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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. Financing Academic Departments of Psychiatry

    Science.gov (United States)

    Liptzin, Benjamin; Meyer, Roger E.

    2011-01-01

    Objective: The authors describe the many financial challenges facing academic departments of psychiatry and the resulting opportunities that may arise. Method: The authors review the history of financial challenges, the current economic situation, and what may lie ahead for academic departments of psychiatry. Results: The current environment has…

  3. Turnover of First-Time Chairs in Departments of Psychiatry

    Science.gov (United States)

    Buckley, Peter F.; Rayburn, William F.

    2011-01-01

    Objective: The authors examine the tenure of first-time Chairs in academic departments of psychiatry in order to stimulate discussion on extant workforce and leadership issues. Method: Data on tenure of Chairs in psychiatry and other nonsurgical specialties were derived from the longitudinal database of the Association of American Medical Colleges…

  4. Assisting Undergraduate Physician Assistant Training in Psychiatry: The Role of Academic Psychiatry Departments.

    Science.gov (United States)

    Rakofsky, Jeffrey J; Ferguson, Britnay A

    2015-12-01

    Physician assistants (PAs) are medical professionals who practice medicine with the supervision of a physician through delegated autonomy. PA school accreditation standards provide limited guidance for training PAs in psychiatry. As a result, PA students may receive inconsistent and possibly inadequate exposure to psychiatry. Providing broad and in-depth exposure to the field of psychiatry is important to attract PA students to pursue careers in psychiatry and provide a possible solution to the shortage of psychiatrists nationwide. Additionally, this level of exposure will prepare PA students who pursue careers in other fields of medicine to recognize and address their patient's psychiatric symptoms in an appropriate manner. This training can be provided by an academic department of psychiatry invested in the education of PA students. We describe a training model implemented at our university that emphasizes psychiatrist involvement in the preclinical year of PA school and full integration of PA students into the medical student psychiatry clerkship during the clinical years. The benefits and challenges to implementing this model are discussed as well.

  5. [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

  6. M. D. Faculty Salaries in Psychiatry and All Clinical Science Departments, 1980-2006

    Science.gov (United States)

    Haviland, Mark G.; Dial, Thomas H.; Pincus, Harold Alan

    2009-01-01

    Objective: The authors compare trends in the salaries of physician faculty in academic departments of psychiatry with those of physician faculty in all academic clinical science departments from 1980-2006. Methods: The authors compared trend lines for psychiatry and all faculty by academic rank, including those for department chairs, by graphing…

  7. [The Asahi Model-Regional Mental Health Services at Department of Psychiatry and Child Psychiatry, Asahi General Hospital].

    Science.gov (United States)

    Aoki, Tsutomu

    2015-01-01

    The Asahi model, Psychiatric Services of Department of Psychiatry and Child Psychiatry, Asahi General Hospital, is characterized by multiple dimensions of mental health services, such as multidisciplinary team approach, medical cooperation, specialized psychiatric treatment of acute care, clozapine and modified ECT, outreach services of home nursing and assertive community treatment, and the close and mutual coordination with housing services and social welfare services. The Asahi Model makes it possible to be deinstitutionalized, to improve patients satisfaction, to shorten hospitalization, to decrease psychiatric emergency visits and to be of service in a natural disaster. It also might prevent the relapse of schizophrenics within twelve months after discharge and improve the quality of mental health staffs trainings to support patients better. In the future, we will need to work on providing sectorized care, early psychosis intervention programs, to construct networking systems of clozapine and modified ECT, to strengthen growth of home nursing, and to take place mental health anti-stigma campaigns. PMID:26552318

  8. Varied Understanding and Application of Counter Transference in Active Music Therapy in Adult Psychiatry

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2006-01-01

    The article presents varied ways of understanding and applying the clinical concept of counter transference. The sources are drawn from the author's own clinical praxis, from psychoanalytic and music therapy literature and from a qualitative interview examination among experienced music therapist...... applying the concept in music therapy improvisational work in adult psychiatry....

  9. Clinical neuropsychology within adolescent and young-adult psychiatry: conceptualizing theory and practice.

    Science.gov (United States)

    Allott, Kelly; Proffitt, Tina-Marie; McGorry, Patrick D; Pantelis, Christos; Wood, Stephen J; Cumner, Marnie; Brewer, Warrick J

    2013-01-01

    Historically, clinical neuropsychology has made significant contributions to the understanding of brain-behavior relationships, particularly in neurological conditions. During the past several decades, neuropsychology has also become established as an important discipline in psychiatric settings. Cognition is increasingly recognized as being core to psychiatric illnesses and predictive of functional outcomes, augmenting theories regarding symptomatology and illness progression. Adult-type psychiatric disorders (including schizophrenia and other psychotic, mood, anxiety, eating, substance-related, and personality disorders) typically emerge during adolescence or young adulthood, a critical neurodevelopmental period. Clinical neuropsychological assessment in adolescent psychiatric patients is particularly valuable in informing clinical formulation and intervention and can be therapeutic across a number of levels. This article articulates the theoretical considerations and practical challenges and applications of clinical neuropsychology within adolescent and young-adult psychiatry. The importance of considering the neurodevelopmental context and its relationship to current theoretical models underpinning clinical practice are discussed.

  10. [History of the department of Psychiatry at the University of Montreal].

    Science.gov (United States)

    Stip, Emmanuel

    2015-01-01

    team at the Hôpital Louis-H. Lafontaine (now IUSMM). Significant advances related to the interaction between the psychoanalytic movement and community psychiatry were greatly influenced by the work at the Pavillon Albert-Prévost and the emergence of behavioral therapies (Dr. Yves Lamontagne) and cognitive studies conducted by the Hôpital Louis-H. Lafontaine. Great discoveries about sleep were performed at the Hôpital du Sacré-Coeur de Montréal by teams gathered around Jacques-Yves Montplaisir.We also recall that two ministers from the Quebec government with important political responsibilities were members or directors of the Département de psychiatrie. These are Drs. Camille Laurin and Denis Lazure.The Département aims to strengthen clinical and basic research by contributing new knowledge that will improve care for people with mental disorders. These efforts benefit both patients and the medical students and residents being trained to care for them. The Département remains committed to its program, to pre-doctoral education (ensuring that all medical students at the Université are trained to recognize, diagnose, and be familiar with treatment options for mental disorders), to post-doctoral education for future psychiatrists, and to the care of Quebec's patients.For over 50 years, the academic department has played a key role in attracting and recruiting excellent academic and clinical resources to staff the programs and services of our hospital partners.

  11. [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

  12. 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

  13. [The Institute Philippe-Pinel and the department of Psychiatry of the University of Montreal: intricate paths].

    Science.gov (United States)

    Bouchard, Anne-Marie; Morissette, Louis; Millaud, Fédéric

    2015-01-01

    The Institute Philippe-Pinel (IPPM) and the Département de psychiatrie de l'Université de Montréal, who are both celebrating their 50 years, have intricated paths and a long history of collaboration. Since its conception (1964), the Institute Philippe-Pinel was planned to become a site for training and teaching in the bosom of the Université de Montréal.Unique in its mission to offer state of the art psychiatric care and forensic assessments to patients presenting a high risk of violence, the Institute Philippe-Pinel, throughout the years, was also able to leave its mark by the way of academic teaching to psychiatric residents and trainees of all disciplines, of organizing national and international conferences, of research and by the publication of numerous articles and books in the field of forensic psychiatry.With, from its beginning, psychiatrists at its helm, the Institute Philippe-Pinel has at all times greatly contributed to the academic activity of the department. Highly committed psychiatric clinicians and professors were always involved at all levels of the psychiatric department. With the coming of the forensic subspecialty, the commitment and influence can only continue.

  14. 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

  15. 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...

  16. 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

  17. Teaching child and adolescent psychiatry to undergraduate medical students - A survey in German-speaking countries

    Directory of Open Access Journals (Sweden)

    Frank Florian

    2010-07-01

    Full Text Available Abstract Objective To conduct a survey about teaching child and adolescent psychiatry to undergraduate medical students in German-speaking countries. Methods A questionnaire was sent to the 33 academic departments of child and adolescent psychiatry in Germany, Austria, and the German-speaking part of Switzerland. Results All departments responded. For teaching knowledge, the methods most commonly reported were lectures and case presentations. The most important skills to be taught were thought to be how to assess psychopathology in children and how to assess families. For elective courses, the departments reported using a wide range of teaching methods, many with active involvement of the students. An average of 34 hours per semester is currently allocated by the departments for teaching child and adolescent psychiatry to medical students. Required courses are often taught in cooperation with adult psychiatry and pediatrics. Achievement of educational objectives is usually assessed with written exams or multiple-choice tests. Only a minority of the departments test the achievement of skills. Conclusions Two ways of improving education in child and adolescent psychiatry are the introduction of elective courses for students interested in the field and participation of child and adolescent psychiatrists in required courses and in longitudinal courses so as to reach all students. Cooperation within and across medical schools can enable departments of child and adolescent psychiatry, despite limited resources, to become more visible and this specialty to become more attractive to medical students. Compared to the findings in earlier surveys, this survey indicates a trend towards increased involvement of academic departments of child and adolescent psychiatry in training medical students.

  18. 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

  19. State of psychiatry in Denmark

    DEFF Research Database (Denmark)

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

    2012-01-01

    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 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...

  20. [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

  1. 精神科护士工作状况及影响因素调查%Investigation of the Working Condition of Nurses in Department of Psychiatry and the Influencing Factors

    Institute of Scientific and Technical Information of China (English)

    马静

    2013-01-01

    Objective To investigate the working condition of nurses in department of psychiatry and the related influencing factors. Methods A general survey and a survey of satisfaction with the working condition were performed among the 250 nurses in department of psychiatry in my hospital and the results were statistically analyzed. Results The working condition for the nurses in department of psychiatry was poor and they had a lower satisfaction with it. Conclusions The working condition of nurses in department of psychiatry needs improvement as well as the treatment to them, and the work stress on them should be relieved.%目的了解精神科护士工作状况及影响因素。方法对我院250名精神科护士进行一般情况调查和工作状况满意度调查,并对调查结果进行统计学分析。结果精神科护士工作状况较差,工作满意度较低。结论应改善精神科护士的工作环境,提高其待遇,减轻其工作压力。

  2. [Social psychiatry].

    Science.gov (United States)

    Miéville, C

    1978-01-01

    The author attempts an analysis of some of the socio-cultural elements which have marked the birth of (modern?) psychiatry and which have consequently influenced the education, identity and ethical values of the practitioner who choses to become a psychiatrist. The author draws attention to the problem of the psychiatrist's autonomy by stressing the important relationship between autonomy (or lack of autonomy) and the dominant political ideologies. Such relationship appears more clearly when the psychiatrist uncritically accepts to become "the psychiatric expert" in criminal and civil law, suicide, sex, death, etc., in other words, whenever accepting the role of "managerial technician". It is evident that the psychiatrist cannot renounce the social responsibilities which fall upon him because of his understanding and analysis of human behaviour, but it is also evident that a redefinition of the psychiatrist's role in society is called for. Such a re-definition will be possible only by the permanent exercise of self-criticism, honesty towards oneself, moral integrity and the capacity to differentiate between true autonomy and the illusion of autonomy when operating in the name of an official psychiatry which is often also a vehicle for the enforcement of a political ideology.

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

    Directory of Open Access Journals (Sweden)

    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

  4. TOWARDS AN ANTHROPOLOGICAL PSYCHIATRY

    NARCIS (Netherlands)

    Mooij, A.W.M.

    1995-01-01

    The situation of present day psychiatry is described as being dominated by an empiricist perspective. The limitations of this perspective are analyzed and a rough sketch of the hermeneutical approach in psychiatry is offered. It is argued that a fully developed hermeneutical psychiatry implies a ref

  5. 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.

  6. 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

  7. 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

  8. 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...

  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. 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

  11. [(Community) psychiatry, a parenthesis?].

    Science.gov (United States)

    Bucheron, Bastien

    2015-01-01

    Beyond an a priori antagonism between these two notions, alienism and mental health cultivate analogies as to the place to which they assign mental health. Is community psychiatry not therefore simply a parenthesis in the history of psychiatry? The question is raised therefore regarding the place given to subjectivity and complexity. What must be done to ensure that this parenthesis of community psychiatry does not close? It is perhaps a case of making use of the tools which institutional psychotherapy has developed to keep the community psychiatry spirit alive.

  12. Using the Technique of Journal Writing to Learn Emergency Psychiatry

    Science.gov (United States)

    Bhuvaneswar, Chaya; Stern, Theodore; Beresin, Eugene

    2009-01-01

    Objective: The authors discuss journal writing in learning emergency psychiatry. Methods: The journal of a psychiatry intern rotating through an emergency department is used as sample material for analysis that could take place in supervision or a resident support group. A range of articles are reviewed that illuminate the relevance of journal…

  13. Old age psychiatry in the modern age.

    Science.gov (United States)

    Warner, James P

    2015-11-01

    Old age psychiatry services globally are under threat. The discipline enjoyed its heyday in the two decades bridging the millennium. More recently there has been a move to integrate old age services with those of working age adults, to create 'ageless' services. Evidence is beginning to accumulate that this is a bad idea.

  14. Emergency Department Visits by Older Adults for Motor Vehicle Collisions

    Directory of Open Access Journals (Sweden)

    Vogel, Jody A.

    2013-11-01

    Full Text Available Introduction: To describe the epidemiology and characteristics of emergency department (ED visits by older adults for motor vehicle collisions (MVC in the United States (U.S..Methods: We analyzed ED visits for MVCs using data from the 2003–2007 National Hospital Ambulatory Medical Care Survey (NHAMCS. Using U.S. Census data, we calculated annual incidence rates of driver or passenger MVC-related ED visits and examined visit characteristics, including triage acuity, tests performed and hospital admission or discharge. We compared older (65+ years and younger (18-64 years MVC patients and calculated odds ratios (OR and 95% confidence intervals (CIs to measure the strength of associations between age group and various visit characteristics. Multivariable logistic regression was used to identify independent predictors of admissions for MVC-related injuries among older adults.Results: From 2003–2007, there were an average of 237,000 annual ED visits by older adults for MVCs. The annual ED visit rate for MVCs was 6.4 (95% CI 4.6-8.3 visits per 1,000 for older adults and 16.4 (95% CI 14.0-18.8 visits per 1,000 for younger adults. Compared to younger MVC patients, after adjustment for gender, race and ethnicity, older MVC patients were more likely to have at least one imaging study performed (OR 3.69, 95% CI 1.46-9.36. Older MVC patients were not significantly more likely to arrive by ambulance (OR 1.47; 95% CI 0.76–2.86, have a high triage acuity (OR 1.56; 95% CI 0.77-3.14, or to have a diagnosis of a head, spinal cord or torso injury (OR 0.97; 95% CI 0.42-2.23 as compared to younger MVC patients after adjustment for gender, race and ethnicity. Overall, 14.5% (95% CI 9.8-19.2 of older MVC patients and 6.1% (95% CI 4.8-7.5 of younger MVC patients were admitted to the hospital. There was also a non-statistically significant trend toward hospital admission for older versus younger MVC patients (OR 1.78; 95% CI 0.71-4.43, and admission to the ICU if

  15. The future of community psychiatry.

    Science.gov (United States)

    Cohen, Carl I; Feiner, Joel S; Huffine, Charles; Moffic, H Steven; Thompson, Kenneth S

    2003-10-01

    Leaders of national groups that have focused on issues of community and social psychiatry present their ideas about the future of psychiatry. They identify five areas: theory development; the relevance of community psychiatry in the 21st century; education and training; the relationship between community psychiatry and health maintenance organizations; and role of community psychiatry in bridging medical science with humanism. The unifying theme for these topics is that community psychiatry can be a vehicle for modifying general psychiatry's propensity towards individualism and reductionism by offering a more holistic and integrative approach to illness and well-being.

  16. 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.

  17. 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...

  18. 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

  19. 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...

  20. 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...

  1. 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...

  2. 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…

  3. [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

  4. [Can psychiatry become neuropsychiatry?].

    Science.gov (United States)

    Slosarczyk, Mariusz

    2005-01-01

    Today more and more often there are prognoses that in the future psychiatry will have been absorbed by neurology. It would be thanks to the stormy progress of research on the neurophysiological, genetic and molecular foundations of mental disorders. The aim of the article is to assess the possibility as well as the supposed consequences of such an evolution of psychiatry. The considerations concern the peculiarity of the object of interest and the methods used in psychiatry in relation to the neurological object and methodology. This way the appraisal of raison d'etre of one common science: neuropsychiatry becomes possible. The question of fundamental importance for the evaluation of similarities and differences between the psychiatric and neurological perspectives is the way the psychophysical issue and especially the problem of the mind-brain relation are approached. The article presents the manners of solving these problems proposed by the contemporary philosophy of the mind. Together with parting with the full of errors and simplifications heritage of Descartes it appears the necessity to regard the presence of subjective mental states both conscious and unconscious in model of mind-brain relation. The example of such a solution is the biological naturalism of John Searle. The psychical life of the man in its subjective dimension remains the peculiar area of interests for psychiatry irrespective of the progress in research on the biological base of mental disorders. The especially valuable cognitive and therapeutic tool in this aspect is psychotherapy constituting the integral part of psychiatry. The present state of knowledge does not indicate that the psychotherapeutic wing of psychiatry can lose its importance and rather somewhat the contrary. The progress of neurobiology does not have to threaten the autonomy of psychiatry by any means and the maintenance of this autonomy depends decisively on the psychiatrists themselves. PMID:15881619

  5. [Hundred years' psychiatry in Korea (1899-1999)].

    Science.gov (United States)

    Rhi, B Y

    1999-01-01

    The western medical knowledges of the human anatomy and physiology including knowledges of central nervous system have probably been introduced into Korea by Prince Sohyŏn Seja in 1645. The authentic education for the western medicine at the governmental and private medical schools, however, originated from 1899 and the education of mental disease was included in curriculum of Tai-Han-uiwon, the governmental medical school before 1910. In 1913 the first department of psychiatry (Department of Mental Disease) was established at the Chongdokbu-uiwon, the clinic of the Japanese colonial government, the former Korean governmental hospital which has later developed to the Kyŏngs ŏng Imperial University Hospital. On the other hand, there was in Severance Hospital Medical College, one Australian missionary psychiatrist McLaren, who has served at Paton Memorial Hospital in Jinju, Korea from 1911, taught neurology and psychiatry from 1913 at Severance Hospital Medical College, established psychiatry ward in 1923 at the Hospital, conducted the ward in humanistic way until 1940. It was the German psychiatry which the Japanese psychiatrists have brought to the Korean peninsula and it remained as major trends of psychiatry in Korea during the Japanese occupation between 1911 and 1945. The academic levels of Kyŏngsŏng Imperial University in psychiatry as well as the quality of mental care seemed to be almost equivocal to the psychiatry in Japan. However, psychiatrists scope of social psychiatric issues and of the research interests seemed to be somewhat narrow. Due to the political discrimination for the Korean students, the Koreans had less opportunity for the promotion at the university than Japanese residents in Korea. In 1945, after the end of the Pacific War only about 11 Korean psychiatrists were left in Korea, who organized Korean Neuropsychiatric Association. The Department of Neuropsychiatry of Seoul National University (former Department of Neurology and

  6. Cognitive Impairment among Older Adults in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Hirschman, Karen

    2011-02-01

    Full Text Available Background: Within the next 30 years, the number of visits older adults will make to emergency departments (EDs is expected to double from 16 million, or 14% of all visits, to 34 million and comprise nearly a quarter of all visits.Objective: The objectives of this study were to determine prevalence rates of cognitive impairment among older adults in the ED and to identify associations, if any, between environmental factors unique to the ED and rates of cognitive impairment.Methods: A cross-sectional observational study of adults 65 and older admitted to the ED of a large, urban, tertiary academic health center was conducted between September 2007 and May 2008. Patients were screened for cognitive impairment in orientation, recall and executive function using the Six-Item Screen (SIS and the CLOX1, clock drawing task. Cognitive impairment among this ED population was assessed and both patient demographics and ED characteristics (crowding, triage time, location of assessment, triage class were compared through adjusted generalized linear models.Results: Forty-two percent (350/829 of elderly patients presented with deficits in orientation and recall as assessed by the SIS. An additional 36% of elderly patients with no impairment in orientation or recall had deficits in executive function as assessed by the CLOX1. In full model adjusted analyses patients were more likely to screen deficits in orientation and recall (SIS if they were 85 years or older (Relative Risk [RR]=1.63, 95% Confidence Interval [95% CI]=1.3-2.07, black (RR=1.85, 95% CI=1.5-2.4 and male (RR=1.42, 95% CI=1.2-1.7. Only age was significantly associated with executive functioning deficits in the ED screened using the clock drawing task (CLOX1 (75-84 years: RR=1.35, 95% CI= 1.2-1.6; 85+ years: RR=1.69, 95% CI= 1.5-2.0.Conclusion: These findings have several implications for patients seen in the ED. The SIS coupled with a clock drawing task (CLOX1 provide a rapid and simple method for

  7. [Psychiatry and humanitarianism].

    Science.gov (United States)

    Heimann, H

    1976-01-01

    Opposing positions on mental disorder in current psychiatry, their origins and therapy are presented through a few extreme viewpoints. Considering the foundations of the 'medical model' of psychiatric disorder (Griesinger), it is evident that this model is not a closed system, but rather an open approach which still has validity today. The humanitarian roots of psychiatry prevented Griesinger from treating various positions in an absolute or ideological manner. Finally, the concept of 'illness' is discussed in relation to psychophysiological activation research. Pathology changes in each different situation and is therefore not a static phenomenon. Mental disturbance is not determined by absolute measures, but rather by a reduction in variability of reactions to the particular situation. This concept of illness can determine somato-, psycho-, and sociotherapeutic measures. Psychiatry can only remain based on humanitarian concepts as long as the sciences upon which it is founded are kept in appropriate relation to one another. PMID:964006

  8. Emergency Department Use Among Older Adults With Dementia.

    Science.gov (United States)

    LaMantia, Michael A; Stump, Timothy E; Messina, Frank C; Miller, Douglas K; Callahan, Christopher M

    2016-01-01

    Although persons with dementia are frequently hospitalized, relatively little is known about the health profile, patterns of health care use, and mortality rates for patients with dementia who access care in the emergency department (ED). We linked data from our hospital system with Medicare and Medicaid claims, Minimum Data Set, and Outcome and Assessment Information Set data to evaluate 175,652 ED visits made by 10,354 individuals with dementia and 15,020 individuals without dementia over 11 years. Survival rates after ED visits and associated charges were examined. Patients with dementia visited the ED more frequently, were hospitalized more often than patients without dementia, and had an increased odds of returning to the ED within 30 days of an index ED visit compared with persons who never had a dementia diagnosis (odds ratio, 2.29; Pdementia status (Pdementia. These results show that older adults with dementia are frequent ED visitors who have greater comorbidity, incur higher charges, are admitted to hospitals at higher rates, return to EDs at higher rates, and have higher mortality after an ED visit than patients without dementia.

  9. 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.)

  10. Epistemology of psychiatry.

    Science.gov (United States)

    Marková, Ivana S; Berrios, German E

    2012-01-01

    In historical and epistemological terms, psychiatry is a new discipline born during the 19th century. Rooted in both the natural and social sciences, psychiatric objects of inquiry, namely mental symptoms and mental disorders, are hybrid, constituted by the blending of components arising from disparate sources of knowledge ranging from the biological to the semantic in its widest sense. This poses problems for psychiatric research and therapy. Whilst conventional pluralism may be a convenient approach to manage aspects of psychiatric practice, it lacks the capacity to analyse psychiatric objects in their entirety. For the latter, psychiatry demands a new, tailored regional epistemology. This paper outlines the main features of an epistemology specific to the needs of psychiatry. It highlights the relational approach that needs to be taken and illustrates the usefulness of this approach by analysing the structure of psychiatric objects, exploring the manner in which they may be inscribed in the brain, and identifying the need to periodically recalibrate the language of psychiatry.

  11. [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

  12. [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.

  13. Acute Myeloid Leukemia in Adolescents and Young Adults Treated in Pediatric and Adult Departments in the Nordic Countries

    DEFF Research Database (Denmark)

    Wennström, Lovisa; Edslev, Pernille Wendtland; Abrahamsson, Jonas;

    2016-01-01

    BACKGROUND: Studies on adolescents and young adults with acute lymphoblastic leukemia suggest better results when using pediatric protocols for adult patients, while corresponding data for acute myeloid leukemia (AML) are limited. PROCEDURE: We investigated disease characteristics and outcome...... for de novo AML patients 10-30 years old treated in pediatric or adult departments. We included 166 patients 10-18 years of age with AML treated according to the pediatric NOPHO-protocols (1993-2009) compared with 253 patients aged 15-30 years treated in hematology departments (1996-2009) in the Nordic...... countries. RESULTS: The incidence of AML was 4.9/million/year for the age group 10-14 years, 6.5 for 15-18 years, and 6.9 for 19-30 years. Acute promyelocytic leukemia (APL) was more frequent in adults and in females of all ages. Pediatric patients with APL had similar overall survival as pediatric patients...

  14. 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...

  15. Psychiatry in former socialist countries: implications for north korean psychiatry.

    Science.gov (United States)

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

    2014-10-01

    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 Party. Psychiatry was primarily concerned with psychotic disorders, and this diagnostic category was sometimes applied based on political considerations. Neurotic disorders were ignored by psychiatry or were regarded as the remnants of capitalism. Several neurotic disorders characterized by high levels of somatization were considered to be neurological or physical in nature. The majority of "mental patients" were institutionalized for a long periods in large-scale psychiatric hospitals. Treatment of psychiatric disorders depended largely on a few outdated biological therapies. In former socialist countries, psychodynamic psychotherapy was not common, and psychiatric patients were likely to experience social stigma. According to North Korean doctors living in South Korea, North Korean psychiatry is heavily influenced by the aforementioned traditions of psychiatry. During the post-socialist transition, the suicide rate in many of these countries dramatically increased. Given such mental health crises in post-socialist transitional societies, the field of psychiatry may face major challenges in a future unified Korea. PMID:25395966

  16. 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

  17. 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.

  18. 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...

  19. 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.

  20. Training Needs and Effect of Anti-violence Skill for Nurses in Psychiatry Department%精神科护士防暴技能的培训需求及效果

    Institute of Scientific and Technical Information of China (English)

    汪丽莎

    2015-01-01

    目的:探讨精神科护士对防暴技能培训的需求以及培训后应对暴力侵袭行为的效果。方法选取我院未曾受过系统防暴技能培训的精神科护士60名,采用问卷调查方法,于培训前评估护士对防暴知识和技能的需求,培训后6个月评估防暴技能培训的效果。结果12%的护士对精神病患者暴力先兆表示了解,17%的护士对暴力先兆的知识和技能表示了解,93%的护士受到精神科患者不同程度的暴力侵害。护士未接受和很少接受防暴知识和技能培训的占57%和25%;精神科护士对防暴知识和技能有需求均占97%;培训后,护士对防暴知识和技能掌握的程度均明显提高(P<0.001);与上年同期相比,6个月精神科护士积极应对暴力行为发生率提高到1.63倍,控制暴力行为时受伤率降低为0.39倍。结论精神科护士对防暴技能培训的需求较高,加强防暴技能培训能够明显提高护理人员的防暴知识,提高其应对暴力攻击行为的能力。%Objective To explore the effect of anti-violence skill training for nurses in psychiatry department. Methods Sixty nurses in psychiatry department received anti- violence training for six months and were surveyed before and after the training. Results The investigation before the training showed that 12%of the nurses understood the portent of patients ’ violence and 17%of them knew anti-violence knowledge and skill. Of the total, 93%of the nurses experienced violence from patients with varying degrees and 97%of the nurses needed anti-violence training since nurses never or seldom receiving anti-violence training accounted for 57%and 25%respectively. After the training, nurses’ understanding of anti-violence knowledge and skill improved significantly (P<0.001). Compared with the same time period of last year, the incidence of coping with violence increased to 1.63 times while the injury rate when coping with violence

  1. Treatment resistance and psychodynamic psychiatry: concepts psychiatry needs from psychoanalysis.

    Science.gov (United States)

    Plakun, Eric

    2012-06-01

    Over the last 30 years psychiatry and psychoanalysis have moved in substantially divergent directions. Psychiatry has become rich in methodology but conceptually limited, with a drift toward biological reductionism. Psychoanalysis has remained relatively limited in methodology, but conceptually rich. The rich methodology of psychiatry has led to major contributions in discovering gene by environment interactions, the importance of early adversity, and to recognition of the serious problem posed by treatment resistance. However, psychiatry's biologically reductionistic conceptual focus interferes with the development of a nuanced clinical perspective based on emerging knowledge that might help more treatment resistant patients become treatment responders. This article argues that recognition of the problem of treatment resistance in psychiatry creates a need for it to reconnect with the conceptual richness of psychoanalysis in order to improve patient care. Psychodynamic psychiatry is defined as the relevant intersection of psychiatry and psychoanalysis where this reconnection can occur. I will suggest selected aspects of psychoanalysis that are especially relevant to psychiatry in improving outcomes in work with treatment resistant patients.

  2. 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.

  3. Developing a Structured Teaching Plan for Psychiatry Tutors at Oxford University

    Science.gov (United States)

    Al-Taiar, Hasanen

    2014-01-01

    Purpose: The purpose of this thesis was to examine the teaching ways I undertook in teaching medical students and to examine the use of a structured teaching plan for the academic and clinical tutors in psychiatry. The teaching plan was developed for use, initially by Oxford University Academic tutors at the Department of Psychiatry. In addition,…

  4. A Pilot Use of Team-Based Learning in Psychiatry Resident Psychodynamic Psychotherapy Education

    Science.gov (United States)

    Touchet, Bryan K.; Coon, Kim A.

    2005-01-01

    Objective: Demonstrating psychotherapy competency in trainees will test the resources of psychiatry training programs. The authors outline the phases of team-based learning (TBL). Methods: The University of Oklahoma College of Medicine, Tulsa (OUCM-T), Department of Psychiatry reorganized its psychodynamic psychotherapy didactic course using TBL.…

  5. 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.

  6. Ethics Training in Psychiatry

    Directory of Open Access Journals (Sweden)

    Sinan Guloksuz

    2009-09-01

    Full Text Available Although ethics training is one of the core components of psychiatric education, it is not sufficiently addressed in the curricula of many educational institutions. It is shown that many of the psychiatry residents received no ethics training in both residency and medical school. Predictably, over half of the psychiatry residents had faced an ethical dilemma that they felt unprepared to meet, and nearly all of them indicated ethics education would have helped them to solve this dilemma. In addition to learning about the fundamental topics of ethics like confidentiality, boundary violations, justice, benefience and nonmaleficence, psychiatrists must also learn to deal with other hidden ethical dilemmas which are mostly due to the changing world order. It is obvious that residency training should include a well developed ethics curriculum. However, some still believe that ethical principles cannot be taught and are formed in one’s early moral development. Accepting the fact that teaching ethics is difficult, we believe that it is getting easier with the new methods for teaching in medicine. These methods are clinical supervisions, rol-models, case studies, role playing, small group discussions, team based learning and “let’s talking medicine” groups which is a useful methods for discussing ethics dilemmas on daily practice and C.A.R.E (Core Beliefs, Actions, Reasons, Experience which is a special training method for teaching ethics. In this review, the need of ethics training in residency curriculum will be discussed and new methods for teaching ethics will be proposed.

  7. 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.

  8. 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.

  9. 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

  10. [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

  11. 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.

  12. 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.

  13. Psychiatry and terrorism.

    Science.gov (United States)

    Stoddard, Frederick J; Gold, Joel; Henderson, Schuyler W; Merlino, Joseph P; Norwood, Ann; Post, Jerrold M; Shanfield, Stephen; Weine, Stevan; Katz, Craig L

    2011-08-01

    Terrorism has dominated the domestic and international landscape since 9/11. Like other fields, psychiatry was not well prepared. With the 10th anniversary of the 9/11 attack approaching, it is timely to consider what can be done to prepare before the next event. Much has been learned to provide knowledge and resources. The roles of psychiatrists are challenged by what is known of the causes of, consequences of, and responses to terrorism. Reflecting on knowledge from before and since 9/11 introduces concepts, how individuals become terrorists, how to evaluate the psychiatric and behavioral effects of terrorism, and how to expand treatments, behavioral health interventions, public policy initiatives, and other responses for its victims. New research, clinical approaches, and policy perspectives inform strategies to reduce fear and cope with the aftermath. This article identifies the psychiatric training, skills and services, and ethical considerations necessary to prevent or reduce terrorism and its tragic consequences and to enhance resilience.

  14. Personalized medicine in psychiatry

    DEFF Research Database (Denmark)

    Wium-Andersen, Ida Kim; Vinberg, Maj; Kessing, Lars Vedel;

    2016-01-01

    BACKGROUND: Personalized medicine is a model in which a patient's unique clinical, genetic, and environmental characteristics are the basis for treatment and prevention. Aim, method, and results: This review aims to describe the current tools, phenomenological features, clinical risk factors......, and biomarkers used to provide personalized medicine. Furthermore, this study describes the target areas in which they can be applied including diagnostics, treatment selection and response, assessment of risk of side-effects, and prevention. DISCUSSION AND CONCLUSION: Personalized medicine in psychiatry...... is challenged by the current taxonomy, where the diagnostic categories are broad and great biological heterogeneity exists within each category. There is, thus, a gap between the current advanced research prospects and clinical practice, and the current taxonomy is, thus, a poor basis for biological research...

  15. American Association for Geriatric Psychiatry

    Science.gov (United States)

    ... in your area. Read more » AAGP Journal Official Journal of the American Association for Geriatric Psychiatry. Read more ... RESEARCHERS GMHF Scholars Since my program is so small and there is not much interest among my ...

  16. [Psychiatry and the Great War].

    Science.gov (United States)

    Fras, Ivan

    2002-01-01

    During the World War I, the high rate of psychiatric casualties was differently tackled according to the nations: the Central Powers carried an authoritarian approach with prevailing physical treatment methods whereas the Allies' attitude reflected their democratic background. Particularly French psychiatry demonstrated a real willingness and ability to respond to the clinical realities. The conceptual problem of what DSM IV now classified as acute stress disorder was resolved so successfully that this disorder deserves the eponym "Viovenel's Syndrome". American Military Psychiatry followed the French methods of precise diagnosis and expeditious treatment close to the front and amplified them by creating effective treatment methods : brief psychotherapy methods and group psychotherapy within a therapeutic environment. Franco-American psychiatry thereby created the foundation for modern community psychiatry.

  17. 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

  18. Cultural psychiatry: a general perspective.

    Science.gov (United States)

    Alarcón, Renato D

    2013-01-01

    The current scene in the field of cultural psychiatry shows a vigorous growth, multifaceted conceptual and research developments and more relevant clinical presence. After a pertinent definition of the discipline, this chapter examines the contribution of cultural psychiatry to the etiopathogenesis of mental disorders, to the variations of clinical presentations in numerous entities, to psychiatric diagnosis and treatment and to the relatively unexplored rubric of preventive psychiatry. Advanced concepts of neurosciences and technology-based research can find a place in the realm of biocultural correlates. The role of culture in the definition of mental illness, the renewed notions of the old 'culture-bound syndromes', hope, cognition and culture in psychiatric treatments (including the so-called 'cultural therapies'), and resiliency are areas duly examined and discussed. Cultural psychiatry has re-emerged as a reliable body of knowledge aimed at a comprehensive assessment of human beings as patients.

  19. A Novel Approach to Medicine Training for Psychiatry Residents

    Science.gov (United States)

    Onate, John; Hales, Robert; McCarron, Robert; Han, Jaesu; Pitman, Dorothy

    2008-01-01

    Objective: A unique rotation was developed to address limited outpatient internal medicine training in psychiatric residency by the University of California, Davis, Department of Psychiatry and Behavioral Sciences, which provides medical care to patients with mental illness. Methods: The number of patients seen by the service and the number of…

  20. 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...

  1. 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.…

  2. [Hundred years' psychiatry in Korea (1899-1999)].

    Science.gov (United States)

    Rhi, B Y

    1999-01-01

    The western medical knowledges of the human anatomy and physiology including knowledges of central nervous system have probably been introduced into Korea by Prince Sohyŏn Seja in 1645. The authentic education for the western medicine at the governmental and private medical schools, however, originated from 1899 and the education of mental disease was included in curriculum of Tai-Han-uiwon, the governmental medical school before 1910. In 1913 the first department of psychiatry (Department of Mental Disease) was established at the Chongdokbu-uiwon, the clinic of the Japanese colonial government, the former Korean governmental hospital which has later developed to the Kyŏngs ŏng Imperial University Hospital. On the other hand, there was in Severance Hospital Medical College, one Australian missionary psychiatrist McLaren, who has served at Paton Memorial Hospital in Jinju, Korea from 1911, taught neurology and psychiatry from 1913 at Severance Hospital Medical College, established psychiatry ward in 1923 at the Hospital, conducted the ward in humanistic way until 1940. It was the German psychiatry which the Japanese psychiatrists have brought to the Korean peninsula and it remained as major trends of psychiatry in Korea during the Japanese occupation between 1911 and 1945. The academic levels of Kyŏngsŏng Imperial University in psychiatry as well as the quality of mental care seemed to be almost equivocal to the psychiatry in Japan. However, psychiatrists scope of social psychiatric issues and of the research interests seemed to be somewhat narrow. Due to the political discrimination for the Korean students, the Koreans had less opportunity for the promotion at the university than Japanese residents in Korea. In 1945, after the end of the Pacific War only about 11 Korean psychiatrists were left in Korea, who organized Korean Neuropsychiatric Association. The Department of Neuropsychiatry of Seoul National University (former Department of Neurology and

  3. 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

  4. 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

  5. American Academy of Child and Adolescent Psychiatry

    Science.gov (United States)

    ... members of AACAP. Be CAPtivated - Child and Adolescent Psychiatry as a Career AACAP's Current Award Opportunities More... ... More... Copyright ©2016 - American Academy of Child Adolescent Psychiatry. All Rights Reserved. Contact Us | Disclaimer | Privacy Statement ...

  6. 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...

  7. 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

  8. 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…

  9. The safe practice of CT coronary angiography in adult patients in UK imaging departments.

    Science.gov (United States)

    Harden, S P; Bull, R K; Bury, R W; Castellano, E A; Clayton, B; Hamilton, M C K; Morgan-Hughes, G J; O'Regan, D; Padley, S P G; Roditi, G H; Roobottom, C A; Stirrup, J; Nicol, E D

    2016-08-01

    Computed tomography coronary angiography is increasingly used in imaging departments in the investigation of patients with chest pain and suspected coronary artery disease. Due to the routine use of heart rate controlling medication and the potential for very high radiation doses during these scans, there is a need for guidance on best practice for departments performing this examination, so the patient can be assured of a good quality scan and outcome in a safe environment. This article is a summary of the document on 'Standards of practice of computed tomography coronary angiography (CTCA) in adult patients' published by the Royal College of Radiologists (RCR) in December 2014. PMID:27207375

  10. The safe practice of CT coronary angiography in adult patients in UK imaging departments.

    Science.gov (United States)

    Harden, S P; Bull, R K; Bury, R W; Castellano, E A; Clayton, B; Hamilton, M C K; Morgan-Hughes, G J; O'Regan, D; Padley, S P G; Roditi, G H; Roobottom, C A; Stirrup, J; Nicol, E D

    2016-08-01

    Computed tomography coronary angiography is increasingly used in imaging departments in the investigation of patients with chest pain and suspected coronary artery disease. Due to the routine use of heart rate controlling medication and the potential for very high radiation doses during these scans, there is a need for guidance on best practice for departments performing this examination, so the patient can be assured of a good quality scan and outcome in a safe environment. This article is a summary of the document on 'Standards of practice of computed tomography coronary angiography (CTCA) in adult patients' published by the Royal College of Radiologists (RCR) in December 2014.

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

    OpenAIRE

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

    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, cognitiv...

  12. 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.

  13. [The "Psychiatrie-Enquete" - the German Report on the State of Psychiatry in 1975].

    Science.gov (United States)

    Finzen, Asmus

    2015-10-01

    Forty years ago an expert-commission submitted a report on the deplorable state of German psychiatric care, called the "Psychiatrie-Enquete" to the Bundestag, the German parliament. The Report initiated a substantial change of Psychiatric services in the country. Inhuman treatment and living conditions were superseded. Mental hospitals were not completely abolished. But they lost their importance in favour of decentralized psychiatric services including departments at general hospitals, day hospitals and outpatient services. Custodial care was largely successfully developed into therapeutic and rehabilitative care. This article attempts a mildly critical evaluation of the Enquête 40 years after.

  14. 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...

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. 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...

  1. 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...

  2. 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...

  3. 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

  4. 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...

  5. 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.

  6. Psychiatry and humanism in Argentina.

    Science.gov (United States)

    Niño Amieva, Alejandra

    2016-04-01

    The authors of the present selection of Latin American Psychiatry texts were characterized by a common deep humanistic attitude. These prolific writers were able to establish or extend the scope of the discipline in which they chose to act, questioning the establishment of rigid boundaries within the framework of a rigorous epistemological reflection. Thus the systematizing spirit of Jose Ingenieros' in the context of positivist evolutionism, resulted in the act of founding a discipline that integrated the biological and the social. In the case of Guillermo Vidal his conception of mental health went beyond the biomedical to consider psychotherapies as an emotional commitment, continence and empathic understanding; with regard to César Cabral his formation and extensive clinical practice resulted in a work defined by the inquiring into the theoretical concepts underlying Psychiatry and Clinical Psychology. This brief selection does not exhaust the issues or the level of ideas and discussions of Psychiatry in Argentina, but constitutes a textual corpus representative of a disciplinary conception understood as scientific and humanistic endeavor.

  7. Attitudes of Medical Students toward Psychiatry and Psychiatry as a Career: A Systematic Review

    Science.gov (United States)

    Lyons, Zaza

    2013-01-01

    Objective: The discipline of psychiatry, and psychiatry as a career option, have been negatively regarded by medical students for decades. There is a large amount of literature on attitudes of students and the factors that attract them to and detract from psychiatry. The aim of this article is to systematically review this literature from 1990 to…

  8. Models of Integrated Training in Psychiatry and Child and Adolescent Psychiatry

    Science.gov (United States)

    Sexson, Sandra B.; Thomas, Christopher R.; Pope, Kayla

    2008-01-01

    Objective: Previous studies indicate declining interest in child and adolescent psychiatry (CAP) as a career choice during psychiatry residency training. Programs have developed integrated training in psychiatry and CAP as a means to address the workforce shortage in CAP, but little is known about the number or nature of these training tracks.…

  9. Positive psychiatry: its time has come.

    Science.gov (United States)

    Jeste, Dilip V; Palmer, Barton W; Rettew, David C; Boardman, Samantha

    2015-06-01

    Traditionally, psychiatry has been defined and practiced as a branch of medicine focused on the diagnosis and treatment of mental illnesses. Based on growing empirical evidence, we believe that this definition warrants expansion to include the concept of positive psychiatry. In the present article, we provide a critical overview of this emerging field and a select review of relevant scientific literature. Positive psychiatry may be defined as the science and practice of psychiatry that seeks to understand and promote well-being through assessment and interventions involving positive psychosocial characteristics (PPCs) in people who suffer from or are at high risk of developing mental or physical illnesses. It can also benefit nonclinical populations. Positive psychiatry has 4 main components: (1) positive mental health outcomes (eg, well-being), (2) PPCs that comprise psychological traits (resilience, optimism, personal mastery and coping self-efficacy, social engagement, spirituality and religiosity, and wisdom-including compassion) and environmental factors (family dynamics, social support, and other environmental determinants of overall health), (3) biology of positive psychiatry constructs, and (4) positive psychiatry interventions including preventive ones. There are promising empirical data to suggest that positive traits may be improved through psychosocial and biological interventions. As a branch of medicine rooted in biology, psychiatry, especially with the proposed conceptualization of positive psychiatry, is well poised to provide major contributions to the positive mental health movement, thereby impacting the overall health care of the population.

  10. 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...

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

    Directory of Open Access Journals (Sweden)

    Yona Lunsky

    2012-01-01

    Full Text Available 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.

  12. 防跌倒护理风险管理在精神科住院患者中的应用%Application of nursing risk management in the prevention of fall-down in inpatients in the department of psychiatry

    Institute of Scientific and Technical Information of China (English)

    蔡秀英

    2013-01-01

    目的:探讨防跌倒护理风险管理在精神科住院患者中的应用方法及临床效果.方法:将120例精神科住院患者随机分为观察组和对照组各60例,对照组实施常规安全护理管理,观察组在此基础上实施防跌倒护理风险管理.比较两组管理效果.结果:两组干预后简明精神病量表(BPRS)总分及意外跌倒率比较差异有统计学意义(P<0.05);观察组意外跌倒因素中,互相戏耍打架致跌倒发生率显著低于对照组(P<0.05).结论:对精神科住院患者实施防跌倒护理风险管理可避免跌倒事件发生,确保患者安全.%Objective:To explore the approaches of nursing risk management in the prevention of fall-down in inpatients in the department of psychiatry and investigate the clinical effect.Methods:120 inpatients in the department of psychiatry were randomly divided into the observation group and the control group (60 cases in each group).The routine nursing safety management was implemented in the control group; the nursing risk management in the prevention of fall-down was applied in the observation group.The management effects were compared between the two groups.Results:There were statistically significant differences in the comparison of the scores of Brief Psychiatric Rating Scale (BPRS) and the rate of accidental fall-down between the two groups (P < 0.05) ; the incidence of fall-down because of play and fight was lower in the observation group than the control group (P < 0.05).Conclusion:The nursing risk management in the prevention of fall-down for the inpatients in the department of psychiatry can avoid the events of fall-down and ensure patient safety.

  13. 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

  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. Magnetic resonance imaging in psychiatry. Kernspintomographie in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Mann, K. (Psychiatrische Universitaetsklinik, Tuebingen (Germany))

    1993-08-13

    Diagnosis and research in psychiatry are increasingly availing themselves of magnetic resonance imaging (MRI). In comparison to computed tomography (CT), this offers the combined benefits of no exposure to radiation, high resolution, artefact-free display of structures near bone, and a sharp contrast between the grey and white brain matter, with freedom to select the section. With the exception of very anxious patients, MRI will gradually replace CT scans for a wide range of differential diagnostic investigations. Its superiority in systematic studies of psychiatric patients with discrete cerebral parenchyma lesions is already considered proven. This is illustrated on the basis of research into schizophrenia and alcoholism. (orig.)

  16. Positron emission tomography (PET) in psychiatry. PET in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Herholz, K. (Max-Planck-Institut fuer Neurologische Forschung und Neurologische Klinik der Universitaet Koeln (Germany))

    1993-08-13

    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.)

  17. Cranial computed tomography in psychiatry. Kraniale Computertomographie in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Falkai, P. (Rheinische Landes- und Hochschulklinik Duesseldorf, Psychiatrische Klinik der Heinrich-Heine-Universitaet (Germany)); Bogerts, B. (Rheinische Landes- und Hochschulklinik Duesseldorf, Psychiatrische Klinik der Heinrich-Heine-Universitaet (Germany))

    1993-08-13

    Computed tomography has gained importance as a diagnostic tool in psychiatry to exclude structural brain pathology, but has passed on its role in research to magnetic resonance tomography. It helps to distinguish between senile dementia of Alzheimer type and multi-infarct dementia. The enlargement of the ventricular system and cortical sulci is well established in schizophrenic and affective psychosis. Some alcohol addicts show a considerable degree of cerebral atrophy, only exceeded by demented patients, but this condition is potentially reversible. To screen psychiatric patients by CT is recommendable, as 2-10% of hospitalized psychiatric patients have structural brain disease. (orig.)

  18. 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,…

  19. Putting "Rural" into Psychiatry Residency Training Programs

    Science.gov (United States)

    Nelson, William A.; Pomerantz, Andrew; Schwartz, Jonathan

    2007-01-01

    Objective: Evidence indicates disparities in the number of psychiatrists practicing in rural America compared to urban areas suggesting the need for a greater emphasis on rural psychiatry in residency training programs. The authors offer suggestions for integrating a rural focus in psychiatry residency training to foster greater competency and…

  20. 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.

  1. 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.

  2. 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...

  3. Polypharmacy in psychiatry: A review

    Directory of Open Access Journals (Sweden)

    Sanjay Kukreja

    2013-01-01

    Full Text Available Psychiatric polypharmacy refers to the prescription of two or more psychiatric medications concurrently to a patient. It can be categorised as same-class, multi-class, adjunctive, augmentation and total polypharmacy. Despite advances in psychopharmacology and a better understanding of the principles of therapeutics, its practice is increasing rapidly. The prevalence of polypharmacy in psychiatry varies between 13%-90%. There are various clinical and pharmaco-economic factors associated with it. Dealing with polypharmacy requires an understanding of its associated factors. Education, guidelines and algorithms for the appropriate management of various conditions are effective ways to avoid irrational polypharmacy.

  4. Some gestalt contributions to psychiatry.

    Science.gov (United States)

    Clegg, Kathleen A

    2010-07-01

    Gestalt theory and methods support significant behavioral change and personal growth, yet they have not been widely incorporated into modern psychiatric practice. Challenges to employing Gestalt principles in psychiatric practice exist, such as focus on diagnosis to guide treatment planning, key elements of psychiatric training, primacy of medication management in psychiatric practice, and financial pressures. However, the concepts of the co-created relational field in the here and now, the paradoxical theory of change, the cycle of experience, and the use of experiment are Gestalt concepts and methods that can be effectively applied in the modern practice of clinical psychiatry and psychiatric education.

  5. 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...

  6. 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.

  7. 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.

  8. 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

  9. 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...

  10. 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.

  11. Relational agents in clinical psychiatry.

    Science.gov (United States)

    Bickmore, Timothy; Gruber, Amanda

    2010-01-01

    Relational agents are computational artifacts, such as animated, screen-based characters or social robots, that are designed to establish a sense of rapport, trust, and even therapeutic alliance with patients, using ideal therapeutic relationships between human counselors and patients as role models. We describe the development and evaluation of several such agents designed for health counseling and behavioral-change interventions, in which a therapeutic alliance is established with patients in order to enhance the efficacy of the intervention. We also discuss the promise of using such agents as adjuncts to clinical psychiatry, a range of possible applications, and some of the challenges and ethical issues in developing and fielding them in psychiatric interventions.

  12. [Disaster psychiatry in late life].

    Science.gov (United States)

    Awata, Shuichi

    2013-10-01

    Disaster preparedness in geriatric psychiatry was proposed on the basis of experience of the Great East Japan Earthquake. 1) Frail or demented elderly should be considered as a special population at risk for disaster victims and addressed in local disaster prevention programs. 2) To response to various psychiatric symptoms(delirium, BPSD, depression, anxiety, insomnia, and posttraumatic stress disorder) caused by medical conditions and rapid environmental changes due to disaster, linkage and coordination systems between psychiatric and medical sections should be established. 3) As a medium- and long-term support for the elderly who lost the community familiar to them, creation of a new community should be promoted in order to prevent depression, alcohol dependence, BPSD, and suicide.

  13. 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

  14. [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

  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. Research in Psychiatry: Concepts and Conceptual Analysis.

    Science.gov (United States)

    Marková, Ivana S; Berrios, German E

    2016-01-01

    Current research in psychiatry is increasingly focused on empirical studies with methods and technologies adopted from medicine. This paper argues that psychiatry has a different epistemological basis from medicine, and it is on account of this that research in psychiatry demands a different approach, one that perforce focuses on the clarification of concepts central to psychiatric practice. This means undertaking conceptual analysis and conceptual history and only then moving on to empirical study. This paper highlights the crucial epistemological differences between the practice of medicine and psychiatry, showing that the latter is enacted at the level of language and communication. Consequently, the structures of psychiatric objects, namely, mental disorders and mental symptoms, are complexes of meaning derived from heterogeneous sources - both organic and semantic. Conceptual analysis of such structures is essential as ultimately the validity of empirical research is directly dependent on the conceptual clarification of its objects of inquiry. PMID:27463619

  17. The organizational culture of emergency departments and the effect on care of older adults: a modified scoping study.

    Science.gov (United States)

    Skar, Pål; Bruce, Anne; Sheets, Debra

    2015-04-01

    How does the organizational micro culture in emergency departments (EDs) impact the care of older adults presenting with a complaint or condition perceived as non-acute? This scoping study reviews the literature and maps three levels of ED culture (artifacts, values and beliefs, and assumptions). Findings on the artifact level indicate that EDs are poorly designed for the needs of older adults. Findings on the ED value and belief level indicate that EDs are for urgent cases (not geriatric care), that older adults do not receive the care and respect they should be given, that older adults require too much time, and that the basic nursing needs of older adults are not a priority for ED nurses. Finally, finding on the assumptions level underpinning ED behaviors suggest that older adults do not belong in the ED, most older adults in the ED are not critically ill and therefore can wait, and staff need to be available for acute cases at all times. A systematic review on the effect of ED micro culture on the quality of geriatric care is warranted.

  18. 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...

  19. Why is psychiatry prone to fads?

    Science.gov (United States)

    Paris, Joel

    2013-10-01

    Psychiatry has long been prone to fads. The main reason is that mental illness is poorly understood and can be difficult to treat. Most diagnostic fads have involved the extension of well-known categories into broader spectra. The most prominent treatment fads have involved the overuse of pharmacological interventions and a proliferation of methods for psychotherapy. The best antidote to fads is a commitment to evidence-based psychiatry.

  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. Divergent Fates of the Medical Humanities in Psychiatry and Internal Medicine: Should Psychiatry Be Rehumanized?

    Science.gov (United States)

    Rutherford, Bret R.; Hellerstein, David J.

    2008-01-01

    Objective: To determine the degree to which the medical humanities have been integrated into the fields of internal medicine and psychiatry, the authors assessed the presence of medical humanities articles in selected psychiatry and internal medicine journals from 1950 to 2000. Methods: The journals searched were the three highest-ranking…

  3. Attitudes of Medical Students towards Psychiatry: Effects of Training, Courses in Psychiatry, Psychiatric Experience and Gender

    Science.gov (United States)

    Kuhnigk, Olaf; Strebel, Bernd; Schilauske, Joerg; Jueptner, Markus

    2007-01-01

    Objective: The attitudes of medical students towards psychiatry and psychotherapy were examined considering the extent of their education, previous psychiatry experience, the evaluation of the course, their career intentions and socio-demographic variables. Methods: Five hundred and eight medical students in their second, fifth, ninth and tenth…

  4. Innovative Training in Pediatrics, General Psychiatry, and Child Psychiatry: Background, Outcomes, and Experiences

    Science.gov (United States)

    Gleason, Mary Margaret; Fritz, Gregory K.

    2009-01-01

    Objectives: The authors describe the history, rationale, and outcomes of combined training programs in pediatrics, psychiatry, and child psychiatry ("triple board"), including narrative feedback from graduates and reflections upon the important components of the program. Methods: This article reviews the background and experiences of triple board…

  5. 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

  6. 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.

  7. 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

  8. 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

  9. [Reform of psychiatry in Spain].

    Science.gov (United States)

    Pedrosa Gil, F; Luderer, H J

    2000-11-01

    Since the 1980's psychiatric care in Spain changed considerably (Reforma psiquiátrica española). In the course of this reform, many positive results were achieved. An extensive community network of mental health centres was build up which resulted in the majority of psychiatric patients being integrated in the Spanish general health care system and making a better organized mental health care structure possible. New legislation also improved the care and civil rights of patients. An analysis of the experiences of the Spanish psychiatric reform shows that the tendency to retain the old mental hospitals, alongside the other institutions still exists. The process of deinstitutionalization and the original aims of the psychiatric reform cannot only be satisfied by the closure of large psychiatric hospitals as during the reform new aspects and problems as well the great complexity of the task have become apparent. This article together with the details of the Spanish sources gives the German public a good overview of the developments in Spanish psychiatry.

  10. Neurology and psychiatry in Babylon.

    Science.gov (United States)

    Reynolds, Edward H; Wilson, James V Kinnier

    2014-09-01

    We here review Babylonian descriptions of neurological and psychiatric disorders, including epilepsy, stroke, psychoses, obsessive compulsive disorder, phobias, psychopathic behaviour, depression and anxiety. Most of these accounts date from the first Babylonian dynasty of the first half of the second millennium BC, within a millennium and a half of the origin of writing. The Babylonians were remarkably acute and objective observers of medical disorders and human behaviour. Their detailed descriptions are surprisingly similar to modern 19th and 20th century AD textbook accounts, with the exception of subjective thoughts and feelings which are more modern fields of enquiry. They had no knowledge of brain or psychological function. Some neuropsychiatric disorders, e.g. stroke or facial palsy, had a physical basis requiring the attention of a physician or asû, using a plant and mineral based pharmacology; some disorders such as epilepsy, psychoses, depression and anxiety were regarded as supernatural due to evil demons or spirits, or the anger of personal gods, and thus required the intervention of the priest or ašipu; other disorders such as obsessive compulsive disorder and psychopathic behaviour were regarded as a mystery. The Babylonians were the first to describe the clinical foundations of neurology and psychiatry. We discuss these accounts in relation to subsequent and more modern clinical descriptions. PMID:25037816

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. [Challenges for the future of psychiatry and psychiatric medical care].

    Science.gov (United States)

    Higuchi, Teruhiko

    2013-01-01

    In addition to the prolonged economic recession and global financial crisis, the Great East Japan Earthquake of March 2011 has caused great fear and devastation in Japan. In the midst of these, Japanese people have felt to lose the traditional values and common sense they used to share, and it has become necessary to build a new consciousness. Engaged in psychiatry and psychiatric care under these circumstances, we have to analyze the challenges we face and to brainstorm on appropriate prescriptions that can be applied to solve the problems. Five points in particular were brought up: [1] The persistently high number of suicides. [2] The increase in depression and overflowing numbers of patients visiting clinics and outpatient departments at hospitals. [3] The absolute shortage of child psychiatrists. [4] Little progress with the transition from hospitalization-centered to community-centered medical care. [5] The disappearance of beds for psychiatry patients from general hospitals. The situations surrounding these five issues were briefly analyzed and problems were pointed out. The following are five problems that psychiatry is facing: 1) A lack of large clinical trials compared to the rest of the world. 2) The drug lag and handling of global trials. 3) The lack of staff involved in education and research (in the field of psychiatry). 4) Following the DSM diagnostic criteria dogmatically, without differentiating therapeutics. 5) Other medical departments, the industry, patients, and their families are demanding objective diagnostic techniques. After analyzing the problems, and discussing to some extent what kind of prescription may be considered to solve the problems, I gave my opinion. (1) The first problem is the deep-rooted prejudice and discrimination against psychiatric disorders that continue to be present among Japanese people. The second problem is the government's policy of low remuneration (fees) for psychiatric services. The third problem, symbolic of the

  16. [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.

  17. Attitudes of psychiatry residents toward mental illness

    Directory of Open Access Journals (Sweden)

    Pejović-Milovančević Milica

    2007-01-01

    Full Text Available Introduction. Attitudes of lay people and physicians towards mentally ill patients are frequently highly biased. The aim of this study was to investigate differences in attitudes of psychiatry and internal medicine residents toward mental illness and to establish the relationship between their attitudes and their personal characteristics. Material and methods. The sample consisted of 45 psychiatry and 36 internal medicine residents. The attitudes toward mental illness were assessed using Opinions about Mental Illness Questionnaire (OMI and personality traits were examined using the Eysenck Personality Questionnaire (EPQ. Results. Our findings showed that in regard to internal medicine residents, psychiatry residents do not consider mentally ill patients to be inferior and dangerous. Psychiatry residents have a benevolent attitude toward the mentally ill. Personality traits of psychiatry residents were not related to their opinions about mental illness. Discussion. The results suggest that there is a need to develop strategies that would bring about changes in the curriculum of training programs for medical residents, including proper training in mental health issues. Such strategies should help in destigmatization of persons with mental disorders and increase the competence of physicians to deal with mentally ill. .

  18. 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.

  19. 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.

  20. 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

  1. [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

  2. 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.

  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. The rise of liaison psychiatry: challenges and implications for sustainability.

    Science.gov (United States)

    Udo, Itoro; Odeyale, Foluke; Gash, Amanda; Fossey, Matt

    2016-09-01

    Liaison or general hospital psychiatry is experiencing unprecedented expansion in the UK. A liaison psychiatry team in a typical general hospital may deliver savings of up to £5 million a year. However, liaison psychiatry faces challenges associated with this pace of change, with consequences for its long-term sustainability. PMID:27640655

  5. Teaching Psychiatry Residents to Teach: A National Survey

    Science.gov (United States)

    Crisp-Han, Holly; Chambliss, R. Bryan; Coverdale, John

    2013-01-01

    Objective: Because there have been no previously published national surveys on teaching psychiatry residents about how to teach, the authors surveyed United States psychiatry program directors on what and how residents are taught about teaching. Methods: All psychiatry training programs across the United States were mailed a semistructured…

  6. Factors Affecting Recruitment into Child and Adolescent Psychiatry Training

    Science.gov (United States)

    Shaw, Jon A.; Lewis, John E.; Katyal, Shalini

    2010-01-01

    Objective: The authors studied the factors affecting the recruitment into child and adolescent psychiatry training in the United States. Methods: Medical students (n = 154) and general and child and adolescent psychiatry residents (n = 111) completed a questionnaire to evaluate career choice in child psychiatry (n = 265). Results: Compared with…

  7. Survey of Threats and Assaults by Patients on Psychiatry Residents

    Science.gov (United States)

    Dvir, Yael; Moniwa, Emiko; Crisp-Han, Holly; Levy, Dana; Coverdale, John H.

    2012-01-01

    Objective: The authors sought to determine the prevalence of threats and assaults by patients on psychiatry residents, their consequences, and the perceived adequacy of supports and institutional responses. Method: Authors conducted an anonymous survey of 519 psychiatry residents in 13 psychiatry programs across the United States. The survey…

  8. 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

  9. 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.

  10. [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

  11. Central registry in psychiatry: A structured review

    Directory of Open Access Journals (Sweden)

    Jyoti Prakash

    2014-01-01

    Full Text Available Background: Central registry in psychiatry is being practiced in few countries and has been found useful in research and clinical management. Role of central registry has also expanded over the years. Materials and Methods: All accessible internet database Medline, Scopus, Embase were accessed from 1990 till date. Available data were systematically reviewed in structured manner and analyzed. Results: Central registry was found useful in epidemiological analysis, association studies, outcome studies, comorbidity studies, forensic issue, effective of medication, qualitative analysis etc., Conclusion: Central registry proves to be effective tool in quantitative and qualitative understanding of psychiatry practice. Findings of studies from central registry can be useful in modifying best practice and evidence based treatment in psychiatry.

  12. 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

  13. 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

  14. 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.

  15. [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

  16. 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.

  17. How Health Reform is Recasting Public Psychiatry.

    Science.gov (United States)

    Shaner, Roderick; Thompson, Kenneth S; Braslow, Joel; Ragins, Mark; Parks, Joseph John; Vaccaro, Jerome V

    2015-09-01

    This article reviews the fiscal, programmatic, clinical, and cultural forces of health care reform that are transforming the work of public psychiatrists. Areas of rapid change and issues of concern are discussed. A proposed health care reform agenda for public psychiatric leadership emphasizes (1) access to quality mental health care, (2) promotion of recovery practices in primary care, (3) promotion of public psychiatry values within general psychiatry, (4) engagement in national policy formulation and implementation, and (5) further development of psychiatric leadership focused on public and community mental health.

  18. Senior Medical Students' Attitudes toward Psychiatry as a Career Choice before and after an Undergraduate Psychiatry Internship in Iran

    Science.gov (United States)

    Amini, Homayoun; Moghaddam, Yasaman; Nejatisafa, Ali-Akbar; Esmaeili, Sara; Kaviani, Hosein; Shoar, Saeed; Shabani, Amir; Samimi-Ardestani, Mehdi; Akhlaghi, Amir Abbas Keshavarz; Noroozi, Alireza; Mafi, Mostafa

    2013-01-01

    Objectives: The study aimed to assess 1) the attitudes of medical students in the sixth and seventh years (known as interns in Iran) toward psychiatry as a career choice, and 2) the degree of attractiveness of psychiatry as a career choice, with regard to various defined aspects, before and after an undergraduate psychiatry internship (similar to…

  19. 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.

  20. 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.

  1. 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

  2. [Psychiatry and mental health in the Institutp de Seguridad Social para los Trabajadores del Estado. Philosophy of its development].

    Science.gov (United States)

    Dallal y Castillo, E

    1977-01-01

    In 1972, prepaid medical care for government employees provided by their social security institute, ISSSTE, was reorganized. A division of planning and technical standards was established, within which a Department of Psychiatry was included. Psychiatric care was restructured at three levels: psychiatric hospital, psychiatric OPD at clinic and hospital level and a pilot program in community psychiatry. A three-year psychiatric residency program was established, in addition to participation in other postgraduate, in-service training and monographic courses. Systematic research was started, as well as a publications program, working relationship with other institutions and societies were enhanced. A descriptive example is Child Psychiatry. Most frequent diagnoses are reviewed, and development of services is followed in relation to pediatric departments.

  3. 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...

  4. 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…

  5. 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.

  6. 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...

  7. 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…

  8. 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…

  9. Undergraduate Child Psychiatry Teaching in Melbourne, Australia

    Science.gov (United States)

    Gough, Jenny K.; McCallum, Zoe; Bevan, Catherine; Vance, Alasdair

    2010-01-01

    Objective: The teaching of child psychiatry in Australian medical schools is under review: the content, the placement of the field within medical curricula, and the appropriate teaching and learning methods are all contested. The authors developed a 1-day program in the 9-week child and adolescent health course conducted in the final two semesters…

  10. 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

  11. 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.

  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. [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

  14. [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

  15. Emergency Department Visits for Traumatic Brain Injury in Older Adults in the United States: 2006-08

    Directory of Open Access Journals (Sweden)

    William S. Pearson

    2012-08-01

    Full Text Available Introduction: Traumatic brain injury (TBI can be complicated among older adults due to age-related frailty, a greater prevalence of chronic conditions and the use of anticoagulants. We conducted this study using the latest available, nationally-representative emergency department (ED data to characterize visits for TBI among older adults.Methods: We used the 2006-2008 National Hospital Ambulatory Medical Care – Emergency Department (NHAMCS-ED data to examine ED visits for TBI among older adults. Population-level estimates of triage immediacy, receipt of a head computed tomography (CT and/or head magnetic resonance imaging (MRI, and hospital admission by type were used to characterize 1,561 sample visits, stratified by age <65 and ≥65 years of age.Results: Of ED visits made by persons ≥65 years of age, 29.1% required attention from a physician within 15 minutes of arrival; 82.1% required a head CT, and 20.9% required hospitalization. Persons≥65 years of age were 3 times more likely to receive a head CT or MRI compared to younger patients presenting with TBI (adjusted odds ratio [aOR] 3.2; 95% confidence interval [CI], 1.8-5.8, and were 4 times more likely to be admitted to an intensive care unit, step-down unit, or surgery (aOR 4.1; 95% CI 2.1-8.0 compared to younger patients presenting with TBI, while controlling for sex and race.Conclusion: Results demonstrate increased emergent service delivery for older persons presenting with TBI. As the United States population ages and continues to grow, TBI will become an even more important public health issue that will place a greater demand on the healthcare system. [West J Emerg Med. 2012;13(3:289-293.

  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. Neuropsychiatrie of biologische psychiatrie; een toekomstvisie in historisch perspectief.

    Science.gov (United States)

    Verhoeven, W M; Tuinier, S

    1999-06-01

    Neuropsychiatry or Biological Psychiatry There is an urgent need to reconsider the position of psychiatry within the neurosciences because of the exploding knowledge about the relationship between brain and behaviour and the delay in implementation of new findings due to the separation of neurology and psychiatry. Biological psychiatry and psychopharmacology originate from the discovery by chance of psycho-active compounds in the early fifties and have contributed to the scientification of psychiatry. The impact of biological psychiatry for the pathophysiology of psychiatric disorders, however, is limited as a result of its biased orientation on neurotransmitters and receptors. The neuropsychiatric paradigm integrates knowledge from several domains, such as functional neuroanatomy, genetics and endocrinology and opens new vistas for the involvement of neuronal circuits in the initiation and maintenance of behavioural disturbances. In addition, novel and more specific treatment modalities may emerge.

  19. [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.

  20. 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

  1. [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

  2. [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

  3. 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

  4. Indianization of psychiatry utilizing Indian mental concepts.

    Science.gov (United States)

    Avasthi, Ajit; Kate, Natasha; Grover, Sandeep

    2013-01-01

    Most of the psychiatry practice in India is guided by the western concepts of mental health and illness, which have largely ignored the role of religion, family, eastern philosophy, and medicine in understanding and managing the psychiatric disorders. India comprises of diverse cultures, languages, ethnicities, and religious affiliations. However, besides these diversities, there are certain commonalities, which include Hinduism as a religion which is spread across the country, the traditional family system, ancient Indian system of medicine and emphasis on use of traditional methods like Yoga and Meditation for controlling mind. This article discusses as to how mind and mental health are understood from the point of view of Hinduism, Indian traditions and Indian systems of medicine. Further, the article focuses on as to how these Indian concepts can be incorporated in the practice of contemporary psychiatry. PMID:23858244

  5. 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.

  6. 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.

  7. 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...

  8. 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...

  9. 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

  10. Women in psychiatry: A view from the Indian subcontinent

    OpenAIRE

    Sood, Mamta; Chadda, Rakesh Kumar

    2009-01-01

    Background: Psychiatry has not been a preferred medical specialty for women in the Indian subcontinent unlike in the Western countries like USA, Canada or UK. Recent years have seen an increase in the number of women doctors in India choosing psychiatry as career. Materials and Methods: Information on women in psychiatry in the Indian subcontinent was collected using resources like PubMed, directories of the professional societies, websites of medical institues, souvenirs and scientific progr...

  11. Evolutionary psychiatry: a new College special interest group

    Science.gov (United States)

    Abed, Riadh; St John-Smith, Paul

    2016-01-01

    Evolutionary science remains an overlooked area in psychiatry and medicine. The newly established Royal College of Psychiatrists' Evolutionary Psychiatry Special Interest Group aims to reverse this trend by raising the profile of evolutionary thinking among College members and others further afield. Here we provide a brief outline of the importance of the evolutionary approach to both the theory and practice of psychiatry and for future research.

  12. The Third Wave of Biological Psychiatry

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    Henrik eWalter

    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.

  13. 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...

  14. Diagnostic imaging in psychiatry; Bildgebende Verfahren in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Stoppe, G.; Hentschel, F.; Munz, D.L. (eds.)

    2000-07-01

    The textbook presents an exhaustive survey of diagnostic imaging methods available for clinical evaluation of the entire range of significant psychiatric symptoms via imaging of the anatomy and functions of the brain. The chapters discuss: The methods and their efficient use for given diagnostic objectives, image analysis, description and interpretation of findings with respect to the clinical symptoms. Morphology and functional correlation of findings. The book is intended to help psychiatrists and neurologists as well as doctors in the radiology and nuclear medicine departments. (orig./CB) [German] Die Entwicklung der modernen Bildgebung ermoeglicht faszinierende Einblicke in Anatomie und Funktionen des Gehirns und ihre Veraenderungen bei psychiatrischen Erkrankungen. Die Methodik der Untersuchungsverfahren und die Befunde bei allen wichtigen psychiatrischen Krankheitsbildern sind in diesem Buch systematisch und umfassend beschrieben: - gezielter und effizienter Einsatz der Verfahren, - Bildanalyse und Befundbeschreibung, - Bewertung der Befunde und Beziehung zum klinischen Bild, - morphologische und funktionelle Korrelate der Befunde. Psychiater und Neurologen werden ebenso angesprochen wie Radiologen und Nuklearmediziner. (orig.)

  15. In India, Psychiatry Has Come a Long Way

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    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.

  16. Is psychiatry scientific? A letter to a 21st century psychiatry resident.

    Science.gov (United States)

    de Leon, Jose

    2013-09-01

    During the development of the DSM-5, even the lay press questioned psychiatr's scientific validity. This review provides 21st century psychiatry residents with ways of answering these attacks by defining the concepts and history of psychiatry (a branch of medicine), medicine and science. Psychiatric language has two levels: first, describing symptoms and signs (19th century descriptive psychopathology developed in France and Germany), and second, describing disorders (psychiatric nosology was developed in the early 20th century by Kraepelin and resuscitated by the US neo-Kraepelinian revolution leading to the DSM-III). Science is a complex trial-and-error historical process that can be threatened by those who believe too much in it and disregard its limitations. The most important psychiatric advances, electroconvulsive therapy and major psychopharmacological agents, were discovered by "chance", not by scientific planning. Jaspers's General Psychopathology is a complex 100-year-old book that describes: 1) psychiatric disorders as heterogeneous and 2) psychiatry as a hybrid scientific discipline requiring a combination of understanding (a social science method) and explanation (a natural science method). In the 21st century Berrios reminds us of psychiatry's unfortunate methodological issues due to hybrid symptoms and disorders, some of which are better understood as problems in communication between interacting human beings; in those situations neuroscience methods such as brain imaging make no sense. A new language is needed in psychiatry. East Asian psychiatry residents, who are not particularly attached to the antiquated language currently used, may be particularly equipped for the task of recreating psychiatric language using 21st century knowledge. PMID:24302942

  17. Initiatives in biological research in Indian psychiatry.

    Science.gov (United States)

    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 and effective utilization of contemporary technological advances. It is a matter of great pride to see that in spite of difficult times in terms of challenges of practice and services, administration, resource, funding and manpower the zest for research was very forthcoming. There was neither dedicated time nor any funding for conducting research. It came from the intellectual insight of our fore fathers in the field of mental health to gradually grow to the state of strategic education in research, training in research, international research collaborations and setting up of internationally accredited centers. During difficult economic conditions in the past, the hypothesis tested and conclusions derived have not been so important. It is more important how it was done, how it was made possible and how robust traditions were established. Almost an entire spectrum of biological research has been touched upon by Indian researchers. Some of these are electroconvulsive therapy, biological markers, neurocognition, neuroimaging, neuroendocrine, neurochemistry, electrophysiology and genetics. A lot has been published given the limited space in the Indian Journal of Psychiatry and other medical journals published in India. A large body of biological research conducted on Indian patients has also been published in International literature (which I prefer to call non-Indian journals). Newer research questions in biological psychiatry, keeping with trend of international standards are

  18. 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

  19. 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

  20. Shorter Psychiatry Clerkship Length Is Associated with Lower NBME Psychiatry Shelf Exam Performance

    Science.gov (United States)

    Bostwick, J. Michael; Alexander, Cara

    2012-01-01

    Objective: The goal of this study was to evaluate a recent medical school curriculum change at our institution 3 years ago; specifically: shortening the Psychiatry core clerkship from 4 to 3 weeks and adding an optional 6-week core/elective combination rotation in lieu of the 3-week core. The authors aimed to determine whether clerkship length was…

  1. 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…

  2. Child Psychiatry: What Are We Teaching Medical Students?

    Science.gov (United States)

    Dingle, Arden D.

    2010-01-01

    Objective: The author describes child and adolescent psychiatry (CAP) undergraduate teaching in American and Canadian medical schools. Methods: A survey asking for information on CAP teaching, student interest in CAP, and opinions about the CAP importance was sent to the medical student psychiatry director at 142 accredited medical schools in the…

  3. An Investigation of Psychiatry Residents' Important Experiences

    Science.gov (United States)

    Long, Jody

    2011-01-01

    This research study was conducted to explore the phenomenon of the third-year experiences of the psychiatry residents. A review of the literature identified themes and subthemes related to the third-year of psychiatry education. The study was conducted at a university health science center. Data were collected from five residents using participant…

  4. 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…

  5. Psychiatry Residency Education in Canada: Past, Present and Future

    Science.gov (United States)

    Saperson, Karen

    2013-01-01

    Objective: This article provides a brief overview of the history of psychiatry residency training in Canada,and outlines the rationale for the current training requirements, changes to the final certification examination,and factors influencing future trends in psychiatry education and training. Method: The author compiled findings and reports on…

  6. 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…

  7. The Recruitment Problem in Psychiatry: A Critical Commentary

    Science.gov (United States)

    Stampfer, Hans

    2011-01-01

    The continuing shortfall in recruitment to Psychiatry is examined with suggestions for affirmative action. Recruitment may improve in the near future because of the high demand for psychiatrists, the incentives offered, greater competition for other specialties and a pool of international graduates willing to work in Psychiatry. There remains the…

  8. 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…

  9. Screening for Psychopathology Symptoms in Mexican Psychiatry Residents

    Science.gov (United States)

    Rios, Francisco Javier Mesa; Munoz, Maria Del Carmen Lara

    2011-01-01

    Background: Various rates of alcoholism, drug abuse, mental illness, and suicide among physician have been reported, generally higher than those in the general population. Psychiatry residents, as other specializing physicians, seem to be prone to suffering them. The prevalence of psychological symptoms among psychiatry residents has not been…

  10. 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

  11. 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…

  12. Medical School Research Pipeline: Medical Student Research Experience in Psychiatry

    Science.gov (United States)

    Balon, Richard; Heninger, George; Belitsky, Richard

    2006-01-01

    Objective: The authors discuss the importance of introducing research training in psychiatry and neurosciences to medical students. Methods: A review of existing models of research training in psychiatry with focus on those providing research training to medical students is presented. Results: Two research-training models for medical students that…

  13. 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.

  14. Older adults who persistently present to the emergency department with severe, non-severe, and indeterminate episode patterns

    Directory of Open Access Journals (Sweden)

    Ohsfeldt Robert L

    2011-10-01

    Full Text Available Abstract Background It is well known that older adults figure prominently in the use of emergency departments (ED across the United States. Previous research has differentiated ED visits by levels of clinical severity and found health status and other individual characteristics distinguished severe from non-severe visits. In this research, we classified older adults into population groups that persistently present with severe, non-severe, or indeterminate patterns of ED episodes. We then contrasted the three groups using a comprehensive set of covariates. Methods Using a unique dataset linking individual characteristics with Medicare claims for calendar years 1991-2007, we identified patterns of ED use among the large, nationally representative AHEAD sample consisting of 5,510 older adults. We then classified one group of older adults who persistently presented to the ED with clinically severe episodes and another group who persistently presented to the ED with non-severe episodes. These two groups were contrasted using logistic regression, and then contrasted against a third group with a persistent pattern of ED episodes with indeterminate levels of severity using multinomial logistic regression. Variable selection was based on Andersen's behavioral model of health services use and featured clinical status, demographic and socioeconomic characteristics, health behaviors, health service use patterns, local health care supply, and other contextual effects. Results We identified 948 individuals (17.2% of the entire sample who presented a pattern in which their ED episodes were typically defined as severe and 1,076 individuals (19.5% who typically presented with non-severe episodes. Individuals who persistently presented to the ED with severe episodes were more likely to be older (AOR 1.52, men (AOR 1.28, current smokers (AOR 1.60, experience diabetes (AOR (AOR 1.80, heart disease (AOR 1.70, hypertension (AOR 1.32 and have a greater amount of

  15. 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

  16. 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.

  17. [The problem of truth in psychiatry].

    Science.gov (United States)

    López-Ibor Aliño, J J

    2000-01-01

    Psychiatry has forgotten too early about the problem of truth (Zutt). In the first treatises on delusions, these are described as pathological errors, as mistakes in the ability to judge reality. For French psychiatry, delusions are false ideas of pathological origin, resistant to logical argumentation that alter the ability to judge reality, a concept still present in DSM-IV, in which it is defined as wrong beliefs that normality imply a wrong interpretation of perceptions of experiences. As a consequence, delusions are classified according to its contents. German psychiatry however seeks for the structures underlying to all delusions, some authors have even defended the notion of a single psychosis. The Heidelberg School, so well analyzed by Laín, developed a psychopathology which dismantled the notion of delusion then accepted (falseness is a relative and accessory notion and the lack of information plays an important role, as well as cultural and religious factors). K. Schneider describes the two forms of delusion: delusional perception and delusional occurrence. Both concepts have been criticized, therefore it is necessary to consider truth as a process and not as a state and to take into account the contributions of the philosophy of science and psychoanalysis. The concept of truth of Aristotle (the adaptation of the logos to the thing) is the one that has prevailed along history. But, for Heidegger the truth as aletheia (the process of revealing) is deeper and allows, applied to psychopathology, the connection of truth, liberty and relationship between human beings. As a consequence, the error of delusion, its lack of liberty, is also a lack of communication. The process of getting closer to truth is marked by an ethical attitude of tolerance. PMID:11205045

  18. 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...

  19. Optogenetics in psychiatry: The light ahead

    Directory of Open Access Journals (Sweden)

    Jyoti Prakash

    2012-01-01

    Full Text Available Complexities of the human mind have been beyond the scope of understanding because a intricate neuronal network and difficulty in specific localization and assessment of area responsible for a specific behavior; more so in a freely moving living being. Optogenetics off late has been able to address this issue to great extent and holds promises for future. Relevant literatures in this direction were looked into and the salient aspects of this science is being discussed here with specific relevance to psychiatry.

  20. 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...

  1. [Between law and psychiatry: homosexuality in the project of the Swiss penal code (1918)].

    Science.gov (United States)

    Delessert, Thierry

    2005-01-01

    In 1942 the Swiss penal code depenalises homosexual acts between agreeing adults under some conditions. The genesis of the penal article shows that it was constructed before the First World War and bears marks of the forensic theories of the turn of the century. Both by direct contacts and the authority of its eminent figures, Swiss psychiatry exerts an unquestionable influence on the depenalisation. The conceptualisation of homosexuality is also strongly influenced by the German psychiatric theories and discussed in reference to Germanic law. By the penal article, the Swiss lawyers and psychiatrists link the homosexual question with the determination of the irresponsibility of criminal mental patients and degeneracy.

  2. 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…

  3. The state of psychiatry in Spain.

    Science.gov (United States)

    Bobes, Julio; Garcia-Portilla, Maria Paz; Bobes-Bascaran, Maria-Teresa; Parellada, Mara; Bascaran, Maria-Teresa; Saiz, Pilar Alejandra; Bousoño, Manuel; Arango, Celso

    2012-08-01

    The 1986 General Health Act and the so-called 'psychiatric reform' were key issues in the development of the mental healthcare system (MHCS) in Spain. The World Health Organization Declaration and Action Plan on Mental Health in 2005 gave it a revitalizing impetus and resulted in the first National Health System (NHS) Mental Health Strategy in 2006. A literature search was performed using MEDLINE, Spanish journals, reference lists, national databases, and European and Spanish official documents to describe the current state of the MHCS in Spain. The main results were: (1) existence of great variability among the autonomous communities with respect to mental health resources and provision of care; (2) lack of national epidemiological information on mental disorders with the exception of substance use disorders and suicide, which comprise powerful longitudinal national data, (3) training in psychiatry is well established, although there is no specialism of child and adolescent psychiatry, and (4) a dramatic increase in scientific productivity in the last decade among research groups, in part due to the creation of the Spanish Mental Health Network, the Centro de Investigación Biomédica en Red en el Área de Salud Mental (CIBERSAM). Quantifiable and reliable indicators are needed to provide efficient monitoring and analysis of epidemiological events and subsequently to understand the status of the Spanish MHCS.

  4. 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

  5. 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.

  6. 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”.

  7. [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

  8. Applied psychometrics in clinical psychiatry: the pharmacopsychometric triangle

    DEFF Research Database (Denmark)

    Bech, P

    2009-01-01

    OBJECTIVE: To consider applied psychometrics in psychiatry as a discipline focusing on pharmacopsychology rather than psychopharmacology as illustrated by the pharmacopsychometric triangle. METHOD: The pharmacopsychological dimensions of clinically valid effects of drugs (antianxiety, antidepress......OBJECTIVE: To consider applied psychometrics in psychiatry as a discipline focusing on pharmacopsychology rather than psychopharmacology as illustrated by the pharmacopsychometric triangle. METHOD: The pharmacopsychological dimensions of clinically valid effects of drugs (antianxiety...... psychometrics in psychiatry have been found to cover a pharmacopsychometric triangle illustrating the measurements of wanted and unwanted effects of pharmacotherapeutic drugs as well as health-related quality of life....

  9. [Some reflections on evidence based psychiatry and its impact on contemporary psychiatry].

    Science.gov (United States)

    Conti, Norberto A

    2010-01-01

    In this work, the proposal of evidence based psychiatry (EBP) is presented together with a critical reflection about its paradigmatic perspective, taking into account Thomas S. Khun's epistemological lineaments. It is also shown how blurring of language in its approximation to the human behavioral disorders is EBP point of major inconsistency, as demonstrates a marked epistemological reductionism. Finally, consequences of its restrictive employment both to psychiatrists teaching and to the treatments they provide to their patients are also discussed.

  10. Functional MRT in psychiatry and neurology; Funktionelle MRT in Psychiatrie und Neurologie

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, F. [Universitaetsklinikum der RWTH Aachen (Germany). Klinik fuer Psychiatrie und Psychotherapie; Fink, G.R. (eds.) [Koeln Univ. (Germany). Klinik und Poliklinik fuer Neurologie

    2007-07-01

    Almost no other method has reach such an interest as the functional imaging in psychiatric and neurological science; it is fascinating to observe the brain at work. The fundamentals of functional magnetic resonance tomography (fMRT) and the interpretation of MRT images are explained; the state-of-the-art is discussed. The book is focussed on the functional imaging within psychiatry and neurology. The book contains 45 contributions within the following chapters: fundamentals, higher brain accomplishments, disease pattern, examinatory examples, perspectives.

  11. 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

  12. 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

  13. The genomic psychiatry cohort: partners in discovery.

    Science.gov (United States)

    Pato, Michele T; Sobell, Janet L; Medeiros, Helena; Abbott, Colony; Sklar, Brooke M; Buckley, Peter F; Bromet, Evelyn J; Escamilla, Michael A; Fanous, Ayman H; Lehrer, Douglas S; Macciardi, Fabio; Malaspina, Dolores; McCarroll, Steve A; Marder, Stephen R; Moran, Jennifer; Morley, Christopher P; Nicolini, Humberto; Perkins, Diana O; Purcell, Shaun M; Rapaport, Mark H; Sklar, Pamela; Smoller, Jordan W; Knowles, James A; Pato, Carlos N

    2013-06-01

    The Genomic Psychiatry Cohort (GPC) is a longitudinal resource designed to provide the necessary population-based sample for large-scale genomic studies, studies focusing on Research Domain Criteria (RDoC) and/or other alternate phenotype constructs, clinical and interventional studies, nested case-control studies, long-term disease course studies, and genomic variant-to-phenotype studies. We provide and will continue to encourage access to the GPC as an international resource. DNA and other biological samples and diagnostic data are available through the National Institute of Mental Health (NIMH) Repository. After appropriate review and approval by an advisory board, investigators are able to collaborate in, propose, and co-lead studies involving cohort participants.

  14. [Psychiatry and psychoanalysis: a crazy dialogue].

    Science.gov (United States)

    Chamorro, Jorge

    2006-01-01

    The relation between psychiatry and psychoanalysis has been and is complex and fertile, in the frame of coincidences and differences. The common sense will be the first point that will allow us to guide the reflection. The hermeneutic treatment of the sense and its opposite, the non sense, will open the way for enquiring a diversity of concepts: 1. A different use of the word. 2. The consequent destination between two ways of the truth. 3. It is extracted from the previous point two positions that I call: psychiatric volunteer and the psychoanalyst's desire. At the end of the article, we explore different positions, but not necessarily incompatible, referred to the suicide act risk. PMID:16967109

  15. Use of Telepsychiatry in Psychodynamic Psychiatry.

    Science.gov (United States)

    Saeed, Sy Atezaz; Anand, Vivek

    2015-12-01

    This article reviews the organization, infrastructure basics, applications, effectiveness, outreach, and implementation barriers related to telepsychiatry. We highlight the tremendous potential and promise that this technology holds and also discuss the importance that telepsychiatry may play in the field of psychodynamic psychiatry. Given the growing effectiveness evidence base for therapy delivered over the Internet, telepsychiatry holds a large unexplored territory to help psychodynamically minded patients connect with psychodynamically oriented psychiatrists. This economically advantageous medium can be utilized to deliver psychodynamically guided approaches to the patient, alone or in combination with pharmacological and other psychosocial interventions. We hope, this article will help psychodynamically trained psychiatrists to consider bridging the gap with the remotely located, chronically mentally ill population which oftentimes has scarcity of resources.

  16. [The cultural psychiatry in Latin America].

    Science.gov (United States)

    Villaseñor-Bayardo, Sergio J; Rojas-Malpica, Carlos; Aceves-Pulido, Martha P

    2014-01-01

    This paper presents only some of the most important contributions in the development of cultural psychiatry in Latin America. The continental efforts to understand the role that culture plays in the manifestation and treatment of mental disorders have been fruitful. The authors included are: Fernando Pagés of Argentina; Mario G. Hollweg of Bolivia; Rubim Alvaro de Pinho and Adalberto Barreto of Brazil; Carlos A. Leon and Carlos A. Uribe of Colombia; Antonio José A. Bustamante and Santa Cruz de Cuba, Carlos Leon Andrade of Ecuador, Guatemala Cristina Chavez; Sergio Villasenor J. Bayardo of Mexico; Carlos A. Seguin, Hermilio Valdizán and Javier Mariátegui in Peru; Y. Bespaldi of Consens of Uruguay; Rojas and Carlos Malpica and Jacqueline Briceño Clarac of Venezuela.

  17. 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.

  18. [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

  19. 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...

  20. 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...

  1. 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...

  2. ["Psychological employees" in psychiatry. The establishment of clinical psychology at the example of Lilo Süllwolds diagnostic efforts to incipient schizophrenia].

    Science.gov (United States)

    Rzesnitzek, Lara

    2015-01-01

    Lilo Süllwold (*1930) was the first psychologist in the German Federal Republic to acquire habilitation for Clinical Psychology at a Medical Faculty. However, she had already been appointed professor for Clinical Psychology following to a new University Act implementing the recommendations of the National Council of Science and Humanities. Her habilitation treatise to justify the initial professorship appointment centered on a self-made questionnaire as a diagnostic tool for beginning schizophrenia. The manner how the questionnaire together with the politico-scientific structural changes at the German Federal universities endowed the young psychologist with a carrier in psychiatry, is an illuminating example of psychology's way into psychiatry: the institutionalization and professionalization of Clinical Psychology in psychiatry since the end of the 1950s up to the end of the 1970s. In a comparative perspective on the developments of Clinical Psychology in the German Democratic Republic, the example demonstrates not only the role of new psychological theories und methods in research and clinic in enabling the entry of the new profession into psychiatry, but also the importance of initial socio-economic and socio-politic frame conditions and decisions. The negotiation of the scope or limits of competences between doctors and psychologists created more than a professional niche inside the clinic; it changed psychiatry and psychology as academic branches in their structures due to the establishment of new Clinical Psychology departments. The role of the psychologist turned from a doctor's "assistant" into a colleague at "eye level".

  3. 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

  4. 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

  5. Cultural psychiatry: research strategies and future directions.

    Science.gov (United States)

    Kirmayer, Laurence J; Ban, Lauren

    2013-01-01

    This chapter reviews some key aspects of current research in cultural psychiatry and explores future prospects. The first section discusses the multiple meanings of culture in the contemporary world and their relevance for understanding mental health and illness. The next section considers methodological strategies for unpacking the concept of culture and studying the impact of cultural variables, processes and contexts. Multiple methods are needed to address the many different components or dimensions of cultural identity and experience that constitute local worlds, ways of life or systems of knowledge. Quantitative and observational methods of clinical epidemiology and experimental science as well as qualitative ethnographic methods are needed to capture crucial aspects of culture as systems of meaning and practice. Emerging issues in cultural psychiatric research include: cultural variations in illness experience and expression; the situated nature of cognition and emotion; cultural configurations of self and personhood; concepts of mental disorder and mental health literacy; and the prospect of ecosocial models of health and culturally based interventions. The conclusion considers the implications of the emerging perspectives from cultural neuroscience for psychiatric theory and practice.

  6. Deep pharma: psychiatry, anthropology, and pharmaceutical detox.

    Science.gov (United States)

    Oldani, Michael

    2014-06-01

    Psychiatric medication, or psychotropics, are increasingly prescribed for people of all ages by both psychiatry and primary care doctors for a multitude of mental health and/or behavioral disorders, creating a sharp rise in polypharmacy (i.e., multiple medications). This paper explores the clinical reality of modern psychotropy at the level of the prescribing doctor and clinical exchanges with patients. Part I, Geographies of High Prescribing, documents the types of factors (pharmaceutical-promotional, historical, cultural, etc.) that can shape specific psychotropic landscapes. Ethnographic attention is focused on high prescribing in Japan in the 1990s and more recently in the Upper Peninsula of Michigan, in the US. These examples help to identify factors that have converged over time to produce specific kinds of branded psychotropic profiles in specific locales. Part II, Pharmaceutical Detox, explores a new kind of clinical work being carried out by pharmaceutically conscious doctors, which reduces the number of medications being prescribed to patients while re-diagnosing their mental illnesses. A high-prescribing psychiatrist in southeast Wisconsin is highlighted to illustrate a kind of med-checking taking place at the level of individual patients. These various examples and cases call for a renewed emphasis by anthropology to critically examine the "total efficacies" of modern pharmaceuticals and to continue to disaggregate mental illness categories in the Boasian tradition. This type of detox will require a holistic approach, incorporating emergent fields such as neuroanthropology and other kinds of creative collaborations.

  7. [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

  8. [Intercommunication psychiatry in a burn center].

    Science.gov (United States)

    Ravella, P; Prallet, J P; Latarjet, J; Parizot, S; Bouchet, P

    1990-01-01

    The support of psychiatric disorders in a burn centre has been effected since three years, in Saint Luc Hospital (Lyon) thanks to a liaison group. One hour a week, several cases of patients are approached in this group which gathers two psychiatrists and the team dealing with burnt patients. Psychiatrists are attached to clarify the relation between people who attend and patients, to give a diagnosis and propose a strategy in front of difficulties they meet. The psychiatric care is reintegrated in the somatic support and assured by people who are daily effectively in contact with patients. This paper describes the advantages of the liaison psychiatry with regard to a direct intervention of the psychiatrist on the patient. It defines the targets these therapeutic weapon can aim and details the obtained results: for 3 years, the group has met 104 times for 241 "indirect consultations" concerning 99 different patients and count 50 good results on site and 5 specialized orientations; 10 deaths and 11 quick departures exclude 21 patients from the study; 17 cases have been stayed without continuation and 6 without any change.

  9. 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

  10. Distinctive Rorschach profiles of young adults with schizophrenia and autism spectrum disorder

    Directory of Open Access Journals (Sweden)

    Kishimoto N

    2016-09-01

    Full Text Available Naoko Kishimoto,1 Kazuhiko Yamamuro,1 Junzo Iida,2 Toyosaku Ota,1 Shohei Tanaka,1 Masanori Kyo,3 Sohei Kimoto,1 Toshifumi Kishimoto1 1Department of Psychiatry, 2Faculty of Nursing, Nara Medical University School of Medicine, 3Department of Psychiatry, Kyo Mental Clinic, Nara, Japan Objective: The differential diagnosis of schizophrenia (SZ versus autism spectrum disorder (ASD can be clinically challenging because accumulating evidence suggests both clinical and biological overlaps between them. The aim of this study was to compare Rorschach profiles between young adults with SZ and those with ASD.Methods: We evaluated quantitative tendencies on the Rorschach test among 20 patients diagnosed with SZ and 20 diagnosed with ASD. Both groups were matched for age, sex, and intelligence quotient.Results: We found significant differences in six response variables on the Rorschach comprehensive system. Those with SZ had significantly higher scores on D score, adjusted D score (Adj D, developmental quality code reflecting ordinary response (DQo, and form quality minus (FQ - than those with ASD. In contrast, those with SZ had significantly lower scores on the active and developmental quality code reflecting synthesized response (DQ+ subscales than those with ASD.Conclusion: The present findings reveal that individuals with SZ might have more stress tolerance, stronger perception distortions, and simpler and poorer recognition than those with ASD. We suggest that the Rorschach test might be a useful tool for differentiating between SZ and ASD. Keywords: autism spectrum disorder, perception, psychopathology, Rorschach test, schizophrenia

  11. Improving the quality of handover in a liaison psychiatry team.

    Science.gov (United States)

    Brook, Jennifer; Amaro Calcia, Marilia

    2016-01-01

    Handover is a high risk point for errors in clinical care, in many cases leading to adverse events or near misses. The timely transfer of accurate and useful information between professionals is vital to ensure quality and safety, and to ensure the transfer of accountability for care. In this project standards were developed for quality handover between doctors in a liaison psychiatry department. The aim of these were to ensure adequate identification of patients, clear communication of tasks to be completed and relevant risk issues, as well as a guide to the priority of jobs. We measured compliance with these standards for all patients documented in the handover book during three week periods in 2013, 2014 (following delivery of education and guidance on handover to all doctors), and finally in 2015 after implementation of a proforma for handover. Handover documentation prior to the implementation of standards was of poor quality with significant absences of information. Key information to identify patients was frequently absent, for example hospital number was only recorded in 1% of cases. Only 81% of entries included the reason for the patient's referral, and 27% made no mention of the outstanding tasks for completion. Despite guidance and education of all doctors regarding the standards, there was no consistent improvement in compliance. It was particularly concerning that risk issues were only mentioned in 18% of cases, even when assessed immediately after education was given. Following introduction of the proforma compliance increased with overall completeness of handover improving from 40% to 71%. Without guidelines handover between shifts is of a poor quality, and often lacks key information to allow colleagues to identify patients and prioritise need. Education of those performing these handovers did not produce any benefits, either immediately following its delivery or in longer term follow up. The implementation of a template to aid clinicians in

  12. 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...

  13. 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

  14. Influence of Clerkship on Attitudes of Medical Students toward Psychiatry across Cultures: United States and Qatar

    Science.gov (United States)

    Burgut, F. Tuna; Polan, H. Jonathan

    2013-01-01

    Objective: To assure adequate treatment for patients with mental illness worldwide, medical schools must impart positive attitudes toward psychiatry. The authors examined the effect of culture on changes in attitudes toward psychiatry among medical students receiving the same psychiatry clerkship curriculum in two different countries. Methods: A…

  15. What Do Psychiatric Residents Think of Addiction Psychiatry as a Career?

    Science.gov (United States)

    Renner, John A., Jr.; Karam-Hage, Maher; Levinson, Marjorie; Craig, Thomas; Eld, Beatrice

    2009-01-01

    Objective: The authors attempt to better understand the recent decline in the number of applicants to addiction psychiatry training. Methods: The Corresponding Committee on Training and Education in Addiction Psychiatry of APA's Council on Addiction Psychiatry sent out a 14-question anonymous e-mail survey to all postgraduate-year 2 (PGY-2)…

  16. Evaluating the Workload of On-Call Psychiatry Residents: Which Activities Are Associated with Sleep Loss?

    Science.gov (United States)

    Cooke, Brian K.; Cooke, Erinn O.; Sharfstein, Steven S.

    2012-01-01

    Objective: The purpose of this study was to review the workload inventory of on-call psychiatry residents and to evaluate which activities were associated with reductions in on-call sleep. Method: A prospective cohort study was conducted, following 20 psychiatry residents at a 231-bed psychiatry hospital, from July 1, 2008 through June 30, 2009.…

  17. Evaluating Psychiatry Residents as Physician-Managers: Development of an Assessment Tool

    Science.gov (United States)

    Sockalingam, Sanjeev; Stergiopoulos, Vicky; Maggi, Julie D.; Zaretsky, Ari; Stovel, Laura; Hodges, Brian

    2013-01-01

    Objectives: With the emergence of physician-manager (PM) curricula in medical education, more effective assessment tools are needed to evaluate psychiatry trainees in this role. The aim of this study was to determine psychiatry residents', program directors', and PM educators' perceptions about PM role-assessment. Methods: Psychiatry residents at…

  18. Incorporating Active Learning into a Psychiatry Clerkship: Does It Make a Difference?

    Science.gov (United States)

    Morreale, Mary; Arfken, Cynthia; Bridge, Patrick; Balon, Richard

    2012-01-01

    Objective: Medical students' satisfaction with the psychiatry clerkship, sense of preparedness for an institutional Objective Structured Clinical Exam (OSCE), expressed likelihood of choosing psychiatry as a specialty, and National Board of Medical Examiners (NBME) psychiatry shelf-examination scores were compared after a curriculum based on…

  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. [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

  1. [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.

  2. 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

  3. 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

    DEFF Research Database (Denmark)

    Barfod, Charlotte; Laurtizen, Marlene Mp; Danker, Jakob K;

    2012-01-01

    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...... 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...

  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. 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.

  6. 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

  7. 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

  8. [Maurycy Urstein: forgotten Polish contributor to German psychiatry].

    Science.gov (United States)

    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 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.

  9. 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

  10. Sound and Music Interventions in Psychiatry at Aalborg University Hospital

    DEFF Research Database (Denmark)

    Nystrup Lund, Helle; Bertelsen, Lars Rye; Bonde, Lars Ole

    2016-01-01

    This article reports on the ongoing project development and research study called “A New Sound and Music Milieu at Aalborg University Hospital”. Based on a number of pilot studies in AUH Psychiatry, investigating how special playlists and sound equipment (“sound pillows” and portable players) can...... in music medicine and music therapy. A special design of software and hardware - ”The Music Star” and directional line array speakers for the patient room – has been developed and recently implemented on two wards at AUH Psychiatry. The aim of the project is to empower patients to choose music suited...

  11. 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.

  12. Kandinsky-Clerambault's Syndrome: concept of use for Western psychiatry.

    Science.gov (United States)

    Lerner, Vladimir; Kaptsan, Alexander; Witztum, Eliezer

    2003-01-01

    The aim of our paper is to describe Kandinsky-Clerambault's Syndrome, which has important cultural-historical value in the history of psychiatry, and to illustrate the syndrome by means of a case report. Although its component symptoms are known among Western psychiatrists, the syndrome's specific name is generally unknown. The authors suggest that detailed clinical descriptions of some specific conditions may contribute to a more detailed knowledge of psychopathology, a more colorful and memorable view of conditions, with an increased awareness of the historical and cultural origins of psychiatry.

  13. Reflexions on the identity and the practice of child psychiatry.

    Science.gov (United States)

    Terziev, D

    2013-01-01

    Τhe issue of the professional identity is salient for any medical discipline but especially for these, like child psychiatry and perhaps psychiatry, where the professional is the principal "instrument" in the assessment and in providing interventions. The Ericksonian view on identity implies self-sameness, continuity and synthesis which the child psychiatry as a specialty and child psychiatrists as professionals are to achieve more or less successfully. As a professional, the child psychiatrist is directed to the prevention, diagnosis and treatment of psychiatric disorders and associated problems in children and adolescents viewing children as developing biopsychological entities being in ongoing co-influencing interaction with their immediate and wider societal contexts. As a discipline, child and adolescent psychiatry needs to integrate developmental biological and psychological aspects, and holistic child-centered and family-focused perspectives. Child psychiatry is to integrate not only various aspects of the child as individual and of his environments as they are, but also in their diachronic dimension. As child psychiatrists, in my view, we must keep integrated in our professional armamentarium the consideration for intra- and interpersonal processes. In that perspective, of special value is the appreciation of setting, of timing, and of interpersonal processes in their interaction with intrapersonal ones. In addition, being both child-centered and family-focused, we need a systemic literacy to look at the families and of children as part of them. Apart from evidence-based information and clinical skills, we need some mature attitude to helpfully use our knowledge and skills. This attitude can transcend the state of the art professional algorithms; rather it integrates and not just imitates them. It cautions against too much enthusiasm in following the pendulum. It implies awareness of some reasonable limit to the urge to change the children and families. In

  14. [On the history of the German Democratic Republic Journal Psychiatry, Neurology and Medical Psychology (1949-1990)].

    Science.gov (United States)

    Teitge, M; Kumbier, E

    2015-05-01

    Scientific journals were established in the Soviet occupied zone following WWII in order to distinguish themselves from the other occupying powers. Starting in 1949 a journal with the title "Psychiatry, Neurology and Medical Psychology" was founded as no publishing house existed in the field of psychiatry and neurology and it became necessary to establish a new journal that was competitive. The journal was primarily distributed in the German Democratic Republic (GDR) until 1990 but the interest internationally was very limited. State affairs had a great influence from the very beginning so that the political involvement was reflected in the selection of staff, such as the publishers and the head of the editorial department and by the close interconnection between the Society for Psychiatry and Neurology of the GDR and the editorship of the journal. The publishers who were primarily responsible and the authors were at the interface of politics and science. Nevertheless, in an international comparison many parallels can be found in the orientation with respect to the content.

  15. 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

  16. 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.

  17. 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…

  18. 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…

  19. Promoting Scholarship during Child and Adolescent Psychiatry Residency

    Science.gov (United States)

    Mezzacappa, Enrico; Hamoda, Hesham M.; DeMaso, David R.

    2012-01-01

    Background: In 2003, the Institute of Medicine (IOM) drew attention to the critical national shortage of psychiatrist-researchers and the need for competency-based curricula to promote research training during psychiatry residency as one way to address this shortage at the institutional level. Here, the authors report on the adaptation,…

  20. 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…

  1. [Turning points in American psychiatry of the 20th century].

    Science.gov (United States)

    Sabshin, M

    1990-09-01

    Sabshin describes three turning points in twentieth century American psychiatry. Following "the time of the Thirteen", the time of the founders of modern American psychiatry, the first turning point was marked by the rise of Meyerian psychobiology and had its peak impact during the second quarter of the twentieth century. In the post World War II years diverging therapeutic ideologies became dominant, including the important impact of psychoanalysis. But competing ideologies (e.g. in social and biological psychiatry) were of importance also. The most recent turning point was marked by the current surge of neuro-science and psychopharmacology along with empiricism and logical positivsm. It is predicted to peak in the middle of the current decade. Following the preceding demedicalization a remedicalization of psychiatry was the result. For the turn of the 21st century, as Sabshin predicts, a re-emergence of analogues of Meyerian psychobiology will take center stage, particularly concentrating on questions of coping and adaptability, on how the human being keeps himself healthy and sane during subsequent developmental stages as well as in the face of stressful life events. PMID:2262194

  2. Current research in transcultural psychiatry in the Nordic countries

    DEFF Research Database (Denmark)

    Ekblad, Solvig; Kastrup, Marianne Carisius

    2013-01-01

    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...

  3. 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…

  4. 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...

  5. 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

  6. 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

  7. Blood culture collection through peripheral intravenous catheters increases the risk of specimen contamination among adult emergency department patients.

    Science.gov (United States)

    Self, Wesley H; Speroff, Theodore; McNaughton, Candace D; Wright, Patty W; Miller, Geraldine; Johnson, James G; Daniels, Titus L; Talbot, Thomas R

    2012-05-01

    Five hundred five blood cultures collected through a peripheral intravenous catheter (PIV) in an emergency department were matched to cultures obtained by dedicated venipuncture from the same patient within 10 minutes. The relative risk of contamination for cultures collected through PIVs compared with dedicated venipuncture was 1.83 (95% confidence interval, 1.08-3.11).

  8. 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

  9. Emergency Department Visits Related to Schizophrenia Among Adults Aged 18-64: United States, 2009-2011.

    Science.gov (United States)

    Albert, Michael; McCaig, Linda F

    2015-09-01

    ED care is important for the treatment of acute presentations of schizophrenia and may serve as a safety net for schizophrenic patients not otherwise receiving care (4,5). This analysis of National Hospital Ambulatory Medical Care Survey (NHAMCS) data indicates that during 2009-2011, an average of 382,000 ED visits related to schizophrenia occurred each year among adults aged 18-64, corresponding to an overall visit rate of 20.1 per 10,000 adults. A visit having a first-, second-, or third-listed diagnosis of schizophrenia (i.e., whether the visit was directly or indirectly related to schizophrenia) was included in the analysis to provide a broader description of ED use by these patients. The distribution of the primary diagnosis of visits related to schizophrenia was: schizophrenia (58.8%), another mental disorder (15.4%), and a nonmental health disorder (25.7%) (data not shown). Among adults aged 18-64, the rate for ED visits related to schizophrenia was about twice as high for men as for women. Public insurance (Medicaid, Medicare, or dual Medicare and Medicaid) was more frequently the primary expected source of payment for ED visits related to schizophrenia compared with ED visits not related to schizophrenia. ED visits related to schizophrenia were more frequently made by patients who were homeless compared with ED visits not related to schizophrenia. About one-third of ED visits related to schizophrenia resulted in a hospital admission, and another 16.7% resulted in a transfer to a psychiatric hospital--both higher than the percentages for ED visits not related to schizophrenia. One of the goals of Healthy People 2020 is to improve mental health through prevention and by ensuring access to appropriate, quality mental health services (6). National data on the rates and characteristics of ED visits related to schizophrenia will help policymakers and practitioners address disparities and meet this goal.

  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. Psychiatry in the Deep South: A Pilot Study of Integrated Training for Psychiatry Residents and Seminary Students

    Science.gov (United States)

    Stuck, Craig; Campbell, Nioaka; Bragg, John; Moran, Robert

    2012-01-01

    Objective: The authors describe an interdisciplinary training experience developed for psychiatry residents and seminary students that assessed each group's beliefs and attitudes toward the other's profession. The training was designed to enhance awareness, positive attitudes, and interaction between the disciplines. Methods: From 2005 to 2008,…

  12. 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

  13. Determinants of patient satisfaction with hospital health care in psychiatry: results based on the SATISPSY-22 questionnaire

    Directory of Open Access Journals (Sweden)

    Zendjidjian XY

    2014-10-01

    Full Text Available Xavier Y Zendjidjian,1,2 Pascal Auquier,1 Christophe Lançon,1,3 Anderson Loundou,1 Nathalie Parola,4 Melanie Faugère,3 Laurent Boyer1 1Aix-Marseille University, Public Health, Chronic Diseases and Quality of Life, Research Unit, Marseille, France; 2Department of Psychiatry, Inpatient Psychiatric Unit, La Conception University Hospital, Marseille, France; 3Department of Psychiatry, Psychiatric Public Sector 6, 4Department of Addictology, Day Hospital, Sainte-Marguerite University Hospital, Marseille, France Background: The aim of our study was to identify patient- and care-related factors that are associated with patients’ satisfaction with psychiatric hospital care, using a specific, self-administered questionnaire based exclusively on the patient’s point of view: the Satisfaction with Psychiatry Care Questionnaire-22 (SATISPSY-22.Methods: This cross-sectional study was conducted in the psychiatric departments of two French public university teaching hospitals. The data collected included sociodemographic information, clinical characteristics, care characteristics, and the SATISPSY-22. A multivariate analysis using multiple linear regressions was performed to determine the variables potentially associated with satisfaction levels.Results: Two hundred seventy patients were enrolled in our study. Only one moderate association was found between satisfaction and sociodemographic characteristics: the personal experience dimension with age (ß=0.15. Clinical improvement was moderately associated with higher global satisfaction (ß=–0.15, higher satisfaction with quality of care (ß=–0.19, and higher satisfaction with food (ß=–0.18. Stronger associations with satisfaction were found for care characteristics, particularly the therapeutic alliance with all of the satisfaction dimensions (ß, 0.20–0.43 except food, and for seclusion with global satisfaction (ß=–0.33 and personal experience (ß=–0.32. Patients with previous

  14. 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.

  15. The structural equation analysis of childhood abuse, adult stressful life events, and temperaments in major depressive disorders and their influence on refractoriness

    Directory of Open Access Journals (Sweden)

    Toda H

    2015-08-01

    Full Text Available Hiroyuki Toda,1 Takeshi Inoue,2,3 Tomoya Tsunoda,1 Yukiei Nakai,2 Masaaki Tanichi,1 Teppei Tanaka,1 Naoki Hashimoto,2 Yasuya Nakato,2 Shin Nakagawa,2 Yuji Kitaichi,2 Nobuyuki Mitsui,2 Shuken Boku,4 Hajime Tanabe,5 Masashi Nibuya,1 Aihide Yoshino,1 Ichiro Kusumi2 1Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan; 2Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 3Department of Psychiatry, Tokyo Medical University, Tokyo, Japan; 4Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan; 5Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan Background: Previous studies have shown the interaction between heredity and childhood stress or life events on the pathogenesis of a major depressive disorder (MDD. In this study, we tested our hypothesis that childhood abuse, affective temperaments, and adult stressful life events interact and influence the diagnosis of MDD. Patients and methods: A total of 170 healthy controls and 98 MDD patients were studied using the following self-administered questionnaire surveys: the Patient Health Questionnaire-9 (PHQ-9, the Life Experiences Survey, the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire, and the Child Abuse and Trauma Scale (CATS. The data were analyzed with univariate analysis, multivariable analysis, and structural equation modeling. Results: The neglect scores of the CATS indirectly predicted the diagnosis of MDD through cyclothymic and anxious temperament scores of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire in the structural equation modeling. Two temperaments – cyclothymic and anxious – directly predicted the diagnosis of MDD. The validity of this result was supported by the results of the stepwise multivariate logistic regression analysis

  16. 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)…

  17. Psychiatry residents and dynamic psychiatry: two narratives, a survey, and some ideas to enhance recruitment.

    Science.gov (United States)

    Katz, Debra A; Tuttle, Jeffrey P; Housman, Beth T

    2011-01-01

    Psychiatric residency has undergone a major shift over the past 50 years with increasing emphasis on psychopharmacology evidence-based treatments, and competency-based requirements which has led to concerns that psychodynamic knowledge and skills are in jeopardy. Narratives of two residents who developed strong interest in psychodynamic psychotherapy and psychoanalytic training are presented to illustrate the important influences on their identities as psychodynamically oriented psychiatrists. Results from a recent survey of U.S. residents regarding psychodynamic psychiatry indicate that they value psychodynamic psychotherapy, want to incorporate psychotherapy into their careers as psychiatrists, and strongly endorse personal psychotherapy but view their psychodynamic skills as weak. Recommendations about how to enhance education and interest include (1) building or strengthening relationships with mentors, supervisors, and teachers, (2) emphasizing the importance of psychodynamic understanding of patients whether or not the resident is functioning as a therapist, (3) using psychopharmacology to engage residents in thinking psychodynamically, (4) encouraging personal psychotherapy for residents and helping find ways to make it affordable, (5) utilizing awards, visiting scholars, specialized programs, and distance learning, especially for programs without adequate resources, and (6) encouraging clinicians to become familiar with the research base in psychodynamic psychotherapy to correct biases and misperceptions. PMID:21434747

  18. 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

  19. Factors Influencing Uptake of Rapid HIV and Hepatitis C Screening Among Drug Misusing Adult Emergency Department Patients: Implications for Future HIV/HCV Screening Interventions.

    Science.gov (United States)

    Merchant, Roland C; DeLong, Allison K; Liu, Tao; Baird, Janette R

    2015-11-01

    In this randomized, controlled trial among 957 English- or Spanish-speaking drug misusing adult emergency department (ED) patients, we determined if a tailored brief intervention (BI) increased uptake of rapid HIV/HCV screening, and identified factors associated with greater screening uptake. Rapid HIV/HCV screening uptake was greater in the control than the BI arm (45 vs. 38 %; p Screening uptake depended on elapsed study time and which research staff member offered testing. In the control arm, uptake was lowest for those spending screening uptake generally increased over time. Tailored BI content specifically addressing participant HIV/HCV knowledge, HIV/HCV risk behaviors, or need for HIV/HCV screening was not associated with greater screening uptake. These study findings suggested factors that should be considered when designing future ED-based screening initiatives, such as elapsed study time, who offers testing, and the content of interventions.

  20. 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

  1. Characteristics and determinants of adult patients with acute poisoning attending the accident and emergency department of a teaching hospital in Qatar.

    Science.gov (United States)

    Khudair, I F; Jassim, Z; Hanssens, Y; Alsaad, W A

    2013-09-01

    Data about etiologic and demographic characteristics of acute poisoning in adults in Qatar are lacking. This prospective observational study was undertaken to analyze characteristics and possible determinants of acute poisoning in adults in Qatar. During 2010, 18,073 patients attended the emergency department of Hamad General Hospital, a teaching hospital in Qatar. Out of them, 599 (3.3%) patients were diagnosed as "poisoning case" with either chemical or pharmaceutical substances. The prevalence rate of poisoning incidence was 35.3/100,000 population. Seven patients died, corresponding with a case-fatality rate of 0.39/1000. The majority were male (65%) and the mean age was 34 years. The poisons involved were mainly chemicals (61.6%) and pharmaceuticals (38.4%). Female, mainly single, suffered more intentional poisoning compared to male. Of the patients aged 60 years and above (7.2%), the majority (95.3%) suffered unintentional poisoning with pharmaceuticals; 56% with warfarin, 12% with digoxin and 7% with insulin. Multivariate analysis shows that female gender, single status, younger than 35 years of age, being poisoned by pharmaceutical products, and the need for hospitalization are significant determinants for acute intentional poisoning after adjusting all other possible covariates. The findings of this study can be used to establish awareness and prophylactic campaigns in Qatar.

  2. ["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.

  3. Critical issues in the evaluation and management of adult patients presenting to the emergency department with suspected pulmonary embolism.

    Science.gov (United States)

    Fesmire, Francis M; Brown, Michael D; Espinosa, James A; Shih, Richard D; Silvers, Scott M; Wolf, Stephen J; Decker, Wyatt W

    2011-06-01

    This clinical policy from the American College of Emergency Physicians is the revision of a 2003 clinical policy on the evaluation and management of adult patients presenting with suspected pulmonary embolism (PE).(1) A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the following critical questions: (1) Do objective criteria provide improved risk stratification over gestalt clinical assessment in the evaluation of patients with possible PE? (2) What is the utility of the Pulmonary Embolism Rule-out Criteria (PERC) in the evaluation of patients with suspected PE? (3)What is the role of quantitative D-dimer testing in the exclusion of PE? (4) What is the role of computed tomography pulmonary angiogram of the chest as the sole diagnostic test in the exclusion of PE? (5) What is the role of venous imaging in the evaluation of patients with suspected PE? (6) What are the indications for thrombolytic therapy in patients with PE? Evidence was graded and recommendations were given based on the strength of the available data in the medical literature. PMID:21621092

  4. [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

  5. [Psychiatry as cultural science: considerations following Max Weber].

    Science.gov (United States)

    Bormuth, M

    2010-11-01

    Psychiatry can be seen as a natural and cultural science. According to this the postulate of freedom is its strong value judgment. Since the times of enlightenment it has been described metaphorically by the myth of the expulsion from Paradise. Following Max Weber and Wilhelm Dilthey, Karl Jaspers has introduced this perspective into psychiatry. His strict dichotomy between explaining and understanding has later been critically revised by Werner Janzarik and Hans Heimann. Their concepts of structure dynamic, of pathography and of anthropology are closer to Max Weber who connected natural and cultural sciences in a much stronger way. Especially the pathographic example of Nietzsche allows to demonstrate the differences between Jaspers and the later psychopathologists of the Heidelberg and Tübingen schools.

  6. The relationship of psychosomatic medicine to consultation-liaison psychiatry.

    Science.gov (United States)

    Rosenbaum, M; McCarty, T

    1994-01-01

    Consultation-liaison psychiatry arose in the mid-1960s from the matrix of psychoanalytically oriented psychosomatic medicine. The influence of psychoanalysis and psychoanalytically trained academic psychiatrists gradually waned. The liaison aspect of consultation-liaison psychiatry faded in the early 1980s, and most consultation-liaison services are now primarily high-quality consultation services that contribute much to university teaching hospitals. The consultation-liaison service at the University of New Mexico (UNM) and several others have eliminated the term "liaison." The consultation service at UNM sees relatively few patients with classic psychosomatic disorders. The majority of requests to UNM's consultation service relate to suicide attempts, delirium, complicated medical problems with psychiatric illness, substance abuse, burns, trauma, and competency evaluations. PMID:7809359

  7. A Call to Restructure Psychiatry General and Subspecialty Training.

    Science.gov (United States)

    Kirwin, Paul; Conroy, Michelle; Lyketsos, Constantine; Greenwald, Blaine; Forester, Brent; deVries, Christine; Ahmed, Iqbal Ike; Wiechers, Ilse; Zdanys, Kristina; Steffens, David; Reynolds, Charles F

    2016-02-01

    Dire shortages of psychiatrists with special expertise in geriatrics, substance abuse, forensics, and psychosomatics create barriers to care for populations with complex mental disorders and pose a significant public health concern. To address these disparities in access to care, we propose streamlining graduate medical education to increase efficiency and enhance cost-effectiveness while simultaneously increasing the number of psychiatric subspecialists in these key areas. We propose that trainees interested in subspecialties complete their general training in 3 years, while meeting ACGME required milestones, and then utilize their 4th year to complete subspecialty fellowship training. Eligible trainees would then qualify for psychiatry subspecialty certification and general psychiatry ABPN certification at the end of 4 years.

  8. The current dialogue between phenomenology and psychiatry: a problematic misunderstanding.

    Science.gov (United States)

    Abettan, Camille

    2015-11-01

    A revival of the dialogue between phenomenology and psychiatry currently takes place in the best international journals of psychiatry. In this article, we analyse this revival and the role given to phenomenology in this context. Although this dialogue seems at first sight interesting, we show that it is problematic. It leads indeed to use phenomenology in a special way, transforming it into a discipline dealing with empirical facts, so that what is called "phenomenology" has finally nothing to do with phenomenology. This so-called phenomenology tallies however with what we have always called semiology. We try to explain the reasons why phenomenology is misused in that way. In our view, this transformation of phenomenology into an empirical and objectifying discipline is explained by the role attributed to phenomenology by contemporary authors, which is to solve the problems raised by the Diagnostic and Statistical Manual of Mental Disorders.

  9. 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

  10. Ethics in psychiatry: a view from the clinic.

    Science.gov (United States)

    Hassenfeld, I N; Silver, R J

    1984-01-01

    Decisions and interventions made in the course of psychiatric practice often have important ethical dimensions. Issues such as confidentiality, freedom of information, the duty to warn, double agentry, the patient's rights to treatment, and to refuse treatment are often identified in the context of inpatient psychiatry. In the practice of ambulatory psychiatry these issues are more easily ignored and therefore less frequently considered. The authors present six cases seen in an outpatient clinic of a community mental health program which illustrate ethical dilemmas in the six areas listed above. Questions raised by the cases and the clinic's interventions are discussed. Consequences for the patients and the clinic of the ethical decisions made in these are explored.

  11. Law and psychiatry in America over the past 150 years.

    Science.gov (United States)

    Quen, J M

    1994-10-01

    American forensic psychiatry was founded in 1838 with the publication of Isaac Ray's Treatise on the Medical Jurisprudence of Insanity. Ray's ideas were influential in the early history of forensic psychiatry but were overlooked in the formulation of the M'Naghten Rules in England, an early parliamentary effort to define criteria for the insanity defense. In the mid-1800s, asylum-based psychiatrists formulated model laws addressing involuntary commitment and debated the definition of mental illness for legal purposes. In the late 1800s, courts became interested in findings of brain pathology in insanity defense cases, and neurologists joined psychiatrists as expert witnesses. Beginning around 1950, increased judicial activism led to a new standards for insanity in criminal cases, advances in the civil rights of mentally ill persons, and refinements in the role of expert witnesses. In 1969 forensic psychiatrists established a professional organization, and board certification in the subspecialty began in 1979.

  12. [The history of the psychiatry not told by Foucault].

    Science.gov (United States)

    Freitas, Fernando Ferreira Pinto de

    2004-01-01

    The article proposes a revision of the approach to madness and the birth of the psychiatric institution taken by Foucault in History of Madness. The hypothesis is that the origins of modern Psychiatry revolutionize the approach to madness by proposing it is possible to dialogue with the insane, because the madman is not someone who has lost his reason . It is hoped that this critique of Foucault's book will be a contribution to the process of psychiatric reform currently underway in Brazil.

  13. 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...

  14. Suicide in anti-psychiatry and in psychoanalysis

    OpenAIRE

    Cristia Rosineiri Gonçalves Lopes Correa

    2008-01-01

    In psychiatry, the criteria by which the need for psychiatric attention is evaluated are often the object of disagreements, thus bringing to the fore debates regarding the validity of the concept of mental illness. Whereas anti-psychiatrists, such as Szasz (1961), argue against the prevention of suicide, Freud (1915) describes a case of melancholia that would justify psychiatric intervention in suicidal individuals. In this article, I examine these arguments and argue that Freud's account of ...

  15. 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...

  16. Intertwining Psychiatry Residency Training and Ethics in the College Setting.

    Science.gov (United States)

    Sondheimer, Adrian

    2015-10-01

    An ethical responsibility exists, currently unaddressed, for mandated psychiatry residency training with college student populations. Such training brings numerous potential benefits, including exposure to specific disorders and administrative structures. As well, individual cases pose ethical dilemmas unique to this developmental stage, which segues seamlessly from that of adolescence. Relevant case illustrations are employed. Likewise, psychiatric education oversight bodies are urged to fulfill their ethical obligations to provide pertinent training.

  17. Ethics and risk management in administrative child and adolescent psychiatry.

    Science.gov (United States)

    Sondheimer, Adrian

    2010-01-01

    This article examines ethics (the philosophic study of "doing the right thing") and risk management (the practice that seeks to manage the likelihood of "doing the wrong thing") and the relationship between them in the context of administrative child and adolescent psychiatry. Issues that affect child and adolescent psychiatrists who manage staff and business units and clinical practitioners who treat and manage individual patients are addressed. Malpractice, budgeting, credentialing, boundaries, assessment, documentation, treatment, research, dangerousness, and confidentiality are among the topics reviewed.

  18. [ETHICS IN PSYCHIATRY: FROM ANTIQUITY TO THE RENAISSANCE].

    Science.gov (United States)

    Martini, Mariano; De Stefano, Francesco; Schia-Vonea, Michele; Ciliberti, Rosagemma

    2015-01-01

    Ethical issues always played an important role in the historical development in psychiatry. As wll known, many ancient cultures associated mental illness with gods and divine punishments. In the first centuries of the Christian Era, mental illness is often interpreted according to demonological views and in connection with theological conceptions of sin. The article briefly examines the history of mental illness medical and cultural interpretations, focusing on medieval medicine and the treatment of psychiatric patients from Antiquity to the Early modern Period.

  19. 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.

  20. [Disclosure of conflicts of interest in the Tijdschrift voor Psychiatrie].

    Science.gov (United States)

    Bergoets, M; Pieters, G

    2009-01-01

    Between March 2000 and December 2008 authors disclosed conflicts of interest in 9% of articles in the Tijdschrift voor Psychiatrie. For the same period, in the articles dealing with pharmaceuticals, the percentage of articles containing disclosures of conflict of interest was considerably higher, namely 24%. The policy of the journal with regard to the disclosure of conflicts of interest has helped to promote transparency. Further efforts are needed to encourage authors to disclose conflicts of interest.

  1. [Psychiatry and psychiatrists in the U.S.A. cinema].

    Science.gov (United States)

    Tarsitani, Lorenzo; Tarolla, Emanuele; Pancheri, Paolo

    2006-03-01

    United States cinema motion pictures from the beginning of 20th century to the present are characterized by massive use of sterotypes to represent psychiatrist's image, as well as psychiatric treatment and inpatients psychiatric facilities. Representation tends to undergo considerable changes between psychiatric different historical periods. Psychiatric disorders also are commonly depicted in movies, often in a not realistic way. The images of psychiatrist and mental disorders shown in movies are likely to impact on the beliefs and attitudes of people towards psychiatry.

  2. 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...

  3. 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....

  4. German wine in an American bottle: the spread of modern psychiatry in China, 1898-1949.

    Science.gov (United States)

    Li, Wenjing; Schmiedebach, Heinz-Peter

    2015-09-01

    Modern psychiatry was first introduced to mainland China around 1900 by Western missionaries. By 1949 the field had developed gradually as a result of contact with Western psychiatry and especially its American practitioners. This paper analyses the role played by key individuals and events in this process in the years prior to 1949. It argues that modern psychiatry was introduced to China through a process of cultural adaptation in which the USA served as a bridge for German thought.

  5. 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.

  6. 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

  7. Victor Kandinsky (1849-89): pioneer of modern Russian forensic psychiatry.

    Science.gov (United States)

    Lerner, Vladimir; Margolin, Jacob; Witztum, Eliezer

    2012-06-01

    The paper describes Victor Kandinsky's professional achievements within nineteenth-century Russian forensic psychiatry. A thorough review of nineteenth-century Russian psychiatry is presented, followed by a short biographical account of Kandinsky's personal life. Within the backdrop of Russian forensic psychiatry toward the end of nineteenth century, Kandinsky's pioneer innovations in psychopathology and classification as well as his contributions to Russian forensic psychiatry are reviewed. These are exemplified by two of his forensic case studies relating to forensic responsibility and malingering, which are included in his famous book 'On Irresponsibility'.

  8. Recommendations for switching antipsychotics. A position statement of the Spanish Society of Psychiatry and the Spanish Society of Biological Psychiatry.

    Science.gov (United States)

    Bernardo, Miquel; Vieta, Eduard; Saiz Ruiz, Jerónimo; Rico-Villademoros, Fernando; Alamo, Cecilio; Bobes, Julio

    2011-07-01

    Switching antipsychotics is common in the clinical practice setting and is associated with potential clinically relevant complications. An expert group selected by Spanish Society of Psychiatry and the Spanish Society of Biological Psychiatry has reviewed the evidence provided by randomized clinical trials and other relevant information to reach consensus recommendations for switching antipsychotics. In this article, we will review all the information that has led to those recommendations and which includes: indications and contraindications for switching antipsychotics, pharmacological issues, switching strategies, switching antipsychotics due to efficacy problems, switching antispychotics due to tolerability issues (including extrapyramidal symptoms and tardive dyskinesia, weight gain, metabolic disorders, hyperprolactinemia, sexual dysfunction, persistent sedation, and QT prolongation), switching antypsychotics due to lack of treatment compliance, and switching antipsychotics in patients with bipolar disorders.

  9. 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

  10. 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

  11. 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.

  12. Neuropsychological assessment, neuroimaging, and neuropsychiatric evaluation in pediatric and adult patients with sickle cell disease (SCD

    Directory of Open Access Journals (Sweden)

    Christopher L Edwards

    2007-01-01

    Full Text Available Christopher L Edwards1, Renee Dunn Raynor1, Miriam Feliu1, Camela McDougald1, Stephanie Johnson2, Donald Schmechel3, Mary Wood1, Gary G Bennett4, Patrick Saurona5, Melanie Bonner1, Chante’ Wellington1, Laura M DeCastro6, Elaine Whitworth6, Mary Abrams6, Patrick Logue1, Lekisha Edwards1, Salutario Martinez7, Keith E Whitfield81Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; 2American Psychological Association, Science Directorate, Washington, DC, USA; 3Department of Medicine, Division of Neurology, Duke University Medical Center, Durham, NC, USA; 4Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, USA; 5Taub Institute For Research on Alzheimer’s Disease and The Aging Brain, Columbia University, New York, NY, USA; 6Department of Medicine, Division of Hematology, Duke University Medical Center, Durham, NC, USA; 7Department of Radiology, Duke University Medical Center, Durham, NC, USA; 8Duke University, Durham, NC, USAAbstract: Traditionally, neuropsychological deficits due to Sickle Cell Disease (SCD have been understudied in adults. We have begun to suspect, however, that symptomatic and asymptomatic Cerebrovascular Events (CVE may account for an alarming number of deficits in this population. In the current brief review, we critically evaluated the pediatric and adult literatures on the neurocognitive effects of SCD. We highlighted the studies that have been published on this topic and posit that early detection of CVE via neurocognitive testing, neuropsychiatric evaluations, and neuroimaging may significantly reduce adult cognitive and functional morbidities.Keywords: cerebral vascular event, neuropsychological assessment, sickle cell disease, neuroimaging

  13. 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

  14. 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…

  15. Preparing International Medical Graduates for Psychiatry Residency: A Multi-Site Needs Assessment

    Science.gov (United States)

    Sockalingam, Sanjeev; Hawa, Raed; Al-Battran, Mazin; Abbey, Susan E.; Zaretsky, Ari

    2012-01-01

    Objective: Despite the growing number of international medical graduates (IMGs) training in medicine in Canada and the United States, IMG-specific challenges early in psychiatry residency have not been fully explored. Therefore, the authors conducted a needs-assessment survey to determine the needs of IMGs transitioning into psychiatry residency.…

  16. Modified Attitudes to Psychiatry Scale Created Using Principal-Components Analysis

    Science.gov (United States)

    Shankar, Rohit; Laugharne, Richard; Pritchard, Colin; Joshi, Pallavi; Dhar, Romika

    2011-01-01

    Objective: The Attitudes to Psychiatry Scale (APS) is a tool used to assess medical students' attitudes toward psychiatry. This study sought to examine the internal validity of the APS in order to identify dimensions within the questionnaire. Method: Using data collected from 549 medical students from India and Ghana, the authors analyzed 28…

  17. What Medical Students Say about Psychiatry: Results of a Reflection Exercise

    Science.gov (United States)

    Brenner, Adam M.

    2011-01-01

    Objective: The author describes the results of a reflection exercise for psychiatry clerkship students. Method: The author performed a qualitative analysis on 100 "reflection" papers written by medical students in their psychiatry clerkship and identified the most prominent thematic content. Results: The most common thematic content involved…

  18. Using Simulation to Train Junior Psychiatry Residents to Work with Agitated Patients: A Pilot Study

    Science.gov (United States)

    Zigman, Daniel; Young, Meredith; Chalk, Colin

    2013-01-01

    Objective: This article examines the benefit and feasibility of introducing a new, simulation-based learning intervention for junior psychiatry residents. Method: Junior psychiatry residents were invited to participate in a new simulation-based learning intervention focusing on agitated patients. Questionnaires were used to explore the success of…

  19. Fostering Psychiatry in Ghana: The Impact of a Short Review Course through an International Collaboration

    Science.gov (United States)

    Laugharne, Jonathan; Appiah-Poku, John; Laugharne, Richard; Stanley, Susanne

    2011-01-01

    Objective: The aim of the current study was to evaluate a short review course in psychiatry conducted at the Kwame Nkrumah University of Science and Technology medical school and any change in student interest in a career in psychiatry. Method: Students were asked to complete a general psychiatric knowledge questionnaire before and immediately…

  20. 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…

  1. Effect of Curriculum Change on Exam Performance in a 4-Week Psychiatry Clerkship

    Science.gov (United States)

    Niedermier, Julie; Way, David; Kasick, David; Kuperschmidt, Rada

    2010-01-01

    Objective: The authors investigated whether curriculum change could produce improved performance, despite a reduction in clerkship length from 8 to 4 weeks. Methods: The exam performance of medical students completing a 4-week clerkship in psychiatry was compared to national data from the National Board of Medical Examiners' Psychiatry Subject…

  2. 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'…

  3. A 4-Year Curriculum on Substance Use Disorders for Psychiatry Residents

    Science.gov (United States)

    Iannucci, Rocco; Sanders, Kathy; Greenfield, Shelly F.

    2009-01-01

    Objective: The authors describe an addiction psychiatry curriculum integrated in a general psychiatry training program to demonstrate comprehensive and practical approaches to educating general psychiatric residents on the recognition and treatment of substance use disorders. Methods: The Massachusetts General Hospital/McLean Hospital adult…

  4. Attitudes toward Psychiatry: A Survey of Medical Students at the University of Nairobi, Kenya

    Science.gov (United States)

    Ndetei, David M.; Khasakhala, Lincoln; Ongecha-Owuor, Francisca; Kuria, Mary; Mutiso, Victoria; Syanda, Judy; Kokonya, Donald

    2008-01-01

    Objectives: The authors aim to determine the attitudes of University of Nairobi, Kenya, medical students toward psychiatry. Methods: The study design was cross-sectional. Self-administered sociodemographic and the Attitudes Toward Psychiatry-30 items (ATP-30) questionnaires were distributed sequentially to every third medical student in his or her…

  5. Promoting Psychiatry as a Career Option for Ghanaian Medical Students through a Public-Speaking Competition

    Science.gov (United States)

    Agyapong, Vincent Israel Opoku; McLoughlin, Declan

    2012-01-01

    Objectives: Authors assessed the impact of a public-speaking competition on the level of interest in psychiatry of Ghanaian medical students. Method: An inter-medical school public-speaking competition was organized to promote psychiatry as a fulfilling career option for Ghanaian medical students. Feedback questionnaires were completed by the…

  6. Subspecialty Exposure in a Psychiatry Clerkship Does Not Improve Student Performance in the Subject Examination

    Science.gov (United States)

    Retamero, Carolina; Ramchandani, Dilip

    2013-01-01

    Objective: The authors compared the NBME subject examination scores and subspecialty profiles of 3rd-year medical students who were assigned to psychiatry subspecialties during their clerkship with those who were not. Method: The authors collated and analyzed the shelf examination scores, the clinical grades, and the child psychiatry and emergency…

  7. Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons

    Science.gov (United States)

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-01-01

    Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

  8. Poor Intentions or Poor Attention: Misrepresentation by Applicants to Psychiatry Residency

    Science.gov (United States)

    Caplan, Jason P.; Borus, Jonathan F.; Chang, Grace; Greenberg, William E.

    2008-01-01

    Objective: This study examines the veracity of self-reported data by applicants to psychiatry residency. Methods: The authors reviewed the reported publications of all applicants to a psychiatry residency training program over a 2-year span. Results: Nine percent of applicants reporting publications were found to have misrepresented them.…

  9. 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…

  10. What can psychiatry learn from the Munro Review of Child Protection?

    Science.gov (United States)

    Cohen, Mark

    2016-02-01

    The Munro Review of Child Protection approached the problem of child protection from an understanding based upon systems analysis. Risk assessment in psychiatry has similarities to the assessment by social workers of child protection issues. Psychiatry as a profession could learn from the Review, and, in doing so, be supported in recovering and communicating the requirements for good clinical practice.

  11. 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…

  12. 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

  13. "It's High-Tech, but Is It Better?": Applications of Technology in Psychiatry Education

    Science.gov (United States)

    Krain, Lewis P.; Bostwick, J. Michael; Sampson, Shirlene

    2007-01-01

    Objective: This article reviews the existing literature on the use of computer assisted instruction (CAI) in the field of psychiatry to answer the questions, 1) Is CAI an effective tool for teaching psychiatry? and 2) What are the best methods for studying CAI in a real-world training environment? Method: A Medline search was conducted for…

  14. 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…

  15. 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…

  16. Increasing Interest in Child and Adolescent Psychiatry in the Third-Year Clerkship: Results from a Post-Clerkship Survey

    Science.gov (United States)

    Malloy, Erin; Hollar, David; Lindsey, Anthony

    2008-01-01

    Objective: The authors aimed to determine whether a structured clinical experience in child and adolescent psychiatry (CAP) during the third-year psychiatry clerkship would impact interest in pursuing careers in psychiatry and CAP. Methods: The authors constructed and administered a post-rotation survey, the Child and Adolescent Psychiatry…

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. [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

  2. 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

  3. 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.

  4. Suicide in anti-psychiatry and in psychoanalysis

    Directory of Open Access Journals (Sweden)

    Cristia Rosineiri Gonçalves Lopes Correa

    2008-09-01

    Full Text Available In psychiatry, the criteria by which the need for psychiatric attention is evaluated are often the object of disagreements, thus bringing to the fore debates regarding the validity of the concept of mental illness. Whereas anti-psychiatrists, such as Szasz (1961, argue against the prevention of suicide, Freud (1915 describes a case of melancholia that would justify psychiatric intervention in suicidal individuals. In this article, I examine these arguments and argue that Freud's account of melancholia puts Szasz's position into question.

  5. [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

  6. 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.

  7. 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

  8. 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...

  9. [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

  10. [History of psychiatry in Venezuela: milestones in social work education].

    Science.gov (United States)

    Ibáñez, J

    1991-01-01

    A historical compilation, initiated with Dr. Lorenzo Campins y Ballester in 1773, covering the teaching aspect, and culminated with the creation of the first postgraduate in psychiatry at the Central University of Venezuela in 1939, is made. On the assistential side, the way in which patients were treated during colonial times is mentioned, introducing the attempts which were carried out up to 1892, when Dr. G.T. Villegas Pulido ordered the moving of 30 patients to the remodeled military hospital, becoming this latter institution the Psychiatric Hospital of Caracas. The influence of private institutions on both teaching formation and assistential level is also mentioned.

  11. ["Shock" therapies in Nazi Germany. The example of Berlin psychiatry].

    Science.gov (United States)

    Rzesnitzek, L

    2014-09-01

    The idea that "shock" therapies were introduced by "Nazi-Psychiatry" very early and used radically in a cruel way darkens the image of these therapies until today. A case analysis of patient files of psychiatric hospitals in Berlin is used to recapitulate the introduction of insulin coma, metrazol and electroconvulsive therapy during the National Socialism era. Contrary to the false assumption that these "shock" therapies would have been introduced and preferred by psychiatrists involved with the Nazi regime and "euthanasia", in the case of Berlin these therapies were delayed by them and seldom used.

  12. 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.

  13. 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, ...

  14. 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...

  15. Public health system and psychiatry in the treatment of 'dangerous' young offenders in Brazil.

    Science.gov (United States)

    Ribeiro, Rafael Bernardon; Cordeiro, Quirino; Taborda, José G V

    2015-01-01

    We describe the Experimental Health Unit, a special forensic mental health facility in Brazil, created by court order and administered by the São Paulo Department of Health. It was designed for young offenders receiving compulsory inpatient treatment for severe personality disorders. All nine patients admitted to date came from Foundation CASA (a socio-educational centre of assistance for adolescents, the juvenile correctional centres managed by the São Paulo state Department of Justice). The court decision is questionable, relying on a new interpretation of the Child and Adolescent Statute and the law that regulates psychiatric treatment in Brazil. The public health system and psychiatry have been supporting the isolation of some individuals from society, based on the seriousness of their crimes and possession of particular personality characteristics. The decision to commit and send a small group of personality disordered individuals to this unit as inpatients is an unfair decision, since jails and correctional centres hold a high number of psychopathic who have also committed barbaric crimes. The central mental health issue is the role that the public health system should play in the custody of dangerous people; the cost-effectiveness of this model, the accuracy of risk assessment and tractability of people with severe personality disorders are also debatable. From a legal perspective, the operation of this facility raises questions about age of legal majority, the maximum period of incarceration of young offenders and use of whole-life sentences for certain types of crimes and criminals in Brazil.

  16. 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

  17. 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

  18. 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.

  19. Entrenched reductionisms: The bête noire of psychiatry.

    Science.gov (United States)

    Frances, Allen

    2016-02-01

    Like Hannah Decker, I too deplore the destructive battle of psychosocial and biological reductionisms that has bedeviled psychiatry. When I started my psychiatric training almost 50 years ago, the prevailing model for understanding mental disorders was broadly bio/psycho/social in the grand tradition of Pinel and Freud, brought to and adapted in America by Adolph Meyer. When psychiatry is practiced well, it integrates insights from all the different ways of understanding human nature. Unfortunately, the mental health field has since degenerated into a civil war between the biomedical and psychosocial models with little room for compromise or finding middle ground. The inflexible biological reductionists assume that genes are destiny and that there is a pill for every problem: they take a "mindless" position. The inflexible psychosocial reductionists assume that mental health problems all arise from unpleasant experience: They take a "brainless" position. I have spent a good deal of frustrating time trying to open the minds of extremists at both ends, though rarely making much headway. In my view, however, and where I differ from Decker, the reductionisms do not sort so neatly into alternating historical periods.

  20. Computational Psychiatry: towards a mathematically informed understanding of mental illness.

    Science.gov (United States)

    Adams, Rick A; Huys, Quentin J M; Roiser, Jonathan P

    2016-01-01

    Computational Psychiatry aims to describe the relationship between the brain's neurobiology, its environment and mental symptoms in computational terms. In so doing, it may improve psychiatric classification and the diagnosis and treatment of mental illness. It can unite many levels of description in a mechanistic and rigorous fashion, while avoiding biological reductionism and artificial categorisation. We describe how computational models of cognition can infer the current state of the environment and weigh up future actions, and how these models provide new perspectives on two example disorders, depression and schizophrenia. Reinforcement learning describes how the brain can choose and value courses of actions according to their long-term future value. Some depressive symptoms may result from aberrant valuations, which could arise from prior beliefs about the loss of agency ('helplessness'), or from an inability to inhibit the mental exploration of aversive events. Predictive coding explains how the brain might perform Bayesian inference about the state of its environment by combining sensory data with prior beliefs, each weighted according to their certainty (or precision). Several cortical abnormalities in schizophrenia might reduce precision at higher levels of the inferential hierarchy, biasing inference towards sensory data and away from prior beliefs. We discuss whether striatal hyperdopaminergia might have an adaptive function in this context, and also how reinforcement learning and incentive salience models may shed light on the disorder. Finally, we review some of Computational Psychiatry's applications to neurological disorders, such as Parkinson's disease, and some pitfalls to avoid when applying its methods.

  1. TOLERANCE AS A PROFESSIONALIZATION FACTOR OF NURSES IN PSYCHIATRY

    Directory of Open Access Journals (Sweden)

    Irina Vyacheslavovna Klimentova

    2016-02-01

    Full Text Available Nurses in psychiatric service are a special group of nursing professionals. Their individualization is due to the specific needs of their patients who have increased level of aggressiveness, behavioral and communicative deviations and problems in self-service. These patients’ quality factors increase the risks of medical staff intolerance. As mechanisms of intolerance decrease some specific mechanisms of tolerance are developed in professional nursing practices. These include specific corporative standards, religious practices and forms of group action.Staff members can approve, ignore or condemn intolerance towards patients, the regulatory basis for this position at the level of subcultural organizational standards meaning the application of moral sanctions to an offender. Active inclusion of religious affiliations in the life of psychiatric healthcare institutions allows external moral arbitrator to enter professional space influencing both the behavior of professionals and the system of moral standards. Specificity of nursing profession in psychiatry requires additional means of inprofessionalization and professional improvement which are spontaneous practices of mentoring (guidance in psychiatric hospital. All the mechanisms of tolerance increase hold professional community of nurses in psychiatry together.

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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.

  7. Taking consultation-liaison psychiatry into primary care.

    Science.gov (United States)

    Kisely, Stephen; Campbell, Leslie Anne

    2007-01-01

    Up to 50% of patients seen in primary care have mental health problems, the severity and duration of their problems often being similar to those of individuals seen in the specialized sector. This article describes the reasons, advantages, and challenges of collaborative or shared care between primary and mental health teams, which are similar to those of consultation-liaison psychiatry. In both settings, clinicians deal with the complex interrelationships between medical and psychiatric disorders. Although initial models emphasized collaboration between family physicians, psychiatrists, and nurses, collaborative care has expanded to involve patients, psychologists, social workers, occupational therapists, pharmacists, and other providers. Several factors are associated with favorable patient outcomes. These include delivery of interventions in primary care settings by providers who have met face-to-face and/or have pre-existing clinical relationships. In the case of depression, good outcomes are particularly associated with approaches that combined collaborative care with treatment guidelines and systematic follow-up, especially for those with more severe illness. Family physicians with access to collaborative care also report greater knowledge, skills, and comfort in managing psychiatric disorders, even after controlling for possible confounders such as demographics and interest in psychiatry. Perceived medico-legal barriers to collaborative care can be addressed by adequate personal professional liability protection on the part of each practitioner, and ensuring that other health care professionals with whom they work collaboratively are similarly covered.

  8. [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.

  9. Can interoception improve the pragmatic search for biomarkers in psychiatry?

    Directory of Open Access Journals (Sweden)

    Sahib S Khalsa

    2016-07-01

    Full Text Available 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.

  10. 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

  11. 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

  12. 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

  13. 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.

  14. Psychiatry and fads: why is this field different from all other fields?

    Science.gov (United States)

    Shorter, Edward

    2013-10-01

    Fads in psychiatry are little more than bad ideas with short half-lives. They have arisen because of the great discontinuities that have swept psychiatry unlike other specialties in the 20th century: the transition in the 1920s from asylum-based biological psychiatry to psychoanalysis, and the transition in the 1960s from psychoanalysis to a biological model based on psychopharmacology. In no other medical specialty has the knowledge base been scrapped and rebuilt, and then again scrapped and rebuilt. In these great transitions, when psychiatry each time has had to reconstruct from scratch, bad ideas have crept in with good. Psychiatry, in its heavy use of consensus conferences, is often unable to employ science as a means of discarding fads, which, once installed, are often difficult to remove. Each of the great paradigms of psychiatry in the last hundred years has given rise to fads, and psychopharmacology is no exception, with faddish uses of neurotransmitter doctrine claiming centre stage. Only when psychiatry becomes firmly linked to the neurosciences will its subjugation to the turbulence of faddism be moderated.

  15. 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.

  16. 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.

  17. 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.

  18. Le Secteur de Psychiatrie en Milieu Pénitentiaire : Solutions de continuité ?

    Directory of Open Access Journals (Sweden)

    Catherine Paulet

    2012-10-01

    Full Text Available Une petite mise en mots et en sigles pour commencer si vous le voulez bien. Par secteur de psychiatrie en milieu pénitentiaire (SPMP, j’entends non seulement les 26 services médico-psychologiques régionaux (SMPR à vocation régionale, mais aussi tous les dispositifs de soins psychiatriques (DSP qui sont implantés dans les prisons, services constitués parfois, ou plus souvent unités fonctionnelles de secteurs de psychiatrie.Après vingt ans ou presque de pratique de la psychiatrie en milieu p...

  19. 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

  20. Another History for Another Psychiatry. The Patient’s View

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    Huertas, Rafael

    2013-06-01

    Full Text Available This article aims to summarise, in the first instance, some of the historiographical trends which have built a “critical” history of psychiatry from the 1960s onwards. Thereafter, it will demonstrate, with suitably significant examples, how methods and discourses were being refined and updated, before reaching a proposal for a new cultural history of psychiatry and subjectivity. In our analysis, special emphasis is placed on the “patient's view”. This renders necessary the task of identifying little consulted sources, such as the writings of the mad, and the incorporation of interdisciplinary hermeneutic tools, including, most notably, those taken from cultural studies and, in particular, written culture. Finally, it will offer a reflection on the epistemic role that this historiographical approach could play in the construction of new ways of understanding mental health, such as that represented by so-called post-psychiatry.Este artículo pretende revisar, en primer lugar, algunas de las tendencias historiográficas que han configurado una historia “crítica” de la psiquiatría a partir de los años sesenta del siglo XX. Se muestra a continuación, con algunos ejemplos suficientemente significativos, de qué manera los métodos y los discursos se fueron afinando y actualizando hasta llegar a la propuesta de una novedosa historia cultural de la psiquiatría y de la subjetividad. Especial importancia se concede, en nuestro análisis, al “punto de vista del paciente”. Esto obliga a una labor de identificación de fuentes escasamente trabajadas -como los escritos de los locos-, y a la incorporación de herramientas hermenéuticas de características interdisciplinares, entre las que destacan las procedentes de los estudios culturales y, de manera particular, de la cultura escrita. Finalmente, se ofrece una reflexión sobre el papel epistemológico que este enfoque historiográfico puede tener en la construcción de nuevas formas de

  1. Innovative methods in teaching psychiatry to medical students

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    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

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

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    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.

  3. 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

  4. Editorial: Bayesian benefits for child psychology and psychiatry researchers.

    Science.gov (United States)

    Oldehinkel, Albertine J

    2016-09-01

    For many scientists, performing statistical tests has become an almost automated routine. However, p-values are frequently used and interpreted incorrectly; and even when used appropriately, p-values tend to provide answers that do not match researchers' questions and hypotheses well. Bayesian statistics present an elegant and often more suitable alternative. The Bayesian approach has rarely been applied in child psychology and psychiatry research so far, but the development of user-friendly software packages and tutorials has placed it well within reach now. Because Bayesian analyses require a more refined definition of hypothesized probabilities of possible outcomes than the classical approach, going Bayesian may offer the additional benefit of sparkling the development and refinement of theoretical models in our field. PMID:27535649

  5. 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

  6. Positive emotions, spirituality and the practice of psychiatry

    Directory of Open Access Journals (Sweden)

    George E. Vaillant

    2008-01-01

    Full Text Available This paper proposes that eight positive emotions: awe, love (attachment, trust (faith, compassion, gratitude, forgiveness, joy and hope constitute what we mean by spirituality. These emotions have been grossly ignored by psychiatry. The two sciences that I shall employ to demonstrate this definition of spirituality will be ethology and neuroscience. They are both very new. I will argue that spirituality is not about ideas, sacred texts and theology; rather, spirituality is all about emotion and social connection. Specific religions, for all their limitations, are often the portal through which positive emotions are brought into conscious attention. Neither Freud nor psychiatric textbooks ever mention emotions like joy and gratitude. Hymns and psalms give these emotions pride of place. Our whole concept of psychotherapy might change if clinicians set about enhancing positive emotions rather than focusing only on negative emotions.

  7. 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.

  8. A day in the life of a public psychiatry fellow.

    Science.gov (United States)

    Shoyinka, Sosunmolu O; Barber, Mary E; Ranz, Jules

    2011-12-01

    Now in its 29th year, the Public Psychiatry Fellowship of the New York Psychiatric Institute at Columbia Medical Center selects 10 fellows per year for its 1-year program (1). This award-winning fellowship trains future leaders for the public mental health sector. The curriculum (2) employs a combination of a didactic seminar series, management-problem-focused presentations by guest speakers, field trips, and supervision by fellowship faculty to instill the values and skills required for practice and leadership in the public sector. Fellows utilize the framework of the academic curriculum to carry out a series of presentations throughout the year that allow them to organize, implement and evaluate concepts that they learn during the year. The following account, written from bird's eye view, details one fellow's day at his field placement in a State Hospital outpatient clinic setting, with the aim of illustrating how the concepts taught by the fellowship find application in day to day practice. PMID:21516350

  9. Natural substances in psychiatry (Ginkgo biloba in dementia).

    Science.gov (United States)

    Itil, T; Martorano, D

    1995-01-01

    Natural substances and/or their synthetically developed active ingredients are frequently used in medicine. In psychiatry, two of the most well known natural compounds are reserpine and Ginkgo biloba extract (EGb). EGb is among the most popular over-the-counter medicines in Europe and is also available in the United States, primarily in health food stores. Already the European medical community has recognized EGb as an effective compound in the treatment of cerebral insufficiency. In a pilot bioequivalency study, the effects of three different commercially available EGb products were examined. Findings indicated significant quantitative central nervous system (CNS) effects in, at least, one of the three. Furthermore, the CNS effects of Ginkgold were similar to other psychoactive compounds classified as cognitive activators. Recent studies in which EGb 761 demonstrated therapeutic effects in the treatment of dementia have earned EGb the approval of the German BGA (Bundesgesundheit Amt) for use in the treatment of dementia. PMID:7675979

  10. [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

  11. Natural substances in psychiatry (Ginkgo biloba in dementia).

    Science.gov (United States)

    Itil, T; Martorano, D

    1995-01-01

    Natural substances and/or their synthetically developed active ingredients are frequently used in medicine. In psychiatry, two of the most well known natural compounds are reserpine and Ginkgo biloba extract (EGb). EGb is among the most popular over-the-counter medicines in Europe and is also available in the United States, primarily in health food stores. Already the European medical community has recognized EGb as an effective compound in the treatment of cerebral insufficiency. In a pilot bioequivalency study, the effects of three different commercially available EGb products were examined. Findings indicated significant quantitative central nervous system (CNS) effects in, at least, one of the three. Furthermore, the CNS effects of Ginkgold were similar to other psychoactive compounds classified as cognitive activators. Recent studies in which EGb 761 demonstrated therapeutic effects in the treatment of dementia have earned EGb the approval of the German BGA (Bundesgesundheit Amt) for use in the treatment of dementia.

  12. 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.

  13. Multidisciplinary teams in consultation-liaison psychiatry: the Yale model.

    Science.gov (United States)

    Leigh, H

    1987-01-01

    The consultation-liaison service at Yale features integrated teams of psychiatrists, social workers, and clinical nurse specialists working together in both consultation and outpatient settings. The model is based on the tenets that (1) comprehensive evaluation of patients is essential for effective treatment; (2) role definition is necessary for specific disciplines, including the definition of overlapping and separate areas of expertise and practice. The multidisciplinary teams are coordinated by a psychiatric resident, who is supervised by an attending psychiatrist. The role of the resident is that of a diagnostician and coordinating physician. The social worker functions as an expert in family evaluation and treatment, and the nurse specialist functions as supportive therapist and liaison with the nursing staff. The structure of the division of consultation-liaison and ambulatory services at Yale is described and the advantages and disadvantages of the multidisciplinary team concept are discussed in comparison with other models of consultation-liaison psychiatry.

  14. [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.

  15. Editorial: Bayesian benefits for child psychology and psychiatry researchers.

    Science.gov (United States)

    Oldehinkel, Albertine J

    2016-09-01

    For many scientists, performing statistical tests has become an almost automated routine. However, p-values are frequently used and interpreted incorrectly; and even when used appropriately, p-values tend to provide answers that do not match researchers' questions and hypotheses well. Bayesian statistics present an elegant and often more suitable alternative. The Bayesian approach has rarely been applied in child psychology and psychiatry research so far, but the development of user-friendly software packages and tutorials has placed it well within reach now. Because Bayesian analyses require a more refined definition of hypothesized probabilities of possible outcomes than the classical approach, going Bayesian may offer the additional benefit of sparkling the development and refinement of theoretical models in our field.

  16. [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

  17. 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.

  18. Drug Utilization Pattern In Psychiatry Outdoor Patients At Tertiary Care Teaching Hospital Of Bastar Region

    Directory of Open Access Journals (Sweden)

    Ahmed Tabish

    2015-04-01

    Full Text Available Background: Psychotropic drugs have had a remarkable impact in psychiatric practice. However, their utilization in actualClinical practice, effectiveness and safety in real life situation need continuous study.Aim: To evaluate the utilization pattern of antipsychotics drugs in the OPD of Psychiatry department.Materials and Methods: A prospective cross-sectional study was     undertaken for a period of three months.   The total number of prescriptions that were analyzed were 264. Patients of all ages and both sexes were included in the study while inpatients,Referred patients and patients of epilepsy were excluded.Results: Out of 264 patients, 180(68.18% were males and84 (31.81% were females. Depression (30.6% was the commonest psychotic ailment. Fluoxetine (34% was the most common antidepressant prescribed for its treatment.Anxiety comprised the second commonest category of psychotic disorder (24.4% followed by Schizophrenia (22%. Lorazepam (43.4% was the most prescribed anxiolytic whereas      Risperidone (46.6% was used to treat it.Conclusion:  Depression was the commonest psychotic ailment followed by anxiety and schizophrenia. Polypharmacy was found in 45% of prescriptions. Risperidone + Trihexyphenidyl was the commonest fixed dose combination used for Schizophrenia and Psychosis followed by amitriptyline+Chlordiazepoxide for anxiety and depression.

  19. Neonatal Intensive Care and Child Psychiatry Inpatient Care: Do Different Working Conditions Influence Stress Levels?

    Directory of Open Access Journals (Sweden)

    Evalotte Mörelius

    2013-01-01

    Full Text Available Introduction. Nurses often experience work-related stress. High stress can negatively affect job satisfaction and lead to emotional exhaustion with risk of burnout. Aim. To analyse possible differences in biological stress markers, psychosocial working conditions, health, and well-being between nurses working in two different departments. Methods. Stress was evaluated in nurses working in a neonatal intensive care unit (NICU (n=33 and nurses working in a child and adolescent psychiatry inpatient ward (CAP (n=14 using salivary cortisol and HbA1c. Salivary cortisol was measured three times a day on two consecutive days during two one-week periods, seven weeks apart (= 12 samples/person. Psychosocial working conditions, health, and well-being were measured once. Results. NICU nurses had better social support and more self-determination. CAP nurses had a lower salivary cortisol quotient, poorer general health, and higher client-related burnout scores. Conclusion. When comparing these nurses with existing norm data for Sweden, as a group their scores reflect less work-related stress than Swedes overall. However, the comparison between NICU and CAP nurses indicates a less healthy work situation for CAP nurses. Relevance to Clinical Practice. Healthcare managers need to acknowledge the less healthy work situation CAP nurses experience in order to provide optimal support and promote good health.

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

    Science.gov (United States)

    Brüne, Martin

    2007-10-05

    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 civilization 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 is proposed that human

  1. 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".

  2. 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

  3. Structure and process of university teaching in psychiatry: a field for methods of quality assurance and evaluation

    Directory of Open Access Journals (Sweden)

    Barkmann, Claus

    2005-08-01

    Full Text Available Objective: Given the exceptional workload at a university psychiatric hospital and the current emphasis on clinical medicine and science, teaching is systematically being neglected.Methods: With the help of evaluation methods involving the completion of a questionnaire, lectures and seminars held during one semester at the Department for Child and Adolescent Psychiatry and Psychotherapy of the University Hospital Hamburg-Eppendorf were assessed separately by students and lecturers in terms of form, content, lecturers, and overall assessment.Results: Despite organizational shortcomings, the lectures and seminars were rated on average as good in all four assessment areas. Using a bivariate prediction model, it was possible to explain 46% of the variance in overall assessment. A surprisingly high concordance was found between the assessments by students and lecturers.Conclusion: Continuous and systematic evaluation of lectures and seminars ensures and improves the quality of current and future teaching methods.

  4. 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

  5. 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, who...... do not belong solely to one of the three sectors and thereby often get lost in the system. The PSP cooperation was introduced to ensure that relevant information concerning vulnerable citizens was shared between the three sectors and to improve collaboration between the sectors involved in order...

  6. 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...

  7. Off-Label Prescription of Psychopharmacological Drugs in Child and Adolescent Psychiatry

    DEFF Research Database (Denmark)

    Braüner, Julie Vestergaard; Johansen, Lily Manzello; Roesbjerg, Troels;

    2016-01-01

    and Adolescent Psychiatry, Capital Region of Denmark, aged 0 to 17 years receiving medical treatment with antidepressants, antipsychotic agents, benzodiazepines, melatonin and/or attention deficit hyperactivity disorder (ADHD) medication. We included a total of 5555 prescriptions representing 2932 patients...

  8. 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

  9. 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

  10. [Structural quality in inpatient and daycare child and adolescent psychiatry- indicators for planning future staff ratios for the era following the Psychiatry Personnel Act].

    Science.gov (United States)

    Schepker, Renate; Fegert, Jörg M; Becker, Katja

    2015-11-01

    The German Psychiatry Personnel Act, which went into effect in 1990, has led to a decrease in the number of child and adolescent psychiatry inpatient beds, to a decrease in the length of stay, and to an increase in inpatient psychotherapy. Today, this act is outdated~ for a number of reasons, such as changes in the morbidity of the population, the rising number of emergencies, and new professional standards such as documentation. In addition, new legal provisions and conventions (like the UN Convention on the Rights of the Child) necessitate a complete reevaluation. Child and adolescent psychiatry needs a normative act to enable the necessary implementation. Many different rationales are available to support the debate.

  11. 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?...

  12. 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...

  13. 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...

  14. 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...

  15. [Psychiatry and psychology integrated in somatics is a profit for the clinic. Consultation liaison psychiatry important for the future of healthcare].

    Science.gov (United States)

    Wahlström, Lars; Blomdahl-Wetterholm, Margareta

    2015-10-06

    The mental health needs of patients receiving physical health care often remain undiagnosed and untreated, resulting in significant costs to the health care system. However, some countries have recently seen fast progress with the development of consultation liaison psychiatry. In Sweden, this service has developed quite slowly, but a breakthrough may be imminent. There is evidence that providing better support for co-morbid health problems may improve the psychological quality of care and reduce physical health care costs in acute hospitals. Consultation liaison psychiatry fits well with the current trends of value-based health care, personalized care, and an emphasis on networking in care.

  16. 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...

  17. NOHSS Adult Indicators

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1999, 2002-2014 (even years). Data from BRFSS for indicators of adult oral health for 1999 and even years from 2002 through 2014. National estimates are represented...

  18. Standing on the shoulders of Pinel, Freud, and Kraepelin: a historiometric inquiry into the histories of psychiatry.

    Science.gov (United States)

    Messias, Erick

    2014-11-01

    History of psychiatry can provide us with a map of the evolution of the practice and identify its major figures. A historiometric approach was taken to available history of psychiatry texts and a historical dictionary. Reliability was tested against data from the journal History of Psychiatry. Those cited in all historical accounts are characterized as major figures, whereas those cited in at least 60% of the sources are considered significant figures. An index of eminence is calculated for each significant figure. The Cronbach's α was 0.89. Seventy-four significant figures were identified, of which 18 are considered major figures. Among these, Freud, Pinel, and Kraepelin have the highest eminence-in that order. Pinel, Freud, and Kraepelin represent key moments in three epochs in the history of psychiatry: the asylum era, the first biological psychiatry, and the psychoanalytical period, respectively. The most recent historical periods are not well represented in histories of psychiatry.

  19. 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 ...

  20. [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.

  1. [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

  2. 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

  3. 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

  4. 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…

  5. Psychosocial first aid for refugees (an essay in social psychiatry).

    Science.gov (United States)

    Tyhurst, L

    1977-01-01

    Post-war refugee resettlement schemes offer an opportunity for the study of contemporary social phenomena of compulsory mass migration. The process, set in motion by man-made disasters of war, oppression and persecution, deeply affects not only the victims but also the social institutions as they mobilize resources to accommodate the stateless and homeless new populations. The traditional focus on 'culture-change' is inadequate for the development of principles of aid to the refugees. In this paper, an operational definition of the structure and natural history of the social situation of resettlement is outlined, with reference to the working hypotheses of (1) the Social Displacement Syndrome and (2) the Psychosocial First Aid for Refugees Project. This has been derived from clinical and field studies of four successive refugee groups in Canada over the past 27 years, with specific focus on the social dynamics of the situation from immediately upon resettlement to one year after. In this early phase, the coexistence of personal and social disequilibrium in the refugees and among those who represent the institutions responsible for their management creates specific conditions, of which some enhance the disposition for recovery or 'repair' and some might reinforce the disposition for lasting 'social breakdown'. Some generalizations concerning practical and theoretical work in social psychiatry are made.

  6. 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

  7. Optogenetics, sex, and violence in the brain: implications for psychiatry.

    Science.gov (United States)

    Anderson, David J

    2012-06-15

    Pathological aggression and the inability to control aggressive impulses takes a tremendous toll on society. Yet aggression is a normal component of the innate behavior repertoire of most vertebrate animal species as well as of many invertebrates. Progress in understanding the etiology of disorders of aggressive behavior, whether genetic or environmental in nature, therefore requires an understanding of the brain circuitry that controls normal aggression. Efforts to understand this circuitry at the level of specific neuronal populations have been constrained by the limited resolution of classical methodologies, such as electrical stimulation and electrolytic lesion. The availability of new, genetically based tools for mapping and manipulating neural circuits at the level of specific, genetically defined neuronal subtypes provides an opportunity to investigate the functional organization of aggression circuitry with cellular resolution. However, these technologies are optimally applied in the mouse, where there has been surprisingly little traditional work on the functional neuroanatomy of aggression. Here we discuss recent, initial efforts to apply optogenetics and other state-of-the-art methods to the dissection of aggression circuitry in the mouse. We find, surprisingly, that neurons necessary and sufficient for inter-male aggression are located within the ventrolateral subdivision of the ventromedial hypothalamic nucleus, a structure traditionally associated with reproductive behavior. These neurons are intermingled with neurons activated during male-female mating, with approximately 20% overlap between the populations. We discuss the significance of these findings with respect to neuroethological and neuroanatomical perspectives on the functional organization of innate behaviors and their potential implications for psychiatry.

  8. 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.

  9. The many faces of oxytocin: implications for psychiatry.

    Science.gov (United States)

    Zik, Jodi B; Roberts, David L

    2015-03-30

    Oxytocin is known as the 'love hormone' due its role in promoting mother-child and pair bonding. More recent research indicates that oxytocin may have broader pro-social effects on behavior and cognition, which points towards oxytocin's potential as an agent to help improve social cognition and functioning in psychiatric disorders such as schizophrenia and autism. However, new research on oxytocin has also uncovered a 'darker side', including oxytocin's possible role in social out-grouping and envy. Instead of a simple view of oxytocin as 'good' or 'bad', a more accurate depiction of oxytocin's role in social processing likely involves the presence of moderating factors. We review moderation effects in oxytocin and their implications for psychiatry. One implication is that, across diagnostic categories, oxytocin administration may have positive effects for patients with social cognitive deficits but negative effects for patients with social cognitive bias. We conclude that future intervention studies should use methods such as signal detection to measure both deficit and bias parameters of social cognition and to evaluate potential individual and contextual moderators both within and between psychiatric diagnoses in order to determine for whom oxytocin treatment may be beneficial and for whom it may actually be harmful.

  10. 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.

  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. 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.

  13. 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

  14. 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.

  15. 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

  16. 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.

  17. 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

    In 2009 the WPA President established a Task Force that was to examine available evidence about the stigmatization of psychiatry and psychiatrists and to make recommendations about action that national psychiatric societies and psychiatrists as professionals could do to reduce or prevent the stig......In 2009 the WPA President established a Task Force that was to examine available evidence about the stigmatization of psychiatry and psychiatrists and to make recommendations about action that national psychiatric societies and psychiatrists as professionals could do to reduce or prevent...... the stigmatization of their discipline as well as to prevent its nefarious consequences. This paper presents a summary of the Task Force's findings and recommendations. The Task Force reviewed the literature concerning the image of psychiatry and psychiatrists in the media and the opinions about psychiatry...... of recommendations to the national psychiatric societies and to individual psychiatrists. The Task Force laid emphasis on the formulation of best practices of psychiatry and their application in health services and on the revision of curricula for the training of health personnel. It also recommended that national...

  18. 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).

  19. 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.

  20. Results of a Multisite Survey of U.S. Psychiatry Residents on Education in Professionalism and Ethics

    Science.gov (United States)

    Jain, Shaili; Dunn, Laura B.; Warner, Christopher H.; Roberts, Laura Weiss

    2011-01-01

    Objective: The authors assess the perspectives of psychiatry residents about the goals of receiving education in professionalism and ethics, how topics should be taught, and on what ethical principles the curriculum should be based. Method: A written survey was sent to psychiatry residents (N = 249) at seven U.S. residency programs in Spring 2005.…

  1. [What should general hospital psychiatry do in a community?].

    Science.gov (United States)

    Takehisa, Takahashi

    2003-01-01

    Some experiences in Nagano Red Cross hospital and Nagano Prefecture are presented, and the role of general hospital psychiatry (GHP) in a community is discussed. Psychiatric services in Nagano prefecture with population 2.21 million consist of four blocks. Our unit is in north block, providing treatment for acute phase and, in 2000, 1504 cases were new outpatients, daily outpatients were 198 cases and new inpatients were 604 cases including 146 emergency inpatients. In fiscal 2001, 25.6% of notifications of involuntary hospitalization from all psychiatric hospitals were submitted from GHP occupying 12.9% psychiatric beds, and 129 notifications from our unit were largest in Nagano prefecture. Total 7 GHPs with beds are presented by some data, suggesting two types as GHP. One type has relatively many new inpatients by small beds with short-term hospitalization like our GHP, and another type has relatively small new inpatients by large beds with long-term hospitalization like conventional mental hospital. It is necessary for GHP to pursue the former type, and to functionally differentiate from psychiatric hospital. Results of psychiatric emergency system in Nagano prefecture are presented. Designated hospitals are our GHP with 60 beds in north block, Prefectural Hospital with 310 beds in south block, National Sanatorium with 280 beds in east block and rotating 5 psychiatric hospitals with total 968 beds in west block. GHP with 60 beds hospitalized more emergency new cases than other psychiatric hospitals with large beds and discharged 84% of emergency inpatients to their home. Recently, short-term hospitalization of general hospital beds has rapidly progressed, and shared goal settings are needed, and treatment plans with teamwork by various types of experts have started from community-based home care. This teamwork will be expected throughout community psychiatric services. Although until today GHP's ward unit is financially disadvantageous, patients anticipate

  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. Psiquiatria baseada em evidências Evidence-based psychiatry

    Directory of Open Access Journals (Sweden)

    Maurício S de Lima

    2000-09-01

    Full Text Available Em psiquiatria, observa-se grande variabilidade de práticas clínicas, muitas vezes desnecessária. Essas variações podem estar relacionadas à ausência de evidência científica confiável ou ao desconhecimento das evidências de boa qualidade disponíveis. A medicina baseada em evidências (MBE é uma combinação de estratégias que busca assegurar que o cuidado individual do paciente seja baseado na melhor informação disponível, a qual deve ser incorporada à prática clínica. Neste artigo, conceitos de MBE são discutidos com relação a aspectos e desafios no tratamento de pacientes com distimia, bulimia nervosa e esquizofrenia. A partir de resultados de três revisões sistemáticas recentemente publicadas, conclui-se que a prática de psiquiatria baseada em evidências acrescenta qualidade à prática psiquiátrica tradicional.The unnecessary variability often seen in the clinical practice can be related to both the absence of reliable evidence and unawareness of the existence of good quality evidence. Evidence-Based Medicine (EBM is a set of linked strategies designed to assist clinicians in keeping themselves up-to-date with the best available evidence. Such evidence must be incorporated into the clinical practice. EBM concepts are discussed here through common aspects and challenges doctors face when treating patients with dysthymia, bulimia nervosa, and schizophrenia. In the light of some results from three systematic reviews it is concluded that Evidence-Based Psychiatry strategies, rather than replacing the traditional ones, may be a valuable tool to improving quality in a good clinical practice.

  4. 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.

  5. Realizing the potential of mobile mental health: new methods for new data in psychiatry.

    Science.gov (United States)

    Torous, John; Staples, Patrick; Onnela, Jukka-Pekka

    2015-08-01

    Smartphones are now ubiquitous and can be harnessed to offer psychiatry a wealth of real-time data regarding patient behavior, self-reported symptoms, and even physiology. The data collected from smartphones meet the three criteria of big data: velocity, volume, and variety. Although these data have tremendous potential, transforming them into clinically valid and useful information requires using new tools and methods as a part of assessment in psychiatry. In this paper, we introduce and explore numerous analytical methods and tools from the computational and statistical sciences that appear readily applicable to psychiatric data collected using smartphones. By matching smartphone data with appropriate statistical methods, psychiatry can better realize the potential of mobile mental health and empower both patients and providers with novel clinical tools.

  6. 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

  7. 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

  8. [Liaison psychiatry: a new perspective on mental health in Latin America].

    Science.gov (United States)

    Bórquez Rojas, E; Torres, P; Tapia, L; Rodríguez, A; Rocha, P; Larrea, J; Yulis, J; Bórquez, J A

    1989-01-01

    The situation of Mental Health in Latin America is analyzed. Urgently creating a system able at handling the psychiatric disease increase in the years to come is a conclusion this paper strongly aims at. The beginning of Psychiatry is reviewed, and the importance of Psychiatry at the General Hospital is outlined as well as its rapprochement toward the community, which led to a better control and prevention in the field of Mental Health. A definition of Psychiatry is proposed, as a branch of Medicine which stands in between mental hospitals and communities. Active teamwork, coupled with the physician's work and the tasks other members of the health personnel are engaged in, has led to a more integrated approach onto the ill thus benefiting not only patients but also the whole community. PMID:2634332

  9. 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...

  10. Beyond the 'new cross-cultural psychiatry': cultural biology, discursive psychology and the ironies of globalization.

    Science.gov (United States)

    Kirmayer, Laurence J

    2006-03-01

    The 'new cross-cultural psychiatry' heralded by Kleinman in 1977 promised a revitalized tradition that gave due respect to cultural difference and did not export psychiatric theories that were themselves culture bound. In the ensuing years, the view of culture within anthropology has continued to change, along with our understanding of the relationship of biological processes to cultural diversity, and the global political economic contexts in which mental health care is delivered. This article considers the implications of these new notions of culture, biology and the context of practice for theory in cultural psychiatry. The future of cultural psychiatry lies in advancing a broad perspective that: (a) is inherently multidisciplinary (involving psychiatric epidemiology, medical anthropology and sociology, cognitive science and social psychology), breaking down the nature/culture dichotomy with an integrative view of culture as a core feature of human biology, while remaining alert to cultural constructions of biological theory; (b) attends to psychological processes but understands these as not exclusively located within the individual but as including discursive processes that are fundamentally social; and (c) critically examines the interaction of both local and global systems of knowledge and power. Globalization has brought with it many ironies for cultural psychiatry: Transnational migrations have resulted in cultural hybridization at the same time as ethnicity has become more salient; the call for evidence-based medicine has been used to limit the impact of cultural research; and cultural psychiatry itself has been co-opted by pharmaceutical companies to inform marketing campaigns to promote conventional treatments for new populations. Cultural psychiatry must address these ironies to develop the self-critical awareness and flexibility needed to deliver humane care in shifting contexts. PMID:16671396

  11. 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 

  12. A new protocol for screening adults presenting with their own medical problems at the Emergency Department to identify children at high risk for maltreatment

    NARCIS (Netherlands)

    Diderich, H.M.; Fekkes, M.; Verkerk, P.H.; Pannebakker, F.D.; Velderman, M.K.; Sorensen, P.J.G.; Baeten, P.; Oudesluys-Murphy, A.M.

    2013-01-01

    Identifying child abuse and neglect solely on the grounds of child characteristics leaves many children undetected. We developed a new approach (Hague protocol) based on characteristics of parents who attend the Emergency Department (ED) because they have the following problems: (1) intimate partner

  13. [Knowledge and power at a molecular level; biological psychiatry in a social context].

    Science.gov (United States)

    Verhoeff, B

    2009-01-01

    How do we acquire our knowledge about psychiatric disorders and how did the current biologically way of thinking in psychiatry originate? With the help of the philosophy of Michel Foucault and Nikolas Rose this essay describes the conditions that made possible today's biological approach in psychiatry. It will become clear that research in the life sciences and the psychiatric knowledge arising from this research are shaped and formed in a complex network of social, economic, political and scientific forces. The biological approach to psychiatric disorders is the product of present-day relationships between scientific developments and commercial corporations.

  14. [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.

  15. 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.

  16. [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

  17. 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

  18. Epistemological issues in the history of Italian psychiatry: the contribution of Gaetano Perusini (1879-1915).

    Science.gov (United States)

    Passione, Roberta

    2015-12-01

    In the late nineteenth and early twentieth centuries, Italian psychiatry was characterized by its emphasis on an organic explanation of mental illness. 'Cerebral mythology' was a major influence in Italy, at least until the second half of the twentieth century, often at the expense of the development of psychology. In this context, a few psychiatrists adopted a different epistemological perspective, based on a more 'integrative' view of their discipline. In particular, Gaetano Perusini stands out. He promoted the concept of psychiatry as a science which embraced many different fields, thus emphasizing the theme of pluralism, which is still debated today in the philosophy of science and psychiatric practice.

  19. Excess use of coercive measures in psychiatry among migrants compared with native Danes

    DEFF Research Database (Denmark)

    Nørredam, Marie Louise; Garcia-Lopez, A; Keiding, N;

    2010-01-01

    Norredam M, Garcia-Lopez A, Keiding N, Krasnik A. Excess use of coercive measures in psychiatry among migrants compared with native Danes.Objective: To investigate differences in risk of compulsory admission and other coercive measures in psychiatric emergencies among refugees and immigrants....... This was most striking for refugee men (RR = 2.00; 95%CI: 1.53; 2.61) and immigrant women (RR = 1.73; 95%CI: 1.45; 2.60). Moreover, refugees and immigrants experienced higher frequencies of other coercive measures during hospitalisation compared with native Danes. Conclusion: Coercive measures in psychiatry...

  20. The flexible brain. On mind and brain, neural darwinism and psychiatry.

    Science.gov (United States)

    den Boer, J A

    1997-09-01

    A theoretical introduction is given in which several theoretical viewpoints concerning the mind-brain problem are discussed. During the last decade philosophers like Searle, Dennett and the Churchlands have taken a more or less pure materialistic position in explaining mental phenomena. Investigators in biological psychiatry have hardly ever taken a clear position in this discussion, whereas we believe it is important that the conclusions drawn from biological research are embedded in a theoretical framework related to the mind-brain problem. In this article the thesis is defended that the theory of neural darwinism represents a major step forward and may bridge previous distinctions between biological, clinical and social psychiatry.