Canadian Psychiatric Association journal最新文献

{"title":"Psychosocial adjustment of the offspring of psychiatric inpatients: the effect of alcoholic, depressive and schizophrenic parentage.","authors":"N El-Guebaly, D R Offord, K T Sullivan, G W Lynch","doi":"10.1177/070674377802300502","DOIUrl":"https://doi.org/10.1177/070674377802300502","url":null,"abstract":"While there is a growing body of literature describing the plight of being the child of a particular diagnostic group of psychiatrically ill parents, little is yet known about the comparable vulnerability of the children of various diagnostic groups. This study includes data collected on 90 psychiatric inpatients, their spouses and children. For each consecutive admission of fifteen male and fifteen female alcoholics with a child less than age 21, a schizophrenic and a depressive parent were matched by sex, age and time of admission. Data were collected on the parents and their children from the patient's chart and through a structured interview with the spouse. A medical history, Rutter's parental questionnaire on children's behaviour and the Randall-McClure behaviour checklist were filled out on 231 children. Some of the findings of the study include that the adjustment of the children based on checklist information is not affected by the psychiatric diagnosis of the parents; controlling for sibship size is important in this type of research; the boys of sick fathers score almost two times higher on the checklists compared to the boys of sick mothers. The results argue for the provision of coordinated services between adult and child psychiatry departments for the children of the psychiatrically ill parents.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 5","pages":"281-90"},"PeriodicalIF":0.0,"publicationDate":"1978-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11880275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The superior-mesenteric-artery syndrome: cause or complication of anorexia nervosa?","authors":"A P Froese,&nbsp;J Szmuilowicz,&nbsp;J D Bailey","doi":"10.1177/070674377802300508","DOIUrl":"https://doi.org/10.1177/070674377802300508","url":null,"abstract":"<p><p>The so-called superior-mesenteric-artery syndrome is not mentioned in psychiatric journals or books. Yet two variations of the condition have been described. In its acute form, it can be mistaken for psychogenic vomiting in anorexic patients, while its chronic intermittent form is readily misdiagnosed as anorexia nervosa. The case report is of a 16 year old boy admitted for investigation and treatment of severe weight loss. He initially responded to a modified behaviour program, but within days developed an acute small-bowel obstruction. Superior-mesenteric-artery syndrome was diagnosed and he improved with appropriate medical management. This condition needs to be considered by the psychiatrist who otherwise might not differentiate it from the symptoms of anorexia nervosa.</p>","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 5","pages":"325-7"},"PeriodicalIF":0.0,"publicationDate":"1978-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11880281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistency in the diagnosis of the functional psychoses.","authors":"I B Amara","doi":"10.1177/070674377802300509","DOIUrl":"https://doi.org/10.1177/070674377802300509","url":null,"abstract":"<p><p>A review of the case books of 868 patients who had been admitted into a psychiatric hospital from January 1, 1970, to December 31, 1973, was carried out for consistency in the pattern of diagnosis by the same or different psychiatrists. Of these, 16.5% had a revision in diagnosis. The pertinent literature was reviewed. The possible factors that contribute to the observed inconsistency in diagnosis in this and other investigations are discussed. It is concluded that the problems as reflected in the significant change in diagnosis in this study are multifactorial. It is suggested that these problems may be related to the unknown etiology of the functional psychoses and the absence of identifiable specific lesions.</p>","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 5","pages":"329-36"},"PeriodicalIF":0.0,"publicationDate":"1978-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11880282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social class, symptom type and the utilization of children's psychiatric services: some comparative Canadian data.","authors":"J Beitchman","doi":"10.1177/070674377802300504","DOIUrl":"https://doi.org/10.1177/070674377802300504","url":null,"abstract":"This paper examines three aspects of the distribution and use of children's psychiatric services in Canada under National Health Insurance. These are: 1) Class disparities in the utilization rates of these services; 2) The extent to which those children most in need of treatment are receiving it; and 3) The extent of unmet need for psychiatric services for children 17 years of age and under in the Ottawa-Carleton region. The subjects of this investigation were 96 children between the ages of 6.5 and 12 years who have attended the Children's Services at the Royal Ottawa Hospital. The results indicate that class disparities in the distribution of services were the reverse of those typically found under private fee-for-service arrangements. The high social class had the lowest proportionate use and the welfare classes the highest. In addition, there was a significant association between social class and age for the boys only; the higher the social class, the younger the boy at the time of referral. Almost two-thirds of this sample were found to have antisocial and aggressive disorders. Consistent with estimates of the high rates of these disorders in the general population, this suggests that a proportionate number of those children most in need of treatment are receiving it. For children 17 years of age and under, the one-year treated prevalence of disorder in the Ottawa-Carleton region was estimated to be .95%. Though higher than reports from other sources, it is clear that free medical care alone is not sufficient to bridge the gap between estimates of the true prevalence and treated prevalence of childhood psychiatric disorder. These findings are discussed in terms of the importance of non-economic factors as determinants of the distribution and use of children's psychiatric services. As well, the importance of referral practice, especially for the lower social classes is commented upon. Finally, suggestions are made for further research.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 5","pages":"297-302"},"PeriodicalIF":0.0,"publicationDate":"1978-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300504","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11880277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidal behaviour in Halifax, Nova Scotia: with some general observations.","authors":"S Hirsch,&nbsp;M Lowman,&nbsp;R Perry","doi":"10.1177/070674377802300506","DOIUrl":"https://doi.org/10.1177/070674377802300506","url":null,"abstract":"A brief report of suicide statistics — completed suicides, attempts with lethal intent (a new category), and other attempts — is presented. The highest risk group in Halifax County is the male from late adolescence to early middle life. Statistics from Canada and Nova Scotia reveal a marked increase in the rate of completed suicides in the young adult male during the past twenty years. It is noteworthy that completed suicides and attempts with lethal intent frequently occur in persons with no clear evidence of significant depressive illness and that many patients with severe depressive illness are never seriously suicidal. Many persons and some families have a pattern of reacting to stress and/or psychiatric illness with suicidal behaviour. There is often little correlation between the seriousness of the stress and/ or illness and the seriousness, of the suicidal behaviour. Most suicide's were considered to be not preventable by ordinary techniques of management. Various patterns of behaviour relevant to preventability are described. A brief description of reactions of physicians and nurses to suicidal behaviour is given. There is a negative reaction of both groups to suicidal attempts which are not serious, particularly to repeaters; and this reaction is much stronger in nurses than in physicians. There is also a brief description of unusual complications of suicidal attempts and of the very high medical costs of caring for those who make attempts.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 5","pages":"309-16"},"PeriodicalIF":0.0,"publicationDate":"1978-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11880279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Criteria for early diagnosis of brain dysfunction.","authors":"A Lazor,&nbsp;D Chandler","doi":"10.1177/070674377802300507","DOIUrl":"https://doi.org/10.1177/070674377802300507","url":null,"abstract":"This paper is concerned with the early identification in the pre-school years of those symptoms considered to be significant for the diagnosis of minimal brain dysfunction (MBD) (6). The history through the sixties and seventies shows a growing concern on the part of psychiatrists, neurologists and psychologists for the identification of those symptoms significant for the diagnosis of MBD (1,3,6–8,23). The paucity of follow-up studies and our own concerns regarding the diagnosis of brain dys-functioning led to a follow-up study on forty children diagnosed in pre-school years. The original diagnosis was made on a cluster of symptoms classified as primary, secondary and tertiary. Primary symptoms are neurological signs. The secondary symptoms are defensive mechanisms against the intrapsychic problems such as fears, compulsiveness, etc. Some symptoms may be either primary or secondary, e.g. distractibility, mood fluctuation. Tertiary symptoms are the results of the inability to interpret and respond to the social situation effectively again because of the organic dysfunctioning and the child's reaction to the rejection and hostility which he engenders by his own inappropriate social behaviour and emotional responses, such as, diffusely hostile attitude or over-dependence. The study showed that in that group of forty, thirty seven or 93.7% had positive neurological signs, with three or more occurring frequently. Psychiatric diagnostic evaluation shows severe personality deviation in thirty-seven cases. On psychological testing sixty percent were dull normal or above (above 80 I.Q.) and forty percent below normal. Examination of school placement reveals that only thirty percent are in regular classes and the remainder in special classes. The findings confirm that the diagnosis can be made in pre-school years on the basis of behavioural symptoms in the presence of neurological signs. The neurological impairment is permanent and the dysfunctioning affects emotional, social and intellectual functioning. The severity of the dysfunctioning of the family affected the child's rate of improvement.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 5","pages":"317-24"},"PeriodicalIF":0.0,"publicationDate":"1978-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300507","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11880280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of dreams in psychotherapy: practical guidelines.","authors":"D S Werman","doi":"10.1177/070674377802300305","DOIUrl":"https://doi.org/10.1177/070674377802300305","url":null,"abstract":"<p><p>Although there is a large literature pertaining to the use of the dream in psychoanalysis, there is no systematic approach to working with dreams in psychotherapy. This communication seeks to present some guidelines for the use of the dream in psychotherapy. Reference is made to the significant difference in the \"dimensions\" of psychoanalysis as compared to psychotherapy. A distinction is drawn between the use of the dream in supportive psychotherapy as contrasted with insight-oriented psychotherapy. In the former, the dream--if used at all--serves supportive functions; in the latter, the goals are to develop better awareness by the patient of himself. Understanding of the dream is reached by inserting it into the context of the patient's psychological life; however, what is actually communicated to the patient will be keyed to the psychologic surface that the patient presents.</p>","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 3","pages":"153-8"},"PeriodicalIF":0.0,"publicationDate":"1978-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11849198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the psychiatrist in the criminal justice system.","authors":"E L Greenspan","doi":"10.1177/070674377802300302","DOIUrl":"https://doi.org/10.1177/070674377802300302","url":null,"abstract":"<p><p>In this article, the author explores the relationship between the lawyer as advocate and the psychiatrist as expert. He argues that the role of the psychiatrist in aiding the Court in the determination of relevant issues is one of increasing importance. Often the diagnostic opinions offered by the psychiatrist border on conclusory legal determination. As such, those opinions must necessarily be subjected to the testing of adversarial processes. The role of the psychiatrist is to proffer a relevant opinion while nevertheless realizing that the inexact nature of the science limits the use such an opinion may have. The lawyer as adversary must subject that opinion to as rigorous an examination as possible. This examination is not an affront to the psychiatrist but rather an attempt to explore and expose the definitiveness of that opinion. It is through this combination of realized opinionating and adversarial examination that relevant legal-medical determinations can best be made within the confines of our existing judicial mode of dispute settlement.</p>","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 3","pages":"137-42"},"PeriodicalIF":0.0,"publicationDate":"1978-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11849195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of emergency departments for psychiatric treatment.","authors":"G D Watson","doi":"10.1177/070674377802300303","DOIUrl":"https://doi.org/10.1177/070674377802300303","url":null,"abstract":"Introduction The increasing use of the general hospital emergency department (E.D.) for all kinds of health problems has been well documented. A variety of recent surveys in Canada and the United States estimate that emergency room visits are mushrooming at a rate of between 10 and 30% per year, with non-urgent problems making up an increasing proportion of the total caseload (3,7,8,12,19). Many emotionally disturbed persons need, or they or their families or anyone of a number of helping professionals believe they need immediate psychiatric attention. It has been suspected by many emergency room physicians, that such potential psychiatric problems are contributing to the increasing E.D. caseload and that in spite of the development of alternate mental health facilities, trust in the conventional, medical mode of treatment persists, and is responsible for the increasing readiness with which patients resort to E.D.'s during times of emotional crisis. If these suspicions are true, then it can beappreciated that modem E.D.'s should function as a portal of entry into the mental health care system and as such should be an ideal site for the application of the principles of community mental health (4). The present study was initiated in 1975, by a request from Edmonton civic officials to the Local Board of Health to provide data regarding the utilization of local emergency departments by emotionally disturbed persons.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 3","pages":"143-8"},"PeriodicalIF":0.0,"publicationDate":"1978-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11849196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender identity problems of children and adolescents: the establishment of a special clinic.","authors":"S J Bradley,&nbsp;B Steiner,&nbsp;K Zucker,&nbsp;R W Doering,&nbsp;J Sullivan,&nbsp;J K Finegan,&nbsp;M Richardson","doi":"10.1177/070674377802300309","DOIUrl":"https://doi.org/10.1177/070674377802300309","url":null,"abstract":"<p><p>Theoretical accounts of the origins of gender identity disturbance are reviewed and then followed by a description of the establishment of a child and adolescent gender identity clinic. Clinical impressions of 16 gender disturbed patients are presented and the position is taken that most patients manifested a confused, as opposed to fixed, core gender identity.</p>","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 3","pages":"175-83"},"PeriodicalIF":0.0,"publicationDate":"1978-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11849202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}