psychic distress. Redefining Pinelian intuition using contemporary vocabulary regarding the epistemological and ethical challenge of an area of knowledge and practice of care the scope of which is psychic distress, the thesis will be proposed that it is also necessary to articulate the planes of body, experience and narrative in an ongoing dialogue. PMID:22124908

  20. Can Interoception Improve the Pragmatic Search for Biomarkers in Psychiatry?

    Science.gov (United States)

    Khalsa, Sahib S; Lapidus, Rachel C

    2016-01-01

    Disrupted interoception is a prominent feature of the diagnostic classification of several psychiatric disorders. However, progress in understanding the interoceptive basis of these disorders has been incremental, and the application of interoception in clinical treatment is currently limited to panic disorder. To examine the degree to which the scientific community has recognized interoception as a construct of interest, we identified and individually screened all articles published in the English language on interoception and associated root terms in Pubmed, Psychinfo, and ISI Web of Knowledge. This search revealed that interoception is a multifaceted process that is being increasingly studied within the fields of psychiatry, psychology, neuroscience, and biomedical science. To illustrate the multifaceted nature of interoception, we provide a focused review of one of the most commonly studied interoceptive channels, the cardiovascular system, and give a detailed comparison of the most popular methods used to study cardiac interoception. We subsequently review evidence of interoceptive dysfunction in panic disorder, depression, somatic symptom disorders, anorexia nervosa, and bulimia nervosa. For each disorder, we suggest how interoceptive predictions constructed by the brain may erroneously bias individuals to express key symptoms and behaviors, and outline questions that are suitable for the development of neuroscience-based mental health interventions. We conclude that interoception represents a viable avenue for clinical and translational research in psychiatry, with a well-established conceptual framework, a neural basis, measurable biomarkers, interdisciplinary appeal, and transdiagnostic targets for understanding and improving mental health outcomes. PMID:27504098

  1. Treatment of adult ADHD: Is current knowledge useful to clinicians?

    Directory of Open Access Journals (Sweden)

    Terje Torgersen

    2008-03-01

    Full Text Available Terje Torgersen1,2, Bjørn Gjervan1,3, Kirsten Rasmussen31Department of Psychiatry, Sykehuset Levanger, Helse Nord-Troendelag HF, Levanger, Norway; 2Faculty of Medicine and 3Department of Psychology, Norwegian University of Science and Technology, Trondheim, NorwayAbstract: Psychostimulant drugs have for decades been considered the cornerstone of ADHD treatment. Non-stimulant drugs have also been reported successful. However, many controlled studies exclude patients with comorbidities typical for patients seen in clinical setting. Many patients are also considered non-responders to medication. Current knowledge might not be directly useful to clinicians. The present article reviews the literature on pharmacological and psychotherapeutic treatment in adult ADHD emphasizing comorbidity and other clinically important factors, as well as ADHD specific outcomes. Thirty-three relevant studies of pharmacotherapy and three studies of psychotherapy were included. Most subjects had little current comorbidity, but some studies included subjects with substance use disorder. Significant effect of treatment on ADHD symptoms was found in most studies using pharmacotherapy and all studies of psychotherapy. Both positive and negative effects on comorbid anxiety and depression measures were reported. Pharmacotherapy did not seem to have effect on substance use disorder. Few pharmacotherapy studies conducted any long-term follow-up; two studies that did, found that most subjects had discontinued medication. A clear-cut dose-respons relationship was not substanciated. In conclusion, clinicians have good support for both pharmacological and psychotherapeutic treatment of ADHD in adults, but should take additional measures to deal with comorbidities as well as treatment adherence.Keywords: ADHD, adults, treatment, stimulants, psychotherapy, comorbidity

  2. A Nationwide Study of Attention-Deficit/Hyperactivity Disorder Drug Use among Adults in Iceland 2003-2012

    DEFF Research Database (Denmark)

    Geirs, D. P.; Pottegård, Anton; Halldorsson, M.;

    2014-01-01

    most pronounced increases among young adults (19-24years). The annual incidence increased 3 times, similarly among men and women. Extended-release methylphenidate formulations were the most commonly used ADHD drugs. Specialists in psychiatry initiated treatment in 79% of new adult ADHD drug users. The...

  3. Effects of cardiac resynchronization therapy on health-related quality of life in older adults with heart failure

    Directory of Open Access Journals (Sweden)

    Karin F Hoth

    2008-10-01

    Full Text Available Karin F Hoth1,2, Justin Nash3, Athena Poppas4, Kristin E Ellison4, Robert H Paul5, Ronald A Cohen31Division of Psychosocial Medicine, National Jewish Medical and Research Center, Denver, CO, USA; 2Department of Psychiatry, University of Colorado, Denver, CO, USA; 3Department of Psychiatry and Human Behavior; 4Department of Cardiology, Warren Alpert Medical School of Brown University, Providence, RI, USA; 5Department of Psychology, Division of Behavioral Neuroscience, University of Missouri St. Louis, St. Louis, MO, USAAbstract: The aim of the study was to examine changes in health-related quality of life among older adults undergoing cardiac resynchronization therapy (CRT, a pacemaker based intervention for heart failure. Twenty-one patients (mean age = 68; SD = 8 completed measures of cardiovascular health and quality of life prior to and 3-months post-CRT. Following the intervention, patients reported improvements in their perception of their physical functioning (t = 2.8, p < 0.01 and feelings of vitality (t = 2.9, p < 0.01 on the MOS SF-36 Health Survey. Patients improved on objective clinical measures of exercise capacity, cardiac ejection fraction, and ventricular dyssynchrony. Younger patients reported greater improvements in physical functioning and decreases in pain. Higher baseline body mass index was associated with less improvement in physical functioning. Finally, patients with nonischemic heart failure reported greater improvements on multiple subscales of the SF-36 than patients with ischemic heart failure. This preliminary study documented improvements in health-related quality of life following CRT. The findings highlight that specific patient characteristics may be associated with quality of life changes. Future studies will benefit from including quality of life measures that assess multiple health-related domains.Keywords: cardiac resynchronization therapy, heart failure, quality of life

  4. Medical students' views about an undergraduate curriculum in psychiatry before and after clinical placements

    Directory of Open Access Journals (Sweden)

    Oyebode Femi

    2008-04-01

    Full Text Available Abstract Background It has been suggested that medical students wish to focus their learning in psychiatry on general skills that are applicable to all doctors. This study seeks to establish what aspects of psychiatry students perceive to be relevant to their future careers and what psychiatric knowledge and skills they consider to be important. It is relevant to consider whether these expectations about learning needs vary prior to and post-placement in psychiatry. To what extent these opinions should influence curriculum development needs to be assessed. Methods A questionnaire was distributed to medical students before they commenced their psychiatry placement and after they had completed it. The questionnaire considered the relevance of psychiatry to their future careers, the relevance of particular knowledge and skills, the utility of knowledge of psychiatric specialties and the utility of different settings for learning psychiatry. Results The students felt skills relevant to all doctors, such as assessment of suicide risk, were more important than more specialist psychiatric skills, such as the management of schizophrenia. They felt that knowledge of how psychiatric illnesses present in general practice was important and it was a useful setting in which to learn psychiatry. They thought that conditions that are commonly seen in the general hospital are important and that liaison psychiatry was useful. Conclusion Two ways that medical students believe their teaching can be made more relevant to their future careers are highlighted in this study. Firstly, there is a need to focus on scenarios which students will commonly encounter in their initial years of employment. Secondly, psychiatry should be better integrated into the overall curriculum, with the opportunity for teaching in different settings. However, when developing curricula the need to listen to what students believe they should learn needs to be balanced against the necessity of

  5. Serum 25-hydroxyvitamin D predicts cognitive performance in adults

    OpenAIRE

    Darwish H; Zeinoun P; Ghusn H; Khoury B; Tamim H; Khoury SJ

    2015-01-01

    Hala Darwish,1 Pia Zeinoun,2 Husam Ghusn,3,4 Brigitte Khoury,2 Hani Tamim,5 Samia J Khoury6 1Hariri School of Nursing, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; 2Psychiatry Department, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; 3Internal Medicine Department, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; 4Geriatrics Department, Ain Wazein Hospital, El Chouf, Lebanon; 5Clinical Research Institute, Faculty of Medicine, ...

  6. Innovative methods in teaching psychiatry to medical students

    Directory of Open Access Journals (Sweden)

    Antonio Lobo

    2015-03-01

    Full Text Available 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 results of an intensive clerkship on bedside teaching are also studied. Trainee performance was assessed by the marks in the final examination, and a reliable and valid tool, the Medical Teaching Quality Questionnaire (MTQQ was used to document trainee satisfaction. The results of five academic courses are presented in this report. Results: External experts consulted assured that the content of the course was adequate. Eight hundred and thirty eight medical students have completed the learning course in the study period, and 418 (one of the two groups completed the evaluation with the MTQQ. Most items related to the students' satisfaction were rated “high” or “very high”, including the items asking about the usefulness of the course for physicians, the quality of the teaching methods and the bedside teaching. In relation to innovation, the discussion of clinical cases in small groups was also very satisfactory and the “enhancement of a researcher's mind” was rated “high” or “very high” by 1/3rd of medical students. The utility of the yearly evaluation of the quality of teaching methods was supported by results showing that items scored not favourably in the initial evaluation were considerably improved in the follow-up evaluations, when modifications in the method were introduced. Conclusions: Good performance and high satisfaction of medical students was documented in a course on general psychiatry. Lessons may be drawn to inform about

  7. The reception of Eugen Bleuler in British psychiatry, 1892-1954.

    LENUS (Irish Health Repository)

    Dalzell, Thomas

    2012-02-01

    This article draws on over 60 years of British medical journals and psychiatry textbooks to indicate the chronological stages of the reception of Eugen Bleuler in British psychiatry. Bleuler was already well known in Britain before his schizophrenia book appeared, with the journals containing numerous references, mainly positive, to his work. The psychiatry textbooks, however, were slower to integrate his contribution. This paper argues that this was not due to Bleuler\\'s placing Freud on a par with Kraepelin, but because of the early negative reaction to Kraepelin\\'s dementia praecox concept, despite Bleuler\\'s wider and less ominous conception of the illness.

  8. What attracts medical students towards psychiatry? A review of factors before and during medical school.

    Science.gov (United States)

    Farooq, Kitty; Lydall, Gregory J; Bhugra, Dinesh

    2013-08-01

    Potential psychiatrists decide on their careers before, during or after medical school. This article summarises the literature focusing on the first two groups. Pre-medical school factors associated with choosing psychiatry include gender, academic aptitude, ethnicity and migration, exposure to mental illness, economic considerations and medical school route and selection. Factors involved in influencing career choice at medical school level include attitudes towards psychiatry, teaching methods, quality and length of clinical exposure, electives and enrichment activities, and personality factors. Considering these factors may improve recruitment to psychiatry and address shortages in the speciality. PMID:24032490

  9. The naturalization of psychiatry in Indonesia and its interaction with indigenous therapeutics

    Directory of Open Access Journals (Sweden)

    Nathan Porath

    2008-12-01

    Full Text Available Psychiatry developed as a modern branch of medical knowledge in Western societies and arrived in Southeast Asia in the late nineteenth century. Dutch colonialism brought psychiatry and psychology to the Dutch East Indies as part of the development of European therapeutics in that part of the empire. During the twentieth century, psychiatry was naturalized in Indonesia (and other Southeast Asian countries and integrated into the national health care system. In the post-independence period, most Indonesian psychiatrists – there are currently about 450 – received training at Western universities and brought the knowledge of this subject back with them to their home country.

  10. Informed Consent at Gunpoint: When Psychiatry Affects Gun Ownership.

    Science.gov (United States)

    Candilis, Philip J; Khurana, Gagandeep; Leong, Gregory B; Weinstock, Robert

    2015-06-01

    As states take more steps to connect patients' gun ownership to their mental health, psychiatrists are being asked to provide mental health information after clinical interviews as well as after confiscation. This move into the patient-physician relationship raises new questions about how psychiatrists should obtain informed consent when interviews may result in reports to legal authorities. Consent warnings are already practiced more in the breach than in the observance and informed consent is imperfect at its best. In communities torn by controversies surrounding gun control, vehement political views will further influence these established themes to result in unprecedented pressures on patient confidentiality. This analysis draws on new movements in ethical theory and behavioral medicine that go beyond balancing principles to question the use of psychiatry in firearm reporting, and support a vigorous practice of informed consent to protect both individuals and the communities they live in. PMID:25640524

  11. Marginal revenue and length of stay in inpatient psychiatry.

    Science.gov (United States)

    Pletscher, Mark

    2016-09-01

    This study examines the changes in marginal revenue during psychiatric inpatient stays in a large Swiss psychiatric hospital after the introduction of a mixed reimbursement system with tariff rates that vary over length of stay. A discrete time duration model with a difference-in-difference specification and time-varying coefficients is estimated to assess variations in policy effects over length of stay. Among patients whose costs are fully reimbursed by the mixed scheme, the model demonstrates a significant effect of marginal revenue on length of stay. No significant policy effects are found among patients for whom only health insurance rates are delivered as mixed tariffs and government contributions are made retrospectively. The results indicate that marginal revenue can affect length of stay in inpatient psychiatry facilities, but that the reduction in marginal revenue must be sufficiently large. PMID:26445962

  12. The Potential Utility of Pharmacogenetic Testing in Psychiatry

    Directory of Open Access Journals (Sweden)

    Kathryn R. Gardner

    2014-01-01

    Full Text Available Over the last decade, pharmacogenetics has become increasingly significant to clinical practice. Psychiatric patients, in particular, may benefit from pharmacogenetic testing as many of the psychotropic medications prescribed in practice lead to varied response rates and a wide range of side effects. The use of pharmacogenetic testing can help tailor psychotropic treatment and inform personalized treatment plans with the highest likelihood of success. Recently, many studies have been published demonstrating improved patient outcomes and decreased healthcare costs for psychiatric patients who utilize genetic testing. This review will describe evidence supporting the clinical utility of genetic testing in psychiatry, present several case studies to demonstrate use in everyday practice, and explore current patient and clinician opinions of genetic testing.

  13. [Anankastic phenomena in psychiatry (predestination and dace in mental life)].

    Science.gov (United States)

    Rojas Malpica, Carlos Alberto

    2012-01-01

    The purpose of this communication is to compare behavioral mineralization occurring in mental illness to the freshness and plasticity behavior in health. The epistemological fundamentals of this paper include the theories of chaos and complexity of Edgar Morin, the concept of autopoiesis developed from the theory of systems, the latest discoveries on the neurobiology of consciousness and their associations with Darwinian psychiatry and also, following Lain Entralgo, recreating the Greek concept of ananke to describe the behavior fixation in an anachronistic place of the physis in mental illness. It provides some empirical evidence to support the proposal, and all this is rigorously examined with hermeneutic phenomenology and its theoretical possibilities. This leads to an epistemological rethinking of clinical and therapeutic proposal aimed at the subject and the recovery of his or her freedom. PMID:24294723

  14. [The frontiers of 'abnormality': psychiatry and social control].

    Science.gov (United States)

    Engel, M G

    1998-01-01

    The article examines some of the main aspects governing psychiatry's role in the Brazilian political and social context at the close of the nineteenth century and beginning of the twentieth. It analyzes certain themes - civilization, race, labor, fanaticism, political dissent, sexuality - that were emphasized by specialists in their construction of a very broad notion of 'mental illness'. Through the analysis of texts produced by psychiatrists and legal experts (including dissertations written at the Faculdade de Medicina do Rio de Janeiro, reports from the Serviço de Assistência a Alienados, and works and articles by specialists), the relation between the psychiatric definition of the frontiers of 'abnormality' and efforts to implement new strategies of social control is discussed. PMID:16676447

  15. Current research in transcultural psychiatry in the Nordic countries

    DEFF Research Database (Denmark)

    Ekblad, Solvig; Kastrup, Marianne Carisius

    2013-01-01

    , and after migration, with potential effects on their physical, mental, social, and spiritual health. Growing interest in transcultural issues is reflected in the level of scientific research and clinical activity in the field by Nordic physicians, psychologists, social scientists, demographers, medical......This article discusses major themes in recent transcultural psychiatric research in the Nordic countries from 2008 to 2011: (a) epidemiological studies of migration, (b) indigenous populations, and (c) quality of psychiatric care for migrants. Over the past several decades, the populations...... anthropologists, as well as other clinicians and policy planners. Research includes work with migrants and indigenous minorities in the Nordic countries, as well as comparisons with mental health in postconflict countries. We conclude by suggesting future directions for transcultural psychiatry research...

  16. Cross-Sector Problems of Collaboration in Psychiatry

    DEFF Research Database (Denmark)

    Mikkelsen, Elisabeth Naima; Petersen, Anne; Lyager Kaae, Anne Marie;

    2013-01-01

    community-based services. Results: Staff and management experiencing cross-sector problems of collaboration point to ineffective coordination of services between systems and lack of mutual understanding of how systems other than the staffs’ own systems work. Solutions include specific procedural changes......Introduction: Some mental health service users need support from both hospital-based and community-based services. Treatment requires well-functioning collaboration practices between different mental health organizations and professions. However, serious cross-sector problems of collaboration have...... during service users’ admission to and discharge from hospital and during hospitalization and measures to increase cross-sector know­ledge about each system’s practices and methods. Conclusion: Improvement of cross-sector collaboration in psychiatry should take the form of a multi-faceted approach...

  17. Globalization of psychiatry - a barrier to mental health development.

    Science.gov (United States)

    Fernando, Suman

    2014-10-01

    The concept of globalization has been applied recently to ways in which mental health may be developed in low- and middle-income countries (LMICs), sometimes referred to as the 'Third World' or developing countries. This paper (1) describes the roots of psychiatry in western culture and its current domination by pharmacological therapies; (2) considers the history of mental health in LMICs, focusing on many being essentially non-western in cultural background with a tradition of using a plurality of systems of care and help for mental health problems, including religious and indigenous systems of medicine; and (3) concludes that in a post-colonial world, mental health development in LMICs should not be left to market forces, which are inevitably manipulated by the interests of multinational corporations mostly located in ex-colonizing countries, especially the pharmaceutical companies. PMID:25343630

  18. Beyond categorical diagnostics in psychiatry: Scientific and medicolegal implications.

    Science.gov (United States)

    Anckarsäter, Henrik

    2010-01-01

    Conforming to a medical disease model rooted in phenomenology and natural science, psychiatry classifies mental disorders according to signs and symptoms considered to be stable and homogeneous across individuals. Scientific studies addressing the validity of this classification are scarce. Following a seminal paper by Robins and Guze in 1970, validity of categories has been sought in specific criteria referring to symptoms and prognosis, aggregation in families, and "markers", preferentially laboratory tests. There is, however, a growing misfit between the model and empirical findings from studies putting it to the test. Diagnostic categories have not been shown to represent natural groups delineated from the normal variation or from each other. Aetiological factors (genetic and/or environmental), laboratory aberrations, and treatment effects do not respect categorical boundaries. A more adequate description of mental problems may be achieved by: 1) a clear definition of the epistemological frame in which psychiatry operates, 2) a basic rating of the severity of intra- and interpersonal dysfunctions, and 3) empirical comparisons to complementary rather than exclusive dimensions of inter-individual differences in context-specific mental functions, treatment effects, and laboratory findings. Such a pluralistic understanding of mental health problems would fit empirical models in the neurosciences and postmodern notions of subjectivity alike. It would also clarify the assessment of dysfunction and background factors in relation to the requisites for penal law exemptions or insurance policies and make them empirically testable rather than dependent on expert opinion on issues such as whether a specific dysfunction is "psychiatric", "medical", or ascribable to "personality". PMID:20080303

  19. On human self-domestication, psychiatry, and eugenics

    Directory of Open Access Journals (Sweden)

    Brüne Martin

    2007-10-01

    Full Text Available Abstract The hypothesis that anatomically modern homo sapiens could have undergone changes akin to those observed in domesticated animals has been contemplated in the biological sciences for at least 150 years. The idea had already plagued philosophers such as Rousseau, who considered the civilisation of man as going against human nature, and eventually "sparked over" to the medical sciences in the late 19th and early 20th century. At that time, human "self-domestication" appealed to psychiatry, because it served as a causal explanation for the alleged degeneration of the "erbgut" (genetic material of entire populations and the presumed increase of mental disorders. Consequently, Social Darwinists emphasised preventing procreation by people of "lower genetic value" and positively selecting favourable traits in others. Both tendencies culminated in euthanasia and breeding programs ("Lebensborn" during the Nazi regime in Germany. Whether or not domestication actually plays a role in some anatomical changes since the late Pleistocene period is, from a biological standpoint, contentious, and the currently resurrected debate depends, in part, on the definitional criteria applied. However, the example of human self-domestication may illustrate that scientific ideas, especially when dealing with human biology, are prone to misuse, particularly if "is" is confused with "ought", i.e., if moral principles are deduced from biological facts. Although such naturalistic fallacies appear to be banned, modern genetics may, at least in theory, pose similar ethical problems to medicine, including psychiatry. In times during which studies into the genetics of psychiatric disorders are scientifically more valued than studies into environmental causation of disorders (which is currently the case, the prospects of genetic therapy may be tempting to alter the human genome in patients, probably at costs that no-one can foresee. In the case of "self-domestication", it

  20. University psychiatry in Italy: organisation and integration of university clinics and the National Health Service

    Directory of Open Access Journals (Sweden)

    Pier Maria Furlan

    2013-09-01

    Full Text Available INTRODUCTION: In the Italian psychiatric system, community-based care has become increasingly important and widespread since the national reform of 1978. This report aims to provide an overview of the involvement of university medical schools in this process, considering their responsibility for teaching and training specialist practitioners and professionals. METHODS: The study was carried out between early 2010 and February 2011. An 18-items, self-administered, questionnaire was designed to investigate the number of faculty members that are responsible both for running a clinical ward and for providing community-based healthcare. RESULTS: Nine out of 53 faculty members (17% manage a Mental Health Department, 9 (17% manage a University Department, and 2 (3.8% manage both types of department. Less than half of the teachers have full responsibility (hospital and community; however the percentage reaches 73.2% if we include the hospital wards open to the community emergencies. The remaining 26.8% have no responsibility for community psychiatry. Moreover there were undoubtedly still too many universities with specialisation schools that are without an appropriate network of facilities enabling them to offer complex psychiatric training. DISCUSSION: As expected, there were several types of healthcare management that were not uniformly distributed throughout Italy and there were also marked differences between mental health care provision in the North, Centre, and South of Italy. The university involvement in clinical responsibility was great, but at the management level there was a lack of equality in terms of clinical care, which risks being reflected also on the institutional functions of teaching and research.

  1. Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department - a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Barfod Charlotte

    2012-04-01

    Full Text Available Abstract Background Assessment and treatment of the acutely ill patient have improved by introducing systematic assessment and accelerated protocols for specific patient groups. Triage systems are widely used, but few studies have investigated the ability of the triage systems in predicting outcome in the unselected acute population. The aim of this study was to quantify the association between the main component of the Hillerød Acute Process Triage (HAPT system and the outcome measures; Admission to Intensive Care Unit (ICU and in-hospital mortality, and to identify the vital signs, scored and categorized at admission, that are most strongly associated with the outcome measures. Methods The HAPT system is a minor modification of the Swedish Adaptive Process Triage (ADAPT and ranks patients into five level colour-coded triage categories. Each patient is assigned a triage category for the two main descriptors; vital signs, Tvitals, and presenting complaint, Tcomplaint. The more urgent of the two determines the final triage category, Tfinal. We retrieved 6279 unique adult patients admitted through the Emergency Department (ED from the Acute Admission Database. We performed regression analysis to evaluate the association between the covariates and the outcome measures. Results The covariates, Tvitals, Tcomplaint and Tfinal were all significantly associated with ICU admission and in-hospital mortality, the odds increasing with the urgency of the triage category. The vital signs best predicting in-hospital mortality were saturation of peripheral oxygen (SpO2, respiratory rate (RR, systolic blood pressure (BP and Glasgow Coma Score (GCS. Not only the type, but also the number of abnormal vital signs, were predictive for adverse outcome. The presenting complaints associated with the highest in-hospital mortality were 'dyspnoea' (11.5% and 'altered level of consciousness' (10.6%. More than half of the patients had a Tcomplaint more urgent than Tvitals

  2. Systolic Blood Pressure Lower than Heart Rate upon Arrival at and Departure from the Emergency Department Indicates a Poor Outcome for Adult Trauma Patients

    Science.gov (United States)

    Lai, Wei-Hung; Wu, Shao-Chun; Rau, Cheng-Shyuan; Kuo, Pao-Jen; Hsu, Shiun-Yuan; Chen, Yi-Chun; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

    2016-01-01

    Background: Hemorrhage is a leading cause of preventable trauma death. In this study, we used the reverse shock index (RSI), a ratio of systolic blood pressure (SBP) to heart rate (HR), to evaluate the hemodynamic stability of trauma patients. As an SBP lower than the HR (RSI < 1) may indicate hemodynamic instability, the objective of this study was to assess the associated complications in trauma patients with an RSI < 1 upon arrival at the emergency department (ED) (indicated as (A)RSI) and at the time of departure from the ED (indicated as (L)RSI) to the operative room or for admission. Methods: Data obtained from all 16,548 hospitalized patients recorded in the trauma registry system at a Level I trauma center between January 2009 and December 2013 were retrospectively reviewed. A total of 10,234 adult trauma patients aged ≥20 were enrolled and subsequently divided into four groups: Group I, (A)RSI ≥ 1 and (L)RSI ≥ 1 (n = 9827); Group II, (A)RSI ≥ 1 and (L)RSI < 1 (n = 76); Group III, (A)RSI < 1 and (L)RSI ≥ 1 (n = 251); and Group IV, (A)RSI < 1 and (L)RSI < 1 (n = 80). Pearson’s χ2 test, Fisher’s exact test, or independent Student’s t-test was conducted to compare trauma patients in Groups II, III, and IV with those in Group I. Results: Patients in Groups II, III, and IV had a higher injury severity score and underwent a higher number of procedures, including intubation, chest tube insertion, and blood transfusion, than Group I patients. Additionally, patients of these groups had increased hospital length of stay (16.3 days, 14.9 days, and 22.0 days, respectively), proportion of patients admitted to the intensive care unit (ICU) (48.7%, 43.0%, and 62.5%, respectively), and in-hospital mortality (19.7%, 7.6%, and 27.5%, respectively). Although the trauma patients who had a SBP < 90 mmHg either upon arrival at or departure from the ED also present a more severe injury and poor outcome, those patients who had a SBP ≥ 90 mmHg but an RSI < 1 had

  3. CD64 and Group II Secretory Phospholipase A2 (sPLA2-IIA) as Biomarkers for Distinguishing Adult Sepsis and Bacterial Infections in the Emergency Department

    Science.gov (United States)

    Tan, Toh Leong; Ahmad, Nurul Saadah; Nasuruddin, Dian Nasriana; Ithnin, Azlin; Tajul Arifin, Khaizurin; Zaini, Ida Zarina; Wan Ngah, Wan Zurinah

    2016-01-01

    Introduction Early diagnosis of sepsis and bacterial infection is imperative as treatment relies on early antibiotic administration. There is a need to develop new biomarkers to detect patients with sepsis and bacterial infection as early as possible, thereby enabling prompt antibiotic treatment and improving the survival rate. Methods Fifty-one adult patients with suspected bacterial sepsis on admission to the Emergency Department (ED) of a teaching hospital were included into the study. All relevant cultures and serology tests were performed. Serum levels for Group II Secretory Phospholipase A2 (sPLA2-IIA) and CD64 were subsequently analyzed. Results and Discussion Sepsis was confirmed in 42 patients from a total of 51 recruited subjects. Twenty-one patients had culture-confirmed bacterial infections. Both biomarkers were shown to be good in distinguishing sepsis from non-sepsis groups. CD64 and sPLA2-IIA also demonstrated a strong correlation with early sepsis diagnosis in adults. The area under the curve (AUC) of both Receiver Operating Characteristic curves showed that sPLA2-IIA was better than CD64 (AUC = 0.93, 95% confidence interval (CI) = 0.83–0.97 and AUC = 0.88, 95% CI = 0.82–0.99, respectively). The optimum cutoff value was 2.13μg/l for sPLA2-IIA (sensitivity = 91%, specificity = 78%) and 45 antigen bound cell (abc) for CD64 (sensitivity = 81%, specificity = 89%). In diagnosing bacterial infections, sPLA2-IIA showed superiority over CD64 (AUC = 0.97, 95% CI = 0.85–0.96, and AUC = 0.95, 95% CI = 0.93–1.00, respectively). The optimum cutoff value for bacterial infection was 5.63μg/l for sPLA2-IIA (sensitivity = 94%, specificity = 94%) and 46abc for CD64 (sensitivity = 94%, specificity = 83%). Conclusions sPLA2-IIA showed superior performance in sepsis and bacterial infection diagnosis compared to CD64. sPLA2-IIA appears to be an excellent biomarker for sepsis screening and for diagnosing bacterial infections, whereas CD64 could be used for

  4. Working towards a new psychiatry - neuroscience, technology and the DSM-5

    Directory of Open Access Journals (Sweden)

    Alam Sabina

    2012-01-01

    Full Text Available Abstract This Editorial introduces the thematic series on 'Toward a New Psychiatry: Philosophical and Ethical Issues in Classification, Diagnosis and Care' http://www.biomedcentral.com/series/newpsychiatry.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    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...

  6. Mental Health promotion of a hospital through the nurse in the liaison psychiatry team

    OpenAIRE

    Natalia Cámara Conde; Julián Carretero Román; Ángela García Pozo; Marta Menéndez Rubiera; Javier Sánchez Alfonso; Nuria Sekade Gutiérrez

    2008-01-01

    We show a proposal to increase the quality of nursing cares, improving mental health care of hospitalized patients by creating the figure of the liaison nurse within the liaison psychiatry team. This nurse would not only be a reference to support the nursing staff at the level of patient care, but also the psycho-emotional self-care professional.Objectives: Justifying the need to include the figure of the specialist mental health team liaison psychiatry nurse. Method: The rotation as resident...

  7. Music Therapy as Psychotherapy in Psychiatry at all Levels of the GAF Scale

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2009-01-01

    Presentation and disussion on how to apply different music therapy methods and techniques in psychiatry at different levels of the GAF (Global Functioning Scoring system) scale described in combination with McGlashan's relational process levels and other therapeutic principles as illustrated in 5...... books on 'relational treatment in psychiatry' by Lars Thorgaard (DK) and Ejvind Haga (N). Is music therapy as psychotherapy applicable also at the lower GAF scorings? Which methods/techniques?...

  8. Non-mammalian models in behavioral neuroscience: consequences for biological psychiatry

    OpenAIRE

    Caio eMaximino; Rhayra Xavier do Carmo Silva; Suéllen de Nazaré dos Santos da Silva; Laís do Socorro dos Santos Rodrigues; Hellen eBarbosa; Tayana Silva de Carvalho; Luana Ketlen Reis Leão; Monica Gomes Lima; Karen Renata Matos Oliveira; Anderson Manoel Herculano

    2015-01-01

    Current models in biological psychiatry focus on a handful of model species, and the majority of work relies on data generated in rodents. However, in the same sense that a comparative approach to neuroanatomy allows for the idenfication of patterns of brain organization, the inclusion of other species and an adoption of comparative viewpoints in behavioral neuroscience could also lead to increases in knowledge relevant to biological psychiatry. Specifically, this approach could help to ident...

  9. WPA guidance on how to combat stigmatization of psychiatry and psychiatrists

    DEFF Research Database (Denmark)

    Sartorius, Norman; Gaebel, Wolfgang; Cleveland, Helen-Rose;

    2010-01-01

    psychiatrists of the general public, of students of medicine, of health professionals other than psychiatrists and of persons with mental illness and their families. It also reviewed the evidence about the interventions that have been undertaken to combat stigma and consequent discrimination and made a series...... prevention of stigmatization of psychiatry, stressing the need to develop a respectful relationship with patients, to strictly observe ethical rules in the practice of psychiatry and to maintain professional competence....

  10. Educational needs assessment for psychiatry residents to prevent suicide: A qualitative approach

    OpenAIRE

    Majid Barekatain; Mahin Aminoroaia; Seyed Mehdi Ardestani Samimi; Fatemeh Rajabi; Abbas Attari

    2013-01-01

    Background: Suicide is a commonly encountered and stressful event in professional life of any psychiatrist. Suicide risk assessment is a major gateway to patient treatment and management. It is a core competency requirement in training of psychiatry. The present study designed to assesseducational needsfor suicide prevention in residents of psychiatry in two medical schools in Iran, Isfahan University of Medical Sciences (IUMS) and Shahid Beheshti Medical University (SBUMS) inTehran. Meth...

  11. Simulation-based learning in psychiatry for undergraduates at the University of Zimbabwe medical school

    OpenAIRE

    Piette, A.; Muchirahondo, F; Mangezi, W; Iversen, A.; Cowan, F; Dube, M; Peterkin, HG; Araya, R.; Abas, M

    2015-01-01

    BACKGROUND: The use of simulated patients to teach in psychiatry has not been reported from low-income countries. This is the first study using simulation teaching in psychiatry in Africa. The aim of this study was to introduce a novel method of psychiatric teaching to medical students at the University of Zimbabwe and assess its feasibility and preliminary effectiveness. We selected depression to simulate because students in Zimbabwe are most likely to see cases of psychoses during their war...

  12. Fourth revolution in psychiatry – Addressing comorbidity with chronic physical disorders

    OpenAIRE

    Gautam, Shiv

    2010-01-01

    The moral treatment of mental patients, Electro Convulsive therapy (ECT), and Psychotropic medications constitute the first, second, and third revolution in psychiatry, respectively. Addressing comorbidities of mental illnesses with chronic physical illnesses will be the fourth revolution in psychiatry. Mind and body are inseparable; there is a bidirectional relationship between psyche and soma, each influencing the other. Plausible biochemical explanations are appearing at an astonishing rat...

  13. Relationship between practice counselling and referral to outpatient psychiatry and clinical psychology.

    OpenAIRE

    Cape, J; Parham, A.

    1998-01-01

    BACKGROUND: Although reduction in the use of secondary care mental health services is a suggested benefit of counselling in general practice, there has been little empirical investigation of this relationship. AIM: To investigate the relationship between the provision of counselling in general practice and the use of outpatient psychiatry and clinical psychology services across a geographical area. METHOD: Information on referrals to outpatient psychiatry and clinical psychology from all gene...

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

    Science.gov (United States)

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

    1992-05-01

    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

  15. Figures and Institutions of the neurological sciences in Paris from 1800 to 1950. Part IV: Psychiatry and psychology.

    Science.gov (United States)

    Poirier, J; Clarac, F; Barbara, J-G; Broussolle, E

    2012-05-01

    We present a short historical review on the major institutions and figures who contributed to make Paris a renowned centre of physiology and neurology during the XIXth and the first half of the XXth century. We purposely chose to focus on the period 1800-1950, as 1800 corresponds to the actual beginning of neurosciences, and as 1950 marks their exponential rise. Our presentation is divided into four chapters, matching the main disciplines that have progressed and contributed most to the knowledge we have of the brain sciences: anatomy, physiology, neurology, and psychiatry-psychology. The present article is the fourth of the four parts of this review, which deals with the chapter on psychiatry and psychology. When the French Revolution occurred, only a few institutions were taking care of the mentally ill. In the Paris area, these included Maison Royale de Charenton, Les Petites Maisons, and one of the departments of larger hospitals such as Hôtel-Dieu, the Salpêtrière Hospital and Bicêtre Hospital. One of the founders of psychiatry in Paris at that time and thereafter was Philippe Pinel (1745-1826) who was the first to distinguish insane/alienated patients from misfits, beggars, and other vagabonds. During the first half of the XIXth century, his student Jean-Étienne Esquirol (1772-1840) also played a major role with his treatise on mental diseases and the 1838 law and the creation of asylums in all parts of France. Alienists were in general caregivers and learned by themselves. In contrast, at the academic level, the emerging disciplines psychiatry and neurology were very close to each other in the second half of the XIXth century, the best example being Jules Baillarger (1809-1890). The actual development of psychiatry and psychology and the foundation of psychoanalysis later in the XIXth century and in the first half of the XXth century owed much to several European doctors and scientists, particularly those from British institutions and from German

  16. Students' Perceptions of Questioning Strategies in an Adult EFL Classroom in the English Department at the College of Basic Education in Kuwait

    Directory of Open Access Journals (Sweden)

    Badria Al-Hajji

    2014-03-01

    Full Text Available This aim of this paper is to study the students’ perceptions and evaluation of teacher questioning skills in adult EFL classrooms of the English Department, the College of Basic Education at the Public Authority of Applied Education in Kuwait.  For the purpose of the study, the following research questions were examined: (1  What is the students’ perception of the levels and types of questions posed by the instructor? (2   What is the students’ perception of the instructor’s attending behavior? The findings of the study were based on a 25-item questionnaire distributed among the sample of the study. Results indicated that generally the types and levels of teachers' questions (the first question of the study and the teachers' attending behavior (the second question seemed to provide opportunities for students to enrich their learning experiences, and hence, reach the goals of the curriculum and their personal goals.  However, as the answers to some questions showed that there is a lack of balance manifested in the tendency among teachers towards information retrieval questions  more than higher cognitive questions ( the first question of the study, and towards intermittently using an authoritative tone ( the second question. In light of these results, the researchers recommend that Kuwaiti teachers need to put extra effort towards recognizing the importance of critical thinking in education, and as such move from the traditional model to cooperative learning, where the authoritative classroom atmosphere is replaced by a more relaxed classroom milieu in which students engage in independent thinking.

  17. Associations between dimensions of religious commitment and mental health reported in the American Journal of Psychiatry and Archives of General Psychiatry: 1978-1989.

    Science.gov (United States)

    Larson, D B; Sherrill, K A; Lyons, J S; Craigie, F C; Thielman, S B; Greenwold, M A; Larson, S S

    1992-04-01

    The authors assessed all measures of religious commitment (N = 139) reported in research studies published in the American Journal of Psychiatry and Archives of General Psychiatry in 1978 through 1989 (N less than 35). For nearly two-thirds of the measures, the studies either made no hypotheses or reported no results concerning the relationship of religious commitment to mental health status. For the great majority of the measures assessed, the studies reported a positive relationship between religious commitment and mental health. PMID:1532477

  18. Efficacy of Group Art Therapy on Depressive Symptoms in Adult Heterogeneous Psychiatric Outpatients

    Science.gov (United States)

    Chandraiah, Shambhavi; Ainlay Anand, Susan; Avent, Lindsay Cherryl

    2012-01-01

    This study evaluated the potential benefit of weekly group art therapy in groups of adult psychiatric outpatients at a university medical center. Eighteen patients participated in 4 successive 8-week groups of 6 to 8 patients each that met weekly and were led by 2 therapists (a board-certified art therapist and a psychiatry resident). The…

  19. New and extended-action treatments in the management of ADHD: a critical appraisal of lisdexamfetamine in adults and children

    Directory of Open Access Journals (Sweden)

    Diana Domnitei

    2010-05-01

    Full Text Available Diana Domnitei, Vishal MadaanDepartment of Psychiatry, Creighton University Medical Center, Omaha, NE, USAAbstract: Treatment guidelines from the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics state that stimulant medications have the most evidence for safety and efficacy in the treatment of childhood attention deficit hyperactivity disorder (ADHD. Longer-acting stimulants are thus considered as first-line for management of ADHD symptoms. Over the years, concerns about the abuse potential of stimulants have led to the development of alternative formulations of these agents. One such recent development, lisdexamfetamine (LDX was FDA approved for treating ADHD in children in early 2007 and in adults in early 2008. LDX is a prodrug, which when orally ingested, is converted to l-lysine and active d-amphetamine, which is responsible for its therapeutic activity. This unique formulation may lead to a possible reduction of the abuse potential, by bypassing the first-pass metabolism. In fact, a statistically significant difference for the ‘liking’ effects on the Drug Questionnaire Response has been reported with intravenous LDX compared to d-amphetamine. LDX appears to have an efficacy and tolerability profile comparable to other extended-release stimulant formulations used to treat ADHD, but reduced potential for abuse-related liking effects when compared to equivalent amounts of immediate-release d-amphetamine. The most common adverse events include decreased appetite, insomnia, upper abdominal pain, headache, irritability, weight loss, and nausea.Keywords: lisdexamfetamine, attention deficit hyperactivity disorder, adults, children

  20. Gender and racial/ethnic differences in addiction severity, HIV risk, and quality of life among adults in opioid detoxification: results from the National Drug Abuse Treatment Clinical Trials Network

    OpenAIRE

    Bruce Burchett; et al.; Li-Tzy Wu; Walter Ling

    2010-01-01

    Li-Tzy Wu1,2, Walter Ling3, Bruce Burchett1, Dan G Blazer1,2, Jack Shostak2, George E Woody41Department of Psychiatry and Behavioral Sciences, School of Medicine, 2Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA; 3David Geffen School of Medicine, NPI/Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA; 4Department of Psychiatry, School of Medicine, University of Pennsylvania and Treatment Research Institute, Philadelphia, PA, U...

  1. Choice and rejection of psychiatry as a career: surveys of UK medical graduates from 1974 to 2009†

    OpenAIRE

    Goldacre, Michael J; Fazel, Seena; Smith, Fay; Lambert, Trevor

    2013-01-01

    Background Recruitment of adequate numbers of doctors to psychiatry is difficult. Aims To report on career choice for psychiatry, comparing intending psychiatrists with doctors who chose other clinical careers. Method Questionnaire studies of all newly qualified doctors from all UK medical schools in 12 qualification years between 1974 and 2009 (33 974 respondent doctors). Results One, three and five years after graduation, 4–5% of doctors specified psychiatry as their first choice of future ...

  2. Blueprint for an Indian Nobel Laureate in Psychiatry

    Directory of Open Access Journals (Sweden)

    Ajai R Singh

    2015-01-01

    General qualities for a Nobel: The need to be really bright is a given; what is necessary is to be sufficiently crazy about a research topic to make it an obsession; be ready to forgo many creature comforts for long stretches of time; and after all this, be ready to accept that the Nobel may never happen, yet continue to do a type of research solely because it is intrinsically worth doing.Nobel in Physiology or Medicine: Here, the key is to do fundamental/basic research to answer persistent, nagging, unanswered questions of medicine which others neglect because they are discomforting. Or, find treatments that change the whole manner a disease has been hitherto treated.Nobel in Psychiatry: There are many Nobels waiting to be won, provided: (a The branch becomes more precise; (b Science, quantitative study and biology remain its bedrock; and (c There is an almost obsessive preoccupation with unravelling the mysteries of the brain. One has to choose wisely where to put in efforts, e.g., fields like fundamental research into the causes of psychiatric disorders, especially schizophrenia, depression, bipolar disorders. Or their definitive treatments. Or, work at the cellular or molecular level of the neuron and brain; or, the glandular or genetic level of the systems connected with psychiatric disorders; or, in brain radio imaging. If other, or allied, fields are chosen, to work with finding quantitative data and attempt to pinpoint their precise biological correlates.Indian Nobel in Medicine: There is first the need to give up the colonial mindset that everything trend-setting in science comes only from the West. As also, for Departmental Heads, to protect and nurture those with research excellence rather than the mediocre and the sycophants. For governments, to set up an autonomous Research Excellence Council to expressly and exclusively cater to promoting research excellence, with a sizeable fund to put this into practice.All these four points are summarised as four

  3. [A role of Russian psychiatrists in the formation of forensic psychiatry in Russia in the beginning of XIX century].

    Science.gov (United States)

    Bezchasniy, K V

    2016-01-01

    The formation of forensic psychiatry knowledge as a special area of concern was due to fundamental changes in the social, economic and political life of Russia society. It reflected public awareness of the urgent need in solving the problem of support, preserve and maintain the mental health of the people. Forensic psychiatry was based on the development of psychiatry, public health and community medicine. Author describes of the role of Russian psychiatrists in the formation of forensic psychiatry, their active particitpation in internation professional meetings and in the development of the problem of responsibility. PMID:26977630

  4. SIX DECADES OF THE PULA NEUROPSYCHIATRIC MEETINGS--FROM NEUROPSYCHIATRY TO BORDERLANDS OF NEUROLOGY AND PSYCHIATRY BRAIN AND MIND.

    Science.gov (United States)

    Barac, Bosko; Demarin, Vida

    2015-12-01

    In 2010, the International Neuropsychiatric Pula Symposia, from 2005 Congresses (INPS/INPC), founded in 1961 by Zagreb and Graz University Neuropsychiatry Departments, celebrated their 50th anniversary of successful development. The co-author of the paper, Bosko Barac, witnessed their growth from 1966, collaborating in their organization from 1974 with the first Secretary General Gerald Grinschgl; elected for his successor after his unexpected death in 1985, he was leading the Kuratorium (Scientific Board) as Secretary General for 23 years, collaborating in this period with his Austrian partner and friend Helmut Lechner. In 2007, Barac handed over this responsible function to the co-author Vida Demarin. Starting when neuropsychiatry was a unique discipline, the INPC followed the processes of emancipation of neurology and psychiatry and their evolution to independent disciplines with new subspecialties. These respectable conferences greatly surpassed the significance of the two disciplines, neurology and psychiatry, granting collaboration of borderland medical and non-medical disciplines, connecting experts from the region, European countries and the world. Inaugurated in 'cold-war' times, in their first phase they enabled to make professional and human contacts between scientists from the two divided 'blocs' thanks to the 'non-aligned' position of the then Yugoslavia, fostering the ideas of mutual understanding and collaboration. On the other hand, the scientific development of the meetings took in the center of their study fields connecting the two disciplines, giving a quite unique quality to these meetings. For many years, the meetings cherished specific neurologic and psychiatric topics, at the same time planning increasing important topics of the 'borderland areas' in their programs. For the important achievements, they earned the title of the Pula School of Science and Humanism, promoting interdisciplinary scientific collaboration important for humanistic

  5. Treatment of adult ADHD: Is current knowledge useful to clinicians?

    OpenAIRE

    Torgersen, Terje

    2008-01-01

    Terje Torgersen1,2, Bjørn Gjervan1,3, Kirsten Rasmussen31Department of Psychiatry, Sykehuset Levanger, Helse Nord-Troendelag HF, Levanger, Norway; 2Faculty of Medicine and 3Department of Psychology, Norwegian University of Science and Technology, Trondheim, NorwayAbstract: Psychostimulant drugs have for decades been considered the cornerstone of ADHD treatment. Non-stimulant drugs have also been reported successful. However, many controlled studies exclude patients with comorbiditi...

  6. Current research in transcultural psychiatry in the Nordic countries.

    Science.gov (United States)

    Ekblad, Solvig; Kastrup, Marianne Carisius

    2013-12-01

    This article discusses major themes in recent transcultural psychiatric research in the Nordic countries from 2008 to 2011: (a) epidemiological studies of migration, (b) indigenous populations, and (c) quality of psychiatric care for migrants. Over the past several decades, the populations of the Nordic countries, Denmark, Finland, Norway, and Sweden, which were relatively homogeneous, have become increasingly culturally diverse. Many migrants to Nordic countries have been exposed to extreme stress, such as threats of death and/or torture and other severe social adversities before, during, and after migration, with potential effects on their physical, mental, social, and spiritual health. Growing interest in transcultural issues is reflected in the level of scientific research and clinical activity in the field by Nordic physicians, psychologists, social scientists, demographers, medical anthropologists, as well as other clinicians and policy planners. Research includes work with migrants and indigenous minorities in the Nordic countries, as well as comparisons with mental health in postconflict countries. We conclude by suggesting future directions for transcultural psychiatry research and providing guidelines for the education and training of future clinicians in the Nordic countries. PMID:24301661

  7. Innovative practices in Psychiatry. Argentina, 1960-1970

    Directory of Open Access Journals (Sweden)

    Aida Alejandra Golcman

    2012-09-01

    Full Text Available The paper analyzes innovative psychiatric practices that took place in Argentina during the sixties and seventies at the Hospital Jose Esteves in the province of Buenos Aires. Objective: To present the coexistence of different paradigms related to mental health in the same institution and to analyze the complexities generated by this scenario. Methodology: This study uses primary sources in the form of medical records of patients admitted to the hospital between 1960 and 1979. The medical records were cross-referenced with publications of newspapers and magazines of the time. Results: The analysis shows that the political environment during the era of military dictatorship —characterized by ideological persecution and the inhibition of political expression— influenced the development of innovative psychiatric practices. At the same time, instances of anti-Semitism and ideological persecution among health workers affected therapeutic approaches. Conclusions: While the introduction of innovative practices in mental health led to some resistance among the more orthodox psychiatrists, the presence of different paradigms shows a plan, both political and professional, to transform psychiatry and admission policy in Argentina.

  8. Biomedical psychiatry and its concealed metaphors: an anthropological perspective.

    Science.gov (United States)

    Martínez-Hernáez, Angel

    2013-09-01

    The idea that power relations structure social life is self-evident to most anthropologists. Western medical knowledge or biomedicine, and by extension science or scientific knowledge, however, has until relatively recently been exempt from anthropological scrutiny in political terms. An understanding of biomedicine as a system of knowledge that is not a copy of facts but a representation of them has entailed a break with the traditional separation of folk knowledge and scientific knowledge in anthropology, making it possible to include biomedicine in the repertoire of ethnographic objects. The peculiarity of biomedicine as a cultural system, seen from this perspective, lies in a paradox: its self-characterization as a set of non-ideological discourses and practices is a representation that conceals its ideological and power-saturated nature. Through an analysis of DSM-IV-TR, this article explores some of the representational strategies through which this concealment takes place in biomedical psychiatry: the asocial and universal character of mental illness categories; the neutrality of clinical practice; and the non-moral nature of clinical criteria and judgment. These are concealed metaphors in the true sense, for not only do they speak of something without naming it but they also deny their own existence as metaphors. PMID:24308254

  9. Psychiatry, German society, and the Nazi "euthanasia" programme.

    Science.gov (United States)

    Burleigh, Michael

    1994-08-01

    The paper begins by establishing the position of psychiatry after the First World War, concentrating upon the interplay between economy measures and limited reform during the Weimar Republic. Each therapeutic advance involved the definition of irremediable subgroups within the already socially marginalized psychiatric constituency. Nazi policy towards psychiatric patients during the 1930s involved further economy measures, and the introduction of negative eugenic strategies, were similar in kind if not degree, to those pursued in some other countries at that time. The decision to kill the mentally ill and physically disabled was taken by Hitler in order to clear the decks for war, and was justified with the aid of crude utilitarian arguments, as well as what limited evidence there was regarding popular attitudes on these issues. Many health professionals and psychiatrists accommodated themselves to policies which a few years later became one of the components of the 'Final Solution of the Jewish Question', i.e. Hitler's vengeance against the Jewish people in circumstances of war he had envisaged much earlier. PMID:11645892

  10. Quality of education at multidisciplinary case conferences in psychiatry.

    LENUS (Irish Health Repository)

    Naughton, Marie

    2012-02-01

    PURPOSE: A large Dublin-based teaching hospital facilitates a weekly Psychiatric Case Presentation meeting, which is relatively unique in medicine and even in psychiatry, in that there is a large variety of attendees from various multidisciplinary groups: consultant psychiatrists, psychiatric trainees, nurses, psychologists and psychoanalytic psychotherapists, occupational therapists, social workers and pastoral care staff. The aim of this audit is to assess the quality of education for members of different disciplines at these meetings, and to highlight the differing learning needs of the attendees. DESIGN\\/METHODOLOGY\\/APPROACH: Group-structured assessments and Likert scale questionnaires were used to identify what attendees thought were educational and what needed to be improved. FINDINGS: Overall, the case conference is educationally worthwhile but there were several areas of dissatisfaction. Some felt that the case conference was overly medical in its orientation and that there was excessive medical jargon. The seating arrangements were not conducive to group discussion. Consultants and psychiatric trainees felt that the quality of the clinical presentations could be improved. Presentation skills teaching classes and topic-based classes would be useful inclusions. Feedback to the multidisciplinary group on the patients\\' progress and feedback to the patient is important. Changes were implemented in areas of dissatisfaction, and these changes evaluated. ORIGINALITY\\/VALUE: The educational qualities of multidisciplinary Case Conferences need to be constantly evaluated to ensure that the learning needs of the different disciplines who attend are being met.

  11. The role of the standard EEG in clinical psychiatry.

    LENUS (Irish Health Repository)

    O'Sullivan, S S

    2012-02-03

    BACKGROUND: The EEG is a commonly requested test on patients attending psychiatric services, predominantly to investigate for a possible organic brain syndrome causing behavioural changes. AIMS: To assess referrals for EEG from psychiatric services in comparison with those from other sources. We determine which clinical factors were associated with an abnormal EEG in patients referred from psychiatric sources. METHODS: A retrospective review of EEG requests in a 1-year period was performed. Analysis of referral reasons for psychiatric patients was undertaken, and outcome of patients referred from psychiatric services post-EEG was reviewed. RESULTS: One thousand four hundred and seventy EEGs were reviewed, of which 91 (6.2%) were referred from psychiatry. Neurology service referrals had detection rates of abnormal EEGs of 27%, with psychiatric referrals having the lowest abnormality detection rate of 17.6% (p < 0.1). In psychiatric-referred patients the only significant predictors found of an abnormal EEG were a known history of epilepsy (p < 0.001), being on clozapine (p < 0.05), and a possible convulsive seizure (RR = 6.51). Follow-up data of 53 patients did not reveal a significant clinical impact of EEG results on patient management. CONCLUSIONS: Many patients are referred for EEG from psychiatric sources despite a relatively low index of suspicion of an organic brain disorders, based on reasons for referral documented, with an unsurprising low clinical yield.

  12. The neuroscience of free will: implications for psychiatry.

    Science.gov (United States)

    Pierre, J M

    2014-09-01

    Belief in free will has been a mainstay in philosophy throughout history, grounded in large part in our intuitive sense that we consciously control our actions and could have done otherwise. However, psychology and psychiatry have long sought to uncover mechanistic explanations for human behavior that challenge the notion of free will. In recent years, neuroscientific discoveries have produced a model of volitional behavior that is at odds with the notion of contra-causal free will and our sense of conscious agency. Volitional behavior instead appears to have antecedents in unconscious brain activity that is localizable to specific neuroanatomical structures. Updating notions of free will in favor of a continuous model of volitional self-control provides a useful paradigm to conceptualize and study some forms of psychopathology such as addiction and impulse control disorders. Similarly, thinking of specific symptoms of schizophrenia as disorders of agency may help to elucidate mechanisms of psychosis. Beyond clinical understanding and etiological research, a neuroscientific model of volitional behavior has the potential to modernize forensic notions of responsibility and criminal punishment in order to inform public policy. Ultimately, moving away from the language of free will towards the language of volitional control may result in an enhanced understanding of the very nature of ourselves. PMID:24330830

  13. Causality in Psychiatry: A Hybrid Symptom Network Construct Model.

    Science.gov (United States)

    Young, Gerald

    2015-01-01

    Causality or etiology in psychiatry is marked by standard biomedical, reductionistic models (symptoms reflect the construct involved) that inform approaches to nosology, or classification, such as in the DSM-5 [Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; (1)]. However, network approaches to symptom interaction [i.e., symptoms are formative of the construct; e.g., (2), for posttraumatic stress disorder (PTSD)] are being developed that speak to bottom-up processes in mental disorder, in contrast to the typical top-down psychological construct approach. The present article presents a hybrid top-down, bottom-up model of the relationship between symptoms and mental disorder, viewing symptom expression and their causal complex as a reciprocally dynamic system with multiple levels, from lower-order symptoms in interaction to higher-order constructs affecting them. The hybrid model hinges on good understanding of systems theory in which it is embedded, so that the article reviews in depth non-linear dynamical systems theory (NLDST). The article applies the concept of emergent circular causality (3) to symptom development, as well. Conclusions consider that symptoms vary over several dimensions, including: subjectivity; objectivity; conscious motivation effort; and unconscious influences, and the degree to which individual (e.g., meaning) and universal (e.g., causal) processes are involved. The opposition between science and skepticism is a complex one that the article addresses in final comments. PMID:26635639

  14. The 3 D's of geriatric psychiatry: depression, delirium, and dementia.

    Science.gov (United States)

    Dharia, Sheetal; Verilla, Kailen; Breden, Ericka L

    2011-08-01

    A Caucasian female octogenarian with multiple medical problems was admitted to the inpatient geriatric psychiatry unit with intermittent altered mental status and decline in memory. She had been hospitalized four times in the previous three months. She was admitted on more than 10 medications and received more than 20 different medications in this time period. It was determined that she had delirium concurrent with dementia and/or depression. During her hospital stay a urinary tract infection (UTI) was treated, her anticholinergic medications were minimized, and her digoxin dose was adjusted. As her mental status cleared, a workup was completed to differentiate between dementia and depression. She was initially treated with memantine, but as time progressed it became more evident she was experiencing depression and a "pseudodementia," which was treated with sertraline. Her Mini-Mental State Examination returned to 29/30 (her score previously was 26/29). This case demonstrates the complexity of treating an elder individual and the importance of differentiating among delirium, depression, and dementia. The pharmacy team played an active role in medication reconciliation. Additionally, they worked with the medical team to minimize her potentially harmful medications and optimize the treatment of her UTI and depression. PMID:21840820

  15. Functional MRT in psychiatry and neurology. 2. rev. and upd. ed.; Funktionelle MRT in Psychiatrie und Neurologie

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Frank [Universitaetsklinikum Aachen (Germany); Fink, Gereon R. (eds.) [Forschungszentrum Juelich GmbH (Germany); Uniklinik Koeln (Germany)

    2013-08-01

    The book on functional MRT in psychiatry and neurology covers the following topics: (I) Fundamentals: functional neuro-anatomy, fundamentals of NMR imaging, basic research on the clinical use for diagnostics and therapy; basics of morphometry; real-time fMRT, planning and execution of experimental paradigms; data analysis and statistics; reliability and quality of fMRT experiments; eye movement, neuropharmacologic functional imaging, gender dependent effects, age dependent effects, resting state fMRT; meta analyses. (II) Higher brain achievements: movement and action, perception and attention, visual system and object processing, auditory system, executive functions, somatosensoric system, memory, learning and gratification system, functional neuro-anatomy of speech, number processing and calculation, connectivity, social cognition, emotions, olfactory system, functional imaging in the pain research. (III) Disease pattern: dystonia, Parkinson syndrome, Chorea Huntington, aphasia, apraxia, neglect, amnesia, function recovery following apoplexy, schizophrenia, affective disturbances, anxiety and fear, post-traumatic disturbances, hyperactivity syndrome, personality disorder. (IV) Working tools: brain atlas, tool for integrated analyses of structure, functionality and connectivity (SPM anatomy toolbox).

  16. The Third Revolution: Philosophy into Practice in Twenty-first Century Psychiatry

    Directory of Open Access Journals (Sweden)

    KWM (Bill Fulford

    2008-12-01

    Full Text Available Three revolutions in psychiatry characterised the closing decade of the twentieth century: 1 in the neurosciences, 2 in patient-centred models of service delivery, and 3 in the emergence of a rapidly expanding new cross-disciplinary field of philosophy and psychiatry. Starting with a case history, the paper illustrates the impact of this third revolution - the new philosophy of psychiatry - on day-to-day clinical practice through training programmes and policy developments in what has become known as values-based practice. Derived from philosophical value theory and phenomenology, values-based practice is a partner to evidence-based practice in supporting clinical decision-making in the highly complex environment of mental health care. The paper concludes by setting values-based practice in context with other potentially practical important areas of the new philosophy of psychiatry arguing that all three revolutions need to be brought together if psychiatry is to meet the challenges of the twenty-first century.

  17. A comparative study of attitudes toward psychiatry among nursing students across successive training years

    Directory of Open Access Journals (Sweden)

    Yatan Pal Singh Balhara

    2013-01-01

    Full Text Available Context: Psychiatry nurses are an integral component of a multidisciplinary mental health-care team. Aim: The current study aimed at understanding the attitude of undergraduate nursing students toward psychiatry. Additionally, the attitudes toward psychiatry have been compared across the training years among these students. Materials and Methods: The study was carried out at a tertiary care nurse-training institute. All the nursing students enrolled with the institute at the time of the study constituted the sample frame. The study questionnaire used in the current study was a 29-item questionnaire that assessed attitudes toward psychiatry. Statistical Analysis: The data were analyzed using SPSS ver 17. Results: Overall, the majority of the nursing students from all four groups had a favorable response to the statements of the Likert scale. Most of the significantly positive responses (as assessed by the Kruskal-Wallis analysis of variance of the rank order were from the third-year and internship students. These findings were supported by the significant correlation between these statements and ranked order of the nurse-training years. Conclusions: The findings of the current study present some interesting insights into the attitude of nursing students toward psychiatry.

  18. EPA guidance on how to improve the image of psychiatry and of the psychiatrist.

    Science.gov (United States)

    Bhugra, D; Sartorius, N; Fiorillo, A; Evans-Lacko, S; Ventriglio, A; Hermans, M H M; Vallon, P; Dales, J; Racetovic, G; Samochowiec, J; Roca Bennemar, M; Becker, T; Kurimay, T; Gaebel, W

    2015-03-01

    Stigma against mental illness and the mentally ill is well known. However, stigma against psychiatrists and mental health professionals is known but not discussed widely. Public attitudes and also those of other professionals affect recruitment into psychiatry and mental health services. The reasons for this discriminatory attitude are many and often not dissimilar to those held against mentally ill individuals. In this Guidance paper we present some of the factors affecting the image of psychiatry and psychiatrists which is perceived by the public at large. We look at the portrayal of psychiatry, psychiatrists in the media and literature which may affect attitudes. We also explore potential causes and explanations and propose some strategies in dealing with negative attitudes. Reduction in negative attitudes will improve recruitment and retention in psychiatry. We recommend that national psychiatric societies and other stakeholders, including patients, their families and carers, have a major and significant role to play in dealing with stigma, discrimination and prejudice against psychiatry and psychiatrists. PMID:25735809

  19. NOHSS Adult Indicators

    Data.gov (United States)

    U.S. Department of Health & Human Services — Data from BRFSS for indicators of adult oral health for 1999 and even years from 2002 through 2012. National estimates are represented by the median prevalence...

  20. NOHSS Adult Indicators

    Data.gov (United States)

    U.S. Department of Health & Human Services — Data from BRFSS for indicators of adult oral health for 1999 and even years from 2002 through 2014. National estimates are represented by the median prevalence...

  1. Analysis of adverse drug reactions of atypical antipsychotic drugs in psychiatry OPD

    Directory of Open Access Journals (Sweden)

    Kiran G Piparva

    2011-01-01

    Full Text Available Background: Novel atypical antipsychotics are superior to conventional antipsychotics as they significantly reduce both positive and negative symptoms of schizophrenia and have lower risk of extrapyramidal symptoms (EPS. However, these drugs have separate set of adverse drug reactions (ADRs. Therefore, this study was carried out to assess these ADRs, which can have impact on long-term compliance and achieving successful treatment. Materials and Methods: A prospective study of analysis of ADR of atypical antipsychotic drugs was carried out in the psychiatry outpatient department. Patients of psychotic disorder (any age, either sex, who were prescribed atypical antipsychotic drugs, were included. Those who were prescribed conventional antipsychotics or combinations of antipsychotics were excluded from the study. Apart from spontaneously reported ADRs, a questionnaire related to the likely ADR was used and patients′ responses were recorded in the case record form. Results: Totally 93 ADRs were recorded from 84 prescriptions. Majority of the ADRs (82 out of 93 were seen with risperidone and olanzepine, as they were the commonly prescribed drugs. Weight gain, dizziness, sleep disturbance and appetite disturbance accounted for nearly 78% of the total events. With risperidone (at 4-6 mg/day and olanzepine (at 10-15 mg/day, gastrointestinal and sleep disturbance were observed in the initial (within 7 days to 2-3 months after treatment course of treatment, while EPS, fatigue, seizure, increased frequency of micturition and dizziness were observed after long-term (3-9 months use. Conclusion: The present study adds to the existing information on the prevalence of adverse effects of atypical antipsychotic drugs. Role of active surveillance in post-marketing phase is also emphasized.

  2. MSM Book Review: OXFORD TEXTBOOK OF PHILOSOPHY AND PSYCHIATRY

    Directory of Open Access Journals (Sweden)

    Ajit V. Bhide

    2008-01-01

    Full Text Available This tome was passed on to me by a dear old classmate, now a psychiatrist in Canada, who attended the last Annual Conference of the Indian Psychiatric Society (ANCIPS 2007, with a smirk and a whisper, "Here, you might want to get started on weightlifting at least now!" Her whisper was not merely for dramatic effect; she was clearly out of breath, wielding the heavy volume, a freebie from the conference that I was unable to attend.Weighty it is indeed; and for those who relish intellectual sparring with insights into the raison d'etre of our discipline, there could be no better and closer-to-complete reference volume. The interface of the vast domains of philosophy and psychiatry is considered in five parts; the division, albeit and even inevitably artificial, facilitates reference to particular relevant material greatly. The first part is "Core concepts in philosophy and mental health," which includes some fundamentals of the two disciplines, a broad review of the Szazian antipsychiatry and its tenets, as also the arguments against these. Framed well are the usefulness and limits of the medical model. The topic of psychopathology is here introduced. Boorse's distinction between illness and disease is elaborated.In the second part, "A philosophical history of psychopathology," there is a succinct summary of the history of concepts of mental illness. The phenomenological approaches of Karl Jaspers and Edmund Husserl are expanded upon, and the limitations of a purely phenomenological approach are rightly emphasized. "Philosophy of science and mental health" is the third part, wherein the philosopher J.L. Austin's notions of the nature of science, the place of psychiatry and indeed of psychology in the realm of the sciences (often so grudgingly granted by other well-recognized 'pure' and 'applied' sciences and Freudian psychoanalysis are deliberated upon. The importance of subjective and objective judgments and the 'evidence-base,' much bandied

  3. A Complex Systems Approach to Causal Discovery in Psychiatry.

    Directory of Open Access Journals (Sweden)

    Glenn N Saxe

    Full Text Available Conventional research methodologies and data analytic approaches in psychiatric research are unable to reliably infer causal relations without experimental designs, or to make inferences about the functional properties of the complex systems in which psychiatric disorders are embedded. This article describes a series of studies to validate a novel hybrid computational approach--the Complex Systems-Causal Network (CS-CN method-designed to integrate causal discovery within a complex systems framework for psychiatric research. The CS-CN method was first applied to an existing dataset on psychopathology in 163 children hospitalized with injuries (validation study. Next, it was applied to a much larger dataset of traumatized children (replication study. Finally, the CS-CN method was applied in a controlled experiment using a 'gold standard' dataset for causal discovery and compared with other methods for accurately detecting causal variables (resimulation controlled experiment. The CS-CN method successfully detected a causal network of 111 variables and 167 bivariate relations in the initial validation study. This causal network had well-defined adaptive properties and a set of variables was found that disproportionally contributed to these properties. Modeling the removal of these variables resulted in significant loss of adaptive properties. The CS-CN method was successfully applied in the replication study and performed better than traditional statistical methods, and similarly to state-of-the-art causal discovery algorithms in the causal detection experiment. The CS-CN method was validated, replicated, and yielded both novel and previously validated findings related to risk factors and potential treatments of psychiatric disorders. The novel approach yields both fine-grain (micro and high-level (macro insights and thus represents a promising approach for complex systems-oriented research in psychiatry.

  4. World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2

    DEFF Research Database (Denmark)

    Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas;

    2013-01-01

    These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in 2006. For this 2012 revision, all available publications pertaining to the biological treatment of schizoph......These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in 2006. For this 2012 revision, all available publications pertaining to the biological treatment of...... evidence for its efficacy and then categorised into six levels of evidence (A-F) and five levels of recommendation (1-5) ( Bandelow et al. 2008a ,b, World J Biol Psychiatry 9:242, see Table 1 ). This second part of the updated guidelines covers long-term treatment as well as the management of relevant side...

  5. Improving Psychiatry Residents' Attitudes Toward Individuals Diagnosed with Substance Use Disorders.

    Science.gov (United States)

    Avery, Jonathan; Zerbo, Erin

    2015-01-01

    Special attention needs to be paid to the attitudes of psychiatry residents toward individuals diagnosed with substance use disorders. The attitudes of trainees may be worse toward these individuals than toward individuals with other diagnoses, and these attitudes may worsen over time. While psychiatry residencies are increasingly teaching residents about how to diagnosis and treat individuals diagnosed with substance use disorders, more attention needs to be paid to educating residents about common attitudes toward these individuals. We recommend that psychiatry residency programs start with basic educational didactics and reflection exercises on attitudes toward individuals diagnosed with substance use disorders and that programs try to form a positive "hidden curriculum" in their institutions. PMID:26146757

  6. Moving Toward Integrative, Multidimensional Research in Modern Psychiatry: Lessons Learned From Fragile X Syndrome.

    Science.gov (United States)

    Fung, Lawrence K; Reiss, Allan L

    2016-07-15

    The field of psychiatry is approaching a major inflection point. The basic science behind cognition, emotion, behavior, and social processes has been advancing rapidly in the past 20 years. However, clinical research supporting the classification system in psychiatry has not kept up with these scientific advances. To begin organizing the basic science of psychiatry in a comprehensive manner, we begin by selecting fragile X syndrome, a neurogenetic disease with cognitive-behavioral manifestations, to illustrate key concepts in an integrative, multidimensional model. Specifically, we describe key genetic and molecular mechanisms (e.g., gamma-aminobutyric acidergic dysfunction and metabotropic glutamate receptor 5-associated long-term depression) relevant to the pathophysiology of fragile X syndrome as well as neural correlates of cognitive-behavioral symptoms. We then describe what we have learned from fragile X syndrome that may be applicable to other psychiatric disorders. We conclude this review by discussing current and future opportunities in diagnosing and treating psychiatric diseases. PMID:26868443

  7. A Propitious Moment in the Midst of Crisis: A Case Study of Organizational Change in an Academic Department

    Science.gov (United States)

    Buckley, Peter F.; Grigsby, R. Kevin

    2011-01-01

    Objective: The authors analyze the change, growth, and healing process of the Department of Psychiatry and Health Behavior at the Medical College of Georgia School of Medicine, which came close to its demise when the department Chair and a senior faculty member were arrested and charged with criminal misconduct related to financial transactions in…

  8. Ending political abuse of psychiatry: where we are at and what needs to be done.

    Science.gov (United States)

    van Voren, Robert

    2016-02-01

    The number of reports of political activists falling victim to the political abuse of psychiatry is increasing. When the USSR first disintegrated, this practice virtually ceased to occur. What came in its place, however, was a disturbing collection of other forms of abuses, including human rights abuses, caused by a lack of resources, outdated treatment methods, a lack of understanding of individual human rights and a growing lack of tolerance in society. The number of cases of political abuse of psychiatry has increased since the 21st century began, particularly over the past few years in Russia, Belarus and Kazakhstan. PMID:26958357

  9. A comparative and empirical analysis of practices in Norwegian forensic psychiatry

    OpenAIRE

    2010-01-01

    List of papers. Papers I-III are removed from the thesis due to copyright restrictions. Paper I: Grøndahl, P. Scandinavian forensic psychiatric practices – an overview and evaluation. Nordic Journal of Psychiatry 2005; 59:92-102. DOI: 10.1080/08039480510022927 Paper II: Grøndahl, P., Ikdahl, S.E., Dahl, A.A. A study of forensic psychiatric screening reports and their relationship to full psychiatric reports. Journal of Forensic Psychiatry & Psychology 2007; 18:331-41....

  10. Modern psychiatry in India: the British role in establishing an Asian system, 1858-1947.

    Science.gov (United States)

    Mills, J

    2006-08-01

    Four broad phases can be traced in the development of modern psychiatry in India. After briefly considering the outline of each of these phases this article will focus its attention on the second and third. It will be argued through tracing the trends in patient admission, treatment regimes and the organisation of the asylum system in these years that the foundations of modern psychiatry were laid in India in the period 1858 to 1947 and that the modern psychiatric system in India as it is today, although it has evolved since Independence in 1947, continues in significant ways to be shaped by the colonial period. PMID:16943145

  11. [Philosophy of psychiatry and phenomenology of everyday life: The disruptions of ordinary experience in schizophrenia].

    Science.gov (United States)

    Troubé, Sarah

    2016-12-01

    The paper considers the philosophy of psychiatry from the perspective of everyday life, as a particular structure of experience. We outline some questions raised by disturbances typical of psychotic disorders with regard to a phenomenology of the everyday and common sense. As a link between philosophy and clinical psychopathology, this phenomenology implies a transcendental point of view, embedded in concrete and practical forms of ordinary experience, along with social norms. This opens the possibility of a mutual questioning between philosophy and psychiatry, drawing on its clinical, epistemological, and ethical dimensions. PMID:27550459

  12. Ein Lehrbuch über Psychiatrie und Psychotherapie – Geschlechtsunterschiede unter der Lupe? A Textbook for Psychiatry and Psychotherapy—Gender Differences under the Microscope?

    OpenAIRE

    Isabella Heuser; Nicole C. Schommer

    2007-01-01

    Anke Rohde und Andreas Marneros haben sich ein hohes Ziel gesetzt: ein übersichtliches Lehrbuch für Psychiatrie und Psychotherapie, das erstmals eine systematische Zusammenstellung des Wissens über geschlechtsspezifische Aspekte von Symptomatologie, Epidemiologie, Diagnostik, Pharmakotherapie und Psychotherapie psychischer Störungen enthält. Bemerkenswert ist dabei zweierlei: Erstens werden bei der Betrachtung geschlechtsspezifischer Unterschiede im Sinne der Genderforschung Frauen und Männer...

  13. Neurociência e psiquiatria Neuroscience and psychiatry

    Directory of Open Access Journals (Sweden)

    Frederico G. Graeff

    2006-01-01

    Full Text Available Ao longo da história da psiquiatria, observa-se uma oscilação entre uma perspectiva biológica e outra mentalista. A perspectiva biológica enfatiza explicações calcadas no sistema nervoso central e intervenções psicofarmacológicas. Por outro lado, a perspectiva mentalista prioriza a experiência subjetiva e intervenções através da psicoterapia. Embora o embate entre estas duas perspectivas esteja longe de ser resolvido, o presente trabalho defende uma posição intermediária, privilegiando um equilíbrio entre estas duas perspectivas. Ao longo do artigo, apresenta-se o pensamento de autores dualistas, que propõem uma interação entre mente e cérebro, assim como de autores monistas, que consideram o cérebro como gerador dos processos mentais. Discute-se, também, a crítica que o conhecimento de natureza subjetiva, produzido pela psicanálise, vem sofrendo por parte de alguns neurocientistas. Finalmente, considera-se o conceito de "complementaridade", elaborado pelos físicos quânticos Heisenberg e Bohr, como uma possível forma de solucionar o impasse epistemológico entre psicanálise e neurociência.Throughout its history, Psychiatry shows a clear oscillation between biological and mentalistic perspectives. The biological perspective emphasizes explanations based on the central nervous system and psychopharmacological interventions. On the other hand, the mentalistic perspective highlights subjective experience and interventions based on psychotherapy. Although this difference of opinion is far from being solved, the present work stands for a balance between these two perspectives. The paper presents the dualistic and monist point of views regarding the brain-mind debate. It also discusses the criticisms put forward by some neuroscientists on the subjective knowledge produced by Psychoanalysis. Finally, it is suggested that the "complementarity" concept developed by the quantum physicists Heisenberg and Bohr might help to

  14. Adult attention deficit hyperactivity disorder is associated with migraine headaches

    OpenAIRE

    Fasmer, Ole Bernt; Halmøy, Anne; Ødegaard, Ketil Joachim; Haavik, Jan

    2011-01-01

    Attention deficit hyperactivity disorder (ADHD) is now recognized as a common disorder both in child and adult psychiatry. Adult patients with a diagnosis of ADHD (n = 572) and community controls (n = 675) responded to auto-questionnaires rating past and present symptoms of ADHD, co-morbid conditions, including migraine, treatment history and work status. The prevalence of migraine was significantly higher in the patient group compared to the controls (28.3% vs. 19.2%, P 

  15. Autism spectrum disorder in adults: diagnosis, management, and health services development

    OpenAIRE

    Murphy, Clodagh

    2016-01-01

    Clodagh M Murphy,1,2 C Ellie Wilson,1–3 Dene M Robertson,1,2 Christine Ecker,1,4 Eileen M Daly,1,2 Neil Hammond,1,2 Anastasios Galanopoulos,1,2 Iulia Dud,1,2 Declan G Murphy,1,2 Grainne M McAlonan1,2 1Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, 2Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Gen...

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

    Science.gov (United States)

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

    2010-01-01

    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…

  17. Trends in Psychotherapy Training: A National Survey of Psychiatry Residency Training

    Science.gov (United States)

    Sudak, Donna M.; Goldberg, David A.

    2012-01-01

    Objective: The authors sought to determine current trends in residency training of psychiatrists. Method: The authors surveyed U.S. general-psychiatry training directors about the amount of didactic training, supervised clinical experience, and numbers of patients treated in the RRC-mandated models of psychotherapy (psychodynamic,…

  18. People see what papers show! Psychiatry's stint with print media: A pilot study from Mumbai, India.

    Science.gov (United States)

    Shrivastava, Shivanshu; Kalra, Gurvinder; Ajinkya, Shaunak

    2015-01-01

    Mass media including television, internet, and newspapers influences public views about various issues by means of how it covers an issue. Newspapers have a wider reach and may affect the impact that a news story has on the reader by factors such as placement of the story within the different pages. We did a pilot study to see how two English newspapers from Mumbai, India were covering psychiatry related news stories. The study was done over a period of 3 months. We found a total of 870 psychiatry related news stories in the two newspapers over 3 months with the majority of them being covered in the main body of the newspapers. Sex-related crime stories and/or sexual dysfunction stories received the highest coverage among all the news while treatment and/or recovery related stories received very little coverage. It is crucial that the print media takes more efforts in improving reporting of psychiatry-related stories and help in de-stigmatizing psychiatry as a discipline. PMID:26816431

  19. Resident psychiatrists as assessors for lectures in continued medical education in psychiatry

    OpenAIRE

    Melamed Yuval; Ophir Gil; Nechama Yael; Abramovitzh Ruth; Notzer Netta; Apter Alan

    2006-01-01

    OBJECTIVES: We examined the quality of instruction in a continued medical education course and the correspondence between the residents and lecturers evaluations of the program. MATERIALS AND METHODS : Resident psychiatrists and instructors completed structured evaluation forms immediately following each lecture in a psychiatry course for one academic year. RESULTS : Residents′ and lecturers′ evaluations of goal achievement, but not general ratings of lecture quality correlated ...

  20. Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

    Science.gov (United States)

    Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

    2008-01-01

    Objective: Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access…

  1. The impact of generational change and retirement on psychiatry to 2025

    Directory of Open Access Journals (Sweden)

    Schofield Deborah J

    2007-09-01

    Full Text Available Abstract Background Australia is currently experiencing widespread shortages of psychiatrists. The changing nature of the workforce and increasing demand mean that these shortages are unlikely to ease. This study aims to identify demographic change and retirement patterns of the Australian psychiatry workforce from 1995 to 2003, and the implications of those changes for future workforce planning. Methods Data from the Australian Institute of Health and Welfare (AIHW Medical Labour Force Survey from 1995 to 2003 is used to examine ageing of the psychiatry workforce and attrition of psychiatrists aged 50 years and over. Future attrition from the workforce is projected to 2025. Results Sixty two percent of psychiatrists practicing in the year 2000 are predicted to have retired by 2025. Most psychiatrists continue to work until late in life, with only 18 per cent retiring before age 65. The psychiatry workforce aged significantly between 1995 and 2003 (p Conclusion The impact of ageing of the workforce may be more immediate for psychiatry than for some other health professions. With the growing proportion of females and their typically lower workforce participation, more than one younger psychiatrist will be required to replace each of the mostly male retirees.

  2. Training in Cognitive Behavioral Therapy in Psychiatry Residency: An Overview for Educators

    Science.gov (United States)

    Sudak, Donna M.

    2009-01-01

    In January 2001, Accreditation Council of Graduate Medical Education accredited general psychiatry training programs were charged with the requirement to train residents in cognitive-behavioral therapy (CBT) to a level of competence. Programs were given the responsibility to delineate standards for trainees, to determine measures of competence,…

  3. Do Clinical Evaluations in a Psychiatry Clerkship Favor Students with Positive Personality Characteristics?

    Science.gov (United States)

    Chibnall, John T.; Blaskiewicz, Robert J.

    2008-01-01

    Objective: The authors examine associations of personality characteristics, National Board of Medical Examiners subject examination performance, and Objective Structured Clinical Examination performance with clinical evaluations of third-year medical students in a psychiatry clerkship. Methods: Students completed the Revised NEO Personality…

  4. Do editorial policies support ethical research? A thematic text analysis of author instructions in psychiatry journals.

    Directory of Open Access Journals (Sweden)

    Daniel Strech

    Full Text Available INTRODUCTION: According to the Declaration of Helsinki and other guidelines, clinical studies should be approved by a research ethics committee and seek valid informed consent from the participants. Editors of medical journals are encouraged by the ICMJE and COPE to include requirements for these principles in the journal's instructions for authors. This study assessed the editorial policies of psychiatry journals regarding ethics review and informed consent. METHODS AND FINDINGS: The information given on ethics review and informed consent and the mentioning of the ICMJE and COPE recommendations were assessed within author's instructions and online submission procedures of all 123 eligible psychiatry journals. While 54% and 58% of editorial policies required ethics review and informed consent, only 14% and 19% demanded the reporting of these issues in the manuscript. The TOP-10 psychiatry journals (ranked by impact factor performed similarly in this regard. CONCLUSIONS: Only every second psychiatry journal adheres to the ICMJE's recommendation to inform authors about requirements for informed consent and ethics review. Furthermore, we argue that even the ICMJE's recommendations in this regard are insufficient, at least for ethically challenging clinical trials. At the same time, ideal scientific design sometimes even needs to be compromised for ethical reasons. We suggest that features of clinical studies that make them morally controversial, but not necessarily unethical, are analogous to methodological limitations and should thus be reported explicitly. Editorial policies as well as reporting guidelines such as CONSORT should be extended to support a meaningful reporting of ethical research.

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

    Science.gov (United States)

    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.

    2014-01-01

    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…

  6. Cinemeducation in Psychiatry: A Seminar in Undergraduate Medical Education Combining a Movie, Lecture, and Patient Interview

    Science.gov (United States)

    Kuhnigk, Olaf; Schreiner, Julia; Reimer, Jens; Emami, Roya; Naber, Dieter; Harendza, Sigrid

    2012-01-01

    Objective: Psychiatric educators are often faced with students' negative attitudes toward psychiatry. A new type of seminar has been established in order to enable students to gain a deeper understanding of psychiatric illness. Method: A "cinemeducation seminar," combining a movie, a lecture, and a patient interview, has been established as part…

  7. Teaching of Psychiatry by PSP: Impact on NBME-Examination Scores

    Science.gov (United States)

    Gregory, Ian; And Others

    1977-01-01

    A Personalized Study Program (PSP) was implemented in 1974 at Ohio State for all students on the psychiatry clerkship. PSP included an assigned textbook and syllabus of reading assignments, private meetings with tutors, standardized practice quizzes, optional use of other opportunities, and a written final exam. Its success is noted. (LBH)

  8. Diagnoses and Presenting Symptoms in an Infant Psychiatry Clinic: Comparison of Two Diagnostic Systems.

    Science.gov (United States)

    Frankel, Karen A.; Boyum, Lisa A.; Harmon, Robert J.

    2004-01-01

    Objective: To present data from a general infant psychiatry clinic, including range and frequency of presenting symptoms, relationship between symptoms and diagnoses, and comparison of two diagnostic systems, DSM-IV and Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3). Method: A…

  9. Effect of Medical Education on Students' Attitudes toward Psychiatry and Individuals with Mental Disorders

    Science.gov (United States)

    Hofmann, Marzellus; Harendza, Sigrid; Meyer, Jelka; Drabik, Anna; Reimer, Jens; Kuhnigk, Olaf

    2013-01-01

    Objective: This study aimed to explore the effect of medical education on students' attitudes toward psychiatry and psychiatric patients, and examined the usefulness of a new evaluation tool: the 6-item Psychiatric Experience, Attitudes, and Knowledge (PEAK-6). Method: Authors studied the attitudes of 116 medical students toward psychiatry…

  10. Preparing for a Successful Psychiatry Residency Review Committee Site Visit: A Guide for New Training Directors

    Science.gov (United States)

    Bhatia, Shashi K.; Bhatia, Subhash C.

    2005-01-01

    Objective: New residency training directors are often faced with multiple competing tasks such as meeting Accreditation Council for Graduate Medical Education (ACGME) Psychiatry Program Requirements and achieving successful completion of residency review committee (RRC) site visits. For many years, the authors have presented workshops on this…

  11. Associate Residency Training Directors in Psychiatry: Demographics, Professional Activities, and Job Satisfaction

    Science.gov (United States)

    Arbuckle, Melissa R.; DeGolia, Sallie G.; Esposito, Karin; Miller, Deborah A.; Weinberg, Michael; Brenner, Adam M.

    2012-01-01

    Objective: The purpose of this study was to characterize associate training director (ATD) positions in psychiatry. Method: An on-line survey was e-mailed in 2009 to all ATDs identified through the American Association of Directors of Psychiatric Residency Training (AADPRT). Survey questions elicited information regarding demographics,…

  12. Rehabilitation : New term for or further development of social psychiatry? A Dutch perspective

    NARCIS (Netherlands)

    Wiersma, Durk

    2008-01-01

    Social psychiatry as an academic discipline and field of clinical practice seems to have lost its prominence and is being incorporated in regular clinical services of mental healthcare and also in various branches of social, genetic, psychiatric or clinical epidemiology. However, the central debate

  13. A Description of the Use of Music Therapy in Consultation-Liaison Psychiatry

    OpenAIRE

    Rafieyan, Roia; Ries, Rose

    2007-01-01

    Music therapy is gaining increasing recognition for its benefit in medical settings both for its salutary effects on physiological parameters and on psychological states associated with medical illness. This article discusses the role of a music therapist in consultation-liaison psychiatry, a specialty that provides intervention for medical and surgical patients with concomitant mental health issues.

  14. Recent Trends in American Board of Psychiatry and Neurology Psychiatric Subspecialties

    Science.gov (United States)

    Faulkner, Larry R.; Juul, Dorthea; Andrade, Naleen N.; Brooks, Beth Ann; Colenda, Christopher C.; Guynn, Robert W.; Mrazek, David A.; Reus, Victor I.; Schneidman, Barbara S.; Shaw, Kailie R.

    2011-01-01

    Objective: This article reviews the current status and recent trends in the American Board of Psychiatry and Neurology (ABPN) psychiatric subspecialties and discusses the implications of those trends as well as several key questions whose answers may well determine subspecialty viability. Methods: Data are presented on specialty and subspecialty…

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

    Science.gov (United States)

    Dingle, Arden D.; Sexson, Sandra B.

    2007-01-01

    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,…

  16. [Contribution of the Polish-German Mental Health Society to changes in Polish psychiatry].

    Science.gov (United States)

    Cichocki, Łukasz; Cechnicki, Andrzej

    2014-01-01

    The aim of this presentation is to give a profile of the history and work of the Polish-German Mental Health Society (PNTZP). Founded in 1990, the PNTZP's supreme objective is to develop and reinforce partnership between Polish and German psychiatry on a range of levels. The methods it uses to further this aim include bilateral meetings, seminars, and annual symposia. In view of its historical roots, the PNTZP is constantly mindful of the excesses perpetrated on the mentally ill during the National Socialist period, and believes it has an obligation to promote a brand of psychiatry founded on the person, respect for human dignity, and the will and individuality of every man. For this reason, ethics are an essential element of discussion, including discussions with patients and their families. The society advocates the implementation of the National Programme of Mental Health Care and the development of community psychiatry in Poland. It supports the development of various structures for the treatment and assistance of people with mental illness, as well as scientific and academic reflection on the social and cultural implications of psychiatric thought and action. It is committed to facilitating the exchange of experiences between different professional groups, patients, and their families in order to promote mutual inspiration and support in the challenging task of developing psychiatry. A record of these years of meetings may be found in the twenty issues of the periodical Dialog. This example of cooperation across official state borders may be held up as a benchmark for the development of European psychiatry, and the joint work and discussions may offer help and inspiration in day-to-day therapeutic practice. The PNTZP is open to new people and initiatives, and is always looking for people willing to get involved in its work. PMID:25016775

  17. Perception of 1 st year medical students towards career choices and specialty of psychiatry

    Directory of Open Access Journals (Sweden)

    Suneet Kumar Upadhyaya

    2015-01-01

    Full Text Available Background: Shortage of psychiatrists is a worldwide phenomenon. If the factors that attract or repel students towards a specialty can be identified, it may be possible to encourage them towards it. Choice of specialty as a career depends on the complex interplay of experiences before, during or after exposure to the specialty. Objectives: The aim was to understand perceptions of 1 st year medical students regarding career choices and the specialty of psychiatry through a cross-sectional questionnaire-based study. Materials and Methods: Perceptions of 137 1 st year medical students from the Government Medical College were recorded using a semi-structured questionnaire. Students provided their opinions about future career choices; perspective of these specialties in terms of financial reward, reputation, work-life balance, challenging aspect, ability to help patients effectively and emotional stability; their preferences in life and interaction with psychiatrist and its impact. Statistical Analysis Used: One-way analysis of variance (ANOVA with post-hoc analysis by Tukey-Kramer test. Results: Surgery was a high priority for 69 (50% while psychiatry was a high priority only for 11 (8%. Surgery was highest for financial reward and reputation, but lowest for work-life balance. Psychiatry had higher emotional stability, however, its the reputation was lower than surgery, medicine, obstetrics and gynaecology and paediatrics. Students preferred reputation (41% over social service opportunities (43%, work-life balance (16%, and high-income (11%. Interaction with psychiatrist increased inclination for psychiatry in 69% (9/13 students. Conclusions: Psychiatry is not a preferred specialty among 1 st year medical students due to its poor reputation.

  18. Is psychiatry only neurology? Or only abnormal psychology? Déjà vu after 100 years.

    Science.gov (United States)

    de Leon, Jose

    2015-04-01

    Forgetting history, which frequently repeats itself, is a mistake. In General Psychopathology, Jaspers criticised early 20th century psychiatrists, including those who thought psychiatry was only neurology (Wernicke) or only abnormal psychology (Freud), or who did not see the limitations of the medical model in psychiatry (Kraepelin). Jaspers proposed that some psychiatric disorders follow the medical model (Group I), while others are variations of normality (Group III), or comprise schizophrenia and severe mood disorders (Group II). In the early 21st century, the players' names have changed but the game remains the same. The US NIMH is reprising both Wernicke's brain mythology and Kraepelin's marketing promises. The neo-Kraepelinian revolution started at Washington University, became pre-eminent through the DSM-III developed by Spitzer, but reached a dead end with the DSM-5. McHugh, who described four perspectives in psychiatry, is the leading contemporary representative of the Jaspersian diagnostic approach. Other neo-Jaspersians are: Berrios, Wiggins and Schwartz, Ghaemi, Stanghellini, Parnas and Sass. Can psychiatry learn from its mistakes? The current psychiatric language, organised at its three levels, symptoms, syndromes, and disorders, was developed in the 19th century but is obsolete for the 21st century. Scientific advances in Jaspers' Group III disorders require collaborating with researchers in the social and psychological sciences. Jaspers' Group II disorders, redefined by the author as schizophrenia, catatonic syndromes, and severe mood disorders, are the core of psychiatry. Scientific advancement in them is not easy because we are not sure how to delineate between and within them correctly. PMID:25849592

  19. [Modern criticism of psychiatry -- rebellion or return to tradition? (author's transl)].

    Science.gov (United States)

    Glatzel, J

    1976-02-01

    Modern criticism of psychiatry started about 10 years ago with violent attacks on the ways in which psychiatric patients were handled in practice. In its attempt to shatter rigid structures and to adopt attitudes, wellknown for many years, for therapeutic action, this criticism remains in an historical scientific tradition which can be traced back to the beginning of this century. With the advance of sociologic thinking and the adoption of radical sociogenetic demands, mainly in the Anglo-Saxon literature, this criticism finds its own feet towards the end of the sixties as a kind of antipsychiatry. It obtains its leverage in the lack of differentiation between diagnosis and psychopathologic description in psychiatry ignoring like Birnbaum the "essential" history of psychiatric science dating from the middle of the 19th century, it returns to the psychiatry of late romanticism. It assesses the place of psychiatry within the range of sciences. In a similar manner it opposes the detached, individual-psychologic, approach or classical psychopathology and sees the various psychopathologic data as forms of a deviation in the sense of symbolic interactionism. Modern criticism of psychiatry could, therefore, mark the start of a developing interactional psychopathology which would certainly not have to compete with traditional psychopathology. It could take its place as an independent approach on equal terms with existing trends. A precondition would be a disnissal of a- and antihistoric basic tendencies which alone would make possible the necessary re-interpretation with the developments up to date and with present-day achievements. PMID:767236

  20. Contribution of the Polish-German Mental Health Society to changes in Polish psychiatry

    Directory of Open Access Journals (Sweden)

    Cichocki, Łukasz

    2014-04-01

    Full Text Available The aim of this presentation is to give a profile of the history and work of the Polish-German Mental Health Society (PNTZP. Founded in 1990, the PNTZP’s supreme objective is to develop and reinforce partnership between Polish and German psychiatry on a range of levels. The methods it uses to further this aim include bilateral meetings, seminars, and annual symposia. In view of its historical roots, the PNTZP is constantly mindful of the excesses perpetrated on the mentally ill during the National Socialist period, and believes it has an obligation to promote a brand of psychiatry founded on the person, respect for human dignity, and the will and individuality of every man. For this reason, ethics are an essential element of discussion, including discussions with patients and their families. The society advocates the implementation of the National Programme of Mental Health Care and the development of community psychiatry in Poland. It supports the development of various structures for the treatment and assistance of people with mental illness, as well as scientific and academic reflection on the social and cultural implications of psychiatric thought and action. It is committed to facilitating the exchange of experiences between different professional groups, patients, and their families in order to promote mutual inspiration and support in the challenging task of developing psychiatry. A record of these years of meetings may be found in the twenty issues of the periodical Dialog. This example of cooperation across official state borders may be held up as a benchmark for the development of European psychiatry, and the joint work and discussions may offer help and inspiration in day-to-day therapeutic practice. The PNTZP is open to new people and initiatives, and is always looking for people willing to get involved in its work.

  1. Impact of social support and self-efficacy on functioning in depressed older adults with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Patricia Marino

    2008-08-01

    Full Text Available Patricia Marino, Jo Anne Sirey, Patrick J Raue, George S AlexopoulosDepartment of Psychiatry, Weill Medical College of Cornell University, White Plains, NY, USAObjective: The objective of this study was to examine the association between social support, self-efficacy, and functioning among a sample of depressed older adults with chronic obstructive pulmonary disease (COPD.Methods: Participants were recruited immediately following admission to an acute pulmonary rehabilitation unit of a rehabilitation hospital. One hundred and fifty-six subjects completed assessments of depression, functioning, social support, and self-efficacy at admission to the rehabilitation unit. Regression analyses were conducted to evaluate the impact of different aspects of social support and self-efficacy on overall functioning at admission.Results: Controlling for depression, COPD severity, and age, subjective social support (p = 0.05 and self-efficacy (p < 0.01 were associated with overall functioning.Conclusion: The perception of social support as well as self-efficacy are important constructs related to overall functioning among depressed older adults with COPD. Attention to these psychosocial variables in health management interventions may help maintain or improve the overall functioning of depressed COPD patients.Keywords: COPD, depression, social support, self-efficacy, functioning

  2. The Brazilian Neurology centenary (1912-2012) and the common origin of the fields of Neurology and Psychiatry

    OpenAIRE

    Marleide da Mota Gomes; Jose Luiz de Sá Cavalcanti

    2013-01-01

    It is reported the Brazilian Neurology birth (1912), that has as the hallmark its first Neurology Cathedra of Rio de Janeiro, and the links between Neurology and Psychiatry, besides the main medical protagonists at that time in Rio de Janeiro: João Carlos Teixeira Brandão (1854-1921), first professor of the cathedra of Clinical Psychiatry and Nervous Diseases (1883-1921); Juliano Moreira (1873-1933), the founder of the Brazilian scientific Psychiatry and director of the Hospício Nacional de A...

  3. [Dynamic paradigm in psychopathology: "chaos theory", from physics to psychiatry].

    Science.gov (United States)

    Pezard, L; Nandrino, J L

    2001-01-01

    For the last thirty years, progress in the field of physics, known as "Chaos theory"--or more precisely: non-linear dynamical systems theory--has increased our understanding of complex systems dynamics. This framework's formalism is general enough to be applied in other domains, such as biology or psychology, where complex systems are the rule rather than the exception. Our goal is to show here that this framework can become a valuable tool in scientific fields such as neuroscience and psychiatry where objects possess natural time dependency (i.e. dynamical properties) and non-linear characteristics. The application of non-linear dynamics concepts on these topics is more precise than a loose metaphor and can throw a new light on mental functioning and dysfunctioning. A class of neural networks (recurrent neural networks) constitutes an example of the implementation of the dynamical system concept and provides models of cognitive processes (15). The state of activity of the network is represented in its state space and the time evolution of this state is a trajectory in this space. After a period of time those networks settle on an equilibrium (a kind of attractor). The strength of connections between neurons define the number and relations between those attractors. The attractors of the network are usually interpreted as "mental representations". When an initial condition is imposed to the network, the evolution towards an attractor is considered as a model of information processing (27). This information processing is not defined in a symbolic manner but is a result of the interaction between distributed elements. Several properties of dynamical models can be used to define a way where the symbolic properties emerge from physical and dynamical properties (28) and thus they can be candidates for the definition of the emergence of mental properties on the basis of neuronal dynamics (42). Nevertheless, mental properties can also be considered as the result of an

  4. 38 CFR 18.438 - Adult education.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on...

  5. [Asylum for curing or securing? The confinement of forensic patients as a challenge of asylum psychiatry in Imperial Germany].

    Science.gov (United States)

    Müller, Christian

    2006-01-01

    Asylum for curing or securing? The confinement of forensic patients as a challenge of asylum psychiatry in Imperial Germany. In Imperial Germany psychiatrists sought to give their asylums the character of modern medical hospitals. Due to the increase of insanity defence these efforts were obstructed by the high number of inmates with a criminal background. Special departments for mentally ill criminals were founded both in asylums and in prisons. But the clientele was not welcome in any of these institutions. Thus, there was a high fluctuation between prisons and asylums. A new definition of criminal responsibility was needed. In order to keep criminals out of their hospitals psychiatrists developed the medical concept of psychopathy referring to a mental defect without lack of responsibility. On the other hand penal law reformers plead to introduce preventive measures, such as security confinement, into the criminal law book. Since the resolution of the 'law against habitual criminals' in November 1933 judges are allowed to sentence mentally ill offenders to indefinite confinement in psychiatric institutions. PMID:17144371

  6. Psychiatry, authoritarianism, and revolution: the politics of mental illness during military dictatorships in Argentina, 1966-1983.

    Science.gov (United States)

    Ramos, Marco A

    2013-01-01

    From 1966 to 1983, Argentina underwent a period of political radicalization as fascist regimes used terror to control its citizens and leftist guerrillas resorted to violence to spark revolution. During this politically volatile period, psychiatry transformed from an apolitical clinical specialty into an ideological tool used for both leftist resistance and military oppression. The largest psychiatric organization at the time, the Federación Argentina de Psiquiatras (FAP), became the center for a new politically committed brand of psychiatry in Argentina that united psychoanalysis and community psychiatry with Marxist theory. Though the military targeted and eventually dismantled the FAP and its leftist brand of psychoanalysis and community psychiatry, sectors of the government also paradoxically appropriated and reframed community-based psychiatric perspectives to pathologize leftist subversion and advance their own conservative ideology. PMID:23811712

  7. Adult Strabismus

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Adult Strabismus En Español Read in Chinese Can anything be done for adults with strabismus (misaligned eyes)? Yes. Adults can benefit ...

  8. Ein Lehrbuch über Psychiatrie und Psychotherapie – Geschlechtsunterschiede unter der Lupe? A Textbook for Psychiatry and Psychotherapy—Gender Differences under the Microscope?

    Directory of Open Access Journals (Sweden)

    Isabella Heuser

    2007-07-01

    Full Text Available Anke Rohde und Andreas Marneros haben sich ein hohes Ziel gesetzt: ein übersichtliches Lehrbuch für Psychiatrie und Psychotherapie, das erstmals eine systematische Zusammenstellung des Wissens über geschlechtsspezifische Aspekte von Symptomatologie, Epidemiologie, Diagnostik, Pharmakotherapie und Psychotherapie psychischer Störungen enthält. Bemerkenswert ist dabei zweierlei: Erstens werden bei der Betrachtung geschlechtsspezifischer Unterschiede im Sinne der Genderforschung Frauen und Männer berücksichtigt, zweitens wird ein vollständiger Überblick sowohl über die häufigen und bekannten psychischen Störungen als auch die äußerst seltenen psychiatrischen Erkrankungen der gesamten Altersspanne gegeben. Wenngleich die Qualität der einzelnen Beiträge deutlich zwischen sehr differenzierter und leider auch für ein Handbuch eindeutig zu oberflächlicher Betrachtung variiert, liegt in dem Band ein weitgehend informatives Nachschlagewerk vor, das einen ersten Überblick über die geschlechtsspezifische Psychiatrie gibt.Anke Rohde and Andres Marneros have given themselves a lofty goal: To put together a systematic collection for the first time that contains the entire body of knowledge on the gender-specific aspects of symptomatology, epidemiology, diagnostics, pharmacotherapy, and psychotherapy of psychological disturbances. There are two notable aspects: First, in accordance with contemporary gender analysis, the examination of the gender-specific differences takes both women and men into account; second, the book provides a complete overview of the common and well-known psychological disturbances as well as the extremely rare psychiatric illnesses along the entire age spectrum. Although the quality of the individual articles clearly ranges from the very sophisticated to a superficial treatment inappropriate for a textbook, the volume itself is, for the most part, an informative work of reference that offers an initial overview of

  9. Is There a Way out of This Clinic? An Adult and Community Education Perspective on Methadone and the Absence of Rehabilitation

    Science.gov (United States)

    O'Brien, Thomas

    2007-01-01

    This paper critically examines methadone treatment from the perspective of adult and community education and questions the absence of rehabilitation. It identifies biomedicine and the methodology of evidence based medicine as the discourses that determine our understanding of addiction and treatment. It is especially critical of psychiatry for the…

  10. Public-Private Substitution Among Medicaid Adults...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Few adult Medicaid enrollees in Ohio voluntarily replace their private coverage with Medicaid. In 2008, only 2.9 percent of new Medicaid adults voluntarily...

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

    OpenAIRE

    Sneha, Jadhav; Prakash, Chandra; Vinay, Saranga

    2011-01-01

    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...

  12. Canadian Academy of Geriatric Psychiatry 2015 Annual Scientific Meeting Abstracts

    OpenAIRE

    Drance, Elisabeth; Neil, Margaret McKenzie; Maldeniya, Pramudith; Arena, Amanda; Ionson, Emily; Burhan, Amer; Wetmore, Stephen; Newman, Ronnie; Abdool, Petal; Leon, Chloe; Wilkins-Ho, Michael; Looper, Karl; Friedland, Jess; Nair, Vasavan; Woo, Tricia

    2016-01-01

    The P.I.E.C.E.S. education program provides the foundation for a vision, language, and approach to the care of older persons with increasingly complex physical and cognitive mental health needs and associated behavioural symptoms. This framework works in concert with the British Columbia BPSD Algorithm and enhances the capacity of the interdisciplinary team to provide care, services and support to those older adults. The BC project started with the Kamloops Integrated P.I.E.C.E.S initiative i...

  13. Resting and reactive frontal brain electrical activity (EEG among a non-clinical sample of socially anxious adults: Does concurrent depressive mood matter?

    Directory of Open Access Journals (Sweden)

    Elliott A Beaton

    2008-03-01

    Full Text Available Elliott A Beaton1, Louis A Schmidt2, Andrea R Ashbaugh2,5, Diane L Santesso2, Martin M Antony1,3,4, Randi E McCabe1,31Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; 2Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada; 3Anxiety Treatment and Research Centre, St. Joseph’s Healthcare, Hamilton, Ontario, Canada; 4Department of Psychology, Ryerson University, Toronto, Ontario, Canada; 5Concordia University, Montreal, Quebec, CanadaAbstract: A number of studies have noted that the pattern of resting frontal brain electrical activity (EEG is related to individual differences in affective style in healthy infants, children, and adults and some clinical populations when symptoms are reduced or in remission. We measured self-reported trait shyness and sociability, concurrent depressive mood, and frontal brain electrical activity (EEG at rest and in anticipation of a speech task in a non-clinical sample of healthy young adults selected for high and low social anxiety. Although the patterns of resting and reactive frontal EEG asymmetry did not distinguish among individual differences in social anxiety, the pattern of resting frontal EEG asymmetry was related to trait shyness after controlling for concurrent depressive mood. Individuals who reported a higher degree of shyness were likely to exhibit greater relative right frontal EEG activity at rest. However, trait shyness was not related to frontal EEG asymmetry measured during the speech-preparation task, even after controlling for concurrent depressive mood. These findings replicate and extend prior work on resting frontal EEG asymmetry and individual differences in affective style in adults. Findings also highlight the importance of considering concurrent emotional states of participants when examining psychophysiological correlates of personality.Keywords: social anxiety, shyness, sociability

  14. Phelan-McDermid syndrome in two adult brothers: atypical bipolar disorder as its psychopathological phenotype?

    Directory of Open Access Journals (Sweden)

    Verhoeven WMA

    2012-04-01

    Full Text Available Willem MA Verhoeven1,2, Jos IM Egger1,3,4, Marjolein H Willemsen5, Gert JM de Leijer6, Tjitske Kleefstra51Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Neuropsychiatry, Venray, 2Erasmus University Medical Centre, Department of Psychiatry, Rotterdam, 3Donders Centre for Cognition, Radboud University Nijmegen, Nijmegen, 4Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, 5Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, 6Dichterbij, Institutes for Intellectual Disabilities, Gennep, The NetherlandsAbstract: The 22q13.3 deletion, or Phelan-McDermid syndrome, is characterized by global intellectual disability, generalized hypotonia, severely delayed or absent speech associated with features of autism spectrum disorder, and minor dysmorphisms. Its behavioral phenotype comprises sleep disturbances, communication deficits, and motor perseverations. Data on psychological dysfunctions are so far not available. Previous studies have suggested that the loss of one copy of the gene SH3 and multiple ankyrin repeat domains 3 (SHANK3 is related to the neurobehavioral phenotype. Additional genes proximal to SHANK3 are also likely to play a role in the phenotype of patients with larger deletions. The present paper describes two adult brothers with an identical 2.15 Mb 22qter (22q13.32q13.33 deletion, of whom the youngest was referred for evaluation of recurrent mood changes. In both patients, magnetic resonance imaging of the brain showed hypoplasia of the vermis cerebelli. Extensive clinical examinations led to a final diagnosis of atypical bipolar disorder, of which symptoms fully remitted during treatment with a mood stabilizer. In the older brother, a similar psychopathological picture appeared to be present, although less severe and with a later onset. It is concluded that the behavioral phenotype of the 22q13.3 deletion syndrome comprises absent or delayed speech and perseverations

  15. Teaching Cultural Competence to Psychiatry Residents: Seven Core Concepts and Their Implications for Therapeutic Technique.

    Science.gov (United States)

    Pena, Jose M; Manguno-Mire, Gina; Kinzie, Erik; Johnson, Janet E

    2016-04-01

    The authors describe the Tulane Model for teaching cultural competence to psychiatry residents in order to outline an innovative approach to curricula development in academic psychiatry. The authors focus on the didactic experience that takes place during the first and second postgraduate years and present seven core concepts that should inform the emerging clinician's thinking in the formulation of every clinical case. The authors discuss the correspondence between each core concept and the Outline for Cultural Formulation, introduced in Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV and updated in DSM-5. The authors illustrate how each of the core concepts is utilized as a guideline for teaching residents a process for eliciting culturally relevant information from their patients and their personal histories and how to apply that knowledge in the assessment and treatment of patients in clinical settings. PMID:25749919

  16. The secular and the supernatural: madness and psychiatry in the short stories of Muriel Spark.

    Science.gov (United States)

    Beveridge, A W

    2015-01-01

    Edinburgh-born Muriel Spark is one of modern Scotland's greatest writers. Examination of her work reveals that the subjects of madness and psychiatry are recurrent themes in her writing. She herself had a mental breakdown when she was a young woman and she took an interest in the world of psychiatry and psychoanalysis. In her short stories, Spark approaches the subject of madness in a variety of ways: she relates it to the supernatural; to writing fiction; and to religion. She frequently juxtaposes secular and supernatural explanations of mental disturbance. Spark adopts a sceptical and, at times, mocking view of psychiatrists and psychiatric treatment. Both psychoanalysis and pills are seen as problematic. PMID:27070895

  17. World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, part 1

    DEFF Research Database (Denmark)

    Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas;

    2012-01-01

    These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry Guidelines for Biological Treatment of Schizophrenia published in 2005. For this 2012 revision, all available publications pertaining to the biological treatment of schizophrenia were...... on the first version of these guidelines, a systematic review of the MEDLINE/PUBMED database and the Cochrane Library, in addition to data extraction from national treatment guidelines, has been performed for this update. The identified literature was evaluated with respect to the strength of...... evidence for its efficacy and then categorised into six levels of evidence (A-F; Bandelow et al. 2008b, World J Biol Psychiatry 9:242). This first part of the updated guidelines covers the general descriptions of antipsychotics and their side effects, the biological treatment of acute schizophrenia and the...

  18. Cyborg psychiatry to ensure agency and autonomy in mental disorders. A proposal for neuromodulation therapeutics.

    Directory of Open Access Journals (Sweden)

    Jean-Arthur eMicoulaud Franchi

    2013-09-01

    Full Text Available Neuromodulation therapeutics—as repeated Transcranial Magnetic Stimulation (rTMS and neurofeedback—are valuable tools for psychiatry. Nevertheless, they currently face some limitations: rTMS has confounding effects on neural activation patterns, and neurofeedback fails to change neural dynamics in some cases. Here we propose how coupling rTMS and neurofeedback can tackle both issues by adapting neural activations during rTMS and actively guiding individuals during neurofeedback. An algorithmic challenge then consists in designing the proper recording, processing, feedback, and control of unwanted effects. But this new neuromodulation technique also poses an ethical challenge: ensuring treatment occurs within a biopsychosocial model of medicine, while considering both the interaction between the patients and the psychiatrist, and the maintenance of individuals’ autonomy. Our solution is the concept of Cyborg psychiatry, which embodies the technique and includes a self-engaged interaction between patients and the neuromodulation device.

  19. What is Constructionism in Psychiatry? From Social Causes to Psychiatric Classification

    Directory of Open Access Journals (Sweden)

    Raphael van Riel

    2016-04-01

    Full Text Available It is common to note that social environment and cultural formation shape mental disorders. The details of this claim are, however, not well understood. The paper takes a look at the claim that culture has an impact on psychiatry from the perspective of metaphysics and the philosophy of science. Its aim is to offer, in a general fashion, partial explications of some significant versions of the thesis that culture and social environment shape mental disorders, and to highlight some of the consequences social constructionism about psychiatry has for psychiatric explanation. In particular, it will be argued that the alleged dependence of facts about particular mental disorders and about the second order property of being a mental disorder on social facts amounts to a robust form of constructivism, whereas the view that clinician-patient interaction is influenced by cultural facts is perfectly compatible with an anti-constructivist stance.

  20. [The representation of Italian psychiatry in Italian Treccani Encyclopedia in 1930's].

    Science.gov (United States)

    Piazzi, Andrea; Piazzi, Gioia; Testa, Luana; Coccanari dè Fornari, Maria Antonietta

    2013-01-01

    The article reconstruct the situation of Italian psychiatry around 1930, using as unusual sources the pages of the Enciclopedia Italiana di Scienze, Lettere e Arti. This important work, conceived in 1925 and finished in 1937, is due - as well known - to the strong interest of Giovanni Gentile and to his capacity to involve in the project a great part of Italian intellectual world, without any ideological preclusion. The section devoted to Medical Sciences, including Psychiatry, was directed by Nicola Pende (1880-1970) and Giacinto Viola (1870-1943). A prevalent positivistic approach to science is well testified by their specific attention to preventive and social medicine, researches in Genetics and in biotypological constitutions. Psycopathological and psycological lemmas are very limited, underlying the medical disinterest towards contemporary philosophy and psycology. PMID:25807782

  1. [Biological psychiatry (neuropsychiatry)--status and perspectives for for the 1990s].

    Science.gov (United States)

    Rosenberg, R

    1993-01-01

    In recent years, research into biological aspects of psychiatric disorders has had high priority. Biological psychiatry, or neuropsychiatry, is characterised by (a) empiricist epistemology, (b) a diathesis-stress disease model, (c) neurobiological pathogenetic theories, (d) chemical or physical treatment as an essential though not necessarily sufficient measure, and (e) a patient-oriented ethical approach. A short review of some major topics is given, including standardised assessment, clinical and molecular genetics, neurotransmitter theories, neuro-imaging techniques, panic disorder, classic and novel psychopharmacological compounds, and alcohol and drug dependence. Avenues of future research endeavours are delineated, and it is concluded that in the future neuropsychiatry should play a major part in psychiatry, though closely integrated with psychological and social theory. PMID:8098866

  2. Paliperidone palmitate injection for the acute and maintenance treatment of schizophrenia in adults

    OpenAIRE

    Bishop, Jeffrey

    2012-01-01

    Shiyun Kim,1 Hugo Solari,2 Peter J Weiden,2 Jeffrey R Bishop11Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, 2Department of Psychiatry, University of Illinois at Chicago College of Medicine, Chicago, IL, USAPurpose: To review the use of paliperidone palmitate in treatment of patients with schizophrenia.Methods: Published clinical trial data for the development and utilization of paliperidone palmitate for the treatment of schizophrenia were assessed in...

  3. A Qualitative Analysis of Medical Students Views of Their First Psychiatry Rotation

    OpenAIRE

    Pai, Nagesh B.; Shae-Leigh C. Vella; Kerry Dawes

    2012-01-01

    Objective: The importance of student’s perspectives in informing curricula and pedagogy has long been recognised. However, student’s perspectives are rarely reported in the academic literature. Therefore this study explores and reports on medical student’s perspectives of their first psychiatry clinical rotation in a ‘new’ era medical school in Australia. Method: Seventy-three graduate entry medical students completed a semi-structured questionnaire about their experiences during a mental hea...

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

    Directory of Open Access Journals (Sweden)

    Breland-Noble Alfiee

    2009-03-01

    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

  5. Ethical considerations for evaluating the issue of physical restraint in psychiatry

    OpenAIRE

    Carlo Petrini

    2013-01-01

    This article examines some of the ethical issues associated with the use of physical restraint in psychiatry and neurology. It offers no specific answers to individual operational problems, but a methodological matrix is proposed as an aid to experts in the various settings in which decisions are taken. The subject is addressed mainly by considering two sources: reference documents published by eminent organisations, and the theoretical framework of ethical values (or principles). A number of...

  6. Perception of 1 st year medical students towards career choices and specialty of psychiatry

    OpenAIRE

    Suneet Kumar Upadhyaya; Raval, Chintan M.

    2015-01-01

    Background: Shortage of psychiatrists is a worldwide phenomenon. If the factors that attract or repel students towards a specialty can be identified, it may be possible to encourage them towards it. Choice of specialty as a career depends on the complex interplay of experiences before, during or after exposure to the specialty. Objectives: The aim was to understand perceptions of 1 st year medical students regarding career choices and the specialty of psychiatry through a cross-sectional ...

  7. The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review

    OpenAIRE

    Vidal-Ribas Belil, Pablo; Brotman, Melissa A.; Valdivieso, Isabel; Leibenluft, Ellen; Stringaris, Argyris

    2016-01-01

    ObjectiveResearch and clinical interest in irritability have been on the rise in recent years. Yet several questions remain about the status of irritability in psychiatry, including whether irritability can be differentiated from other symptoms, whether it forms a distinct disorder, and whether it is a meaningful predictor of clinical outcomes. In this paper we try to answer these questions by reviewing the evidence on how reliably irritability can be measured and its validity.MethodWe combin...

  8. Financial impact of accurate discharge coding in a liaison psychiatry service.

    LENUS (Irish Health Repository)

    Jordan, Iain

    2012-12-01

    Previous research has shown that patients seen by liaison psychiatry services are a complex and expensive patient group and that the psychiatric co-morbidities of hospital inpatients are poorly attested at discharge for assignment to diagnosis-related groups (DRGs). The aim of this study was to investigate the accuracy of discharge coding in a neuropsychiatry liaison population. We also aimed to establish whether or not, had the correct diagnosis been assigned, additional funding would have been allocated to the hospital.

  9. Medicine and psychiatry in Western culture: Ancient Greek myths and modern prejudices

    OpenAIRE

    Clementi Nicoletta; Fornaro Michele; Fornaro Pantaleo

    2009-01-01

    Abstract The origins of Western culture extensively relate to Ancient Greek culture. While many ancient cultures have contributed to our current knowledge about medicine and the origins of psychiatry, the Ancient Greeks were among the best observers of feelings and moods patients expressed towards medicine and toward what today is referred to as 'psychopathology'. Myths and religious references were used to explain what was otherwise impossible to understand or be easily communicated. Most an...

  10. The impact of generational change and retirement on psychiatry to 2025

    OpenAIRE

    Schofield Deborah J; Fletcher Susan L

    2007-01-01

    Abstract Background Australia is currently experiencing widespread shortages of psychiatrists. The changing nature of the workforce and increasing demand mean that these shortages are unlikely to ease. This study aims to identify demographic change and retirement patterns of the Australian psychiatry workforce from 1995 to 2003, and the implications of those changes for future workforce planning. Methods Data from the Australian Institute of Health and Welfare (AIHW) Medical Labour Force Surv...

  11. The Endurance of Uncertainty: Antisociality and Ontological Anarchy in British Psychiatry, 1950–2010

    OpenAIRE

    Pickersgill, Martyn

    2014-01-01

    Argument Research into the biological markers of pathology has long been a feature of British psychiatry. Such somatic indicators and associated features of mental disorder often intertwine with discourse on psychological and behavioral correlates and causes of mental ill-health. Disorders of sociality – particularly psychopathy and antisocial personality disorder – are important instances where the search for markers of pathology has a long history; research in this area has played an import...

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

    Science.gov (United States)

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

    2006-01-01

    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

  13. The GABA-A benzodiazepine receptor complex: Role of pet and spect in neurology and psychiatry

    International Nuclear Information System (INIS)

    Nuclear medicine imaging techniques such as positron emission tomography (PET) and single photon emission tomography (SPECT) for selective depiction of GABA-A-benzodiazepine receptor (GBZR) binding are complementary investigations in the diagnostic process of neurological and psychiatric disorders. This review summarizes the current knowledge about options and limitations of PET and SPECT for in vivo diagnostics in neurology and psychiatry. The growing importance of GBZR-imaging for the understanding of pathophysiology and pharmacological treatment in different psychiatric syndromes is discussed. (orig.)

  14. Psychiatry in the flesh. Embodiment of troubled lives. Studies of anorexia nervosa and eating disorders.

    OpenAIRE

    2007-01-01

    Body and mind – new perspectives on eating disorders In this doctoral dissertation the author focuses on models of understanding of how body and mind might interact in eating disorders, with particular emphasis on anorexia nervosa. The thesis ”Psychiatry in the flesh. Embodiment of troubled lives. Studies of anorexia nervosa and eating disorders” is based on six scientific articles which all have been published in referee-based psychiatric journals. Three of these scientific papers d...

  15. Do Editorial Policies Support Ethical Research? A Thematic Text Analysis of Author Instructions in Psychiatry Journals

    OpenAIRE

    Strech, Daniel; Metz, Courtney; Knüppel, Hannes

    2014-01-01

    Introduction According to the Declaration of Helsinki and other guidelines, clinical studies should be approved by a research ethics committee and seek valid informed consent from the participants. Editors of medical journals are encouraged by the ICMJE and COPE to include requirements for these principles in the journal’s instructions for authors. This study assessed the editorial policies of psychiatry journals regarding ethics review and informed consent. Methods and Findings The informati...

  16. Do Editorial Policies Support Ethical Research? A Thematic Text Analysis of Author Instructions in Psychiatry Journals

    OpenAIRE

    Strech, Daniel; Metz, Courtney; Knueppel, Hannes

    2014-01-01

    Introduction: According to the Declaration of Helsinki and other guidelines, clinical studies should be approved by a research ethics committee and seek valid informed consent from the participants. Editors of medical journals are encouraged by the ICMJE and COPE to include requirements for these principles in the journal's instructions for authors. This study assessed the editorial policies of psychiatry journals regarding ethics review and informed consent. Methods and Findings: The informa...

  17. Experience and views of academic psychiatrists on the role of spirituality in South African specialist psychiatry

    OpenAIRE

    Janse Van Rensburg ABR; M Poggenpoel; CPH Myburgh; CP Szabo

    2012-01-01

    BACKGROUND: The importance of having to consider the role of spirituality in health, mental health and psychiatry in South Africa has in particular been emphasized by recent legislation on African traditional health practice. OBJECTIVE: The purpose of this study was to explore the views and experience of local psychiatrists regarding the role of spirituality in South African specialist psychiatric practice and training. METHOD: This study is an explorative, descriptive, contextual, phenomenol...

  18. A pilot study of user acceptance and educational potentials of virtual patients in transcultural psychiatry

    OpenAIRE

    Ioannis Pantziaras; Olivier Courteille; Richard Mollica; Uno Fors; Solvig Ekblad

    2012-01-01

    Objectives: The purpose of this pilot study was to evaluate user acceptance, educational potentials and face and construct validity of a dedicated Virtual Patient system for refugee trauma cases, designed to enhance clinical, interpersonal, social and cultural competence. Methods: We developed a Virtual Patient system portraying a female refugee - mediated by a still image and pre-recorded voice - that was evaluated by an invited group of physicians (n=9) working as residents in Psychiatry (n...

  19. Psychiatric penguins: writing on psychiatry for Penguin Books Ltd, c.1950-c.1980

    OpenAIRE

    Miller, Gavin

    2015-01-01

    The British mass-market publisher Penguin produced a number of texts on psychiatric topics in the period c.1950–c.1980. Investigation of editorial files relating to a sample of these volumes reveals that they were shaped as much by the commercial imperatives and changing aspirations of the publisher as by developments and debates in psychiatry itself. A number of economic imperatives influenced the publishing process, including the perennial difficulty in finding psychiatrists willing and abl...

  20. Replication Validity of Initial Association Studies: A Comparison between Psychiatry, Neurology and Four Somatic Diseases

    Science.gov (United States)

    Dumas-Mallet, Estelle; Button, Katherine; Boraud, Thomas; Munafo, Marcus; Gonon, François

    2016-01-01

    Context There are growing concerns about effect size inflation and replication validity of association studies, but few observational investigations have explored the extent of these problems. Objective Using meta-analyses to measure the reliability of initial studies and explore whether this varies across biomedical domains and study types (cognitive/behavioral, brain imaging, genetic and “others”). Methods We analyzed 663 meta-analyses describing associations between markers or risk factors and 12 pathologies within three biomedical domains (psychiatry, neurology and four somatic diseases). We collected the effect size, sample size, publication year and Impact Factor of initial studies, largest studies (i.e., with the largest sample size) and the corresponding meta-analyses. Initial studies were considered as replicated if they were in nominal agreement with meta-analyses and if their effect size inflation was below 100%. Results Nominal agreement between initial studies and meta-analyses regarding the presence of a significant effect was not better than chance in psychiatry, whereas it was somewhat better in neurology and somatic diseases. Whereas effect sizes reported by largest studies and meta-analyses were similar, most of those reported by initial studies were inflated. Among the 256 initial studies reporting a significant effect (p<0.05) and paired with significant meta-analyses, 97 effect sizes were inflated by more than 100%. Nominal agreement and effect size inflation varied with the biomedical domain and study type. Indeed, the replication rate of initial studies reporting a significant effect ranged from 6.3% for genetic studies in psychiatry to 86.4% for cognitive/behavioral studies. Comparison between eight subgroups shows that replication rate decreases with sample size and “true” effect size. We observed no evidence of association between replication rate and publication year or Impact Factor. Conclusion The differences in reliability

  1. Avoiding violence by technologies? Rectal feeding in German psychiatry,c. 1860?85

    OpenAIRE

    Sammet, Kai

    2006-01-01

    Abstract During the nineteenth century, the use of the stomach tube became the preferred method to treat the insane refusing to eat. But it was not unusual for this practice to result in violence and serious injuries. Especially around 1860, when the discussion of non-restraint in German psychiatry reached its climax, other methods of dealing with sitophobia became the focus of interest. In particular, two ...

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

    OpenAIRE

    Enebrink, Pia

    2005-01-01

    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...

  3. A Qualitative Analysis of Medical Students' Views of Their First Psychiatry Rotation

    OpenAIRE

    Nagesh B. Pai; Shae-Leigh C. Vella; Kerry Dawes

    2012-01-01

    Objective: The importance of student’s perspectives in informing curricula and pedagogy has long been recognised. However, student’s perspectives are rarely reported in the academic literature. Therefore this study explores and reports on medical student’s perspectives of their first psychiatry clinical rotation in a ‘new’ era medical school in Australia. Method: Seventy-three graduate entry medical students completed a semi-structured questionnaire about their experiences during a mental hea...

  4. Postdischarge Impact of C-L Psychiatry Treatment in Obstetrical Inpatients

    OpenAIRE

    Sharon Kirsh; Eileen Patricia Sloan

    2011-01-01

    Purpose. Twenty-eight women, referred to C-L Psychiatry during their obstetrical inpatient stay were interviewed six months post-discharge to determine how they experienced the consultation process, whether they recollected and adhered to treatment recommendations, and whether they developed or had a recurrence of mental health problems post-discharge. Method. Semi-structured telephone interviews were conducted by a psychologist who had not been involved with patient care. Results. There was ...

  5. Consensus Guideline Based Therapeutic Drug Monitoring (TDM) in Psychiatry and Neurology.

    Science.gov (United States)

    Hiemke, Christoph

    2016-01-01

    Therapeutic drug monitoring (TDM) is a valuable tool for tailoring the dosage of the prescribed medication(s) to the individual pharmacokinetic characteristics of a patient. In psychiatry and neurology, however, proven evidence that TDM should be used for treatment with the multiple neuropsychiatric medications is restricted to few compounds. Well-designed clinical trials on medical and economic benefits of TDM are rare. The use of TDM is limited in most countries to few antiepileptics, especially carbamazepine, phenobarbital and phenytoin, some mood stabilizers, especially lithium and valproic acid, some antidepressants, especially tricyclic antidepressants and some antipsychotics, primarily clozapine because these drugs have a narrow therapeutic index. On the other hand, specific indications and distinct problems can make TDM most useful for individualized pharmacotherapy with almost any neuropsychiatric drug. Potential benefits of TDM can, however, only be reaped if the method is adequately integrated into the clinical treatment process. The TDM expert group of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) issued consensus guidelines for the best practice of TDM in psychiatry and neurology. A first version was published in 2004. These guidelines were extended in 2011 and are actually updated (see: www.agnp.de). Exemplified by single cases it is shown here how to use TDM consensus guidelines for problem solving in psychiatry and neurology. Studies on depressed patients give evidence for tricyclic antidepressants, venlafaxine and citalopram that TDM could become a standard of care in psychiatry and neurology. There is potential to accelerate improvement. Reducing phases of suffering will not only have medical benefits for the patients but also an impact on costs for the health system which needs to be clarified by controlled studies. PMID:26511090

  6. The politics of psychiatry and the vicissitudes of faith circa 1950: Karl Stern's psychiatric novel.

    Science.gov (United States)

    Burston, Daniel

    2015-01-01

    Karl Stern, MD (1906-1975) was the author of The Pillar of Fire (1951) and three nonfiction books on psychiatry, psychoanalysis, and religion. His novel, Through Dooms of Love (1960), written with the assistance of his friend and admirer Graham Greene, covers a number of topics that were to psychiatric theory, treatment, and research at mid-century, and reflects several features of his own personal and professional vicissitudes. PMID:26334447

  7. Soviet psychiatrists under Stalinist duress: the design for a new Societ psychiatry and its demise.

    Science.gov (United States)

    Windholz, G

    1999-09-01

    A Scientific Session of the USSR Academy of Sciences and the USSR Academy of Medical Sciences met in 1950 in Moscow, to comply with the order of I.V. Stalin to institutionalize the theory of higher nervous activity of I.P. Pavlov. This Scientific Session decreed that annual scientific conferences should be held to consider problems related to Pavlovian physiology. In response to this call, a session on the Physiological Teachings of the Academician I. P. Pavolv on Psychiatry and Neuropathology was convened in Moscow in 1951. Certain influential Soviet psychiatrists - V.A. Giliarovski, M.O. Gurevich and A. S. Shmarian were condemned for adhering to anti-Marxist ideology and to psychiatric theories conceived by Western psychiatrists. The named psychiatrists acknowledged the correctness of the accusations, admitted their errors, and promised in the future to follow Pavlov's teachings on psychiatry. The session's Presidium urged the development of a New Soviet Psychiatry based upon experimental and clinical findings and consistent with the Pavlovian conceptualization of higher nervous activity, which considered pychiatric and neurotic syndromes in terms of the dynamic localization of the brain's functions. Long-range consequences of the 1951 session are considered. PMID:11624008

  8. Medicalization in psychiatry: the medical model, descriptive diagnosis, and lost knowledge.

    Science.gov (United States)

    Sedler, Mark J

    2016-06-01

    Medicalization was the theme of the 29th European Conference on Philosophy of Medicine and Health Care that included a panel session on the DSM and mental health. Philosophical critiques of the medical model in psychiatry suffer from endemic assumptions that fail to acknowledge the real world challenges of psychiatric nosology. The descriptive model of classification of the DSM 3-5 serves a valid purpose in the absence of known etiologies for the majority of psychiatric conditions. However, a consequence of the "atheoretical" approach of the DSM is rampant epistemological confusion, a shortcoming that can be ameliorated by importing perspectives from the work of Jaspers and McHugh. Finally, contemporary psychiatry's over-reliance on neuroscience and pharmacotherapy has led to a reductionist agenda that is antagonistic to the inherently pluralistic nature of psychiatry.  As a result,  the field has suffered a loss of knowledge that may be difficult to recover. PMID:26602907

  9. Measuring the stigma of psychiatry and psychiatrists: development of a questionnaire.

    Science.gov (United States)

    Gaebel, Wolfgang; Zäske, Harald; Cleveland, Helen-Rose; Zielasek, Jürgen; Stuart, Heather; Arboleda-Florez, Julio; Akiyama, Tsuyoshi; Gureje, Oye; Jorge, Miguel R; Kastrup, Marianne; Suzuki, Yuriko; Tasman, Allan; Sartorius, Norman

    2011-11-01

    The stigma of mental illness is a severe burden for people suffering from mental illness both in private and public life, also affecting their relatives, their close social network, and the mental health care system in terms of disciplines, providers, and institutions. Interventions against the stigma of mental illness employ complementary strategies (e.g., protest, education, and contact) and address different target groups (e.g., school children and teachers, journalists, stakeholders). Within this framework, the World Psychiatric Association has adopted an Action Plan with the goal to improve the image of psychiatry and to reduce potential stigmatizing attitudes toward psychiatry and psychiatrists. To evaluate such interventions, a questionnaire has been developed that assesses opinions and attitudes toward psychiatrists and psychiatry in different samples of medical specialists (psychiatrists and general practitioners). The questionnaire comprises scales about perceived stigma in terms of the perception of societal stereotypes, self-stigma in terms of stereotype agreement, perceived stigma in terms of structural discriminations, discrimination experiences, stigma outcomes, and attitudes toward a second medical discipline. It is available in several languages (Arab, English, German, Japanese, Polish, and Spanish) and can easily be adapted for utilization in other medical specialties. PMID:21947511

  10. Assessment Methods of an Undergraduate Psychiatry Course at a Saudi University

    Directory of Open Access Journals (Sweden)

    Mostafa Amr

    2012-05-01

    Full Text Available Objectives: In Arab countries there are few studies on assessment methods in the field of psychiatry. The objective of this study was to assess the outcome of different forms of psychiatric course assessment among fifth year medical students at King Faisal University, Saudi Arabia. Methods: We examined the performance of 110 fifth-year medical students through objective structured clinical examinations (OSCE, traditional oral clinical examinations (TOCE, portfolios, multiple choice questions (MCQ, and a written examination. Results: The score ranges in TOCE, OSCE, portfolio, and MCQ were 32–50, 7–15, 5–10 and 22–45, respectively. In regression analysis, there was a significant correlation between OSCE and all forms of psychiatry examinations, except for the MCQ marks. OSCE accounted for 65.1% of the variance in total clinical marks and 31.5% of the final marks (P = 0.001, while TOCE alone accounted for 74.5% of the variance in the clinical scores. Conclusions: This study demonstrates a consistency among the students’ assessment methods used in the psychiatry course, particularly the clinical component, in an integrated manner. This information would be useful for future developments in undergraduate teaching.

  11. Research to reduce the suicide rate among older adults: methodology roadblocks and promising paradigms

    OpenAIRE

    Szanto, Katalin; Lenze, Eric J.; Waern, Margda; Duberstein, Paul; Bruce, Martha L.; Epstein-Lubow, Gary; Conwell, Yeates

    2013-01-01

    The National Institute of Mental Health and the National Action Alliance for Suicide Prevention have requested input into the development of a national suicide research agenda. In response, a working group of the American Association for Geriatric Psychiatry has prepared recommendations to ensure that the suicide prevention dialogue includes older adults, a large and fast-growing population at high risk of suicide. In this Open Forum, the working group describes three methodology roadblocks t...

  12. Test blueprints for psychiatry residency in-training written examinations in Riyadh, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Gaffas EM

    2012-05-01

    Full Text Available Eisha M Gaffas,1 Reginald P Sequeira,2 Riyadh A Al Namla,1 Khalid S Al-Harbi31Al-Amal Complex for Mental Health, Riyadh, Kingdom of Saudi Arabia; 2College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 3King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Kingdom of Saudi ArabiaBackground: The postgraduate training program in psychiatry in Saudi Arabia, which was established in 1997, is a 4-year residency program. Written exams comprising of multiple choice questions (MCQs are used as a summative assessment of residents in order to determine their eligibility for promotion from one year to the next. Test blueprints are not used in preparing examinations.Objective: To develop test blueprints for the written examinations used in the psychiatry residency program.Methods: Based on the guidelines of four professional bodies, documentary analysis was used to develop global and detailed test blueprints for each year of the residency program. An expert panel participated during piloting and final modification of the test blueprints. Their opinion about the content, weightage for each content domain, and proportion of test items to be sampled in each cognitive category as defined by modified Bloom's taxonomy were elicited.Results: Eight global and detailed test blueprints, two for each year of the psychiatry residency program, were developed. The global test blueprints were reviewed by experts and piloted. Six experts participated in the final modification of test blueprints. Based on expert consensus, the content, total weightage for each content domain, and proportion of test items to be included in each cognitive category were determined for each global test blueprint. Experts also suggested progressively decreasing the weightage for recall test items and increasing problem solving test items in examinations, from year 1 to year 4 of the psychiatry residence program.Conclusion: A systematic

  13. Adult Education and Adult Learning

    DEFF Research Database (Denmark)

    Illeris, Knud

    Kort beskrivelse Bogen, 'Adult Education og Adult Learning', giver et fyldestgørende overblik over forståelsen af voksenuddannelse og læring. Abstract I "Adult Education and Adult Learning' ser Knud Illeris på voksenuddannelse fra to perspektiver. På den ene side beskrives de aktuelle udfordringer...

  14. Inservice Instructors: Adult Educator Competencies.

    Science.gov (United States)

    Petersen, Mary Beth Harper

    1983-01-01

    Describes how fourteen principles of adult education provide the conceptual framework for performance competencies to guide the daily practice of instructors in the centralized inservice department of a large acute-care hospital. (JOW)

  15. Older Adults and Food Safety

    Science.gov (United States)

    ... Standard Forms FSIS United States Department of Agriculture Food Safety and Inspection Service About FSIS District Offices Careers ... JSR 286) Actions ${title} Loading... Older Adults and Food Safety An adage states, "With age, comes wisdom." Hopefully ...

  16. SNARE complex in developmental psychiatry: neurotransmitter exocytosis and beyond.

    Science.gov (United States)

    Cupertino, Renata Basso; Kappel, Djenifer B; Bandeira, Cibele Edom; Schuch, Jaqueline Bohrer; da Silva, Bruna Santos; Müller, Diana; Bau, Claiton Henrique Dotto; Mota, Nina Roth

    2016-08-01

    Multiple biological processes throughout development require intracellular vesicular trafficking, where the SNARE (soluble N-ethylmaleimide-sensitive factor (NSF) attachment protein (SNAP) receptors) complex plays a major role. The core proteins forming the SNARE complex are SNAP-25 (synaptosomal-associated protein 25), VAMP (vesicle-associated membrane protein) and Syntaxins, besides its regulatory proteins, such as Synaptotagmin. Genes encoding these proteins (SNAP25, VAMP1, VAMP2, STX1A, SYT1 and SYT2) have been studied in relation to psychiatric disorders susceptibility. Here, we review physiological aspects of SNARE complex and genetic association results reported for attention deficit hyperactivity disorder, both in children and adults, autism spectrum disorders, major depressive disorder, bipolar disorder and schizophrenia. Moreover, we included findings from expression, pharmacogenetics and animal model studies regarding these clinical phenotypes. The overall scenario depicted here suggests that the SNARE complex may exert distinct roles throughout development, with age-specific effects of genetic variants in psychiatric disorders. Such perspective should be considered in future studies regarding SNARE complex genes. PMID:26856328

  17. Psychiatry disorders and dengue: Is there a relationship?

    Directory of Open Access Journals (Sweden)

    Leonardo Caixeta

    2011-12-01

    Full Text Available OBJECTIVE: The aim of this study was to examine the relationship of compulsive hoarding with dengue. METHOD: Fifty two adults notified by health vigilance authorities because of inappropriate trash accumulation in vacant lots in Goiânia, Central Brazil, completed a questionnaire regarding the presence and severity of hoarding behavior (Hoarding Rating Scale-Interview HRS-I. Five dimensions of hoarding are evaluated with this instrument: difficulty using spaces due to clutter, difficulty discarding possessions, excessive acquisition of objects, emotional distress and functional impairment due to hoarding behaviors. RESULTS: The sample was primarily male, with an average age of 49 years. Eighty six percent of the sample scored 14 or greater on the HRS-I, indicating pathological hoarding. The medias of the five HRS-I domains were high, indicating severeness of all dimentions of pathological hoarding. CONCLUSION: These results highlight the relationship between psychiatric disorder and actions upon environmental conditions that favors dengue, as well as its associated public health burden.

  18. A Psychodynamic Psychologist in Community Psychiatry: 14 Years of Experience

    Directory of Open Access Journals (Sweden)

    Tânia Roquette

    2013-11-01

    Full Text Available This paper aims to critically review the role of a psychodynamic psychologist integrated in a community outpatient clinic of a Psychiatric Department. It describes the characteristics of a psychodynamic intervention that is complementary to the psychiatric approach while sharing a common goal –the suffering patient – and enhancing the knowledge and understanding of several domains like psychopathology, diagnosis, treatment, rehabilitation and integration. Furthermore it describes how the use of Psychological Assessment led to the formulation of specific individual psychotherapies, spanning 14 years of clinical practice. The paper concludes with some considerations regarding the integration of Psychodynamic Psychology in a multidisciplinary mental health team, addressing issues such as the boundaries between technical characteristics, the appropriateness of language to other disciplines and psychodynamic implications of the different features of this clinical setting.

  19. Outcomes and Costs of Poisoned Patients Admitted to an Adult Emergency Department of a Spanish Tertiary Hospital: Evaluation through a Toxicovigilance Program

    Science.gov (United States)

    Quintana, Manuel; Martínez, Ana; Carcas, Antonio J.

    2016-01-01

    Abstract Toxicovigilance is the active process of identifying and evaluating the toxic risks existing in a community, and evaluating the measures taken to reduce or eliminate them. Objective Through a validated toxicovigilance program (SAT-HULP) we examined the characteristics of acute poisoning cases (APC) attended in the Emergency Department (ED) of La Paz Hospital (Madrid, Spain) and assessed their economic impact on the health system. Material and Methods The active poisoning surveillance system performs a daily search for cases in the hospital´s computerized case records. Found cases are entered into a database for recording of type of poisoning episode, reasons for exposure, causative agent, signs and symptoms and treatment. We carried out a cross-sectional epidemiological study with analytical projection, based on an impact study on cost per survivor. The data for the costs attributable to cases of APC observed at HULP (outpatients and inpatients) was obtained from the based on the information provided by the diagnosis-related groups (DRG) through the corresponding hospital discharge reports (available through SAT-HULP). Results During the first 30 month of SAT-HULP operation we found a total of 3,195 APC, a cumulative incidence rate of 1.75% of patients attended in the ED. The mean (SD) patient age was 40.9 (17.8) years and 51.2% were men. Drug abuse accounted for 47.5% of the cases. Suicide attempt was the second most frequent category (38.1%) and other causes accounted for 14.5% of APC. The total cost of hospital care for our hospital rose to €1,825,263.24 (approximately €730,105.30/year) resulting in a permanent occupation of 4 beds/year. Conclusions SAT-HULP constitutes a validated toxicovigilance tool, which continuously integrates available data in real-time and helps health services manage APC data flexibly, including the consumption of resources from the health system. PMID:27100460

  20. Adult population dynamics of the bolivian fruit flies Anastrepha sp. (Diptera: Tephritidae at Municipality Coroico, Department of The La Paz, Bolivia

    Directory of Open Access Journals (Sweden)

    Gonzáles Manuel

    2011-08-01

    Full Text Available The investigation was carried out in Paco (1603 msnm communities, it Marca (1511 msnm and Capellania (1720 msnm, of the Municipality of Coroico, department of La Paz, Bolivia. In orchards frutícolas semicomerciales, they settled 15 traps distributed McPhail in a similar way among areas, five for community, sampling" "points. The censuses were carried out with an interval of 15 days, they were identified and they quantified the mature flies of the fruit. For the captures of the individuals, they settled the traps McPhail, using the attractive (Buminal one and as conserving borax. The traps were distributed in representative parcels, having as main cultivations, orange, mandarin, grapefruit, guava and avocado. The identification taxonómica of the captured species was carried out in the laboratory of the National Program of Control of Flies of the fruit (PROMOSCA, clerk of the National Service of Agricultural Sanity and Alimentary (SENASAG Inocuidad. 1210 mature flies of the fruit were captures, those that grouped for species, sex, capture dates and community, corresponding to the seven carried out censuses. The species of Anastrepha fraterculus (Wiedeman were identified, Anastrepha striata Schiner, Anastrepha serpentine (Wiedeman, Anastrepha sp, Ceratitis capitata (Wiedemann, Blepharoneura sp Loew, Hexaresta sp Hering, Hexachaeta sp Loew, Tomoplagia sp Coquillett, Tetreuaresta sp Hendel, being that of more presence Anastrepha fraterculus (Wiedeman with 818 and Ceratitis capitata (Wiedemann, with 354. The temperature and presence of spices put up frutícolas of flies of the fruit in maturation state explain the observed fluctuations.

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

    Science.gov (United States)

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

    2010-04-01

    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

  2. The behavioural sciences and undergraduate education in psychiatry.

    Science.gov (United States)

    Rakoff, V

    1984-12-01

    The Behavioural Sciences are becoming increasingly important in medical education and in medical treatment. But medical students and the profession generally, appear to have difficulty accepting behavioural sciences as a valid part of the curriculum and in the practice of medicine. One of the reasons for this may be related to a narrow definition of the physician's social role in the years following the adoption of the Flexner Report in 1911 which emphasized the model of the physician/scientist. The perennial model of the physician occupying a social role in which science is used to increase and rationalize responsiveness to suffering has been eroded in favour of the pursuit of the scientific as the essential goal of medicine. The newer, "softer", sciences of anthropology, ecology, economics, psychology and sociology have not fitted into the professional self-perception of the medical role. Furthermore, some departments of behavioural science have adopted an intellectual stance at times antagonistic to the rest of the medical school emphasizing the shortcomings of the profession in its delivery of health care. The aspirant medical student may have been disaffected by teachers who do not embody acceptable role models. Students should receive specific instructions in the social role of the physician, physicians should be actively involved in teaching the behavioral sciences and the curriculum should at all times emphasize the relevance of the behavioural sciences to the daily practice of medicine. PMID:6518435

  3. The Development of the Interface between Law, Medicine and Psychiatry: Medico-Legal Perspectives in History

    Directory of Open Access Journals (Sweden)

    M Swanepoel

    2009-12-01

    Full Text Available Medicine and law were related from early times. This relation resulted as a necessity of protecting communities from the irresponsible acts of impostors. Various legal codes dealing with medical malpractice existed in Egypt, Mesopotamia, China, Islam, Greece, Rome, Persia and India. Over the course of the past 30 years, interest in the history of psychiatry has boomed. Much of this proliferation of interest has taken place under the broad influence of postmodernism and has resulted in multiple and diverse histories that no longer seek to provide a linear narrative of constant evolutionary progress. Rather, these new histories explore and disrupt taken for granted assumptions about the past and provide a starting point for discussion and debate about the some of the very foundations of mental health care in South Africa. As a matter of practical importance knowledge of how knowledge accrues and knowledge of the mistakes of the past is of prime importance in preventing similar mistakes in present and future work. An important reason for specifically understanding historical psychiatry is the fact that many of the uncertainties experienced in the present are a direct result of decisions made in the past. The key issue is that while it is tempting to experience current psychiatric and legal approaches towards the mentally disordered as natural and permanent, an understanding of the past helps mental health and legal practitioners to see things in a different perspective. Psychiatric and legal approaches towards the mentally disordered have changed over time and can undoubtedly also be changed in future. Therefore, the research conducted in this article focuses on the history and development of law and psychiatry including prehistoric times, the Arabian countries, the Nile Valley as well as Greece and Rome.

  4. People see what papers show! Psychiatry's stint with print media: A pilot study from Mumbai, India

    OpenAIRE

    Shrivastava, Shivanshu; Kalra, Gurvinder; Ajinkya, Shaunak

    2015-01-01

    Mass media including television, internet, and newspapers influences public views about various issues by means of how it covers an issue. Newspapers have a wider reach and may affect the impact that a news story has on the reader by factors such as placement of the story within the different pages. We did a pilot study to see how two English newspapers from Mumbai, India were covering psychiatry related news stories. The study was done over a period of 3 months. We found a total of 870 psych...

  5. [Marxist-Leninist philosophical personality theory and the development of the theory and practice of psychiatry].

    Science.gov (United States)

    Thom, A

    1978-06-01

    This is a concise presentation of the essential positions of the Marxist-Leninist philosophical theory of personality. Its consequences to modern psychiatry are discussed. Particular emphasis has been placed on establishing practical relations with mental patients and creating optimum conditions for promoting the distinctive qualities or characteristics of persons within the framework of therapy. Also discussed by the author in his present paper are questions associated with pathogenesis. Integration of clinical and sociopsychological research into the development of psychoses is considered necessary. PMID:715077

  6. Current research on transcultural psychiatry in the Anglophone Caribbean: epistemological, public policy, and epidemiological challenges.

    Science.gov (United States)

    Hickling, Frederick W; Gibson, Roger C; Hutchinson, Gerard

    2013-12-01

    In this article, we review recent research on mental health in the Caribbean. Three major themes emerge: (a) the effects of colonialism on the Caribbean psyche; (b) decolonization of psychiatric public policy, including innovative treatment approaches, deinstitutionalization, and community and policy responses to mental health issues; and (c) the nature and epidemiology of psychiatric pathology among contemporary Caribbean people, with particular focus on migration, genetic versus social causation of psychosis and personality disorders, and mechanisms of resilience and social capital. Caribbean transcultural psychiatry illustrates the principles of equipoise unique to developing countries that protect the wellness and continued survival of postcolonial Caribbean people. PMID:24151148

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

    Science.gov (United States)

    Pasco Fearon, R M

    2016-03-01

    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

  8. World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia. Part 3

    DEFF Research Database (Denmark)

    Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas;

    2015-01-01

    These updated guidelines are based on the first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in the years 2005 and 2006. For this 2015 revision, all available publications pertaining to the biological....... Based on the first version of these guidelines a systematic review, as well as a data extraction from national guidelines have been performed for this update. The identified literature was evaluated with respect to the strength of evidence for its efficacy and subsequently categorised into six levels of...

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

    Science.gov (United States)

    Green, Jonathan

    2016-05-01

    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

  10. [Applying a social network for the practice and learning of psychiatry].

    Science.gov (United States)

    Mondin, Estefanía; Matusevich, Daniel

    2014-01-01

    Social networking is a virtual space in which people relate and build their identity, share information, publish content and intervene on the content posted by others. We will describe an experiment carried out in the psychiatry service of Italian Hospital in Buenos Aires, in which we use Whatsapp Social Network applied to the development of clinical work and teaching task. From these new ways of relating between professional, emerge a new way to work, participate in groups or try to evaluate various options for dealing with a patient. We analyze the usefulness of this virtual platform as a working tool. PMID:25153981

  11. How psychiatry journals support the unbiased translation of clinical research. A cross-sectional study of editorial policies.

    Directory of Open Access Journals (Sweden)

    Hannes Knüppel

    Full Text Available INTRODUCTION: Reporting guidelines (e.g. CONSORT have been developed as tools to improve quality and reduce bias in reporting research findings. Trial registration has been recommended for countering selective publication. The International Committee of Medical Journal Editors (ICMJE encourages the implementation of reporting guidelines and trial registration as uniform requirements (URM. For the last two decades, however, biased reporting and insufficient registration of clinical trials has been identified in several literature reviews and other investigations. No study has so far investigated the extent to which author instructions in psychiatry journals encourage following reporting guidelines and trial registration. METHOD: Psychiatry Journals were identified from the 2011 Journal Citation Report. Information given in the author instructions and during the submission procedure of all journals was assessed on whether major reporting guidelines, trial registration and the ICMJE's URM in general were mentioned and adherence recommended. RESULTS: We included 123 psychiatry journals (English and German language in our analysis. A minority recommend or require 1 following the URM (21%, 2 adherence to reporting guidelines such as CONSORT, PRISMA, STROBE (23%, 7%, 4%, or 3 registration of clinical trials (34%. The subsample of the top-10 psychiatry journals (ranked by impact factor provided much better but still improvable rates. For example, 70% of the top-10 psychiatry journals do not ask for the specific trial registration number. DISCUSSION: Under the assumption that better reported and better registered clinical research that does not lack substantial information will improve the understanding, credibility, and unbiased translation of clinical research findings, several stakeholders including readers (physicians, patients, authors, reviewers, and editors might benefit from improved author instructions in psychiatry journals. A first step of

  12. Use, perceptions, and acceptability of a ready-to-use supplementary food among adult HIV patients initiating antiretroviral treatment: a qualitative study in Ethiopia

    OpenAIRE

    Olsen MF; Tesfaye M; Kaestel P; Friis H; Holm L

    2013-01-01

    Mette Frahm Olsen,1 Markos Tesfaye,2 Pernille Kæstel,1 Henrik Friis,1 Lotte Holm3 1Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark; 2Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia; 3Department of Food and Resource Economics, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark Objectives: Ready-to-use supplementary foods (RUSF) are used increasin...

  13. Use, perceptions, and acceptability of a ready-to-use supplementary food among adult HIV patients initiating antiretroviral treatment: a qualitative study in Ethiopia

    OpenAIRE

    Olsen, Mette,

    2013-01-01

    Mette Frahm Olsen,1 Markos Tesfaye,2 Pernille Kæstel,1 Henrik Friis,1 Lotte Holm3 1Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark; 2Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia; 3Department of Food and Resource Economics, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark Objectives: Ready-to-use supplementary foods (RUSF) are used incr...

  14. A guide to a new short course to promote interest and engagement in psychiatry in medical students.

    Science.gov (United States)

    Langley, Matthew; Lomas, Benjamin; Schofield, Zena; Doody, Gillian

    2015-08-01

    This article describes a new course for preclinical medical undergraduates designed to promote interest and engagement in psychiatry. The course employed a range of innovative teaching techniques alongside ward visits to provide students with early clinical experience. Unusually, assessment for the course involved the production of creative works as well as reflective writing about students' experiences. We collected a variety of feedback from participants showing that they found the course enjoyable and educational. We conclude that, overall, the course had a positive effect on student perceptions of psychiatry. PMID:26755955

  15. A Qualitative Analysis of Medical Students Views of Their First Psychiatry Rotation

    Directory of Open Access Journals (Sweden)

    Nagesh B. Pai

    2012-07-01

    Full Text Available Objective: The importance of student’s perspectives in informing curricula and pedagogy has long been recognised. However, student’s perspectives are rarely reported in the academic literature. Therefore this study explores and reports on medical student’s perspectives of their first psychiatry clinical rotation in a ‘new’ era medical school in Australia. Method: Seventy-three graduate entry medical students completed a semi-structured questionnaire about their experiences during a mental health rotation. The responses were analysed and coded into thematic categories. Results: The following thematic categories were evident; staff, breadth of experience, attitudes towards mental health, course materials and structure, and professional development. Conclusion: The results are discussed in the context of the current academic recommendations for the teaching of psychiatry and behavioural science to medical students. Although the use of student feedback is recommended by the literature, pragmatically it is rarely utilised and if it is utilised it is not reported in the academic literature. It is recommended that educators embrace the use of student’s perspectives to evaluate and inform their teaching.

  16. [First stage in identifying traumatic profil inpatients hospitalised in psychiatry in Martinique].

    Science.gov (United States)

    Evans, M; Vacher, E; Lamy, S; Seridi, H; Jan, M; Debien, C; Sigward, J-M; Jehel, L

    2014-01-01

    The population hospitalised in psychiatry seems more exposed to traumatic events than the French general population, with particularly more sexual aggressions. The aim of this study is to describe the population hospitalised in psychiatry and more precisely the traumatic history of these patients, their comorbidities (mental diseases and addictions), and socio economical level. This descriptive, cross sectional and retrospective study took place in the Crisis Center in the University Hospital in Martinique (French West Indies), from February to July 2013. A socio-demographic information, the Mini International Neuropsychiatric Interview 5.0, the Trauma History Questionnaire and the Impact Events Scale-Revised were realised with 49 of the 143 patients admitted during this period (34.3%). In this population, we found a mean of 6.5 (standart-deviation=4.2) different types of traumatic event, with 38.8% patients reporting a natural disaster, and 38.8% declaring at least one sexual aggression. In the 25 patients suffering from post-traumatic stress disorder, 66.7% underwent a sexual aggression, significatively during childhood (before 10 years old, P=0.01), and during adolescence (between 10 to 18 years old, P=0.01). These results underline the importance of a systematic screening of the traumatic profile: the characteristics of the traumatic events and its clinical impact. PMID:25590554

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

    Directory of Open Access Journals (Sweden)

    Fegert Jörg M

    2009-04-01

    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.

  18. Ein Lehrbuch über Psychiatrie und Psychotherapie – Geschlechtsunterschiede unter der Lupe?

    Directory of Open Access Journals (Sweden)

    Isabella Heuser

    2007-07-01

    Full Text Available Anke Rohde und Andreas Marneros haben sich ein hohes Ziel gesetzt: ein übersichtliches Lehrbuch für Psychiatrie und Psychotherapie, das erstmals eine systematische Zusammenstellung des Wissens über geschlechtsspezifische Aspekte von Symptomatologie, Epidemiologie, Diagnostik, Pharmakotherapie und Psychotherapie psychischer Störungen enthält. Bemerkenswert ist dabei zweierlei: Erstens werden bei der Betrachtung geschlechtsspezifischer Unterschiede im Sinne der Genderforschung Frauen und Männer berücksichtigt, zweitens wird ein vollständiger Überblick sowohl über die häufigen und bekannten psychischen Störungen als auch die äußerst seltenen psychiatrischen Erkrankungen der gesamten Altersspanne gegeben. Wenngleich die Qualität der einzelnen Beiträge deutlich zwischen sehr differenzierter und leider auch für ein Handbuch eindeutig zu oberflächlicher Betrachtung variiert, liegt in dem Band ein weitgehend informatives Nachschlagewerk vor, das einen ersten Überblick über die geschlechtsspezifische Psychiatrie gibt.

  19. "The tempest in my mind": cultural interfaces between psychiatry and literature, 1844-1900.

    Science.gov (United States)

    Blumenthal, S L

    1995-01-01

    The professional literature of the first generation of American psychiatrists is replete with poetical passages drawn from the imaginative works of such English authors as Shakespeare, Byron, and Scott as well as the writings of residents of the asylums they tended. A close reading of such passages in the American Journal of Insanity (AJI), the central medium through which members of this nascent profession attempted to "popularize the study of insanity," suggests they were not simply textual ornaments or signs of the underdeveloped state of American psychiatry in the mid-nineteenth century. Indeed, literary manifestations of the imaginative minds of patients and renowned writers were scrutinized by psychiatrists seeking to advance their understanding of mental disease. Moreover, the English authors were often elevated to the status of medical experts and their poetry and prose were commended to fellow medical practitioners as sources of psychological insight. Toward the turn of the century psychiatrists' engagement with these literary forms was less pronounced in the AJI, due in large part to the impact of rising asylum populations and the coming of a culture of positivist medicine. Yet literary influences on psychiatric writing are still evident in this period, indicating the complexity of the cultural interfaces between psychiatry and literature and the importance of examining the historical processes that have served to define and distinguish the enterprise of the psychiatrist from that of the poet. PMID:7897178

  20. Mental Health promotion of a hospital through the nurse in the liaison psychiatry team

    Directory of Open Access Journals (Sweden)

    Natalia Cámara Conde

    2008-09-01

    Full Text Available We show a proposal to increase the quality of nursing cares, improving mental health care of hospitalized patients by creating the figure of the liaison nurse within the liaison psychiatry team. This nurse would not only be a reference to support the nursing staff at the level of patient care, but also the psycho-emotional self-care professional.Objectives: Justifying the need to include the figure of the specialist mental health team liaison psychiatry nurse. Method: The rotation as residents, for a month, with the interconsultation team psychiatric hospital Gregorio Marañón and literature review. Results: There have been partially unmet needs, these could be covered with the existence of a nurse specialist in mental health consultation in this hospital. Discussion: Possibly it poses difficulties in defining the roles of various liaison team professionals, which we expect can be defined at the start implementing the new member.The hospital itself has an own field defined, articulated through the NANDA, NIC, NOC methodology, which covers aspects that so far have not being made, there is not a nurse figure into the psychiatric consultation liaison team.