Sample records for liaison psychiatry group

  1. Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 1--The model. (United States)

    Dawber, Chris


    In the present study, we outline the evolution of a process-focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3-year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group-as-a-whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process-focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

  2. Neurology referrals to a liaison psychiatry service.

    LENUS (Irish Health Repository)

    Fitzgerald, P


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

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

    LENUS (Irish Health Repository)

    Jordan, Iain


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

  4. Multidisciplinary teams in consultation-liaison psychiatry: the Yale model. (United States)

    Leigh, H


    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.

  5. Liaison psychiatry on a burn unit. (United States)

    Billowitz, A; Friedson, W; Schubert, D S


    Psychiatric liaison activities and intervention on a burn unit are described. The authors review the psychiatrist's interventions with regard to unhealthy staff denial; educating staff about psychiatric issues; facilitating improved staff-patient communication; and helping nurses manage patients' inappropriate sexual behavior.

  6. Why are hospital doctors not referring to Consultation-Liaison Psychiatry? - a systemic review. (United States)

    Chen, Kai Yang; Evans, Rebecca; Larkins, Sarah


    Consultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatry that provides care to inpatients under non-psychiatric care. Despite evidence of benefits of CLP for inpatients with psychiatric comorbidities, referral rates from hospital doctors remain low. This review aims to understand barriers to CLP inpatient referral as described in the literature. We searched on Medline, PsychINFO, CINAHL and SCOPUS, using MESH and the following keywords: 1) Consultation-Liaison Psychiatry, Consultation Liaison Psychiatry, Consultation Psychiatry, Liaison Psychiatry, Hospital Psychiatry, Psychosomatic Medicine, the 2) Referral, Consultation, Consultancy and 3) Inpatient, Hospitalized patient, Hospitalized patient. We considered papers published between 1 Jan 1965 and 30 Sep 2015 and all articles written in English that contribute to understanding of barriers to CLP referral were included. Thirty-five eligible articles were found and they were grouped thematically into three categories: (1) Systemic factors; (2) Referrer factors; (3) Patient factors. Systemic factors that improves referrals include a dedicated CLP service, active CLP consultant and collaborative screening of patients. Referrer factors that increases referrals include doctors of internal medicine specialty and comfortable with CLP. Patients more likely to be referred tend to be young, has psychiatric history, live in an urban setting or has functional psychosis. This is the first systematic review that examines factors that influence CLP inpatient referrals. Although there is research in this area, it is of limited quality. Education could be provided to hospital doctors to better recognise mental illness. Collaborative screening of vulnerable groups could prevent inpatients from missing out on psychiatric care. CLP clinicians should use the knowledge gained in this review to provide quality engagement with referrers.

  7. [Consultation-liaison psychiatry: strategy for care, opportunity for training]. (United States)

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


    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.

  8. [Economic impact of consultation-liaison psychiatry in a French University Hospital Centre]. (United States)

    Yrondi, A; Petiot, D; Arbus, C; Schmitt, L


    In times of fiscal restraint for health structures, apart from the clinical input, it seems important to discuss the economic impact of liaison psychiatry. There are only a few studies on the economic added value provided by a liaison psychiatry team. In addition to this, only a few psychiatric pathologies are coded as they should be, hence we make the assumption of an additional development provided by a specialised team. Over a short period of 4months, in three departments of the Toulouse University Hospital Centre, the added value to the general pricing system of liaison psychiatry was studied. The population was represented by all the consecutive requests for consultations from patients over 18years old, men and women, hospitalised at that time. These three departments frequently request consultations with the psychiatry liaison team. They set a diagnostic, and if this is associated with a higher Homogeneous Group of Patients (HGP), it provides added value. Fifty-two patients benefited from a psychiatric consultation over 4months. The results highlight a development of € 8630.43 for the traumatology department, € 3325.03 for the internal medicine department, and € 513.61 for the haematology department over the study period. The overall development over this period was € 12,469.07. To our knowledge, this approach is one of the first in France to highlight an economic impact of the intervention of liaison psychiatry in the claiming departments. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  9. Transfers to psychiatry through the consultation-liaison psychiatry service: 11 years of experience

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    Michopoulos Ioannis


    Full Text Available Abstract Background There are only a few reports on issues related to patient transfer from medical and surgical departments to the psychiatric ward by the consultation-liaison psychiatry service, although it is a common practice. Here, we present a study assessing the factors that influence such transfers. Method We examined the demographic and clinical backgrounds of a group of patients transferred from internal medicine and surgery to the psychiatric ward over an 11-year period. A comparison was made of this data with data obtained from a group of non-transferred patients, also seen by the same consultation-liaison psychiatry service. Results According to our findings, the typical transferred patient, either female or male, is single, divorced or widowed, lives alone, belongs to a lower socioeconomic class, presents initially with (on the whole a disturbed and disruptive behaviour, has had a recent suicide attempt with persistent suicidal ideas, suffers from a mood disorder (mainly depressive and dysthymic disorders, has a prior psychiatric history as well as a prior psychiatric inpatient treatment, and a positive diagnosis on axis II of the five axis system used for mental health diagnosis. Conclusion The transfer of a patient to the psychiatric ward is a decision depending on multiple factors. Medical diagnoses do not seem to play a major role in the transfer to the psychiatric ward. From the psychiatric diagnosis, depressive and dysthymic disorders are the most common in the transferred population, whilst the transfer is influenced by social factors regarding the patient, the patient's behaviour, the conditions in the ward she/he is treated in and any recent occurrence(s that increase the anxiety of the staff.

  10. Audit of an inpatient liaison psychiatry consultation service.

    LENUS (Irish Health Repository)

    Lyne, John


    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.

  11. Taking consultation-liaison psychiatry into primary care. (United States)

    Kisely, Stephen; Campbell, Leslie Anne


    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.

  12. [Liaison psychiatry nurse: the development of supervision in somatic medicine]. (United States)

    Dorogi, Y; Campiotti, C; Gebhard, S


    Over the years, somatic care has become increasingly specialized. Furthermore, a rising number of patients requiring somatic care also present with a psychiatric comorbidity. As a consequence, the time and resources needed to care for these patients can interfere with the course of somatic treatment and influence the patient-caregiver relationship. In the light of these observations, the Liaison Psychiatry Unit at the University Hospital in Lausanne (CHUV) has educated its nursing staff in order to strengthen its action within the general care hospital. What has been developed is a reflexive approach through supervision of somatic staff, in order to improve the efficiency of liaison psychiatry interventions with the caregivers in charge of patients. The kind of supervision we have developed is the result of a real partnership with somatic staff. Besides, in order to better understand the complexity of interactions between the two systems involved, the patient's and the caregivers', we use several theoretical references in an integrative manner. PSYCHOANALYTICAL REFERENCE: The psychoanalytical model allows us to better understand the dynamics between the supervisor and the supervised group in order to contain and give meaning to the affects arising in the supervision space. "Containing function" and "transitional phenomena" refer to the experience in which emotions can find a space where they can be taken in and processed in a secure and supportive manner. These concepts, along with that of the "psychic envelope", were initially developed to explain the psychological development of the baby in its early interactions with its mother or its surrogate. In the field of supervision, they allow us to be aware of these complex phenomena and the diverse qualities to which a supervisor needs to resort, such as attention, support and incentive, in order to offer a secure environment. SYSTEMIC REFERENCE: A new perspective of the patient's complexity is revealed by the group

  13. Opening the ‘black box’: liaison psychiatry services and what they actually do (United States)

    Guthrie, Elspeth; McMeekin, Aaron; Thomasson, Rachel; Khan, Sylvia; Makin, Sally; Shaw, Ben; Longson, Damien


    Aims and method To develop a simple, pragmatic typology to characterise the nature of liaison interventions delivered by a liaison service in a National Health Service setting. We carried out a retrospective electronic case-note review of referrals to a ward-based liaison psychiatry service. Results Three hundred and forty-four patients were referred to the service over a 12-month period. Ten different types of liaison interventions were identified, with the most common interventions being diagnosis (112 patients, 32.6%), medication management (57 patients, 16.6%), risk assessment and treatment (56 patients, 16.3% each). Mental Health Act work accounted for the greatest number of contacts per patient (median 7). Clinical implications There are inherent limitations in any single-site observational study, as site-specific results cannot be generalised to other liaison services. The intervention categories we developed, however, are easy to use and will provide a way of comparing and benchmarking the range of interventions delivered by different liaison psychiatry services. PMID:27512583

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


    Rafieyan, Roia; Ries, Rose


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

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

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    Natalia Cámara Conde


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

  16. Quality of psychiatric care in the general hospital: referrer perceptions of an inpatient liaison psychiatry service. (United States)

    Solomons, Luke C; Thachil, Ajoy; Burgess, Caroline; Hopper, Adrian; Glen-Day, Vicky; Ranjith, Gopinath; Hodgkiss, Andrew


    To explore the experience of senior staff on acute medical wards using an established inpatient liaison psychiatry service and obtain their views on clinically relevant performance measures. Semistructured face-to-face interviews with consultants and senior nurses were taped, transcribed and analyzed manually using the framework method of analysis. Twenty-five referrers were interviewed. Four key themes were identified - benefits of the liaison service, potential areas of improvement, indices of service performance such as speed and quality of response and expanded substance misuse service. Respondents felt the liaison service benefited patients, staff and service delivery in the general hospital. Medical consultants wanted stepped management plans devised by consultant liaison psychiatrists. Senior nurses, who perceived themselves as frontline crisis managers, valued on-the-spot input on patient management. Consultants and senior nurses differed in their expectations of liaison psychiatry. Referrers valued speed of response and regarded time from referral to definitive management plan as a key performance indicator for benchmarking services. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Utilization of a consultation liaison psychiatry service in a general hospital. (United States)

    Gobar, A H; Collins, J L; Mathura, C B


    This retrospective study was conducted in response to a need to evaluate the overall utilization rates of the psychiatric consultation liaison service by nonpsychiatric units within Howard University Hospital, which deals almost exclusively with a black, inner-city population. The study covers a three-year period (July 1982 to July 1985). During this time only 815 patients (2 percent) were referred for psychiatric evaluation out of the total number of hospital admissions (40,000 patients).Patient characteristics and general attitudes appear to have had a major role in this low ratio of referrals, particularly a lack of awareness and bias against psychiatry. This latter finding is in disparity with other published reports. Diagnostically, depression, organic mental disorders (acute), and substance abuse (mainly PCP) constituted the greater bulk of the patients seen by the consultation liaison psychiatry service. The review of a random sample of psychiatric inpatients (n = 100) revealed that in 50 percent of the cases there was a coexisting physical illness or abnormality.The role of mental health education and the liaison function needs to be emphasized. It is suggested that efforts should be directed toward a wider acceptance and utilization of consultation liaison psychiatry by primary care physicians in general hospitals. The factors listed by physicians and patients that may account for the observed underutilization of consultation liaison services are discussed. The results of 20 interviews and the reasons given by referring physicians as to whether or not they will seek consultation from the consultation liaison services are also reviewed.

  18. A proposal of basic guidelines for training in psychosomatic and liaison psychiatry in Spanish psychiatry training programs

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    Ignacio Gómez-Reino


    Full Text Available Background and Objectives: The Psychosomatic and Liaison Psychiatry is an emerging psychiatric subspecialty. This article is intended to summarize the philosophy supporting training programmes in Spain, and the recommended training guidelines. Methods: Review of the literature and teaching experience. Results: The increasing complexity of diagnosis and treatment, and the demand by patients and providers of resources for higher and more efficient quality of care, make skills training a key tool for achieving these goals. The human being is biology, feelings, thoughts, experiences and thus individuality when sick. Understanding all this is the core on which to base our competencies in this exciting crossroads between psychiatry and other medical specialties. We propose a set of competencies to achieve, and point learning spaces and evaluation mechanisms. Conclusions: Based on accumulated experiences in Spain, and the review of European and international literature, it is possible to summarize a realistic set of norms and directions for training in Psychosomatic and Liaison Psychiatry in residency programmes.

  19. Liaison Old Age Psychiatry Service in a Medical Setting: Description of the Newcastle Clinical Service

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    E. B. Mukaetova-Ladinska


    Full Text Available Liaison Old Age Psychiatry services (LOAP have begun to emerge in the UK and further development of the service is supported by the latest health policies. Since qualitative and quantitative studies in this area are lacking, we have undertaken a detailed quantitative prospective review of referrals to the Newcastle LOAP to evaluate the clinical activity of the service. We report high referral rates and turnover for the LOAP service. Reasons for referral are diverse, ranging from requests for level of care and capacity assessments and transfer to other clinical services to management of behaviour, diagnosis, and treatment. We outline the value of a multidisciplinary model of LOAP activity, including the important role of the liaison nursing team, in providing a rapid response, screening, and followup of high number of clinical referrals to the service.

  20. [Psychiatry and psychology integrated in somatics is a profit for the clinic. Consultation liaison psychiatry important for the future of healthcare]. (United States)

    Wahlström, Lars; Blomdahl-Wetterholm, Margareta


    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.

  1. Consultation-liaison psychiatry in China%中国会诊联络精神医学现状

    Institute of Scientific and Technical Information of China (English)

    季建林; 叶尘宇


    Consultation-liaison psychiatry (CLP) was first established in China after liberation in 1949. It has developed more rapidly over the last two decades but, despite major regional differences in the level of CLP, the overall practice of CLP in the country remains quite basic, largely limited to case-based consultation with other medical departments. There is little ongoing collaboration between departments of psychiatry and other departments, and medical students and non-psychiatric clinicians rarely get training in CLP.

  2. The Rhythmic Group, Liaison, Nouns and Verbs of French (United States)

    Ashby, William J.


    The "rhythmic group" in French (noun group or verb group) is described with examples. The aim is to find some relation between the morphophonological phenomena such as "liaison" occurring within such rhythmic groups and the syntactic structure of French. Available from Liber Laeromedel, Box 1205, S-22105 Lund, Sweden. (TL)

  3. The Rhythmic Group, Liaison, Nouns and Verbs of French (United States)

    Ashby, William J.


    The "rhythmic group" in French (noun group or verb group) is described with examples. The aim is to find some relation between the morphophonological phenomena such as "liaison" occurring within such rhythmic groups and the syntactic structure of French. Available from Liber Laeromedel, Box 1205, S-22105 Lund, Sweden. (TL)

  4. Assessment of a consultation-liaison psychiatry and psychology health care program

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    Paola BA Andreoli


    Full Text Available OBJECTIVE: To investigate the relevance of subjective criteria adopted by a psychiatry and psychology consultation-liaison service, and their suitability in the evaluation of case registries and objective results. METHODS: Semi-structured interviews were conducted and all supervisors of the university hospital service were interviewed. Routinely collected case registries were also reviewed. Standardized assessment with content analysis for each category was carried out. RESULTS: The results showed distortions in the adopted service focus (doctor-patient relationship and consultant requests. This focus is more on consulting physician-oriented interventions than on patients. DISCUSSION: Evaluation of the relevance of service criteria could help promoting quality assessment of the services provided, mainly when objective criteria have not yet been established to assure their suitability.

  5. The Theory and Practice of Consultation-Liaison (CL Psychiatry in Trinidad and Tobago with Reference to Suicidal Behavior

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    Hari D. Maharajh


    Full Text Available Consultation-Liaison Psychiatry (CL Psychiatry is not a well-established discipline in developing countries. It is a multifaceted area that incorporates clinical, teaching, and research activities both within the hospital and extramurally in community health services. Our purpose was first to define the role of CL Psychiatry, to review essential steps in the process, and to advise on how to set up services. Second, a 1-year retrospective analysis was conducted on all patients referred. A total of 708 persons were referred for psychiatric consultation, of which 41% (291 were referred because of suicidal behavior. Sixty-six percent were female and there was an over-representation of Indo-Trinidadians (67%. Twenty-six percent of all cases of suicidal behavior were diagnosed with clinical depression, 3% were suffering from a psychotic illness (schizophrenia, and 8% (24/291 were under the influence of alcohol. The most vulnerable group was the 25- to 35-year-old age group, accounting for 27% (78/291 of attempters, with the largest number of female attempters. The 36- to 55-year-old males were most likely to attempt suicide (35/99. Ingestion of a toxic substance was the most popular method among all races, genders, and age groups. Of all referrals, 95% originated from medical wards. The most common reason cited for attempts was depressed mood, secondary to a domestic dispute with a family member or significant other. Among Caribbean countries, Trinidad and Tobago has high rates of suicide and suicidal behavior, depression, and alcoholism. CL psychiatrists have a major role to play in the delivery of services to these groups, facilitating the transition of care from admission in the emergency room to discharge and follow-up in the community.

  6. [Liaison psychiatry at a neonatal intensive care unit. Interphase between psychiatry of the infant and neonatology]. (United States)

    Maldonado-Durán, J M; González-Cabello, H; Cárdenas-Zetina, J A; Sauceda-García, J M; Jasso-Gutiérrez, L


    A description is made of the situation of neonates and their families during hospitalization in the Neonatal Intensive Care Unit (NICU). Emphasis is made on the stressful situations faced by the infants, the families and the caregivers as well as on potential interventions to ameliorate their negative impact and to promote a favorable outcome. With the infants, the situation is one of overwhelming aversive stimulation, noncontingent responses and painful procedures, coupled with deprivation of normative experiences, propiciated by their illness and the structure of the unit. With the families, their feelings of impotence, guilt, and separation from their infant are highlighted, and interventions are described that may help them in this situation of crisis. With the staff the intervention consists on education and sensitization to the infant's needs. The liaison psychiatrist is the infant's voices with the families and the staff. The literature is reviewed in terms of the potential effects of favorable stimulation and of the negative experiences of neonates while at the NICU.

  7. Mental Capacity Assessments Among Inpatients Referred to the Consultation-Liaison Psychiatry Unit at a University Hospital in Bangkok, Thailand. (United States)

    Pariwatcharakul, Pornjira; Singhakant, Supachoke


    Clinicians routinely assess patients' mental capacity on a daily basis, but a more thorough assessment may be needed in complex cases. We aimed to identify the characteristics of inpatients in a general hospital, who were referred to a liaison psychiatry service for mental capacity assessment, reasons for the referrals, and the factors associated with their mental capacity. A 6-year retrospective study (2008-2013) was conducted using data collected routinely (e.g., age, gender, diagnosis, Thai Mental State Examination score, reasons for the referral, and the outcome of capacity assessment) on referrals for mental capacity assessment to a Consultation-liaison Psychiatry Unit at a university hospital in Thailand. Among 6194 consecutive referrals to the liaison-psychiatry services, only 0.6 % [n = 37, mean age (SD), 59.83 (20.42)] were referred for capacity assessment, 43.24 % of which lacked mental capacity. The most common requests from referring physicians were for assessment of testamentary capacity (15 assessed, 53.33 % lacking capacity), financial management capacity (14 assessed, 50 % lacking capacity), and capacity to consent to treatment (9 assessed, 22.22 % lacking capacity). Delirium, rather than dementia or other mental disorders, was associated with mental incapacity (p < 0.001) and being more dependent during the admission (p = 0.048). There were no significant differences for mean age (p = 0.257) or Thai Mental State Examination score (p = 0.206). The main request from referring clinicians was to assess testamentary capacity. Delirium and being more dependent during the admission were associated with lack of mental capacity, whereas age and dementia were not.

  8. [New perspective in liaison psychiatry. Experience at the Pediatric Hospital of the National Medical Center Siglo XXI]. (United States)

    Sauceda García, J M; Maldonado Durán, J M; Angel Montoya Cabrera, M


    In hospitalized and chronically ill children, the prevalence of psychopathology is very high. It is necessary that in its prevention, diagnosis and treatment not only professionals of the mental health disciplines intervene but also that the pediatricians, nurses and the family of the patient himself participate actively. Consultation Liaison Child Psychiatry activities at the Pediatric Hospital of the National Medical Center "Siglo XXI" are described. Its goal is to incorporate the mental health professional to the team of hospital care and promote that pediatricians gain a greater conscience of psychological and social factors that are crucial for the sick child.

  9. My favorite tips for engaging the difficult patient on consultation-liaison psychiatry services. (United States)

    Knesper, David J


    Disengagement is the main enemy for the consultation-liaison psychiatrist. The goal of the first interview is to transform the unwilling, uncooperative, and often difficult and hostile patient into an engaged interview participant. Otherwise, the interview is an unproductive interrogation and an unpleasant power struggle. Once the difficult patient is engaged, the more typical psychiatric interview can begin. The three interview-engagement tips or techniques described are among the author's favorite ways to overcome the impediments to engagement most often associated with difficult patients.

  10. Developing effective educational approaches for Liaison Old Age Psychiatry teams: a literature review of the learning needs of hospital staff in relation to managing the confused older patient. (United States)

    Teodorczuk, Andrew; Welfare, Mark; Corbett, Sally; Mukaetova-Ladinska, Elizabeta


    Deficiencies in the knowledge, skills and attitudes of all healthcare professionals working within the general hospital contribute towards the suboptimal care of older hospitalized patients with confusion. In the U.K., policy dictates that Liaison Old Age Psychiatry teams deliver effective education to general hospital clinical staff. The purpose of this paper is to review the literature concerning the learning needs of healthcare professionals in relation to managing confusion in the older patient in order to inform effective educational approaches for Liaison Old Age Psychiatry teams. A broad range of medical and educational databases were searched. Identified English language studies were selected for further analysis if they had a specific educational focus in the hospital setting and then further subdivided into intervention and naturalistic studies. The impact of intervention studies was evaluated by Kirkpatrick's system. Learning needs, as determined from the naturalistic studies, were mapped to identify themes. 13 intervention studies were identified. Despite a high level of effectiveness for educational interventions, it was unclear what the active components were. A further 23 naturalistic studies were identified; their findings focused on knowledge gaps, diagnostic behaviors and experiences, attitudes and training issues. Few studies specifically researched learning needs or the educational role of liaison teams. Conspicuous by its absence was reference to relevant educational theories. The findings of this review can be incorporated in the planning of local curricula by Liaison Teams in order to design educational strategies. There is a need for further research, especially studies exploring the learning needs of all healthcare professionals.

  11. Library collection of the psychosocial publications in consultation-liaison psychiatry. (United States)

    McCartney, C F; Evans, D L; Richardson, W


    Psychiatric oncology is a relatively new area, and few comprehensive reviews of related subject matter are available. Thus, the psychiatrists at North Carolina Memorial Hospital who provide liaison to oncology saw the need for a collection of pertinent psychiatric oncology materials that could be studied by faculty, residents, and staff. Such materials would be valuable for patient consultation, lecture preparation, and research background. Their bibliography and library system are discussed here, with a description of the methods of its compilation. The unique features are referenced materials are filed in a centrally available location (departmental library), so that readers have immediate access to them, and bibliographic entries are stored in a small computer in the library, and can be retrieved by topic, title, author. The file currently holds over 340 articles, and is continuously updated. It has been extensively utilized by professionals in this tertiary care teaching hospital as well as in programs across the state.

  12. Clinical characteristics of delirium Patients referred to consultation-liaison Psychiatry in general hosPi-tals%综合医院精神科会诊患者谵妄的临床特点

    Institute of Scientific and Technical Information of China (English)

    郑学宝; 王洪飞; 李金亮; 罗忠; 张开宇


    Objective:To explore the clinical characteristics of delirium patients referred to consultation-liaison psychiatry in general hospitals,as well as those in psychiatric hospitals. Method:The clinical data of 28 delirium patients referred to consultation-liaison psychiatry in general hospitals(consulation-liaison group) and 24 delirium patients in psychiatric hospitals(non-consulation-liaison group)admitted were included for a contrast analysis. They were all evaluated by the Chinese revision of confusion assessment method(CAM-CR). Results:Delirium patients in the consultation-liaison group were with elder age and complex etiology. Medi-cine diseases they suffering from were mainly in respiratory tract infections,brain stroke and cardiovascular dis-eases,while the surgical diseases were mainly in cerebral trauma,post-operation and fractures. Among them, multi-system diseases had the highest probability of causing delirium. The psychomotor retardation score in CAM-CR was significantly higher than the non-consultation-liaison group. However,delirium patients in non-consulation-liaison group were with younger age and simple etiology. Their diseases were mainly caused by with-drawing from psychoactive substances,senile dementia and improper application of antipsychotics. The total score,change in the level of consciousness,perceptual disturbance and psychomotor excitation scores in CAM-CR were all significantly higher than the consultation-liaison group. Conclusion:Elder age,complex etiology and symptoms,high misdiagnosis rate and poor prognosis are among the main features in delirium patients in general hospitals,the consultation liaison needs to be strengthened.%目的:探讨综合性医院精神科会诊中的谵妄与精神病专科医院中的谵妄的临床特点。方法:对综合性医院中精神科会诊中的28例谵妄患者(会诊组)与同期在精神病院的24例患者(非会诊组)的临床资料进行对照分析,并使用谵妄

  13. Intentional self-harm in children and adolescents: A study from psychiatry consultation liaison services of a tertiary care hospital

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    Sandeep Grover


    Full Text Available Objective: The objective of this study was to evaluate the socio-demographic and the clinical profile of children and adolescents presenting with Intentional self-harm. Materials and Methods: Records of all children and adolescents (≤19 years seen by the consultation liaison (CL services during the period of 2000-2012 were screened. Patients with a diagnosis of intentional self-harm (at the time of assessment were taken up for this study. Data was extracted from the records, to study the socio-demographic and clinical profile. Results: During the study period, 101 patients aged ≤19 years and diagnosed with intentional self-harm at the time of admission were evaluated by the psychiatry CL services in various emergency and medical surgical wards. In the study population, females (N = 61; 60.4% outnumbered males. The age of the patients ranged from 12 to 19 with a median and mean of 17.0 years (standard deviation-1.6 years; interquartile range 16-18 years. Children and adolescent with self harm were more commonly females, from nuclear families, middle socio-economic status and Hindu by religion. The common method of self-harm in adolescents is by ingestion of insecticides (65% and the self-harm behavior was often precipitated by interpersonal problems in the family context. About one-fifth of the patients have psychiatric morbidity. Conclusion: Findings suggest that the most common method of intentional self-harm in children and adolescents is consumption of insecticides and precipitated by interpersonal problems in the family context.

  14. Evolutionary psychiatry: a new College special interest group. (United States)

    Abed, Riadh; St John-Smith, Paul


    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.

  15. Evolutionary psychiatry: a new College special interest group (United States)

    Abed, Riadh; St John-Smith, Paul


    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.

  16. [Feasibility of consultation - liaison psychiatry in a large general hospital: quantitative description of services and personnel expenditure]. (United States)

    Windhager, Elmar; Thaler, Katharina; Selberis-Vahl, Wilia Vasiliki; Friedl-Wörgetter, Petra; Windhager, Isabella; Zauner, Katharina


    The integration of psychiatric departments in general hospitals lead to an increasing demand of psychiatric consultation, which often overstrains personnel resources of short staffed psychiatric services. To provide consulting service, as it is demanded by guidelines, a multidisciplinary consulting team could be a possible solution. A retrospective descriptive analysis of all consultations made by the psychosocial consultation and liaison service at the general hospital Wels-Grieskirchen in the years 2012 and 2013. There was an increase in referrals overall of 22 % from 2012 to 2013. The largest increase was observed in the group of psychiatrists, who carried out 33.1 % of all consultations. Most consultations, 39.5 %, were done by the group of clinical psychologists, partly substituting medical attendance. Taking together both occupational groups, the expected number of consultations of at least 3 % of all admissions could be achieved. A multidisciplinary consulting team consisting of psychiatrists, psychologists, psychosomatic physicians and social workers staffed with 5.11-6.79 full-time personnel is able to provide psychosocial consultation service at a quantitative level required by international guidelines.

  17. Sociodemographic profile, clinical factors, and mode of attempt in suicide attempters in consultation liaison psychiatry in a tertiary care center

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    Santosh Ramdurg


    Full Text Available Background: The objective was to study the sociodemographic data, psychiatric disorder, precipitating events, and mode of attempt in suicide attempted patients referred to consultation liaison psychiatric services. Settings and Design: A prospective study of 6-month duration was done in a tertiary care center in India. Materials and Methods: During the 6-month period all referrals were screened for the presence of suicide attempters in consultation liaison services. Those who fulfilled the criteria for suicide attempters were evaluated by using semistructured pro forma containing sociodemographic data, precipitating events, mode of attempt, and psychiatric diagnosis by using ICD-10. Results: The male-to-female ratio was similar. Adult age, urban background, employed, matriculation educated were more represented in this study. More than 80% of all attempters had psychiatric disorder. Majority had a precipitating event prior to suicide attempt. The most common method of attempt was by use of corrosive. Conclusions: Majority of suicide attempter patients had mental illness. Early identification and treatment of these disorders would have prevented morbidity and mortality associated with this. There is a need of proper education of relatives about keeping corrosive and other poisonous material away from patients as it was being commonest mode of attempt.

  18. Dangerous Liaisons? Psychiatry and Law in the Court of Protection—Expert Discourses of ‘Insight’ (and ‘Compliance’) (United States)


    A finding that ‘P’ (as the person who is subject to Court of Protection proceedings is known) lacks mental capacity is the trigger for exposing them to decision-making by others and the powers of the Court of Protection (CoP) which, in the words of Justice Hedley, can be ‘invasive and draconian’ (Hedley J in PC v City of York Council cited in [2013] EWCA Civ 478 [13]). Whilst the law asserts the upper hand in the assessment of mental capacity for persons who come before the CoP, it is the discipline of psychiatry, which dominates expert witness testimony in these proceedings. There are a number of implications of allowing psychiatry to dominate this terrain, not least that, as will be argued in this article, clinical discourse, which makes reference to non-statutory terminology such as ‘lack of insight’ and ‘non-compliance’ are imported into the business of capacity assessment. This terminology, if used lazily and without clear reference to the statutory criteria, has the potential to muddy the waters of assessing P’s capacity. At its worst, it can mask value judgements, which threaten to undermine the law’s ‘autonomy promoting’ provisions set out in the Mental Capacity Act 2005. Whilst it is not intended to discredit ‘insight’ as a concept in psychiatry, this article concludes that it has a proper context and that in the mental capacity context, decision-makers, lawyers, and advocates should exercise careful scrutiny of its use, and CoP judgments should carefully interrogate the language imported by expert witnesses. PMID:28007808

  19. Clinical and demographic profile of cancer patients in a consultation-liaison psychiatric service

    Directory of Open Access Journals (Sweden)

    Vanessa de Albuquerque Citero

    Full Text Available ABSTRACT CONTEXT: An almost 50% prevalence of psychiatric disorders among cancer patients has prompted a series of studies on consultation-liaison psychiatry. Nonetheless, there are few reports on the epidemiological factors involving comorbidity between cancer and psychiatric disorders. OBJECTIVE: To evaluate the epidemiological profile of cancer inpatients referred to the consultation-liaison psychiatric service in an oncology hospital during its first year of activity. TYPE OF STUDY: Descriptive study. SETTING: Tertiary-care teaching hospital. PARTICIPANTS: 319 patients referred 412 times to the consultation-liaison psychiatry service. PROCEDURES: From August 97 to July 98, an appraisal was made of data on all admissions registered at the Hospital do Câncer, and also all referrals registered at the consultation-liaison psychiatry service. MAIN MEASUREMENTS: The demographics and patients' clinical data, the type and flow of the request, and the evaluation conducted by the service were analyzed and comparisons with the hospital data were made. The distribution of the number of referrals was used to construct a profile of patients who had repeatedly used the service. RESULTS: Psychiatric diagnoses were found in 59% of the cases. Forty-three percent of these required medication, 18.3% needed psychotherapy, 22.1% family intervention and 20.5% guidance from the staff. Over 22.8% of the consultations were reevaluations, mainly involving younger male patients with worst prognoses. These patients required lengthier and more elaborate intervention, and had higher prevalence of depressive and behavioral disorders. CONCLUSION: A younger and mainly male population of non-surgical oncological cases was referred to the consultation-liaison psychiatric service during its first year of activity. The psychiatric disorder prevalence was higher than expected, and consisted predominantly of mood disorders. We detected a priority group, namely the reevaluated

  20. [Significance of expert-guided groups for relatives in psychiatry]. (United States)

    Plessen, U; Postzich, M; Wilkmann, M


    Psychiatric interest in relatives of patients was concentrated in the past on their pathogenetic and etiological influence on mental illness. The medical paradigma of mental illness did not account for relatives affliction in psychic disturbance of their family member. Against this a community care oriented approach involves relatives into psychiatric care, particularly under the aspects of coping strategies and rehabilitative sources. Practicability and effects of this approach were explored in expert-guided relative groups at the Psychiatric Hospital Gütersloh (FRG). Results indicated that relatives are concerned with a series of problems. Participating in relative groups facilitates coping with these problems. Expert-guided and relative centered groups were found helpful, discharging and encouraging for relatives.

  1. Holistic-medical foundations of American psychiatry: a bicentennial. (United States)

    Lipowski, Z J


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

  2. [Sociolinguistics and liaison psychiatry: a particular aspect]. (United States)

    Singy, P; Bourquin, C; Sulstarova, B; Weber, O


    Verbal language is a major tool of medical communication. However, its use can be problematic, namely because the speakers of a given language do not necessarily agree on the meaning of the words they exchange. This phenomenon is usually called linguistic variability. Based on a famous political and legal case and medical examples, we will show how variability is a critical source of misunderstandings and other communicational breakdowns. In addition, we will suggest some strategies which are likely to limit the impact of variability on clinician/patient interaction.

  3. History background of the unity of the “pampeanas” agricultural groups. The formation of the Liaison Committee and the dispute over the rent (1970-1973

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    Gonzalo Sebastián Sanz Cerbino


    Full Text Available This paper seeks to contribute to the understanding of the political intervention of the agrarian “pampeana” bourgeoisie, taking as observable the actions and the rural groups positions at a time of political crisis. Studies on the topic have tended to overestimate the differences between small producers ("landholders" and large ("oligarchs", which has overshadowed the study of the moments of confluence, which have at least 40 years of history in the Argentina. After discussing the dominant approach in the literature, we will address the creation, in 1970, of the Liaison Committee, where converged Agrarian Federation, CONINAGRO, Argentine Rural Confederations and Rural Society. Drawing on national newspapers and corporate institutional documents, we rebuild the agreements around this alliance was structured and her specific intervention

  4. The Hannover Consultation Liaison model: some empirical findings. (United States)

    Freyberger, H; Künsebeck, H W; Lempa, W; Avenarius, H J; Liedtke, R; Plassman, R; Nordmeyer, J


    Starting from the definitions concerning the concepts 'Liaison medicine' and 'Consultative Psychiatry' we begin with remarks with regard to the Consultation Liaison-Situation in West Germany on the basis of the key-words 'Brief history', 'Independent university units with regard to Psychotherapy and Psychosomatics as well as the connected organization' and 'Teaching procedures'. Following it the Hannover Consultation Liaison model is presented particularly with regard to both the psychosomatic inpatient ward including the functional organization and psychotherapeutic processes as well as the so-called 'Innere Ambulanz' which includes the consultation liaison services in the clinico-medical departments outside Psychiatry and Psychosomatics. Within the 'Innere Ambulanz', which is closely connected to our psychosomatic inpatient ward, the consultation liaison activities and the resulting supportive psychotherapeutic strategies are performed by student auxiliary therapists who are interested in completing their 4-5 months internship-time in our department. We describe both the three supportive psychotherapeutic steps, which may last months to years including subsequent dynamically psychotherapeutic strategies as well as the reactions of the auxiliary therapist function on the students. Furthermore, we may state that there exists no one more optional education procedure of graduate students than the student's confrontation with his partial self-responsibility vis-à-vis a patient who is being supportive-psychotherapeutically treated by him. Specific empirical proofs concerning our patient oriented consultation liaison activities are demonstrated on the basis of previous psychotherapeutic findings in Crohn patients. Here we are able to demonstrate the effectivity of psychotherapy in the case of the supplementarily psychotherapeutically treated patients in comparison to the patients who received medical therapy only. Finally we are able to present quantitative clinico

  5. Are the Cochrane group registers comprehensive? A case study of Japanese psychiatry trials

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    McGuire Hugh


    Full Text Available Abstract Background Language bias is a form of publication bias and constitutes a serious threat to meta-analyses. The Cochrane Controlled Trials Register is one attempt to remedy this and now contains more than 300,000 citations. However we are still unsure if it provides comprehensive coverage, particularly for non-English trials. Methods We have recently established a comprehensive register of Japanese trials of psychotropic drugs through extensive personal contacts, electronic searches and handsearches. We examined two Cochrane psychiatry group registers against this Japanese database. Results The Japanese register contained 56 reports of randomized controlled trials (RCTs of antidepressants for depression but the Cochrane Depression, Anxiety and Neurosis group register contained 18, with an overlap of only nine. The Japanese register contained 61 reports of RCTs of neuroleptics for schizophrenia and the Cochrane Schizophrenia group register contained 36, with an overlap of only six. Taking account of some duplicate publications, only a quarter to a third of all relevant Japanese RCTs were retrievable from the Cochrane group registers. Conclusions Similar, or worse, yields may be expected with RCTs conducted in other East Asian countries, and in other fields of medicine. What evidence there is suggests that this situation may lead to a systematic over estimate of treatment effect.

  6. The future of community psychiatry. (United States)

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


    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.

  7. [Intercommunication psychiatry in a burn center]. (United States)

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


    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.

  8. Departments applying for consultation-liaison psychiatry and distribution of diagnosed different psychiatric diseases in general hospitals: Analysis of 154 cases%综合医院内联络精神病学会诊科室及病种分布特征:154例分析

    Institute of Scientific and Technical Information of China (English)

    林志雄; 邹晓波; 林举达; 陆兰; 律东


    背景:在综合医院临床专科存在着越来越多的精神心理问题,需要在医院内进行联络会诊.目的:在综合医院中,通过开展精神心理的联络会诊,加强非精神科临床医师对精神医学疾病的认识.设计:病例分析.单位:广东医学院附属医院心理科.对象:选择广东医学院附属医院2003-04/2004-04心理科会诊,不同性别、年龄与文化程度的住院患者154例.方法:统计会诊例数,对154例患者进行申请精神心理科会诊的科室分布和精神障碍病种的分布情况的调查.主要观察指标:①申请精神心理科会诊的科室分布.②精神障碍病种的分布情况. 结果:纳入患者154例,均进入结果分析,无脱落者.①申请精神心理科会诊的科室分布:申请会诊的科室中,内科占首位57例(37.0%),其次是急诊科26例(16.8%),传染科17例(11.0%)和神经内科13例(8.4%).②精神障碍病种的分布情况:会诊诊断最多见的是脑器质性神经症性障碍(31.1%)、精神障碍(25.3%)和躯体疾病所致的精神障碍(13.6%).结论:在综合医院临床各科均存在精神医学问题.在综合医院中,加强开展联络精神病学会诊是必要的.%BACKGROUND: More and more psychiatric problems require liaison consultation in specific clinical departments of general hospital.OBJECTIVE: To enhance the recognition of physicians in non-psychiatric departments on psychiatric illness by carrying on psychiatric liaison consultation in general hospital.DESIGN: Case analysis.SETTING: Department of Psychology in the affiliated hospital to Guangdong Medical College.PARTICIPANTS: Totally 154 inpatients for the consultation in Department of Psychology were selected in the Affiliated Hospital of Guangdong Medical College from April 2003 to April 2004, of either sex and different age and educational backgrounds.METHODS: It was to investigate the distributions of departments and diseases with consultation-liaison psychiatry (CLP) in

  9. The practice of standardized management of liaison nurses committed to coordinating stomatologic nursing groups%口腔专科护理小组联络护士规范化管理的实践

    Institute of Scientific and Technical Information of China (English)

    彭美娟; 梁宝卿; 黄静; 欧仲爱; 胡惠贤; 陈琳


    Objective To explore the effect of standardized management of liaison nurses who are committed to coordinating stomatologic nursing groups on their work quality. Methods In the self controlled study, we selected 56 liaison nurses who were committed to coordinating stomatological nursing groups as participants. We managed these nurses in the following standardized measures: we developed a liaison nurse workbook, formulated a tracking system to keep track of difficult-to-treat cases; also, we built up a communication platform for nurse specialists and provided assorted training programs. Results After the intervention, liaison nurse s work quality was significantly improved; among others, their clinical competency and their sense of job achievement as an liaison nurse were significantly higher than before the intervention; they applied for a consultation with a nursing specialist group more actively than before (P<0. 05, P<0. 01). Also, nursing specialist groups had higher appraisal on liaison nurses work(P<0. 01). The rate of successful consultation with oral nursing specialist groups amounted to 91. 30%. Conclusion The implementation of standardized management helps develop liaision nurses advantage, and improve their clinical competency as well as quality of work.%目的 探讨规范化管理对口腔专科护理小组联络护士工作质量的影响.方法 采取自身对照的方法,对56名口腔专科护理小组联络护士,采用设计联络护士工作手册、制定疑难护理个案跟踪管理制度、建立专科护理交流平台、开展形式多样专科护理培训等进行跟踪管理.结果 干预后联络护士的工作质量显著优于干预前,其中联络护士临床实践能力、主动请专科护理小组会诊、担任联络护士的工作成就感等显著优于干预前(P<0.05,P<0.01);干预后专科护理小组对联络护士工作评价显著提高(P<0.01),口腔专科护理小组护理会诊成功率达91.30%.结论 实

  10. [The Aachen liaison model (United States)

    Petzold, Ernst Richard; Flatten, Guido; Wälte, Dieter; Kröger, Friedebert


    The encounter between physician and patient is impregnated by contemporary theories of disease. From the point of view of psychotherapeutic medicine, the physician-patient-relationship fuses normative and relationship-oriented thinking. The disease as the object of treatment is being supplemented by the care for the patient as a subject. The participating observation and the respective reflection are professional tools of the medical carer. The realisation of this point of view in clinical practice is exemplified using the Aachen Psychosomatic model of Liaison. The importance of this model for interdisciplinary cooperation is being discussed.

  11. What Is Psychiatry?

    Medline Plus

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

  12. What Is Psychiatry?

    Medline Plus

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

  13. What Is Psychiatry?

    Medline Plus

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

  14. What Is Psychiatry?

    Medline Plus

    Full Text Available ... may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry Pain medicine ... American Association of Community Psychiatrists American Association for Geriatric Psychiatry Academy of Psychosomatic Medicine American Academy of ...

  15. [Gerontopsychiatric problems in a consultation-liaison practice]. (United States)

    Gazdag, Gábor; Sebestyén, Gábor


    The most effective way for the diagnosing and the treatment of psychopathological symptoms appearing in non-psychiatric hospitalized patients is the utilization of consultation-liaison psychiatry. With the increasing number of the elderly patients, number of appearing gerontopsychiatric problems in consultation work is also growing. We have studied among the patients of a consultation-liaison service the problems which led to the psychiatric consultations, the diagnoses which were set up, the concomitant somatic disorders and the treatment recommendations. We have retrospectively studied the data of the patients in the consultation-liaison service of St. László Hospital. 77% of the consultations were asked from internal medicine. Most frequent reason of the requests were the presence of any psychiatric symptom, but unexplained somatic complains were also common. Gerontopsychiatric problems were most frequently associated to cardiovascular disorders. Demencia and delirium were the most frequent diagnoses. The rate of affective disorders was higher than reported in the literature. Consultations were most frequently asked for non-compliance in patients with demencia, and for unexplained somatic complain in affective disorders. Most frequent reason of psychiatric referrals was symptoms of delirium. Authors try to explain these results in accordance with the literature.

  16. Teaching Medical Gerontology: Utilization of a Psychiatry Consultation Program. (United States)

    Hall, Georgia G.; Starkman, Monica N.


    A pilot project to explore the feasibility of using the clinical Adult Service Psychiatry Consultation-Liaison Program at the University of Michigan as the locus for teaching medical gerontology to psychiatric and medical/surgical residents and medical students is described. The goals, techniques, content, and implementation procedures are…

  17. Consultation liaison psychiatry in Africa – essential service or ...

    African Journals Online (AJOL)

    the patient (longer hospital stays, delayed return to work or disability), as well as ... In Africa, many health professionals view mental illness as synonymous with ... expansion of successful medical-psychiatric care environments. In Africa, CL ...

  18. Subject Liaisons in Academic Libraries: An Open Access Data Set from 2015 (United States)

    Nero, Neil; Langley, Anne


    The work of subject liaison librarians in academic libraries has morphed to include a variety of roles that reach beyond the traditional. This study captures responses of 1,808 participants from land-grant, Oberlin Group, and Association of Research Libraries (ARL) institutions to a questionnaire about subject liaison librarians. The questionnaire…

  19. Subject Liaisons in Academic Libraries: An Open Access Data Set from 2015 (United States)

    Nero, Neil; Langley, Anne


    The work of subject liaison librarians in academic libraries has morphed to include a variety of roles that reach beyond the traditional. This study captures responses of 1,808 participants from land-grant, Oberlin Group, and Association of Research Libraries (ARL) institutions to a questionnaire about subject liaison librarians. The questionnaire…

  20. What Is Psychiatry?

    Medline Plus

    Full Text Available ... of Community Psychiatrists American Association for Geriatric Psychiatry Academy of Psychosomatic Medicine American Academy of Addiction Psychiatry American Association for Emergency Psychiatry ...

  1. What Is Psychiatry?

    Medline Plus

    Full Text Available ... Because they are physicians, psychiatrists can order or perform a full range of medical laboratory and psychological ... training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry ...

  2. Effectiveness of a liaison program in meeting information needs of college of pharmacy faculty. (United States)

    Kramer, Sandra S; Martin, Jennifer R; Schlimgen, Joan B; Slack, Marion K; Martin, Jim


    This article describes the creation and implementation of focus groups to evaluate the effectiveness of a health sciences library's liaison program of the College of Pharmacy faculty and to better understand the faculty's information needs in order to design new and improved library services. The liaison services support the teaching and research needs of faculty and students through literature research, classroom teaching, and an extensive library collection of pharmacy literature. Focus group results demonstrated a high level of satisfaction with library liaison services and collections. Opportunities exist for expanded interaction with graduate students and greater marketing of library services to increase faculty awareness of specific library programs.

  3. Customizing for clients: developing a library liaison program from need to plan. (United States)

    Tennant, M R; Butson, L C; Rezeau, M E; Tucker, P J; Boyle, M E; Clayton, G


    Building on the experiences of librarian representatives to curriculum committees in the colleges of dentistry, medicine, and nursing, the Health Science Center Libraries (HSCL) Strategic Plan recommended the formation of a Library Liaison Work Group to create a formal Library Liaison Program to serve the six Health Science Center (HSC) colleges and several affiliated centers and institutes. The work group's charge was to define the purpose and scope of the program, identify models of best practice, and recommend activities for liaisons. The work group gathered background information, performed an environmental scan, and developed a philosophy statement, a program of liaison activities focusing on seven primary areas, and a forum for liaison communication. Hallmarks of the plan included intensive subject specialization (beyond collection development), extensive communication with users, and personal information services. Specialization was expected to promote competence, communication, confidence, comfort, and customization. Development of the program required close coordination with other strategic plan implementation teams, including teams for collection development, education, and marketing. This paper discusses the HSCL's planning process and the resulting Library Liaison Program. Although focusing on an academic health center, the planning process and liaison model may be applied to any library serving diverse, subject-specific user populations.

  4. New directions for academic liaison librarians

    CERN Document Server

    Crawford, Alice


    Aimed at practitioners and students of librarianship, this book is about interesting and unusual practical projects currently being run by academic liaison librarians. It shows how liaison librarians can extend their roles beyond the established one of information literacy teaching and showcases areas in which they can engage in collaborative ventures with academic and administrative staff. Designed to excite and inspire, New Directions for Academic Liaison Librarians demonstrates the potential of the liaison role and emphasises the need for flexibility, imagination and initiative in those who

  5. The "Marital" Liaisons of Gay Men. (United States)

    Harry, Joseph


    Reports research on the nature of enduring sexual liaisons among homosexual men. Such relationships vary widely and may be subinstitutional adaptions to lack of community support. Gay men committed to the heterosexual world were less likely to enter enduring relationships. Open marriage is the more enduring form of gay male liaisons. (Author)

  6. Predicting Liaison: an Example-Based Approach

    NARCIS (Netherlands)

    Greefhorst, A.P.M.; Bosch, A.P.J. van den


    Predicting liaison in French is a non-trivial problem to model. We compare a memory-based machine-learning algorithm with a rule-based baseline. The memory-based learner is trained to predict whether liaison occurs between two words on the basis of lexical, orthographic, morphosyntactic, and

  7. The "Marital" Liaisons of Gay Men. (United States)

    Harry, Joseph


    Reports research on the nature of enduring sexual liaisons among homosexual men. Such relationships vary widely and may be subinstitutional adaptions to lack of community support. Gay men committed to the heterosexual world were less likely to enter enduring relationships. Open marriage is the more enduring form of gay male liaisons. (Author)

  8. Factors Affecting the Choice of Psychiatry as a Specialty and Satisfaction among Turkish Psychiatry Residents. (United States)

    Ozer, Urun; Ceri, Veysi; Carpar, Elif; Sancak, Baris; Yildirim, Fatma


    This study aimed to investigate the factors affecting the choice of psychiatry among psychiatry residents, identify the fulfillment of expectations, and assess their satisfaction level. Anonymous questionnaires were administered to 98 psychiatry residents, and sociodemographic and professional data were collected. Among the reasons for choosing psychiatry, the opportunity to cultivate interest in humanities, importance of social and relational issues, and intellectual challenge were most frequently selected. The opportunity for complete use of medical training, salary, and opportunity to practice psychotherapy were the expectations least met. The largest group of participants was satisfied to have chosen psychiatry (41.5%), decided on psychiatry training after medical school (35.4%), and attached importance to becoming a clinician (70.7%). Although the satisfaction level was high in this study, addressing the areas in which expectations were not met may increase the satisfaction of psychiatry residents and the selection of psychiatry as a specialty.

  9. What Is Psychiatry?

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  10. What Is Psychiatry?

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  11. What Is Psychiatry?

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  12. State of psychiatry in Denmark

    DEFF Research Database (Denmark)

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


    of common mental disorders, in particular depression and anxiety. Furthermore, 'new' diagnostic groups are represented in the treatment statistics with steeply increasing incidences, e.g. attention deficit hyperactivity disorder (ADHD) and eating disorders, especially in the outpatient part...... 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...

  13. [Psychiatry and the Great War]. (United States)

    Fras, Ivan


    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.

  14. Confidentiality principles in psychiatry. (United States)

    Carasevici, B


    Confidentiality stands out in psychiatry through its multiple connotations as an intrinsic necessity in the ethics of professional relationships. Thus it represents an important characteristic of this profession and at the same time a stringent request which, through its specificity, implies a direct contact with persons in need for help. Despite being inserted in professional codes and legislative systems, confidentiality in psychiatry is far from being considered a clarified matter and does not stand aside from ethical controversy. Keeping the professional secret is often a hard task due to the pressure of the law or of other professional groups who can bring multiple justifications, including that of action for the benefit of society. The therapist is often sub- mitted to a tension caused on the one hand by the promise of keeping the professional secret and on the other hand by multiple requests of breaking the confidentiality. So the problem of confidentiality in Psychiatry deserves special attention because in this profession, more than in other branches of medicine, the gain of the patient's trust is essential in the psychotherapeutic relationship.

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

    Directory of Open Access Journals (Sweden)

    Singh Ajai


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

  16. LTACH liaison aids appropriate level of care. (United States)


    The long-term acute care liaison at Pennsylvania State University Milton S. Hershey Medical Center identifies patients eligible for a long-term acute care hospital (LTACH) stay and coordinates their transition. The LTACH liaison works with the case management and social work staffto identify patients early in the stay and give families information they can use to make an informed decision about a facility. The liaison follows up with the LTACH treatment team to ensure that they have all the information they need and feel comfortable about the treatment plan. As a result of the program, the hospital has increased the number of patients it transfers to LTACHs each month from about 18 to about 30.

  17. Psychosomatic medicine : A new psychiatric subspecialty in the US focused on the interface between psychiatry and medicine

    NARCIS (Netherlands)

    Lyketsos, Constantine G.; Huyse, Frits J.; Gitlin, David F.; Levenson, James L.


    Background and Objectives: In the past, Psychosomatic Medicine (PM) has had ambiguous connotations, and there have been many other names for this specialized fields, including Consultation-Liaison Psychiatry. The objective of this report is to briefly review the background, the history and current s


    NARCIS (Netherlands)

    Mooij, A.W.M.


    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

  19. Congressional Liaison Offices of Selected Federal Agencies (United States)


    Contacts Author Contact Information ...................................................................................................... 32...703) 604-6617 Fax: (703) 601-4469 E-mail: E-mail: LPA- web Senate Liaison: Lorna...301) 415-1776 Fax: (301) 415-8571 Occupational Safety and Health Review Commission Ray Darling Executive Secretary

  20. Ethics Training in Psychiatry

    Directory of Open Access Journals (Sweden)

    Sinan Guloksuz


    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.

  1. Conceptualising molecular psychiatry and translational psychiatry. (United States)

    Thome, Johannes


    The terms "molecular psychiatry" and "translational psychiatry" are frequently used key words of today's scientific community. However, the exact meaning of these terms remains surprisingly unclear. They also seem to be interpreted in different ways by different authors. Here, we first analyse how the terms have emerged historically and then try to indicate how meaningful and widely acceptable definitions could be achieved. Clearly, with the further development of these emerging psychiatric research areas, it will be necessary to regularly adjust these definitions accordingly.

  2. Preventive psychiatry: Current status in contemporary psychiatry

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar Chadda


    Full Text Available Preventive psychiatry is one of the most ignored subdiscipline of psychiatry, which has got important role to play in the contemporary psychiatry. Mental disorders are very common with lifetime prevalence of about 25%, and tend to be chronic. Due to the stigma associated with mental disorders, lack of awareness, and also lack of adequate mental health resources, nearly 60%–80% of the persons suffering from mental disorders do not access mental health care services. Mental and substance use disorders have been identified as one of the major contributors to the disease-related burden and disability-adjusted life years. In this background, preventive psychiatry has an important role to play in public health sector. Since etiology of most of the mental disorders is not known, it is not possible to follow here the standard model of primary, secondary, and tertiary prevention of public health. A concept of universal, selective, and indicated prevention has been proposed in primary prevention. Preventive approaches in psychiatry focus on evidence-based risk and protective factors, promoting quality of life, reducing stressors, and improving resilience. Such interventions, when planned targeting at specific mental disorders, have a potential to prevent mental disorders. Thus, preventive psychiatry has a crucial role to play in mental health, considering the high prevalence of mental disorders, the associated disability and burden, and a great drain on human resources.

  3. What Is Psychiatry?

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    Full Text Available ... mental disorders with psychotherapy and some specialize in psychological testing and evaluation. More Resources World Psychiatric Association American Association of Child and Adolescent Psychiatry American ...

  4. [(Community) psychiatry, a parenthesis?]. (United States)

    Bucheron, Bastien


    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.

  5. 'Being the bridge and the beacon': a qualitative study of the characteristics and functions of the liaison role in child and family health services in Australia. (United States)

    Olley, Hannah; Psaila, Kim; Fowler, Cathrine; Kruske, Sue; Homer, Caroline; Schmied, Virginia


    This article explores the characteristics and functions of the liaison role in child and family health services in Australia. Liaison roles are increasingly being used to improve communication between health services and professionals and to facilitate access to support for individuals and families in need. Nurses are commonly, although not always, the professionals who undertake these roles. Research on the role and outcomes of liaison positions in child and family health services is limited in Australia and internationally. A qualitative interpretive design informed this study. Interviews and focus groups were conducted with 40 liaison and other health professionals, primarily nurses, working with families with newborn and young children in two Australian States. Data were analysed thematically. Three major themes were identified reflecting the importance of defining the role and tasks which included building bridges between services and professionals, supporting families during transition between services and supporting clinicians. Several facilitators and barriers were identified, including concerns about sustainability of the roles. Professionals working in a liaison role in child and family health services emphasise that these positions have the potential to link services and professionals, thereby providing more effective care pathways for children and families especially for those with complex and multiple vulnerabilities. While a few children and family health services in Australia provide liaison services, the extent of liaison support and the outcomes for families in Australia is unknown. Nurses working with children and families are the most likely health professionals to undertake a liaison role. In many nursing contexts, liaison roles are relatively new and those in the role have the responsibility to define the key purpose of their role. Liaison roles are multifaceted requiring the nurse to have excellent communication and negotiation skills to

  6. The Effect of Liaison Nurse Service on Patient Outcomes after Discharging From ICU: a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Zeinab Tabanejad


    Full Text Available Introduction: Recent studies suggest that liaison nurse intervention might be effective to solve the gap between intensive care unit and wards, but little studies are known about the effect of this intervention. The aim of this study was to investigate the effect of liaison nurse service on patient outcomes after discharging from intensive care unit. Methods: In this single blinded randomized controlled trial, a total of 80 patients were selected by convenience sampling method from two teaching hospitals located in Tehran, Iran. Patients were randomly allocated to either the experimental or the control groups. Patients in the experimental group received post-ICU care from a liaison nurse and patients in the control group received the routine care. After the intervention, patients’ vital signs, level of consciousness, length of hospital stay, need for re-hospitalization in ICU, and satisfaction with care were measure. Data were analyzed by SPSS Ver.13 software. Results: None of the participants experienced ICU re-hospitalization. According to the result and there were no significant differences between the study groups regarding heart rate, respiratory rate, systolic blood pressure, post-ICU level of consciousness, satisfaction with care, and length of hospitalization in medical-surgical wards. However, the study groups differed significantly in terms of body temperature. Conclusion: Care services provided by an ICU liaison nurse has limited effects on patient outcomes. However, considering the contradictions among the studies, further studies are needed for providing clear evidence about the effectiveness of the liaison nurse strategy.

  7. The Effect of Liaison Nurse Service on Patient Outcomes after Discharging From ICU: a Randomized Controlled Trial (United States)

    Tabanejad, Zeinab; Pazokian, Marzieh; Ebadi, Abbas


    Introduction: Recent studies suggest that liaison nurse intervention might be effective to solve the gap between intensive care unit and wards, but little studies are known about the effect of this intervention. The aim of this study was to investigate the effect of liaison nurse service on patient outcomes after discharging from intensive care unit. Methods: In this single blinded randomized controlled trial, a total of 80 patients were selected by convenience sampling method from two teaching hospitals located in Tehran, Iran. Patients were randomly allocated to either the experimental or the control groups. Patients in the experimental group received post-ICU care from a liaison nurse and patients in the control group received the routine care. After the intervention, patients’ vital signs, level of consciousness, length of hospital stay, need for re-hospitalization in ICU, and satisfaction with care were measure. Data were analyzed by SPSS Ver.13 software. Results: None of the participants experienced ICU re-hospitalization. According to the result and there were no significant differences between the study groups regarding heart rate, respiratory rate, systolic blood pressure, post-ICU level of consciousness, satisfaction with care, and length of hospitalization in medical-surgical wards. However, the study groups differed significantly in terms of body temperature. Conclusion: Care services provided by an ICU liaison nurse has limited effects on patient outcomes. However, considering the contradictions among the studies, further studies are needed for providing clear evidence about the effectiveness of the liaison nurse strategy. PMID:27752487

  8. Foundations of Child Psychiatry. (United States)

    Miller, Emanuel, Ed.; And Others

    Twenty-eight papers examine basic theories and clinical methods in child psychiatry. Theories and methods discussed concern child psychiatry and the World Health Organization, pediatrics, child disturbances, observation, the psychodiagnostic approach, longitudinal research in child development, the comparative approach to early child development,…

  9. What Is Psychiatry?

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    Full Text Available ... Psychiatry Association of Gay and Lesbian Psychiatrists Mental Health Disorders A – Z Addiction and Substance Use Disorders ... APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Terms of Use Copyright Contact © 2017 American Psychiatric ...

  10. What Is Psychiatry?

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    Full Text Available ... APA Foundation APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents and ... Learning Center APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Terms of Use Copyright Contact © 2017 ...

  11. What Is Psychiatry?

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  12. Lobotomy in Norwegian psychiatry. (United States)

    Tranøy, Joar; Blomberg, Wenche


    Lobotomy is still a hidden chapter in the history of Norwegian psychiatry. The main reasons, which are discussed here, may have been the role of Ørnulv Ødegård at Gaustad Hospital in Oslo and the links between health authorities and the power élite in Norwegian psychiatry.

  13. What Is Psychiatry?

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  14. History of psychiatry (United States)

    Shorter, Edward


    Purpose of review The present review examines recent contributions to the evolving field of historical writing in psychiatry. Recent findings Interest in the history of psychiatry continues to grow, with an increasing emphasis on topics of current interest such as the history of psychopharmacology, electroconvulsive therapy, and the interplay between psychiatry and society. The scope of historical writing in psychiatry as of 2007 is as broad and varied as the discipline itself. Summary More than in other medical specialties such as cardiology or nephrology, treatment and diagnosis in psychiatry are affected by trends in the surrounding culture and society. Studying the history of the discipline provides insights into possible alternatives to the current crop of patent-protected remedies and trend-driven diagnoses. PMID:18852567

  15. Factors predicting adherence with psychiatric follow-up appointments for patients assessed by the liaison psychiatric team in the emergency department.

    LENUS (Irish Health Repository)

    Agyapong, Vincent I O


    Several factors may predict adherence with psychiatric follow-up appointment for patients seen in the emergency department (ED) by liaison psychiatric teams. Awareness of these factors would allow for interventions targeted at vulnerable groups.

  16. Psychiatry in Australia

    African Journals Online (AJOL)


    articles. 45. Volume 10 No. 2 July 2004 - SAJP. Robert M Kaplan, MB ChB, FRANZCP, MA. The Liaison ... World War II, psychoanalysis was brought to Australia by ... (PBS) in which prescribed drugs are subsidised to keep them to the cost of a ...

  17. The Family Liaison Position in High-Poverty, Urban Schools (United States)

    Dretzke, Beverly J.; Rickers, Susan R.


    This study examined the roles and responsibilities of family liaisons working in urban schools with enrollments characterized by high poverty, high mobility, and ethnic diversity. Results indicated that the major responsibilities of the liaisons were creating a trusting and welcoming environment, facilitating parent involvement in the school,…

  18. Historicizing Indian psychiatry. (United States)

    Basu, Amit Ranjan


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

  19. Evaluation of Police General Hospital's Fracture Liaison Service (PGH's FLS: The first study of a Fracture Liaison Service in Thailand

    Directory of Open Access Journals (Sweden)

    Tanawat Amphansap


    Conclusions: Patients with recent hip fractures participating in the Fracture Liaison service had a significantly higher post-injury BMD follow up and osteoporotic medication administration rates. This resulted in a lower risk of secondary fracture than those who did not participate in the Fracture Liaison service at a follow up time of one year.

  20. What Is Psychiatry?

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    Full Text Available ... Psychiatric medications can help correct imbalances in brain chemistry that are thought to be involved in some ... additional specialized training after their four years of general psychiatry training. They may become certified in: Child ...

  1. What Is Psychiatry?

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

  2. What Is Psychiatry?

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

  3. What Is Psychiatry?

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    Full Text Available ... mental disorders with psychotherapy and some specialize in psychological testing and evaluation. More Resources World Psychiatric Association American Association of Child and Adolescent Psychiatry American Association ...

  4. What Is Psychiatry?

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    Full Text Available ... OCD) Postpartum Depression Posttraumatic Stress Disorder (PTSD) More Climate Change and Mental Health Connections Patients & Families Patients & ... OCD) Postpartum Depression Posttraumatic Stress Disorder (PTSD) More Climate Change and Mental Health Connections What Is Psychiatry? ...

  5. What Is Psychiatry?

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    Full Text Available ... mental disorders with psychotherapy and some specialize in psychological testing and evaluation. More Resources World Psychiatric Association American Association of Child and Adolescent Psychiatry American Association ...

  6. What Is Psychiatry?

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

  7. What Is Psychiatry?

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

  8. What Is Psychiatry?

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    Full Text Available ... of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. A psychiatrist ... Coping After Disaster, Trauma Share Your Story Suicide Prevention Warning Signs of Mental Illness What is Psychiatry? ...

  9. What Is Psychiatry?

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    Full Text Available ... OCD) Postpartum Depression Posttraumatic Stress Disorder (PTSD) More Climate Change and Mental Health Connections Patients & Families Patients & Families ... OCD) Postpartum Depression Posttraumatic Stress Disorder (PTSD) More Climate Change and Mental Health Connections What Is Psychiatry? Back ...

  10. Genetics in psychiatry. (United States)

    Umesh, Shreekantiah; Nizamie, Shamshul Haque


    Today, psychiatrists are focusing on genetics aspects of various psychiatric disorders not only for a future classification of psychiatric disorders but also a notion that genetics would aid in the development of new medications to treat these disabling illnesses. This review therefore emphasizes on the basics of genetics in psychiatry as well as focuses on the emerging picture of genetics in psychiatry and their future implications.

  11. Psychiatry and music


    Nizamie, Shamsul Haque; Tikka, Sai Krishna


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

  12. Impact of duration of psychiatry rotation on medical interns’ attitude towards psychiatry

    Directory of Open Access Journals (Sweden)

    Srikanth Reddy


    Full Text Available Background: Medical Council of India allowed the interns to take up an extra 15 days of elective posting in psychiatry along with the mandatory posting of 15 days. The study was planned to assess the effect of the additional period of psychiatry internship on the attitude of interns towards psychiatry. Material and methods: The consenting interns were given a semi structured proforma enquiring about their age and gender and were asked to fill up Attitude Towards Psychiatry (ATP scale. The assessment was done at the beginning and then after 15 days of mandatory posting. Those participants who were willing to do an additional 15 days of elective posting in psychiatry were assessed again on the 30th day of the training. Results: Mean age of the participating interns (n=47 was 25.44±1.52 and the male female ratio was 0.8. Twenty six interns did only the 15 days mandatory psychiatry internship posting (Group 1 and the remaining 21 interns took up the additional elective 15 days posting (Group 2. At the end of the 15 days posting, Mean ATP score of the group 1 increased from 88.34±6.07 to 88.46±6.19 (p=0.80 whereas the same increased from 88.04±7.06 to 88.19±7.65 (p=0.7 in the group 2 and further increased to 91.09±8.3 at the end of the additional 15 days of elective posting (p<0.05. Conclusion: A thirty days exposure of psychiatry during internship had more favourable impact on the attitude of interns towards psychiatry.

  13. Using the Technique of Journal Writing to Learn Emergency Psychiatry (United States)

    Bhuvaneswar, Chaya; Stern, Theodore; Beresin, Eugene


    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…

  14. Using the Technique of Journal Writing to Learn Emergency Psychiatry (United States)

    Bhuvaneswar, Chaya; Stern, Theodore; Beresin, Eugene


    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…

  15. Making reasonable and achievable adjustments: the contributions of learning disability liaison nurses in 'Getting it right' for people with learning disabilities receiving general hospitals care. (United States)

    MacArthur, Juliet; Brown, Michael; McKechanie, Andrew; Mack, Siobhan; Hayes, Matthew; Fletcher, Joan


    To examine the role of learning disability liaison nurses in facilitating reasonable and achievable adjustments to support access to general hospital services for people with learning disabilities. Mixed methods study involving four health boards in Scotland with established Learning Disability Liaison Nurses (LDLN) Services. Quantitative data of all liaison nursing referrals over 18 months and qualitative data collected from stakeholders with experience of using the liaison services within the previous 3-6 months. Six liaison nurses collected quantitative data of 323 referrals and activity between September 2008-March 2010. Interviews and focus groups were held with 85 participants included adults with learning disabilities (n = 5), carers (n = 16), primary care (n = 39), general hospital (n = 19) and liaison nurses (n = 6). Facilitating reasonable and achievable adjustments was an important element of the LDLNs' role and focussed on access to information; adjustments to care; appropriate environment of care; ensuring equitable care; identifying patient need; meeting patient needs; and specialist tools/resources. Ensuring that reasonable adjustments are made in the general hospital setting promotes person-centred care and equal health outcomes for people with a learning disability. This view accords with 'Getting it right' charter produced by the UK Charity Mencap which argues that healthcare professionals need support, encouragement and guidance to make reasonable adjustments for this group. LDLNs have an important and increasing role to play in advising on and establishing adjustments that are both reasonable and achievable. © 2015 John Wiley & Sons Ltd.

  16. LiAISON: Linked, Autonomous Interplanetary Satellite Orbit Navigation Project (United States)

    National Aeronautics and Space Administration — A new navigation technique known as LiAISON (Linked Autonomous Interplanetary Satellite Orbit Navigation) may be used to propel the benefits of GPS to new orbits,...

  17. Teaching Psychology to Medical Students on a Consultation-Liaison Psychiatry Service. (United States)

    Gabinet, Laille; And Others


    Practical advice on teaching skills which are essential, but difficult for many medical students to master, is presented. Topics covered include interviewing skills, the mental status examination, the use of psychotropic medication in the general hospital, psychodiagnostic techniques, and dealing with ward management problems. (RM)

  18. Transcranial direct current stimulation and repetitive transcranial magnetic stimulation in consultation-liaison psychiatry

    Directory of Open Access Journals (Sweden)

    L.C.L. Valiengo


    Full Text Available Patients with clinical diseases often present psychiatric conditions whose pharmacological treatment is hampered due to hazardous interactions with the clinical treatment and/or disease. This is particularly relevant for major depressive disorder, the most common psychiatric disorder in the general hospital. In this context, nonpharmacological interventions could be useful therapies; and, among those, noninvasive brain stimulation (NIBS might be an interesting option. The main methods of NIBS are repetitive transcranial magnetic stimulation (rTMS, which was recently approved as a nonresearch treatment for some psychiatric conditions, and transcranial direct current stimulation (tDCS, a technique that is currently limited to research scenarios but has shown promising results. Therefore, our aim was to review the main medical conditions associated with high depression rates, the main obstacles for depression treatment, and whether these therapies could be a useful intervention for such conditions. We found that depression is an important and prevalent comorbidity in a variety of diseases such as epilepsy, stroke, Parkinson's disease, myocardial infarction, cancer, and in other conditions such as pregnancy and in patients without enteral access. We found that treatment of depression is often suboptimal within the above contexts and that rTMS and tDCS therapies have been insufficiently appraised. We discuss whether rTMS and tDCS could have a significant impact in treating depression that develops within a clinical context, considering its unique characteristics such as the absence of pharmacological interactions, the use of a nonenteral route, and as an augmentation therapy for antidepressants.

  19. Chronic anorexia nervosa: enteral nutrition via percutaneous endoscopic gastrostomy and liaison psychiatry. (United States)

    Malfi, G; Agnello, E; Da Pont, M C; Palmo, A; Zullo, G; Monero, A; Macario, P F; Sterpone, S; Munno, D


    Anorexia nervosa is a complex mental disorder characterized by altered eating behaviour often resulting in life-threatening weight loss (1 month) enteral feeding at home, a percutaneous endoscopic gastrostomy was performed and a home nutrition support regimen that met her energy-protein intake requirements was prescribed. During the follow-up period, an overall improvement in nutritional status, general condition, mood and cognitive functioning was observed. Patient compliance with refeeding is notoriously problematic; however, enteral feeding interventions may be feasible in the long-term treatment of selected anorexia nervosa patients when closely followed-up by a multidisciplinary medical team.

  20. Molecular psychiatry of zebrafish. (United States)

    Stewart, A M; Ullmann, J F P; Norton, W H J; Parker, M O; Brennan, C H; Gerlai, R; Kalueff, A V


    Due to their well-characterized neural development and high genetic homology to mammals, zebrafish (Danio rerio) have emerged as a powerful model organism in the field of biological psychiatry. Here, we discuss the molecular psychiatry of zebrafish, and its implications for translational neuroscience research and modeling central nervous system (CNS) disorders. In particular, we outline recent genetic and technological developments allowing for in vivo examinations, high-throughput screening and whole-brain analyses in larval and adult zebrafish. We also summarize the application of these molecular techniques to the understanding of neuropsychiatric disease, outlining the potential of zebrafish for modeling complex brain disorders, including attention-deficit/hyperactivity disorder (ADHD), aggression, post-traumatic stress and substance abuse. Critically evaluating the advantages and limitations of larval and adult fish tests, we suggest that zebrafish models become a rapidly emerging new field in modern molecular psychiatry research.

  1. Gender differences in career paths in psychiatry. (United States)

    Krener, P


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

  2. Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients.

    Directory of Open Access Journals (Sweden)

    Liesbeth Hempenius

    Full Text Available The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a postoperative delirium on long term outcomes was examined.A three month follow-up was performed in participants of the Liaison Intervention in Frail Elderly study, a multicentre, prospective, randomized, controlled trial. Patients were randomized to standard treatment or a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium and daily visits by a geriatric nurse during the hospital stay. The long term outcomes included: mortality, rehospitalisation, Activities of Daily Living (ADL functioning, return to the independent pre-operative living situation, use of supportive care, cognitive functioning and health related quality of life.Data of 260 patients (intervention n = 127, Control n = 133 were analysed. There were no differences between the intervention group and usual-care group for any of the outcomes three months after discharge. The presence of postoperative delirium was associated with: an increased risk of decline in ADL functioning (OR: 2.65, 95% CI: 1.02-6.88, an increased use of supportive assistance (OR: 2.45, 95% CI: 1.02-5.87 and a decreased chance to return to the independent preoperative living situation (OR: 0.18, 95% CI: 0.07-0.49.A hospital-based geriatric liaison intervention for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour did not improve outcomes 3 months after discharge from hospital. The negative effect of a postoperative delirium on late outcome was confirmed.Nederlands Trial Register, Trial ID NTR 823.

  3. Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients (United States)

    Hempenius, Liesbeth; Slaets, Joris P. J.; van Asselt, Dieneke; de Bock, Truuske H.; Wiggers, Theo; van Leeuwen, Barbara L.


    Background The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a postoperative delirium on long term outcomes was examined. Methods A three month follow-up was performed in participants of the Liaison Intervention in Frail Elderly study, a multicentre, prospective, randomized, controlled trial. Patients were randomized to standard treatment or a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium and daily visits by a geriatric nurse during the hospital stay. The long term outcomes included: mortality, rehospitalisation, Activities of Daily Living (ADL) functioning, return to the independent pre-operative living situation, use of supportive care, cognitive functioning and health related quality of life. Results Data of 260 patients (intervention n = 127, Control n = 133) were analysed. There were no differences between the intervention group and usual-care group for any of the outcomes three months after discharge. The presence of postoperative delirium was associated with: an increased risk of decline in ADL functioning (OR: 2.65, 95% CI: 1.02–6.88), an increased use of supportive assistance (OR: 2.45, 95% CI: 1.02–5.87) and a decreased chance to return to the independent preoperative living situation (OR: 0.18, 95% CI: 0.07–0.49). Conclusions A hospital-based geriatric liaison intervention for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour did not improve outcomes 3 months after discharge from hospital. The negative effect of a postoperative delirium on late outcome was confirmed. Trial Registration Nederlands Trial Register, Trial ID NTR 823

  4. SPECT in psychiatry. SPECT in der Psychiatrie

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


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

  5. Training in psychiatry throughout Europe

    NARCIS (Netherlands)

    Brittlebank, A.; Hermans, M.; Bhugra, D.; Costa, M.; Rojnic-Kuzman, M.; Fiorillo, A.; Kurimay, T.; Hanon, C.; Wasserman, D.; Gaag, R.J. van der


    Psychiatry is the largest medical specialty in Europe. Despite efforts to bring harmonisation, training in psychiatry in Europe continues to be very diverse. The Union Europeenne des Medecins Specialistes (UEMS) has issued as from 2000 a charter of requirements for the training in psychiatry with an

  6. [Shall psychiatry change its target? Reflections on the evolving role of psychiatry]. (United States)

    Pinna, Federica; Del Vecchio, Valeria; Luciano, Mario; Sampogna, Gaia; De Rosa, Corrado; Ferrari, Silvia; Pingani, Luca; Tarricone, Ilaria; Volpe, Umberto; Carrà, Giuseppe; Roncone, Rita; Catapano, Francesco; Fiorillo, Andrea


    In this paper we will describe cultural, social and scientific changes occurred in psychiatry in the last years, identifying the new target for mental health professionals. Groups of young psychiatrists from the Italian Psychiatric Association, the European Psychiatric Association and the World Psychiatric Association have established an international network that launched a debate on the future role of psychiatry. In a rapidly changing world, there is the need to: 1) adapt training in psychiatry to the modern world; 2) identify the new target of mental health professionals; 3) enhance the image of psychiatry in the society; 4) overcome stigma towards people with mental disorders. In recent years, socio-cultural and scientific changes have had a significant impact on the psychiatrists' clinical practice. Mental health professionals should deal with these changes appropriately in order to overcome the current "crisis" of psychiatry, which should be considered as a developmental phase rather than a conceptual one. From time to time psychiatry is criticized both from inside and outside the profession. The current crisis was unavoidable due to the recent socio-cultural changes, but it should be considered an opportunity to adapt the profession to modern times.

  7. Student career choice in psychiatry: findings from 18 UK medical schools. (United States)

    Halder, Neel; Hadjidemetriou, Christiana; Pearson, Rachel; Farooq, Kitty; Lydall, Gregory J; Malik, Amit; Bhugra, Dinesh


    Psychiatry recruitment continues to be a problem in the UK and large-scale studies are required to understand the factors surrounding this. A quantitative, cross-sectional online survey, incorporating demographics, career choices, teaching exposure, attitudes to psychiatry and personality factors, was administered to final-year UK medical students. A total of 484 students from 18 medical schools responded (66% women). Sixteen (16%) had chosen psychiatry at medical school entry. By final year, 15 respondents (3%) had decided to pursue a career in psychiatry, while another 78 (17%) were seriously considering it. There was little difference in the quality ratings of lectures and small group teaching between those interested in psychiatry and those not. Experience of 'enrichment activities' (psychiatry special study modules or components, psychiatric research, university psychiatry clubs, and psychiatry electives) were significantly more likely to take up psychiatry. Causality cannot, however, be determined in this study. The study identified several distinct groups of UK students: those deciding on psychiatry before medical school and maintaining that career choice, those deciding on psychiatry during medical school, and those interested in other fields. Addressing psychiatry teaching and exposure may improve recruitment into the speciality.

  8. Epistemology of psychiatry. (United States)

    Marková, Ivana S; Berrios, German E


    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.

  9. Racism and Psychiatry. (United States)

    Thomas, Alexander; Sillen, Samuel

    White racism has influenced theory and practice in psychiatry and allied fields. Psychiatrists have largely ignored the interactionist approach, as expounded by Sullivan and Rush, in analyzing Negroes within their respective societies. Rather, in the vein of Freudian preoccupation with unconscious motivation, abnormal behavior and what is…

  10. Artificial intelligence and psychiatry. (United States)

    Servan-Schreiber, D


    This paper provides a brief historical introduction to the new field of artificial intelligence and describes some applications to psychiatry. It focuses on two successful programs: a model of paranoid processes and an expert system for the pharmacological management of depressive disorders. Finally, it reviews evidence in favor of computerized psychotherapy and offers speculations on the future development of research in this area.

  11. What Is Psychiatry?

    Medline Plus

    Full Text Available ... Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents and Fellows Medical Students International ... an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are ...

  12. [Sophrology and psychiatry]. (United States)

    Diehr, Jan


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

  13. Psychiatrie en reclassering

    NARCIS (Netherlands)

    Goudsmit, Walter


    Het doel van dit onderzoek is geweest de bestudering van de bijdrage die de hedendaagse psychiatrie aan de reclassering van met de justitie in aanraking gekomen delinquenten kan leveren. In de inleiding wordt erop gewezen hoe de reclassering zich in ons land heeft ontwikkeld van een persoonlijk init

  14. Psychiatric nursing liaison in a combat zone: an autoethnography. (United States)

    Whybrow, D


    Military mental health nurses are tasked with providing psychiatric liaison to British forces deployed to combat zones. This forms part of a wider effort to maintain the combat effectiveness of the fighting force. During a recent deployment, I maintained a reflexive journal of my experience of liaising with the British Chain of Command. I then used line by line coding via the NVIVO 9 software package to formulate the core themes that became a framework for this autoethnography. My personality and social anxieties shaped how I performed the psychiatric liaison role. I was able to develop a template for liaison that accounted for both 'me' and my need to feel authentic or credible as a nurse, yet still enabled me to communicate effectively with the Chain of Command. One template for psychiatric nursing liaison with British combat forces is to focus upon key stakeholders within the Chain of Command, specifically, the Officer Commanding, the Sergeant Major, the Trauma Risk Management co-ordinator (usually the Sergeant Major) and the embedded medical asset. Further research is needed to establish how other nurses approach psychiatric nursing liaison.

  15. Psychiatry in former socialist countries: implications for north korean psychiatry. (United States)

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


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

  16. Psychiatry in Former Socialist Countries: Implications for North Korean Psychiatry (United States)

    Park, Young Su; Park, Sang Min; Jun, Jin Yong


    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

  17. Mumbai Psychiatry: Current Obstacles

    Directory of Open Access Journals (Sweden)

    Sanjay V Bagadia


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

  18. [Psychiatry and neuroethics]. (United States)

    Suárez Richards, Manuel


    Neuroscientific knowledge have enter to psychiatry in a new era, however, new technology for viewing images, brain function, psychopharmacology, non-invasive methodology requires an ethical approach, framed in the bioethical environment. The field of neuroethics has evolved to address many of the specific concerns and what neuroenhancement and neuroimaging provide us, is necessary to extend the scope of ethical things to consider the clinical implications for the psychiatric work.

  19. What psychiatry means to us

    Directory of Open Access Journals (Sweden)

    J.K. Trivedi


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

  20. Librarian-researcher cooperation with a liaison program

    Energy Technology Data Exchange (ETDEWEB)

    Ekkebus, A.E.


    During the four years of the liaison program, changes that have resulted include an increase in levels of library activity especially literature searching (a 60% increase in three years), a willingness by researchers to make their information needs known, and the development of a responsive collection. Surveys of recipients of the literature searches have indicated high satisfaction of the search results. The liaison program encourages communication between the reference librarian and researcher and better enables the library to attain its objective of interpreting and meeting the information needs of its users.

  1. Pedagogical Implications of Partnerships Between Psychiatry and Obstetrics-Gynecology in Caring for Patients with Major Mental Disorders. (United States)

    Coverdale, John; Roberts, Laura Weiss; Balon, Richard; Beresin, Eugene V


    Because there are no formal reviews, the authors set out to identify and describe programs that serve female patients with major mental disorders by integrating mental health care with services in obstetrics and gynecology and to describe the pedagogical implications of those programs. The authors searched PubMed for all articles describing a program in which psychiatry was formally integrated with obstetric or gynecological services, other than standard consultation-liaison programs, in the care of patients with major mental disorders. The search terms used included interdisciplinary, interprofessional, integrated, collaborative care, psychiatry, and obstetrics-gynecology or psychosomatic obstetrics-gynecology. The authors found six distinct integrated programs. These included family planning clinics that were integrated into inpatient psychiatry services; inpatient and outpatient psychiatry services for pregnant mentally ill women in close collaboration with obstetric services; a day hospital for pregnant women with psychiatric disorders in an obstetric setting; an interdisciplinary training site providing care for predominantly depressed, low-income, and minority women; a primary care HIV service for women integrated with departments of obstetrics-gynecology and psychiatry; and an obstetrics-gynecology clinic-based collaborative depression care intervention for socially disadvantaged women. Residents' involvement was described in four of the programs. These innovative and integrated programs potentially enhance the care of vulnerable and culturally diverse women with major mental disorders. The authors discuss how these programs may contribute to the education of residents in psychiatry and obstetrics-gynecology.

  2. Psychiatry beyond the current paradigm.

    LENUS (Irish Health Repository)

    Bracken, Pat


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

  3. Measuring the stigma of psychiatry and psychiatrists

    DEFF Research Database (Denmark)

    Gaebel, Wolfgang; Zäske, Harald; Cleveland, Helen-Rose


    to improve the image of psychiatry and to reduce potential stigmatizing attitudes toward psychiatry and psychiatrists. To evaluate such interventions, a questionnaire has been developed that assesses opinions and attitudes toward psychiatrists and psychiatry in different samples of medical specialists...

  4. Long term GP opinions and involvement after a consultation-liaison intervention for mental health problems

    Directory of Open Access Journals (Sweden)

    Passerieux Christine


    Full Text Available Abstract Background Shared Mental Health care between Psychiatry and Primary care has been developed to improve the care of common mental health problems but has not hitherto been adequately evaluated. The present study evaluated a consultation-liaison intervention with two objectives: to explore long-term GP opinions (relating to impact on their management and on patient medical outcome and to determine the secondary referral rate, after a sufficient time lapse following the intervention to reflect a "real-world" primary care setting. Methods All the 139 collaborating GPs (response rate: 84.9% were invited two years after the intervention to complete a retrospective telephone survey for each patient (181 patients; response rate: 69.6%. Results 91.2% of GPs evaluated effects as positive for primary care management (mainly as support and 58.9% noted positive effects for patient medical outcome. Two years post-intervention, management was shared care for 79.7% of patients (the GP as the psychiatric care provider and care by a psychiatrist for 20.3% patients. Secondary referral occurred finally in 44.2% of cases. Conclusion The intervention supported GP partners in their management of patients with common mental health problems. Further studies are required on the appropriateness of the care provider.

  5. Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice


    Lyons, Zaza; Janca, Aleksandar


    Background Mental illnesses are a major public health problem around the world and the prevalence and burden of common mental disorders is growing. Psychiatry is an unpopular career choice for many medical students and this impacts negatively on the supply of psychiatrists to the workforce. The psychiatry clerkship can play an important role in influencing students’ attitudes towards psychiatry, either positively or negatively. However, stigma towards mental illness detracts students from con...

  6. Treatment resistance and psychodynamic psychiatry: concepts psychiatry needs from psychoanalysis. (United States)

    Plakun, Eric


    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.

  7. [Forensic psychiatry. Its relations to clinical psychiatry and criminology]. (United States)

    Kröber, H-L


    A basic task of psychiatry is to identify and treat mentally disordered persons at risk of committing crimes. Psychiatry has an important function in preserving social peace, law, and order. How the psychiatric world handles this duty has changed with time. There have been very important changes from asylums to mental hospitals and from voluntary or involuntary inpatient treatment to outpatient care; but clinical psychiatry cannot give up forensic psychiatry. As a result of developments, inpatient care in mental hospitals often concentrates on crisis management, risk assessment, and risk management. On the other hand, forensic psychiatry has made great efforts in recent decades with special therapies for mentally disturbed criminals and collaborated closely with criminologists in developing instruments for risk assessment and prognosis of repeat offenses.


    Directory of Open Access Journals (Sweden)



    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.

  9. Personalized medicine in psychiatry

    DEFF Research Database (Denmark)

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


    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....... The discussion proposes possible solutions to narrow this gap and to move psychiatric research forward towards personalized medicine....

  10. Is treatment in groups a useful alternative for psychiatry in low-income countries? An evaluation of a psychiatric outpatient unit in Nicaragua. (United States)

    Caldera, T; Kullgren, G; Penayo, U; Jacobsson, L


    Centro de Atención Psicosocial in León, Nicaragua is a psychiatric outpatient unit that has developed a group-oriented model of working, in which 80% of all visits are in groups: first-admission groups, insight-oriented group psychotherapy, psycho-educative, family groups and relatives groups. The aim of the present study was to analyze patient characteristics and make a preliminary study of improvement, compliance and patient satisfaction in a 1-year perspective. One hundred consecutive visits were assessed, 44 of them first admissions. They were assessed according to all axes of DSM-III-R plus the Structural Clinical Interview for DSM-III Disorders. A 1-year follow up was conducted on 39 of 41 selected patients within the major diagnostic groups. One of 4 patients had a psychotic disorder where schizophrenia dominated. Among nonpsychotics major depression, anxiety and adjustment disorders were most frequent. Personality disorders were common (80%) among nonpsychotic patients, paranoid, obsessive-compulsive, passive-aggressive and masochistic personality disorders dominating. The illiteracy rate was 10%, but 50% had high school or university background. Severity of mental disorders and functional level did not differ between educational levels. There was a strong male dominance in all diagnostic, socioeconomic and educational level strata and few old patients. Improvement in functional level was clinically and statistically significant in all groups, and more than two thirds were very satisfied with the group treatment offered.

  11. Financing Academic Departments of Psychiatry (United States)

    Liptzin, Benjamin; Meyer, Roger E.


    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…

  12. Pediatric referrals to psychiatry in a Tertiary Care General Hospital: A descriptive study

    Directory of Open Access Journals (Sweden)

    Bheemsain Tekkalaki


    Full Text Available Background: Children with chronic physical illnesses frequently have psychiatric comorbidities, which often go un-noticed and may lead to more resource utilization and morbidity. Pediatric liaison services can be effectively used to bridge this gap. Literature on pediatric liaison services is sparse. Aims: To study the referral patterns, reasons for referrals, psychiatric diagnoses and interventions in children and adolescents referred to psychiatry department in a tertiary care hospital. Materials and Methods: A retrospective chart analysis of all children and adolescents below 19 years of age, referred to psychiatry department from 2010 to 2015, was done. Data was collected and statistical analysis was done. Results: Two hundred and nine subjects were included in the study. Mean age of sample was 12.15 (±4.20 years, with about 66.02% being males. About 54.06% of the participants were referred from pediatricians. Almost three fourth (72.25% of children had no diagnosable physical illness. Intellectual disability (19.62% was the most common psychiatric diagnosis, followed by depressive disorders (14.35%, and dissociative disorders (12.92%. Conclusions: In our study, majority of the referrals were the adolescent males from pediatric department. Intellectual disability, depressive disorder, and stress-related disorders were the common diagnoses. The fact that three-fourth of the referred children had no physical illness implies lack of awareness, stigma toward mental illness, and pathway of care.

  13. [Patient Groups with Different Risk Profiles for Irregular Drop-Out from Forensic Psychiatry (§ 64 StGB)]. (United States)

    Rosch, Ingeborg; Lachmanski, Anita; Herich, Lena; Taddey, Sandra; Lange, Michaela; Wolf, Marita; Wolf, Ralf; Buchholz, Angela


    About 50 - 70 % of the patients with substance abuse disorders who are mandated to forensic treatment according to the section 64 of the German penal code are discharged from treatment irregularly. Previous research identified a number of potential risk factors for irregular treatment dropout. Systematic assessment of risks factors and their consideration for treatment planning may help to improve treatment retention. Therefore, the aim of this study was to identify groups of patients with a comparable risk profile for treatment dropout. From 2007 - 2012, patients entering forensic treatment completed the MATE-Crimi and a sociodemographic questionnaire. From 431 patients entering forensic treatment, 357 patients agreed to participate. Of the 357 included patients 35.9 % had completed the forensic treatment irregular. Using cox regression, young age, low treatment motivation and a primary criminal behaviour with the substance use as a consequence of criminal behaviour were identified as risk factors for early drop-out. A subsequent analysis of latent classes using these variables resulted in three classes. Our study revealed a small number of risk factors being relevant for treatment drop-out. Furthermore, we identified three groups of patients with different risk profiles. Next steps include the development of treatment pathways for these patient groups. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Why a career in psychiatry? (United States)

    Kumar, Varun


    To reflect upon the factors that might motivate one to undertake a career in psychiatry from the personal perspective of a current registrar in training. The reasons for choosing a career path in psychiatry are complex, and relate to an individual doctor's life experience, training experiences and own value system. Dissatisfaction with the traditional "medical model" of illness may be a contributing factor, with a perception that psychiatry may embrace the biopsychosocial model of illness more fully. Beyond this, a particular interest in the poetry inherent to an individual's story and appreciation of the artistic underpinnings of medicine may also contribute. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  15. YouTube and 'psychiatry'. (United States)

    Gordon, Robert; Miller, John; Collins, Noel


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

  16. Personalized medicine in psychiatry. (United States)

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


    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. 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. The discussion proposes possible solutions to narrow this gap and to move psychiatric research forward towards personalized medicine.

  17. 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


    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.

  18. Forensic psychiatry in Pakistan. (United States)

    Hassan, Tariq; Nizami, Asad Tamizuddin; Hirji, Sarah


    This article reviews existing forensic psychiatric services in Pakistan highlighting the role played by the judicial and the medical fraternity in managing the legal and forensic issues of the population of patients with mental illnesses. Until 2001, all legal and forensic issues were dealt with the mental health legislation of 1912, the Lunacy Act of 1912. This was inherited from the British rulers in the Sub-Continent at the time. The Mental Health Ordinance of 2001 could not sustain following the 18th constitutional amendment in 2010, whereby psychiatric healthcare was devolved to the provinces from the previous federal authority. The article also highlights the difficulties and the barriers in implementation of the forensic psychiatric services in Pakistan at various levels within the healthcare system. This article also delves into the current framework of training in forensic psychiatry for postgraduates as well as the assessments and management schedules for the mentally ill offenders at tertiary care institutions in Pakistan.

  19. Psychiatry and terrorism. (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


    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.

  20. Computational neurology and psychiatry

    CERN Document Server

    Bhattacharya, Basabdatta; Cochran, Amy


    This book presents the latest research in computational methods for modeling and simulating brain disorders. In particular, it shows how mathematical models can be used to study the relationship between a given disorder and the specific brain structure associated with that disorder. It also describes the emerging field of computational psychiatry, including the study of pathological behavior due to impaired functional connectivity, pathophysiological activity, and/or aberrant decision-making. Further, it discusses the data analysis techniques that will be required to analyze the increasing amount of data being generated about the brain. Lastly, the book offers some tips on the application of computational models in the field of quantitative systems pharmacology. Mainly written for computational scientists eager to discover new application fields for their model, this book also benefits neurologists and psychiatrists wanting to learn about new methods.

  1. A social paradigm in psychiatry - themes and perspectives. (United States)

    Priebe, S


    Psychiatry as science is underpinned by paradigms. Considering whether a social paradigm may help to advance the current state of psychiatry, the review provides a reference to the rich, but fragmented past of related initiatives in the history of psychiatry and a personal view of themes, challenges and perspectives of using a social paradigm in psychiatry. Major themes are the evidence on social determinants of mental health; the value-based importance of integrating people with mental disorders in society; options to overcome the social isolation and improve the networks of psychiatric patients; utilising a systemic approach for interventions in families and communities; and understanding group and one-to-one treatments in psychiatry primarily as social interactions. Whilst all these themes open up perspectives for future action and/or research, there are also conceptual challenges through the limitations of the current construct of mental disorders and the dominating terminology. Initiatives for using a social paradigm in psychiatry may refer to important achievements in the past, but need to go beyond this and consider on-going societal changes. Innovation may benefit from close collaboration with social sciences and humanities.

  2. Embeddedness Creates Opportunities for Enhanced Library Liaison Services and Relationships

    Directory of Open Access Journals (Sweden)

    Richard Hayman


    Full Text Available A Review of: O’Toole, E., Barham, R., & Monahan, J. (2016. The impact of physically embedded librarianship on academic departments. portal: Libraries and the Academy, 16(3, 529-556. Objective – To examine whether liaison librarian interactions increase when librarians are physically embedded in their liaison areas. Design – Natural experiment using quantitative measures. Setting – A large, public university in the United States of America. Subjects – Liaison librarian reference interactions. Methods – This research is organized around four primary research questions that examine the effect of liaison librarian physical, co-located embeddedness on the following: 1 the frequency of walk-up reference transactions of the embedded location versus the service desk; 2 the frequency of reference and instructional transactions with liaison areas after the implementation of embedded services; 3 the frequency of walk-up transactions at embedded sites compared to the number of reference and instructional transactions after embeddedness began; and 4 liaison librarian participation in new collaborative or integrative activities with their liaison areas. Researchers used data collected between Fall 2012 and Spring 2014 and compared this to data collected in the pre-embedded period for Fall 2010 to Fall 2011. Data sources included the library’s locally developed reference services statistics tracking tool, individual librarians’ calendar appointment records, and librarian performance agreements. The analysis uses descriptive statistics. Main Results – Researchers discovered a decrease in the frequency of liaison librarians’ walk-up reference transactions at the service desk, as tracked by transactions per hour, occurring before the transition, during the transition, and after the transition to embedded librarianship. They note a decrease of 45% in the number of walk-up interactions at service points

  3. Do Consultation Psychiatrists, Forensic Psychiatrists, Psychiatry Trainees, and Health Care Lawyers Differ in Opinion on Gray Area Decision-Making Capacity Cases? A Vignette-Based Survey. (United States)

    Armontrout, James; Gitlin, David; Gutheil, Thomas


    Previous research in the area of medical decision-making capacity has demonstrated relatively poor agreement between experienced evaluators in "gray area" cases. We performed a survey to determine the level of agreement about gray area decision-making capacity case scenarios within and between individuals of different professional backgrounds. Participants received a survey consisting of 3 complicated decision-making capacity vignettes with an accompanying "yes/no" question regarding capacity and a certainty scale for each vignette. Participants were identified from mailing lists of professional organizations and local hospitals. We received responses from psychiatry trainees, consultation-liaison psychiatrists, forensic psychiatrists, and lawyers with experience in health care law. Results were analyzed using SPSS. Across the 3 vignettes, the percentage agreeing that the individual described had capacity to refuse medical treatment ranged between 35% and 40% for trainees, 33% and 67% for consult psychiatrists, 41% and 76% for forensic psychiatrists, and 40% and 83% for health care lawyers. Only question 2 reached significance between-group differences (Pearson χ(2) = 11.473, p decision-making than were forensic psychiatrists and lawyers. As found in previous research, agreement among experienced evaluators appears generally low in gray area capacity cases. It is noteworthy that individuals of different professional backgrounds at times offer divergent between-group opinions on capacity. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  4. American Association for Geriatric Psychiatry (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 ...

  5. Choosing a Career in Psychiatry (United States)

    ... students follow a standard curriculum. In addition to anatomy, biochemistry, and physiology, students take courses in psychiatry, ... university medical centers, community agencies, courts and prisons, nursing homes, industry, government, military settings, schools and universities, ...

  6. Cultural psychiatry: a general perspective. (United States)

    Alarcón, Renato D


    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.

  7. Cultural competency training in psychiatry. (United States)

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


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

  8. Incorporating active learning in psychiatry education. (United States)

    Kumar, Sonia; McLean, Loyola; Nash, Louise; Trigwell, Keith


    We aim to summarise the active learning literature in higher education and consider its relevance for postgraduate psychiatry trainees, to inform the development of a new Formal Education Course (FEC): the Master of Medicine (Psychiatry) at the University of Sydney. We undertook a literature search on 'active learning', 'flipped classroom', 'problem-based learning' and 'psychiatry education'. The effectiveness of active learning pedagogy in higher education is well supported by evidence; however, there have been few psychiatry-specific studies. A new 'flipped classroom' format was developed for the Master of Medicine (Psychiatry). Postgraduate psychiatry training is an active learning environment; the pedagogical approach to FECs requires further evaluation.

  9. Adding a dietitian to a Danish Liaison

    DEFF Research Database (Denmark)

    Pohju, Anne; Lugnet, Kerstin; Rasmussen, Nanna;


    with (intervention group, IG) or without a dietitian (control group, CG). The IG received three home visits by the dietitian during a 12-week period. Data included in the economic analysis was time spent by the dietitian, use of oral nutritional supplements (ONS) and number of hospitalization days. Results......: Of the 71 included patients, 34 were in the IG, 30 patients received all three dietitian visits. Cumulated number of hospitalization days was 172 in the IG and 415 in the CG. Use of ONS was 48 % in the IG and 17% in the CG (P=0.001). Estimated cost for the dietitian and ONS combined in the IG was €9...

  10. American Academy of Child and Adolescent Psychiatry (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 ...

  11. Forensic psychiatry in Africa: prospects and challenges

    African Journals Online (AJOL)

    mental health care has always had an important interface with the law.1 Nevertheless, .... protection of the mentally ill user's human rights. According to the South .... Njenga F. Forensic psychiatry:The African experience. World. Psychiatry 2006 ...

  12. Communication skills in psychiatry training. (United States)

    Ditton-Phare, Philippa; Halpin, Sean; Sandhu, Harsimrat; Kelly, Brian; Vamos, Marina; Outram, Sue; Bylund, Carma L; Levin, Tomer; Kissane, David; Cohen, Martin; Loughland, Carmel


    Mental health clinicians can experience problems communicating distressing diagnostic information to patients and their families, especially about severe mental illnesses such as schizophrenia. Evidence suggests that interpersonal communication skills can be effectively taught, as has been demonstrated in the specialty of oncology. However, very little literature exists with respect to interpersonal communication skills training for psychiatry. This paper provides an overview of the communication skills training literature. The report reveals significant gaps exist and highlights the need for advanced communication skills training for mental health clinicians, particularly about communicating a diagnosis and/or prognosis of schizophrenia. A new communication skills training framework for psychiatry is described, based on that used in oncology as a model. This model promotes applied skills and processes that are easily adapted for use in psychiatry, providing an effective platform for the development of similar training programs for psychiatric clinical practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  13. The relevance of medical sociology to psychiatry: a historical view. (United States)

    Bloom, Samuel W


    Collaboration between sociology and psychiatry is traced to the 1920s when, stimulated by Harry Stack Sullivan and Adolph Meyer, the relationship was activated by common theoretical and research interests. Immediately after World War II, this became a true partnership, stimulated by the National Institute of Mental Health, the Group for the Advancement of Psychiatry, and the growing influence of psychoanalytic theory. The effects of a sociology that focused on issues of health and illness proceeded to grow in medical education, research, and the treatment of mental illness until 1980, when a distinct shift of emphasis in psychiatry occurred. In its role as educator of future physicians, postwar psychiatry developed a paradigm of biopsychosocial behavior but, after 3 decades, changed to a biopharmacological model. The definition of mental illness as a deviant extreme in developmental and interpersonal characteristics lost favor to nosological diagnoses of discrete or dichotomous models. Under a variety of intellectual, socioeconomic, and political pressures, psychiatry reduced its interest in and relationship with sociology, replacing it in part with bioethics and economics. In this article, the detailed underpinnings of these changes are described and interpreted.

  14. Internet resources for psychiatry and neuropsychiatry


    Stone, J.; Sharpe, M


    Some of the most useful internet resources relevant to psychiatry and neuropsychiatry are summarised. Web sites recommended for professionals and patients are detailed, including where to find evidence based psychiatry, psychiatry news, and professional organisations. Some thoughts on "cyberchondria" and the opportunities that the internet offers for illness transmission are also considered.

  15. Internet resources for psychiatry and neuropsychiatry (United States)

    Stone, J; Sharpe, M


    Some of the most useful internet resources relevant to psychiatry and neuropsychiatry are summarised. Web sites recommended for professionals and patients are detailed, including where to find evidence based psychiatry, psychiatry news, and professional organisations. Some thoughts on "cyberchondria" and the opportunities that the internet offers for illness transmission are also considered. PMID:12486258

  16. Consultation-Liaison psychiatric service delivery : results from a European study

    NARCIS (Netherlands)

    Huyse, FJ; Herzog, T; Lobo, A; Malt, UF; Opmeer, BC; Stein, B; de Jonge, P; van Dijck, R; Creed, F; Crespo, MD; Cardoso, G; Guimaraes-Lopes, R; Mayou, R; van Moffaert, M; Rigatelli, M; Sakkas, P; Tienari, P


    The reported Endings of the European Consultation-Liaison Workgroup (ECLW) Collaborative Study describe consultation-liaison service delivery by 56 services from ZI European countries aggregated on a C-L service level. During the period of 1 year (1991), the participants applied a standardized, reli

  17. Integration of a psychoanalytic liaison department at a public hospital. (United States)

    Neuburger, R P


    A general overview of liaison-psychoanalysis in a general hospital is presented. The team's trajectory is revisited, as generating a presence in the inpatient units: a demand which changes from a purely psychiatric, scarcely operative level to an acknowledgment of subjectivity. Generally, this appears disruptively in medical proceedings. Two case histories are presented: (i) 'the tenant' and (ii) 'the nail-polishing file'. With regard to the first case history, the transference in its double aspect, with the patient as well as with the unit's staff, is examined. The analyst's intervention seeks to untangle the impasse, which prevents the physicians from helping the patient. With regard to the second case history, in which the de-mystification aspects of liaison work are shown, the horror that the so-called 'mental illness' can produce in the medical institution is explored. The aim of narrating this experience is to preserve a psy-space in the hospital where the overwhelming technological developments menace with its disappearance.

  18. The structure of mental health research: networks of influence among psychiatry and clinical psychology journals. (United States)

    Haslam, N; Lusher, D


    Psychiatry and clinical psychology are the two dominant disciplines in mental health research, but the structure of scientific influence and information flow within and between them has never been mapped. Citations among 96 of the highest impact psychiatry and clinical psychology journals were examined, based on 10 052 articles published in 2008. Network analysis explored patterns of influence between journal clusters. Psychiatry journals tended to have greater influence than clinical psychology journals, and their influence was asymmetrical: clinical psychology journals cited psychiatry journals at a much higher rate than the reverse. Eight journal clusters were found, most dominated by a single discipline. Their citation network revealed an influential central cluster of 'core psychiatry' journals that had close affinities with a 'psychopharmacology' cluster. A group of 'core clinical psychology' journals was linked to a 'behavior therapy' cluster but both were subordinate to psychiatry journals. Clinical psychology journals were less integrated than psychiatry journals, and 'health psychology/behavioral medicine' and 'neuropsychology' clusters were relatively peripheral to the network. Scientific publication in the mental health field is largely organized along disciplinary lines, and is to some degree hierarchical, with clinical psychology journals tending to be structurally subordinate to psychiatry journals.

  19. Historical aspects of Mexican psychiatry. (United States)

    Bayardo, Sergio Javier Villaseñor


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

  20. Mechanisms and Reduction in Psychiatry

    DEFF Research Database (Denmark)

    Andersen, Lise Marie


    The view that psychiatry should be elucidating the mechanisms behind mental phenomena is gaining momentum. This view, coupled with an intuition that such mechanisms must, by nature, be biological, has inspired the field to look to cognitive neuroscience for classification of mental illnesses. One...... of causation and mechanism to bridge the gab between mechanistic explanations and multilevel models of mental disorders....

  1. Psychiatry in the Deep South: A Pilot Study of Integrated Training for Psychiatry Residents and Seminary Students (United States)

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


    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,…

  2. [Fifty years of psychiatry at the interface between psyche and soma: a SWOT analysis]. (United States)

    van Houdenhove, B; Luyten, P


    During the past 50 years the border area between psychiatry and somatic medicine has undergone remarkable changes. Theories have become better-founded, both psychologically and neurobiologically, research has become more sophisticated, and liaison-psychiatrists and health psychiatrist/behavioural medicine psychologists have played an increasingly active role in this domain. At the beginning of the 21st century modern psychosomatic medicine is facing new challenges; these include how to create a workable diagnostic classification system, how to instruct and educate both health professionals and lay-persons to an adequate level, how to utilize innovative research paradigms without having recourse to reductionism and how to implement in medical practice treatments that are geared to the needs of the individual patient.

  3. Training in psychiatry throughout Europe. (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


    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.

  4. Psychological complications of childhood chronic physical illness in Nigerian children and their mothers: the implication for developing pediatric liaison services

    Directory of Open Access Journals (Sweden)

    Meremikwu Martin M


    Full Text Available Abstract Background Pediatric liaison services attending to the psychological health needs of children with chronic physical illness are limited or virtually non-existent in Nigeria and most sub-Saharan African countries, and psychological problems complicate chronic physical illness in these children and their mothers. There exist needs to bring into focus the public health importance of developing liaison services to meet the psychological health needs of children who suffer from chronic physical illness in this environment. Sickle cell disease (SCD and juvenile diabetes mellitus (JDM are among the most common chronic physical health conditions in Nigerian children. This study compared the prevalence and pattern of emotional disorders and suicidal behavior among Nigerian children with SCD, JDM and a group of healthy children. Psychological distress in the mothers of these children that suffer chronic physical illness was also compared with psychological distress in mothers of healthy control children. Methods Forty-five children aged 9 to 17 years were selected for each group of SCD, JDM and controls. The SCD and JDM groups were selected by consecutive clinic attendance and the healthy children who met the inclusion criteria were selected from neighboring schools. The Youth version of the Computerized Diagnostic Interview Schedule for Children, version IV (C- DISC- IV was used to assess for diagnosis of emotional disorders in these children. Twelve-item General Health Questionnaire (GHQ – 12 was used to assess for psychological distress in mothers of these children and healthy control children. Results Children with JDM were significantly more likely to experience DSM – IV emotional disorders than children with SCD and the healthy group (p = 0.005, while children with JDM and SCD were more likely to have 'intermediate diagnoses' of emotional disorders (p = 0.0024. Children with SCD and JDM had higher rates of suicidal ideation when

  5. Association of cognitive and noncognitive symptoms of delirium: A study from consultation-liaison psychiatry set-up

    Directory of Open Access Journals (Sweden)

    Sandeep Grover


    Full Text Available Aims: This study aims to evaluate the cognitive functions of patients with delirium using Hindi Mental Status Examination (HMSE, to study the correlation of cognitive functions assessed by HMSE with noncognitive symptoms as assessed using Delirium Rating Scale-Revised 1998 (DRS-R-98 and to study the association of cognitive functions assessed using HMSE and DRS-R98. Methods: A total of 76 consecutive patients fulfilling the diagnosis of delirium were evaluated on DRS-R-98, HMSE, and Short Informant Questionnaire on Cognitive Decline in the Elderly (retrospective IQCODE. Results: The mean DRS-R-98 score 33.9 (standard deviation [SD] - 7.2 and the mean DRS-R-98 severity score was 25.9 (SD - 7.2. The mean score on HMSE was 19.3 (7.98. There were significant correlations of all the domains of HMSE with DRS-R-98 total score, DRS-R-98 severity score, DRS-R-98 cognitive subscale score, DRS-R-98 noncognitive domain subscale score, and DRS severity score without attention score. When the association of each item of DRS-R-98 and HMSE was evaluated, except for the items of delusions, lability of affect and motor retardation, there were significant negative association between all the items of DRS-R-98 and HMSE, indicating that higher severity of cognitive symptoms as assessed on HMSE is associated with higher severity of all the cognitive symptoms and most of the noncognitive symptoms as assessed by DRS-R-98. Conclusion: The present study suggests that attention deficits in patients with delirium influence the severity of cognitive and noncognitive symptoms of delirium. Further, the present study suggests an increase in the severity of cognitive symptoms in other domains is also associated with an increase in the severity of noncognitive symptoms of delirium.

  6. The Lorazepam and Diazepam Protocol for Catatonia Due to General Medical Condition and Substance in Liaison Psychiatry (United States)

    Lin, Chin-Chuen; Hung, Yi-Yung; Tsai, Meng-Chang; Huang, Tiao-Lai


    Objective The lorazepam-diazepam protocol had been proved to rapidly and effectively relieve catatonia in patients with schizophrenia or mood disorder. This study aims to investigate the efficacy of lorazepam-diazepam protocol in catatonia due to general medical conditions (GMC) and substance. Method Patients with catatonia that required psychiatric intervention in various settings of a medical center were included. The lorazepam-diazepam protocol had been used to treat the catatonia due to GMC or substance according to DSM-IV criteria. The treatment response had been assessed by two psychiatrists. Results Eighteen (85.7%) of 21 catatonic patients due to GMC or substance became free of catatonia after the lorazepam-diazepam protocol. Five (23.8%) of the 21 patients had passed away with various causes of death and wide range of time periods after catatonia. Conclusion Our results showed that the lorazepam-diazepam protocol could rapidly and effectively relieve catatonia due to GMC and substance. PMID:28114315

  7. Consultation-liaison approach for the management of psychiatric manifestations in Parkinson′s disease and related disorders: A report from Neuropsychiatric Hospital, India

    Directory of Open Access Journals (Sweden)

    Harish Thippeswamy


    Full Text Available Background: Non-motor psychiatric manifestations of Parkinson′s disease have been increasingly noted to contribute to morbidity and mortality. Materials and Methods: We studied the psychiatric manifestations among inpatients with Parkinson′s disease and other movement disorders by examining the referrals (N = 127 to consultation-liaison psychiatry services from neurology/neurosurgery between July 2009 and April 2010 using structured clinical proforma. Results: Parkinson′s disease and other movement disorders was the most common neurological diagnosis (19%. The most common reason for referral was depression (38% followed by behavioral problems (33%. Post-assessment, depression rates were higher (54% and behavioral manifestations were diagnosed as sleep problems (13%, organic psychiatric syndrome (13%, psychosis (8%, anxiety and obsessive compulsive disorder (8%, nil psychiatry (4%. Conclusion: Psychiatric comorbidity is high among in-patients with movement disorders and affective changes are common. Timely assessment using structured clinical proforma would help in enhanced detection of depression in patients with movement disorders.

  8. Nurse-led liaison mental health service for older adults: service development using lean thinking methodology. (United States)

    Atkinson, Paula; Mukaetova-Ladinska, Elizabeta B


    Liaison Psychiatric Services for Older Adults in the UK have been established over the last decade, with rather divergent team composition and involvement. The latest documents (National Dementia Strategy, Who Cares Wins) set the gold standard for liaison services for older adults in England, requiring a proactive approach to services and integrating assessment and treatment of mental disorder into routine general hospital practice. This requires a physical presence of liaison services in the hospital, with collaboration with medical colleagues. We have adopted the above strategy in a nurse-led liaison service working in a General District Hospital, and used the Toyota Production System. In the current study we reflect on the 5 day rapid progress improvement workshops event for the liaison branch of the project, and describe the process of identifying real situation problems for the care of the medically ill, the involvement of the liaison team in their clinical care, and a feedback on the change in practice. The novel approach of identifying areas for change in an ongoing nurse-led Liaison service for Older Adults resulted in improving access to mental health services for elderly medically ill inpatients and improved quality of their overall care. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. The state of psychiatry in Spain. (United States)

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


    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.

  10. Police liaison and section 136: comparison of two different approaches. (United States)

    Jenkins, Oliver; Dye, Stephen; Obeng-Asare, Franklin; Nguyen, Nam; Wright, Nicola


    Aims and method Two police liaison and section 136 schemes were developed alongside police services at different sites within the same NHS trust. In one, a mental health nurse worked with frontline police attending incidents related to mental health. The other involved nurses providing advice from the police control room. Section 136 detentions were measured over two 6-month periods (6 months apart) before and after practice change. Data analysed included total numbers of section 136 assessments, outcomes following subsequent assessment, and relevant diagnostic and demographic factors. Association of any change in section 136 total numbers and proportion subsequently admitted was investigated in both sites. Results The model involving a nurse alongside frontline police showed significant reduction in section 136 numbers (38%, P section 136 detention but showed a non-significant (P = 0.16) decrease in subsequent admission. Clinical implications Mental health nurses working alongside frontline police officers can help improve section 136 numbers and outcomes.

  11. Fracture liaison services: improving outcomes for patients with osteoporosis

    Directory of Open Access Journals (Sweden)

    Walters S


    Full Text Available Samuel Walters,1 Tanvir Khan,2 Terence Ong,3,4 Opinder Sahota3 1East Midlands Major Trauma Centre, Queens Medical Centre, Nottingham University Hospitals NHS Trust, 2Department of Orthopaedics, Trauma and Sports Medicine, University of Nottingham, 3Department for Healthcare of Older People, Queens Medical Centre, Nottingham University Hospitals NHS Trust, 4Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK Abstract: Fragility fractures are sentinels of osteoporosis, and as such all patients with low-trauma fractures should be considered for further investigation for osteoporosis and, if confirmed, started on osteoporosis medication. Fracture liaison services (FLSs with varying models of care are in place to take responsibility for this investigative and treatment process. This review aims to describe outcomes for patients with osteoporotic fragility fractures as part of FLSs. The most intensive service that includes identification, assessment and treatment of patients appears to deliver the best outcomes. This FLS model is associated with reduction in re-fracture risk (hazard ratio [HR] 0.18–0.67 over 2–4 years, reduced mortality (HR 0.65 over 2 years, increased assessment of bone mineral density (relative risk [RR] 2–3, increased treatment initiation (RR 1.5–4.25 and adherence to treatment (65%–88% at 1 year and is cost-effective. In response to this evidence, key organizations and stakeholders have published guidance and framework to ensure that best practice in FLSs is delivered. Keywords: fracture liaison service, fractures, fall, osteoporosis, aged

  12. What Is Psychiatry?

    Medline Plus

    Full Text Available ... a couple, with a family, or in a group. There are many forms of psychotherapy. There are ... that medications are used to treat high blood pressure or diabetes. After completing thorough evaluations, psychiatrists can ...

  13. What Is Psychiatry?

    Medline Plus

    Full Text Available ... years. Psychotherapy can be done individually, as a couple, with a family, or in a group. There ... training then spends at least three additional years learning the diagnosis and treatment of mental health, including ...

  14. What Is Psychiatry?

    Medline Plus

    Full Text Available ... medical laboratory and psychological tests which, combined with discussions with patients, help provide a picture of a ... a couple, with a family, or in a group. There are many forms of psychotherapy. There are ...

  15. The integrative approach to psychiatry. (United States)

    Lipowski, Z J


    From the early days of psychiatry as a distinct field of knowledge and clinical practice two competing approaches to the etiology and treatment of mental disorders have vied for dominance: the somatic and the psychic ("moral"). We are witnessing the same struggle today. To speak metaphorically, we can opt for either brainless or mindless psychiatry, as Szasz proposed. He failed to consider a third option, however, one that may be called an integrative approach. The latter is neither mindless nor brainless but rather encompasses both the mind and the brain in its theoretical and practical consideration. I will formulate the integrative approach in this paper and argue that it has a distinct advantage for both the study and treatment of mental disorders.

  16. Secular humanism and "scientific psychiatry". (United States)

    Szasz, Thomas


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

  17. Secular humanism and "scientific psychiatry" (United States)

    Szasz, Thomas


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

  18. Secular humanism and "scientific psychiatry"

    Directory of Open Access Journals (Sweden)

    Szasz Thomas


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

  19. Secular humanism and "scientific psychiatry"



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

  20. Psychiatry and humanism in Argentina. (United States)

    Niño Amieva, Alejandra


    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.

  1. [On the problem of psychodiagnosis in psychiatry and psychotherapy]. (United States)

    Szewczyk, H; Littmann, E


    Owing to the changed concept of psychiatry and psychotherapy, greater demands are also being made on psychodiagnostics. The article deals with the prerequisites, possible significance and application of the clinical methods and psychological tests, describes the problems of standardization and quality testing and discusses indications and problems of the different groups of methods. The demands of the clinician addressed to test designers are dealt with, as well as the question of which group of methods should be used and by whom.

  2. Attitudes of Medical Students toward Psychiatry and Psychiatry as a Career: A Systematic Review (United States)

    Lyons, Zaza


    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…

  3. Models of Integrated Training in Psychiatry and Child and Adolescent Psychiatry (United States)

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


    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.…

  4. The troubled relationship between psychiatry and sociology. (United States)

    Pilgrim, David; Rogers, Anne


    The alienated relationship between psychiatry and sociology is explored. The two disciplines largely took divergent paths after 1970. On the one side, psychiatry manifested a pre-occupation with methodological questions and sought greater medical respectability, with a biomedical approach returning to the fore. Social psychiatry and its underpinning biopsychosocial model became increasingly marginalised and weakened. On the other side, many sociologists turned away from psychiatry and the epidemiological study of mental health problems and increasingly restricted their interest to social theory and qualitative research. An interdisciplinary void ensued, to the detriment of the investigation of social aspects of mental health.

  5. Positive psychiatry: its time has come. (United States)

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


    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.

  6. Liaison concatenation – A method to obtain feasible assembly sequences from 3D-CAD product

    Indian Academy of Sciences (India)

    M V A Raju Bahubalendruni; Bibhuti Bhusan Biswal


    Selection of optimized assembly sequence from the available feasible assembly sequences is significantly essential to achieve cost-effective manufacturing process. To achieve this, at the outset, generation of feasible assembly sequences with topological, geometrical, precedence and stability conditions should be generated. The increase of part count in a product results huge number of assembly sequences, the Liaison matrix/Liaison graph generated based on the connections between the assembly components eliminates nonpossible assembly sequences at the initial phase. There exist methods namely cut-set method to eliminate the non-possible assembly sequences using liaison graph. In this paper a new approach to eliminate the non-possible assembly sequences based on liaisons is described and the correctness of the methodology is illustrated with an example. The methodology to obtain the feasible assembly sequences is also briefly described and presented. An algorithm to interface with the CAD environment is described briefly.

  7. Does adding a dietician to the liaison team after discharge of geriatric patients improve nutritional outcome

    DEFF Research Database (Denmark)

    Beck, A; Andersen, U. T.; Leedo, E


    (70 + years and at nutritional risk) at discharge. INTERVENTIONS: Participants were randomly allocated to receive discharge Liaison-Team vs. discharge Liaison-Team in cooperation with a dietician. The dietician performed a total of three home visits with the aim of developing and implementing...... an individual nutritional care plan. The first visit took place at the day of discharge together with the discharge Liaison-Team while the remaining visits took place approximately three and eight weeks after discharge and were performed by a dietician alone. MAIN MEASURES: Nutritional status (weight......OBJECTIVES: The objective was to test whether adding a dietician to a discharge Liaison-Team after discharge of geriatric patients improves nutritional status, muscle strength and patient relevant outcomes. DESIGN: Twelve-week randomized controlled trial. SETTING AND SUBJECTS: Geriatric patients...

  8. Impact of the psychiatry clerkship on medical student attitudes towards psychiatry and to psychiatry as a career. (United States)

    Lyons, Zaza


    The psychiatry clerkship forms part of the core curriculum of medical schools worldwide and provides psychiatric educators with an ideal opportunity to positively influence students. The aim of this paper is to systematically review literature on the impact of the psychiatry clerkship to determine the effect on attitudes towards psychiatry and to psychiatry as a career. A systematic review was undertaken. The following key search words were used to search a number of electronic databases: medical student/s, attitude/s, psychiatry and clerkship. Studies published in the English language from 1990 to the present were included. Studies were included if they were based on a pre-/post-design, i.e. the same students must have participated in the study both before and after the clerkship. Twenty-six studies from 19 countries were identified for the review. Sixteen studies reported an overall improvement in attitudes towards psychiatry post-clerkship, and ten found no change in attitudes. In terms of career choice, nine studies reported an increase in the number of students interested in psychiatry as a career post-clerkship, nine found no impact on career choice and, in eight studies, it was not assessed. A number of positive and negative factors regarding the clerkship were identified. Overall, the psychiatry clerkship has a positive impact on students' attitudes towards psychiatry, but does not improve interest in psychiatry as a career option. For those students particularly interested in psychiatry, the challenge is to maintain their enthusiasm post-clerkship. Charismatic teachers, mentorship and stigma reduction may be effective strategies. Future research needs to more clearly identify specific components of the clerkship that are viewed favorably by students.

  9. [Future Psychiatry: a "Think Tank" for the Italian Psychiatry]. (United States)

    Bersani, Giuseppe


    The Future Psychiatry Project was founded with the goal to address the critical ratio of research/training / clinic. Ina series of regular meetings, each devoted to a specific clinical topic, data and more advanced models for the clinical area in questionwill be analyzed in an integrated and multidisciplinary approach and the real possibility of extension of development andprospects of scientific advances to the clinic and therapy will be evaluated.The primary methodological objective of the FuturePsychiatry meetings is the training method to overcome the common type of teacher/learner classroom teaching, albeit dividedinto the various possibilities offered by different types of educational meetings.The structure is informal, with features of intensiveseminars and suggested modes for better interaction.The objective is the "Think Tank", a common space for study and exchangeof knowledge, experiences, opinions and expectations, aimed at producing an integrated and shared dynamic result, thatcan provide a real reference point for participants and for all researchers and clinicians engaged in improving their level of updatingand best clinical activity.The first Future Psychiatry meeting was held in Sermoneta (Latina) in the halls of the Castello Caetanion September 16th to 18th 2010.The chosen topic was "The Future of Depression: the development of knowledge, the evolutionof therapies". The currently most advanced data of research were discussed and developed in their potential to reach ashared model taking into account the etiological complexity of Depression and to be a real reference to the possibility of applicationto real clinical experience.The main guidelines of the current research and major prospects for development of this in thefield Depression have been outlined, also in relation to the ongoing evolution and the future outlook of the models and tools oftherapy. Psychiatrists' clinical needs and expectations in front of the development of scientific

  10. [Psychiatry in Somalia]. (United States)

    Afrah, E


    After a short description of the psychiatric clinic in Mogadishu and the treatment methods, cultural questions and the role of the medicine-men are discussed. The incorporation of the traditional forms of family solidarity, the ways of life and religion into the psychiatric treatment methods is attached the respective importance. In the analysis of the patients according to the international classification of diseases, seven diagnostic groups were worked out. It became clear that basically the same forms of psychose occur as are known in Europe; deviations were worked out. For a further development, specialisation and decentralisation are being continued.

  11. [Logopedia and pediatric psychiatry]. (United States)

    Dvorák, J


    The author presents some methods of special logopaedic examinations of children hospitalized in a psychiatric sanatorium for children. This diagnosis is part of a multidimensional evaluation of the child and the basis for the special development of verbal performance. The author mentions therapeutic methods some diagnostic groups and emphasizes that this work is irreplaceable in the comprehensive concept of paedopsychiatric treatment. Effective logopaedic assistance depends on professional skill which is not taught to teachers at present. In the conclusion the author submits the demand that specialists in this field should be according to norms on the staff of these institutions and should not be engaged only on an optional basis.

  12. Epistemic injustice in psychiatry. (United States)

    Crichton, Paul; Carel, Havi; Kidd, Ian James


    It has been argued that those who suffer from medical conditions are more vulnerable to epistemic injustice (a harm done to a person in their capacity as an epistemic subject) than healthy people. This editorial claims that people with mental disorders are even more vulnerable to epistemic injustice than those with somatic illnesses. Two kinds of contributory factors are outlined, global and specific. Some suggestions are made to counteract the effects of these factors, for instance, we suggest that physicians should participate in groups where the subjective experience of patients is explored, and learn to become more aware of their own unconscious prejudices towards psychiatric patients.

  13. 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))


    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.)

  14. Magnetic resonance imaging in psychiatry. Kernspintomographie in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

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


    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.)

  15. 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))


    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.)

  16. Psychiatry, ethnicity and migration : the case of Palestine, 1920-1948


    Zalashik, Rakefet


    The aim of the paper is to explore the development of psychiatry in Palestine from two main perspectives: ethnicity and immigration. In Palestine the subject of immigration and psychiatry were highly complicated and had unique features. Thus, both psychiatrists and patients were immigrants who belonged to the same ethnic group sharing the same ideology and objectives. The examination will uncover the social construction of mental diseases among Jewish immigrants in Palestine —patients and psy...

  17. Polypharmacy in psychiatry: A review

    Directory of Open Access Journals (Sweden)

    Sanjay Kukreja


    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.

  18. Some gestalt contributions to psychiatry. (United States)

    Clegg, Kathleen A


    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.

  19. Polypharmacy In Psychiatry: A Review (United States)

    Kukreja, Sanjay; Kalra, Gurvinder; Shah, Nilesh; Shrivastava, Amresh


    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. PMID:23678240

  20. [Towards European psychiatry based around shared values]. (United States)

    Halimi, Yvan; Müller, Christian


    In September 2005, the French and German national conferences of the presidents of specialised hospitals' medical committees co-signed a text relatingto the fundamental values and principles of psychiatry. Since then, several countries, such as Italy and Spain, have joined the movement. Among these values, the district is reaffirmed as the base unit, for the construction of psychiatry in Europe.

  1. Putting "Rural" into Psychiatry Residency Training Programs (United States)

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


    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…

  2. The uncertain future of clinical psychiatry. (United States)

    Lesse, S


    Clinical psychiatry is in a crisis state and might not survive in its present form. Health-care costs, in general, have escalated tenfold over a period of twenty years. The various factors that are threatening the existence of clinical psychiatry in its current form are reviewed and suggestions for change are offered.

  3. Child Psychiatry Curricula in Undergraduate Medical Education (United States)

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


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

  4. Fracture liaison services: improving outcomes for patients with osteoporosis. (United States)

    Walters, Samuel; Khan, Tanvir; Ong, Terence; Sahota, Opinder


    Fragility fractures are sentinels of osteoporosis, and as such all patients with low-trauma fractures should be considered for further investigation for osteoporosis and, if confirmed, started on osteoporosis medication. Fracture liaison services (FLSs) with varying models of care are in place to take responsibility for this investigative and treatment process. This review aims to describe outcomes for patients with osteoporotic fragility fractures as part of FLSs. The most intensive service that includes identification, assessment and treatment of patients appears to deliver the best outcomes. This FLS model is associated with reduction in re-fracture risk (hazard ratio [HR] 0.18-0.67 over 2-4 years), reduced mortality (HR 0.65 over 2 years), increased assessment of bone mineral density (relative risk [RR] 2-3), increased treatment initiation (RR 1.5-4.25) and adherence to treatment (65%-88% at 1 year) and is cost-effective. In response to this evidence, key organizations and stakeholders have published guidance and framework to ensure that best practice in FLSs is delivered.

  5. Fracture liaison services: improving outcomes for patients with osteoporosis (United States)

    Walters, Samuel; Khan, Tanvir; Ong, Terence; Sahota, Opinder


    Fragility fractures are sentinels of osteoporosis, and as such all patients with low-trauma fractures should be considered for further investigation for osteoporosis and, if confirmed, started on osteoporosis medication. Fracture liaison services (FLSs) with varying models of care are in place to take responsibility for this investigative and treatment process. This review aims to describe outcomes for patients with osteoporotic fragility fractures as part of FLSs. The most intensive service that includes identification, assessment and treatment of patients appears to deliver the best outcomes. This FLS model is associated with reduction in re-fracture risk (hazard ratio [HR] 0.18–0.67 over 2–4 years), reduced mortality (HR 0.65 over 2 years), increased assessment of bone mineral density (relative risk [RR] 2–3), increased treatment initiation (RR 1.5–4.25) and adherence to treatment (65%–88% at 1 year) and is cost-effective. In response to this evidence, key organizations and stakeholders have published guidance and framework to ensure that best practice in FLSs is delivered. PMID:28138228

  6. ["Great jobs"-also in psychiatry?]. (United States)

    Spiessl, H; Hübner-Liebermann, B


    Against the background of a beginning shortage of psychiatrists, results from interviews with 112 employees of an automotive company with the topic "Great Job" are presented to discuss their relevance to psychiatry. The interviews were analysed by means of a qualitative content analysis. Most employees assigned importance to great pay, constructive collaboration with colleagues, and work appealing to personal interests. Further statements particularly relevant to psychiatry were: successful career, flexible working hours, manageable job, work-life balance, well-founded training, no bureaucracy within the company, and personal status in society. The well-known economic restrictions in health care and the still negative attitude towards psychiatry currently reduce the attraction of psychiatry as a profession. From the viewpoint of personnel management, the attractors of a great job revealed in this study are proposed as important clues for the recruitment of medical students for psychiatry and the development of psychiatric staff.

  7. The history of Italian psychiatry during Fascism. (United States)

    Piazzi, Andrea; Testa, Luana; Del Missier, Giovanni; Dario, Mariopaolo; Stocco, Ester


    Specific features characterized Italian psychiatry during Fascism (1922-45), distinguishing it from Nazi psychiatry and giving rise to different operational outcomes, so we have investigated the state of Italian psychiatry during this period. We review the historical situation that preceded it and describe the social and health policies that Fascism introduced following new legislative and regulatory acts. We examine the preventive and therapeutic role played by psychiatry (the electric shock was an Italian invention) and, thanks to the Enciclopedia Italiano published during those years, we are able to highlight psychiatry's relationship to psychology, psychoanalysis, philosophy and religion. The shortcomings of Italian psychiatric research and practice are also seen in terms of what the State failed to do rather than what it did.

  8. An Analysis of Potential Contributions of the Host Country National Local Liaison Role in Global Knowledge Management

    DEFF Research Database (Denmark)

    Vance, Charles; Vaiman, Vlad; Andersen, Torben


    This paper builds on the existing conceptualization of MNC knowledge transfer by exploring the all-important liaison role in global knowledge management played by host country nationals (HCNs), especially those working directly to with expatriate managers. We first discuss this proposed HCN local...... liaison role between expatriate and local employees within theoretical constructs of network theory and absorptive capacity. Then we consider several possible important components and related behavioral functions of this liaison role, including cultural interpreter, communication manager, information...

  9. A novel method of assessing quality of postgraduate psychiatry training: experiences from a large training programme. (United States)

    Bizrah, Mukhtar; Iacoponi, Eduardo; Parker, Elizabeth; Rymer, Janice; Iversen, Amy; Wessely, Simon


    Most assessments of the quality of postgraduate training are based on anonymised questionnaires of trainees. We report a comprehensive assessment of the quality of training at a large postgraduate psychiatry training institute using non-anonymised face-to-face interviews with trainees and their trainers. Two consultant psychiatrists interviewed 99 trainees and 109 trainers. Scoring of interview responses was determined by using a pre-defined criteria. Additional comments were recorded as free text. Interviews covered 13 domains, including: Clinical, teaching, research and management opportunities, clinical environment, clinical supervision, adequacy of job description, absence of bullying and job satisfaction. Multiple interview domain scores were combined, generating a 'Combined' score for each post. The interview response rate was 97% for trainers 88% for trainees. There was a significant correlation between trainee and trainer scores for the same interview domains (Pearson's r = 0.968, pJob satisfaction scores of year 1 to year 3 core trainees showed a significant increase with increasing seniority (Linear regression coefficient = 0.273, 95% CI: 0.033 to 0.513, ANOVA p= 0.026). This in-depth examination of the quality of training on a large psychiatry training programme successfully elicited strengths and weakness of our programme. Such an interview scheme could be easily implemented in smaller schemes and may well provide important information to allow for targeted improvement of training. Additionally, trends in quality of training and job satisfaction amongst various psychiatric specialities were identified; specifically speciality posts and liaison posts in psychiatry were revealed to be the most popular with trainees.

  10. Against Explanatory Minimalism in Psychiatry. (United States)

    Thornton, Tim


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

  11. What Psychiatry Means to Me

    Directory of Open Access Journals (Sweden)

    Helen Herrman


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

  12. What they think of us: A study of teaching medical specialists' attitude towards psychiatry in India. (United States)

    Patra, Suravi; Patro, Binod Kumar


    Attitudes of teaching medical specialists are important in shaping medical students' attitudes toward psychiatry. Data on attitudes of teaching medical specialists of India toward psychiatry are limited. The aim was to study the attitude of teaching medical specialists of an academic medical center in East India toward psychiatry. This was a cross-sectional descriptive study. We administered attitude toward psychiatry-30 (ATP 30) scale to teaching medical specialists of the All India Institute of Medical Sciences, Bhubaneswar, based on convenience sampling. Of 104 specialists contacted, 88 returned the completed questionnaire. We carried out descriptive statistical analysis and expressed results in mean and standard deviation. We analyzed the association of demographic characteristics, specialization, and duration of professional experience with total ATP scores using Chi-square test. We used subgroup analysis to compare mean ATP scores in different demographic and professional groups. We used independent t-test and ANOVA for between group comparisons. The response rate was 84.62% with a mean ATP score of 88.60. Female gender and having a family member with mental illness was significantly associated with favorable ATP. Notable findings were that 97% of participants were favorable toward patients with psychiatric illness, 90% felt psychiatric interventions as effective whereas 87% found psychiatry unappealing and 52% said that they would not have liked to be a psychiatrist. While favorable attitudes toward patients with psychiatric illness and psychiatric interventions may mean better patient care; unfavorable attitudes toward psychiatry as a career choice may adversely affect postgraduate recruitment rates.

  13. Incorporating Lifelong Learning From Residency to Practice: A Qualitative Study Exploring Psychiatry Learners' Needs and Motivations. (United States)

    Sockalingam, Sanjeev; Soklaridis, Sophie; Yufe, Shira; Rawkins, Sian; Harris, Ilene; Tekian, Ara; Silver, Ivan; Wiljer, David


    There has been an increased focus on lifelong learning (LLL) as a core competency to develop master learners in medical education across the learner continuum. The purpose of this study was to explore the perceptions of psychiatry residents and faculty about LLL implementation, motivation, and training needs. This qualitative study was conducted in a large, urban, multisite psychiatry training program as part of a larger mixed methods study of LLL in psychiatry education. Using a purposive sampling approach, psychiatry residents were recruited to participate in focus groups; early career psychiatrists and psychiatry educators were recruited to participate in semistructured interviews. Content analysis of interviews and focus groups was done using the iterative, inductive method of constant comparative analysis. Of the 34 individuals participating in the study, 23 were residents, six were psychiatry educators, and five were early career psychiatrists. Three predominant themes were identified in participants' transcripts related to (1) the need for LLL training in residency training; (2) the implementation of LLL in residency training and practice; and (3) the spectrum of motivation for LLL from residency training into practice. This study identified the lack of preparation for LLL in residency training and the impact of this gap for psychiatrists transitioning into practice. All participants described the importance of integrating LLL training within clinical rotations and the importance of grounding LLL within the clinical workplace early in residency training to support the delivery of effective, high-quality patient care.

  14. Caregivers, school liaisons, and agency advocates speak out about the educational needs of children and youths in foster care. (United States)

    Zetlin, Andrea; Weinberg, Lois; Shea, Nancy M


    Children in foster care comprise a population of students at great risk for school failure. The child welfare agency, schools, and home must all work together to provide the services and supports required to achieve better results. The purpose of this study was to conduct focus groups with participants from each sector to discuss their views on the educational problems and needs of students in foster care and their recommendations for what is needed to improve the academic prospects of foster students. The article provides details of the distinct themes identified by caregivers, school liaisons, and agency advocates and reveals how each group-while recognizing that foster students face substantial school problems-operates independent of each other and lacks a shared view on what is needed. The article concludes with recommendations for designing a model program that involves all the sectors and provides an arena for strategically addressing barriers to school success.

  15. psychiatry

    African Journals Online (AJOL)

    'People have sought comfort for their miseries and a cure for ... and into the 20th century a medical, organic approach to mental ... tries differ widely from North America and Western Europe. Yet ... beliefs regarding human nature, and in many cultures this means ... The term implies that the responsibility for treatment is not.

  16. Psychiatry

    African Journals Online (AJOL)

    but was only identified in 19589-4 In humans, melatonin is ... It acutely inhibits neuronal firing in the SCN ... and stimulates a number of antioxidative enzymes.1 This might ... secretion and white cell count peak during the transition from ... irregular sleep-wake pattern (ISWP) and non-24-hour sleep- .... same time every year.

  17. L Ron Hubbard's science fiction quest against psychiatry. (United States)

    Hirshbein, Laura


    Layfayette Ronald Hubbard (1911-1986) was a colourful and prolific American writer of science fiction in the 1930s and 1940s. During the time between his two decades of productivity and his return to science fiction in 1980, Hubbard founded the Church of Scientology. In addition to its controversial status as a religion and its troubling pattern of intimidation and litigation directed towards its foes, Scientology is well known as an organised opponent to psychiatry. This paper looks at Hubbard's science fiction work to help understand the evolution of Scientology's antipsychiatry stance, as well as the alternative to psychiatry offered by Hubbard. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  18. A survey of British senior psychiatry trainees' ethnocultural personal values. (United States)

    Neelam, Kishen; Duddu, Venugopal; Chaudhry, Imran Bashir; Antonysamy, A S; Husain, Nusrat


    The authors explored the ethnocultural values of a group of senior psychiatry trainees in the northwest region of England. The authors surveyed senior psychiatry trainees using the Personal Values Questionnaire and analyzed responses under the headings of ethnic stereotypes, ethnocultural service issues, and perceptions of racism. They also explored training requirements on cultural issues in a subsample of trainees. The majority of the trainees disagreed with certain commonly held ethnic stereotypes and acknowledged the role of culture in mental health. However, they had contrasting views on the need for culture-specific services and on perceptions of racism. They expressed interest in training programs on cultural issues in psychiatric practice. In multicultural settings, personal beliefs, perceptions, and values are likely to influence psychiatric practice. A training program on cultural aspects of mental health could help improve awareness and sensitivity of these issues and the quality of care.

  19. Teaching psychiatry residents to teach: a national survey. (United States)

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


    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. All psychiatry training programs across the United States were mailed a semistructured questionnaire; 95 responded (response rate: 53%). The survey included questions on what, if anything, was provided in the way of formal instruction; the number of seminars offered each year; texts and other materials that were used for teaching; and how seminars were evaluated. The majority (N=69, 73%) of all responding programs provided formal instruction to residents about how to teach. Topics most commonly taught included evaluation and feedback (N=57; 60%), lecturing skills (N=43; 45%), small-group skills (N=40; 42%), learning theory (N=37; 39%), and problem-based learning (N=36; 38%). Instructional methods used were predominantly group discussion (N=62; 65%), lecturing (N=59; 62%), reading of relevant literature (N=35; 37%), role-playing (N=33; 35%), and audiovisual instruction (N=32; 34%). There was a heterogeneity of texts and materials used for teaching. Few of the programs utilized formal validated and reliable tools for evaluating their teaching. Although most programs provided formal teaching, there remains a need to further develop teaching programs and to create model ones.

  20. Psychiatry beyond the asylum: the origins of German military psychiatry before World War I. (United States)

    Lengwiler, Martin


    This study examines the co-operation between psychiatry and the army in Germany between 1870 and 1914, leading to the establishment of military psychiatry as an independent discipline. Arguing that military psychiatry played a key role in the history of modern clinical psychiatry, the paper points out how the first generation of military psychiatrists developed innovative diagnostic technologies, such as the intelligence test, and established crucial institutional alliances between psychiatric clinics, military authorities, and local and national administrations. The early history of military psychiatry marks the transition of psychiatry from a medical sub-discipline to a more generally applicable "social technology" assessing the borderline between normality and abnormality in multiple social contexts.

  1. Training Psychiatry Addiction Fellows in Acupuncture (United States)

    Serafini, Kelly; Bryant, Katurah; Ikomi, Jolomi; LaPaglia, Donna


    Objective Acupuncture has been studied as an adjunct for addictions treatment. Because many hospitals, outpatient clinics, and facilities are integrating acupuncture treatment, it is important that psychiatrists remain informed about this treatment. This manuscript describes the National Acupuncture Detoxification Association (NADA) protocol and its inclusion as part of the curriculum for psychiatry addictions fellows. Methods Psychiatry and psychology fellows completed the NADA training (N = 20) and reported on their satisfaction with the training. Results Overall, participants stated that they found the training beneficial and many were integrating acupuncture within their current practice. Conclusions Results support the acceptability of acupuncture training among psychiatry fellows in this program. PMID:26048457

  2. Psychiatry outside the framework of empiricism. (United States)

    Mume, Celestine Okorome


    Science is interested in whatever that is empirical and objective. Any claim that cannot be objectively demonstrated has no place in science, because the subject does not deviate from the role, which it has set out to play in the life of mankind. Psychiatry, as a scientific discipline, plays along these basic principles. In the etiology, symptomatology, and management of psychiatric disorders, the biopsychosocial model recognizes the role of biological, psychological, and social factors. This essay views psychiatry from the biopsychosocial perspective and asserts that certain elements, which may not be readily and empirically verifiable, are important in the practice of psychiatry.

  3. A Marxist approach to psychology and psychiatry. (United States)

    Nahem, J


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

  4. Bright Light Treatment in Psychiatry

    Directory of Open Access Journals (Sweden)

    Pinar Guzel Ozdemir


    Full Text Available Bright light treatment is a treatment modality that leads elevation of mood due to attenuation in depressive symptoms, regulation in circadian rhythm activity, increase the effect of antidepressants and amelioration in sleep quality. Bright light treatment is considered among the first-line treatments for seasonal affective disorder because of high response rates. Additionally, bright light treatment being extended to other conditions, including non-seasonal mood disorders, Alzheimer's disease, circadian rhythm sleep disorders, eating disorders, attention deficit hyperactivity disorder and other behavioral syndromes is likely to have a far reached use. Side effects are often temporary and can generally be overcome by reducing exposure time. The central focus on this paper is to review the action mechanisms, efficacy, usage areas, the ways of administration and side effects of the light treatment. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(2.000: 177-188

  5. Biological Psychiatry, Research And Industry

    Directory of Open Access Journals (Sweden)

    Ajai R. Singh


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

  6. Relational agents in clinical psychiatry. (United States)

    Bickmore, Timothy; Gruber, Amanda


    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.

  7. [Disaster psychiatry in late life]. (United States)

    Awata, Shuichi


    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.

  8. Undergraduate psychiatry students' attitudes towards teaching methods at an Irish university. (United States)

    Jabbar, F; Casey, P; Kelly, B D


    At University College Dublin, teaching in psychiatry includes clinical electives, lectures, small-group and problem-based teaching, consistent with international trends. To determine final-year psychiatry students' attitudes towards teaching methods. We distributed questionnaires to all final-year medical students in two classes (2008 and 2009), after final psychiatry examination (before results) and all of them participated (n = 111). Students' interest in psychiatry as a career increased during psychiatry teaching. Students rated objective structured clinical examination (OSCE) as the most useful element of teaching and examination. The most common learning style was "reflector"; the least common was "pragmatist". Two thirds believed teaching could be improved (increased patient contact) and 89 % reported that experience of psychiatry changed attitudes towards mental illness (increased understanding). Students' preference for OSCEs may reflect the closeness of OSCE as a form of learning to OSCE as a form of assessment: OSCEs both focus on specific clinical skills and help prepare for examinations. Future research could usefully examine the extent to which these findings are university-specific or instructor-dependent. Information on the consistency of various teaching, examination and modularisation methods would also be useful.

  9. Recommendations for switching antipsychotics. A position statement of the Spanish Society of Psychiatry and the Spanish Society of Biological Psychiatry. (United States)

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


    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.

  10. [Clinical psychiatry and suicide prevention]. (United States)

    Cho, Yoshinori


    People do not commit suicide all of a sudden. There is a suicidal process where negative life events are there in the beginning, and social support and help-seeking behavior play an important role in impeding the progress of the process. Mental disturbance would be deeply associated with the suicidal process around the final stage, thinking of the fact that approximately 90% of the suicides suffered from mental disorders at the time of suicide. In considering the strategies for suicide prevention, there are two perspectives: a community model and a medical model. A community model is thought to be related mainly to the first half of the suicidal process and a medical model to the latter half. It is an ideal that both community and medical approaches are put into practice simultaneously. However, if resources available for suicide prevention are limited, a medical-model approach would be more efficient and should be given priority. Starting from a medical model and considering treatment and social resources necessary for suicidal people, the range of suicide prevention activities would be expand more efficiently than starting from a community-model approach. Clinical psychiatry plays a greatly important role in preventing suicide. It is found that approximately 20% of seriously injured suicide attempters were diagnosed as adjustment disorder in Japan, which means that even the mildly depressed can commit suicide. Therefore, no one can take a hands-off approach to suicidality as long as he/she works in the field of clinical psychiatry. It is earnestly desired to detect and treat properly the suicidal patients, but there is no perfect method. It would be helpful to pay attention to patients' personality development, stress-coping style and present suicidal ideation. Besides, as suicide prevention is not completed only in a consulting room, it is important for psychiatrists to look for teamwork.

  11. Liaison activities with the Institute of Physical Chemistry, Russian Academy of Sciences: FY 1997

    Energy Technology Data Exchange (ETDEWEB)

    Delegard, C.H.; Elovich, R.J.


    The Institute of Physical Chemistry of the Russian Academy of Sciences is conducting a program of fundamental and applied research into the chemistry of the actinides and technetium in alkaline media such as are present in the Hanford Site underground waste storage tanks. This work is being coordinated and the results disseminated through a technical liaison maintained at the Pacific Northwest National Laboratory. The technical liaison is performing laboratory studies on plutonium chemistry in alkaline media. The activities at the Institute of Physical Chemistry and through the liaison are pursued to improve understanding of the chemical behavior of key long-lived radioactive elements under current operating and proposed tank waste processing conditions. Both activities are supported by the Efficient Separations and Processing Crosscutting Program under the Office of Science and Technology of the U.S. Department of Energy.

  12. An Analysis of Potential Contributions of the Host Country National Local Liaison Role in Global Knowledge Management

    DEFF Research Database (Denmark)

    Vance, Charles; Vaiman, Vlad; Andersen, Torben


    resource broker, talent developer, and internal change agent. We also consider benefits and limitations of this HCN local liaison role, as well as areas for future exploratory field research to help validate and elucidate this present model of the HCN local liaison role. This model also provides some...

  13. Use of the Planning Outreach Liaison Model in the Neighborhood Planning Process: A Case Study in Seattle's Rainier Valley Neighborhood

    Directory of Open Access Journals (Sweden)

    Molly Oshun


    Full Text Available Our study examines a nontraditional engagement process employed by the City of Seattle during neighborhood plan updates. Adapting the trusted advocates model from the public health field, the city hired planning outreach liaisons (POLs from 13 diverse community groups to solicit input from traditionally underrepresented residents. To explore the efficacy of this approach, we collected data through interviews with residents, neighborhood leaders, community development firm employees, university researchers, and municipal staff; a review of planning documents; observation at planning meetings. We found that the POLs effectively engaged underrepresented groups—including more than 1,200 stakeholders—particularly those characterized as self-organized, centralized or having strong social networks and were important in the advancement of democratic principles. Greater transparency by the city about process goals and constraints, along with strategies to address power issues, may have facilitated better communication and relationship building among the city, newly enfranchised residents, and the “usual suspects.”

  14. Neuropsychological predictors of adaptive kitchen behavior in geriatric psychiatry inpatients. (United States)

    Benedict, R H; Goldstein, M Z; Dobraski, M; Tannenhaus, J


    This study examined the degree to which demographic variables, psychiatric diagnosis, depression rating, and neuropsychological test performance predict adaptive kitchen behavior in geriatric psychiatry patients and normal elderly volunteers. Amixed group of 27 participants including 8 normal volunteers and 19 geriatric psychiatry inpatients underwent psychiatric evaluation, neuropsychological testing, and a kitchen skills assessment conducted in a natural setting. Both depression and dementia were prevalent among patients. The kitchen skills assessment was abnormal in 69% of patients, compared to none of the normal volunteers. Estimated premorbid IQs, psychiatric diagnosis, and neuropsychological test scores significantly predicted the pass/fail status on the kitchen skills assessment, but there was no effect for age, education, gender, or depression. The discriminant function analysis classified 92% of cases, and the canonical correlation coefficient was .84. Of the neuropsychological tests employed in the study, two tests involving visuospatial processing and attention were retained in the discriminant function analysis. The results are consistent with previous studies that suggest that visuospatial tasks are more predictive of instrumental activities of daily living than are cognitive tasks emphasizing verbal and memory abilities. In addition, we conclude that neuropsychological test data are useful and valid for the purpose of guiding clinical judgments regarding activities of daily living in geriatric psychiatry patients.

  15. [Psychiatry, the field of all risks]. (United States)

    Gilioli, Christian


    Mental disorders lead patients along paths of irrationality. Insanity is perceived as excessiveness, often associated with violence. Risk in psychiatry is omnipresent and nursing practice is performed within a narrow safety zone. The media coverage of sensitive situations does not help. Ensuring the patient's recovery, respecting the fundamental principles of individual freedom while assuring the utmost safety of others is the constant challenge facing caregivers in psychiatry. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Why is psychiatry prone to fads? (United States)

    Paris, Joel


    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.

  17. [Specialized training in geriatric psychiatry during residency in France]. (United States)

    Lepetit, Alexis; Lavigne, Benjamin; Legros, Emilie; Herrmann, Mathieu; Sebbane, Déborah


    Aging of the population is a growing concern in developed countries. Therefore, geriatric psychiatry has gradually emerged from general psychiatry. Many names have been proposed to term this sub-specialty: old age psychiatry (OAP), psychogeriatrics, geropsychiatry. A working group of the French federation of psychiatric trainees (AFFEP) set up an inventory of the theoretical instruction and clinical practice of OAP during the training of psychiatrists in France. Methods. A survey of both academic teaching and practical training for OAP was carried out in the 28 local AFFEP representatives of every French medical residency district, including overseas. We assessed the supply of general courses and seminars devoted to OAP during the training of French residents in psychiatry, and the offer of university or inter-university degrees as well as the possibility of specialized internship in every residency district. Results. 96% of French medical residency districts offered general courses of OAP with a mean volume of 11.5 hours along the four years of psychiatric training in France. Fifty percent of medical residency districts proposed at least one seminar devoted to OAP. Half of medical residency districts also offer a specialized university or inter-university degree. Concerning clinical practice, 86% of medical residency districts had one internship dedicated to OAP, in 39% of cases in teaching hospitals. Conclusion. Nationwide, there is an overall effort to make OAP available to French psychiatric residents by general courses and internship, but some disparity appeared in academic teaching (i.e. offering seminars and university/inter-university degrees) according to various residency districts.

  18. On the Subjectivity of Liaison Interpreters in Business Sector——The Person Application

    Institute of Scientific and Technical Information of China (English)

    张菁; 姚青; 向凤雅


    Nowadays,commercial interactions,exchanges,andcorporation occur more and more frequently in almost every business sector between China and other countries.As a result,business interpreting carries an increasing significance day after day,especially between English and Chinese.When it comes to the role of liaison interpreters,specifically in business sector,the importance of their subjectivity hasn’t been widely realized.So it is quite meaningful to propose and implement the active role of liaison interpreters and to apply their subjectivity to real commercial situations.

  19. Frequency of anemia in chronic psychiatry patients

    Directory of Open Access Journals (Sweden)

    Korkmaz S


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

  20. Psychiatry and the military: an update. (United States)

    Ritchie, Elspeth Cameron; Benedek, David; Malone, Ricky; Carr-Malone, Rosemary


    The United States has historically been concerned about the successful adjustment of its military members returning from war. These concerns are based on the recognition that war-zone exposures may have considerable negative emotional or behavior consequences. As the global war on terror continues, the United States military medical system will be required to address issues at the interface of psychiatry and the law. Despite clinical advances within the theater of war and at tertiary facilities in the United States, some military members will develop chronic and disabling mental illness as a result of traumatic exposure and exacerbated by the demands of the austere and dangerous operational environment. The extent to which violent and aggressive behavior in the aftermath of deployment can be attributed to combat experience remains an area of debate and ongoing investigation. However, experience suggests that a very small subgroup of the hundreds of thousands of war veterans deployed in conjunction with the current conflict in Iraq has already been involved in violent crimes. For this group, military forensic psychiatrists will be called on to make determinations of competency and criminal responsibility and to inform the courts about the potential contributions of war-related distress or disorder to criminal behavior. Though the overwhelming majority of war veterans will not be involved in criminal proceedings, a minority will develop career-ending (and in rare instances, life-ending) disabilities as a result of mental illness. For those who are no longer fit for duty, the military Physical Disability Evaluation System must make determinations of the extent to which future military performance and future civilian social and occupational function have been compromised. For a small yet highly visible minority of returning veterans, questions about the cause, precipitants, and manner of death will necessitate psychological autopsies. This article highlighted recent

  1. Divergent Fates of the Medical Humanities in Psychiatry and Internal Medicine: Should Psychiatry Be Rehumanized? (United States)

    Rutherford, Bret R.; Hellerstein, David J.


    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…

  2. Attitudes of Medical Students towards Psychiatry: Effects of Training, Courses in Psychiatry, Psychiatric Experience and Gender (United States)

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


    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…

  3. Innovative Training in Pediatrics, General Psychiatry, and Child Psychiatry: Background, Outcomes, and Experiences (United States)

    Gleason, Mary Margaret; Fritz, Gregory K.


    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…

  4. Physicians as Managers: Psychiatry Residents' Perceived Gaps in Knowledge and Skills in Administrative Psychiatry (United States)

    Sockalingam, Sanjeev; Stergiopoulos, Vicky; Maggi, Julie


    Objective: The authors determine psychiatry residents' perceived needs and educational preferences for a physician-manager curriculum. Method: The authors surveyed 102 psychiatry residents at the University of Toronto for their perceived current and desired knowledge and skills in specific administrative areas, and their educational preferences…

  5. Reaching rural Ohio with intellectual disability psychiatry. (United States)

    Gentile, Julie P; Cowan, Allison E; Harper, Beth; Mast, Ryan; Merrill, Brian


    Individuals with intellectual disability experience higher rates of mental illness when compared with the general population, and there is a lack of medical and mental health professionals in rural and under-served areas. With the increase in discharge of individuals from institutional settings back to their home communities into the least restrictive environments, there are more patients with complex needs being added to the schedules of physicians in the outpatient delivery care system. Patients with disabilities may not travel well or tolerate changes in routine so may not have access to psychiatry. Utilization of telepsychiatry is well suited to this specialized patient population because it allows a highly traumatized group to meet with a psychiatrist and other mental health professionals from a location of their choice. Ohio's Telepsychiatry Project for Intellectual Disability was initiated in 2012 to serve outlying communities with a lack of infrastructure and resources, to provide specialized mental health services to individuals with co-occurring mental illness and intellectual disability. After five years, over 900 patients with intellectual disability from 64 of Ohio's 88 counties receive specialized mental health treatment through this statewide grant-funded project.

  6. Morale is high in acute inpatient psychiatry. (United States)

    Bowers, Len; Allan, Teresa; Simpson, Alan; Jones, Julia; Whittington, Richard


    Morale on acute psychiatric wards has been considered to be problematic, and is reported to contribute to low quality patient care. To assess the relationship of staff morale to patient, service environment, physical environment, patient routines, conflict, containment, staff demographics, and staff group variables. A multivariate cross sectional study was undertaken collecting data on morale, as measured by the Maslach Burnout Inventory, and other variables on 136 acute admission psychiatric wards in England. Morale was higher than published comparison samples. Length of time in post was correlated with low morale, and qualified nurses had higher emotional exhaustion but also higher personal accomplishment. The level of verbal abuse on a ward was associated with low morale, as was a higher level of social deprivation among patients. Higher levels of order and organisation correlated with better morale. Clear policies relating to the management of verbal abuse by patients, high levels of order and organisation, and staff rotation and education, may all support high morale. Acute inpatient psychiatry is generally a happy and rewarding work environment, and identified problems are likely to be due to other factors.

  7. [The potential use of ayahuasca in psychiatry]. (United States)

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


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

  8. New image of psychiatry, mass media impact and public relations. (United States)

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


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

  9. PET and SPECT in psychiatry

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


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

  10. Workplace Based Assessment in Psychiatry

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    Ayse Devrim Basterzi


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

  11. Neurology and psychiatry in Babylon. (United States)

    Reynolds, Edward H; Wilson, James V Kinnier


    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.

  12. [Reform of psychiatry in Spain]. (United States)

    Pedrosa Gil, F; Luderer, H J


    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.

  13. The Benefits of Non-Library Professional Organization Membership for Liaison Librarians (United States)

    Bennett, Miranda Henry


    Although liaison librarians have two important professional identities--librarian and subject specialist--the library literature has paid scant attention to their membership and participation in non-library professional organizations. This article analyzes a study of ten librarians who joined non-library associations and concludes that membership…

  14. Consultation-liaison service in a regional hospital in Hong Kong. (United States)

    Wong, M M C; Yiu, M G C


    To examine consultation-liaison psychiatric services in a general hospital in Hong Kong. All records of Tseung Kwan O Hospital psychiatric consultations from 1 July 2012 to 30 June 2013 were extracted from the database. Patients' demographic data, sources and reasons of referral, psychiatric and suicidal histories, current suicidal attempt, psychiatric diagnoses, psychiatric outcomes, as well as waiting times were analysed accordingly. A total of 1392 psychiatric consultations were received, of which 82% were attended to within the same working day when the referral was received, and 99% were attended to by the end of the next working day. The commonest reasons of consultation were unstable emotion followed by suicidal / deliberate self-harm and aggression. There were 246 consultations with actual suicidal attempt. Overall, 270 (19%) patients who received consultation-liaison psychiatric services were admitted to the psychiatric wards. Follow-up in the psychiatric outpatient department was arranged for 691 (50%) patients while 57 (4%) required referral to the community psychiatric nursing service in addition to outpatient department arrangement. Management of suicidal attempters and provision of risk assessment continue to be the major tasks of consultation-liaison psychiatrists and nurses. A readily available on-site consultation-liaison psychiatric service is an essential component of services provided in acute general hospitals.

  15. Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients

    NARCIS (Netherlands)

    Hempenius, Liesbeth; Slaets, Joris; van Asselt, Dieneke; de Bock, Truuske H; Wiggers, Theo; van Leeuwen, Barbara L


    Background The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a

  16. 75 FR 26757 - National Toxicology Program (NTP); Office of Liaison, Policy and Review; Meeting of the... (United States)


    ... Animals. Federal Agency Research, Development, Translation, and Validation Activities Relevant to the...); Office of Liaison, Policy and Review; Meeting of the Scientific Advisory Committee on Alternative... Agency, 109 T.W. Alexander Drive, Research Triangle Park, NC 27711. The meeting is open to the...

  17. Academic medicine change management: the power of the liaison committee on medical education accreditation process. (United States)

    Chandran, Latha; Fleit, Howard B; Shroyer, A Laurie


    Stony Brook University School of Medicine (SBU SOM) used a Liaison Committee on Medical Education (LCME) site visit to design a change management approach that engaged students, revitalized faculty, and enabled significant, positive institutional transformation while flexibly responding to concurrent leadership transitions. This "from-the-trenches" description of novel LCME site-visit-related processes may provide an educational program quality improvement template for other U.S. medical schools. The SBU SOM site visit processes were proactively organized within five phases: (1) planning (4 months), (2) data gathering (12 months), (3) documentation (6 months), (4) visit readiness (2 months), and (5) visit follow-up (16 months). The authors explain the key activities associated with each phase.The SBU SOM internal leadership team designed new LCME-driven educational performance reports to identify challenging aspects of the educational program (e.g., timeliness of grades submitted, midcourse feedback completeness, clerkship grading variability across affiliate sites, learning environment or student mistreatment incidents). This LCME process increased institutional awareness, identified the school's LCME vulnerabilities, organized corrective actions, engaged key stakeholders in communication, ensured leadership buy-in, and monitored successes. The authors' strategies for success included establishing a strong internal LCME leadership team, proactively setting deadlines for all phases of the LCME process, assessing and communicating vulnerabilities and action plans, building multidisciplinary working groups, leveraging information technology, educating key stakeholders through meetings, retreats, and consultants, and conducting a mock site visit. The urgency associated with an impending high-stakes LCME site visit can facilitate positive, local, educational program quality improvement.

  18. [Where is going philosophy of psychiatry ?]. (United States)

    Basso, Elisabetta


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

  19. Attitudes of psychiatry residents toward mental illness

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    Pejović-Milovančević Milica


    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. .

  20. Educating psychiatry residents in neuropsychiatry and neuroscience. (United States)

    Benjamin, Sheldon


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

  1. Limitations of the biopsychosocial model in psychiatry

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    Benning TB


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

  2. Central registry in psychiatry: A structured review

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    Jyoti Prakash


    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.

  3. Dr. Irvin Yalom Discusses Group Psychotherapy. (United States)

    Forester-Miller, Holly


    In this interview, Dr. Irvin Yalom, director of the Adult Psychiatry Clinic at Stanford University School of Medicine, discusses his beginnings as a group psychotherapist, current issues in group work, and the future of group work. (Author/TE)

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

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    Yatan Pal Singh Balhara


    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.

  5. From Kraepelin to a modern and integrative scientific discipline: the development of transcultural psychiatry in Germany. (United States)

    Machleidt, Wielant; Sieberer, Marcel


    The roots of transcultural psychiatry in Germany can be traced back to Emil Kraepelin, who made the first culturally comparative observations on mental disorders in Southeast Asia at the start of the 20th century. Since the beginning of the 1970s, contributors to the literature of transcultural psychiatry in Germany have been predominantly concerned with the mental health of migrant workers from Mediterranean countries, particularly the practical difficulties and therapeutic implications of inpatient psychiatric treatment of these migrant groups. The inauguration of the Section on Transcultural Psychiatry of the German Association for Psychiatry and Psychotherapy 20 years ago reflected an increasing scientific interest in this topic. In addition to the psychic impact of migration, research into transcultural care is currently focused on disparities in the utilization of health care and conjectured barriers to access to health and mental health care among migrants. Furthermore, studies based on epidemiological approaches have been carried out in order to resolve the question of whether migrants are as affected by mental disorders as the ethnic German population, and which issues contribute to the so-called "healthy migrant" effect. Other topics that have been explored in the last 10 years are the particular psychosocial situation of asylum seekers and refugees in Germany, and the effects of inadequate integration and discrimination on their mental health. In summary, after a short historical and theoretical overview, this article reviews the current major themes in transcultural research in German contemporary psychiatry, and concludes with an overview of future developments in this field.

  6. Challenges in conducting psychiatry studies in India

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    Saifuddin Kharawala


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

  7. Teaching Psychiatry Residents to Teach: A National Survey (United States)

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


    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…

  8. Survey of Threats and Assaults by Patients on Psychiatry Residents (United States)

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


    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…

  9. Factors Affecting Recruitment into Child and Adolescent Psychiatry Training (United States)

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


    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…

  10. Disease mongering in psychiatry: fact or fiction?

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    S Saddichha


    Full Text Available Disease mongering starts at the top of recent accusations being hurled at psychiatry. It is used to refer to the attempts by pharmaceutical companies or others who have similar interests, to enlarge the market for a treatment by convincing people that they are sick and need medical intervention. This paper critically analyses the 'for' and 'against' arguments of disease mongering in psychiatric disorders, both new and old, such as Bipolar disorders, attention deficit hyperactivity disorder, Restless legs syndrome, Premenstrual dysphoric disorder, female sexual dysfunction, social phobia, metabolic syndrome and road rage disorder. Keywords: disease mongeringpharmaceutical companies, psychiatry.

  11. Why do we need a social psychiatry? (United States)

    Ventriglio, Antonio; Gupta, Susham; Bhugra, Dinesh


    Human beings are social animals, and familial or social relationships can cause a variety of difficulties as well as providing support in our social functioning. The traditional way of looking at mental illness has focused on abnormal thoughts, actions and behaviours in response to internal causes (such as biological factors) as well as external ones such as social determinants and social stressors. We contend that psychiatry is social. Mental illness and interventions in psychiatry should be considered in the framework of social context where patients live and factors they face on a daily basis.

  12. Computational Psychiatry and the Challenge of Schizophrenia. (United States)

    Krystal, John H; Murray, John D; Chekroud, Adam M; Corlett, Philip R; Yang, Genevieve; Wang, Xiao-Jing; Anticevic, Alan


    Schizophrenia research is plagued by enormous challenges in integrating and analyzing large datasets and difficulties developing formal theories related to the etiology, pathophysiology, and treatment of this disorder. Computational psychiatry provides a path to enhance analyses of these large and complex datasets and to promote the development and refinement of formal models for features of this disorder. This presentation introduces the reader to the notion of computational psychiatry and describes discovery-oriented and theory-driven applications to schizophrenia involving machine learning, reinforcement learning theory, and biophysically-informed neural circuit models. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center 2017.

  13. How Health Reform is Recasting Public Psychiatry. (United States)

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


    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.

  14. Psychiatry, ethnicity and migration: the case of Palestine, 1920-1948. (United States)

    Zalashik, Rakefet


    The aim of the paper is to explore the development of psychiatry in Palestine from two main perspectives: ethnicity and immigration. In Palestine the subject of immigration and psychiatry were highly complicated and had unique features. Thus, both psychiatrists and patients were immigrants who belonged to the same ethnic group sharing the same ideology and objectives. The examination will uncover the social construction of mental diseases among Jewish immigrants in Palestine - patients and psychiatrists - and elucidate another layer in the development of the Zionist Jewish society in Palestine up to the establishment of the State of Israel.

  15. Italian social psychiatry research: what gets published in peer reviewed journals? (United States)

    Galeazzi, Gian Maria; Priebe, Stefan


    To explore the current state of Italian social psychiatry research as evidenced by original papers published in peer-reviewed journals 2004-2006. Electronic databases and hand searches of leading peer-reviewed journals were used to identify original research papers published in 2004-2006, addressing a social psychiatric issue, having at least one Italian author, and reporting data from Italian samples. A total of 174 papers were identified. A substantial proportion reported findings of international collaborative research. Quantitative methods dominated, with 86 papers on cross-sectional surveys. Only 18 papers showed results of intervention trials with pre and post measures. Most common target group were psychiatric patients in community mental health services which featured in 93 papers. There is a critical mass of Italian social psychiatry research, dominated by a few research centres and with considerable amount of international collaboration. The findings of this survey might reflect the relative shortage of national funding for social psychiatry research.

  16. Senior medical students' attitudes toward psychiatry as a career choice before and after an undergraduate psychiatry internship in Iran. (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


    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 the medical school psychiatry rotation in the United States, but mandatory in Iran) in three major medical schools in Tehran, the capital of Iran. Sixth- and seventh-year medical students (locally called interns, N=347) at Tehran, Shahid Beheshti, and Iran Universities of Medical Sciences were consecutively invited to complete anonymous self-report questionnaires designed to assess their perceptions of careers in psychiatry before and after internship in psychiatry wards. Also, students evaluated psychiatry in terms of the factors that reflected the degree of attractiveness of this specialty. Positive responses toward choosing psychiatry as a career were seen in 18.8% before and 20.0% after psychiatry rotation. No significant differences were observed in the positive responses before and after psychiatry internship. The students' opinions changed to a more attractive degree in terms of only 3 out of the 13 defined aspects. There was also no significant difference in the total score on attractiveness of psychiatry before and after the psychiatry internship. The study indicated that undergraduate psychiatry internship might not induce more students to consider psychiatry as a possible career. The present pattern of psychiatry education in Iran seems not to positively affect most aspects of medical students' attitudes toward psychiatry.

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


    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…

  18. 75 FR 12244 - National Toxicology Program (NTP); Office of Liaison, Policy and Review; Meeting of the NTP Board... (United States)


    ... HUMAN SERVICES National Institutes of Health National Toxicology Program (NTP); Office of Liaison... authorities knowledgeable in fields such as toxicology, pharmacology, pathology, biochemistry, epidemiology, risk assessment, carcinogenesis, mutagenesis, molecular biology, behavioral toxicology,...

  19. Training Psychiatry Residents in Quality Improvement: An Integrated, Year-Long Curriculum (United States)

    Arbuckle, Melissa R.; Weinberg, Michael; Cabaniss, Deborah L.; Kistler; Susan C.; Isaacs, Abby J.; Sederer, Lloyd I.; Essock, Susan M.


    Objective: The authors describe a curriculum for psychiatry residents in Quality Improvement (QI) methodology. Methods: All PGY3 residents (N=12) participated in a QI curriculum that included a year-long group project. Knowledge and attitudes were assessed before and after the curriculum, using a modified Quality Improvement Knowledge Assessment…

  20. Imaging-Genetics Applications in Child Psychiatry (United States)

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


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

  1. Old age psychiatry in the modern age. (United States)

    Warner, James P


    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.

  2. Educational Supervision Appropriate for Psychiatry Trainee's Needs (United States)

    Rele, Kiran; Tarrant, C. Jane


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

  3. American Academy of Child and Adolescent Psychiatry (United States)

    ... latest Policy Statement on Psychologists Prescribing. Be CAPtivated - Child and Adolescent Psychiatry as a Career AACAP Latest News AACAP Statement on DACA Rescission More... AACAP Applauds Oregon Governor’s Veto of Psychology Prescribing Bill More... In Response to "13 Reasons ...

  4. Undergraduate Child Psychiatry Teaching in Melbourne, Australia (United States)

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


    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…

  5. Neurology is psychiatry--and vice versa. (United States)

    Zeman, Adam


    This paper explores the relationship between neurology and psychiatry. It marshals evidence that disorders of the brain typically have neurological and psychological-cognitive, affective, behavioural-manifestations, while disorders of the psyche are based in the brain. Given the inseparability of neurological and psychiatric disorders, their disease classifications should eventually fuse, and joint initiatives in training, service and research should be strongly encouraged.

  6. Assisting Undergraduate Physician Assistant Training in Psychiatry: The Role of Academic Psychiatry Departments. (United States)

    Rakofsky, Jeffrey J; Ferguson, Britnay A


    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.


    Directory of Open Access Journals (Sweden)

    Irina Vyacheslavovna Klimentova


    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.

  8. Development of a system for transferring images via a network: supporting a regional liaison. (United States)

    Mihara, Naoki; Manabe, Shiro; Takeda, Toshihiro; Shinichirou, Kitamura; Junichi, Murakami; Kouji, Kiso; Matsumura, Yasushi


    We developed a system that transfers images via network and started using them in our hospital's PACS (Picture Archiving and Communication Systems) in 2006. We are pleased to report that the system has been re-developed and has been running so that there will be a regional liaison in the future. It has become possible to automatically transfer images simply by selecting the destination hospital that is registered in advance at the relay server. The gateway of this system can send images to a multi-center, relay management server, which receives the images and resends them. This system has the potential to be useful for image exchange, and to serve as a regional medical liaison.

  9. [Successful intervention of a Palliative Liaison Service in case of ethical conflicts]. (United States)

    Hannesschläger, Heinz; Kopp, Martin; Holzner, Bernhard


    In multiprofessional teams, the processes underlying ethical decisions in Palliative Care often become complicated and could cause many conflicts. Different interests and ethical positions often slow down the necessary decision-making. The lack of resources, lack of managerial structures and deficits in competence and education make the situation more difficult. We demonstrated in our case report that an established Palliative Liaison Service could support the creation of consensual decisions by forming multiprofessional ethic round-ups.

  10. Neuroscience and humanistic psychiatry: a residency curriculum. (United States)

    Griffith, James L


    Psychiatry residencies with a commitment to humanism commonly prioritize training in psychotherapy, cultural psychiatry, mental health policy, promotion of human rights, and similar areas reliant upon dialogue and collaborative therapeutic relationships. The advent of neuroscience as a defining paradigm for psychiatry has challenged residencies with a humanistic focus due to common perceptions that it would entail constriction of psychiatric practice to diagnostic and psychopharmacology roles. The author describes a neuroscience curriculum that has taught psychopharmacology effectively, while also advancing effectiveness of language-based and relationship-based therapeutics. In 2000, the George Washington University psychiatry residency initiated a neuroscience curriculum consisting of (1) a foundational postgraduate year 2 seminar teaching cognitive and social neuroscience and its integration into clinical psychopharmacology, (2) advanced seminars that utilized a neuroscience perspective in teaching specific psychotherapeutic skill sets, and (3) case-based teaching in outpatient clinical supervisions that incorporated a neuroscience perspective into traditional psychotherapy supervisions. Curricular assessment was conducted by (1) RRC reaccreditation site visit feedback, (2) examining career trajectories of residency graduates, (3) comparing PRITE exam Somatic Treatments subscale scores for 2010-2012 residents with pre-implementation residents, and (4) postresidency survey assessment by 2010-2012 graduates. The 2011 RRC site visit report recommended a "notable practice" citation for "innovative neurosciences curriculum." Three of twenty 2010-2012 graduates entered neuroscience research fellowships, as compared to none before the new curriculum. PRITE Somatic Treatments subscale scores improved from the 23rd percentile to the 62nd percentile in pre- to post-implementation of curriculum (p neuroscience curriculum for a residency committed to humanistic psychiatry

  11. Influencing Factors on Choosing Psychiatry as a Career: An Exploration in Chinese University Students. (United States)

    Zhong, Jiawei; Zheng, Luna; Chen, Xiaoling; Gao, Qianqian; Zhang, Bingren; Wang, Wei


    There is a consistent need of psychiatric professionals in the world including China, and a consistent challenge to recruit more medical students into the psychiatric careers. We aimed to look for factors which have an impact on career-choosing of psychiatry in Chinese university students. We invited 508 non-medical students (NM), 304 medical students without (MO) and 123 medical students with clinical internship experience (MW), to answer a matrix of 43 questions regarding factors influencing career-choosing of psychiatry. Answers to these questions were analyzed through exploratory and confirmatory factor analyses, once the latent factors were identified and structurally-validated, their mean scores in three groups of students were calculated. Five factors with five items each were identified, namely social status inferiority, career importance, practice reward, career preference, and practice stress. NM scored lower than MO and MW did on Social Status Inferiority; NM group scored higher than MO and MW groups did on Career Importance; MW scored lower than NM and MO did on Practice Reward and on Career Preference; Regarding Practice Stress, NM scored higher than MO did, who then in turn, scored higher than MW did. In addition, Practice Stress was positively correlated with advice of the medical educators; and Social Status Inferiority and Career Preference were positively correlated with the psychiatry teaching of the medical educators. Raising career rewards, improving social status, and reinforcing psychiatric education might help to recruit more medical students to specialize in psychiatry practicing.

  12. Is psychiatry only neurology? Or only abnormal psychology? Déjà vu after 100 years. (United States)

    de Leon, Jose


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

  13. Evaluation of the LIAISON ANA screen assay for antinuclear antibody testing in autoimmune diseases. (United States)

    Ghillani, P; Rouquette, A M; Desgruelles, C; Hauguel, N; Le Pendeven, C; Piette, J C; Musset, L


    Antinuclear antibodies (ANA) are widely detected by immunofluorescence on HEp-2 cells in patients with connective tissue diseases and other pathological conditions. We evaluated the first-automated chemiluminescence immunoassay for the detection of ANA (LIAISON ANA screen, DiaSorin). This study was carried out simultaneously in two laboratories by testing 327 patient samples with clinically defined connective diseases, 273 routine samples for ANA screening, and 300 blood donors. A total of 268 out of 337 IIF-positive sera were positive with LIAISON ANA screen (79.5% of agreement) and 240 out of 263 IIF-negative sera were negative with LIAISON ANA screen (91.2% of agreement). After resolution of discrepant results, the concordance reached, respectively, 94.9% and 98.8%. The specificity was 99.3% and the sensitivity was 94%. Unlike results obtained by other ANA screening assays, we observed acceptable sensitivity and specificity. Despite the presence of HEp-2 cell extract, we failed to detect some antibodies as antinucleolar, antinuclear envelope, and antiproliferating cell nuclear antigen. This automated assay allows quick process to results and exhibits satisfactory sensitivity for the detection of the main ANA specificities of connective tissue diseases.

  14. Differential stigmatizing attitudes of healthcare professionals towards psychiatry and patients with mental health problems : Something to worry about? A pilot study

    NARCIS (Netherlands)

    Gras, L.M.; Swart, M.; Slooff, C.; van Weeghel, J.; Knegtering, H.; Castelein, S.


    Purpose This study compares stigmatizing attitudes of different healthcare professionals towards psychiatry and patients with mental health problems. Methods The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatizing attitudes in three groups: general practitioners

  15. Differential stigmatizing attitudes of healthcare professionals towards psychiatry and patients with mental health problems : something to worry about? A pilot study

    NARCIS (Netherlands)

    Gras, Laura M.; Swart, Marte; Slooff, Cees J.; van Weeghel, Jaap; Knegtering, Henderikus; Castelein, Stynke

    This study compares stigmatizing attitudes of different healthcare professionals towards psychiatry and patients with mental health problems. The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatizing attitudes in three groups: general practitioners (GPs, n = 55),

  16. Differential stigmatizing attitudes of healthcare professionals towards psychiatry and patients with mental health problems : something to worry about? A pilot study

    NARCIS (Netherlands)

    Gras, Laura M.; Swart, Marte; Slooff, Cees J.; van Weeghel, Jaap; Knegtering, Henderikus; Castelein, Stynke


    This study compares stigmatizing attitudes of different healthcare professionals towards psychiatry and patients with mental health problems. The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatizing attitudes in three groups: general practitioners (GPs, n = 55), men

  17. Differential stigmatizing attitudes of healthcare professionals towards psychiatry and patients with mental health problems : Something to worry about? A pilot study

    NARCIS (Netherlands)

    Gras, L.M.; Swart, M.; Slooff, C.; van Weeghel, J.; Knegtering, H.; Castelein, S.


    Purpose This study compares stigmatizing attitudes of different healthcare professionals towards psychiatry and patients with mental health problems. Methods The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatizing attitudes in three groups: general practitioners (G

  18. Cultural psychiatry. Theoretical, clinical, and research issues. (United States)

    Lewis-Fernández, R; Kleinman, A


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

  19. Facial emotion recognition ability: psychiatry nurses versus nurses from other departments. (United States)

    Gultekin, Gozde; Kincir, Zeliha; Kurt, Merve; Catal, Yasir; Acil, Asli; Aydin, Aybike; Özcan, Mualla; Delikkaya, Busra N; Kacar, Selma; Emul, Murat


    Facial emotion recognition is a basic element in non-verbal communication. Although some researchers have shown that recognizing facial expressions may be important in the interaction between doctors and patients, there are no studies concerning facial emotion recognition in nurses. Here, we aimed to investigate facial emotion recognition ability in nurses and compare the abilities between nurses from psychiatry and other departments. In this cross-sectional study, sixty seven nurses were divided into two groups according to their departments: psychiatry (n=31); and, other departments (n=36). A Facial Emotion Recognition Test, constructed from a set of photographs from Ekman and Friesen's book "Pictures of Facial Affect", was administered to all participants. In whole group, the highest mean accuracy rate of recognizing facial emotion was the happy (99.14%) while the lowest accurately recognized facial expression was fear (47.71%). There were no significant differences between two groups among mean accuracy rates in recognizing happy, sad, fear, angry, surprised facial emotion expressions (for all, p>0.05). The ability of recognizing disgusted and neutral facial emotions tended to be better in other nurses than psychiatry nurses (p=0.052 and p=0.053, respectively) Conclusion: This study was the first that revealed indifference in the ability of FER between psychiatry nurses and non-psychiatry nurses. In medical education curricula throughout the world, no specific training program is scheduled for recognizing emotional cues of patients. We considered that improving the ability of recognizing facial emotion expression in medical stuff might be beneficial in reducing inappropriate patient-medical stuff interaction.

  20. [Malaise in psychiatry and its history]. (United States)

    Chebili, S


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

  1. [Philosophy against psychiatry, right up against it]. (United States)

    Demazeux, Steeves


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

  2. Forensic psychiatry determination of mental capacity

    Directory of Open Access Journals (Sweden)

    Jovanović Aleksandar A.


    Full Text Available Forensic psychiatry determination is, ordered by a court, the analysis and interpretation of medical facts with important legal implications. In that sense, psychiatrists (or neuropsychiatrists, apart from their professional expertise, must be familiar with legal, economical and social significance of medical data, so that their forensic reports are clear and useful in the context of legal procedure. This review deals with forensic psychiatry aspects of mental capacity. In the introduction of the article, the explanation of relevant concepts such as mental capacity, contractual and testamentary capacity, informed consent, undue influence and forensic determination in light of Serbian statutory law is presented. Further, the authors present basic principles of making forensic reports on mental capacity as well as contractual and testamentary capacity, and informed consent for eventual medical examination and treatment.

  3. Advances in IT and social psychiatry

    Directory of Open Access Journals (Sweden)

    Varghese P Punnoose


    Full Text Available IT has revolutionized the way individuals carry on with their lives and has been harnessed for varied applications like business management, classroom teaching, online sales and ticketing, and so forth.[1],[2] IT itself has seen development over the course of the last few decades and has seen greater access to the population, increase in computing power and speed, and enrichment in terms of content. The scope of IT has been appropriately recognized for health-care delivery and has led to the emergence of offshoot disciplines of eHealth and mHealth. Consequently, social psychiatry has also been favorably impacted, either directly or indirectly, by the ever expanding horizons of IT. This editorial discusses the application of IT in the realm of social psychiatry

  4. Logical and conceptual problems of existential psychiatry. (United States)

    Hanly, C


    The author has argued that existential psychology and psychiatry are not consistent with existential philosophy, from which they derive their basic concepts. Existential philosophy treats consciousness as an epistemic and ontological absolute while existential psychology and psychiatry acknowledge the existence of unconscious mental processes. It is not possible to base a viable concept of psychodynamic psychotherapy, the nature of transference, or the efficacy of interpretation upon the radical concept of freedom, which is basic to existential philosophy. If psychiatrists wish to experiment with nonpsychoanalytic dynamic psychologies, then it is the author's opinion that the advancement of knowledge would be better served either by using existentialist concepts and principles consistently or by explicitly altering them in clearly defined ways for stated reasons, or by formulating psychodynamic hypotheses that do not lay claim to any foundation in existential philosophy.

  5. Psychiatry and neurology: from dualism to integration. (United States)

    Sobański, Jerzy A; Dudek, Dominika


    The two objectives of the following paper are: to make few remarks on the topic absorbing neurologists, psychiatrists, and neuropsychiatrists - integration and division of their specialties; and to describe the situation in Poland, reflected in the latest literature. The authors describe the former and present processes of approaches and divisions in psychiatry and neurology. They indicate dissemination of mutual methods of structural and action brain neuroimaging, neurophysiology, neurogenetics, and advanced neurophysiology diagnostics. As it seems, even the effectiveness of psychotherapy, has recently been associated with changes in brain in functional and even structural markers. The authors indicate the value of the strive to join the still divided specialties, reflected worldwide in attempts of common education and clinical cooperation of physicians. It can be expected that subsequent years will bring further triumphs of neuropsychiatry - a field that combines psychiatry and neurology.

  6. Computational Psychiatry in Borderline Personality Disorder. (United States)

    Fineberg, Sarah K; Stahl, Dylan; Corlett, Philip


    We review the literature on the use and potential use of computational psychiatry methods in Borderline Personality Disorder. Computational approaches have been used in psychiatry to increase our understanding of the molecular, circuit, and behavioral basis of mental illness. This is of particular interest in BPD, where the collection of ecologically valid data, especially in interpersonal settings, is becoming more common and more often subject to quantification. Methods that test learning and memory in social contexts, collect data from real-world settings, and relate behavior to molecular and circuit networks are yielding data of particular interest. Research in BPD should focus on collaborative efforts to design and interpret experiments with direct relevance to core BPD symptoms and potential for translation to the clinic.

  7. Indianization of psychiatry utilizing Indian mental concepts (United States)

    Avasthi, Ajit; Kate, Natasha; Grover, Sandeep


    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

  8. Artiss Symposium 2013: Psychiatry and Sleep Disorders (United States)


    Saturdays. They increase caffeine con- sumption. They use over the counter or even prescription sleep aids in a chronic fashion. They become over-focused on...cognitive side effects. Your ability to do a 46 Artiss Symposium 2013—Psychiatry and Sleep Disorders neurological exam may be impaired if a patient is...Patient education includes talking to your patients about caffeine use, alcohol use, exercise, and stimulus control. Stimulus control addresses what you

  9. European psychiatry: needs, challenges and structures. (United States)

    Höschl, Cyril


    European psychiatry stays now on the crossroad due to conceptual challenges, drifts of political power from the national to the European level, the current economical situation, arising ethical concerns and an emphasis on patients rights. The latter challenge mainly the structure of mental health care demanding a more important role of patients and families. The needs of harmonisation of research, educational, legislative, and political activities in the field of mental health on the European level are briefly discussed.

  10. The Third Wave of Biological Psychiatry

    Directory of Open Access Journals (Sweden)

    Henrik eWalter


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

  11. Women in academic psychiatry in Canada. (United States)

    Penfold, P S


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

  12. A frame of mind from psychiatry. (United States)

    Vintiadis, Elly


    A distinctive characteristic of psychiatry is that it is a discipline that deals with both the physical and the mental lives of individuals. Largely because of this characteristic, different models are used for different disorders, however, there is still a remnant tendency towards reductionist views in the field. In this paper I argue that the available empirical evidence from psychiatry gives us reasons to question biological reductionism and that, in its place, we should adopt a pluralistic explanatory model that is more suited to the needs of the discipline and to the needs of the patients it is meant to help. This will allow us to retain psychiatry as an autonomous science that can productively co-exist with neuroscience while also giving patients the kind of attention they need. I further argue that this same evidence supports a view of the mind that is anti-reductive and that allows that causation can be both bottom-up and top-down and that such a view is available in emergentism coupled with an interventionist model of causation.

  13. Neuropsychiatrie of biologische psychiatrie; een toekomstvisie in historisch perspectief. (United States)

    Verhoeven, W M; Tuinier, S


    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.

  14. [Hip Fracture--Epidemiology, Management and Liaison Service. Practice of the secondary fracture prevention of the proximal femoral fracture by the Osteoporosis Liaison Service]. (United States)

    Ikeda, Satoshi


    The proximal femoral fracture number of patients increases with age, and it is predicted that patients over 90 years old will increase in future. It causes a decline of ADL and the QOL, mortality aggravation, a remarkable rise of medical care, the nursing-care cost when they present with a fracture. Primary prevention is important to prevent osteoporotic fracture, but the secondary prevention for the prior or new fracture patient is particularly important. For the practice of the secondary prevention, cooperation of a doctor and the medical staff who included not only the hospital but also the cooperation with the medical institution in the area is indispensable. This report introduces osteoporosis liaison service working on in our hospital and is happy if it is with consideration of the practice of the secondary prevention of the proximal femoral fracture.

  15. At the crossroads of anthropology and epidemiology: current research in cultural psychiatry in the UK. (United States)

    Dein, Simon; Bhui, Kamaldeep Singh


    Cultural psychiatry research in the UK comprises a broad range of diverse methodologies, academic disciplines, and subject areas. Methodologies range from epidemiological to anthropological/ethnographic to health services research; mixed methods research is becoming increasingly popular, as are public health and health promotional topics. After briefly outlining the history of cultural psychiatry in the UK we will discuss contemporary research. Prominent themes include: the epidemiology of schizophrenia among Africans/Afro-Caribbeans, migration and mental health, racism and mental health, cultural identity, pathways to care, explanatory models of mental illness, cultural competence, and the subjective experiences of healthcare provision among specific ethnic groups such as Bangladeshis and Pakistanis. Another strand of research that is attracting increasing academic attention focuses upon the relationship between religion, spirituality, and mental health, in particular, the phenomenology of religious experience and its mental health ramifications, as well as recent work examining the complex links between theology and psychiatry. The paper ends by appraising the contributions of British cultural psychiatrists to the discipline of cultural psychiatry and suggesting promising areas for future research.

  16. [Perspectives on researches in disaster psychiatry]. (United States)

    Tomita, Hiroaki


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

  17. Initiatives in biological research in Indian psychiatry. (United States)

    Shrivatava, Amresh


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

    Directory of Open Access Journals (Sweden)

    Rajesh Parikh


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

  19. How we developed an emergency psychiatry training course for new residents using principles of high-fidelity simulation. (United States)

    Thomson, Alex B; Cross, Sean; Key, Suzie; Jaye, Peter; Iversen, Amy C


    New psychiatry residents must rapidly acquire new clinical skills and learn to work effectively with new colleagues. In medical and surgical specialties, high-fidelity simulation with structured debriefing is widely used, but so far this has not been applied to psychiatry. We have developed a one-day simulation-based training course for emergency psychiatry which incorporates clinical and team-working skills training. Five scenarios covering key psychiatric emergencies are delivered in a purpose-built simulation facility. Patients are played by an actor or a high-fidelity manikin. Each scenario is followed by a 45-minute group debrief. Evaluation of a pilot group found that the course was well received and improved participants' workplace confidence. We are now planning to expand the course, provide it to all new residents and conduct further evaluation.

  20. Maximizing clinical revenues of psychiatric consultation-liaison services. An economic commentary. (United States)

    Koran, L M; Foley, T


    Clinical revenues rarely suffice to support an academic psychiatric consultation-liaison (C-L) service. Nonetheless, the revenue provides a major source of financial support. The authors describe ten steps that can help maximize the financial return from the C-L service's clinical efforts. The steps range from establishing a reasonable fee schedule and creating an efficient charge document, through educating residents and faculty physicians about documentation requirements, to billing quickly and insisting on meaningful monthly reports from the faculty practice plan. A number of "magic phrases" (proper and key wording for reimbursement) are described in detail that can markedly reduce documentation requirements.

  1. Liaison-Supplemented Navigation of a Crewed Vehicle in a Lunar Halo Orbit (United States)

    Parker, Jeffrey S.; Leonard, Jason M.; Anderson, Rodney L.; Born, George H.


    This paper offers an early examination of the challenges of navigating a crewed vehicle, with all of the associated unmodeled accelerations that arise from the crew's activities, in an orbit about the Earth-Moon L2 point. The combination of the unstable nature of libration orbits with the lack of acceleration knowledge makes the station keeping strategy challenging. It is found that a combination of ground tracking and satellite-to-satellite tracking produces the most favorable navigation accuracy. This paper examines the costs and benefits of applying LiAISON (Linked Autonomous Interplanetary Satellite Orbit Navigation) to a crewed mission in an unstable L2 orbit.

  2. Dangerous Liaisons: Working Women and Sexual Justice in the American Civil War


    Barber, E. Susan; Ritter, Charles F.


    The American Civil War drew thousands of white and black women into paid and unpaid work for the Union and Confederate armies.  While the armies provided some women with a reliable income, their very proximity also represented a dangerous liaison that drew them into closer contact with Union troops that rendered them vulnerable to sexual assault.  By 1865, more than four hundred Union soldiers had been court-martialed for sexual crimes against white and black women and girls. At the war’s ons...

  3. The Refugee Health Nurse Liaison: a nurse led initiative to improve healthcare for asylum seekers and refugees. (United States)

    McBride, Jacquie; Russo, Alana; Block, Andrew


    Asylum seekers and refugees experience a range of barriers to health service access and competent use. The Refugee Health Nurse Liaison initiative was piloted at a hospital in a high-settlement region of Victoria, Australia. This initiative aimed to build capacity within the health sector to more effectively respond to the needs of asylum seekers and refugees. A mixed-methods evaluation was undertaken to: describe issues encountered by asylum seekers and refugees within the hospital setting; capture the nature of the Refugee Health Nurse Liaison position; and document key outputs. Throughout the pilot period, 946 patients were referred to the role, of which 99% received an assessment of physical, mental, and social health. Refugee Health Nurse Liaisons effectively provided clinical support, advocacy, education, referrals, and both formal and informal capacity building. Learnings from this model are transferable to services in high-settlement regions, and could have application in improving patient care more broadly.

  4. Inherited variation in pattern recognition receptors and cancer: dangerous liaisons?

    Directory of Open Access Journals (Sweden)

    Yuzhalin AE


    Full Text Available Anton G Kutikhin, Arseniy E YuzhalinDepartment of Epidemiology, Kemerovo State Medical Academy, Kemerovo, Russian FederationAbstract: The group of pattern recognition receptors includes families of Toll-like receptors, NOD-like receptors, C-type lectin receptors, and RIG-I-like receptors. They are key sensors for a number of infectious agents, some of which are carcinogenic, and they launch an immune response against them. Inherited structural variation in genes encoding these receptors and proteins of their signaling pathways may affect their function, modulating cancer risk and features of cancer progression. Relevant malignancies, valuable gene polymorphisms, prime questions about future directions, and answers to these questions are analyzed in this review. It is possible to suggest that polymorphisms of genes encoding pattern recognition receptors and proteins of their signaling pathways may be associated with almost all cancer types, particularly with those in which carcinogenic infectious agents are responsible for the substantial share of cases (namely gastric cancer, colorectal cancer, liver cancer, cervical cancer, and nasopharyngeal carcinoma. The concept of selection of polymorphisms for further oncogenomic investigation, based on a combination of results from basic and epidemiological studies, is proposed.Keywords: pattern recognition receptors, Toll-like receptors, NOD-like receptors, C-type lectin receptors, cancer, gene polymorphisms

  5. The complex liaison between cachexia and tumor burden (Review). (United States)

    De Lerma Barbaro, Andrea


    Cachexia is a wasting syndrome that afflicts end-stage cancer patients. Whereas a consensus statement for a definition of cachexia recently has been accomplished, a useful measurement for this condition at present is lacking. The aim of the present review is to discuss the advantage of introducing the measurement of tumor burden for a better overall evaluation of cachexia. Our suggestion ensues from a somewhat novel perspective in the field of infectious disease research where a careful measurement of the pathogen load, between i.e. different host genotypes, leads to the definition of the concept of tolerance to the infectious insult. Indeed tolerance concurs, together the more classical resistance, in maintaining the host reproductive fitness or health state. Noticeably a similar reasoning may apply to tumor biology as well. Whereas the extent of cachexia increases with tumor burden, the relationship between these two correlates of tumor progression fluctuates in a broad range. We have selected from the literature studies in the rodent model where significant variation in the course of the wasting illness during cancer was observed and quantitatively assessed comparing experimental groups marked by different genotype, drug treatment, diet or gender. These studies may be further classified in two categories: the former where the experimental condition associated to milder cachexia is accompanied to a lesser tumor burden, the latter where the inhibition of cachexia results disentangled from the tumor burden, that is the whole number of cancer cells results unchanged or even, paradoxically, is increased. In addition we survey, even in the context of human malignancy, the significance and feasibility of plotting quantitative estimates of cachexia against the whole tumor burden. Ultimately, the principal endeavor of introducing the measurement of tumor burden, in both experimental and clinical oncology, may be to achieve a better assessment of the inter

  6. [Contribution of the Polish-German Mental Health Society to changes in Polish psychiatry]. (United States)

    Cichocki, Łukasz; Cechnicki, Andrzej


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

  7. Shorter Psychiatry Clerkship Length Is Associated with Lower NBME Psychiatry Shelf Exam Performance (United States)

    Bostwick, J. Michael; Alexander, Cara


    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…

  8. The Psychiatry Major: A Curricular Innovation to Improve Undergraduate Psychiatry Education in China. (United States)

    Jing, Ling; Chang, Wing Chung; Rohrbaugh, Robert; Ouyang, Xuan; Chen, Eric; Liu, Zhening; Hu, Xinran


    In China, a psychiatry major curriculum (PMC) has been implemented in select medical schools to improve the quality of undergraduate psychiatry education (UPE). Our aim was to describe this PMC and compare it with UPE in the standard Chinese clinical medicine curriculum (CMC). We also benchmarked PMC to UPE programs in the Hong Kong Special Administrative Region of China and the United States of America (USA) to determine how well it met standards of well-established programs and to highlight areas for improvement. Based on archival information, relevant literature, and communication with key informants, we described PMC and CMC in a Chinese school with both curriculums. We then compared PMC to UPE curriculums in Hong Kong and the USA. PMC provides substantially more comprehensive exposure to psychiatry than CMC, with more preclinical experiences and psychiatry clerkship course hours, greater diversity of clinical sites, and exploration of subspecialties. PMC employs a variety of teaching methods and offers mentoring for students. PMC has similar UPE preclinical content and course hours as programs in Hong Kong and the USA. PMC also provides more clinical exposure than programs in Hong Kong or the USA, although there is less variety in clinical settings. We recommend implementation of concrete measures to improve UPE in Chinese medical schools, using the PMC curriculum as a model that has been successfully implemented in China. We also recommend improvements to PMC based on comparisons with existing programs outside Mainland China.

  9. Shorter Psychiatry Clerkship Length Is Associated with Lower NBME Psychiatry Shelf Exam Performance (United States)

    Bostwick, J. Michael; Alexander, Cara


    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…

  10. Co-opting psychiatry: the alliance between academic psychiatry and the pharmaceutical industry. (United States)

    Moncrieff, Joanna


    The editorial presents the arguments that an alliance between academic psychiatry and the pharmaceutical industry is harmful through a critical review of the academic literature and media coverage of activities of the pharmaceutical industry. The industry and the psychiatric profession both gain advantages from promoting biomedical models of psychiatric disturbance and pharmacological treatment. This confluence of interests has lead to the exaggeration of the efficacy of psychiatric drugs and neglect of their adverse effects and has distorted psychiatric knowledge and practice. Academic psychiatry has helped the industry to colonise more and more areas of modern life in order to expand the market for psychotropic drugs. Persuading people to understand their problems as biological deficiencies obscures the social origin and context of distress and prevents people from seeking social or political solutions. Psychiatry has the power to challenge the dominance of the pharmaceutical industry and should put its efforts into developing alternatives to routine drug treatment. Psychiatry needs to disengage from the industry if it wants to make genuine advances in understanding psychiatric disorder and help reverse the harmful social consequences of the widening med-icalisation of human experience.

  11. Consultation-Liaison Psychiatrists on Bioethics Committees: Opportunities for Academic Leadership (United States)

    Geppert, Cynthia M. A.; Cohen, Mary Ann


    Objective: This article briefly reviews the history of the relationship between psychiatry and the leadership of ethics committees as a background for examining appropriate educational initiatives to adequately prepare residents and early career psychiatrists to serve as leaders of ethics committees. Method: A Medline review of literature on…

  12. Evolutionary Psychiatry and Nosology: Prospects and Limitations

    Directory of Open Access Journals (Sweden)

    Luc Faucher


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

  13. Optogenetics in psychiatry: The light ahead

    Directory of Open Access Journals (Sweden)

    Jyoti Prakash


    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.

  14. Encompassing Sexual Medicine within Psychiatry: Pros and Cons (United States)

    Segraves, Robert Taylor


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

  15. Evaluation of Professional Role Competency during Psychiatry Residency (United States)

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


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

  16. Child Psychiatry: What Are We Teaching Medical Students? (United States)

    Dingle, Arden D.


    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…

  17. An Investigation of Psychiatry Residents' Important Experiences (United States)

    Long, Jody


    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…

  18. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers (United States)

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


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

  19. Psychiatry Residency Education in Canada: Past, Present and Future (United States)

    Saperson, Karen


    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…

  20. Turnover of First-Time Chairs in Departments of Psychiatry (United States)

    Buckley, Peter F.; Rayburn, William F.


    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…

  1. The Recruitment Problem in Psychiatry: A Critical Commentary (United States)

    Stampfer, Hans


    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…

  2. Screening for Psychopathology Symptoms in Mexican Psychiatry Residents (United States)

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


    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…

  3. The Triple Jump: Assessing Problem Solving in Psychiatry. (United States)

    O'Gorman, Ethna C.; Trimble, Peter; Smyth, Joe


    Describes an attempt to assess a final-year course in psychiatry using the Triple Jump. In this course, students on placement in psychiatric units perfect psychiatry skills that were acquired during the previous year by direct contact with patients. The Triple Jump is used to assess problem-solving skills in management strategy on cases. (PVD)

  4. Research in child and adolescent psychiatry in India (United States)

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


    The primary source for this annotation on child and adolescent psychiatry is Indian Journal of Psychiatry. Articles covering various dimensions of child and adolescent mental health were searched from its electronic data base to discuss relevant articles. Literature was mainly in the form of original research articles, review articles, case reports, editorials, orations and presidential address. PMID:21836681

  5. Family Therapy Training in Child and Adolescent Psychiatry Fellowship Programs (United States)

    Rait, Douglas Samuel


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

  6. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers (United States)

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


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

  7. EPA guidance on improving the image of psychiatry. (United States)

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


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

  8. Family Therapy Training in Child and Adolescent Psychiatry Fellowship Programs (United States)

    Rait, Douglas Samuel


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

  9. Technical liaison with the Institute of Physical Chemistry (Russian Academy of Sciences)

    Energy Technology Data Exchange (ETDEWEB)

    Delegard, C.H. [Pacific Northwest National Lab., Richland, WA (United States)


    DOE has engaged the IPC/RAS to study the fundamental and applied chemistry of the transuranium actinide elements (primarily neptunium, plutonium, and americium) and technetium in alkaline media. This work is supported by DOE because the alkaline radioactive wastes stored in underground tanks at DOE sites (Hanford, Savannah River, and Oak Ridge) contain TRUs and technetium, and these radioelements must be partitioned to the HLW fraction in planned waste processing operations. The chemistries of the TRUs and technetium are not well developed in this system. Previous studies at the IPC/RAS centered on the fundamental chemistry of the TRUs and technetium in alkaline media, and on their coprecipitation reactions. During FY 1996, further studies of fundamental and candidate process chemistries were pursued with continuing effort on coprecipitation. The technical liaison was established at Westinghouse Hanford Company to provide information to the IPC/RAS on the Hanford Site waste system, define and refine the work scope, publish IPC/RAS reports in open literature documents and presentations, provide essential materials and equipment to the IPC/RAS, compare IPC/RAS results with results from other sources, and test chemical reactions or processes proposed by the IPC/RAS with actual Hanford Site tank waste. The liaison task was transferred to the Pacific Northwest Laboratory (PNNL) in October 1996.

  10. Fracture liaison service in a non-regional orthopaedic clinic--a cost-effective service.

    LENUS (Irish Health Repository)

    Ahmed, M


    Fracture liaison services (FLS) aim to provide cost-effective targeting of secondary fracture prevention. It is proposed that a dedicated FLS be available in any hospital to which a patient presents with a fracture. An existing orthopaedic clinic nurse was retrained to deliver a FLS. Proformas were used so that different nurses could assume the fracture liaison nurse (FLN) role, as required. Screening consisted of fracture risk estimation, phlebotomy and DXA scanning. 124 (11%) of all patients attending the orthopaedic fracture clinic were reviewed in the FLS. Upper limb fractures accounted for the majority of fragility fractures screened n=69 (55.6%). Two-thirds of patients (n=69) had reduced bone mineral density (BMD). An evidence based approach to both non-pharmacological and pharmacotherapy was used and most patients (76.6%) receiving pharmacotherapy received an oral bisphosphonate (n=46). The FLS has proven to be an effective way of delivering secondary prevention for osteoporotic fracture in a non-regional fracture clinic, without increasing staff costs.

  11. Contribution of a liaison clinical pharmacist to an inpatient palliative care unit. (United States)

    Lucas, C; Glare, P A; Sykes, J V


    The impact on patient care of interventions made by a liaison clinical pharmacist visiting a busy inpatient palliative care unit were evaluated using a validated six-point scoring system. Interventions made in 13% of patients could improve patient care, save money or both, but rarely involved the drugs that are commonly used for symptom control in patients with terminal cancer. Advice to rationalize inappropriate drug regimens (53%) was the commonest intervention, followed by warnings about drug interactions (24%) and advice about therapeutic drug monitoring (8%). The interventions were evaluated by the pharmacist, a palliative medicine registrar and two independent doctors, confirming that the pharmacist was valid and accurate in assessing her own work. Although more than 60% of interventions could significantly improve patient care, compliance by medical and nursing staff with advice was only 55%, reflecting possible tensions between palliative and general hospital medicine. This survey emphasizes the role of liaison clinical pharmacists in palliative care, the need for much more critical appraisal of prescribing practices and the utility of ranking pharmacist interventions as a quality assurance and educational tool. In particular, providing palliative care for patients with advanced acquired immunodeficiency syndrome (AIDS) is enhanced when a pharmacist with a specialist knowledge of AIDS therapeutics is available.

  12. Liaison activities with the institute of physical chemistry, Russian academy of sciences: FY 1996

    Energy Technology Data Exchange (ETDEWEB)

    Delegard, C.H.


    The task ``IPC/RAS Liaison and Tank Waste Testing`` is a program being conducted in fiscal year (FY) 1996 with the support of the U.S. Department of Energy (DOE) Office of Science and Technology, EM-53 Efficient Separations and Processing (ESP) Crosscutting Program, under the technical task plan RLA6C342. The principal investigator is Cal Delegard of the Westinghouse Hanford Company. The task involves a technical liaison with the Institute of Physical Chemistry of the Russian Academy of Sciences (IPC/RAS) and their DOE-supported investigations into the fundamental and applied chemistry of the transuranium elements (primarily neptunium, plutonium, and americium) and technetium in alkaline media. The task has three purposes: 1. Providing technical information and technical direction to the IPC/RAS. 2. Disseminating IPC/RAS data and information to the DOE technical community. 3. Verifying IPC/RAS results through laboratory testing and comparison with published data. This report fulfills the milestone ``Provide End-of-Year Report to Focus Area,`` due September 30, 1996.

  13. Nutritional Psychiatry: Where to Next?

    Directory of Open Access Journals (Sweden)

    Felice N. Jacka


    Full Text Available The nascent field of ‘Nutritional Psychiatry’ offers much promise for addressing the large disease burden associated with mental disorders. A consistent evidence base from the observational literature confirms that the quality of individuals' diets is related to their risk for common mental disorders, such as depression. This is the case across countries and age groups. Moreover, new intervention studies implementing dietary changes suggest promise for the prevention and treatment of depression. Concurrently, data point to the utility of selected nutraceuticals as adjunctive treatments for mental disorders and as monotherapies for conditions such as ADHD. Finally, new studies focused on understanding the biological pathways that mediate the observed relationships between diet, nutrition and mental health are pointing to the immune system, oxidative biology, brain plasticity and the microbiome-gut-brain axis as key targets for nutritional interventions. On the other hand, the field is currently limited by a lack of data and methodological issues such as heterogeneity, residual confounding, measurement error, and challenges in measuring and ensuring dietary adherence in intervention studies. Key challenges for the field are to now: replicate, refine and scale up promising clinical and population level dietary strategies; identify a clear set of biological pathways and targets that mediate the identified associations; conduct scientifically rigorous nutraceutical and ‘psychobiotic’ interventions that also examine predictors of treatment response; conduct observational and experimental studies in psychosis focused on dietary and related risk factors and treatments; and continue to advocate for policy change to improve the food environment at the population level.

  14. [Charisma and leadership: new challenges for psychiatry]. (United States)

    Fond, G; Ducasse, D; Attal, J; Larue, A; Macgregor, A; Brittner, M; Capdevielle, D


    New challenges arise in medicine, particularly in psychiatry. In the near future, psychiatrists' role may evolve into management of mental health care teams (GPs, nurses, psychologists…) thus creating the need for charisma and leadership. Charisma is defined as « a quality that allows it's possessor to exercise influence, authority over a group »; leadership as « the function, the position of chief, and by extension, a dominant position ». To offer some reflections on charisma and leadership and the ways to develop them in three situations common in clinical practice: dual communication (between caregivers or with patients), oral communication (e.g., during a symposium) and managing a mental health care team. Medline (1966-hits) and Web of Science (1975-hits) were explored according to the PRISMA criteria. The research paradigm was [(psychiatrist OR physician) AND mental health AND (leadership OR charisma)]. Two hundred and eighty articles were found, but only 34 corresponded to our subject and were included in the qualitative analysis. The leader must first ask himself/herself about his/her vision of the future, so as to share it with passion with his/her mental health team. Charisma and leadership are based on several values, among which we can mention: providing understandable, personalized care for the patient, in continuity and confidentiality; adapting care to the general population's request, maintaining one's own physical and mental health, submitting one's daily practice to peer review, engaging in continuous improvement of one's practices in response to new requirements, and recognizing that research and instruction are part of an M.D's professional obligations. The clinician will work on ways to develop his/her own charisma, through interactions with peers and team members, the care of his/her appearance (especially for first meetings) and workplace, and through positive reinforcement (some cognitive-behavioral techniques like assertiveness

  15. Psychiatry Resident Training in Cultural Competence: An Educator's Toolkit. (United States)

    Corral, Irma; Johnson, Toni L; Shelton, Pheston G; Glass, Oliver


    Resident physicians training in psychiatry in the U.S. are required to master a body of knowledge related to cultural psychiatry; are expected to adopt attitudes that endorse the principles of cultural competence; and finally are expected to acquire specific cultural competence skills that facilitate working effectively with diverse patients. This article first provides an overview of the Accreditation Council for Graduate Medical Education (ACGME) competencies related to cultural competence, as well as the American Academy of Child and Adolescent Psychiatry's (AACAP) recommendations for the cultural competence training of child/adolescent fellows. Next, numerous print and electronic resources that can be used in cultural competence education in psychiatry are reviewed and discussed. Finally, we conclude by providing recommendations for psychiatry residency programs that we culled from model cultural competence curricula.

  16. Dimensional psychiatry: reward dysfunction and depressive mood across psychiatric disorders. (United States)

    Hägele, Claudia; Schlagenhauf, Florian; Rapp, Michael; Sterzer, Philipp; Beck, Anne; Bermpohl, Felix; Stoy, Meline; Ströhle, Andreas; Wittchen, Hans-Ulrich; Dolan, Raymond J; Heinz, Andreas


    A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries. We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative mood) of such an impairment. We used functional magnetic resonance imaging (fMRI) and a monetary incentive delay (MID) task to study the functional correlates of reward anticipation across major psychiatric disorders in 184 subjects, with the diagnoses of alcohol dependence (n = 26), schizophrenia (n = 44), major depressive disorder (MDD, n = 24), bipolar disorder (acute manic episode, n = 13), attention deficit/hyperactivity disorder (ADHD, n = 23), and healthy controls (n = 54). Subjects' individual Beck Depression Inventory-and State-Trait Anxiety Inventory-scores were correlated with clusters showing significant activation during reward anticipation. During reward anticipation, we observed significant group differences in ventral striatal (VS) activation: patients with schizophrenia, alcohol dependence, and major depression showed significantly less ventral striatal activation compared to healthy controls. Depressive symptoms correlated with dysfunction in reward anticipation regardless of diagnostic entity. There was no significant correlation between anxiety symptoms and VS functional activation. Our findings demonstrate a neurobiological dysfunction related to reward prediction that transcended disorder categories and was related to measures of depressed mood. The findings underline the potential of a dimensional approach in psychiatry and strengthen the hypothesis that neurobiological research in psychiatric disorders can be targeted at core mechanisms that are likely to be implicated in a range of clinical entities.

  17. Beyond categorical diagnostics in psychiatry: Scientific and medicolegal implications. (United States)

    Anckarsäter, Henrik


    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".

  18. The power of the spoken word in life, psychiatry, and psychoanalysis--a contribution to interpersonal psychoanalysis. (United States)

    Lothane, Zvi


    Starting with a 1890 essay by Freud, the author goes in search of an interpersonal psychology native to Freud's psychoanalytic method and to in psychoanalysis and the interpersonal method in psychiatry. This derives from the basic interpersonal nature of the human situation in the lives of individuals and social groups. Psychiatry, the healing of the soul, and psychotherapy, therapy of the soul, are examined from the perspective of the communication model, based on the essential interpersonal function of language and the spoken word: persons addressing speeches to themselves and to others in relations, between family members, others in society, and the professionals who serve them. The communicational model is also applied in examining psychiatric disorders and psychiatric diagnoses, as well as psychodynamic formulas, which leads to a reformulation of the psychoanalytic therapy as a process. A plea is entered to define psychoanalysis as an interpersonal discipline, in analogy to Sullivan's interpersonal psychiatry.

  19. If Ethics in Psychiatry is the Answer - What was the Question? Exploring Social Space and the Role of Clinical Chaplaincy

    Directory of Open Access Journals (Sweden)

    Helen Kohlen


    Full Text Available Over the last twenty years, ethics has been expanding in health care and chaplains comprise one of the key groups that provide ethics consultation services in the German arena of psychiatry. Like all professional actors in the practical arena, chaplains perform their role. Performance happens in relation to others who occupy positions that allow more or less exercise of power. This architecture of relational positioning and territory constitutes the social space. The question is, whether ethics in psychiatry can overcome the determination of positioning within the social space, and if yes: what is the scope of ethics? This article investigates into the role of chaplaincy as ethical agents (in Germany on the basis of theoretical and empirical studies over the last 10 years. The meaning of social space in the field of psychiatry is explored by taking Pierre Bourdieu’s work into account. For illustration, a case study is given.

  20. Psychoactive substance use in forensic psychiatry. (United States)

    Kermani, E J; Castaneda, R


    The purpose of this article is to discuss the interface between judicial discipline and behavioral science in the context of substance-related disorders. We review the epidemiology of psychoactive drug use and crime and discuss the courts' decisions on relevant landmark cases, particularly as they influence the practice of psychiatry. (1) The phenomenology of addiction and crime is of great epidemiological import. (2) Our legal system inclines toward the view that the use of alcohol or other substances involves an element of choice and therefore would not amount to a legal insanity defense if the substance abuser commits a crime while intoxicated. (3) A state can confine an addict or alcoholic for compulsory treatment if that individual presents a danger to self or others. (4) The law has found that alcoholism and drug abuse are both "willful misconduct" and a disabling condition; the former definition contains the end in view of punitive action. The latter is aimed toward treatment and rehabilitation. (5) The law gives the right to the employer to test a suspected employee for drug abuse. The addicted or alcoholic employee has the choice to either go for treatment or face job termination. (6) Our judicial system gives serious consideration to the welfare of a child whose parents are alcoholic or drug addicted. The two disciplines of psychiatry and law follow their own modes in resolving issues in alcoholism and other substance abuse. We need research and new approaches to build a bridge between the two.

  1. What kind of science for psychiatry?

    Directory of Open Access Journals (Sweden)

    Laurence J Kirmayer


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

  2. Psychiatry as ideology in the USSR. (United States)

    Bloch, S


    This paper was given as a talk at the Venice Biennale on 9 December 1977. It was part of a symposium on "The Freedom of Science--Problems of Science of Scientists in Eastern Europe". Dr Bloch details some of the problems of psychiatry and its vulnerability to improper use and thus the dilemmas which must ensue in day to day practice. He looks at psychiatry in the USSR and the system within which Soviet psychiatrists must work. The Communist Party and career advancement for psychiatrists would appear to be closely related and it is suggested that, in all probability, the majority of psychiatrists are as perturbed at the misuse of their profession as their Western colleagues, but act compliantly out of fear. Severe punishments have been imposed on those psychiatrists who have dared to speak out against the régime and the system as operated. Dr Bloch concludes by urging Western psychiatrists to do all they can to help their Soviet colleagues to initiate a return to an independent and automous psychiatric profession.

  3. The historical development of psychiatry in Serbia. (United States)

    Milovanović, Srdan; Jasović-Gasić, Miroslava; Pantović, Mihailo; Dukić-Dejanović, Slavica; Jovanović, Aleksandar A; Damjanović, Aleksandar; Ravanić, Dragan


    The authors present the development of the concept of mental disease and treatment in Serbian medicine. Serbian medieval medicine did not acknowledge fortune telling, sorcery, the use of amulets and magical rituals and formulas. These progressive concepts were confirmed by the Church and the Serbian state in what is known as Dusan's Code. The Historical data on the establishment of the first psychiatric hospital in the Balkans "Home for the Unsound of Mind" at Guberevac, Belgrade, in 1861 and its founders is reviewed. After World War I, in 1923, the Faculty of Medicine was established in Belgrade to which the coryphaei of Serbian medicine educated in Europe, mostly in France and Germany, flocked and that same year the Psychiatry Clinic of the Faculty of Medicine in Belgrade was set up. Its first seat was on the premises of the Mental Hospital in Belgrade, and it became a training base and laid the foundations of the future Neuropsychiatry Clinic in Belgrade, which in time evolved into the nursery of psychiatric professionals for all of Serbia. The most important data on the further development of psychiatry up to date are presented.

  4. [Psychiatry periodicals in Spain up to 1931]. (United States)

    Bertolín Guillén, J M


    The development of psychiatry, as it happens with other medical specialties, has been linked to that of the journals dedicated to it. They are a good exponent of its state of growing or consolidation. The first psychiatric journal in Spain appeared in 1865 and 27 years later the next one was founded. None of the three journals which existed in the 19th century continued at the beginning of the 20th century. During the first three decades of this century, nine specialized journals were founded, among which the "Revista Frenopática Española" in the first place, and the "Archivos de Neurobiología" afterwards, were the most outstanding in our country and the "Revista Frenopática Española" was that of the greatest international projection. Although the importance of a constellation of prestigious journals which were not dedicated to psychiatry was decisive for the development of this discipline in our country, the professionals organized themselves in the monographic journals about this subject, linked to mental hospitals.

  5. Diagnosis and causal explanation in psychiatry. (United States)

    Maung, Hane Htut


    In clinical medicine, a diagnosis can offer an explanation of a patient's symptoms by specifying the pathology that is causing them. Diagnoses in psychiatry are also sometimes presented in clinical texts as if they pick out pathological processes that cause sets of symptoms. However, current evidence suggests the possibility that many diagnostic categories in psychiatry are highly causally heterogeneous. For example, major depressive disorder may not be associated with a single type of underlying pathological process, but with a range of different causal pathways, each involving complex interactions of various biological, psychological, and social factors. This paper explores the implications of causal heterogeneity for whether psychiatric diagnoses can be said to serve causal explanatory roles in clinical practice. I argue that while they may fall short of picking out a specific cause of the patient's symptoms, they can nonetheless supply different sorts of clinically relevant causal information. In particular, I suggest that some psychiatric diagnoses provide negative information that rules out certain causes, some provide approximate or disjunctive information about the range of possible causal processes, and some provide causal information about the relations between the symptoms themselves.

  6. Assessing competencies during education in psychiatry. (United States)

    Humphrey, Holly J; Marcangelo, Michael; Rodriguez, Elizabeth R; Spitz, Deborah


    The utilization of competencies in medical education is relatively recent. In 1999 the United States Accreditation Council for Graduate Medical Education (ACGME) established six main competencies. Since then, the American Board of Psychiatry and Neurology have approved a specific list of competencies for their specialities in each of the ACGME's core competency areas. Assessment of competencies in both medical students and residents can be achieved through such methods as structured case discussion, direct observation, simulation, standardized patients, and 360-degree assessments, etc. Each assessment methodology has specific applications in the discipline of psychiatry. This paper reviews the different methods for assessing competencies with specific examples in psychiatric education. It is not intended as a comprehensive review of all assessment methods, but to provide examples and strategies to guide psychiatric educators in their practice. Students and residents were intentionally separated because there are differences in the teaching goals and objectives, and thus in the assessment purposes and design. Students are general, undifferentiated physicians-in-training who need to learn about psychiatric nosology, examinations, and treatment. Residents are mental health professionals who need more in-depth supervision in order to hone skills in all the specialized areas that arise in psychiatric practices, making supervision a vital part of residency programs.

  7. Dangerous Liaisons?

    Directory of Open Access Journals (Sweden)

    Norman L Jones


    Full Text Available I sometimes feel that I am so dominated by circumstances and coincidences that I have little free choice, for example, when approaching an editorial. A case in point was a few days last month during which I attended a well-sponsored meeting of the Ontario Lung Association, reviewed a couple of papers reporting drug trials, read of the threats of litigation made by pharmaceutical companies to two Ontario researchers, heard of a public apology made by the New England Journal of Medicine regarding reviewers' conflicts of interest and received a critical letter from Dr Rob McFadden, an associate editor of the Canadian Respiratory Journal, about a sponsored publication that accompanied the last issue of 1999. All this I suppose reflects our rather ambivalent relationship with the pharmaceutical industry that supports many professional and academic programs but clearly expects some returns in addition to corporate tax benefits. We are now dependent on the industry's financial backing for academic and professional meetings that have become so large that they require large and expensive venues. But then the industry has the right to expect some return on its "investment" in such meetings.

  8. Dangerous liaisons

    DEFF Research Database (Denmark)

    Ekdahl, Kristina N; Teramura, Yuji; Hamad, Osama A


    Innate immunity is fundamental to our defense against microorganisms. Physiologically, the intravascular innate immune system acts as a purging system that identifies and removes foreign substances leading to thromboinflammatory responses, tissue remodeling, and repair. It is also a key contributor...

  9. [Hundred years' psychiatry in Korea (1899-1999)]. (United States)

    Rhi, B Y


    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

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

    LENUS (Irish Health Repository)

    Naughton, Marie


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

  11. 75 FR 66766 - National Toxicology Program (NTP); Office of Liaison, Policy and Review; Meeting of the NTP Board... (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Toxicology Program (NTP); Office of Liaison, Policy and Review; Meeting of the..., 2010. John R. Bucher, Associate Director, National Toxicology Program. BILLING CODE 4140-01-P...

  12. 75 FR 21003 - National Toxicology Program (NTP); Office of Liaison, Policy and Review Meeting of the NTP Board... (United States)


    ... HUMAN SERVICES National Toxicology Program (NTP); Office of Liaison, Policy and Review Meeting of the... ``Request for Comments'' below). The NTP welcomes toxicology study information from completed, ongoing, or... concept may also encompass larger public health issues or topics in toxicology that could be...

  13. Experiences of the Implementation of a Learning Disability Nursing Liaison Service within an Acute Hospital Setting: A Service Evaluation (United States)

    Castles, Amy; Bailey, Carol; Gates, Bob; Sooben, Roja


    It has been well documented that people with learning disabilities receive poor care in acute settings. Over the last few years, a number of learning disability liaison nurse services have developed in the United Kingdom as a response to this, but there has been a failure to systematically gather evidence as to their effectiveness. This article…

  14. Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan. (United States)

    Moriwaki, K; Noto, S


    A model-based cost-effectiveness analysis was performed to evaluate the cost-effectiveness of secondary fracture prevention by osteoporosis liaison service (OLS) relative to no therapy in patients with osteoporosis and a history of hip fracture. Secondary fracture prevention by OLS is cost-effective in Japanese women with osteoporosis who have suffered a hip fracture.

  15. 43 CFR 19.4 - Liaison with other governmental agencies and submission of views by interested persons. (United States)


    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Liaison with other governmental agencies and submission of views by interested persons. 19.4 Section 19.4 Public Lands: Interior Office of the... recommendations as to the suitability or nonsuitability for preservation as wilderness of any roadless area in...

  16. Psychosomatic medicine: A new psychiatric subspecialty in the U.S. focused on the interface between psychiatry and medicine

    Directory of Open Access Journals (Sweden)

    Constantine G. Lyketsos


    Full Text Available Background and Objectives: In the past, Psychosomatic Medicine (PM has had ambiguous connotations, and there have been many other names for this specialized fields, including Consultation-Liaison Psychiatry. The objective of this report is to briefly review the background, the history and current status of PM, which recently was recognized in the U.S. a psychiatric subspecialty. Methods: Historical review and review of the literature. Results: PM has a rich history. Psychoanalysts and psychophysiologists pioneered the study of mind-body interactions, and crucial events in the development include the funding of PM units in several U.S. teaching hospitals by the Rockefeller Foundation, and the training grants and a research development program funded by the National Institute of Mental Health. By the 1980s, all psychiatry residency programs were requiered to provide substancial clinical experience in the field, and as of 2005 there were 32 fellowship programs in the Academy of Psychosomatic Medicine's (APM directory. In 2001, The Academy of Psychosomatic Medicine (APM applied for the recognition of PM as a subspecialty of psychiatry, and formal approval was granted by the American Board of Medical Specialties (ABMS in March 2003. The foundation of PM is a specialized body of scientific knowledge regarding psychiatric aspects of medical illness. This has been articulated in contemporary textbooks, journals and regular scientificic meetings of national and international societies A cadre of scholars and researchers has emerged, and important contributions have occurred. A major goal of the PM field is to improve the psychiatric care of patients with complex medical conditions. There are a number of obstacles and challenges ahead in pursuing optimal integration of PM services into existing service delivery systems of care, but anticipated expansion of accredited fellowship programs in PM will hopefully help address this shortfall. In the past 20

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


    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…

  18. Molecular bioengineering of biomaterials in the 1990s and beyond: a growing liaison of polymers with molecular biology. (United States)

    Hoffman, A S


    An important trend in biomaterials research and development is the synthesis of polymers that combine capabilities of biologic recognition (biomimetic) with special physicochemical properties of the synthetic polymer system. Another important trend in such "molecular bioengineering" is to develop, perhaps via computer-aided molecular design, new artificial biomimetic systems by exact placement of functional groups on rigid polymer backbones, cross-linked structures, or macromolecular assemblies. In this way, biocatalytic functioning or biorecognition similar to enzymes and antibodies can be achieved without the inherent instability often encountered with the native biomolecules or assemblies. Perhaps the most exciting trend in biomaterials research and development is the availability of new biomolecules, e.g., via protein engineering and of hardy cells with specific biofunctions and bioresponses that can be tailored to specific medical or biotechnological needs. The wide variety of ways that such biomolecules and cells can be combined with polymeric biomaterials provides tremendously exciting opportunities for the biomaterials scientists and engineers. In addition to these synthetic approaches, new and exciting analytical tools, such as the scanning tunneling microscope and the atomic force microscope, are permitting study on a molecular scale of individual and small clusters of proteins and other biomolecular assemblies on surfaces. Cell attachments and spreading may also be visualized at various depths within the cell using the confocal laser microscope. Such analytical techniques can lead to important new knowledge about biologic interactions with biomaterials and, therefore, to development of even more biocompatible implants and devices. This paper overviews the present state of polymeric biomaterials and highlights the important and exciting opportunities generated by the liaison of these materials with molecular biology.

  19. [The transfer of psychiatry-narratives, termini and cross-cultural psychiatry in Japan]. (United States)

    Leitner, Bernhard


    This article is based on German and Japanese sources and shows how around 1900 European psychiatric concepts and practices embedded themselves into emerging scientific Japanese discourses. The article argues that now forgotten German-Japanese exchanges in the field of psychiatric pathology, together with the historical development of psychiatric care, were central mechanisms for the establishment of a distinctly psychiatric discourse in Japan priot to its broad institutionalization. Three discursive strategies were key: Japanese and German experts from a range of medical fields reinvented a body of traditions loosely related to actual pre-modern cultural practices; they engaged in comparative evaluations of psychiatric conditions; and, through the simple but effective transformation of specific concepts and termini at the margins of European psychiatry, these experts contributed to the transfer not only of a psychiatric discourse but also affected the power relations on a national and international scale as European psychiatry permeated into new territory, namely the Japanese landscape of emerging modern scientific disciplines.

  20. [Madness and malaria--intersections and boundary blurring between psychiatry and tropical medicine in Hamburg]. (United States)

    Wulf, Stefan; Schmiedebach, Heinz-Peter


    The object of this article is to point out and to discuss the significant intersections and boundary blurring between psychiatry and tropical medicine while treating malaria in the German "colonial metropolis" Hamburg. The focus of this study is the Hamburg asylum at Friedrichsberg and the Institute for Maritime and Tropical Diseases (Hamburg Tropical Institute). Under analysis are two groups of patients as well as the means with which their doctors treated them: 1. patients who have been sent back from the German colonies in Africa after mental disorders had been diagnosed, and 2. patients suffering from general paralysis and treated in Friedrichsberg after 1919 using the then newly developed malaria fever therapy (according to Wagner-Jauregg). The implementation of this latter led to an intensification of the cooperation between psychiatry and tropical medicine in Hamburg which prior to this had been only very sporadic.

  1. [Archivos de Neurobiología: seventy five years of Spanish psychiatry]. (United States)

    Lázaro, J


    One might consider that the first Spanish psychiatrists were a group of alienists, that have been forgotten for many years, who worked in isolated conditions in the asylums of the 19th Century. On the other hand, there were a group of personalities, university professors specialised in other disciplines, that were not psychiatrists but had a much greater influence than the former during the early stages of the development of Spanish psychiatry as a differentiated medical speciality. This development was produced (considerably later than in other European countries) in two successive stages: a preliminary one, with local or aborted institutions (from the 15th Century to the year 1919) and a further one, with institutions that extended throughout the entire country, and were developed between 1920 and 1936. These national institutions were the ones that defined the beginning of Spanish psychiatry. The first one, that appeared in January of 1920, was the journal Archivos de Neurobiología, that related each other, stimulated and served as on organ of expression to the remaining institutions that established this specialty. Finally, a summary is offered of the characteristics and the historical evolution of this journal emblematic of Spanish psychiatry, that is currently commemorating its 75th anniversary.

  2. [Some reflections on evidence based psychiatry and its impact on contemporary psychiatry]. (United States)

    Conti, Norberto A


    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.

  3. 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


    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.

  4. How new is the new philosophy of psychiatry?

    Directory of Open Access Journals (Sweden)

    Denys Damiaan


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

  5. Pilot Evaluation of a Communication Skills Training Program for Psychiatry Residents Using Standardized Patient Assessment. (United States)

    Ditton-Phare, Philippa; Sandhu, Harsimrat; Kelly, Brian; Kissane, David; Loughland, Carmel


    Mental health clinicians can experience difficulties communicating diagnostic information to patients and their families/carers, especially about distressing psychiatric disorders such as schizophrenia. There is evidence for the effectiveness of communication skills training (CST) for improving diagnostic discussions, particularly in specialties such as oncology, but only limited evidence exists about CST for psychiatry. This study evaluated a CST program specifically developed for psychiatry residents called ComPsych that focuses on conveying diagnostic and prognostic information about schizophrenia. The ComPsych program consists of an introductory lecture, module booklets for trainees, and exemplary skills videos, followed by small group role-plays with simulated patients (SPs) led by a trained facilitator. A standardized patient assessment (SPA) was digitally recorded pre- and post-training with a SP using a standardized scenario in a time-limited (15 min) period. Recorded SPAs were independently rated using a validated coding system (ComSkil) to identify frequency of skills used in five skills categories (agenda setting, checking, questioning, information organization, and empathic communication). Thirty trainees (15 males and 15 females; median age = 32) undertaking their vocational specialty training in psychiatry participated in ComPsych training and pre- and post-ComPsych SPAs. Skills increased post-training for agenda setting (d = -0.82), while questioning skills (d = 0.56) decreased. There were no significant differences in any other skills grouping, although checking, information organization, and empathic communication skills tended to increase post-training. A dose effect was observed for agenda setting, with trainees who attended more CST sessions outperforming those attending fewer. Findings support the generalization and translation of ComPsych CST to psychiatry.

  6. An Exploratory Analysis of Work Engagement, Satisfaction, and Depression in Psychiatry Residents. (United States)

    Agarwal, Gaurava; Karpouzian, Tatiana


    This exploratory study aims to measure work engagement levels in psychiatry residents at three psychiatry residency programs using the Utrecht Work Engagement Scale (UWES). In addition, the study investigates the relationship between total engagement and its subscales, resident satisfaction, and a depression screen. Recruitment of 53/79 residents from three psychiatry residency programs in Illinois was completed. The residents were administered a questionnaire consisting of the UWES, the Primary Care Evaluation of Mental Disorders (Prime-MD) depression screen, and a residency satisfaction scale. Statistical analysis using independent samples t test and a one-way analysis of variance was used to assess differences on engagement total score and subscales and satisfaction scale. A logistic regression was used with the engagement subscales and the satisfaction scale as predictors of belonging to the depressed or non-depressed group. Psychiatry residents scored in the high range for total engagement and all its subscales except for vigor which was in the moderate range. Residents who screened positive for depression reported lower total engagement than those who were negative on the depression screen. Vigor was the only significant predictor (p = .004) of being in the depressed group after logistic regression. Total engagement and the subscale of dedication significantly predicted overall residency satisfaction (β = .473, p = .016). Higher total UWES-15 and its subscales of vigor and dedication are correlated with a lower rate of screening positive for depression and higher residency satisfaction. This exploratory study lends support for further study of this psychological construct in medical training programs, but replication is needed.

  7. [Interdisciplinarity and psychiatry: is it time not to know?]. (United States)

    de Menezes, Mardônio Parente; Yasui, Silvio


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

  8. [The making of madness: counterculture and anti-psychiatry]. (United States)

    Oliveira, William Vaz de


    The 1950s and especially the 1960s saw constant revisions of social values and customs, with young people's movements playing a major role, above all the so-called counter-culture. The powers-that-be categorized the behavior and attitudes of the movement's followers as constituting madness. This making of madness gave rise to a stream of thought known as anti-psychiatry, which calls into question the very essence of psychiatry. The present article criticizes the psychiatric models of that era and draws links between counter-culture movements and anti-psychiatry.

  9. Etude de la liaison BTS/BSC du réseau GSM



    Le réseau GSM est la première norme de téléphonie mobile dans le monde. Un nombre croissant des abonnés en face des ressources radio limitées demande une utilisation adéquate de ces ressources. Le transport de la bonne qualité de service des réseaux cellulaires constitue la préoccupation majeure des opérateurs de réseaux. Dans ce contexte, nous avons étudiée dans ce projet les liaisons entre la BTS et BSC et nous nous sommes intéressés sur les PDH etles trames E1, E2, E3 et ...

  10. Congressional liaison task force - a briefing of the October 1994 meeting

    Energy Technology Data Exchange (ETDEWEB)



    As the US Senate overturned roadblocks attempting-unsuccessfully-to halt passage of the elementary and secondary education reauthorization legislation representatives from several federal agencies and laboratories addressed Congressional Liaison Task Force (CLTF) participants October 12th. They spoke about their commitment, programs, and accomplishments toward the nation`s science knowledge, particularly at the precollege level. Marjorie S. Steinberg legislative assistant to bill cosponsor Sen. Jeff Bingaman (DNM), and Gary Allen, Triangle Coalition director of Governmental affairs, spoke about education legislation and specifically about the Technology for Education Act that was on the Senate floor for a vote in October and now is law. Bruce A. Fuchs talked about the National Institute of Health`s (NIH) work in science literacy and education. The National Aeronautics and Space Administration`s (NASA) Frank C. Owens and Eddie Anderson contributed to this report.

  11. The genomic psychiatry cohort: partners in discovery. (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


    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. Copyright © 2013 Wiley Periodicals, Inc.

  12. [Biologism controversy: ethical implications for psychiatry]. (United States)

    Stier, M; Muders, S; Rüther, M; Schöne-Seifert, B


    Current biological psychiatry, it is frequently claimed by its opponents, is "biologistic" and unduly narrows psychological disorders to neurobiology and molecular biology. They deem a complete neuroscientific reduction of the mental phenomena to be impossible because of the impossibility of reducing certain phenomena, such as the individual subjective experience. If such a reduction is nevertheless undertaken it is ultimately to the disadvantage of the patients. We argue in this article that the very term "biologism" has to be put under scrutiny in the first place. As a result it becomes obvious that "biologism", as a subclass of "philosophical naturalism", is ultimately quite unproblematic. Biologism is dangerous only if it implies an eliminative rejection or an inappropriate underestimation of the relevance of the psyche. On closer examination it gets evident that such implications do not follow necessarily from biologism but cannot be precluded either. To better identify and possibly prevent such dangers, a more differentiated terminology seems helpful.

  13. Use of Telepsychiatry in Psychodynamic Psychiatry. (United States)

    Saeed, Sy Atezaz; Anand, Vivek


    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.

  14. [Community psychiatry. Evaluation and research perspectives]. (United States)

    Hochmann, J


    The author deals with 3 possible types of epidemiological studies in community mental health services: studies on the efficiency measuring the difference between the objectives of each team and the results; studies on the distribution between the teams and within each team, institutionalised models and implicit defensive modalities elaborated by the staff against the fear of the insane; studies on the populations considered at risk by psychoanalytical theories en vogue (depressive mothers, relationship anomalies). These studies would have the advantage to limit the "etiopathogenic pretentions" in psychiatry and avoid the "realistic slide" of imaginary constructions (myths or fiction of origin) which the community health service psychiatrist needs to work with but which has only an uncertain relationship with historical truth.

  15. [The cultural psychiatry in Latin America]. (United States)

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


    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.

  16. Descartes' dogma and damage to Western psychiatry. (United States)

    Ventriglio, A; Bhugra, D


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

  17. Psychiatry, religion, positive emotions and spirituality. (United States)

    Vaillant, George E


    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 that are more dependent on the limbic system than the cortex. 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 the negative ones.

  18. [Research and Post-graduate in Psychiatry]. (United States)

    Carlos, A Palacio A


    The research component and the acquisition of skills related to the generation of knowledge in the training of medical and surgical specialists in the country is an issue that has recently begun to be discussed. For over 50 years this training has included only the area of professionalism as a copy of an educational model from the mid-twentieth century. Currently the country requires specialists with critical and analytical skills to question their actions and knowledge and generate alternative clinical care to apply to the general population in the search of bettering their own welfare. This article is a review in which the current situation of the teaching of psychiatry and the inclusion of research in the academic processes of our medical specialties in the country are analyzed. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  19. Adding a dietitian to a Danish Liaison-team after discharge of geriatric patients at nutritional risk may save health care costs

    DEFF Research Database (Denmark)

    Pohju, Anne; Belqaid, Kerstin; Brandt, Christopher Flintenborg


    Background: A previous study investigated the value of adding a dietitian to a geriatric discharge Liaison-Team. The scope of this study was to explore the possible economic savings of this. Methods: Patients, 70+ and at nutritional risk, were randomized to receive discharge Liaison-Team either......,416 compared to €1,150 (ONS only) in the CG. For hospitalizations, estimated cost was €92,020 in the IG and €220,025 in the CG. Cost savings added up to €3,048 per patient in the IG. Conclusion: Adding a dietitian to a Danish geriatric discharge Liaison-Team decreased health care costs...

  20. Liaison activities with the Institute of Physical Chemistry/Russian Academy of Science Fiscal Year 1995

    Energy Technology Data Exchange (ETDEWEB)

    Delegard, C.H.


    Investigations into the chemistry of alkaline Hanford Site tank waste (TTP RL4-3-20-04) were conducted in Fiscal Year 1995 at Westinghouse Hanford Company under the support of the Efficient Separations and Processing Crosscutting Program (EM-53). The investigation had two main subtasks: liaison with the Institute of Physical Chemistry of the Russian Academy of Science and further laboratory testing of the chemistry of thermal reconstitution of Hanford Site tank waste. Progress, which was achieved in the liaison subtask during Fiscal Year 1995, is summarized as follows: (1) A technical dialogue has been established with Institute scientists. (2) Editing was done on a technical literature review on the chemistry of transuranic elements and technetium in alkaline media written by researchers at the Institute. The report was issued in May 1995 as a Westinghouse Hanford Company document. (3) Four tasks from the Institute were selected for support by the U.S. Department of Energy. Work on three tasks commenced on 1 March 1995; the fourth task commenced on 1 April 1995. (4) Technical information describing the composition of Hanford Site tank waste was supplied to the Institute. (5) A program review of the four tasks was conducted at the Institute during a visit 25 August to 1 September, 1995. A lecture on the origin, composition, and proposed treatment of Hanford Site tank wastes was presented during this visit. Eight additional tasks were proposed by Institute scientists for support in Fiscal Year 1996. (6) A paper was presented at the Fifth International Conference on Radioactive Waste Management and Environmental Remediation (ICEM`95) in Berlin, Germany on 3 to 9 September, 1995 on the solubility of actinides in alkaline media.

  1. Psychiatrie in meervoud. De wetenschappelijke oriëntaties van de Nederlandse psychiatrie in het interbellum (1918-1940

    Directory of Open Access Journals (Sweden)

    Joost Vijselaar


    Full Text Available Psychiatry in multiplicity According to a widespread interpretation, the history of psychiatry is characterized by a strong opposition between biological and psychological paradigms, which would dominate consecutive periods in history. The image of a swinging pendulum is a popular metaphor to describe this idea. The culture of Dutch psychiatry in the interwar years (1918-1940 seems to gainsay this image. Psychological, biological and socials models of explanation and therapy were used alongside each other without apparent debate and conflict. Influential professors of psychiatry like H.C. Rümke (Utrecht University even pleaded for a conscious integration of these approaches. Some historians have interpreted this stance as a sign of scientific ‘vagueness’ and ‘anarchy’. Analyzing the work of three major representatives of Dutch psychiatry in the Interbellum (Leendert Bouman, Han Rümke and Lammert van der Horst, the authors (former students of the master Historical and Comparative Studies of the Sciences and the Humanities shed light on the psychiatric climate of this era, dealing with themes like the openness of psychiatry to other sciences, the interactions of psychiatry and literature, and the relationship between theory and clinical practice. As a result a further qualification of the image of the pendulum is argued for.

  2. [Development of forensic psychiatry in Serbia]. (United States)

    Milovanović, Srdjan; Jovanović, Aleksandar; Jasović-Gasić, Miroslava; Ilanković, Nikola; Dunjić, Dusan; Lakić, Aneta; Djukić-Dejanović, Slavica; Nenadović, Milutin; Randjelović, Dragisa; Milovanović, Dimitrije


    The development of legislation in the field of mental health in our region is linked with the emergence and development of the oldest psychiatric hospitals in Serbia.The principle that the mentally ill who committed a criminal offense need to be placed in a psychiatric hospital instead of a prison was introduced at the same time as in the most developed European countries. The founders of the Serbian forensic psychiatry, Dr. Jovan Danić, Dr.Vojislav Subotić Jr. and Dr. Dusan Subotić, were all trained at the first Serbian Psychiatric Hospital ("Home for the Unsound of Mind") that was founded in 1861 in the part of Belgrade called Guberevac. Their successors were psychiatric enthusiasts Prof. Dr.Vladimir F.Vujić and Prof. Dr. Laza Stanojević. A formal establishment of the School of Medicine of Belgrade, with acquirement of new experience and positive shifts within this field, based on the general act of the University in 1932, led to the formation of the Council of the School of Medicine, which, as a collective body passed expert opinions. Thus, the first Forensic Medicine Committee of the School of Medicine was formed and started its activities in 1931 when Forensic Medicine Committee Regulations were accepted. After the World War II prominent educators in the field of mental health, and who particularly contributed to further development of forensic psychiatry in Serbia were Prof. Dr. Uros Jekić, Prof Dr. Dusan Jevtić, Dr. Stevan Jovanović, Prof. Dr. Borislav Kapamadzija, Prof. Dr. Maksim Sternić, Prof. Dr. Josif Vesel and Prof. Dr. Dimitrije Milovanović.

  3. Editorial cognition, neurology, psychiatry: golden triangle or bermuda triangle? (United States)

    Baddeley, A D


    Cognitive neuropsychiatry occupies the comparatively neglected research region that lies between neurology, psychiatry, and cognitive psychology. Reasons for this neglect are discussed, together with arguments as to why it may be timely to focus on this intellectual no man's land.

  4. Epigenetics and Child Psychiatry: Ethical and Legal Issues. (United States)

    Thomas, Christopher R


    Epigenetics has the potential to revolutionize diagnosis and treatment in psychiatry, especially child psychiatry, as it may offer the opportunity for early detection and prevention, as well as development of new treatments. As with the previous introduction of genetic research in psychiatry, there is also the problem of unrealistic expectations and new legal and ethical problems. This article reviews the potential contributions and problems of epigenetic research in child psychiatry. Previous legal and ethical issues in genetic research serve as a guide to those in epigenetic research. Recommendations for safeguards and guidelines on the use of epigenetics with children and adolescents are outlined based on the identified issues. Copyright © 2015 John Wiley & Sons, Ltd.

  5. The assessment of undergraduate psychiatry training: a paradigm shift

    African Journals Online (AJOL)


    Oct 24, 2005 ... conduct assessments accountably and according to the latest ... Department of Neurosciences, Division of Psychiatry, University of Witwatersrand, Johannesburg, South ... of view essays are easy to set but are notoriously time.

  6. [The meaning of bibliotherapy and expressive writing in child and adolescent psychiatry]. (United States)

    Blechinger, Tobias; Klosinski, Gunther


    Child- and adolescent psychiatry is a good field for the application of creative and playful therapies. Bibliotherapy and expressive writing are two examples of them. The effectiveness of both, for different types of disorders, has been proved in many studies. Up until today it was unknown just how prevalent these therapies are within child and adolescent psychiatry in the german speaking countries. The following article summarizes the results of a survey conducted in 122 child and adolescence psychiatric clinics in Germany, Austria and Switzerland to gain more information about their use. The survey takes into account the frequency of application of bibliotherapy and expressive writing therapies depending on age and type of disorder, preferences amongst patient groups, as well as specific approaches. More than half of the surveyed child and adolescent psychiatries are using at least one of the two therapies. They are used on an irregular and non-systematic basis and rather symptom- than diagnosis-orientated. Bibliotherapy and expressive writing are dynamic therapies which can be used in manifold ways. Reading and writing are two of the main pillars of our educational system and can be utilized within a therapeutic setting. Provided that the patient is not suffering from severe cognitive or mental limitations, the spoken and written word can leave deep imprints within the patient's, but also the therapist's, soul.

  7. [Madness is Conforming to One's Own Norms, and No Others: Psychiatry in Post-war Quebec]. (United States)

    Perreault, Isabelle


    In the early 1950s, both the publication of the first Diagnostic and Statistical Manual (DSM-I) and the advent of psychopharmacology - particularly the development of chlorpromazine (Thorazine - RP4650) - set the stage for models of psychiatric thought, research and practice that remain dominant today. It was during this pivotal period, in 1955, that the Département de psychiatrie de l'Université de Montréal was founded by a cohort of young researchers newly arrived from well-known universities in France and the northeastern United States. This influential group quickly became staunch critics of the province's religion-based asylum system and lobbied for a government review that culminated into the 1962 Commission d'étude des hôpitaux psychiatriques (popularly known as the Bédard Report). What followed in Quebec between 1965 and 1975 was the secularization of psychiatric institutions and widespread deinstitutionalization. This paper illuminates cultural changes and intellectual shifts that have been overlooked in historical studies of post-war psychiatry by exploring the expansion of such "anti-psychiatry" schools of thought in Quebec in this period.

  8. Using the Script Concordance Test to Evaluate Clinical Reasoning Skills in Psychiatry. (United States)

    Kazour, François; Richa, Sami; Zoghbi, Marouan; El-Hage, Wissam; Haddad, Fady G


    Although clinical reasoning is a major component of psychiatric training, most evaluating tools do not assess this skill properly. Clinicians mobilize networks of organized knowledge (scripts) to assess ambiguous or uncertain situations. The Script Concordance Test (SCT) was developed to assess clinical reasoning in an uncertainty context. The objective of this study was to test the usefulness of the SCT to assess the reasoning capacities of interns (7th year medical students) during the psychiatry training. The authors designed a SCT for psychiatry teaching, adapted to interns. The test contained 20 vignettes of five questions each. A reference panel of senior psychiatrists underwent the test, and we used their scoring as a reference for the student group. The SCT assessed the competence of students at the beginning and the end of their training in psychiatry. A panel of 10 psychiatrists and 47 interns participated to this study. As expected, the reference panel performed significantly (preasoning competence. It can provide a valid alternative to classical evaluation methods.

  9. [Epistemologic perspectives for a nosography in child psychiatry]. (United States)

    Berquez, G


    The author tries to question psychiatric nosography based on references. To do so, after defining nosography as well as psychiatric and medical nosography, he studies two ideas of thought. The first is a causal medical way dealing with child schizophrenia as developed in Eastern European psychiatry, whereas the second deals with the structural psychopathological way which describes the concept of child psychosis, the dominant way of dealing with child psychiatry in France.

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


    L Eugene Arnold


    I have been a grandfather for only 12 years, but for 37 years I have lived a grandparent's dream: people pay me to tell them how to raise their children. This is only one of the many rewards child and adolescent psychiatry has offered me. Table 1 lists some more of them.Probably the greatest satisfaction in child psychiatry is the wide selection of options for specialization: psychotherapy, psychopharmacology, nutrition, biochemistry, genetics, family therapy, parent guidance, custody and vis...

  11. Attitudes toward neuroscience education in psychiatry: a national multi-stakeholder survey. (United States)

    Fung, Lawrence K; Akil, Mayada; Widge, Alik; Roberts, Laura Weiss; Etkin, Amit


    The objective of this study is to assess the attitudes of chairs of psychiatry departments, psychiatrists, and psychiatry trainees toward neuroscience education in residency programs and beyond in order to inform future neuroscience education approaches. This multi-stakeholder survey captured data on demographics, self-assessments of neuroscience knowledge, attitudes toward neuroscience education, preferences in learning modalities, and interests in specific neuroscience topics. In 2012, the authors distributed the surveys: by paper to 133 US psychiatry department chairs and electronically through the American Psychiatric Association to 3,563 of its members (1,000 psychiatrists and 2,563 trainees). The response rates for the chair, psychiatrist, and trainee surveys were 53, 9, and 18 %, respectively. A large majority of respondents agreed with the need for more neuroscience education in general and with respect to their own training. Most respondents believed that neuroscience will help destigmatize mental illness and begin producing new treatments or personalized medicines in 5-10 years. Only a small proportion of trainees and psychiatrists, however, reported a strong knowledge base in neuroscience. Respondents also reported broad enthusiasm for transdiagnostic topics in neuroscience (such as emotion regulation and attention/cognition) and description at the level of neural circuits. This study demonstrates the opportunity and enthusiasm for teaching more neuroscience in psychiatry among a broad range of stakeholder groups. A high level of interest was also found for transdiagnostic topics and approaches. We suggest that a transdiagnostic framework may be an effective way to deliver neuroscience education to the psychiatric community and illustrate this through a case example, drawing the similarity between this neuroscience approach and problem-based formulations familiar to clinicians.

  12. Delphi consensus on the physical health of patients with schizophrenia: evaluation of the recommendations of the Spanish Societies of Psychiatry and Biological Psychiatry by a panel of experts. (United States)

    Bobes-García, Julio; Saiz-Ruiz, Jerónimo; Bernardo-Arroyo, Miquel; Caballero-Martínez, Fernando; Gilaberte-Asín, Inmaculada; Ciudad-Herrera, Antonio


    Available data from scientific literature show that patients with schizophrenia have higher rates of physical comorbidity and excess mortality due to other physical pathologies. The growing interest to investigate and improve the health of these patients has led a group of Spanish experts to publish in 2008 a "Consensus on physical health of patients with schizophrenia from the Spanish Societies of Psychiatry and Biological Psychiatry" (2008 Consensus). These recommendations imply a significant change to the present model of medical attention. To gauge the level of agreement of a group of expert psychiatrists on the clinical criteria and recommendations collected from the scientific literature and the 2008 Consensus on the physical health of patients with schizophrenia. The process involved four phases: 1) Scientific Committee established to manage the study and to define the 66-item questionnaire; 2) Panel of 15 experts in psychiatry is established; 3) Submission of questionnaire to the Expert Panel in two consecutive rounds, with an intermediate processing and sharing of results; 4) Evaluation of results, discussion and conclusions between Scientific Committee and Expert Panel. All items, as set by the Scientific Committee and aligned with the recommendations published in the 2008 Consensus, achieved consensus on agreement from the Expert Panel, except 5 items, for which most of the answers were placed in the indeterminate position rate. The expert criteria shown in this study indicate a global agreement with regard to clinical criteria on the physical health of patients with schizophrenia, as well as with the present recommendations to improve the health of patients having, or at risk to have, other concomitant pathologies. The need to incorporate new intervention guidelines that facilitate a better control and improvement of the physical health of patients with schizophrenia must be disseminated in the psychiatric providers' collectives.

  13. [Clinical ethics in psychiatry: state of the art]. (United States)

    Reiter-Theil, Stella; Schürmann, Jan; Schmeck, Klaus


    Overview on Clinical Ethics Consultation in Psychiatry. Systematic literature search in data bases (PubMed, Web of Knowledge, SpringerLink, PubPsych, PsychSpider und PsycINFO) against the background of practical experiences with pilot model of implementation of Ethics Consultation in one psychiatric university hospital. Reports on Ethics Consultation in Psychiatry were published only sporadically. This is contrasted by recent experiences showing considerable needs for ethics support in Child and Adolescent Psychiatry, Adult as well as Forensic Psychiatry. This somewhat "late" development of Ethics Consultation in Psychiatry (compared with somatic medicine) might have structural reasons (lacking resources), be related to strong compensatory competencies of psychiatric staff, esp. regarding communication or legal knowledge, but could also relate to an under-estimation ("under-diagnostic") of ethical problems in psychiatric patient care - both, in the eyes of psychiatric insiders, as well as seen from the outside. Needs for model projects and accompanying research on Ethics Consultation in Psychiatry. Proved in practice: patient- as well as team-oriented ethics support. © Georg Thieme Verlag KG Stuttgart · New York.

  14. [Use of informatics technology in psychiatry]. (United States)

    Margariti, M; Papadimitriou, G N


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

  15. Literature Review on the Design of Composite Mechanically Fastened Joints (Revue de la Documentation sur la Conception des Joints a Liaison Mecanique en Composites), (United States)


    importantes, compl~tes et durables en termes de contribution aux connaissances actuelles. Rapports de ginie mecanique (MS): Informations scientifiques et...CONCEPTION * DES JOINTS A LIAISON MECANIQUE EN COMPOSITES Accr-! nnFor by/par I C. Poon p. National Aeronautical Establishment AERONAUTICAL NOTE/ OTTAWA NAE...mdthodes analytiques et expdrimentales de pointe, utilis~es dans l’industrie a~rospatiale pour la conception de joints a liaison m~canique en matdriaux

  16. Training Groups and Foreign-Born Psychiatric Medical Residents in the United States. (United States)

    Greenberg, Andrea; Juthani, Nalini


    About two-thirds of all psychiatry residents are foreign-born medical graduates. Discusses the operation, content, focus, challenges, and benefits of a training group experience for the psychiatry residents at Bronx Lebanon Hospital. The goals are to aid acculturation, improve group psychotherapeutic skills, encourage self-awareness, and promote…

  17. [The "Psychiatrie-Enquete" - the German Report on the State of Psychiatry in 1975]. (United States)

    Finzen, Asmus


    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.

  18. Liaison neurologists facilitate accurate neurological diagnosis and management, resulting in substantial savings in the cost of inpatient care.

    LENUS (Irish Health Repository)

    Costelloe, L


    BACKGROUND: Despite understaffing of neurology services in Ireland, the demand for liaison neurologist input into the care of hospital inpatients is increasing. This aspect of the workload of the neurologist is often under recognised. AIMS\\/METHODS: We prospectively recorded data on referral and service delivery patterns to a liaison neurology service, the neurological conditions encountered, and the impact of neurology input on patient care. RESULTS: Over a 13-month period, 669 consults were audited. Of these, 79% of patients were seen within 48 h and 86% of patients were assessed by a consultant neurologist before discharge. Management was changed in 69% cases, and discharge from hospital expedited in 50%. If adequate resources for neurological assessment had been available, 28% could have been seen as outpatients, with projected savings of 857 bed days. CONCLUSIONS: Investment in neurology services would facilitate early accurate diagnosis, efficient patient and bed management, with substantial savings.

  19. Psychosocial first aid for refugees (an essay in social psychiatry). (United States)

    Tyhurst, L


    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.

  20. Teaching and learning the physician manager role: psychiatry residents' perspectives. (United States)

    Stergiopoulos, Vicky; Maggi, Julie; Sockalingam, Sanjeev


    Despite widespread consensus that additional training in administration is needed to prepare physicians for practice, little is known about how best to teach managerial competencies and how to integrate teaching into existing postgraduate curricula. This study aimed to elicit resident perspectives on administrative curriculum development following exposure to a pilot physician manager curriculum at the University of Toronto. The authors held five focus groups of psychiatry residents at the University of Toronto during 2008, engaging 40 trainees. Resident perspectives on barriers to teaching and learning administrative skills, preferred curriculum content and format and suggestions for integration of administrative training into the residency programme were elicited. Identified barriers to learning include lack of physician manager role clarity, dearth of learning opportunities and multiple competing demands on residents' time. Residents value a formal administrative curriculum and propose additional opportunities for experiential learning such as elective rotations and mentorship opportunities. Suggested strategies for integrating administrative teaching into residency include faculty development, rotation-specific administrative objectives and end of rotation resident evaluations. Our findings provide valuable learner input into an emerging educational framework aiming to address barriers to teaching administrative skills during residency and facilitate longitudinal reinforcement of learning.

  1. [Assessment of an Evaluation System for Psychiatry Learning]. (United States)

    Campo-Cabal, Gerardo


    Through the analysis of a teaching evaluation system for a Psychiatry course aimed at Medicine students, the author reviews the basic elements taken into account in a teaching assessment process. Analysis was carried out of the assessment methods used as well as of the grades obtained by the students from four groups into which the they were divided. The selected assessment methods are appropriate to evaluate educational objectives; the contents are selected by means of a specification matrix; there is a high correlation coefficient between the grades obtained in previous academic periods and the ones obtained in the course, thus demonstrating the validity of the results (both considering the whole exam or just a part of it). Most of the students are on the right side of the grading curve, which means that the majority of them acquire the knowledge expected. The assessment system used in the Psychopathology course is fair, valid and reliable, specifically concerning the objective methods used, but the conceptual evaluation should be improved or, preferably, eliminated as a constituernt part of the evaluation system. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  2. Deep pharma: psychiatry, anthropology, and pharmaceutical detox. (United States)

    Oldani, Michael


    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.

  3. Cultural psychiatry: research strategies and future directions. (United States)

    Kirmayer, Laurence J; Ban, Lauren


    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.

  4. Contested boundaries: psychiatry, disease, and diagnosis. (United States)

    Rosenberg, Charles E


    Since the 19th century, we have come to think of disease in terms of specific entities--entities defined and legitimated in terms of characteristic somatic mechanisms. Since the last third of that century, we have expanded would-be disease categories to include an ever-broader variety of emotional pain, idiosyncrasy, and culturally unsettling behaviors. Psychiatry has been the residuary legatee of these developments, developments that have always been contested at the ever-shifting boundary between disease and deviance, feeling and symptom, the random and the determined, the stigmatized and the value-free. Even in our era of reductionist hopes, psychopharmaceutical practice, and corporate strategies, the legitimacy of many putative disease categories will remain contested. The use of the specific disease entity model will always be a reductionist means to achieve necessarily holistic ends, both in terms of cultural norms and the needs of suffering individuals. Bureaucratic rigidities and stakeholder conflicts structure and intensify such boundary conflicts, as do the interests and activism of an interested lay public.

  5. Neuropsychiatry and neuroscience education of psychiatry trainees: attitudes and barriers. (United States)

    Benjamin, Sheldon; Travis, Michael J; Cooper, Joseph J; Dickey, Chandlee C; Reardon, Claudia L


    The American Association of Directors of Psychiatric Residency Training (AADPRT) Task Force on Neuropsychiatry and Neuroscience Education of Psychiatry Residents was established in 2011 with the charge to seek information about what the field of psychiatry considers the core topics in neuropsychiatry and neuroscience to which psychiatry residents should be exposed; whether there are any "competencies" in this area on which the field agrees; whether psychiatry departments have the internal capacity to teach these topics if they are desirable; and what the reception would be for "portable curricula" in neuroscience. The task force reviewed the literature and developed a survey instrument to be administered nationwide to all psychiatry residency program directors. The AADPRT Executive Committee assisted with the survey review, and their feedback was incorporated into the final instrument. In 2011-2012, 226 adult and child and adolescent psychiatry residency program directors responded to the survey, representing over half of all US adult and child psychiatry training directors. About three quarters indicated that faculty resources were available in their departments but 39% felt the lack of neuropsychiatry faculty and 36% felt the absence of neuroscience faculty to be significant barriers. Respectively, 64 and 60% felt that neuropsychiatry and psychiatric neuroscience knowledge were very important or critically important to the provision of excellent care. Ninety-two percent were interested in access to portable neuroscience curricula. There is widespread agreement among training directors on the importance of neuropsychiatry and neuroscience knowledge to general psychiatrists but barriers to training exist, including some programs that lack faculty resources and a dearth of portable curricula in these areas.

  6. Factors Influencing Medical School Graduates Toward a Career in Psychiatry: Analysis from the 2011-2013 Association of American Medical Colleges Graduation Questionnaire. (United States)

    Wilbanks, Lindsey; Spollen, John; Messias, Erick


    Various factors influence choice of medical specialty. Previous research grouped specialties into controllable lifestyle, primary care, and surgical. This study compared factors influencing individuals to choose psychiatry versus other specialties. Data came from the 2011-2013 Association of American Medical Colleges Graduation Questionnaire. The authors grouped responses, ranging from no influence to minor, moderate, and strong influence, into psychiatry and controllable lifestyle, primary care, and surgical specialties and analyzed the data using one-way analysis of variance. The analyses included 29,227 students, of which 1329 (4.5%) elected psychiatry; 10,998 (37.6%), controllable lifestyle specialties; 12,320 (42.2%), primary care specialties; and 4580 (15.7%), surgical specialties. Students choosing psychiatry reported less influence of competitiveness, student debt, and salary expectations than those choosing controllable lifestyle and surgical specialties (p personality than controllable lifestyle, primary care, and surgical specialties (p < 0.004). Students entering psychiatry do not fit the traditional categories of controllable lifestyle, primary care, and surgical profiles, but fall between controllable lifestyle and primary care specialties. Recruitment efforts may need to address this different pattern of influences.

  7. [An analysis of advertisements for psychotropic drugs in the Dutch Journal of Psychiatry ('Tijdschrift voor Psychiatrie')]. (United States)

    Vandereycken, W; Kuyken, K


    Through the marketing of psychotropics the pharmaceutical industry is able to influence the way in which psychiatrists practise their profession. To look at the image of psychiatry as reflected in advertisements for psychotropics. method Quantitative and qualitative analysis of the advertisements for psychotropics in the Tijdschrift voor Psychiatrie between 1999 and 2006. On average 6 per cent of the total number of pages was given over annually to advertisements of psychotropics. The number of pages used for these advertisements changed over the years, with a sharp decline between 2002 and 2004. Before 2002 the majority of advertisements was for antidepressants, but later most of them were for antipsychotics. Three-quarters of the illustrations for antidepressants featured women whereas three-quarters of the illustrations for antipsychotics featured men. In general, the advertisements were of an 'emotional' nature and surprisingly few of them contained any scientific information. The advertisements for psychotropics portrayed a stereotyped image implying that it is mainly women who are depressed and mainly men who are psychotic. In its advertisements the pharmaceutical industry seeks primarily emotional reactions and uses hardly any scientific arguments. We wonder if the editorial boards of scientific journals should perhaps adopt a more critical attitude to these kinds of advertisements.

  8. Effectiveness of Resident Physicians as Triage Liaison Providers in an Academic Emergency Department. (United States)

    Weston, Victoria; Jain, Sushil K; Gottlieb, Michael; Aldeen, Amer; Gravenor, Stephanie; Schmidt, Michael J; Malik, Sanjeev


    Emergency department (ED) crowding is associated with detrimental effects on ED quality of care. Triage liaison providers (TLP) have been used to mitigate the effects of crowding. Prior studies have evaluated attending physicians and advanced practice providers as TLPs, with limited data evaluating resident physicians as TLPs. This study compares operational performance outcomes between resident and attending physicians as TLPs. This retrospective cohort study compared aggregate operational performance at an urban, academic ED during pre- and post-TLP periods. The primary outcome was defined as cost-effectiveness based upon return on investment (ROI). Secondary outcomes were defined as differences in median ED length of stay (LOS), median door-to-provider (DTP) time, proportion of left without being seen (LWBS), and proportion of "very good" overall patient satisfaction scores. Annual profit generated for physician-based collections through LWBS capture (after deducting respective salary costs) equated to a gain (ROI: 54%) for resident TLPs and a loss (ROI: -31%) for attending TLPs. Accounting for hospital-based collections made both profitable, with gains for resident TLPs (ROI: 317%) and for attending TLPs (ROI: 86%). Median DTP time for resident TLPs was significantly lower (pfinancial profile.

  9. A promiscuous liaison between IL-15 receptor and Axl receptor tyrosine kinase in cell death control. (United States)

    Budagian, Vadim; Bulanova, Elena; Orinska, Zane; Thon, Lutz; Mamat, Uwe; Bellosta, Paola; Basilico, Claudio; Adam, Dieter; Paus, Ralf; Bulfone-Paus, Silvia


    Discrimination between cytokine receptor and receptor tyrosine kinase (RTK) signaling pathways is a central paradigm in signal transduction research. Here, we report a 'promiscuous liaison' between both receptors that enables interleukin (IL)-15 to transactivate the signaling pathway of a tyrosine kinase. IL-15 protects murine L929 fibroblasts from tumor necrosis factor alpha (TNFalpha)-induced cell death, but fails to rescue them upon targeted depletion of the RTK, Axl; however, Axl-overexpressing fibroblasts are TNFalpha-resistant. IL-15Ralpha and Axl colocalize on the cell membrane and co-immunoprecipitate even in the absence of IL-15, whereby the extracellular part of Axl proved to be essential for Axl/IL-15Ralpha interaction. Most strikingly, IL-15 treatment mimics stimulation by the Axl ligand, Gas6, resulting in a rapid tyrosine phosphorylation of both Axl and IL-15Ralpha, and activation of the phosphatidylinositol 3-kinase/Akt pathway. This is also seen in mouse embryonic fibroblasts from wild-type but not Axl-/- or IL-15Ralpha-/- mice. Thus, IL-15-induced protection from TNFalpha-mediated cell death involves a hitherto unknown IL-15 receptor complex, consisting of IL-15Ralpha and Axl RTK, and requires their reciprocal activation initiated by ligand-induced IL-15Ralpha.

  10. [Supporting system for regional medical liaison and role of a central hospital]. (United States)

    Kitano, Seigo


    The current status and future development of the supporting system for regional medical liaison and a role of the central hospital in the network were outlined. One of such supportive systems for regional medical network would be tele-medicine or tele-mentoring that include radiological and pathological diagnoses in distance, tele-surgery, and tele-education. Most of these systems are facilitated in the universities and affiliated hospitals and generally need high-cost communication equipment. Another approach is the information sharing system through the modern telecommunication network. Electronic patient record (EPR) systems are the key to achieving this and currently active in several areas. Since the recent progress in information technology (IT) is astonishing, community-based EPR systems are practical with the capability of clinical information exchange between different institutions and even with patients. The role of a central hospital in these systems must be capacious. Management and continuous operation of the system would be the most important affairs. For extending these supporting systems to the ones working in a broader area, the establishment of a "one ID for one patient" system is crucial. Strict security management of the data base and legal institution for distant medical practice still remain as the future tasks.

  11. Cardiovascular Risk Factor Analysis in Patients with a Recent Clinical Fracture at the Fracture Liaison Service

    Directory of Open Access Journals (Sweden)

    Caroline E. Wyers


    Full Text Available Patients with a low bone mineral density have an increased risk of cardiovascular diseases (CVD and venous thromboembolic events (VTE. The aim of our retrospective chart review was to investigate the prevalence of CVD, VTE, hypertension (HT, and diabetes mellitus type 2 (DM2 in patients with a recent clinical fracture visiting the Fracture Liaison Service (FLS. Out of 3057 patients aged 50–90 years, 1359 consecutive patients, who agreed and were able to visit the FLS for fracture risk evaluation, were included (71.7% women; mean age 65.2 yrs. Based on medical history, 29.9% had a history of CVD (13.7%, VTE (1.7%, HT (14.9%, and DM2 (7.1% or a combination. Their prevalence increased with age (21% in patients aged 50–59 years to 48% in patients aged >80 years and was higher in men than in women (36% versus 27%, but independent of bone mineral density and fracture type. Careful evaluation of medical history with respect to these risk factors should be performed in patients with a recent clinical fracture before starting treatment with medications that increase the risk of VTE or cardiovascular events, such as raloxifene, strontium ranelate, or NSAIDs.

  12. [Irrationality in psychiatry. I. Irrationality in analytical psychology]. (United States)

    Vacek, J


    In the author's opinion the contemporary western world is experiencing an offensive of irrationality which affects also psychiatry. When psychiatry got rid of irrational illusions of preceding centuries, analytical psychology contributed to the introduction of irrationality into psychiatry. In the first part of his paper he maintains that Freud's share was not substantial in this respect and that in particular Jung contributed towards the development of irrational trends in psychiatry by this concept of collective unconscious. In the second part of his paper the author deals with so-called transpersonal, psychology, in particular the contribution made by the Czech psychiatrist Grof who, based on his experiments with LSD, created the theory of three levels of experience from unconscious (psychodynamic, perinatal, and transpersonal). His interpretation is a relapse of neoplatonism and represents antirational agnostic spiritualism with utopic antipsychiatric elements. In the third part of his paper the author deals with Capro's ideology of the New Age Movement to the establishment of which Ghof contributed in an important way. The New Age ideology is an irrational conglomeration of anti-civilization trends which negate modern thinking. The chances of manking are fallaciously seen in alienation from science and an approach to mysticism and irrational Asian traditions. Contemporary popularity of irrational trends, incl. transpersonal psychology, is a reaction of the overationalized society. Consequential enforcement of transpersonal psychology would imply a negation of the entire arsenal of thinking in psychiatry as a medial discipline.

  13. Centenary of Karl Jaspers's general psychopathology: implications for molecular psychiatry. (United States)

    Thome, Johannes


    Modern molecular psychiatry benefits immensely from the scientific and technological advances of general neuroscience (including genetics, epigenetics, and proteomics). This "progress" of molecular psychiatry, however, will be to a degree "unbalanced" and "epiphytic" should the development of the corresponding theoretical frameworks and conceptualization tools that allow contextualization of the individual neuroscientific findings within the specific perspective of mental health care issues be neglected. The General Psychopathology, published by Karl Jaspers in 1913, is considered a groundbreaking work in psychiatric literature, having established psychopathology as a space of critical methodological self-reflection, and delineating a scientific methodology specific to psychiatry. With the advance of neurobiology and molecular neuroscience and its adoption in psychiatric research, however, a growing alienation between current research-oriented neuropsychiatry and the classical psychopathological literature is evident. Further, consensus-based international classification criteria, although useful for providing an internationally accepted system of reliable psychiatric diagnostic categories, further contribute to a neglect of genuinely autonomous thought on psychopathology. Nevertheless, many of the unsolved theoretical problems of psychiatry, including those in the areas of nosology, anthropology, ethics, epistemology and methodology, might be fruitfully addressed by a re-examination of classic texts, such as Jaspers's General Psychopathology, and their further development and adaptation for 21st century psychiatry.

  14. The political use of psychiatry: A comparison between totalitarian regimes. (United States)

    Buoli, Massimiliano; Giannuli, Aldo Sabino


    After the end of Second World War, the recent experience of the Nazi horrors stimulated a debate about the political use of psychiatry. Over the years, the focus shifted on major dictatorships of the time and especially on Soviet Union. This article aims to provide a critical review of the ways in which psychiatry was used by totalitarian regimes of the 20th century. We summarized relevant literature about political use of psychiatry in totalitarian regimes of the 20th century, with particular focus on Fascism, Nazism, Argentina dictatorship, Soviet Union and China. One of the features that are common to most of the dictatorships is that the use of psychiatry has become more prominent when the regimes have had the need to make more acceptable the imprisonment of enemies in the eyes of the world. This for example happened in the Nazi regime when sterilization and killing of psychiatric patients was explained as a kind of euthanasia, or in the Soviet Union after the formal closure of the corrective labor camps and the slow resumption of relations with the capitalistic world, or in China to justify persecution of religious minorities and preserve economic relations with Western countries. Psychiatry has been variously used by totalitarian regimes as a means of political persecution and especially when it was necessary to make acceptable to public opinion the imprisonment of political opponents.

  15. Attitudes toward neuroscience education among psychiatry residents and fellows. (United States)

    Fung, Lawrence K; Akil, Mayada; Widge, Alik; Roberts, Laura Weiss; Etkin, Amit


    The purpose of this study is to assess the attitudes of psychiatry trainees toward neuroscience education in psychiatry residency and subsequent training in order to inform neuroscience education approaches in the future. This online survey was designed to capture demographic information, self-assessed neuroscience knowledge, attitudes toward neuroscience education, preferences in learning modalities, and interest in specific neuroscience topics. Volunteers were identified through the American Psychiatric Association, which invited 2,563 psychiatry trainees among their members. Four hundred thirty-six trainees completed the survey. Nearly all agreed that there is a need for more neuroscience education in psychiatry residency training (94%) and that neuroscience education could help destigmatize mental illness (91%). Nearly all (94%) expressed interest in attending a 3-day course on neuroscience. Many neuroscience topics and modes of learning were viewed favorably by participants. Residents in their first 2 years of training expressed attitudes similar to those of more advanced residents and fellows. Some differences were found based on the level of interest in a future academic role. This web-based study demonstrates that psychiatry residents see neuroscience education as important in their training and worthy of greater attention. Our results suggest potential opportunities for advancing neuroscience education.

  16. Cyclical swings: The bête noire of psychiatry. (United States)

    Decker, Hannah S


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

  17. PET application in psychiatry and psychopharmacology

    Energy Technology Data Exchange (ETDEWEB)

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


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

  18. Comparison of Two Different Curricula in Psychiatry Clerkship at Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    S. Ali Ahmadi-Abhari


    Full Text Available Objectives: The aim of this study was to evaluate the efficacy of a new psychiatry clerkship curriculum which was designed to improve the knowledge and skills of medical students of Tehran University of Medical Sciences (TUMS, Iran.Methods:This quasi-experimental study was conducted in two consecutive semesters from February 2009 to January 2010. In total, 167 medical students participated in the study. In the first semester, as the control group, the clerks’ training was based on the traditional curriculum. In the next semester, we constructed and applied a new curriculum based on the SPICES model (student-centered, problem-based, integrated, community-based, elective and systematic.At the end of the clerkship, the students were given two exams: Multiple Choice Questions (MCQ to assess their knowledge, and Objective Structured Clinical Examination (OSCE to assess their skills. Baseline data and test performance for each student were analyzed. Results:Compared to the control group, students in the intervention group showed significantly higher OSCE scores (P= 0.01. With respect to MCQ score, no significant difference was found between the two groups.Conclusions:The results suggest that the revised curriculum is more effective than the traditional one in improving the required clinical skills in medical students during their psychiatry clerkship.

  19. [Applying a social network for the practice and learning of psychiatry]. (United States)

    Mondin, Estefanía; Matusevich, Daniel


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

  20. [Karl Jaspers and the challenges of social psychiatry]. (United States)

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


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

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

    DEFF Research Database (Denmark)

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


    of staff identify the care of mentally disordered offenders in general psychiatric units as either "a parking space" or a very difficult or frightening course, where staff members tend to behave like pleasers in order to avoid risks of conflict or physical violence. Either way, it seems hard to provide......PURPOSE: To illuminate whether and how taking care of forensic inpatients is experienced as a burden among staff and managers in general psychiatry. DESIGN AND METHODS: Qualitative analytical strategies based on interviews and questionnaires. FINDINGS: The interplay between physical environment...... sufficient mental health care. PRACTICE IMPLICATIONS: Nationwide training and teaching as well as knowledge exchange between specialized forensic psychiatry and general psychiatry are recommended. Further exploration is needed on patient perspectives and on avenues to increase efficiency and decrease...

  2. [Human dignity as foundation of an ethics in psychiatry]. (United States)

    Achatz, Johannes; Knoepffler, Nikolaus


    Psychiatry is distinguished from other fields of medical expertise and bears a particular kind of responsibility, namely the treatment of persons incapable of informed consent per se. The History of psychiatry shows that much too often inhuman abuse was happening in psychiatric facilities. An ethics of psychiatry therefore requires a reliable and stable foundation for values that allow justifying normative claims embracing both characteristics. Such a basic foundation already exists in form of the pluralistic and international recognition of human dignity. We argue that human dignity does and has to go beyond "respect for autonomy" and by that it can function as highest authority on questions concerning value judgments on critical cases in psychiatric bioethics.

  3. Link prediction boosted psychiatry disorder classification for functional connectivity network (United States)

    Li, Weiwei; Mei, Xue; Wang, Hao; Zhou, Yu; Huang, Jiashuang


    Functional connectivity network (FCN) is an effective tool in psychiatry disorders classification, and represents cross-correlation of the regional blood oxygenation level dependent signal. However, FCN is often incomplete for suffering from missing and spurious edges. To accurate classify psychiatry disorders and health control with the incomplete FCN, we first `repair' the FCN with link prediction, and then exact the clustering coefficients as features to build a weak classifier for every FCN. Finally, we apply a boosting algorithm to combine these weak classifiers for improving classification accuracy. Our method tested by three datasets of psychiatry disorder, including Alzheimer's Disease, Schizophrenia and Attention Deficit Hyperactivity Disorder. The experimental results show our method not only significantly improves the classification accuracy, but also efficiently reconstructs the incomplete FCN.

  4. A new ethics of psychiatry: neuroethics, neuroscience, and technology. (United States)

    Cheung, Erick H


    Neuroethics is a new subset of bioethics that addresses ethical issues pertaining to the brain, primarily in the fields of neuroscience, cognitive science, and neuroradiology. Research in brain science is progressing at a phenomenal rate and, as a result, the acquisition and application of knowledge and technology raises ethical questions of a practical and philosophical nature. While neuroethics is developing as a distinct field of study, one area that should be addressed in greater depth is the relevance and potential impact of neurotechnology in psychiatry. New knowledge in the mind-brain conundrum and increasingly sophisticated techniques for imaging and intervening in human cognition, emotion, and behavior pose ethical issues at the intersection of technology and psychiatry. This article presents a broad survey of the new directions in neuroethics, neuroscience, and technology and considers the implications of technological advances for the practice of psychiatry in the new millennium. (Journal of Psychiatric Practice 2009;15:391-401).

  5. Cultural psychiatry in the French-speaking world. (United States)

    Westermeyer, Joseph


    For the last five centuries, France's international influence has been constant. This has been particularly evident in the areas of general culture, history and science. In psychiatry, the role of Pinel during the French Revolution, and the discovery of the first psychotropic agent, chlorpromazine, by Delay and Deniker are two outstanding historical facts. This chapter examines the contributions of French social scientists in the understanding of the sequelae of colonial exploitation, racism and political oppression. The establishment of a multi-ethnic society in France and Francophile regions of the world has led to the gradual creation of a cultural psychiatry rich in terminological influences, clinical understanding, training programs and research. Closer connections between French psychiatric thought and Anglophile psychiatry is likely to produce beneficial effects.

  6. [Adult psychiatry does not recognize child neuropsychiatric disorders. A registry study shows discrepancy between expected and real number of cases]. (United States)

    Scharin, Mikael; Hellström, Per


    To identify the group of patients with presumed special needs in adult psychiatry, a list survey was made covering 11 months of diagnostic work in adult psychiatry with a catchment area of 213,000 inhabitants. The survey was made in the urban setting of Gothenburg. During the period of observation, 6,386 patients were diagnosed. Among them 156 (2.4%) were diagnosed with a neuropsychiatric diagnosis of attention deficit hyperactivity disorder, autism spectrum disorders, disorders associated with Tourette's syndrome or mental retardation. The adult psychiatric hospital care does not recognize child neuropsychiatric disorders in the patient population by the frequency the disorders presumably appear. This is especially clear in the group of patients with a combination of narcotic substance abuse and psychiatric symptoms.

  7. Quantitative Description of Medical Student Interest in Neurology and Psychiatry. (United States)

    Ramos, Raddy L; Cuoco, Joshua A; Guercio, Erik; Levitan, Thomas


    Given the well-documented shortage of physicians in primary care and several other specialties, quantitative understanding of residency application and matching data among osteopathic and allopathic medical students has implications for predicting trends in the physician workforce. To estimate medical student interest in neurology and psychiatry based on numbers of applicants and matches to neurology and psychiatry osteopathic and allopathic residency programs. Also, to gauge students' previous academic experience with brain and cognitive sciences. The number of available postgraduate year 1 positions, applicants, and matches from graduating years 2011 through 2015 were collected from the National Matching Services Inc and the American Association of Colleges of Osteopathic Medicine for osteopathic programs and the National Resident Matching Program and the Association of American Medical Colleges for allopathic programs. To determine and compare osteopathic and allopathic medical students' interest in neurology and psychiatry, the number of positions, applicants, and matches were analyzed considering the number of total osteopathic and allopathic graduates in the given year using 2-tailed χ2 analyses with Yates correction. In addition, osteopathic and allopathic medical schools' websites were reviewed to determine whether neurology and psychiatry rotations were required. Osteopathic medical students' reported undergraduate majors were also gathered. Compared with allopathic medical students, osteopathic medical students had significantly greater interest (as measured by applicants) in neurology (χ21=11.85, Pneurology and psychiatry residency programs. Approximately 6% of osteopathic vs nearly 85% of allopathic medical schools had required neurology rotations. Nearly 10% of osteopathic applicants and matriculants had undergraduate coursework in brain and cognitive sciences. Osteopathic medical students demonstrated greater interest than allopathic medical

  8. Pediatric bipolar disorder in an era of "mindless psychiatry". (United States)

    Parry, Peter I; Levin, Edmund C


    Pediatric bipolar disorder (PBD) reflects shifts in conceptualizing bipolar disorder among children and adolescents since the mid-1990s. Since then, PBD diagnoses, predominantly in the United States, have increased dramatically, and the diagnosis has attracted significant controversy. During the same period, psychiatric theory and practice has become increasingly biological. The aim of this paper is to examine the rise of PBD in terms of wider systemic influences. In the context of literature referring to paradigm shifts in psychiatry, we reviewed the psychiatric literature, media cases, and information made available by investigative committees and journalists. Social historians and prominent psychiatrists describe a paradigm shift in psychiatry over recent decades: from an era of "brainless psychiatry," when an emphasis on psychodynamic and family factors predominated to the exclusion of biological factors, to a current era of "mindless psychiatry" that emphasizes neurobiological explanations for emotional and behavioral problems with limited regard for contextual meaning. Associated with this has been a tendency within psychiatry and society to neglect trauma and attachment insecurity as etiological factors; the "atheoretical" (but by default biomedical) premise of the Diagnostic and Statistical Manual of Mental Disorders (3rd and 4th eds.); the influence of the pharmaceutical industry in research, continuing medical education, and direct-to-consumer advertising; and inequality in the U.S. health system that favors "diagnostic upcoding." Harm from overmedicating children is now a cause of public concern. It can be argued that PBD as a widespread diagnosis, particularly in the United States, reflects multiple factors associated with a paradigm shift within psychiatry rather than recognition of a previously overlooked common disorder.

  9. Undergraduate Neuroscience Majors: A Missed Opportunity for Psychiatry Workforce Development. (United States)

    Goldenberg, Matthew N; Krystal, John H


    This study sought to determine whether and to what extent medical students with an undergraduate college major in neuroscience, relative to other college majors, pursue psychiatry relative to other brain-based specialties (neurology and neurosurgery) and internal medicine. The authors analyzed data from AAMC matriculation and graduation surveys for all students who graduated from US medical schools in 2013 and 2014 (n = 29,714). Students who majored in neuroscience, psychology, and biology were compared to all other students in terms of their specialty choice at both time points. For each major, the authors determined rates of specialty choice of psychiatry, neurology, neurosurgery, and, for comparison, internal medicine. This study employed Chi-square statistic to compare odds of various specialty choices among different majors. Among medical students with an undergraduate neuroscience major (3.5% of all medical students), only 2.3% preferred psychiatry at matriculation, compared to 21.5% who chose neurology, 13.1% neurosurgery, and 11% internal medicine. By graduation, psychiatry specialty choice increased to 5.1% among neuroscience majors while choice of neurology and neurosurgery declined. Psychology majors (OR = 3.16, 95% CI 2.60-4.47) but not neuroscience majors (OR 1.28, 0.92-1.77) were more likely than their peers to choose psychiatry. Psychiatry struggles to attract neuroscience majors to the specialty. This missed opportunity is an obstacle to developing the neuroscience literacy of the workforce and jeopardizes the neuroscientific future of our field. Several potential strategies to address the recruitment challenges exist.

  10. A Survey of the Interactions between Psychiatry Residency Programs and the Pharmaceutical Industry (United States)

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


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

  11. Incorporating Active Learning into a Psychiatry Clerkship: Does It Make a Difference? (United States)

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


    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…

  12. A Survey of the Interactions between Psychiatry Residency Programs and the Pharmaceutical Industry (United States)

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


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

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

    Burgut, F. Tuna; Polan, H. Jonathan


    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…

  14. What Do Psychiatric Residents Think of Addiction Psychiatry as a Career? (United States)

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


    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)…

  15. Evaluating the Workload of On-Call Psychiatry Residents: Which Activities Are Associated with Sleep Loss? (United States)

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


    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.…

  16. Evaluating Psychiatry Residents as Physician-Managers: Development of an Assessment Tool (United States)

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


    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…

  17. Incorporating Active Learning into a Psychiatry Clerkship: Does It Make a Difference? (United States)

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


    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…

  18. Big data are coming to psychiatry: a general introduction. (United States)

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


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

  19. Reflexions on the identity and the practice of child psychiatry. (United States)

    Terziev, D


    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

  20. [Maurycy Urstein: forgotten Polish contributor to German psychiatry]. (United States)

    Marcinowski, Filip


    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.

  1. The curious case of the advance directive in psychiatry

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    Alok Sarin


    Full Text Available As discussions around the Mental Health Care Bill 2013 gain pace, one aspect of the bill, which is the Advance Directive, has perhaps not been discussed enough. The present essay is an attempt to explore different aspects of the advance directive in psychiatry, to understand the implications better. The article attempts to look at the conceptualization of the advance directive, questions regarding implementation, and possible unintended consequences. In doing so, it interrogates the larger question of ideology that drives the concept of the advance directive in psychiatry.

  2. Kandinsky-Clerambault's Syndrome: concept of use for Western psychiatry. (United States)

    Lerner, Vladimir; Kaptsan, Alexander; Witztum, Eliezer


    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.

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

    DEFF Research Database (Denmark)

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


    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...

  4. Maurycy Urstein: forgotten Polish contributor to German psychiatry

    Directory of Open Access Journals (Sweden)

    Marcinowski, Filip


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

  5. Consulting Psychiatry within an Integrated Primary Care Model (United States)

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


    Summary 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. PMID:24185149

  6. Crossroads: Identity struggles in Latin America and Latin American psychiatry. (United States)

    Alarcón, Renato D; Pérez-Rincón, Héctor


    Identity can be defined from different perspectives such as those from philosophy, social sciences and phenomenology. The latter entails sameness, uniqueness, distinctiveness, continuity, diversity, universality and equality connotations to define characteristics of the existence and action of individuals, institutions, entities, organizations and collectivities. In order to elaborate on the identity of Latin American Psychiatry, this chapter deals first with the identity of the Latin American continent, the result of a 'collision of cultures' with mestizaje as its most prominent collective contribution. In turn, the Latin American population (and its 'Hispanic' equivalent in other countries and regions of the world) has been the subject of a pluralistic search, and played a combined role of hope and conflict, advances and setbacks in a fascinating historical process. In such context, Latin American psychiatry offers a mixed identity, resulting from a succession of mythic-religious, moral, phenomenologico-existential, biological and social/community-based routes. Each of them are assessed, and the contributions of two eponymous figures, Honorio Delgado and Gregorio Bermann, are duly delineated. Current realities in Latin American psychiatry and mental health in socio-political, conceptual, professional, ideological, academic and heuristic areas, are examined. The chapter ends with considerations of the future of psychiatry in the continent, the postulation of a 'new synthesis' embracing the essence of contemporary neurobiological knowledge and a new, revitalized humanism in the context of a healthy eclecticism, progressive educational training and didactic programmes, and concrete contributions embodying the promise of well justified expectations.

  7. Education and Training in Psychiatry in the U.K. (United States)

    Carney, Stuart; Bhugra, Dinesh K.


    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…

  8. A Novel Approach to Medicine Training for Psychiatry Residents (United States)

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


    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…

  9. Promoting Scholarship during Child and Adolescent Psychiatry Residency (United States)

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


    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,…

  10. Trends in cultural psychiatry in the United kingdom. (United States)

    Bhui, Kamaldeep


    Cultural psychiatry in the United Kingdom exhibits unique characteristics closely related to its history as a colonial power, its relationship with Commonwealth countries and the changing socio-demographic characteristics of its diverse population throughout the centuries. It is not surprising, therefore, that the emergence of this discipline was centred around issues of race and religion. After a brief historical review of the development of cultural psychiatry and the mention of pioneering intellectual and academic figures, as well as the evolvement of the field in organizations such as the Royal College of Psychiatrists, this chapter examines the need of a critical cultural psychiatry, more than a narrative social science distanced from the realities of clinical practice. In such context, issues such as policies and experience with efforts to delivering race equality, and address inequities in a renewed public health approach seem to confer British cultural psychiatry with a defined socially active role aimed at the pragmatic management, understanding and improvement of diverse and alternative systems of care and care practices.

  11. The role of lead and cadmium in psychiatry

    Directory of Open Access Journals (Sweden)

    Orish Ebere Orisakwe


    Full Text Available Psychiatric disorders are associated with long-term disability and huge social and economic costs. The possible influence of heavy metals exposure on public health remains a matter of concern. A recurring research question that persisted among researchers in neuropsychiatry has been "are psychiatric patients more likely to have a high body burden of lead or other heavy metals?" This is an update account on the role of lead and cadmium in psychiatry. This review, which has employed search words like "lead and cadmium in psychiatry" , "lead and cadmium in schizophrenia", "lead and cadmium in psychosis" in citation indices such as PubMed, Google Scholar, Scirus, and Scopus. A total of 415 articles were found; 60 fulfiled the inclusion criteria. Evidence-based information suggests that lead and cadmium may be involved in psychiatry. Should environmental lead and cadmium be implicated in the etiogenesis of psychiatry given the characteristic high environmental pollution in Sub Sahara Africa, it is worthwhile for toxicologists and scientists in Sub-Sahara Africa to investigate if lead and cadmium can become additional biomarkers in the diagnosis of psychiatric disorders.

  12. Psychiatry Residents' Use of Educational Websites: A Pilot Survey Study. (United States)

    Torous, John; Franzan, Jamie; O'Connor, Ryan; Mathew, Ian; Keshavan, Matcheri; Kitts, Robert; Boland, Robert


    Psychiatry residents have numerous online educational resources readily available to them although currently there are no data regarding residents' use and perception of such websites. A survey was offered to 62 residents from all four years of training as well as recent graduates of a single psychiatry residency training program. Residents reported utilizing online resources on average 68 % of the time, in comparison to 32 % on average for printed materials. Residents reported UpToDate, PubMed, and Wikipedia as the most visited websites and ranked each highly but for different purposes. Thirty-five percent of residents felt that insufficient faculty guidance was a barrier to use of these educational websites. Pilot data indicate psychiatry residents use online resources daily for their education in various settings. Resident perceptions of individual website's trustworthiness, ease of use, and sources of clinical decision-making and personal learning suggest potential opportunities for educators to better understand the current use of these resources in residency training. Reported barriers including lack of faculty guidance suggest opportunities for academic psychiatry. Further study is necessary at multiple sites before such results may be generalized.

  13. The American Psychiatric Association and the history of psychiatry. (United States)

    Hirshbein, Laura


    The history committee within the American Psychiatric Association was actively involved in the history of psychiatry in the early decades of the twentieth century, as well as from 1942 to 2009.This paper explores the role of this committee in the context of changes in the psychiatric profession over the twentieth century.

  14. The Critic as Rhetor: Psychiatry and Fantasy Theme Analysis. (United States)

    Vatz, Richard E.; Weinberg, Lee S.


    Examines Barbara Sharf's article analyzing public commentary about psychiatrists generated by the Hinkley trial and finds that dominant media messages elicit undeserved negative fantasy themes concerning psychiatry. Argues that fantasy theme analysis offers rhetorical critics a framework for examining process by which the meaning of world events…

  15. A brief history of placebos and clinical trials in psychiatry. (United States)

    Shorter, Edward


    The history of placebos in psychiatry can be understood only in the context of randomized controlled trials (RCTs). Placebo treatments are as old as medicine itself, and are particularly effective in dealing with psychosomatic symptoms. In psychiatry, placebos have mainly been featured in clinical drug trials. The earliest controlled trial in psychiatry (not involving drugs) occurred in 1922, followed by the first crossover studies during the 1930s. Meanwhile the concept of randomization was developed during the interwar years by British statistician Ronald A Fisher, and introduced in 3 trials of tuberculosis drugs between 1947 and 1951. These classic studies established the RCT as the gold standard in pharmaceutical trials, and its status was cemented during the mid-1950s. Nevertheless, while the placebo became established as a standard measure of drug action, placebo treatments became stigmatized as unethical. This is unfortunate, as they constitute one of the most powerful therapies in psychiatry. In recent years, moreover, the dogma of the placebo-controlled trial as the only acceptable data for drug licensing is also being increasingly discredited. This backlash has had 2 sources: one is the recognition that the US Food and Drug Administration has been too lax in permitting trials controlled with placebos alone, rather than also using an active agent as a test of comparative efficacy. In addition, there is evidence that in the hands of the pharmaceutical industry, the scientific integrity of RCTs themselves has been degraded into a marketing device. The once-powerful placebo is thus threatened with extinction.

  16. Psychiatry Trainees' Training and Experience in Fetal Alcohol Spectrum Disorders (United States)

    Eyal, Roy; O'Connor, Mary J.


    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…

  17. The computational psychiatry of reward: Broken brains or misguided minds?

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    Michael eMoutoussis


    Full Text Available Research into the biological basis of emotional and motivational disorders is in danger of riding roughshod over a patient-centred psychiatry and falling into the dualist errors of the past, i.e. by treating mind and brain as conceptually distinct. We argue that a psychiatry informed by computational neuroscience, computational psychiatry, can obviate this danger. Through a focus on the reasoning processes by which humans attempt to maximise reward (and minimise punishment, and how such reasoning is expressed neurally, computational psychiatry can render obsolete the polarity between biological and psychosocial conceptions of illness. Here, the term 'psychological' comes to refer to information processing performed by biological agents, seen in light of underlying goals. We reflect on the implications of this perspective for a definition of mental disorder, including what is entailed in asserting that a particular disorder is ‘biological’ or ‘psychological’ in origin. We propose that a computational approach assists in understanding the topography of mental disorder, while cautioning that the point at which eccentric reasoning constitutes disorder often remains a matter of cultural judgement.

  18. Educational needs assessment for psychiatry residents to prevent suicide: a qualitative approach. (United States)

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


    Suicide is a commonly encountered and stressful event in professional life of any psychiatrist. Suicide risk assessment is a major gateway to patient treatment and management. It is a core competency requirement in training of psychiatry. The present study designed to assesseducational needsfor suicide prevention in residents of psychiatry in two medical schools in Iran, Isfahan University of Medical Sciences (IUMS) and Shahid Beheshti Medical University (SBUMS) inTehran. This was a qualitative triangulation study, conducted in two steps. The first step was based on a phenomenological approach and the second was based on focus groups. The studied population was the psychiatric residents of IUMS and SBUMS. Purposive sampling was implemented until saturation. Interviews were performed. Colaizzi method was used to analyze the data. In the second step, participants attended a session, in which all final codes of the first step were discussed, and regarding the views, educational priorities and needs were listed. A total of 2047 codes, extracted from 31 interviews, analyzed through Colaizzi method, were categorized in three groups: Educational, facilities and processes, human resources. According to defects of current educational program, we suggest regular reevaluations and revisions of clinical training programs according to current needs.

  19. The new philosophy of psychiatry: its (recent) past, present and future: a review of the Oxford University Press series International Perspectives in Philosophy and Psychiatry (United States)

    Banner, Natalie F; Thornton, Tim


    There has been a recent growth in philosophy of psychiatry that draws heavily (although not exclusively) on analytic philosophy with the aim of a better understanding of psychiatry through an analysis of some of its fundamental concepts. This 'new philosophy of psychiatry' is an addition to both analytic philosophy and to the broader interpretation of mental health care. Nevertheless, it is already a flourishing philosophical field. One indication of this is the new Oxford University Press series International Perspectives in Philosophy and Psychiatry seven volumes of which (by Bolton and Hill; Bracken and Thomas; Fulford, Morris, Sadler, and Stanghellini; Hughes, Louw, and Sabat; Pickering; Sadler; and Stanghellini) are examined in this critical review.

  20. Impact of a structured review session on medical student psychiatry subject examination performance [version 2; referees: 2 approved

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    Shan H. Siddiqi


    Full Text Available Introduction: The National Board of Medical Examiners (NBME subject examinations are used as a standardized metric for performance in required clerkships for third-year medical students. While several medical schools have implemented a review session to help consolidate knowledge acquired during the clerkship, the effects of such an intervention are not yet well-established. An improvement in NBME psychiatry examination scores has previously been reported with a single end-of-clerkship review session, but this was limited by a small sample size and the fact that attendance at the review session was optional, leading to likely selection bias.   Methods: A 1.5-hour structured review session was conducted for medical students in the last week of each 4-week psychiatry clerkship between September 2014 and July 2015. Students were required to attend unless excused due to scheduling conflicts. Scores on the NBME psychiatry subject exam were compared with those of students taking the examination in the corresponding time period in each of the previous two academic years.   Results: 83 students took the exam during the experimental period, while 176 took the exam during the control period. Statistically significant improvements were found in mean score (p=0.03, mean for the two lowest scores in each group (p<0.0007, and percentage of students scoring 70 or less (p=0.03. Percentage of students achieving the maximum possible score (99 was higher in the experimental group, but did not reach significance (p=0.06.   Conclusions: An end-of-clerkship review session led to increased mean scores on the NBME psychiatry subject examination, particularly for students at the lower end of the score range. Future research should investigate the impact of such an intervention in other specialties and other institutions.