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Sample records for psychiatry scip-s scale

  1. [Psychiatry].

    PubMed

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

    2011-01-19

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

  2. Psychiatry and the resource-based relative value scale.

    PubMed

    Dorwart, R A; Chartock, L R

    1988-10-01

    Attention to reform of reimbursement for psychiatric inpatient services largely focuses on the use of prospective payment systems, e.g., payment based on diagnosis-related groups (DGRs), for hospitals. Recently, there also has been interest in proposals for altering physician reimbursement (inpatient and outpatient) by using physician DRGs, capitation models, or relative value scales instead of the charge-based, fee-for-service model. The authors review the resource-based relative value scale (RBRVS) as an option for psychiatry. The RBRVS uses the setting, the time spent, the difficulty in treating the patient, the training, and the psychiatrist's role to determine reimbursement rates.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  4. Computational Psychiatry

    PubMed Central

    Wang, Xiao-Jing; Krystal, John H.

    2014-01-01

    Psychiatric disorders such as autism and schizophrenia arise from abnormalities in brain systems that underlie cognitive, emotional and social functions. The brain is enormously complex and its abundant feedback loops on multiple scales preclude intuitive explication of circuit functions. In close interplay with experiments, theory and computational modeling are essential for understanding how, precisely, neural circuits generate flexible behaviors and their impairments give rise to psychiatric symptoms. This Perspective highlights recent progress in applying computational neuroscience to the study of mental disorders. We outline basic approaches, including identification of core deficits that cut across disease categories, biologically-realistic modeling bridging cellular and synaptic mechanisms with behavior, model-aided diagnosis. The need for new research strategies in psychiatry is urgent. Computational psychiatry potentially provides powerful tools for elucidating pathophysiology that may inform both diagnosis and treatment. To achieve this promise will require investment in cross-disciplinary training and research in this nascent field. PMID:25442941

  5. Computational psychiatry.

    PubMed

    Montague, P Read; Dolan, Raymond J; Friston, Karl J; Dayan, Peter

    2012-01-01

    Computational ideas pervade many areas of science and have an integrative explanatory role in neuroscience and cognitive science. However, computational depictions of cognitive function have had surprisingly little impact on the way we assess mental illness because diseases of the mind have not been systematically conceptualized in computational terms. Here, we outline goals and nascent efforts in the new field of computational psychiatry, which seeks to characterize mental dysfunction in terms of aberrant computations over multiple scales. We highlight early efforts in this area that employ reinforcement learning and game theoretic frameworks to elucidate decision-making in health and disease. Looking forwards, we emphasize a need for theory development and large-scale computational phenotyping in human subjects.

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

    PubMed

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

    2014-10-01

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

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

    PubMed Central

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

    2014-01-01

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

  8. Teaching Forensic Psychiatry to General Psychiatry Residents

    ERIC Educational Resources Information Center

    Lewis, Catherine F.

    2004-01-01

    Objective: The Accreditation Council on Graduate Medical Education (ACGME) requires that general psychiatry residency training programs provide trainees with exposure to forensic psychiatry. Limited information is available on how to develop a core curriculum in forensic psychiatry for general psychiatry residents and few articles have been…

  9. Digital psychiatry.

    PubMed

    Tang, S; Helmeste, D

    2000-02-01

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

  10. [Sleep psychiatry].

    PubMed

    Chiba, Shigeru

    2013-01-01

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

  11. [Social psychiatry].

    PubMed

    Miéville, C

    1978-01-01

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

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

    PubMed

    Bucheron, Bastien

    2015-01-01

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

  13. Do Medical Students' Attitudes Toward Psychiatry and Their Intention to Pursue Psychiatry as a Career Change During Psychiatric Attachment?

    PubMed Central

    Khajeddin, Niloofar; Riahi, Foroughe; Salehi Veysi, Mhammad; Hoseyni, Hajar; Izadi Mazidi, Sakineh

    2012-01-01

    Objective: The aim of this study was to assess the attitudes of medical students toward psychiatry and their intention to pursue psychiatry as a career; and to determine if they change after psychiatric attachment. It also examined the relationship between the students' characteristics and their attitudes in details. Methods: Pre and post-surveys using Likert-type scales were conducted versus 106 medical students of Ahwaz Jondishapour University who entered psychiatric attachment between spring 2007 and spring 2010. They completed a demographic form and an "attitude toward psychiatry" questionnaire with two excess questions which measured their intention to pursue psychiatry as a career in future. Results: The majority of students appeared to have favorable attitudes before the attachment which improved during the course; but they didn't show significant change in their intention to pursue psychiatry as a prospective career. There was a significant correlation between age and change in attitudes. Also the career intention was significantly correlated with their attitudes. Conclusion: The study confirms previous reports that training can change students' attitudes toward psychiatry, but contrasting with them suggests that negative attitudes are not likely to be the main cause of the low career intention to psychiatry. Thus, teaching psychiatry can get the students rid of their negative attitudes but is not enough to encourage them to pursue psychiatry as a career. The authors suggest it is based on poor opportunities for postgraduates in the field and social stigma attached to psychiatry, which needs further studies. PMID:24644470

  14. History of psychiatry

    PubMed Central

    Shorter, Edward

    2013-01-01

    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. The future of community psychiatry.

    PubMed

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

    2003-10-01

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

  16. Crime and Psychiatry*

    PubMed Central

    Matcheswalla, Yusuf; De Sousa, Avinash

    2015-01-01

    Psychiatry and crime are linked in certain ways. On one hand, we have criminal offenders with serious psychopathology; and on the other hand, we have psychiatric patients who may commit criminal offences during the influence of a psychiatric disorder. The psychiatrist in practice has to come in contact with the criminal justice system at some point of time in his career. Forensic psychiatry under whose realm these issues reside is a branch yet underdeveloped in India. The present paper reviews the inter-relationship between crime and psychiatry and the factors involved therein. PMID:25838733

  17. Historicizing Indian psychiatry

    PubMed Central

    Basu, Amit Ranjan

    2005-01-01

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

  18. Postmortem studies in psychiatry.

    PubMed

    Bracha, H S; Kleinman, J E

    1984-09-01

    Neurochemical postmortem examination of brain tissue may never be completely replaced as a research tool in psychiatry. This method has already provided support for the hypotheses relating norepinephrine, dopamine, serotonin, peptides, and hemisphere asymmetries to psychiatric syndromes.

  19. [Involuntary treatment in psychiatry].

    PubMed

    Hohendorf, Gerrit

    2014-07-01

    Involuntary treatment in psychiatry should be reflected under the German constitutional right of self-determination und the ethical principles of autonomy and beneficience. Forced treatment in psychiatry should be applied only as a last resort. A narrative perspective reconstructs the case of Gustl Mollath who was hospitalized in forensic-psychiatric institutions because of an alleged delusion. Psychiatric experts should be aware of the potential of misuse when defining what is real and what seems to be a delusion. PMID:24983576

  20. [Quantification in psychiatry: from psychometrics to quantitative psychiatry].

    PubMed

    Pichot, P

    1994-01-01

    The development of quantitative techniques to analyse psychopathological states is reviewed from the XVIIIth Century till today. As far as back as the XIXth Century, Quetelet, Louis and Galton introduced and advocated the use of quantitative methods in medical and psychological sciences. The advent of psychometry dates back 1905, when Alfred Binet published his Intelligence Scale. The construction of instruments like Wechsler and MMPI scales in the forties starts using psychometry in psychiatry. At end of World War II, historical factors (selection and guidance of military recruits) in conjunction with technical advancements (beginning of psychopharmacology, multivariate statistics development and first computers arrival) favor the growth of quantitative psychopathology that further takes four great different courses: 1. Psychometry proper, 2. Symptom-quantifying assessment scales such as BPRS or Hamilton scales, 3. New nosological models constructed using quantified psychopathological data and mathematical procedures, 4. Diagnostic systems relying on operationalized criteria based on psychopathological quantification, such as DSM III.

  1. [Can psychiatry become neuropsychiatry?].

    PubMed

    Slosarczyk, Mariusz

    2005-01-01

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

  2. [Future prospects in psychiatry].

    PubMed

    Pöldinger, W

    1975-01-01

    A questionnaire on the future aspects of psychiatry was submitted to 234 psychiatrists, 111 other doctors and 78 nonmedical persons, that is to a total of 423 people. These were further classified according to their principal activity in private practice, clinical work, research or other fields. It was found that opinions did not differ materially within these subdivisions. It was particularly notable that over two-thirds of those questioned regard the future with optimism. Similarly, some two-thirds take an interest in futurology. There was general agreement that in 1985 the greatest problem in psychiatry will be psychosomatic disorders, neuroses and toxicomania, in that order. Biochemistry and pharmacology were considered decisive for progress in psychiatry. Over one half of those questioned also thought that in 1985 the most important method of treatment in psychiatry would be pharmacotherapy. More than two-thirds of those polled think that in 1985 a computer will be standard equipment in any research hospital and that, by 1985, psychiatry's standing will be improved as compared with today. As a corollary, the investigation was aimed at establishing to what extent the future-oriented and those-not-so-oriented differed in this opinion poll. Our working hypothesis that of the recipients of the questionnaire those with children are more future-oriented than those without children was not confirmed. But the future-oriented differed from those-not-so-oriented mainly in that they regard the future with optimism.

  3. British military forensic psychiatry.

    PubMed

    Turner, Mark A; Neal, Leigh A

    2004-04-01

    Military psychiatry has recently generated a lot of interest. In contrast there is virtually no literature on military forensic psychiatry. The first section of the paper is a brief review of British military psychiatric services and recent data on the prevalence of mental illness in British armed forces personnel. The second section summarizes the relevant aspects of the British military judicial and penal systems including the practice of summary justice, the court martial system, and sentencing and corrective training. The third section of the paper addresses issues which are particular to forensic psychiatry, including mental defences in relation to the military, the military offences of malingering and impersonation, risk assessment in military contexts and the notion of 'temperamental unsuitability' to military service. PMID:15176622

  4. Mental illness: psychiatry's phlogiston.

    PubMed

    Szasz, T

    2001-10-01

    In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness.

  5. Mental illness: psychiatry's phlogiston

    PubMed Central

    Szasz, T

    2001-01-01

    In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness. Key Words: Agency • alchemy • behaviour • cause • chemistry • dignity PMID:11579183

  6. Challenges to academic psychiatry.

    PubMed

    Pardes, H; Pincus, H A

    1983-09-01

    Economic constraints, effects of retrenchments in federal health policy, and increased competition for resources are challenging all sectors of academic medicine. Departments of psychiatry are at particular risk during this era for reasons including the lack of a sound research and research training base in many psychiatry departments; the small number of students entering the field and implications therein for the availability of residency slots in psychiatry; and patterns of allocating resources within academic medical centers which, combined with biases in reimbursement policy toward cognitively based specialties, threaten the economic strength of psychiatric departments. A conceptual model based on marketing principles is proposed to aid in identifying and capitalizing on the unique strengths of the field.

  7. Mental illness: psychiatry's phlogiston.

    PubMed

    Szasz, T

    2001-10-01

    In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness. PMID:11579183

  8. Molecular psychiatry of zebrafish

    PubMed Central

    Stewart, Adam Michael; Ullmann, Jeremy F.P.; Norton, William H.J.; Brennan, Caroline H.; Parker, Matthew O.; Gerlai, Robert; Kalueff, Allan V.

    2014-01-01

    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 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 biological psychiatry research. PMID:25349164

  9. Clinical thinking in psychiatry.

    PubMed

    Wells, Lloyd A

    2015-06-01

    I discuss the lack of precision in the term 'clinical reasoning' and its relationship to evidence-based medicine and critical thinking. I examine critical thinking skills, their underemphasis in medical education and successful attempts to remediate them. Evidence-based medicine (and evidence-based psychiatry) offer much but are hampered by the ubiquity and flaws of meta-analysis. I explore views of evidence-based medicine among psychiatry residents, as well as capacity for critical thinking in residents before and after a course in philosophy. I discuss decision making by experienced doctors and suggest possible futures of this issue.

  10. [Sophrology and psychiatry].

    PubMed

    Diehr, Jan

    2016-01-01

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

  11. [Sophrology and psychiatry].

    PubMed

    Diehr, Jan

    2016-01-01

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

  12. Epistemology of psychiatry.

    PubMed

    Marková, Ivana S; Berrios, German E

    2012-01-01

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

  13. Psychiatry and music

    PubMed Central

    Nizamie, Shamsul Haque; Tikka, Sai Krishna

    2014-01-01

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

  14. Mumbai Psychiatry: Current Obstacles*

    PubMed Central

    Bagadia, Sanjay V.

    2015-01-01

    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. PMID:25838737

  15. [Psychiatry as a profession].

    PubMed

    Häfner, H

    2002-01-01

    With reference to Max Weber's timeless analysis of science and politics as a profession, the present paper describes the philosophical background and historical development of the tasks and tools, institutionalization, and socialization of psychiatry as a profession. In the mid twentieth century, psychiatrists' emergence from ideological confinement in asylums, where they were separated from urban culture and medicine in general, finally allowed them to benefit from accumulating knowledge and technological progress in the field of medicine. After its transition from a custodial to a therapeutic discipline, psychiatry has acquired a variety of new fields of action and duties that require a high degree of expertise on psychological and biological levels. At the same time, people have increasingly come to expect relief not only from disease, but also from manifold problems of everyday life. As a consequence, there has been an inflationary growth of professional psychiatric and psychotherapeutic and nonprofessional services. The professional requirements that psychiatrists should meet have also increased quantitatively and qualitatively in the wake of the historical change from a caring, paternalistic attitude towards the mentally ill to a therapeutic partnership. To a greater degree than physicians working in other medical fields, psychiatrists get personally involved with their patients. As a consequence, the mental burden of their profession is at times immense. For this reason, the ethics of a medical profession has special implications for psychiatrists. The fascinating advances in therapeutic methods, neurobiological knowledge, and the increasingly differentiated diagnostic tools, e.g., noninvasive investigation of the morphology and functioning of the brain, have turned psychiatry into one of the most interesting contemporary professions. Psychiatry is now facing an enormous challenge of meeting the standards of expertise.

  16. PSYCHIATRY AND THE LAW

    PubMed Central

    Zeifert, Mark

    1957-01-01

    In Rex vs. Arnold (1724) it was held that to avail himself of the defense of insanity “a man must be totally deprived of his understanding and memory, so as not to know what he is doing, no more than an infant, a brute, or a wild beast.” Although there has been some modification of this formula in most jurisdictions, the courts still operate under the McNaghten Rule (1843) which is no more logical and actually is more difficult to apply. That such a situation exists in 1956 is a reflection on the indifference of society—and particularly the courts which it elects—as well as on the failure of modern psychiatry to communicate its viewpoint to society. If we are to correct the sad formulae of the “right and wrong” and “policeman at the elbow” tests, we must have more study and better methods of communication in this area. A similar state of confusion exists in the methods of commitment of mentally ill people to psychiatric hospitals. The methods prescribed by law are archaic and cruel—and again reflect the failure of modern psychiatry to communicate its understanding to the legislatures and courts. There are many other areas of conflict between law (which looks to the past for its insights) and psychiatry (which seeks for its concepts in the current scientific advances). PMID:13383383

  17. Psychiatry and the law.

    PubMed

    ZEIFERT, M

    1957-01-01

    In Rex vs. Arnold (1724) it was held that to avail himself of the defense of insanity "a man must be totally deprived of his understanding and memory, so as not to know what he is doing, no more than an infant, a brute, or a wild beast." Although there has been some modification of this formula in most jurisdictions, the courts still operate under the McNaghten Rule (1843) which is no more logical and actually is more difficult to apply. That such a situation exists in 1956 is a reflection on the indifference of society-and particularly the courts which it elects-as well as on the failure of modern psychiatry to communicate its viewpoint to society. If we are to correct the sad formulae of the "right and wrong" and "policeman at the elbow" tests, we must have more study and better methods of communication in this area.A similar state of confusion exists in the methods of commitment of mentally ill people to psychiatric hospitals. The methods prescribed by law are archaic and cruel-and again reflect the failure of modern psychiatry to communicate its understanding to the legislatures and courts. There are many other areas of conflict between law (which looks to the past for its insights) and psychiatry (which seeks for its concepts in the current scientific advances).

  18. Prison psychiatry and professional responsibility.

    PubMed

    Smith, C E

    1987-05-01

    Professional responsibility is a multifaceted concept embracing elements of technical competence and accountability. It may seem anachronistic to examine professional responsibility in the context of prison psychiatry, which is a relatively unpopular and often controversial health service activity. Upon closer scrutiny, however, it appears that prison psychiatry presents a paradigm of the uncertainties, conflicts, and dilemmas which underlie current concerns about professional responsibility in psychiatry. In this paper, the author examines some of these issues and proposes some tentative answers, focusing on the critical question of the proper roles of psychiatry in prisons.

  19. The Task before Psychiatry Today Redux: STSPIR*

    PubMed Central

    Singh, Ajai R.

    2014-01-01

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

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

    PubMed

    Plakun, Eric

    2012-06-01

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

  1. [Forensic psychiatry. Its relations to clinical psychiatry and criminology].

    PubMed

    Kröber, H-L

    2005-11-01

    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.

  2. Financing Academic Departments of Psychiatry

    ERIC Educational Resources Information Center

    Liptzin, Benjamin; Meyer, Roger E.

    2011-01-01

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

  3. [Two Nobel prizes for psychiatry].

    PubMed

    Knezević, Aleksandar; Knezević, Vladimir

    2008-01-01

    It was pointed out that both Nobel prizes for medicine in the field of psychiatry have lost their importance in contemporary medicine. Modern achievements in psychiatry have suppresed both psychosurgery of Egas Moniz and malaria treatment of Wagner-Jauregg as methods in the treatment of mental diseases. PMID:19368289

  4. Ethics and forensic psychiatry.

    PubMed

    Wettstein, Robert M

    2002-09-01

    This article has attempted to outline some of the important ethical issues faced by the psychiatrist in the forensic role. Much of forensic psychiatry is practiced by general psychiatrists without specific forensic training who must thereby familiarize themselves with the problem areas likely to be encountered in this work. They should also be knowledgeable about the ethics guidelines prepared by forensic psychology and forensic psychiatry organizations that are subject to frequent modification. Ethical problems often occur when psychiatrists exceed their expertise, their role as contracted, or the actual facts in the case. Psychiatric experts usually represent just a small part of most litigation, and an attitude of humility rather than grandiosity is appropriate. Expert witnesses serve as educators rather than decision makers in the case [21]. Given the complexity and uncertainty of medical decision making generally, whether in clinical or forensic medicine, forensic psychiatric opinions should be appropriately qualified by their limitations, acknowledged affirmatively rather than only on cross-examination. Expert witnesses commonly take an oath to "tell the truth, the whole truth." Forensic psychiatrists are not experts in moral matters and should not be rendering moral judgments or misusing their authority as psychiatrists to advance their own political or social ideology [19]. Testimony should be based on data and theory generally accepted in the profession, recognizing that there will always be minority views. Psychiatrists, however, should not be testifying based upon idiosyncratic views unsupported by at least a respectable minority of the profession. As in clinical psychiatry, complex or challenging forensic cases often require consultation from a knowledgeable colleague.

  5. PSYCHIATRY-PAST, PRESENT & FUTURE

    PubMed Central

    Doongaji, Dinshaw R.

    1997-01-01

    An overview of psychiatry during the last three decades as practised in a general teaching hospital is presented. Psychiatry as an academic subject has matured tremendously during this period. The empirical treatments of the 1950s and the 1960s which evoke nostalgic memories, have been replaced by modern methods of treatment. However, there is a need to exercise caution against the blind acceptance of new and sophisticated research findings in biological psychiatry. Inspite of the bright future facing psychiatry, the identity of psychiatry as a medical discipline must be preserved at all cost. Psychiatrists should also realise the dangers of gradual fractionation and impersonalisation which threatens the speciality, and makes all possible efforts to prevent this. PMID:21584054

  6. Meditation and psychiatry.

    PubMed

    McGee, Michael

    2008-01-01

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

  7. Meditation and Psychiatry

    PubMed Central

    2008-01-01

    How might meditation promote wellness and healing from psychiatric illness? How might it contribute to the practice of psychiatry? This review of the literature attempts to answer these questions. Meditation is the consciously willed practice of two actions, attending and abstaining, that all people spontaneously perform to a greater or lesser degree. Psychological health may correlate in part with the degree to which we naturally perform these actions. This review analyzes the nature of meditation and its therapeutic benefits. It then concludes with a summary of the issues pertinent to the adjunctive use of meditation in psychiatric care. PMID:19727302

  8. The art of psychiatry

    PubMed Central

    BLOCH, SIDNEY

    2005-01-01

    Psychiatrists would undoubtedly support the notion of promoting such qualities as empathy, sensitivity and caring in the pursuit of good clinical practice. However, cultivating what we may call the "art of psychiatry" is not straightforward, since the qualities that constitute it are elusive. I propose that the means by which we can accomplish the goal of relating empathically and compassionately to our patients and their families is by regarding the humanities and the sciences as of equal relevance and as complementary. The humanities, particularly literature, the visual arts, film and music, are most suited to promoting empathic skills when they are woven into the clinical scenario. Examples are provided to demonstrate how this may be achieved. Were we to succeed in highlighting the art of psychiatry in our educational programs, and as part of continuing professional development, I surmise that our patients and their families would be the beneficiaries. We cannot merely vow to act empathically and sensitively. Instead, we should embark on a lifelong journey through the wonderful world of literature, the visual arts, film and music. The experience will not only prove appealing and engaging, but it will also go far to enrich our personal and professional lives. PMID:16633530

  9. Forensic psychiatry in Singapore.

    PubMed

    Chan, Lai Gwen; Tomita, Todd

    2013-12-01

    Singapore is a geographically small nation-state that has transformed itself from a third-world country to a developed nation after attaining political independence 46 years ago. The pace of change has been tremendous and mental health care is no exception. This paper provides an overview of mental health care and a review of key mental health legislation, including a National Mental Health Blueprint that was rolled out in 2007. On this background, the paper focuses on a description of forensic psychiatric services in Singapore. The role of the Department of Forensic Psychiatry at the Institute of Mental Health, which is the only forensic psychiatry department in the country, will be highlighted. Civil commitment and the treatment of unfit accused persons and insanity acquittees is reviewed. The role of forensic psychiatric assessments in the Singapore courts is examined. The application of the insanity and diminished responsibility defenses are reviewed. A trend is identified in the Singapore courts towards a more rehabilitation-focused sentencing approach and the role that forensic psychiatric assessments play in cases involving mentally disordered offenders is highlighted.

  10. Who's afraid of forensic psychiatry?

    PubMed

    Miller, R D

    1990-01-01

    Forensic psychiatry has come under mounting criticism from the press and other medical professionals, largely for its participation in the insanity defense. The author argues that the expertise available from the specialty is of increasing importance to psychiatry as a whole, as more and more legal issues become relevant to the practice of general psychiatry, and should be actively encouraged and legitimized rather than ostracized. All psychiatrists should be exposed to forensic principles and practices during their training, and the ability of forensic psychiatrists to serve as transducers between the clinical and the legal/judicial should be increasingly used to present the clinical viewpoint effectively in courts and legislatures.

  11. YouTube and 'psychiatry'.

    PubMed

    Gordon, Robert; Miller, John; Collins, Noel

    2015-12-01

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

  12. YouTube and 'psychiatry'.

    PubMed

    Gordon, Robert; Miller, John; Collins, Noel

    2015-12-01

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

  13. Psychiatry and the Palestinian population.

    PubMed

    Gordon, Harvey; Murad, Ibrahim

    2005-01-01

    Some key issues pertaining to Palestinian psychiatry are described. Bearing in mind the geographical location and history of the Palestinian population, the development of psychiatry needs to be seen in the context of the Arab world, on the one hand, and of Israel, on the other. In the Middle Ages, Arab culture and medicine were more developed than in Europe. Aspects of general and forensic psychiatry on the West Bank and Gaza are outlined. Issues pertaining to the death penalty, suicide and suicide bombers are also discussed. The biblically-described relationship between the Arab and Jewish peoples has its resonance today with regard to cohabitation and conflict.

  14. Forensic psychiatry in Pakistan.

    PubMed

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

    2015-01-01

    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.

  15. Psychiatry and terrorism.

    PubMed

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

    2011-08-01

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

  16. Mind, brain, and psychiatry.

    PubMed

    Dalton, R; Forman, M A

    1994-01-01

    The question of how the mind and brain are related has interested philosophers and scientists for over 20 centuries. Psychiatry has approached this question indirectly, from the standpoint of trying to correlate mental and physical functioning. Recent neurobiological advances may help to resolve the mind-body dichotomy. In this paper we review one particular neurobiologically based theory, the theory of neuronal group selection as proposed by Gerald Edelman. We describe the applicability of this theory to the clinical issues of attachment, character pathology, and depression to show how biological and psychological hypotheses of behavior can be assimilated into an integrated approach. We also briefly discuss limitations of Edelman's model, as well as alternative concepts in artificial intelligence, cognitive psychology, and quantum theory.

  17. Cultural psychiatry: a general perspective.

    PubMed

    Alarcón, Renato D

    2013-01-01

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

  18. American Association for Geriatric Psychiatry

    MedlinePlus

    ... 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 ...

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

    PubMed

    Leitner, Bernhard

    2014-01-01

    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. Space Psychology and Psychiatry

    NASA Astrophysics Data System (ADS)

    Kanas, N.; Manzey, D.

    2003-09-01

    This book deals with psychological, psychiatric, and psychosocial issues that affect people who live and work in space. Unlike other books that focus on anecdotal reports and ground-based simulation studies, this book emphasizes the findings from psychological research conducted during actual space missions. Both authors have been active in such research. What is presented in this readable text has previously been found only in scientific journal articles. Topics that are discussed include: behavioral adaptation to space; human performance and cognitive effects; crewmember interactions; psychiatric responses; psychological counter-measures related to habitability factors, work-design, selection, training, and in-flight monitoring and support; and the impact of expeditionary missions to Mars and beyond. People finding this book of interest will include: psychology and social science students and professors in universities; medical students and residents in psychiatry and aerospace medicine; human factors workers in space and aviation professions; individuals involved with isolated environments on Earth (e.g., the Antarctic, submarines); aerospace workers in businesses and space agencies such as NASA and ESA; and anyone who is interested in learning the facts about the human side of long-duration space missions. Link: http://www.wkap.nl/prod/b/1-4020-1341-8

  1. Psychiatry and movies.

    PubMed

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

    2009-06-01

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

  2. DRGs and Australian psychiatry.

    PubMed

    Hunter, C E; McFarlane, A C

    1994-03-01

    The introduction of diagnosis related groups (DRGs) as a basis for funding in the United States has revealed several shortcomings in current DRG systems. Overall, DRGs have proven to be poor predictors of cost, accounting for approximately one third of the variation in cost and length of stay for surgical DRGs and falling to less than 10% for medical DRGs. Their ability to contain costs also remains uncertain, with savings associated with reductions in length of stay being offset by increased readmission rates. Given the increasing commitment of government to casemix approaches to funding it is suggested that psychiatry should participate in the process of solving the problems so far identified with DRG systems. Participation would, it is hoped, create a focussed debate about the provision of a "gold standard" of care for all patients. The evaluation and refinement of existing DRGs is urgently needed and could utilise a number of comprehensive data bases which already exist across the country. Alternatives to diagnosis such as functional status and treatment needs should also be explored.

  3. The Task before Psychiatry Today Redux: STSPIR*

    PubMed Central

    Singh, Ajai R.

    2014-01-01

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

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

    PubMed

    Singh, Ajai R

    2014-01-01

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

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

    PubMed

    Singh, Ajai R

    2014-01-01

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

  6. The Child and Adolescent Psychiatry Trials Network

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  7. Internet resources for psychiatry and neuropsychiatry

    PubMed Central

    Stone, J; Sharpe, M

    2003-01-01

    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

  8. Sleep disorders in psychiatry.

    PubMed

    Costa e Silva, Jorge Alberto

    2006-10-01

    Sleep is an active state that is critical for our physical, mental, and emotional well-being. Sleep is also important for optimal cognitive functioning, and sleep disruption results in functional impairment. Insomnia is the most common sleep disorder in psychiatry. At any given time, 50% of adults are affected with 1 or more sleep problems such as difficulty in falling or staying asleep, in staying awake, or in adhering to a consistent sleep/wake schedule. Narcolepsy affects as many individuals as does multiple sclerosis or Parkinson disease. Sleep problems are especially prevalent in schizophrenia, depression, and other mental illnesses, and every year, sleep disorders, sleep deprivation, and sleepiness add billions to the national health care bill in industrialized countries. Although psychiatrists often treat patients with insomnia secondary to depression, most patients discuss their insomnia with general care physicians, making it important to provide this group with clear guidelines for the diagnosis and management of insomnia. Once the specific medical, behavioral, or psychiatric causes of the sleep problem have been identified, appropriate treatment can be undertaken. Chronic insomnia has multiple causes arising from medical disorders, psychiatric disorders, primary sleep disorders, circadian rhythm disorders, social or therapeutic use of drugs, or maladaptive behaviors. The emerging concepts of sleep neurophysiology are consistent with the cholinergic-aminergic imbalance hypothesis of mood disorders, which proposes that depression is associated with an increased ratio of central cholinergic to aminergic neurotransmission. The characteristic sleep abnormalities of depression may reflect a relative predominance of cholinergic activity. Antidepressant medications presumably reduce rapid eye movement (REM) sleep either by their anticholinergic properties or by enhancing aminergic neurotransmission. Intense and prolonged dreams often accompany abrupt withdrawal

  9. Psychiatry's second coming.

    PubMed

    Reich, W

    1982-08-01

    American psychiatry is in ideological flux. The established professional approach--the environmentalist one, the one that has concerned itself almost exclusively with the influence of the external environment on development and behavior, that has focused on individual psychology, on childhood, on the search for unconscious motivations, on psychoanalysis, on psychotherapy, on the primacy of feeling and meaning and growing, on Freud--is under serious attack. And a new approach--a biological one, one centered on the brain, on neurochemistry, on pharmacology, on medications--is rapidly gaining adherents, not only among young psychiatrists, but also in the press, among the public, and within a universe of newly hopeful and expectant patients. Some American psychiatrists, particularly those in the environmentalist camp, deny that any changes are taking place at all, or that those changes represent anything important--certainly not a significant challenge to the truth and usefulness of the traditional psychiatric concepts and practices; many of them seem perplexed about the increasing power of biologism and about the rush among younger psychiatrists to embrace it. And the biological psychiatrists themselves, or at least some of them, feel that their time has rightfully come, that their ascendance is, simply, an appropriate and direct result of the truths they bear, the science, the knowledge; they interpret their growing strength as a recognition that their explanations for abnormalities of feeling and thinking and being are more correct than the purely psychological ones, that in explaining those human functions in chemical terms they have finally and successfully brought together the mind and the body, and that the understanding of human behavior in health, as well as its therapy in illness, will ultimately be achieved most quickly and most fully through their methods of research and through their approaches to treatment. PMID:7111528

  10. Cultural psychiatry: international perspectives. Epilogue.

    PubMed

    Fàbrega, H

    2001-09-01

    The psychiatry of the 21st century will have to be different from the psychiatry of the 20th century. The latter began its journey in a socially, compartmentalized world in which sharp categories and boundaries for the definition of mental illness were assumed to be relevant. International psychiatry completed its hegemonic hold over the territory of mental health and illness with a commanding home-stretch run of success borne in the confidence and optimism of its neurobiologic and culture free program and agenda. The world in which psychiatry now exists, however is changing rapidly and will continue to change and so of necessity will the practice of psychiatry need to change. This issue offers a guidelines and a vision of the direction that should be followed. Migration and transnational communication and awareness of cultural differences are changing the character of communities around the world. These changes considered in the context of world wide political economic factors are bringing into close physical and symbolic juxtaposition persons from distinct nations and ethnic groups. Clashes in world views, attitudes, spiritual orientation, and general philosophic and moral outlook are becoming ever-present realities of urban centers around the world. In traditional contexts and among persons who do not physically migrate, the power of communications media manages to psychologically migrate them; that is, to challenge their local, native cultural traditions about mental health with the scientific perspectives about mental health and illness. Advances in the social and cultural sciences have underscored ways in which assumptions of reductionism and universalism need to be chastened with an appreciation of human differences and humane considerations as these relate to mental health problems. The science of psychiatry of the 21st century will have to accomodate to this new creolized world of ethnic pluralism, cultural differences, and clashing perspectives between

  11. [The Beca's in Chilean psychiatry].

    PubMed

    Escobar, E

    2000-07-01

    The Chilean psychiatrists, Manuel and Francisco Beca, father and son, who lived at the turn of the XIX century and in the first half of the XX respectively, dedicated their lives to the care of mental patients and to the teaching of psychiatry, contributing in their own way and time to the development of the specialty in Chile. Manuel Beca, a clinician, published the first mental patient statistics and Francisco, an academic, became professor of Psychiatry at the Catholic University. Although they dedicated themselves to different fields in the area of mental health, such as clinical research and teaching, both have outstanding merits to become a part of the historical memory of Chilean psychiatry. PMID:11050844

  12. History of psychiatry in India

    PubMed Central

    Nizamie, S. Haque; Goyal, Nishant

    2010-01-01

    History is a screen through which the past lightens the present and the present brightens the future. Psychiatry by virtue of its ability to deal with human thoughts and emotions and provide a pathway for healthy minds provides an important platform towards being a mentally sound human being and largely the society. This review takes a sneak peek into the foundations of modern psychiatry in India. The description is largely based on the time frame, which provides a better understanding of the factual information in each period starting from the Vedic era and culminating in the post independence period. PMID:21836719

  13. Evolutionary theory, psychiatry, and psychopharmacology.

    PubMed

    Stein, Dan J

    2006-07-01

    Darwin's seminal publications in the nineteenth century laid the foundation for an evolutionary approach to psychology and psychiatry. Advances in 20th century evolutionary theory facilitated the development of evolutionary psychology and psychiatry as recognized areas of scientific investigation. In this century, advances in understanding the molecular basis of evolution, of the mind, and of psychopathology, offer the possibility of an integrated approach to understanding the proximal (psychobiological) and distal (evolutionary) mechanisms of interest to psychiatry and psychopharmacology. There is, for example, growing interest in the question of whether specific genetic variants mediate psychobiological processes that have evolutionary value in specific contexts, and of the implications of this for understanding the vulnerability to psychopathology and for considering the advantages and limitations of pharmacotherapy. The evolutionary value, and gene-environmental mediation, of early life programming is potentially a particularly rich area of investigation. Although evolutionary approaches to psychology and to medicine face important conceptual and methodological challenges, current work is increasingly sophisticated, and may prove to be an important foundational discipline for clinicians and researchers in psychiatry and psychopharmacology.

  14. Historical aspects of Mexican psychiatry.

    PubMed

    Bayardo, Sergio Javier Villaseñor

    2016-04-01

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

  15. An Introduction to Child Psychiatry.

    ERIC Educational Resources Information Center

    Chess, Stella

    The role of child psychiatry is discussed, and the child is described as a developing organism. Genetic factors in behavior are considered as are the presenting problems. Methods treated involve taking the history, conducting the diagnostic interview, using special diagnostic procedures, and applying diagnostic classification. Problem areas dealt…

  16. Historical aspects of Mexican psychiatry.

    PubMed

    Bayardo, Sergio Javier Villaseñor

    2016-04-01

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

  17. [250 years of English psychiatry].

    PubMed

    Freeman, H

    1996-08-01

    The history of British psychiatry is considered from five main viewpoints: clinical practice, the institutional basis, the legislative basis, lay perspectives of-mental disorder, and European influences. Its philosophical basis can be traced back to the work of the seventeenth-century philosophers. Thomas Hobbes and John Locke. In Scotland, both 'philosophy of mind' and new clinical methods flourished during its Enlightenment; the concept of 'neurosis' was developed by William Cullen. Around 1800, James Prichard's concept of 'moral insanity' became the foundation of modern work on personality disorder and psychopathy. The psychotic illness of King George III, beginning in 1788, led to greater public sympathy for the mentally ill. Attitudes since then have varied, with 'antipsychiatry' becoming very influential in the 1960s. By the mid-eighteenth century, specialised institutions for the mentally ill existed in a number of cities, there were also units attached to charitable general hospitals, but none of these continued after about 1830. The neglect of patients in private madhouses, prisons, and poorhouses led to increasing concern by Parliament, which resulted in the development of public asylums throughout the country. Severe legal restrictions on their activities were modified in 1930 and completely reformed in 1959. From the mid-nineteenth century, French and German influences became increasingly strong, but British universities played no active part in psychiatry until the 1950s. Psycho-analysis did not develop strongly in Britain, where the main contribution was through translation and biography, but some leading analysts came as refugees in the 1930s-as did other psychiatrists from central Europe. Another important influence was that of Adolf Meyer at the Institute of Psychiatry, London, particularly through Sir Aubrey Lewis; physical treatment methods also came to Britain from Europe. In the second half of this century, the most important British

  18. Training in psychiatry throughout Europe.

    PubMed

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

    2016-03-01

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

  19. Psychiatry movie club: A novel way to teach psychiatry.

    PubMed

    Kalra, Gurvinder

    2011-07-01

    For decades, films across the world have entertained people and affected their attitudes regarding certain issues and conditions. Documentary films have been used by governments in different parts of the world to educate the general public and promote health and prevent the spread of disease as part of public health programs. Psychiatry as a branch of medicine like the rest of medicine continues to develop. With an increasing awareness among the general population and popularity of films showing various aspects of mental illnesses on the rise, educators and teachers are turning their attention to using films for education of medical students and psychiatric trainees. Although films may be stereotypical and prejudiced, they can be used successfully in teaching psychiatry trainees. In this paper, development of a movie club and its use are described and suggestions made to improve the use of films in this process.

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

    PubMed

    Schäfer, Armin

    2016-09-01

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

  1. The genomic psychiatry cohort: partners in discovery.

    PubMed

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

    2013-06-01

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

  2. Political and economic transformations in Ukraine: The view from psychiatry.

    PubMed

    Yankovskyy, Shelly

    2016-10-01

    This article examines contemporary Ukrainian psychiatry through the voices of patients, practitioners, and advocates, focusing on shifting objects of knowledge, interventions, and institutional transitions. Currently, we are witnessing the reconfiguration of psychiatry on a global scale through neoliberal rhetoric combined with the call for global mental health. The goal of the movement for global mental health is to scale up psychiatric treatments through greater access to psychiatric drugs, justified through the framing of distress as an illness. Neoliberal rhetoric suggests that cutting social service expenditure through the privatization and decentralization of the health care system will stimulate economic growth and, in the long term, combat poverty. This paper traces how these dynamics are playing out in Ukraine, drawing on ethnographic fieldwork conducted at a psychiatric hospital in south-central Ukraine from 2008-2010, while working with a non-governmental organization. PMID:27470483

  3. Psychiatry: the battered child of medicine.

    PubMed

    Greenblatt, M

    1975-01-30

    Psychiatry has had a troubled history. After the French Revolution "moral treatment" brought to America a period of effective and humane hospital treatment, but this progress was corrupted by the Industrial Revolution, and psychiatry was rejected by society as well as by medicine. Although the Freudian enlightenment and the introduction of social psychiatry have led to greater acceptance, today's criticisms are strident. Psychiatry is criticized for imprecise diagnosis, conceptual vagaries, jargon, therapeutic impotence and class bias. The American system of mental-health care is seen by many as a disaster. The federal comprehensive Community Mental Health Act has been aborted at an early stage. Skills involved in the practice of psychotherapy are not unique to the profession. Social ills, over which psychiatry has little control, play a large part in causing mental disability and retardation. Nevertheless, though embattled, psychiatry has contributed to medical practice and to the humane consciousness of society. PMID:1089193

  4. Images of psychiatry and psychiatrists

    PubMed Central

    Stuart, H; Sartorius, N; Liinamaa, T

    2015-01-01

    Objective This study surveyed medical teaching faculty to determine their attitudes toward psychiatry and psychiatrists. Method We conducted a multisite survey of a probability sample of 1057 teaching medical faculty members from 15 academic teaching centers in the United Kingdom, Europe, and Asia stratified by early, middle, and late career stage. The average response rate across countries was 65%. Results The outstanding findings were that 90% of respondents considered that psychiatrists were not good role models for medical students, 84% thought psychiatric patients were unsuitable to be treated outside of specialized facilities, and 73% thought psychiatric patients were emotionally draining. We noted statistically significant differences by country, gender, career stage, and specialty. Conclusion These results highlight why recruitment into psychiatry is problematic in many countries and suggest that greater attention should be given to improving the perception of psychiatrists as good role models and the efficacy of psychiatric treatments. PMID:25495023

  5. Ethics in psychiatry: a framework

    PubMed Central

    LOLAS, FERNANDO

    2006-01-01

    Defining bioethics as the rational use of dialogue in the formulation, justification, and application of ethical principles, with the aim ofgenerating good practices in research, clinical practice, and advocacy, this paper focuses on methods for bioethical deliberation relevantto psychiatry. Stressing that bioethics fuses the two main ethical traditions in Western thought, the deontological and the teleological, thepaper emphasizes the three conditions that any intervention, if considered in the context of bioethics, should fulfil: it should be appropriateto the problem at hand, it should be good (in the sense that it does good to those who receive it but also to those who perform it),and it should be just (in the sense that its outcomes can be generalized to the whole of society). Some implications of these notions for thepractice and teaching of psychiatry are presented. PMID:17139356

  6. The Two Cultures in Psychiatry

    PubMed Central

    Cleghorn, R. A.

    1965-01-01

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

  7. Emil Kraepelin and forensic psychiatry.

    PubMed

    Hoff, P

    1998-01-01

    Kraepelin's main positions in forensic psychiatry, that are understandable only in the context of his underlying psychiatric and, especially, nosological theory, are the following: (1) Criminal behavior, especially if repeatedly shown by the same individual, should be regarded as (or, in the strongest version possible, is) mental illness; (2) above all, this viewpoint is due to Kraepelin's broad acceptance of degeneration theory in general, whereas he rejected simplifying concepts like Lombroso's early hypothesis of clinically observable "stigmata degenerations"; (3) Kraepelin voted for the acceptance of diminished responsibility to provide a more differentiated spectrum for the psychiatric expert and the judge; (4) because delinquency, in his view, was closely linked with mental illness, which should be treated instead of (only) being punished, he strictly objected to the death penalty; and (5) he suggested significantly increasing psychiatry's influence on decisions regarding the kind and length of imprisonment.

  8. Secular humanism and "scientific psychiatry".

    PubMed

    Szasz, Thomas

    2006-04-25

    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.

  9. Secular humanism and "scientific psychiatry"

    PubMed Central

    Szasz, Thomas

    2006-01-01

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

  10. The Two Cultures in Psychiatry.

    PubMed

    Cleghorn, R A

    1965-07-10

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

  11. Psychiatric comorbidity in forensic psychiatry.

    PubMed

    Palijan, Tija Zarković; Muzinić, Lana; Radeljak, Sanja

    2009-09-01

    For the past several years a numerous studies in the field of forensic psychiatry confirmed a close relationship between violent offenders and comorbid substance abuse. The comorbid substance abuse in violent offenders was usually unrecognized and misdiagnosed. Furthermore, comorbidity in forensic psychiatry describes the co-occurrence of two or more conditions or psychiatric disorder known in the literature as dual diagnosis and defined by World Health Organization (WHO). In fact, many violent offenders have multiple psychiatric diagnoses. Recent studies have confirmed causal relationship between major psychiatric disorders and concomitant substance abuse (comorbidity) in 50-80% of forensic cases. In general, there is a high level of psychiatric comorbidity in forensic patients with prevalence of personality disorders (50-90%), mood disorders (20-60%) and psychotic disorders (15-20%) coupled with substance abuse disorders. Moreover, the high prevalence of psychiatric comorbidities could be found in mentally retarded individuals, as well as, in epileptic patients. Drugs and alcohol abuse can produce serious psychotoxic effects that may lead to extreme violent behavior and consequently to serious criminal offence such as physical assault, rape, armed robbery, attempted murder and homicide, all due to an altered brain function and generating psychotic-like symptoms. Studies have confirmed a significant statistical relevance in causal relationship between substance abuse and violent offences. In terms of forensic psychiatry, the comorbidity strongly contributes in the process of establishing psychiatric diagnosis of diminished mental capacity or insanity at the time of the offence in the course of clinical assessment and evaluation of violent offenders. Today, the primary focus of forensic psychiatry treatment services (in-patient or community) is management of the violent offenders with psychiatric comorbidity which requires a multilevel, evidence based approach to

  12. Forensic psychiatry in private practice.

    PubMed

    Modlin, H C; Felthous, A

    1989-01-01

    This paper presents statistical and explanatory analyses of 637 forensic psychiatry cases in a private practice setting during the past 12 years, highlighting the remarkable variety of clinical and legal issues addressed by forensic psychiatrists. Emphasis is on how and why forensic psychiatrists need to be expert diagnosticians and clinicians, and ways in which they may respond to difficult clinical and legal opinions are recommended.

  13. Psychiatry and humanism in Argentina.

    PubMed

    Niño Amieva, Alejandra

    2016-04-01

    The authors of the present selection of Latin American Psychiatry texts were characterized by a common deep humanistic attitude. These prolific writers were able to establish or extend the scope of the discipline in which they chose to act, questioning the establishment of rigid boundaries within the framework of a rigorous epistemological reflection. Thus the systematizing spirit of Jose Ingenieros' in the context of positivist evolutionism, resulted in the act of founding a discipline that integrated the biological and the social. In the case of Guillermo Vidal his conception of mental health went beyond the biomedical to consider psychotherapies as an emotional commitment, continence and empathic understanding; with regard to César Cabral his formation and extensive clinical practice resulted in a work defined by the inquiring into the theoretical concepts underlying Psychiatry and Clinical Psychology. This brief selection does not exhaust the issues or the level of ideas and discussions of Psychiatry in Argentina, but constitutes a textual corpus representative of a disciplinary conception understood as scientific and humanistic endeavor. PMID:27102381

  14. Psychiatry and humanism in Argentina.

    PubMed

    Niño Amieva, Alejandra

    2016-04-01

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

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

    ERIC Educational Resources Information Center

    Lyons, Zaza

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  17. Positive psychiatry: its time has come.

    PubMed

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

    2015-06-01

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

  18. Positive psychiatry: its time has come.

    PubMed

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

    2015-06-01

    Traditionally, psychiatry has been defined and practiced as a branch of medicine focused on the diagnosis and treatment of mental illnesses. Based on growing empirical evidence, we believe that this definition warrants expansion to include the concept of positive psychiatry. In the present article, we provide a critical overview of this emerging field and a select review of relevant scientific literature. Positive psychiatry may be defined as the science and practice of psychiatry that seeks to understand and promote well-being through assessment and interventions involving positive psychosocial characteristics (PPCs) in people who suffer from or are at high risk of developing mental or physical illnesses. It can also benefit nonclinical populations. Positive psychiatry has 4 main components: (1) positive mental health outcomes (eg, well-being), (2) PPCs that comprise psychological traits (resilience, optimism, personal mastery and coping self-efficacy, social engagement, spirituality and religiosity, and wisdom-including compassion) and environmental factors (family dynamics, social support, and other environmental determinants of overall health), (3) biology of positive psychiatry constructs, and (4) positive psychiatry interventions including preventive ones. There are promising empirical data to suggest that positive traits may be improved through psychosocial and biological interventions. As a branch of medicine rooted in biology, psychiatry, especially with the proposed conceptualization of positive psychiatry, is well poised to provide major contributions to the positive mental health movement, thereby impacting the overall health care of the population. PMID:26132670

  19. Medical Decision-Making by Psychiatry Residents

    ERIC Educational Resources Information Center

    El-Mallakh, Rif; Zinner, Jill; Mackey, Amanda; Tamas, Rebecca L.; Martin, Chanley M.; Dalton, Jerad; Dhaliwal, Nitu; Luddington, Nicole; Numan, Farhad U.; Nunes, Ross; Taylor, Stephen; Ye, Lu

    2007-01-01

    Objective: Several conspiring factors have resulted in an increase in the level of medical burden in psychiatric patients. Psychiatry residents require increasing levels of medical sophistication. To assess the medical decision-making of psychiatry residents, the authors examined the outcome in subjects initially seen in the emergency psychiatric…

  20. Psychiatry Residency Training around the World

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  1. Women and Teaching in Academic Psychiatry

    ERIC Educational Resources Information Center

    Hirshbein, Laura D.; Fitzgerald, Kate; Riba, Michelle

    2004-01-01

    Objective: This article explores past, present, and future issues for women and teaching in academic psychiatry. A small study of didactic teaching responsibilities along faculty groups in one academic psychiatry department helps to illustrate challenges and opportunities for women in psychiatric teaching settings. Background: Although women have…

  2. Child Psychiatry Curricula in Undergraduate Medical Education

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  3. Attitude towards psychiatry among medical students.

    PubMed

    Srivastava, Ashish

    2012-10-01

    The proportion of medical graduates opting for psychiatry in career has been observed to be distinctly less compared to those choosing other specialties. The study was undertaken to find out the attitudes of newly entrant medical students towards psychiatry in comparison to other specialties. Sixty-two students of first year MBBS were administered a questionnaire to assess their attitudes towards various specialties. Only 1 student (1.5%) opted for psychiatry as a career choice, another 2 students (3%) considered it as a strong possibility, 71.5% negated psychiatry as a career choice. Students rated psychiatry significantly lower than other specialties in regards to financially rewarding, enjoyable and satisfying work, intellectually challenging, scientific basis, prestige among others, lifestyle. Psychiatry was also rated as poor on prospects of having a bright and interesting future. The present study suggests that new entrants in medical college harbour a negative attitude towards psychiatry, which has not changed over the last three to four decades. A conscious effort in trying to make psychiatry an active and interesting component of medical education and an improved portrayal of this field in society thereby reducing stigma associated with it would be of immense importance in generating interest in this field among newly entrant medical students. PMID:23738403

  4. Putting "Rural" into Psychiatry Residency Training Programs

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  5. The history of Italian psychiatry during Fascism.

    PubMed

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

    2011-09-01

    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.

  6. Forensic psychiatry: contemporary scope, challenges and controversies.

    PubMed

    Arboleda-Flórez, Julio

    2006-06-01

    Forensic psychiatry is the branch of psychiatry that deals with issues arising in the interface between psychiatry and the law, and with the flow of mentally disordered offenders along a continuum of social systems. Modern forensic psychiatry has benefited from four key developments: the evolution in the understanding and appreciation of the relationship between mental illness and criminality; the evolution of the legal tests to define legal insanity; the new methodologies for the treatment of mental conditions providing alternatives to custodial care; and the changes in attitudes and perceptions of mental illness among the public. This paper reviews the current scope of forensic psychiatry and the ethical dilemmas that this subspecialty is facing worldwide.

  7. Forensic psychiatry: contemporary scope, challenges and controversies

    PubMed Central

    ARBOLEDA-FLÓREZ, JULIO

    2006-01-01

    Forensic psychiatry is the branch of psychiatry that deals with issues arising in the interface between psychiatry and the law, and with the flow of mentally disordered offenders along a continuum of social systems. Modern forensic psychiatry has benefited from four key developments: the evolution in the understanding and appreciation of the relationship between mental illness and criminality; the evolution of the legal tests to define legal insanity; the new methodologies for the treatment of mental conditions providing alternatives to custodial care; and the changes in attitudes and perceptions of mental illness among the public. This paper reviews the current scope of forensic psychiatry and the ethical dilemmas that this subspecialty is facing worldwide. PMID:16946941

  8. The Place of Psychotherapy in Contemporary Psychiatry

    PubMed Central

    Tavakoli, Saman

    2014-01-01

    Psychotherapy has long been an essential component of clinical psychiatry and many young physicians choose to train in psychiatry residency programs in order to acquire necessary knowledge and skills, and become competent psychotherapists. Recent advances in psychopharmacology and neuroscience, and growing dominance of managed care and evidence-based medicine have had dramatic impacts on health care delivery systems and clinical psychiatry practice. Despite these changes in the field of mental health, psychotherapy still remains a crucial part of clinical psychiatry and comprises a great proportion of psychiatrists’ clinical practice. Hence, accreditation agencies and regulatory bodies determine compulsory minimum requirements for psychiatry residency programs to ensure that residents, at the end of their specialty training, can demonstrate competence in managing their patients through applying different approaches of psychotherapy. PMID:25798167

  9. ["Great jobs"-also in psychiatry?].

    PubMed

    Spiessl, H; Hübner-Liebermann, B

    2003-09-01

    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.

  10. Some gestalt contributions to psychiatry.

    PubMed

    Clegg, Kathleen A

    2010-07-01

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

  11. The industrialization of American psychiatry.

    PubMed

    Bittker, T E

    1985-02-01

    Physician surpluses and escalating medical care costs have fostered an alliance among government, corporate America, and health insurers that has inspired medicine's industrialization. These same forces will transform psychiatry into an industry where prospective payment, automation, salaried employment, and central control of clinical activities threaten to become the dominant form of medical practice. Emerging trends suggest that both patients and health professionals will gravitate to various forms of alternative provider organizations in an effort to shield themselves from the economic uncertainties of seeking and providing care. The chronically mentally ill and others requiring extensive treatment risk exclusion from this new system, where cost consciousness may supplant compassion.

  12. Polypharmacy In Psychiatry: A Review

    PubMed Central

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

    2013-01-01

    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

  13. The Holy Grail of Psychiatry.

    PubMed

    Nemeroff, Charles B

    2015-01-01

    "Holy Grail" is a well-known metaphor for the eternal spiritual pursuit for truth and wisdom. It suggests that in order for us to find what no one has found, we must search where few have looked. In 2013, a group led by Helen Mayberg published a groundbreaking paper that sought an answer to one of the most discussed conundrums in psychiatry and neuroscience: Can specific patterns of brain activity indicate how a depressed person will respond to treatment with medication or psychotherapy? Our author examines the findings and discusses their potential impact on treatment for a public health problem that affects millions of people worldwide. PMID:27358663

  14. British psychiatry and its discontents

    PubMed Central

    Cooper, Brian

    2010-01-01

    Summary Psychiatry in the UK is currently faced with serious difficulties arising from failure in recruiting British doctors and a high rate of early retirement from the specialty. To diagnose the underlying causes, account must be taken of government policies affecting the NHS in general and mental health services in particular. The latter include an excessive run-down of acute hospital beds, as well as projects aimed at changing the clinical role of psychiatrists and promoting mass treatment of milder mental disorders by non-medical personnel. Psychiatrists have reacted to these developments with anger and dismay, but have as yet reached no consensus with regard to either causal factors or appropriate response. Their uncertainty reflects the need for a firmer grasp of the historical background. Modern British psychiatry was effectively created and moulded as an integral part of the NHS. It flourished as long as the public service framework remained intact, but has suffered a decline since the whole structure began to buckle under the pressure of sustained political assaults. A clearer understanding of this vital connection would help to raise psychiatrists' morale and encourage them to establish common ground with medical colleagues and other healthcare professionals. PMID:20929890

  15. Against Explanatory Minimalism in Psychiatry.

    PubMed

    Thornton, Tim

    2015-01-01

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

  16. Against Explanatory Minimalism in Psychiatry

    PubMed Central

    Thornton, Tim

    2015-01-01

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

  17. A personal journey into cultural psychiatry.

    PubMed

    Westermeyer, Joseph

    2011-04-01

    The two primary audiences for this article are psychiatrists interested in a cultural psychiatry career and academic as well as healthcare leaders who are in a position to support cultural psychiatry training. In addition to describing my own personal journey through cultural psychiatry, this report includes strategic recommendations for becoming a cultural psychiatrist as well as rationales for supporting a cadre of cultural psychiatrists in the coming decades. A World Health Organization (WHO) sponsored program for training clinicians in addictions is described. Finally, the account summarizes those clinical, research, educational, consultative, and leadership roles that cultural training influenced during my career. PMID:21511852

  18. A Marxist approach to psychology and psychiatry.

    PubMed

    Nahem, J

    1982-01-01

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

  19. Commentary: Is ethical forensic psychiatry an oxymoron?

    PubMed

    Dike, Charles C

    2008-01-01

    The role of psychiatry in the legal arena is grossly misunderstood and even controversial. Some respected psychiatrists and members of the public have argued that the current state of the science of psychiatry is such that it has little to offer the legal system, and consequently, psychiatrists should be banned from the courts. Alan Stone's critique of forensic psychiatry 25 years ago is probably the most pointed. In this article, a summary of four different responses to Alan Stone's critique will be presented and analyzed.

  20. Relational agents in clinical psychiatry.

    PubMed

    Bickmore, Timothy; Gruber, Amanda

    2010-01-01

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

  1. Sustainable psychiatry in the UK

    PubMed Central

    Yarlagadda, Sucharita; Maughan, Daniel; Lingwood, Susie; Davison, Phil

    2014-01-01

    Demands on our mental health services are growing as financial pressures increase. In addition, there are regular changes to service design and commissioning. The current political mantra is ‘more and more, of better quality, for less and less, please’. We suggest that mental health services need to actively respond to these constraints and that clinical transformation is needed to move towards a more sustainable system of healthcare. Emphasis on prevention, patient empowerment and leaner, greener services is required alongside more extensive use of technologies. Focusing on these areas will make mental health services more responsive to the challenges we face and serve to future-proof psychiatry in the UK. Services need to be delivered to provide maximum benefit to the health of our patients, but also to our society and the environment. PMID:25505629

  2. [Disaster psychiatry in late life].

    PubMed

    Awata, Shuichi

    2013-10-01

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

  3. Neuroimaging, culture, and forensic psychiatry.

    PubMed

    Aggarwal, Neil K

    2009-01-01

    The spread of neuroimaging technologies around the world has led to diverse practices of forensic psychiatry and the emergence of neuroethics and neurolaw. This article surveys the neuroethics and neurolegal literature on the use of forensic neuroimaging within the courtroom. Next, the related literature within medical anthropology and science and technology studies is reviewed to show how debates about forensic neuroimaging reflect cultural tensions about attitudes regarding the self, mental illness, and medical expertise. Finally, recommendations are offered on how forensic psychiatrists can add to this research, given their professional interface between law and medicine. At stake are the fundamental concerns that surround changing conceptions of the self, sickness, and expectations of medicine. PMID:19535562

  4. Sacred psychiatry in ancient Greece

    PubMed Central

    2014-01-01

    From the ancient times, there are three basic approaches for the interpretation of the different psychic phenomena: the organic, the psychological, and the sacred approach. The sacred approach forms the primordial foundation for any psychopathological development, innate to the prelogical human mind. Until the second millennium B.C., the Great Mother ruled the Universe and shamans cured the different mental disorders. But, around 1500 B.C., the predominance of the Hellenic civilization over the Pelasgic brought great changes in the theological and psychopathological fields. The Hellenes eliminated the cult of the Great Mother and worshiped Dias, a male deity, the father of gods and humans. With the Father's help and divinatory powers, the warrior-hero made diagnoses and found the right therapies for mental illness; in this way, sacerdotal psychiatry was born. PMID:24725988

  5. Primary care psychiatry in Italy.

    PubMed

    Berardi, Domenico; Ferrannini, Luigi; Menchetti, Marco; Vaggi, Marco

    2014-06-01

    In Italy, the importance of integrating primary care and mental health has only recently been grasped. Several reasons may explain this delay: a) until 2005, primary care physicians worked individually instead of in group practices, without any functional network or structured contacts with colleagues; b) community mental health centers with multiprofessional teams were well structured and widespread in several regions but focused on people with severe and persistent mental disorders; and c) specific national government health policies were lacking. Only two regions have implemented explicit policies on this issue. The "G. Leggieri" program started by the Emilia-Romagna region health government in 1999 aims to coordinate unsolicited bottom-up cooperation initiatives developing since the 1980s. In Liguria, a regional work group was established in 2010 to boost the strategic role of collaborative programs between primary care and mental health services. This article describes the most innovative experiences relating to primary care psychiatry in Italy.

  6. Research in Psychiatry: Concepts and Conceptual Analysis.

    PubMed

    Marková, Ivana S; Berrios, German E

    2016-01-01

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

  7. American Academy of Child and Adolescent Psychiatry

    MedlinePlus

    ... aacap.org for questions. Be CAPtivated - Child and Adolescent Psychiatry as a Career AACAP's Current Award Opportunities ... More... AACAP Workforce Maps More... Delirium in Children & Adolescents More... Issues to Consider When Engaging Asian American ...

  8. [Aeromedical Decision-Making in Psychiatry].

    PubMed

    Weber, F

    2016-09-01

    This paper reviews aeromedical decision-making in psychiatry. It explains the "one-percent rule", the general medical criteria for fitness for flying and how they are applied to psychiatric disorders. PMID:27607071

  9. [A journey in the universe of psychiatry].

    PubMed

    Vaudelet, Marcel

    2011-01-01

    The career development of a nurse in psychiatry from 1968 up until 2004 conveys the evolutions in asylum, care and therapeutics. Working as a nurse in a home for children enables us to see the actual roots of this profession.

  10. Why is psychiatry prone to fads?

    PubMed

    Paris, Joel

    2013-10-01

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

  11. Psychiatry, religious conversion, and medical ethics.

    PubMed

    Post, Stephen G

    1991-09-01

    The interface between religion, psychiatry, and ethics is often a locus for considerable controversy. This article focuses on the response of American psychiatry to religious nonconformism, and to religious conversion generally. At issue is the societal pressure against unpopular religious movements. The author argues for an ethic that conserves the freedom of religious conscience, and that guards against inquisitions in the guise of medical expertise and nosology.

  12. Delpech and the origins of occupational psychiatry.

    PubMed Central

    O'Flynn, R R; Waldron, H A

    1990-01-01

    Auguste-Louis Delpech (1818-80) has been remembered principally as the author of the first detailed description of the serious consequences of exposure to carbon disulphide. A close reading of his work suggests that his reputation has been seriously undervalued. The subsequent development of occupational psychiatry, with its emphasis on the distinction between the organic and the functional, may be traced through publications on carbon disulphide. It is argued that a contemporary approach to occupational psychiatry is long overdue. PMID:2183876

  13. What can philosophy do for psychiatry?

    PubMed Central

    Fulford, Kenneth WM; Stanghellini, Giovanni; Broome, Matthew

    2004-01-01

    This article illustrates the practical impact of recent developments in the philosophy of psychiatry in five key areas: patient-centred practice, new models of service delivery, neuroscience research, psychiatric education, and the organisation of psychiatry as an international science-led discipline focused on patient care. We conclude with a note on the role of philosophy in countering the stigmatisation of mental disorder. PMID:16633476

  14. [Psychiatry, the field of all risks].

    PubMed

    Gilioli, Christian

    2015-01-01

    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.

  15. [Psychiatry, the field of all risks].

    PubMed

    Gilioli, Christian

    2015-01-01

    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. PMID:26143214

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

    ERIC Educational Resources Information Center

    Gleason, Mary Margaret; Fritz, Gregory K.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Gold, Liza H.; Epstein, Steven A.

    2006-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Rutherford, Bret R.; Hellerstein, David J.

    2008-01-01

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

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

    PubMed

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

    2010-06-01

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

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

    PubMed

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

    2010-06-01

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

  2. Neurology and psychiatry in Babylon.

    PubMed

    Reynolds, Edward H; Wilson, James V Kinnier

    2014-09-01

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

  3. Gray areas in forensic psychiatry.

    PubMed

    Ryans, M M

    1978-08-01

    The field of forensic psychiatry is not always compatible with legalities in our court system, causing some cases to be in a "gray" area. A case is presented, demonstrating shortcomings of the M'Naghten rule, which is meant to protect the mentally ill person from being incarcerated when he is not aware of the nature or the seriousness of the crime of which he stands accused. However, this rule is not applicable when there is awareness, even if the patient is laboring under a delusional system. In the case to be considered, the individual suffers by being given a criminal record instead of being found not guilty by reason of insanity, although the end result is the same.The author feels there should be a much broader interpretation of the M'Naghten rule to encompass the full intent of protecting the mentally ill person but to exclude the sociopath and those with character disorders. The Durham rule is not workable because of this inclusion.

  4. Cultural competency training in psychiatry.

    PubMed

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

    2008-01-01

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

  5. Neurology and psychiatry in Babylon.

    PubMed

    Reynolds, Edward H; Wilson, James V Kinnier

    2014-09-01

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

  6. Cultural competency training in psychiatry.

    PubMed

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

    2008-01-01

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

  7. [Reform of psychiatry in Spain].

    PubMed

    Pedrosa Gil, F; Luderer, H J

    2000-11-01

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

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

    PubMed

    Basso, Elisabetta

    2016-12-01

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

  9. Gender differences in career paths in psychiatry.

    PubMed

    Krener, P

    1994-03-01

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

  10. History and current condition of Russian psychiatry.

    PubMed

    Krasnov, Valery N; Gurovich, Isaak

    2012-08-01

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

  11. The scientific foundation of anti-psychiatry.

    PubMed

    van Praag, H M

    1978-08-01

    Anti-psychiatry has exerted a substantial influence on the thoughts of workers in the field of mental hygiene; on those of the psychiatrically trained, but even much more on those without psychiatric training. Consequently it seemed important to me to investigate the strength of the foundation of this school of thought. This has been the objective of this study. The point of crystallization of anti-psychiatry is the labelling theory on the origin of deviant behaviour. The scientific status of anti-psychiatry stands or falls with that of the labelling theory. Since this theory has not been formulated in verifiable hypotheses, I ventured to formulate "theses", and then tested these against empirical obtained data. The results of this study were largely negative. The empirical material does not support the labelling theory, and in many cases even contradicts it. Consequently anti-psychiatry--as a model to explain the development of psychological disorders--has not a leg to stand on. The labelling theory has had great merits as a "sensitizing theory". It has given momentum to innovative tendencies in psychiatry. Now that it has proved to be untenable on its principal points, however, it should be abandoned. It has become a rubber check, which has no scientific buying-power. PMID:696382

  12. Ethics in child and adolescent forensic psychiatry.

    PubMed

    Ratner, Richard A

    2002-10-01

    Ethical concerns are ever present in the practice of all branches of psychiatry. They are likely to be more acute and commonplace in the practice of child and adolescent psychiatry because of the complication introduced by the immaturity of the patient. Children, depending on their age and developmental stage, may be incapable of giving meaningful consent, and situations in which breaking confidentiality must be considered arise more often. The field of forensic psychiatry is fundamentally different from clinical psychiatry because of the universal involvement of third parties and because interactions with evaluees do not occur within the context of a doctor patient relationship. Arguably, these conditions compel the forensic psychiatrist to function as a double agent. According to Appelbaum, an influential psychiatric ethicist, forensic practice calls for a different set of ethical guidelines that, while humane, do not either imply or derive from the existence of a doctor patient relationship. Others argue that a mix of forensic and clinical ethics is more appropriate. New developments in psychiatry, including the use of the Internet for E-mail and telepsychiatry, require continuing vigilance by the profession so that ethical standards can evolve to cover new circumstances at the frontiers of psychiatric practice.

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

    PubMed

    Basso, Elisabetta

    2016-12-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  15. Factors Affecting Recruitment into Child and Adolescent Psychiatry Training

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  16. Training Clinicians in Cultural Psychiatry: A Canadian Perspective

    ERIC Educational Resources Information Center

    Kirmayer, Laurence J.; Rousseau, Cecile; Guzder, Jaswant; Jarvis, G. Eric

    2008-01-01

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

  17. Teaching Psychiatry Residents to Teach: A National Survey

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed

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

    2016-09-01

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

  19. The Scientific Status of Psychiatry Within Medicine

    PubMed Central

    Nickens, Herbert W.

    1984-01-01

    Psychiatry is in ferment. In the present sluggish economy nonphysician psychotherapists, often charging lower fees, are competing with psychiatrists for patients. At the same time theories and therapies that can be characterized as psychodynamic appear to be on the defensive, increasingly challenged by those with behavioral or psychopharmacologic foundations. A growing emphasis on statistical rigor in research increases this phenomenon. One general response to all of this by the psychiatric profession has been a reassertion of psychiatry's connections and identification with medicine and with science. The author contends that although this response is understandable and may provide some support for the prestige of psychiatry, the issue at hand is fundamentally an epistemologic one. It is a deeply rooted and structural dilemma. PMID:6471110

  20. Neuroimaging in Psychiatry: From Bench to Bedside

    PubMed Central

    Linden, David E. J.; Fallgatter, Andreas J.

    2009-01-01

    This perspective considers the present and the future role of different neuroimaging techniques in the field of psychiatry. After identifying shortcomings of the mainly symptom-focussed diagnostic processes and treatment decisions in modern psychiatry, we suggest topics where neuroimaging methods have the potential to help. These include better understanding of the pathophysiology, improved diagnoses, assistance in therapeutic decisions and the supervision of treatment success by direct assessment of improvement in disease-related brain functions. These different questions are illustrated by examples from neuroimaging studies, with a focus on severe mental and neuropsychiatric illnesses such as schizophrenia and depression. Despite all reservations addressed in the article, we are optimistic that neuroimaging has a huge potential with regard to the above-mentioned questions. We expect that neuroimaging will play an increasing role in the future refinement of the diagnostic process and aid in the development of new therapies in the field of psychiatry. PMID:20087437

  1. Educating psychiatry residents in neuropsychiatry and neuroscience.

    PubMed

    Benjamin, Sheldon

    2013-06-01

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

  2. [Significant events in Polish psychiatry in 2003?].

    PubMed

    Bomba, Jacek

    2004-01-01

    The aim of this paper was a reflection on the most significant events in Polish psychiatry in 2003. Reform in health care financing and its realisation in 2003 introduced a risk of inhibiting further development of mental health care. The endangerment is a result of allocation of resources, which is inadequate to real costs and promotes in-patient treatment. An additional risk is seen in a project of privatisation of health care institutions. Increasing orientation towards methodology of molecular biology, which is similar to a general global tendency, influences research in psychiatry. Nevertheless the low number of publications resulting from government sponsored studies is disturbing. The situation in forensic psychiatry calls for involvement and studies. Psychiatria Polska published a report indicating low standard of psychiatric expertise for courts and high probability of corruption. The same was reflected in mass media publications later on. Polish Psychiatric Association Board had appointed a special commission to study this problem.

  3. How Health Reform is Recasting Public Psychiatry.

    PubMed

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

    2015-09-01

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

  4. How Health Reform is Recasting Public Psychiatry.

    PubMed

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

    2015-09-01

    This article reviews the fiscal, programmatic, clinical, and cultural forces of health care reform that are transforming the work of public psychiatrists. Areas of rapid change and issues of concern are discussed. A proposed health care reform agenda for public psychiatric leadership emphasizes (1) access to quality mental health care, (2) promotion of recovery practices in primary care, (3) promotion of public psychiatry values within general psychiatry, (4) engagement in national policy formulation and implementation, and (5) further development of psychiatric leadership focused on public and community mental health. PMID:26300038

  5. Transcultural psychiatry, ethnic minorities and marginalization.

    PubMed

    Farrington, A

    Cultural and racial bias has been woven into the fabric of Western psychiatry in its historic development. Western psychiatry emphasizes the medical model as being fundamental to the discipline. Many communities in large cities and industrial areas have become multicultural and multiracial. Culture-bound syndromes are not specific to non-Western ethnic minorities. Black people are overrepresented among psychiatric patients in institutions. Mental health services for ethnic minorities have been haphazard and inconsistent. Cultural experiences and the practical realities of racism are overdue their recognition.

  6. Forensic psychiatry, neuroscience, and the law.

    PubMed

    Silva, J Arturo

    2009-01-01

    The rise of modern neuroscience is transforming psychiatry and other behavioral sciences. Neuroscientific progress also has had major impact in forensic neuropsychiatric practice, resulting in the increased use of neuroscientific technologies in cases of a psychiatric-legal nature. This article is focused on the impact of neuroscientific progress in forensic psychiatry in relation to criminal law. Also addressed are some emerging questions involving the practice of forensic neuropsychiatry. These questions will be reframed by providing alternative perspectives consistent with the objectives of forensic neuropsychiatric practice. The last part of the article is a discussion of potential developments that may facilitate the integration of neuroscientific knowledge in forensic neuropsychiatric practice.

  7. Overview: Ethical issues in contemporary psychiatry.

    PubMed

    Redlich, F; Mollica, R F

    1976-02-01

    The authors survey the ethical problems confronting psychiatry today. They state that with rare exceptions psychiatric intervention can be morally justified only with the potential patient's informed consent. Within this framework, they discuss the fact that today nonpsychiatrists, particularly ethicists, lawyers, legislators, and social scientists, as well as psychiatrists are concerned about medical ethics, specifically regarding the right to be treated, the right not to be treated, the civil rights of psychiatric patients, the ethics of behavior control, the problem of conflicts of interest in therapeutic goals, privacy and confidentiality, the ethics of human experimentation, policy decisions, and psychiatry's relationship to the changing moral value structure of U.S. society.

  8. Why do we need a social psychiatry?

    PubMed

    Ventriglio, Antonio; Gupta, Susham; Bhugra, Dinesh

    2016-07-01

    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. PMID:27369473

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed

    Lipowski, Z J

    1981-07-01

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

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

    PubMed

    Kalmár, Sándor

    2015-06-01

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

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

    PubMed

    Rakofsky, Jeffrey J; Ferguson, Britnay A

    2015-12-01

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

  13. Child and adolescent psychiatry in general children's hospitals. A survey of chairs of psychiatry.

    PubMed

    Campo, J V; Kingsley, R S; Bridge, J; Mrazek, D

    2000-01-01

    This article characterizes the academic, administrative, clinical service, and fiscal characteristics of departments of psychiatry in traditional children's hospitals to determine the characteristics of fiscally successful programs. A survey of chairs of psychiatry from short-term general children's hospitals was conducted based on 38 questions addressing the descriptive characteristics of their respective departments. The characteristics of psychiatry programs identified as fiscally successful were compared to those of programs that required subsidy. Nine of 45 eligible children's hospitals (20%) did not have a department or section of psychiatry, and surveys were returned by 35 of 36 department chairs (97% response). Considerable variation exists in the academic, administrative, clinical services, and fiscal characteristics of programs, although over half are operating at a deficit. Fiscal success was associated with availability of inpatient and intermediate levels of psychiatric care, better integration of the psychiatry program within the children's hospital, and adequate fiscal information being provided to the psychiatry chair. Additional research regarding the potential of psychiatric services to generate clinical success and cost savings is warranted. Pediatric health care professionals and third-party payers should be educated regarding the relevance of psychiatric services within children's hospitals and in physically ill children.

  14. Fifty Years in Child and Adolescent Psychiatry

    ERIC Educational Resources Information Center

    Werry, John

    2013-01-01

    John Werry completed training in child and adolescent psychiatry at McGill University in Montreal, and has been a world renowned leader in children's mental health. Drawing on a half century of work in Canada, the United States, and his native New Zealand, he shares his reflections and vision for the future in the interview given for this…

  15. Old age psychiatry in the modern age.

    PubMed

    Warner, James P

    2015-11-01

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

  16. Undergraduate Child Psychiatry Teaching in Melbourne, Australia

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  17. Gait and its assessment in psychiatry

    PubMed Central

    Sanders, Richard D.

    2010-01-01

    Gait reflects all levels of nervous system function. In psychiatry, gait disturbances reflecting cortical and subcortical dysfunction are often seen. Observing spontaneous gait, sometimes augmented by a few brief tests, can be highly informative. The authors briefly review the neuroanatomy of gait, review gait abnormalities seen in psychiatric and neurologic disorders, and describe the assessment of gait. PMID:20805918

  18. Psychopathology as the basic science of psychiatry.

    PubMed

    Stanghellini, Giovanni; Broome, Matthew R

    2014-09-01

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

  19. Digital applications: the future in psychiatry?

    PubMed

    Thibaut, Florence

    2016-06-01

    Digital applications and new mobile technologies can change the nature of the psychiatrist-patient relationship and future clinical practice in terms of diagnosis, follow-up, and treatment, but need to be further studied. This issue explores these new approaches in psychiatry. PMID:27489451

  20. Annotated Psychodynamic Bibliography for Residents in Psychiatry

    PubMed Central

    CALIGOR, EVE

    1996-01-01

    The author provides an annotated bibliography to introduce psychodynamic psychotherapy and psychoanalysis to residents in psychiatry. The emphasis of the selection is on relevance to practice. The entries are grouped by topic, levels of difficulty are noted, and readings are identified as being of either current or historic relevance. PMID:22700303

  1. Criminal Forensic Psychiatry: A Primer for Psychiatrists.

    PubMed

    Freeman, Scott A

    2016-06-01

    Many mentally ill people are currently held in correctional settings, and general psychiatrists should be familiar with criminal forensic psychiatry in order to understand the legal aspects of the evaluation and treatment of these individuals, especially with regard to competency to stand trial and insanity. This educational activity briefly explains these evaluations and reviews relevant landmark legal cases.

  2. Imaging-Genetics Applications in Child Psychiatry

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  3. [Equine-assisted therapy in child psychiatry].

    PubMed

    Ansorge, Jessie; Sudres, Jean-Luc

    2011-01-01

    The use of a horse or pony as a therapeutic tool is often presented in the media as a recent phenomenon. A survey of 103 institutions shows that it is in fact an approach well rooted in child and adolescent psychiatry. However, professionals who use equine-assisted therapy are calling for an assessment to be carried out enabling them to hone their practices.

  4. Child Psychiatry: The Past Quarter Century.

    ERIC Educational Resources Information Center

    Eisenberg, Leon

    The developments in child psychiatry in the past 25 years have been encouraging but represent only a prelude to the significant work that must be done relatively soon to meet the needs of the contemporary child. Before 1940, the desirability of multidisciplinary study of the child had been well established, and child guidance clinics had appeared.…

  5. Sociology in the context of social psychiatry.

    PubMed

    Cooper, B

    1994-01-01

    The author addresses various aspects of the interface between sociology and social psychiatry, among them the labelling process related to mental deviance, problems related to diagnosis and social ethology. The need for interdisciplinary work is emphasized, not least in the context of prevention. It is underlined that effective preventive measures can precede the full causal elucidation of a disease.

  6. Criminal Forensic Psychiatry: A Primer for Psychiatrists.

    PubMed

    Freeman, Scott A

    2016-06-01

    Many mentally ill people are currently held in correctional settings, and general psychiatrists should be familiar with criminal forensic psychiatry in order to understand the legal aspects of the evaluation and treatment of these individuals, especially with regard to competency to stand trial and insanity. This educational activity briefly explains these evaluations and reviews relevant landmark legal cases. PMID:27337424

  7. Educational Supervision Appropriate for Psychiatry Trainee's Needs

    ERIC Educational Resources Information Center

    Rele, Kiran; Tarrant, C. Jane

    2010-01-01

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

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

    PubMed

    Verhoeven, W M; Tuinier, S

    1999-06-01

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

  9. [Malaise in psychiatry and its history].

    PubMed

    Chebili, S

    2016-04-01

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

  10. Personalized medicine in psychiatry: problems and promises

    PubMed Central

    2013-01-01

    The central theme of personalized medicine is the premise that an individual’s unique physiologic characteristics play a significant role in both disease vulnerability and in response to specific therapies. The major goals of personalized medicine are therefore to predict an individual’s susceptibility to developing an illness, achieve accurate diagnosis, and optimize the most efficient and favorable response to treatment. The goal of achieving personalized medicine in psychiatry is a laudable one, because its attainment should be associated with a marked reduction in morbidity and mortality. In this review, we summarize an illustrative selection of studies that are laying the foundation towards personalizing medicine in major depressive disorder, bipolar disorder, and schizophrenia. In addition, we present emerging applications that are likely to advance personalized medicine in psychiatry, with an emphasis on novel biomarkers and neuroimaging. PMID:23680237

  11. [On the cultural history of psychiatry].

    PubMed

    Schott, H

    2004-08-01

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

  12. A Prescription for "Deprescribing" in Psychiatry.

    PubMed

    Gupta, Swapnil; Cahill, John Daniel

    2016-08-01

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

  13. Indianization of psychiatry utilizing Indian mental concepts.

    PubMed

    Avasthi, Ajit; Kate, Natasha; Grover, Sandeep

    2013-01-01

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

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

    PubMed

    Demazeux, Steeves

    2016-12-01

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

  15. [On the cultural history of psychiatry].

    PubMed

    Schott, H

    2004-08-01

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

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

    PubMed

    Demazeux, Steeves

    2016-12-01

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

  17. The expert witness in forensic psychiatry.

    PubMed

    Chaplow, D G; Peters, J L; Kydd, R R

    1992-12-01

    Forensic psychiatry operates at the interface of the Justice and Health systems and has been defined as: "That branch of psychiatry which requires special knowledge and training in the law as it relates to the mental state of the offender, or alleged offender" [1]. As a consequence of working in this area, psychiatrists are often called into court to give evidence as "expert witnesses". This article examines some of the professional and legal issues involved in providing expert testimony. Secondly, it aims to outline some practical guidelines for giving evidence in the court-room. The predominant focus is on criminal, rather than civil, proceedings in which the forensic psychiatrist gives expert testimony; however much of the information is also relevant to other psychiatrists and psychologists undertaking this role in the legal arena.

  18. Indianization of psychiatry utilizing Indian mental concepts

    PubMed Central

    Avasthi, Ajit; Kate, Natasha; Grover, Sandeep

    2013-01-01

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

  19. The philosophies of psychiatry: empirical perspectives.

    PubMed

    Ralston, Alan S G

    2013-08-01

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

  20. [Malaise in psychiatry and its history].

    PubMed

    Chebili, S

    2016-04-01

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

  1. Psychiatry and Law: Past, Present and Future*

    PubMed Central

    Kamath, Ravindra M.

    2015-01-01

    It is important that every citizen knows the law of the state. Psychiatry and law both deal with human behaviour. This paper attempts to highlight the interplay between these two by discussing about various legislations like The Family Courts Act 1984, Narcotic Drugs and Psychotropic Substances Act 1985, Juvenile Justice Act 1986, Consumer Protection Act 1986, Persons with Disability Act 1995, The Maintenance and Welfare of Senior Citizens Act 2007. PMID:25838729

  2. Psychiatry and law: past, present and future.

    PubMed

    Kamath, Ravindra M

    2015-01-01

    It is important that every citizen knows the law of the state. Psychiatry and law both deal with human behaviour. This paper attempts to highlight the interplay between these two by discussing about various legislations like The Family Courts Act 1984, Narcotic Drugs and Psychotropic Substances Act 1985, Juvenile Justice Act 1986, Consumer Protection Act 1986, Persons with Disability Act 1995, The Maintenance and Welfare of Senior Citizens Act 2007.

  3. Jung's Contribution to Clinical Psychiatry 1

    PubMed Central

    Mackenzie, Murdo

    1935-01-01

    This attempt to correlate Jung's work with practical psychiatry is concerned mainly with his conception of clinical types. Jung went far away from the provinces of clinical medicine and psychiatry for his evidence, and the possible cause for this is discussed. He expands his view of introversion and extraversion, and so the suggestion is made that for practical purposes his early limitation of these terms should be maintained. The difficulties encountered in type description by comparison and contrast are emphasized. The value of his conception of basic functions is discussed and criticized. A review is made of the personalities he describes, and a simplification of his resulting classification suggested for practical purposes. The notion is put forward that Jung describes one type in psychological adaptation much better than any others, and it is hinted that his psycho-pathological description of this type in nerve disorder constitutes his main contribution to clinical psychiatry. A review of the treatable nerve disorders suggests that this disorder has received more adequate description from Jung than any other, and reveals a unique method of investigation and therapy. This does not apply to his other descriptions. Possibly some of the vagueness attributed to Jung is because he did not give this disorder an adequate diagnosis, and an explanation for this is offered. The correlation between the simplified classification and the classification of treatable nerve disorders is close, and it is suggested that this constitutes Jung's contribution to clinical psychiatry in general. The application of Jung's principles is of daily help to the practising psychiatrist. PMID:19990325

  4. Hope: a relevant concept for geriatric psychiatry.

    PubMed

    Farran, C J; Popovich, J M

    1990-04-01

    The focus in psychiatry has been on treating people for hopelessness, as opposed to understanding more about maintaining hope. This study reports findings from a study of hope conducted with community-based older adults. A general linear model procedure was used to more clearly understand the relationships among hope and other relevant variables. This model is used as a basis for proposing an intervention model for maintaining hope in older adults. PMID:2192691

  5. [Equine-assisted therapy in child psychiatry].

    PubMed

    Ansorge, Jessie; Sudres, Jean-Luc

    2011-01-01

    The use of a horse or pony as a therapeutic tool is often presented in the media as a recent phenomenon. A survey of 103 institutions shows that it is in fact an approach well rooted in child and adolescent psychiatry. However, professionals who use equine-assisted therapy are calling for an assessment to be carried out enabling them to hone their practices. PMID:22165335

  6. Setting up a Death Row Psychiatry Program.

    PubMed

    Yanofski, Jason

    2011-02-01

    Death row psychiatry contains a complex set of clinical, ethical, and legal questions. This Forensic Files column makes a case for correctional institutions starting death row programs to address these issues through uniform policies. A list of the relevant issues is provided. Specific issues discussed include death row psychiatric assessment, considering "justifiable" depression, treating for competency to be executed, and balancing boundaries between clinical and forensic work.

  7. Setting Up Private Practice in Psychiatry*

    PubMed Central

    De Sousa, Alan; De Sousa, Avinash

    2015-01-01

    Setting up a private practice in Mumbai is an onerous task. The present paper looks at the difficulties face by young psychiatrists when starting a private practice in psychiatry. It suggests certain guidelines to be followed to ensure the development of a successful practice. It also suggests methods to gain popularity among patients and society along with the ethics to be followed, knowledge base to be garnered, and the role of using multiple therapies and versatility in private practice. PMID:25838718

  8. Setting up a Death Row Psychiatry Program.

    PubMed

    Yanofski, Jason

    2011-02-01

    Death row psychiatry contains a complex set of clinical, ethical, and legal questions. This Forensic Files column makes a case for correctional institutions starting death row programs to address these issues through uniform policies. A list of the relevant issues is provided. Specific issues discussed include death row psychiatric assessment, considering "justifiable" depression, treating for competency to be executed, and balancing boundaries between clinical and forensic work. PMID:21468293

  9. [From Aboriginal psychological medicine to modern psychiatry in Peru].

    PubMed

    Ochoa-Torres, C

    1995-10-01

    It is traced a succinct development of the Peruvian Psychiatry beginning in the Ancient Peru (aborigen psychological medicine) with the pre-Inca and Inca periods. The most important sources of that epoch are the spanish chronicles and also the archeological and ethnological evidences. Then, it is presented the psychiatry evolution during the colonial and post-colonial time, and finally modern psychiatry in Peru.

  10. Evolutionary psychiatry: a new College special interest group

    PubMed Central

    Abed, Riadh; St John-Smith, Paul

    2016-01-01

    Evolutionary science remains an overlooked area in psychiatry and medicine. The newly established Royal College of Psychiatrists' Evolutionary Psychiatry Special Interest Group aims to reverse this trend by raising the profile of evolutionary thinking among College members and others further afield. Here we provide a brief outline of the importance of the evolutionary approach to both the theory and practice of psychiatry and for future research. PMID:27752339

  11. A frame of mind from psychiatry.

    PubMed

    Vintiadis, Elly

    2015-11-01

    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. PMID:25416523

  12. The third wave of biological psychiatry

    PubMed Central

    Walter, Henrik

    2013-01-01

    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. PMID:24046754

  13. Nutritional medicine as mainstream in psychiatry.

    PubMed

    Sarris, Jerome; Logan, Alan C; Akbaraly, Tasnime N; Amminger, G Paul; Balanzá-Martínez, Vicent; Freeman, Marlene P; Hibbeln, Joseph; Matsuoka, Yutaka; Mischoulon, David; Mizoue, Tetsuya; Nanri, Akiko; Nishi, Daisuke; Ramsey, Drew; Rucklidge, Julia J; Sanchez-Villegas, Almudena; Scholey, Andrew; Su, Kuan-Pin; Jacka, Felice N

    2015-03-01

    Psychiatry is at an important juncture, with the current pharmacologically focused model having achieved modest benefits in addressing the burden of poor mental health worldwide. Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a crucial factor in the high prevalence and incidence of mental disorders suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology. Evidence is steadily growing for the relation between dietary quality (and potential nutritional deficiencies) and mental health, and for the select use of nutrient-based supplements to address deficiencies, or as monotherapies or augmentation therapies. We present a viewpoint from an international collaboration of academics (members of the International Society for Nutritional Psychiatry Research), in which we provide a context and overview of the current evidence in this emerging field of research, and discuss the future direction. We advocate recognition of diet and nutrition as central determinants of both physical and mental health. PMID:26359904

  14. Computational Phenotyping in Psychiatry: A Worked Example

    PubMed Central

    2016-01-01

    Abstract Computational psychiatry is a rapidly emerging field that uses model-based quantities to infer the behavioral and neuronal abnormalities that underlie psychopathology. If successful, this approach promises key insights into (pathological) brain function as well as a more mechanistic and quantitative approach to psychiatric nosology—structuring therapeutic interventions and predicting response and relapse. The basic procedure in computational psychiatry is to build a computational model that formalizes a behavioral or neuronal process. Measured behavioral (or neuronal) responses are then used to infer the model parameters of a single subject or a group of subjects. Here, we provide an illustrative overview over this process, starting from the modeling of choice behavior in a specific task, simulating data, and then inverting that model to estimate group effects. Finally, we illustrate cross-validation to assess whether between-subject variables (e.g., diagnosis) can be recovered successfully. Our worked example uses a simple two-step maze task and a model of choice behavior based on (active) inference and Markov decision processes. The procedural steps and routines we illustrate are not restricted to a specific field of research or particular computational model but can, in principle, be applied in many domains of computational psychiatry. PMID:27517087

  15. In India, Psychiatry Has Come a Long Way*

    PubMed Central

    Parikh, Rajesh

    2015-01-01

    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. PMID:25838728

  16. Is Psychiatry Scientific? A Letter to a 21st Century Psychiatry Resident

    PubMed Central

    2013-01-01

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

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

    PubMed

    de Leon, Jose

    2013-09-01

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

  18. Initiatives in biological research in Indian psychiatry

    PubMed Central

    Shrivatava, Amresh

    2010-01-01

    Biological psychiatry is an exploratory science for mental health. These biological changes provide some explicit insight into the complex area of ‘brain-mind and behavior’. One major achievement of research in biological field is the finding to explain how biological factors cause changes in behavior. In India, we have a clear history of initiatives in research from a biological perspective, which goes back to 1958. In the last 61 years, this field has seen significant evolution, precision and effective utilization of contemporary technological advances. It is a matter of great pride to see that in spite of difficult times in terms of challenges of practice and services, administration, resource, funding and manpower the zest for research was very forthcoming. There was neither dedicated time nor any funding for conducting research. It came from the intellectual insight of our fore fathers in the field of mental health to gradually grow to the state of strategic education in research, training in research, international research collaborations and setting up of internationally accredited centers. During difficult economic conditions in the past, the hypothesis tested and conclusions derived have not been so important. It is more important how it was done, how it was made possible and how robust traditions were established. Almost an entire spectrum of biological research has been touched upon by Indian researchers. Some of these are electroconvulsive therapy, biological markers, neurocognition, neuroimaging, neuroendocrine, neurochemistry, electrophysiology and genetics. A lot has been published given the limited space in the Indian Journal of Psychiatry and other medical journals published in India. A large body of biological research conducted on Indian patients has also been published in International literature (which I prefer to call non-Indian journals). Newer research questions in biological psychiatry, keeping with trend of international standards are

  19. [Perspectives on researches in disaster psychiatry].

    PubMed

    Tomita, Hiroaki

    2014-01-01

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

  20. [Perspectives on researches in disaster psychiatry].

    PubMed

    Tomita, Hiroaki

    2014-01-01

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

  1. Initiatives in biological research in Indian psychiatry.

    PubMed

    Shrivatava, Amresh

    2010-01-01

    Biological psychiatry is an exploratory science for mental health. These biological changes provide some explicit insight into the complex area of 'brain-mind and behavior'. One major achievement of research in biological field is the finding to explain how biological factors cause changes in behavior. In India, we have a clear history of initiatives in research from a biological perspective, which goes back to 1958. In the last 61 years, this field has seen significant evolution, precision and effective utilization of contemporary technological advances. It is a matter of great pride to see that in spite of difficult times in terms of challenges of practice and services, administration, resource, funding and manpower the zest for research was very forthcoming. There was neither dedicated time nor any funding for conducting research. It came from the intellectual insight of our fore fathers in the field of mental health to gradually grow to the state of strategic education in research, training in research, international research collaborations and setting up of internationally accredited centers. During difficult economic conditions in the past, the hypothesis tested and conclusions derived have not been so important. It is more important how it was done, how it was made possible and how robust traditions were established. Almost an entire spectrum of biological research has been touched upon by Indian researchers. Some of these are electroconvulsive therapy, biological markers, neurocognition, neuroimaging, neuroendocrine, neurochemistry, electrophysiology and genetics. A lot has been published given the limited space in the Indian Journal of Psychiatry and other medical journals published in India. A large body of biological research conducted on Indian patients has also been published in International literature (which I prefer to call non-Indian journals). Newer research questions in biological psychiatry, keeping with trend of international standards are

  2. Teaching "Global Mental Health:" Psychiatry Residency Directors' Attitudes and Practices regarding International Opportunities for Psychiatry Residents

    ERIC Educational Resources Information Center

    Belkin, Gary S.; Yusim, Anna; Anbarasan, Deepti; Bernstein, Carol Ann

    2011-01-01

    Objective: The authors surveyed Psychiatry Residency Training Directors' (RTDs') attitudes about the role and feasibility of international rotations during residency training. Method: A 21-question survey was electronically distributed that explored RTDs' beliefs about the value, use, and availability of international clinical and research…

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

    ERIC Educational Resources Information Center

    Bostwick, J. Michael; Alexander, Cara

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  5. [Psychiatry with open doors. Part 1: Rational for an open door for acute psychiatry].

    PubMed

    Sollberger, D; Lang, U E

    2014-03-01

    Despite the reform efforts of the last decades modern acute psychiatry still stands between conflicting priorities in everyday practice. The protection of patient autonomy might conflict with a regulatory mandate of psychiatry in societal contexts and the necessity of coercive measures and involuntary treatment might become problematic with respect to presumed but contentious interests of the patient. The conflicts particularly concern questions of involuntary commitment, door closing, coercive and isolation measures. Research on the topic of therapeutic effectiveness of these practices is rare. Accordingly, the practice depends on the federal state, hospital and ward and is very heterogeneous. Epidemiological prognosis predicts an increase of psychiatric disorders; however, simultaneously in terms of medical ethics the warranty of patient autonomy, shared decision-making and informed consent in psychiatry become increasingly more important. This challenges structural and practical changes in psychiatry, particularly in situations of self and third party endangerment which are outlined and a rationale for an opening of the doors in acute psychiatric wards is provided. PMID:23538944

  6. A Neurosciences-in-Psychiatry Curriculum Project for Residents in Psychiatry

    ERIC Educational Resources Information Center

    Dunstone, David C.

    2010-01-01

    Objective: The author describes a 20-session, student-centered course relating contemporary neuroscience to psychiatry for second-year psychiatric residents. Methods: Twenty residents who took the course (2003-2007) completed pre- and postcourse surveys and were contacted for more remote follow-up regarding the course. Results: Survey results are…

  7. A Developmental Model for Enhancing Research Training during Psychiatry Residency

    ERIC Educational Resources Information Center

    Gilbert, Andrew R.; Tew, James D., Jr.; Reynolds, Charles F., III; Pincus, Harold A.; Ryan, Neal; Nash, Kenneth; Kupfer, David J.

    2006-01-01

    Objective: The authors describe a developmental model for enhancing residency research training for careers in academic psychiatry. Over the past 10 years, the University of Pittsburgh Department of Psychiatry has developed a research track (RT) for its residents. While the Department's plan has been to address the critical need of training…

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

    ERIC Educational Resources Information Center

    Buckley, Peter F.; Rayburn, William F.

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Dingle, Arden D.

    2010-01-01

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

  10. Society for Women in Academic Psychiatry: A Peer Mentoring Approach

    ERIC Educational Resources Information Center

    Seritan, Andreea L.; Bhangoo, Robinder; Garma, Sylvia; DuBe, Jane; Hales, Robert

    2007-01-01

    Objective: Despite an increasing presence of women in medicine, the percentage of women in academic psychiatry remains low. At the University of California, Davis, women represent two-thirds of psychiatry residents; however, the percentage of female faculty is one-third. This article presents a novel approach to the academic gender gap problem.…

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

    ERIC Educational Resources Information Center

    Balon, Richard; Heninger, George; Belitsky, Richard

    2006-01-01

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

  12. Psychiatry Morbidity and Mortality Rounds: Implementation and Impact

    ERIC Educational Resources Information Center

    Goldman, Stuart; Demaso, David R.; Kemler, Beth

    2009-01-01

    Objective: This study assessed the implementation of psychiatry morbidity and mortality rounds (M&Ms) on the clinical and educational practice in a children's hospital. Methods: Attendees to monthly M&Ms between July 2005 and May 2007 included staff and trainees from psychiatry, psychology, nursing, and social work. Cases were selected based on a…

  13. Characteristics of Combined Family Practice-Psychiatry Residency Programs

    ERIC Educational Resources Information Center

    Rachal, James; Lacy, Timothy J.; Warner, Christopher H.; Whelchel, Jennifer

    2005-01-01

    Objective: To evaluate how family practice-psychiatry residency programs meet the challenges of rigorous accreditation demands, clinical supervision, and boundaries of practice. Method: A 54-question survey of program directors of family practice-psychiatry residency programs outlining program demographic data, curricula, coordination, resident…

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

    ERIC Educational Resources Information Center

    Bhuvaneswar, Chaya; Stern, Theodore; Beresin, Eugene

    2009-01-01

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

  15. EPA guidance on improving the image of psychiatry.

    PubMed

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

    2016-03-01

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

  16. Therapeutic Uses of the WebCam in Child Psychiatry

    ERIC Educational Resources Information Center

    Chlebowski, Susan; Fremont, Wanda

    2011-01-01

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

  17. How Prepared Are Psychiatry Residents for Treating Nicotine Dependence?

    ERIC Educational Resources Information Center

    Prochaska, Judith J.; Fromont, Sebastien C.; Hall, Sharon M.

    2005-01-01

    Objective: Nicotine dependence is the most prevalent substance abuse disorder among adult psychiatric patients and a leading cause of death and disability. The authors examined the extent to which psychiatry residents are prepared to treat nicotine dependence in clinical practice. Methods: Residents from five psychiatry residency programs in…

  18. Screening for Psychopathology Symptoms in Mexican Psychiatry Residents

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  19. Cross-Cultural Issues in Forensic Psychiatry Training

    ERIC Educational Resources Information Center

    Layde, Joseph B.

    2004-01-01

    Objective: Forensic psychiatry was officially recognized as a subspecialty by the American Board of Medical Specialties in the 1990's. In 1994, the American Board of Psychiatry and Neurology (ABPN) gave its first written examination to certify forensic psychiatrists. In 1996, the Accreditation Council for Graduate Medical Education (ACGME) began…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  1. An Investigation of Psychiatry Residents' Important Experiences

    ERIC Educational Resources Information Center

    Long, Jody

    2011-01-01

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

  2. Evaluation of Professional Role Competency during Psychiatry Residency

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  3. Encompassing Sexual Medicine within Psychiatry: Pros and Cons

    ERIC Educational Resources Information Center

    Segraves, Robert Taylor

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Saperson, Karen

    2013-01-01

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

  5. The Recruitment Problem in Psychiatry: A Critical Commentary

    ERIC Educational Resources Information Center

    Stampfer, Hans

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Rait, Douglas Samuel

    2012-01-01

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

  7. Notes on a Few Issues in the Philosophy of Psychiatry*

    PubMed Central

    Singh, Ajai R.; Singh, Shakuntala A.

    2009-01-01

    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

  8. [The problem of truth in psychiatry].

    PubMed

    López-Ibor Aliño, J J

    2000-01-01

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

  9. Biomarkers and clinical staging in psychiatry

    PubMed Central

    McGorry, Patrick; Keshavan, Matcheri; Goldstone, Sherilyn; Amminger, Paul; Allott, Kelly; Berk, Michael; Lavoie, Suzie; Pantelis, Christos; Yung, Alison; Wood, Stephen; Hickie, Ian

    2014-01-01

    Personalized medicine is rapidly becoming a reality in today's physical medicine. However, as yet this is largely an aspirational goal in psychiatry, despite significant advances in our understanding of the biochemical, genetic and neurobiological processes underlying major mental disorders. Preventive medicine relies on the availability of predictive tools; in psychiatry we still largely lack these. Furthermore, our current diagnostic systems, with their focus on well-established, largely chronic illness, do not support a pre-emptive, let alone a preventive, approach, since it is during the early stages of a disorder that interventions have the potential to offer the greatest benefit. Here, we present a clinical staging model for severe mental disorders and discuss examples of biological markers that have already undergone some systematic evaluation and that could be integrated into such a framework. The advantage of this model is that it explicitly considers the evolution of psychopathology during the development of a mental illness and emphasizes that progression of illness is by no means inevitable, but can be altered by providing appropriate interventions that target individual modifiable risk and protective factors. The specific goals of therapeutic intervention are therefore broadened to include the prevention of illness onset or progression, and to minimize the risk of harm associated with more complex treatment regimens. The staging model also facilitates the integration of new data on the biological, social and environmental factors that influence mental illness into our clinical and diagnostic infrastructure, which will provide a major step forward in the development of a truly pre-emptive psychiatry. PMID:25273285

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

    PubMed

    Lalonde, Pierre

    2015-01-01

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

  11. The evolution of sport psychiatry, circa 2009.

    PubMed

    Glick, Ira D; Kamm, Ronald; Morse, Eric

    2009-01-01

    Over the past three decades, the world of both amateur and professional sports has expanded greatly and become more complex. In part related to these changes - and relatively unknown to sports medicine practitioners - the field of sport psychiatry has steadily evolved and grown. This paper focuses on what these changes have been. A sport psychiatrist is a physician-psychiatrist who diagnoses and treats problems, symptoms and/or disorders associated with an athlete, with their family/significant others, with their team, or with their sport, including spectators/fans. The primary aims of the specialty are to (i) optimize health, (ii) improve athletic performance, and (iii) manage psychiatric symptoms or disorders. The training includes medical training to provide knowledge and skills unique to physicians; psychiatric training to provide knowledge and skills inherent in that field, and training and/or experience in sport psychiatry to provide knowledge and skills about psychiatric aspects of sports. The sport psychiatrist first makes an individual, family-systems and phenomenological diagnosis of the clinical situation. Based on this evaluation, he sets goals for not only the athlete, but also for significant others involved. He delivers treatment based on the psychiatric disorder or problem using a combination of medication, psychotherapy or self-help group interventions plus strategies targeted to specific sport performance issues. Evolution of the International Society of Sport Psychiatry as well as the field, including incorporation into school and professional team sports, is described along with a 'typical day' for a sport psychiatrist. Case examples, a training curriculum and core literature are included.

  12. Transdisciplinary holistic integrative psychiatry - a wishfull thinking or reality?

    PubMed

    Jakovljević, Miro

    2008-09-01

    Modern psychiatry in the last century proposed several aggregative biopsychosocial models as an opposition to prevailing fragmentary, reductionistic and dogmatic approaches. Although the biopsychosocial approach has become the mainstream concept of the present-day psychiatry, it is not fruitful enough because it is excessively broad and provides no real complex field integration and guidance to clinicians and researchers. The postmodern psychiatry alternatives have been appeared as pluralism and integrationism. Holistic and integrative approach in medicine and psychiatry is built on the premise that human beings in health and disease are complex systems of dinamically interacting biological, psychological, social, energetic, informational and spiritual processes. Emerging as a transdisciplinary holistic, complementary and integrative psychiatry implies widely accepted general systems theory on psychopathology, novel integrating interpretative models, new integrative understanding of etiopathogenesis or meanings of symptoms, and novel integrative assessment and treatment approaches addressing those etiopathogenesis and meanings. PMID:18827761

  13. Contributions of genetic studies to clinical psychiatry.

    PubMed

    Abe, K; Oda, N

    1991-12-01

    Recent twin and family studies have demonstrated a genetic factor in Gilles de la Tourette syndrome, some cases of infantile autism, enuresis, specific reading disability, sleepwalking, night terrors, common fears and anxiety. Family studies have been used to elucidate the nosological relationship of psychiatric disorders; e.g. anorexia nervosa (to affective disorder), Gilles de la Tourette syndrome, and sleeptalking. Advances in biochemical genetics and in enzyme polymorphisms suggest that there are wide individual variations in the adverse effects of drugs and that dosage should be tailored to the individual patient. Recently molecular genetic methods have been introduced to psychiatry, but a major breakthrough in this field appears to be still years away.

  14. Ethical issues in child and adolescent psychiatry.

    PubMed Central

    Green, J; Stewart, A

    1987-01-01

    This paper concerns the special ethical problems in child and adolescent psychiatry which relate to the child as a developing being. Two themes are discussed--the sense of responsibility in the child, and the therapist's responsibility towards the child. As a background to understanding the former, ideas on moral and cognitive development are reviewed. The therapist's responsibility is discussed in relation to different styles of therapy and the ethical issues they raise. The article concludes with a number of suggested ethical principles. PMID:3572994

  15. Personal Computer Applications for Psychiatry and Psychology

    PubMed Central

    Green, Rex S.; Gastfriend, David R.; Kolodner, Robert M.; Fowler, Raymond D.

    1984-01-01

    Many different types of mental health computer applications are reviewed by this panel of experts. The availability of the applications software for personal computers is noted. An overview of the many application areas is followed by more specific comments covering psychopharmacology, psychiatry, and psychological testing. Rapid improvements in personal computer hardware are broadening the uses of these models. Most application programs can now be run on desk-top model equipment. Consequently, it is likely that future applications will be developed first for personal computers, then disseminated to other sizes of computers.

  16. Two-tier diagnosing in psychiatry.

    PubMed

    van Praag, H M

    1990-10-01

    This article addresses the question: what is the most productive way to systematize abnormal behavior in order to study its biological roots? Though nosology still occupies the premier position in biological psychiatry, it is, in and by itself, a treacherous beacon. Syndromal organization of psychopathology is likewise seriously flawed. A functional organization of psychopathology is considered the most appropriate framework for biological research and a plea is made for a two-tier diagnostic system of psychiatric disorders. Tier one comprises the nosological diagnosis, and tier two a detailed depiction of the component psychological dysfunctions. Such a two-tier diagnostic system would bring psychopathology onto a true scientific footing.

  17. Disease mongering in psychiatry: fact or fiction?

    PubMed

    Saddichha, S

    2010-01-01

    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. PMID:22049901

  18. The schizophrenogenic mother concept in American psychiatry.

    PubMed

    Hartwell, C E

    1996-01-01

    The development of the schizophrenogenic mother concept within American psychiatry has been something of an enigma. This interpersonal hypothesis of the etiology of schizophrenia involved a sharp break in the historical progression of understanding the disease. Though former promulgators have gone from calling the schizophrenogenic mother a "half truth" to a psychiatric "myth," this psychiatric concept remains a puzzle, still (Arieti 1997, p. 353; Neill 1990). The circumstances surrounding the development, flowering, and decline of the schizophrenogenic mother concept have not been fully explored. PMID:8912946

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

    PubMed

    Rhi, B Y

    1999-01-01

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

  20. Isaac Ray and the development of American psychiatry and the law.

    PubMed

    Quen, J M

    1983-12-01

    This article on historical aspects of forensic psychiatry focuses on the work of Isaac Ray, the father of American forensic psychiatry and places current issues in proper perspective. Dr. Quen, a leading forensic psychiatry historian, provides a comprehensive background to this symposium on psychiatry and the law.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  2. Psychiatry as ideology in the USSR.

    PubMed

    Bloch, S

    1978-09-01

    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. [Institutional therapy. Psychiatry and penitentiary problems. Introduction].

    PubMed

    Miéville, C

    1979-01-01

    The author relates the history of the institutional therapies which have been developed, mainly since 1929, by Hermann Simon. This avant-garde psychiatrist has not only developed the occupational therapies but he has also recommended both the liberalization of the institution and the constant analysis of its problems. The institutional therapies have the tendency, nowadays, to increase infinitely but their choice is not always logically motivated and their use risks being not very useful, if it is not determined by a clear therapeutic plan regarding the patient and by a well defined therapeutic attitude in the institution. The author introduces then the second subject of the discussion: "Psychiatry and penitentiary problems" by recalling the difficulties of the modern psychiatry to abandon its origins and to get rid of the asylum ghetto. This is probably the reason why most of the psychiatrists elude the psychological and psychiatric problems presented in prison and why they avoid every collaboration with the judicial and administrative authorities. Delicate situations, which call the psychiatrists into question by posing them problems of freedom, human rights, justice and social demands.

  4. Some origins of cross-cultural psychiatry.

    PubMed

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

    2005-06-01

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

  5. The place of culture in forensic psychiatry.

    PubMed

    Kirmayer, Laurence J; Rousseau, Cécile; Lashley, Myrna

    2007-01-01

    Members of a multicultural society must all be subject to the same equitable system of justice. However, culture exerts profound influences on human behavior, and cultural considerations have a place in determinations of capacity and in appropriate sentencing. Cultural psychiatry can contribute to forensic psychiatry by helping to contextualize individuals' actions and experiences. This contextualizing can be done through cultural consultations that employ interpreters and culture brokers to identify the role of culture in individuals' psychopathology. Clarifying how cultural background has affected individuals' capacity to form a criminal intent or control their behavior may allow a better determination of level of culpability and guide appropriate sentencing. However, framing behavior as culturally influenced may also stereotype and stigmatize specific groups. To avoid this, culture must be understood in terms of power relationships between minority groups and the dominant society. Cultural factors are not only relevant to the experience of specific groups but pervade the entire judicial system shaping the process of moral and legal reasoning.

  6. Placebo effects in psychiatry: mediators and moderators

    PubMed Central

    Weimer, Katja; Colloca, Luana; Enck, Paul

    2015-01-01

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

  7. What kind of science for psychiatry?

    PubMed Central

    Kirmayer, Laurence J.; Crafa, Daina

    2014-01-01

    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 biobehavioral 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. PMID:25071499

  8. The state of psychiatry in Spain.

    PubMed

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

    2012-08-01

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

  9. Psychiatry as ideology in the USSR.

    PubMed Central

    Bloch, S

    1978-01-01

    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. PMID:691016

  10. [Pharmacovigilance in child and adolescent psychiatry].

    PubMed

    Egberts, Karin; Karwautz, Andreas; Plener, Paul L; Mehler-Wex, Claudia; Kölch, Michael; Dang, Su-Yin; Taurines, Regina; Romanos, Marcel; Gerlach, Manfred

    2015-01-01

    Rational pharmacotherapy is a challenging task in child and adolescent psychiatry. Increasing prescription numbers contrast with the uncertainties of safety and efficacy issues. The lack of clinical (authorization) trials often implies a non- age-specific use of drugs. However, young patients show particular metabolic conditions and a higher vulnerability for adverse drug reactions. Thus it seems mandatory to create age-specific pharmacological data about efficacy and safety of psychotropic drug use in minors. Legislation authorities became aware of this situation and introduced European and national scientific pharmacovigilance regulations and programmes accordingly in order to continuously evaluate the benefit-risk-ratio, detect, collect, minimize, and prevent adverse effects of drugs by appropriate measures, e.g., therapeutic drug monitoring. In this paper the principles and needs of pharmacovigilance in child and adolescent psychiatry are discussed. Furthermore a large multicenter clinical trial («TDM-VIGIL»), funded by the German Federal Institute for Drugs and Medical Devices, is presented, which appeals to collect epidemiological prescription and safety data of psychotropic drugs in children and adolescents using an internet-based data infrastructure (patient registry).

  11. How to Teach Psychiatry to Medical Undergraduates in India?: A Model

    PubMed Central

    Manohari, S. M.; Johnson, Pradeep R.; Galgali, Ravindra Baburao

    2013-01-01

    Psychiatry is not considered important by most medical students. But knowledge of psychiatry is essential for all doctors as psychiatric problems are prevalent in the population either as part of other physical illnesses or independently. All medical practitioners need skills in communication and forming empathy and the ability to counsel that are learnt in psychiatry. Nearly all medical students feel psychiatry is not scientific enough and psychiatrists are peculiar. We need to make psychiatry interesting, and impart skills and techniques to practice psychiatry at the primary care level and in the process change the misconceptions students have of psychiatry. We present a model to accomplish this. PMID:23833338

  12. Forensic psychiatry fellowship training: developmental stages as an educational framework.

    PubMed

    Pinals, Debra A

    2005-01-01

    As an official subspecialty of psychiatry, forensic psychiatry residency training must meet the requirements established by the Accreditation Council of Graduate Medical Education. Attendant to these requirements is the expectation that graduates demonstrate core competencies in general areas common to all medical training programs but delineated for each specialty. In forensic psychiatry, trainees must learn to move from the role of healer to objective evaluator on behalf of third parties, a task that differs from general medical care and treatment. Thus, it is important for educators to maintain awareness of the experience of trainees as they adapt to forensic psychiatry, while understanding core competency requirements. This article outlines stages of development of forensic psychiatry fellows as a model for characterizing learning objectives and for supervising trainees in forensic psychiatry fellowship programs. These stages of development include (1) transformation, (2) growth of confidence and adaptation, and (3) identification and realization. Training directors and trainees can utilize this theoretical framework as a basis on which to establish parameters for core competency attainment and supervisory and assessment methods for forensic psychiatry training.

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

    PubMed

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

    2011-11-01

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

  14. Assessing the relation between career satisfaction in psychiatry with lifelong learning and scientific activity.

    PubMed

    Afonso, Pedro; Ramos, Maria Rosário; Saraiva, Sérgio; Moreira, Cátia Alves; Figueira, Maria Luísa

    2014-07-30

    Lifelong learning (LLL) is an essential feature for the doctor to keep clinically updated and has been described as an indicator of competence and professionalism. The aim of this study was to evaluate the association between career satisfaction in psychiatry, lifelong learning, and commitment in scientific activities, taking into account other personal and professional effects. The survey was sent to 453 national psychiatrists and 190 surveys (41.9%) were completed online and validated. The Jefferson Scale of Physician Lifelong Learning (JSPLL) was used to assess the level of LLL for each doctor. The results of the analysis of JSPLL showed that participants more satisfied with their career have greater motivation and invest more in the LLL. Furthermore, participants who were more satisfied with their career had a higher percentage of scientific activity in the last year. Multiple linear regression with these two effects in the model revealed a positive association between career satisfaction in psychiatry, LLL and the publication of scientific papers, leading to the main conclusion that satisfaction with a career in psychiatry has a significant correlation with LLL and with involvement in scientific activities.

  15. Child and Adolescent Psychiatry Training: A Global Perspective.

    PubMed

    Mian, Ayesha I; Milavić, Gordana; Skokauskas, Norbert

    2015-10-01

    Training programs aim to produce child and adolescent psychiatry professionals who are competent at both clinical work as well as health promotion through teaching and research. Child psychiatry training programs not only offer training in teaching the clinical skills of the discipline of child and adolescent psychiatry but also strive to help with the development of professionalism, ethical behaviors, and leadership skills in their trainees. Ultimately, it is the children of the world who stand to gain by having a skilled work force that adheres to the highest global standards when it comes to the provision of mental health services.

  16. [The making of madness: counterculture and anti-psychiatry].

    PubMed

    Oliveira, William Vaz de

    2011-03-01

    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.

  17. The development of child psychiatry in 19th century Britain.

    PubMed

    von Gontard, A

    1988-09-01

    Child psychiatry was established as a separate discipline in the 1930s. The paper analyses and describes the early development of child psychiatry in Britain, with particular reference to the contributions of the medical profession. Major influences came from general psychiatry. Children were at first treated in adult asylums; the first concepts of childhood insanity were formed around 1800, with moral insanity becoming the most common diagnosis. From 1850 onwards other major contributions came from paediatrics and the care of the mentally retarded. These developments were part of wider socio-economic changes in childhood.

  18. Alan Stone and the ethics of forensic psychiatry: an overview.

    PubMed

    Miller, Glenn H

    2008-01-01

    In 1982, Alan Stone presented a keynote speech at the Annual Meeting of the American Academy of Psychiatry and the Law (AAPL) on the ethics of forensic psychiatry. That speech was sharply critical of the prevailing ethics standards and led forensic psychiatrists to study his ideas carefully. A quarter-century later, he returned to the AAPL's Annual Meeting to present his current thinking. This overview outlines the development of Stone's thought over 25 years and the dialectic among Stone and three critics: Paul Appelbaum, Ezra Griffith, and Stephen Morse. Stone is now more optimistic about the possibility of developing an ethic for forensic psychiatry.

  19. A war over mental health professionalism: Scientology versus psychiatry

    PubMed Central

    Kent, Stephen A.; Manca, Terra A.

    2012-01-01

    Over 60 years ago, founder L. Ron Hubbard began what has become Scientology's greatest battle. Scientology emerged from Dianetics, which Hubbard hoped would replace the psychiatric profession. In this article, we discuss how Scientology attempted to position itself as a rival profession to psychiatry and the consequences of those attempts. Scientology's battle with psychiatry gained some success from the social conditions during which it emerged, but it continues in a time that has seen increasing success with various psychiatric treatments. As such, Scientology's direct influence on the psychiatric profession may be difficult to measure, but its actions have coincided with substantial challenges to psychiatry. PMID:24348087

  20. A survey of state financing of psychiatry residency programs.

    PubMed

    Magen, J G; Banazak, D A; Dahn, J

    1998-09-01

    With upcoming cuts in graduate medical education funding, it is likely that many psychiatry residencies will be searching for new sources of revenue. State funding of residency programs is one possible avenue. The authors surveyed all Accreditation Council for Graduate Medical Education-accredited psychiatry residency programs to assess the present dimensions of state funding. Some programs in both publicly funded and private settings receive large proportions of their budgets from the state. Service commitments are common. State support of psychiatry residency education is currently an important source of funding and could become even more important in the near future. PMID:24442943

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

    PubMed

    Conti, Norberto A

    2010-01-01

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

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

    PubMed

    Conti, Norberto A

    2010-01-01

    In this work, the proposal of evidence based psychiatry (EBP) is presented together with a critical reflection about its paradigmatic perspective, taking into account Thomas S. Khun's epistemological lineaments. It is also shown how blurring of language in its approximation to the human behavioral disorders is EBP point of major inconsistency, as demonstrates a marked epistemological reductionism. Finally, consequences of its restrictive employment both to psychiatrists teaching and to the treatments they provide to their patients are also discussed. PMID:21218210

  3. From local to global – Contributions of Indian psychiatry to international psychiatry

    PubMed Central

    Murthy, R. Srinivasa

    2010-01-01

    Indian psychiatrists have actively engaged with world psychiatry by contributing to understanding and care of persons with mental disorders based on the religious, cultural and social aspects of Indian life. The contributions are significant in the areas of outlining the scope of mental health, classification of mental disorders, understanding the course of mental disorders, psychotherapy, traditional methods of care, role of family in mental health care and care of the mentally ill in the community settings. PMID:21836699

  4. Scales

    MedlinePlus

    Scales are a visible peeling or flaking of outer skin layers. These layers are called the stratum ... Scales may be caused by dry skin, certain inflammatory skin conditions, or infections. Eczema , ringworm , and psoriasis ...

  5. Reasons for choosing to specialise in psychiatry: differences between core psychiatry trainees and consultant psychiatrists

    PubMed Central

    Denman, Melissa; Oyebode, Femi; Greening, Jayne

    2016-01-01

    Aims and method This questionnaire study aimed to investigate the reasons for choosing to specialise in psychiatry in a sample of consultant psychiatrists and core trainee psychiatrists from within the West Midlands. Results Five reasons were significantly different between the core trainees and consultant psychiatrists. ‘Emphasis on the patient as a whole’ was identified as the most important reason for choosing to specialise for both core trainees and consultants. Six additional reasons were shared within the top ten ‘very important’ reasons, although their actual ranking varies. Clinical implications Some of the reasons for choosing to specialise in psychiatry were shown to significantly differ between core trainees and consultants. Numerous key driving factors have remained important over time for both groups, whereas other reasons have been replaced with a shift of importance towards lifestyle and humanitarian factors for core trainees. Consequently, it may be advisable not to use the reasons that consultants gave for choosing psychiatry when thinking about how to attract today's prospective psychiatrists. PMID:26958354

  6. Use of Telepsychiatry in Psychodynamic Psychiatry.

    PubMed

    Saeed, Sy Atezaz; Anand, Vivek

    2015-12-01

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

  7. Biological clocks and the practice of psychiatry

    PubMed Central

    Schulz, Pierre

    2007-01-01

    Endogenous biological clocks enable living species to acquire some independence in relation to time. They improve the efficiency of biological systems, by allowing them to anticipate future constraints on major physyological systems and cell energy metabolism. The temporal organization of a giwen biological function can be impaired in its coordination with astronomical time or with other biological function. There are also external conditions that influence biological clocks. This temporal organization is complex, and it is possible that a series of psychiatric disorders and syndromes involve primary or secondary changes in biological clocks: seasonal and other mood disorders, premenstrual syndromes, social jet lag, free-running rhythms, and several sleep disorders are among them. In this review, we describe the main concepts relevant to chronobiology and explore the relevance of knowledge about biological clocks to the clinical practice of psychiatry PMID:17969862

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

    PubMed

    Chamorro, Jorge

    2006-01-01

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

  9. Homicide and community-based psychiatry.

    PubMed

    Grunberg, F; Klinger, B I; Grumet, B R

    1978-12-01

    The authors studied the records of all persons convicted of homicide or found not guilty by reason of insanity during the uears 1963 through 1975, 6 years before and after the opening of the community-based psychiatric facility, in Albany County, New York. Using the Fisher Exact Probability Test, a statistically significant increase was found for those found not guilty by reason of insanity (p = .041) and those with a history of mental illness found guilty (p = .036). Other factors, including age of the perpetrator, use of alcohol, and relationship to the victim, were also examined. The authors caution against sweeping indictments of community-based psychiatry and urge that the study be repeated elsewhere.

  10. Descartes' dogma and damage to Western psychiatry.

    PubMed

    Ventriglio, A; Bhugra, D

    2015-10-01

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

  11. [Research and Post-graduate in Psychiatry].

    PubMed

    Carlos, A Palacio A

    2012-01-01

    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.

  12. Limitations of the biopsychosocial model in psychiatry

    PubMed Central

    Benning, Tony B

    2015-01-01

    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. PMID:25999775

  13. Psychiatry and society: a sociobiologic synthesis.

    PubMed

    Eisenberg, L

    1977-04-21

    The very legitimacy of psychiatry as a medical speciality has been challenged by social-labelling theory: the hypothesis that psychiatric disorders are artifacts that result from assigning diagnostic labels to minor deviations in behavior and thus generating expectations that condemn the person to a career of patienthood. Close examination of the evidence demonstrats that, through improper care care retard recovery, psychiatric illness exists before the name assigned to it, and independently of theories about its genesis. In this respect, psychiatric illness does not differ from other medical problems. All human diseases reflect the outcome of an interaction between biology and social organization, with culture in a mediating role. Whatever the proximate cause of disease -- viral, genetic, metabolic or neoplastic -- the way in which society is organized affects prevalence, cause and outcome. The physician's task is to intervene to minimize distress and preserve adaptive capacity, when cure is not possible. PMID:846511

  14. Psychiatry, religion, positive emotions and spirituality.

    PubMed

    Vaillant, George E

    2013-12-01

    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.

  15. [The cultural psychiatry in Latin America].

    PubMed

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

    2014-01-01

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

  16. [Research and Post-graduate in Psychiatry].

    PubMed

    Carlos, A Palacio A

    2012-01-01

    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. PMID:26572565

  17. FORENSIC PSYCHIATRY IN INDIA CURRENT STATUS AND FUTURE DEVELOPMENT

    PubMed Central

    Shah, L.P.

    1999-01-01

    Forensic psychiatry is a developing superspeciality in India and other SAARC countries. After a brief historical review, the paper describes the current status of forensic psychiatry in India and compares it with the development in this field in Europe and America. It takes the stock of current scenario in three different areas viz., i) legal and clinical ii) teaching and training and Hi) research. It deliberates on need for teaching this subject at the undergraduate and the postgraduate medical and legal courses and necessity of full time consultants devoted to the practice of forensic psychiatry. It focuses on the recent developments in the field of forensic psychiatry like enactment of Narcotic and Psychotropic Substance Act (1985), Mental Health Act (1987), Juvenile Justice Act (1989), Act for the Disabled (1994) and the Consumer Protection Act (1986). The paper also recommends some strategies for teaching, training, research and future developments in this field. PMID:21455388

  18. [The Research Domain Criteria (Rdoc), reductionism and clinical psychiatry].

    PubMed

    Faucher, Luc; Goyer, Simon

    2016-12-01

    The focus of the advocates of the Research Domain Critria (RDoC) on faulty brain circuits has led some to suspect it of being a reductionist enterprise. And because RDoC will eventually impact clinical psychiatry, some have feared that it will transform clinical psychiatry in a mindless and applied neurobehavioral science. We argue that if RDoC is officially endorsing a kind of reductionism, the particular kind of reductionism it endorses is not suffering from the shortcomings of more classical forms of reductionism. Because of that, at least in principle, RDoC could enrich rather than impoverish clinical psychiatry. This paper raises few potential problems of the RDoC for clinical psychiatry caused by its implicit epistemological reductionism. PMID:27550461

  19. Editorial cognition, neurology, psychiatry: golden triangle or bermuda triangle?

    PubMed

    Baddeley, A D

    1996-08-01

    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.

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

    PubMed

    Giberti, F; Corsini, G; Rovida, S

    1994-06-01

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

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

    PubMed

    Giberti, F; Corsini, G; Rovida, S

    1994-06-01

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

  2. [Recent psychiatric classification systems and their significance for forensic psychiatry].

    PubMed

    Hoff, P

    1992-05-01

    The influence of operationalized diagnostic systems is growing steadily in general and forensic psychiatry. This article discusses the historical context and the advantages and problems that may occur in the application of the new diagnostic systems. It is of special importance that the improvement of communication and reliability within psychiatry does not lead to an uncritical or even dogmatical understanding of the new diagnostic categories.

  3. Public opinion of forensic psychiatry following the Hinckley verdict.

    PubMed

    Slater, D; Hans, V P

    1984-05-01

    The authors obtained opinions of forensic psychiatry in a community survey following the not guilty by reason of insanity verdict in the Hinckley trial. A majority of respondents expressed little or no confidence in the specific psychiatric testimony in the Hinckley trial and only modest faith in the general ability of psychiatrists to determine legal insanity. Respondents' general and specific attitudes were strongly related. Younger people and women were more positive in their views of psychiatry in the courtroom.

  4. [Use of informatics technology in psychiatry].

    PubMed

    Margariti, M; Papadimitriou, G N

    2012-01-01

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

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

    PubMed

    Finzen, Asmus

    2015-10-01

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

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

    PubMed

    Finzen, Asmus

    2015-10-01

    Forty years ago an expert-commission submitted a report on the deplorable state of German psychiatric care, called the "Psychiatrie-Enquete" to the Bundestag, the German parliament. The Report initiated a substantial change of Psychiatric services in the country. Inhuman treatment and living conditions were superseded. Mental hospitals were not completely abolished. But they lost their importance in favour of decentralized psychiatric services including departments at general hospitals, day hospitals and outpatient services. Custodial care was largely successfully developed into therapeutic and rehabilitative care. This article attempts a mildly critical evaluation of the Enquête 40 years after. PMID:25942076

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

    PubMed

    Healey, Dan

    2014-01-01

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

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

    PubMed

    Healey, Dan

    2014-01-01

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

  9. Contested Boundaries: psychiatry, disease, and diagnosis.

    PubMed

    Rosenberg, Charles E

    2015-01-01

    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. PMID:26657686

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

    PubMed

    Pajonk, F-G B

    2015-09-01

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

  11. The state of psychiatry in Sweden.

    PubMed

    Hadlaczky, Gergö; Stefenson, Anne; Wasserman, Danuta

    2012-08-01

    The number of practising psychiatrists in Sweden has increased by nearly 30% between the years 1995-2009; however, the profession has suffered serious recruitment difficulties. The Swedish National Board of Health and Welfare estimated that about 5-10% of the population is in need of psychiatric treatment, but only 3-4% seek psychiatric care. Among patients who receive psychiatric care, approximately 47% are treated with psychopharmacology, 13% are treated with psychotherapy and 40% receive both treatments. There are still challenges facing Swedish psychiatry: reduction in waiting times for psychiatric care, broader accessibility of evidence-based treatment methods for all groups of psychiatric patients both in rural and urban areas, and targeting the needs of immigrants and refugees. The allocation of resources to psychiatric research, and development of novel treatment methods are crucially needed. The Swedish government is strongly committed to decreasing the number of suicides, as there are approximately 1,400 individuals lost to suicide every year in a country with a population of around 10 million. Given that nearly 20% of all suicides are amongst psychiatric inpatients, a regulation has been passed regarding the analysis of all completed suicides in the healthcare system. Results from these analyses can be used for increasing quality of treatment.

  12. [Inclusion - pediatric and adolescent psychiatry aspects].

    PubMed

    Warnke, Andreas

    2015-07-01

    The Convention on the Rights of Persons with Disabilities became legally binding in Germany in March 2009. “Inclusion” is the major concept–all people with any kind of handicap must have the same rights to full and effective participation and inclusion in society. Preceding inclusion come adjustments in society with regard to ethical, legislative, administrative, conceptual, structural, economical, and thus also to healthcare-political frameworks, in order to make disabilities are as far as possible no longer a handicap in an individual’s everyday life. This review first outlines the present social status influencing the development of children, a child’s welfare, and especially the healthcare of children and adolescents with psychiatric disorders and conditions indicating barriers to inclusion. It focuses on those articles of the UN convention which are relevant with regard to ethical attitude, epidemiology, healthcare framework, diagnostics, therapy, teaching, and research with respect to child and adolescent psychiatry. The analysis points to a significant backlog demand in child psychiatric healthcare, teaching, and research.

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

    PubMed

    Oldani, Michael

    2014-06-01

    Psychiatric medication, or psychotropics, are increasingly prescribed for people of all ages by both psychiatry and primary care doctors for a multitude of mental health and/or behavioral disorders, creating a sharp rise in polypharmacy (i.e., multiple medications). This paper explores the clinical reality of modern psychotropy at the level of the prescribing doctor and clinical exchanges with patients. Part I, Geographies of High Prescribing, documents the types of factors (pharmaceutical-promotional, historical, cultural, etc.) that can shape specific psychotropic landscapes. Ethnographic attention is focused on high prescribing in Japan in the 1990s and more recently in the Upper Peninsula of Michigan, in the US. These examples help to identify factors that have converged over time to produce specific kinds of branded psychotropic profiles in specific locales. Part II, Pharmaceutical Detox, explores a new kind of clinical work being carried out by pharmaceutically conscious doctors, which reduces the number of medications being prescribed to patients while re-diagnosing their mental illnesses. A high-prescribing psychiatrist in southeast Wisconsin is highlighted to illustrate a kind of med-checking taking place at the level of individual patients. These various examples and cases call for a renewed emphasis by anthropology to critically examine the "total efficacies" of modern pharmaceuticals and to continue to disaggregate mental illness categories in the Boasian tradition. This type of detox will require a holistic approach, incorporating emergent fields such as neuroanthropology and other kinds of creative collaborations. PMID:24700144

  14. Cultural psychiatry: research strategies and future directions.

    PubMed

    Kirmayer, Laurence J; Ban, Lauren

    2013-01-01

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

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

    PubMed

    Oldani, Michael

    2014-06-01

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

  16. Contested boundaries: psychiatry, disease, and diagnosis.

    PubMed

    Rosenberg, Charles E

    2006-01-01

    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.

  17. The DSM-5 and forensic psychiatry.

    PubMed

    Wortzel, Hal S

    2013-05-01

    In his first Law and Psychiatry column for the Journal of Psychiatric Practice, the author discusses potential forensic consequences of the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). While the transition to DSM-5 may prove challenging for both patients and clinicians, the scrutiny and adversarial process associated with forensic psychiatric practice will entail a unique set of challenges. The philosophy of innovation behind the DSM-5, and the attendant changes, could lead to some unintended consequences, particularly in medicolegal settings. This column highlights some of the major changes in DSM-5 and explores points of particular concern for forensic psychiatric practice, such as the move toward a non-multiaxial diagnostic system and dimensional severity ratings being superimposed on certain categorical diagnoses. The innovative changes featured in DSM-5, and the controversies surrounding some of them, could yield an environment of increased cynicism in courts of law, with renewed skepticism regarding mental health diagnoses and the forensic psychiatrists who testify about them. Fortunately, the best method for forensic psychiatric practice in this environment of change is to continue to adhere to a meticulous and transparent medicolegal process, with recognition that changes in the diagnostic manual will seldom alter essential medicolegal conclusions. Forensic psychiatrists may enhance their credibility and the strength of the opinions they offer by proactively illustrating how nuances in diagnosis do not change legally defined constructs such as insanity or incompetence.

  18. Current clinical research environment: focus on psychiatry.

    PubMed

    Dainesi, Sonia Mansoldo; Elkis, Helio

    2007-09-01

    The introduction of international guidelines on Good Clinical Practices (GCP) in 1996, immediately followed by the publication of Resolution CNS 196/96 in Brazil, created a great opportunity for Brazilian research centers to participate in international trials. Such studies must be strictly monitored in order to assure compliance with the regulations, as well as with the standards of patient safety. Clear agreement among the investigator, the sponsor and the institution carrying out the study must be previously defined in order to avoid any conflicts of interest during or after the study. Operational aspects, such as the time needed to gain regulatory approval of the study design, strategies for patient recruitment/retention and appropriate logistics, are also important. In 2005, the Brazilian National Clinical Research Network was established, bringing together a number of research centers in teaching hospitals. The objective was to subsidize public clinical research with state-of-the-art practices and appropriate technical/scientific training programs. The development of research protocols that prioritize public health care needs in Brazil is other fundamental goal of this network. This article addresses general aspects of clinical research, as well as some specific issues in psychiatry. Improving the health and quality of life of the global population is certainly the major objective of all of the work done in this area.

  19. A theory of ethics for forensic psychiatry.

    PubMed

    Appelbaum, P S

    1997-01-01

    This article offers a justification for a set of principles that constitute the ethical underpinnings of forensic psychiatry. Like professional ethics in general, the principles are based on the particular societal functions performed by forensic psychiatrists and result in the intensification of obligations to promote certain important moral values. For forensic psychiatrists, the primary value of their work is to advance the interests of justice. The two principles on which that effort rests are truth-telling and respect for persons. In the same manner as other physicians who perform functions outside of the usual clinical context (e.g., clinical researchers), forensic psychiatrists cannot simply rely on general medical ethics, embedded as they are in the doctor-patient relationship--which is absent in the forensic setting. Indeed, efforts to retain some residuum of that relationship and its associated ethical principles are likely to create confusion in the minds of both forensic psychiatrists and their evaluees and to heighten the problems of double agency. A virtue of this approach is the clear distinction it offers between clinical and forensic roles. PMID:9323651

  20. Specialist training in psychiatry in Europe--results of the UEMS-survey.

    PubMed

    Lotz-Rambaldi, Winfried; Schäfer, Ines; ten Doesschate, Roelof; Hohagen, Fritz

    2008-04-01

    According to the aim of the Treaty of Rome from 1957 which postulated the free movement of workers throughout the European Union, the European Board of Psychiatry in the UEMS (European Union of Medical Specialists) carried out a comprehensive survey of training in psychiatry, including all member countries in order to evaluate the present state of training in psychiatry in each. The survey should indicate whether the training requirements [UEMS Section Psychiatry. Charter on training of medical specialists in the EU: requirements for the speciality psychiatry. European Archives of Psychiatry and Clinical Neuroscience 1997;247(Suppl.):S45-7; UEMS Section Psychiatry. Charter on training of medical specialists in the EU: requirements for the speciality psychiatry. ; 2003 [last revision

  1. Cyclical swings: The bête noire of psychiatry.

    PubMed

    Decker, Hannah S

    2016-02-01

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

  2. Centenary of Karl Jaspers's general psychopathology: implications for molecular psychiatry.

    PubMed

    Thome, Johannes

    2014-01-01

    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. PMID:25408913

  3. What is psychiatry? Co-producing complexity in mental health

    PubMed Central

    Pickersgill, Martyn

    2012-01-01

    What is psychiatry? Such a question is increasingly important to engage with in light of the development of new diagnostic frameworks that have wide-ranging and international clinical and societal implications. I suggest in this reflective essay that ‘psychiatry' is not a singular entity that enjoins consistent forms of critique along familiar axes; rather, it is a heterogeneous assemblage of interacting material and symbolic elements (some of which endure, and some of which are subject to innovation). In underscoring the diversity of psychiatry, I seek to move towards further sociological purchase on what remains a contested and influential set of discourses and practices. This approach foregrounds the relationships between scientific knowledge, biomedical institutions, social action and subjective experience; these articulations co-produce both psychiatry and each other. One corollary of this emphasis on multiplicity and incoherence within psychiatric theory, research and practice, is that critiques which elide this complexity are rendered problematic. Engagements with psychiatry are, I argue, best furthered by recognising its multifaceted nature. PMID:23226975

  4. [Irrationality in psychiatry. I. Irrationality in analytical psychology].

    PubMed

    Vacek, J

    1991-02-01

    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. PMID:1913937

  5. Centenary of Karl Jaspers's general psychopathology: implications for molecular psychiatry.

    PubMed

    Thome, Johannes

    2014-01-01

    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.

  6. Scale

    ERIC Educational Resources Information Center

    Schaffhauser, Dian

    2009-01-01

    The common approach to scaling, according to Christopher Dede, a professor of learning technologies at the Harvard Graduate School of Education, is to jump in and say, "Let's go out and find more money, recruit more participants, hire more people. Let's just keep doing the same thing, bigger and bigger." That, he observes, "tends to fail, and fail…

  7. Psychiatry of Intellectual and Developmental Disability in the US: Time for a New Beginning

    PubMed Central

    Munir, Kerim M

    2009-01-01

    Although psychiatry in the United States owes its origins to the treatment of persons with intellectual disabilities (ID), over the past 50 years, clinical services, education of professionals and research in psychiatry of ID have consistently lagged behind other fields in psychiatry. The historical and contemporary reasons for this development are discussed with recommendations for establishment of a fully credentialed subspecialty of Psychiatry of Intellectual and Developmental Disabilities in the United States. PMID:20161399

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

    PubMed

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

    2016-01-01

    Purpose. To identify stroke survivors with symptoms of poststroke depression and the extent of psychiatry needs and care they have received while on physiotherapy rehabilitation. Participants. Fifty stroke survivors (22 females and 28 males) at the outpatient unit of Physiotherapy Department, University of Nigeria Teaching Hospital, Enugu, who gave their informed consent, were randomly selected. Their age range and mean age were 26-66 years and 54.76 ± 8.79 years, respectively. Method. A multiple case study of 50 stroke survivors for symptoms of poststroke depression was done with Beck's Depression Inventory, mini mental status examination tool, and Modified Motor Assessment Scale. The tests were performed independently by the participants except otherwise stated and scored on a scale of 0-6. Data were analyzed using Z-test for proportional significance and chi-square test for determining relationship between variables, at p < 0.05. Results. Twenty-one (42.0%) stroke survivors had symptoms of PSD, which was significantly dependent on duration of stroke (χ (2) = 21.680, df = 6, and p = 0.001), yet none of the participants had a psychiatry review. Conclusions. Symptoms of PSD may be common in cold compared to new cases of stroke and may need psychiatry care while on physiotherapy rehabilitation. PMID:27190683

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

    PubMed

    Rhi, B Y

    1999-01-01

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

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

    ERIC Educational Resources Information Center

    Burgut, F. Tuna; Polan, H. Jonathan

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  16. The Importance of Statistics in Psychiatry

    PubMed Central

    Penrose, L. S.

    1947-01-01

    The paper gives an outline, with examples, of various statistical methods which may be of special use in psychiatry. (1) Actuarial data.—The simple accumulation of accurate figures on the ages of patients, their diagnoses and length of stay in hospital or under treatment for mental illness is of great value in understanding the scope of psychiatric problems. The age and sex incidences which correspond to different disease groups are very characteristic. Such material has value in the estimation of the results of therapeutic experiments but special methods have to be devised, as there is no exact prototype in standard vital statistics or in work on therapeutic trials. (2) Biometric techniques.—Knowledge of ordinary statistical practice guards against elementary errors and aids in establishing significance or otherwise of metrical deviations from the normal found in mentally ill subjects. Also the range of variations may be much more marked in abnormal than in normal groups. Furthermore, abnormal reactions in themselves may be characterized by either too much or too little variety, i.e. by scatter or by stereotypy. Discrimination between normal and abnormal reaction can be based on a single quantitative measurement, on difference in variance or on a compound measurement, i.e. pattern or profile. The discriminative approach has advantages over other methods because in this approach the initial factors are concrete and based on known classes such as males and females, children and adults, special clinical types, &c. (3) Genetical analysis.—Actuarial data can be useful in genetic studies by leading to estimation of population frequency of genes and consanguinity rates. Moreover, combined clinical and genetical observations can reveal the existence of new clinical entities. PMID:18919283

  17. [Integrative concepts in modern forensic psychiatry].

    PubMed

    Dittmann, V

    1996-03-01

    Forensic psychiatric diagnosis and treatment should be guided by juridical goals and never be an end in itself. As a whole it is a public service concerning the interests of the perpetrators and the security of the entire population as well. Recent progress in forensic psychiatry is based on integral and comprehensive concepts. In the evaluation of criminal responsibility the new approaches of psychiatric diagnosis like operationalism, application of quantificating instruments and multiaxial diagnostic systems are of considerable importance. The ICD-10 classification of WHO can now be regarded as our reference system. To be acceptable for juridical purposes the evaluation of criminal responsibility has to be based on a systematical analysis of all important factors like actual situation of crime, environment, influence of psychotropic substances, psychosocial stressors, influences of biography and mental disorders. Assessment of prognosis is obligatory by law in many cases. These are juridical decisions, which have to be prepared by the psychiatric experts in the form of risk evaluations considering factors like development of delinquency, analysis of crime, kind of mental disturbance, insight of the perpetrator in his disorder, social competence, selfexamination of the perpetrator of his crime, possible therapies and social circumstances after discharge. Only an integral multiprofessional approach can be regarded as successful in the therapy of forensic high risk patients with paraphilas and aggressive impulse-control disorders. In Switzerland there is still a considerable lack of appropriate institutions for these patients. The vast amount of data accumulated during forensic psychiatric routine should be analysed in multicenter studies with scientific documentation systems to achieve progress in forensic risk calculation and efficiency of therapies.

  18. The importance of statistics in psychiatry.

    PubMed

    PENROSE, L S

    1947-12-01

    The paper gives an outline, with examples, of various statistical methods which may be of special use in psychiatry.(1) Actuarial data.-The simple accumulation of accurate figures on the ages of patients, their diagnoses and length of stay in hospital or under treatment for mental illness is of great value in understanding the scope of psychiatric problems. The age and sex incidences which correspond to different disease groups are very characteristic. Such material has value in the estimation of the results of therapeutic experiments but special methods have to be devised, as there is no exact prototype in standard vital statistics or in work on therapeutic trials.(2) Biometric techniques.-Knowledge of ordinary statistical practice guards against elementary errors and aids in establishing significance or otherwise of metrical deviations from the normal found in mentally ill subjects. Also the range of variations may be much more marked in abnormal than in normal groups. Furthermore, abnormal reactions in themselves may be characterized by either too much or too little variety, i.e. by scatter or by stereotypy.Discrimination between normal and abnormal reaction can be based on a single quantitative measurement, on difference in variance or on a compound measurement, i.e. pattern or profile. The discriminative approach has advantages over other methods because in this approach the initial factors are concrete and based on known classes such as males and females, children and adults, special clinical types, &c.(3) Genetical analysis.-Actuarial data can be useful in genetic studies by leading to estimation of population frequency of genes and consanguinity rates. Moreover, combined clinical and genetical observations can reveal the existence of new clinical entities.

  19. Frequency of anemia in chronic psychiatry patients

    PubMed Central

    Korkmaz, Sevda; Yıldız, Sevler; Korucu, Tuba; Gundogan, Burcu; Sunbul, Zehra Emine; Korkmaz, Hasan; Atmaca, Murad

    2015-01-01

    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. Thus, the study concluded that it would be beneficial to consider the physical symptoms and to conduct the required examinations to determine anemia among this patient group. PMID:26543367

  20. [Treatment of offenders with mental disorders: focusing on prison psychiatry].

    PubMed

    Nakatani, Yoji

    2011-01-01

    Forensic mental health services exist in a nebulous space at the intersection of two different systems-criminal justice and mental health-and the entanglement of these systems poses intricate problems for psychiatrists. This article discusses the present circumstances of forensic mental health services in Japan, focusing on trends in prison psychiatry. In the traditional Japanese system, offenders with mental disorders were treated within general psychiatry as involuntarily admitted patients, or within the prison system as mentally ill inmates. As a consequence of recent legal reform, however, this situation has radically changed. The Medical Treatment and Supervision Act of 2005 aimed to provide intensive psychiatric treatment to offenders with mental disorders, attaching great importance to their reintegration into society. Under the new system, a person who commits a serious criminal offense in a state of insanity or diminished capacity shall be referred by the public prosecutor to the district court; following a treatment order of the court, the person shall be treated in psychiatric facilities established by the law. While the new system is expected to play a role in the context of specialist forensic psychiatry, its distinction from general psychiatry remains unclear. For example, persons who commit serious crimes, such as assault, in an acute psychotic state are occasionally admitted to general psychiatric hospitals, even if they meet the criteria for a treatment order under the Medical Treatment and Supervision Act. The relationship between prison psychiatry and specialist forensic psychiatry is still more problematic. Compared to the intensive, rehabilitation-oriented care provided under the Medical Treatment and Supervision Act, mental health services in penal institutions have a number of disadvantages, and it is unlikely that mentally ill prisoners have benefited from the recent progress in forensic psychiatry. Statistics show that the number of

  1. Personalized medicine in psychiatry: ethical challenges and opportunities.

    PubMed

    Evers, Kathinka

    2009-01-01

    Pharmacogenomic developments hold promise for personalized medicine in psychiatry with adjusted therapeutic doses, predictable responses, reduced adverse drug reactions, early diagnosis, and personal health planning. The prospects are exciting, but at the same time, these new techniques stand faced with important scientific, ethical, legal, and social challenges that need to be met in order for the scientific advances to be responsibly applied. This review discusses the ethical balance between challenge and opportunity of personalized medicine in psychiatry under the aspects of adequacy, cost:benefit ratio, and therapeutic equity. It is argued that the promising nature of these therapeutic possibilities makes it all the more important to avoid exaggerating the expectations, and that a sophisticated social infrastructure needs to be developed in order to ensure the realistic and responsible application of personalized medicine in psychiatry.

  2. Cultural psychiatry in the French-speaking world.

    PubMed

    Westermeyer, Joseph

    2013-01-01

    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.

  3. Adapting the cultural formulation for clinical assessments in forensic psychiatry.

    PubMed

    Aggarwal, Neil Krishan

    2012-01-01

    Even as forensic psychiatrists have increasingly contemplated the role of culture in forensic psychiatry, practical cultural evaluations remain an under-theorized area with scant research. Older conceptions of cultural competence may risk stereotyping the evaluee on the basis of perceived group characteristics. This article offers a revision of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV) Outline for Cultural Formulation for use in forensic psychiatry by adjusting its formal guidelines with recommendations from the forensic mental health literature. As a person-centered method of conducting the interview, the Cultural Formulation probes cultural explanations of identity, illness, social support, functioning, and interaction with the medical and legal systems. In line with other psychiatric subspecialties, future research in forensic psychiatry can examine the extent to which the Cultural Formulation helps trainees with cultural competence, reconfigures diagnosis and treatment, and alters legal outcomes such as length of sentence.

  4. Psychiatry residency education in Canada: past, present and future.

    PubMed

    Saperson, Karen

    2013-07-01

    OBJECTIVE This article provides a brief overview of the history of psychiatry residency training in Canada, and outlines the rationale for the current training requirements, changes to the final certification examination, and factors influencing future trends in psychiatry education and training. METHOD The author compiled findings and reports on residency education in Canada from current and historical sources. RESULTS Residency training in psychiatry in Canada has undergone significant change in the past 5 years, moving from an "apprenticeship" model to a competency-based curriculum with explicit expectations for the acquisition of key, defined competencies. CONCLUSION Continuous evaluation of teaching methodologies, increasing use of innovative and creative medical education techniques, flexible curricula, and increasingly rigorous standards of accreditation are some of the factors likely to continue to shape the future.

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

    PubMed

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

    2015-01-01

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

  6. [Human dignity as foundation of an ethics in psychiatry].

    PubMed

    Achatz, Johannes; Knoepffler, Nikolaus

    2014-07-01

    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. PMID:24983583

  7. Personalized medicine in psychiatry: ethical challenges and opportunities

    PubMed Central

    Evers, Kathinka

    2009-01-01

    Pharmacogenomic developments hold promise for personalized medicine in psychiatry with adjusted therapeutic doses, predictable responses, reduced adverse drug reactions, early diagnosis, and personal health planning. The prospects are exciting, but at the same time, these new techniques stand faced with important scientific, ethical, legal, and social challenges that need to be met in order for the scientific advances to be responsibly applied. This review discusses the ethical balance between challenge and opportunity of personalized medicine in psychiatry under the aspects of adequacy, costbenefit ratio, and therapeutic equity. It is argued that the promising nature of these therapeutic possibilities makes it all the more important to avoid exaggerating the expectations, and that a sophisticated social infrastructure needs to be developed in order to ensure the realistic and responsible application of personalized medicine in psychiatry. PMID:20135900

  8. The importance of neuropsychopharmacology in the development of psychiatry.

    PubMed

    Kalmár, Sandor

    2014-09-01

    The author establishes that Psychiatry has been in a difficult situation especially in Hungary since closing down the National Institute of Psychiatry and Neurology. He reviews the most important factors which hold up the development of Psychiatry. He settles that the development of Psychiatry is inconceivable without a person's holistic approach which assumes the biological, mental, cultural-social and spiritual approach. Disturbances of perception have particular roles in the formation of psychopathological symptoms which are based on the operation of the nervous system. This fact emphasises the importance of the nervous system and the neuropsychopharmacology which we have known since the beginning of history although it is hardly half a century old. He pays the attention to the psychoactive medicine that was well-known in the ancient civilization. He reviews some of them which were actually the first neuropsychopharmacological pharmaceuticals. He emphasises the dichotomy of the psychopathological symptoms which are partly objective, partly subjective but based on the operation of the nervous system by all means. His statements not only establish a new kind of approach of both the person and the Psychiatry but enables the development of Psychiatry, the creation of a new sort of diagnostic system, eliminating the variance among the experts dealing with people, the neurologists, the psychiatrists, the psychologists, the sociologists, the philosophers and the theologians, ensuring the biological (neurological), psychological, cultural and spiritual perpetuity. The biological, genetic, psychic, cultural-social and spiritual approach, the application of nanomedicine that enable not only recognising the organic neurological bases of the psychiatric disorders that are all crucial for the future researchers but also essential in the development of the neuropsychopharmacology based on the function of the nervous system.

  9. The importance of neuropsychopharmacology in the development of psychiatry.

    PubMed

    Kalmár, Sandor

    2014-09-01

    The author establishes that Psychiatry has been in a difficult situation especially in Hungary since closing down the National Institute of Psychiatry and Neurology. He reviews the most important factors which hold up the development of Psychiatry. He settles that the development of Psychiatry is inconceivable without a person's holistic approach which assumes the biological, mental, cultural-social and spiritual approach. Disturbances of perception have particular roles in the formation of psychopathological symptoms which are based on the operation of the nervous system. This fact emphasises the importance of the nervous system and the neuropsychopharmacology which we have known since the beginning of history although it is hardly half a century old. He pays the attention to the psychoactive medicine that was well-known in the ancient civilization. He reviews some of them which were actually the first neuropsychopharmacological pharmaceuticals. He emphasises the dichotomy of the psychopathological symptoms which are partly objective, partly subjective but based on the operation of the nervous system by all means. His statements not only establish a new kind of approach of both the person and the Psychiatry but enables the development of Psychiatry, the creation of a new sort of diagnostic system, eliminating the variance among the experts dealing with people, the neurologists, the psychiatrists, the psychologists, the sociologists, the philosophers and the theologians, ensuring the biological (neurological), psychological, cultural and spiritual perpetuity. The biological, genetic, psychic, cultural-social and spiritual approach, the application of nanomedicine that enable not only recognising the organic neurological bases of the psychiatric disorders that are all crucial for the future researchers but also essential in the development of the neuropsychopharmacology based on the function of the nervous system. PMID:25347244

  10. Descriptive and dynamic psychiatry: a perspective on DSM-III.

    PubMed

    Frances, A; Cooper, A M

    1981-09-01

    The APA Task Force on Nomenclature and Statistics attempted to make DSM-III a descriptive nosology that is atheoretical in regard to etiology. The authors believe that a sharp polarity between morphological classification and explanatory formulation is artificial and misleading, and they critically review DSM-III from a psychodynamic perspective. They compare and contrast the descriptive orientation in psychiatry with the psychodynamic orientation and conclude that the two approaches overlap, that they are complementary and necessary to each other, and that there is a descriptive data base underlying dynamic psychiatry which may be usefully included in future nomenclatures. PMID:7023255

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

    PubMed

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

    2015-12-01

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

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

    PubMed

    Terziev, D

    2013-01-01

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

  13. Patients' rights: a cultural challenge to Western psychiatry.

    PubMed

    Brody, E B

    1985-01-01

    To some degree, all psychiatric encounters, by constraining behavioral variation and autonomous decision making, threaten a personhood already impaired by illness. The challenge presented by this and other factors in Western psychiatry is how to resolve the ethical dilemmas of justice, autonomy, and beneficence inherent in contemporary hospitalization and treatment practices for severely mentally ill persons. The author discusses this challenge in terms of the physician-patient contract, clinical standards for limiting autonomy, and the Kantian concept of equality of mutual respect. The legal code in relation to psychiatry has evolved into a contemporary interpreting mechanism for Kantian cultural tradition.

  14. The journey out and in: psychiatry and space exploration.

    PubMed

    Santy, P

    1983-05-01

    Although psychiatric issues have in theory always been considered important in space biomedical research, specific research into these issues has been severely limited because of other priorities that were more pertinent to the technological development of space flight capacity. As the technical and physical aspects of space flight become more routine, the psychological issues should take on increasing importance. The author reviews the U.S. and U.S.S.R. research in aerospace medicine that is relevant to psychiatry and suggests ways to expand psychiatry's clinical and research usefulness in future space exploration efforts.

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

    PubMed

    Marcinowski, Filip

    2014-01-01

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

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

    PubMed

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

    2015-12-01

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

  17. The impact of medical issues in inpatient geriatric psychiatry.

    PubMed

    Inventor, Ben Remor E; Henricks, John; Rodman, Leslie; Imel, Joel; Holemon, Lance; Hernandez, Fernando

    2005-01-01

    At an advanced age, serious medical and psychiatric illnesses frequently coalesce. Often, the need for admission to inpatient geriatric psychiatric care arises from coexisting medical problems. While cognitive and behavioral interventions are important, the complexity of physical comorbidities usually becomes the focus of hospitalization and requires intensive medical treatments. This paper describes adaptations made in one metropolitan geriatric psychiatry unit in order to better treat complex patients who experience both medical and psychiatric illness. The need for all members of the interdisciplinary team to expand their practice and the importance of complementary approaches of psychiatry and medicine are emphasized.

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

    PubMed

    Lerner, Vladimir; Kaptsan, Alexander; Witztum, Eliezer

    2003-01-01

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

  19. The role of a research seminar for child psychiatry residents.

    PubMed

    Paniagua, F A; Pumariega, A J; O'Boyle, M; Meyer, W J

    1993-03-01

    A major problem confronting the field of child and adolescent psychiatry is the development of teaching strategies to stimulate research activities and an appreciation of research. A teaching approach is described which emphasizes major research concepts using a programmed instruction method and illustrating these concepts with clinical cases. Fourteen child psychiatry residents participated in the seminar during a 3-year period. Overall, trainees' evaluation of the seminar was positive, and they demonstrated a high level of understanding across major research topics. In addition, the seminar may have contributed to an increased preference for academic careers by graduating residents.

  20. Cultural psychiatry and epidemiology: researching the means, methods and meanings.

    PubMed

    Bhui, Kamaldeep

    2011-04-01

    This article describes my developing interest in cultural psychiatry. This is both a challenging and yet a privileged opportunity to reflect on my research and clinical work over the last 25 years. I describe cultural and interpersonal influences on my thinking and interests, and the development of my research career moving from health services research of specialist services, to primary care research to public mental health research. Specifically, social and cultural influences on risks and responses to mental illness are discussed, as are pathways to care, the recognition of mental illness, and public health and cultural psychiatry research. PMID:21511849

  1. Scales

    SciTech Connect

    Murray Gibson

    2007-04-27

    Musical scales involve notes that, sounded simultaneously (chords), sound good together. The result is the left brain meeting the right brain — a Pythagorean interval of overlapping notes. This synergy would suggest less difference between the working of the right brain and the left brain than common wisdom would dictate. The pleasing sound of harmony comes when two notes share a common harmonic, meaning that their frequencies are in simple integer ratios, such as 3/2 (G/C) or 5/4 (E/C).

  2. Scales

    ScienceCinema

    Murray Gibson

    2016-07-12

    Musical scales involve notes that, sounded simultaneously (chords), sound good together. The result is the left brain meeting the right brain — a Pythagorean interval of overlapping notes. This synergy would suggest less difference between the working of the right brain and the left brain than common wisdom would dictate. The pleasing sound of harmony comes when two notes share a common harmonic, meaning that their frequencies are in simple integer ratios, such as 3/2 (G/C) or 5/4 (E/C).

  3. Early psychiatry at Yale: Milton C. Winternitz and the founding of the Department of Psychiatry and Mental Hygiene.

    PubMed Central

    Engel, J. W.

    1994-01-01

    Yale's current department of psychiatry was created by Dean Milton C. Winternitz in the 1920s as part of a broader effort to combine mental and physical components of medical care. This effort, which spurred the founding of Yale's institute of Human Relations, was the basis of Winternitz' interest in mental health. Although the institute soon closed because of interdisciplinary squabbling, this brief chapter in Yale's history illustrates the progressive thinking of the Dean and the pre-War place of psychiatry in medicine. PMID:7645310

  4. Extended Release Drug Delivery Strategies in Psychiatry

    PubMed Central

    2005-01-01

    Objective: An overview of the emerging field of long-term delivery strategies for improved convenience and adherence with psychiatric medications is provided. This review is motivated by the hypothesis that adherence to treatment is an important determinant of clinical outcomes in a wide range of settings and is particularly important in psychiatry practice where patients require treatment for months or years and premature discontinuation can have serious consequences for patient health and quality of life. Design: The author reviews the relevant literature and highlights several approaches to providing improved access to continuous medication through new and innovative delivery strategies ranging from days to annual intervals. Benefits and Disadvantages: Several solutions to the problem of discontinuous access to pharmacotherapy are being developed in the form of new, long-acting drug-delivery systems, which gradually release medication over a period of several days or weeks with a single application. Long-acting formulations of psychiatric medications offer a number of potential benefits in comparison with conventional immediate-release agents, including improved safety and effectiveness. Potential limitations to using long-acting formulations may include pain and discomfort at the injection site, perceived inconvenience of a new treatment method, preference for oral medications, and length of time to titrate down to the lowest effective dose. Conclusions: The introduction of new, long-acting drug formulations could provide significant improvements in clinical outcomes and patient satisfaction for many patients, including those with affective disorders, schizophrenia, and alcohol dependence. Switching from oral administration to these new agents requires careful monitoring to reach the optimal dose, and patient concerns regarding the use of new delivery methods must be addressed. Long-acting formulations are not intended to be a sole form of treatment, and the

  5. 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

    PubMed Central

    Banner, Natalie F; Thornton, Tim

    2007-01-01

    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.

  6. Specialized inpatient psychiatry for serious behavioral disturbance in autism and intellectual disability.

    PubMed

    Siegel, Matthew; Milligan, Briana; Chemelski, Bruce; Payne, David; Ellsworth, Beth; Harmon, Jamie; Teer, Olivia; Smith, Kahsi A

    2014-12-01

    Psychiatric hospitalization of children with autism spectrum disorder and/or intellectual disability is common, however, the effectiveness of this intervention is largely unknown. Thirty-eight clinically-referred children 8-19 years old admitted to a specialized inpatient psychiatry unit were assessed by a consistent caregiver on the Aberrant Behavior Checklist-Irritability (ABC-I) subscale at admission, discharge and 2 months post discharge. There was a decrease in the mean ABC-I score from admission (27.3, SD 7.4) to discharge (11.9, SD 8.8), which was sustained at 2 months post discharge (14.8, SD 9.3) (p < 0.001). Seventy-eight percent of the subjects were rated as "Improved" on the clinician Clinical Global Impressions Improvement scale at discharge. The study is limited by lack of a control group, but offers preliminary evidence for specialized inpatient psychiatry as an intervention for serious behavioral disturbance in this population.

  7. Promoting Scholarship during Child and Adolescent Psychiatry Residency

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  8. A Novel Approach to Medicine Training for Psychiatry Residents

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  9. Psychiatry after virtue: a modern practice in the ruins.

    PubMed

    Michel, Andrew A

    2011-04-01

    Contemporary psychiatry maintains the myth that it is value neutral by appeal to modern medical science for both its diagnostic categories and its therapeutic interventions, leaving the impression that it relies on reason--that is to say, reason divorced from tradition--to master human nature. Such a practice has a certain way of characterizing and defining humanity's lapses from acceptable human behavior--a lapse from human being. The modern practice of psychiatry applies a particular notion (largely influenced by Enlightenment ideals) of scientific instrumentation to the human person in order to diagnose the ailment and manufacture a corresponding treatment in keeping with a hidden conception of human biological flourishing. This covert vision is an impoverished (and possibly dangerous) one. As much as the practice of psychiatry is constrained by the goals of the dominant moral tradition of our day, it becomes a tool (or technique) for achieving the transient and partial ends of modern individualism. Given this truncated view of human nature and human end, modern psychiatry fails to attend comprehensively to the unity of a life, missing altogether the essential relevance of character formation, and thereby forfeiting excellence in human flourishing. PMID:21357653

  10. Student Experiences with Competency Domains during a Psychiatry Clerkship

    ERIC Educational Resources Information Center

    West, Donald A.; Nierenberg, David W.

    2009-01-01

    Objectives: The authors reviewed medical student encounters during 3 years of a required psychiatry clerkship that were recorded on a web-based system of six broad competency domains (similar to ACGME-recommended domains). These were used to determine diagnoses of patients seen, clinical skills practiced, and experiences in interpersonal and…

  11. The computational psychiatry of reward: broken brains or misguided minds?

    PubMed

    Moutoussis, M; Story, G W; Dolan, R J

    2015-01-01

    Research into the biological basis of emotional and motivational disorders is in danger of riding roughshod over a patient-centered 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 maximize reward (and minimize 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 judgment. PMID:26483713

  12. Medical Students' Perceptions of Psychiatry as a Career Choice

    ERIC Educational Resources Information Center

    Cutler, Janis L.; Alspector, Sharon L.; Harding, Kelli J.; Wright, Leslie L.; Graham, Mark J.

    2006-01-01

    Objective: This study describes medical students' perceptions of the field of psychiatry and identifies the impact of those perceptions on their career choices in order to explore the questions: Are we as a field doing all that we can to enhance the educational experience of all medical students, regardless of their career preferences? What are…

  13. Ethical dilemmas in forensic psychiatry: two illustrative cases

    PubMed Central

    Sen, Piyal; Gordon, Harvey; Adshead, Gwen; Irons, Ashley

    2007-01-01

    One approach to the analysis of ethical dilemmas in medical practice uses the “four principles plus scope” approach. These principles are: respect for autonomy, beneficence, non‐maleficence and justice, along with concern for their scope of application. However, conflicts between the different principles are commonplace in psychiatric practice, especially in forensic psychiatry, where duties to patients often conflict with duties to third parties such as the public. This article seeks to highlight some of the specific ethical dilemmas encountered in forensic psychiatry: the excessive use of segregation for the protection of others, the ethics of using mechanical restraint when clinically beneficial and the use of physical treatment without consent. We argue that justice, as a principle, should be paramount in forensic psychiatry, and that there is a need for a more specific code of ethics to cover specialised areas of medicine like forensic psychiatry. This code should specify that in cases of conflict between different principles, justice should gain precedence over the other principles. PMID:17526683

  14. Architecture of research in psychiatry, 1953 to 1983.

    PubMed

    Reich, J; Black, D W; Jarjoua, D

    1987-04-01

    Although there has been one report on the trends in study design in general medicine, we are aware of none for general psychiatry prior to this communication. Accordingly, articles from the American Journal of Psychiatry (N = 194) and the Archives (N = 109) were randomly sampled for the years 1953, 1963, 1973, and 1983. Two raters achieved reliability (kappa = .82) for recognizing the major types of study design (cohort, clinical trial, case control, cross sectional, case report, and review). There was a significant change in study architecture over time, with the percentage of review articles declining and the percentage of case-control and cross-sectional studies increasing. Another major finding was a large increase in use of inclusion and exclusion criteria for diagnosis in non-review article studies. The general trends are for increasingly sophisticated research designs to be used in psychiatry research. The quality of research designs in psychiatry for 1983 also compares favorably with research designs found in a respected medicine journal.

  15. The Child and Adolescent Psychiatry Match: Problems and Potential Solutions

    ERIC Educational Resources Information Center

    Ascherman, Lee I.; Lamps, Christopher

    2005-01-01

    OBJECTIVE: The Child and Adolescent Psychiatry Match was instituted in 1996 to establish fair and uniform resident recruitment practices. METHOD: The impetus for its use was the desire to protect applicants and training programs from premature decisions based on fears of not securing a training position or not filling a program. RESULTS: However,…

  16. Key moments in the history of czech psychiatry.

    PubMed

    Baudis, P; Raboch, J

    2003-06-01

    1783 - The Austrian Emperor Joseph II. established a department for mentally ill priests in the hospital of the Merciful Brothers in Prague. 1790 - Based on the Emperors decision, a new hospital was opened in Prague. A new two-storey building was used exclusively for treatment of the mentally ill patients. 1821 - Lectures about insanity were opened at Prague University. 1844 - A New house (nowadays a psychiatric University department) was established. Building of psychiatric hospitals: 1863 Brno-Cernovice, 1870 Kosmonosy, 1880 Dobrany, 1887 Oparany, 1889 Opava, 1890 Horní Berkovice, 1892 Sternberk, 1906 Kromeríz, 1902 Jihlava, 1908 Praha-Bohnice. 1904 - A Journal, later called Czechoslovak Psychiatry was founded. 1919 - The Czech, later the Czechoslovak and latest the Czech Psychiatric Society were established. 1955 - Specialization for psychiatry. 1956 - Separation psychiatry and neurology. Progress in the out-patient care from 1, 0 psychiatrist per 100.000 inhabitants (1963) to 4, 5 (1995). Form 1989 accent on human and patient's rights and ethical principles, end of abuse of psychiatry. 1993 - First community based-services.

  17. Commentary: evidence-based practice and forensic psychiatry.

    PubMed

    Schneider, Richard D

    2009-01-01

    A diverse sampling of articles was considered as a landscape against which evidence-based practice has been and should be a part of forensic psychiatry. Caveats were identified, limitations suggested, and recommendations made as to how such a marriage might work.

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

    ERIC Educational Resources Information Center

    Carney, Stuart; Bhugra, Dinesh K.

    2013-01-01

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

  19. Pharmacogenetics in psychiatry: translating research into clinical practice

    PubMed Central

    Malhotra, AK; Zhang, J-P; Lencz, T

    2012-01-01

    Pharmacogenetic/pharmacogenomic (PGx) approaches to psychopharmacology aim to identify clinically meaningful predictors of drug efficacy and/or side-effect burden. To date, however, PGx studies in psychiatry have not yielded compelling results, and clinical utilization of PGx testing in psychiatry is extremely limited. In this review, the authors provide a brief overview on the status of PGx studies in psychiatry, review the commercialization process for PGx tests and then discuss methodological considerations that may enhance the potential for clinically applicable PGx tests in psychiatry. The authors focus on design considerations that include increased ascertainment of subjects in the earliest phases of illness, discuss the advantages of drug-induced adverse events as phenotypes for examination and emphasize the importance of maximizing adherence to treatment in pharmacogenetic studies. Finally, the authors discuss unique aspects of pharmacogenetic studies that may distinguish them from studies of other complex traits. Taken together, these data provide insights into the design and methodological considerations that may enhance the potential for clinical utility of PGx studies. PMID:22083729

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

    ERIC Educational Resources Information Center

    Eyal, Roy; O'Connor, Mary J.

    2011-01-01

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

  1. A resident's experience in cross cultural/community psychiatry.

    PubMed

    Krishnan, Brinda S; Cutler, David L

    2005-10-01

    This report examines a psychiatric resident's consultation experience in a community psychiatry rotation serving South Asian women victims of intimate partner violence. It explores experiences related to negotiating and developing a partnership between culturally specific domestic violence services and community mental health services. It also discusses the resident's progression from consultant to administrator and ultimately to the rotation's termination. PMID:16142541

  2. The computational psychiatry of reward: broken brains or misguided minds?

    PubMed Central

    Moutoussis, M.; Story, G. W.; Dolan, R. J.

    2015-01-01

    Research into the biological basis of emotional and motivational disorders is in danger of riding roughshod over a patient-centered 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 maximize reward (and minimize 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 judgment. PMID:26483713

  3. Crossroads: Identity struggles in Latin America and Latin American psychiatry.

    PubMed

    Alarcón, Renato D; Pérez-Rincón, Héctor

    2010-01-01

    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. PMID:20874062

  4. Multifaceted Inpatient Psychiatry Approach to Reducing Readmissions: A Pilot Study

    ERIC Educational Resources Information Center

    Lang, Timothy P.; Rohrer, James E.; Rioux, Pierre A.

    2009-01-01

    Context: Access to psychiatric services, particularly inpatient psychiatric care, is limited and lacks comprehensiveness in rural areas. Purpose: The purpose of this study was to evaluate the impact on readmission rates of a multifaceted inpatient psychiatry approach (MIPA) offered in a rural hospital. Methods: Readmissions within 30 days of…

  5. Editorial cognition, neurology, psychiatry: golden triangle or bermuda triangle?

    PubMed

    Baddeley, A D

    1996-08-01

    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. PMID:16571484

  6. Implementing Interpersonal Psychotherapy in a Psychiatry Residency Training Program

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  7. Psychology and Psychiatry Serials: A Bibliographic Aid for Collection Development.

    ERIC Educational Resources Information Center

    Persson, Dorothy M., Ed.

    1990-01-01

    This bibliography is a guide to major psychology and psychiatry periodicals evaluated by subject relevance, scholarship level, and inclusion in major indexing and abstracting tools. Citations include date first published, frequency, publisher, ISSN, where indexed and abstracted, and an annotation. Indexes by subject and publisher are included.…

  8. Funding the Educational Mission: Challenges to Departments of Psychiatry

    ERIC Educational Resources Information Center

    Magen, Jed; Richards, Madhvi

    2011-01-01

    Objective: The authors review and discuss challenges to funding the educational missions of psychiatry departments. Method: The authors conducted a literature search and also provide examples from their department and lessons learned from business organizations that are applicable to academic departments. Results: The authors discuss and analyze…

  9. AWARENESS ABOUT PSYCHIATRY IN UNDERGRADUATE MEDICAL STUDENTS IN NEPAL

    PubMed Central

    Chadda, R.K.; Singh, Meghachandra M.

    1999-01-01

    Undergraduate medical students in developing countries have a number of misnotions and misconceptions about psychiatry. Carefully planned teaching programmes providing more interactions of students with faculty during a short span may be helpful in increasing students′ awareness and positive attitude towards psychiatry. This study was conducted to assess the impact of a two weeks training programme on the awareness of medical students about psychiatry, its scope and treatment modalities. The subjects included a batch of 29 third year medical students in a medical college in Nepal. A pre and post-test was done before and after conducting the training programme for two weeks using a 20 item semi-structured questionnaire. Students′ awareness about psychiatric disorders like anxiety disorders, somatoform disorders, personality disorders, delirium and mania, psychological manifestations of physical illnesses, electroconvulsive therapy and psychological methods of treatment improved significantly after the teaching programme. The findings show that teaching programme on psychiatry even for a brief period of two weeks is useful in increasing awareness and correcting the misconceptions about the speciality. PMID:21455392

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

    PubMed

    Sabshin, M

    1990-09-01

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

  11. The Chief Resident in Psychiatry: Roles and Responsibilities

    ERIC Educational Resources Information Center

    Lim, Russell F.; Schwartz, Eric; Servis, Mark; Cox, Paul D.; Lai, Alan; Hales, Robert E.

    2009-01-01

    Objective: Psychiatric residency programs have had chief residents for many years, and several articles previously published describe the chief residents' unique role as both faculty and resident. This article describes chief resident roles and responsibilities and explores trends in academic psychiatry departments from 1995 to 2006. Methods: The…

  12. Metric Issues in the Study of Eye Movements in Psychiatry

    ERIC Educational Resources Information Center

    Smyrnis, Nikolaos

    2008-01-01

    This review provides a description of the measurement methods, task definitions and measurement parameters in the study of smooth eye pursuit and saccade-antisaccade tasks in psychiatry. The large heterogeneity in task definitions and definitions of parameters and its potential impact on the large variability of the parameter measures is…

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

    PubMed

    Rudnick, Abraham

    2002-06-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  15. Residency Training in Emergency Psychiatry: A Model Curriculum Developed by the Education Committee of the American Association for Emergency Psychiatry

    ERIC Educational Resources Information Center

    Brasch, Jennifer; Glick, Rachel Lipson; Cobb, Thomas G.; Richmond, Janet

    2004-01-01

    Objective: Describe training goals, objectives and requirements in emergency psychiatry to assist residency programs in developing comprehensive training programs to ensure psychiatric residents acquire the necessary skills and knowledge to competently assess and manage patients with psychiatric emergencies. Methods: The American Association for…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    PubMed

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

    2011-01-01

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

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

    PubMed

    Maio, G

    2015-11-01

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

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

    PubMed

    Maio, G

    2015-11-01

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

  20. Indian scales and inventories

    PubMed Central

    Venkatesan, S.

    2010-01-01

    This conceptual, perspective and review paper on Indian scales and inventories begins with clarification on the historical and contemporary meanings of psychometry before linking itself to the burgeoning field of clinimetrics in their applications to the practice of clinical psychology and psychiatry. Clinimetrics is explained as a changing paradigm in the design, administration, and interpretation of quantitative tests, techniques or procedures applied to measurement of clinical variables, traits and processes. As an illustrative sample, this article assembles a bibliographic survey of about 105 out of 2582 research papers (4.07%) scanned through 51 back dated volumes covering 185 issues related to clinimetry as reviewed across a span of over fifty years (1958-2009) in the Indian Journal of Psychiatry. A content analysis of the contributions across distinct categories of mental measurements is explained before linkages are proposed for future directions along these lines. PMID:21836709

  1. The biopsychosocial paradigm and the future of psychiatry.

    PubMed

    Freedman, A M

    1995-01-01

    Although hazardous, prediction is necessary for sensible programming for the future of psychiatry. Because of the multitude of variables essential for comprehending normal and abnormal behavior, a complex, all-encompassing model takes on increasing importance. Dualism and reductionism have had a chilling effect on progress in developing psychiatric models. The biopsychosocial model as elaborated by Dr. George Engel would appear to be a major step in moving toward an adequate workable model. Dr. Engel rejects the biomedical or Newtonian model in favor of the biopsychosocial model, basing his conception in part on developments in the past century, particularly the contributions of Einstein, Heisenberg, and Planck. The implications and relevance of these advances, including the work of Niels Bohr, are presented. Other ideas such as Chaos Theory and the work of Roger Penrose are also discussed, together with the new thinking that arises from them. This work reinforces notions of holism, leading to a more humanitarian psychiatry and medicine.

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

    PubMed

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

    2016-02-01

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

  3. [Training in psychiatry for health teams in Colombia].

    PubMed

    Climent, C E; de Arango, M V; León, C A

    1983-01-01

    About 90% of the 40 million victims of mental disorders in the developing countries receive no treatment, and little progress is being made in this respect. This article examines the use of new strategies for solving the problem. It is obvious that the traditional methods of mental health care have been ineffective and that new programs should now be undertaken that can ensure proper service within the coming decades for those being neglected. Based on the results of a practical experiment carried out in Colombia, the authors, without making any definitive recommendations, point to the usefulness of training auxiliary staff of urban and rural health centers to work as a team (under the supervision of a physician or a graduate nurse) in the care and management of psychiatric patients. They enumerate the advantages offered by training programs on various aspects of mental health for general practitioners (who usually have little interest in psychiatry), psychiatry residents, nurses, and auxiliaries.

  4. Sport psychiatry in childhood and adolescence: an overview.

    PubMed

    Eppright, T D; Sanfacon, J A; Beck, N C; Bradley, J S

    1997-01-01

    This review explores the importance and relevance of sport during childhood and adolescence, utilizing traditional stage theories of development. The literature supports the notion that sport is a necessary study as a health issue and a preventative tool in the field of psychiatry. Play and sport in childhood and adolescence enhance development physically, mentally, and socially. Participating in athletics encourages the development of leadership skills, self-esteem, muscle development and overall physical health. There is a lack of literature in the important area of sport psychiatry especially when considering beneficial, not deficit oriented youth athletic development. Child psychiatrists need to begin researching sport in order to develop a comprehensive understanding of how athletics can enhance the mental and physical health of youth. PMID:9494234

  5. Social discrediting of psychiatry: the protasis of legal disfranchisement.

    PubMed

    Dietz, P E

    1977-12-01

    The author believes that recent legal decisions against psychiatrists (including class action suits) have their genesis in writings by sociologists and other behavioral scientists, including psychiatrists, who have examined psychiatry in the context of social structure and social processes. The discrediting of the medical model could have been accomplished using theorectical assertions and research observations that had been published before 1940, but it did not occur until the human rights movement of the 1960s. The author reviews the assertions on which the discrediting of the medical model has been based. He stresses the distinction between the testing of a theory and the discrediting of a model and observes that the recent wholesale discrediting of psychiatry has relied less on theory testing than on polemical rhetoric and unwarranted extrapolation from empirical facts.

  6. Computational psychiatry as a bridge from neuroscience to clinical applications.

    PubMed

    Huys, Quentin J M; Maia, Tiago V; Frank, Michael J

    2016-03-01

    Translating advances in neuroscience into benefits for patients with mental illness presents enormous challenges because it involves both the most complex organ, the brain, and its interaction with a similarly complex environment. Dealing with such complexities demands powerful techniques. Computational psychiatry combines multiple levels and types of computation with multiple types of data in an effort to improve understanding, prediction and treatment of mental illness. Computational psychiatry, broadly defined, encompasses two complementary approaches: data driven and theory driven. Data-driven approaches apply machine-learning methods to high-dimensional data to improve classification of disease, predict treatment outcomes or improve treatment selection. These approaches are generally agnostic as to the underlying mechanisms. Theory-driven approaches, in contrast, use models that instantiate prior knowledge of, or explicit hypotheses about, such mechanisms, possibly at multiple levels of analysis and abstraction. We review recent advances in both approaches, with an emphasis on clinical applications, and highlight the utility of combining them.

  7. The 1942 'euthanasia' debate in the American Journal of Psychiatry.

    PubMed

    Joseph, Jay

    2005-06-01

    This paper discusses and analyses three articles appearing in a 1942 issue of the American Journal of Psychiatry. In the first, neurologist Foster Kennedy argued that 'feebleminded' people should be killed (an act which he referred to as 'euthanasia'). The rebuttal was written by psychiatrist Leo Kanner, who argued against 'euthanasia'. An unsigned editorial discussing these positions clearly sided with Kennedy: that 'euthanasia' would be appropriate in some cases, and that parents' opposition to this procedure should be the subject of psychiatric concern. The arguments are analysed and discussed within the context of eugenics and the murder of mental patients in Germany. Finally, the author points out that currently ascendant genetic theories in psychiatry could be a precursor for future proposals similar to Kennedy's.

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

    PubMed

    Hassenfeld, I N; Silver, R J

    1984-01-01

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

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

    PubMed

    Rosenbaum, M; McCarty, T

    1994-01-01

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

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

    PubMed

    Bormuth, M

    2010-11-01

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

  11. Samuel Smith, M.D.: first American professor of psychiatry.

    PubMed

    Pinta, E R

    1994-04-01

    In 1847 Samuel M. Smith, M.D., was appointed professor of medical jurisprudence and insanity at the Willoughby Medical College of Columbus, Ohio, making him the first person to chair a department of psychiatry at an American medical school. Using materials from newspaper reports, records of the medical school and state medical society, and other sources, the author presents a biographical sketch of this pioneer educator. Dr. Smith received his first practical experience in psychiatry as an assistant to William M. Awl, M.D., one of the 13 founders of the American Psychiatric Association. Over the course of his career, he held many prominent positions, including lecturer and dean at the medical school, president of the Ohio State Medical Society, and surgeon general of Ohio during the Civil War.

  12. Ethics and forensic psychiatry: translating principles into practice.

    PubMed

    Appelbaum, Paul S

    2008-01-01

    Twenty-five years ago, Alan Stone expressed his skepticism that forensic psychiatry could be practiced ethically. His remarks have proven a useful goad to the field, focusing attention on the importance of an ethics framework for forensic practice. But Stone remains dubious that any system of ethics--including the "Standard Position" on which he focuses his critique--could be of much value in practice. In contrast, I suggest that Stone's pessimism is not well founded. Immanent in forensic practice itself is a reasonable set of ethics principles, based on truth-telling and respect for persons. Psychiatrists can offer reliable and valid testimony, while resisting seduction into an advocacy role. Indeed, with new structured approaches to assessment, the potential utility of forensic testimony is probably greater than ever. Though problematic behavior still exists, forensic psychiatry offers the factual background and interpretive context to allow legal decision-makers to make better choices than they otherwise would.

  13. Sexual assault, irresistible impulses, and forensic psychiatry in Sweden.

    PubMed

    Bergenheim, Asa

    2014-01-01

    After forensic psychiatry was firmly established in Sweden in the 1930s, many rapists and individuals charged with assaulting children underwent a forensic psychiatric examination. The physicians found that most of them had not been "in control" of their senses or not "in complete control" of their senses at the time of the crime. If the court ordered a forensic psychiatric examination, the defendant had a very good chance of either being discharged or having his sentence reduced considerably. By the 1950s psychological perspectives began to dominate in forensic psychiatry. In the forensic records of the 1950s we can notice a shift from a biomedical to a socio-psychological perspective, and crime was increasingly related to conditions that were not seen as mental derangement from a legal point of view. As a result, it became less and less common, from the 1950s onwards, for sentences to be commuted or defendants discharged.

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

    PubMed

    Hartman, J

    1998-01-01

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

  15. Turning points in twentieth-century American psychiatry.

    PubMed

    Sabshin, M

    1990-10-01

    The author examines four major turning points in twentieth-century American psychiatry, emphasizing the movement during the post-World War II period toward a psychotherapeutic/psychoanalytic approach and the emergence of biological psychiatry, neuroscience, and logical positivism during the 1970s and 1980s. He discusses the impact of Adolf Meyer during the mid-twentieth century and his ongoing influence. The final turning point involves a prediction of a late twentieth-century change, including new directions in nosology, emphasis on combined pharmacotherapeutic/psychotherapeutic treatments, efforts to create alternatives to full inpatient care, better outcome data for psychiatric treatments, and beginning resolution of major boundary problems of current practice. PMID:2205113

  16. Graduates of foreign medical schools in American psychiatry.

    PubMed

    Munoz, R A; Madigan, M

    1986-10-01

    Members of the American Psychiatric Association who graduated from foreign medical schools, currently 25 percent of APA membership, are increasingly integrating themselves into the mainstream of American psychiatry. Nevertheless, an APA survey of members who are foreign medical graduates (FMGs) conducted in 1984 indicates that FMGs continue to pass the American Board of Psychiatry and Neurology examination and to be awarded APA fellowships at a significantly lower rate than their U.S.-trained counterparts. Solutions to these disparities have been increasingly sought by the leaders of APA, especially those of the association's areas II, IV, and V, where FMGs are concentrated. The higher percentage of women among FMGs than among U.S.-trained psychiatrists and the increasing presence of Americans and Canadians among FMGs are likely to enhance pressure to solve the problems of FMGs.

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

    PubMed

    Abettan, Camille

    2015-11-01

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

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

    PubMed

    Quen, J M

    1994-10-01

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

  19. Computational psychiatry as a bridge from neuroscience to clinical applications.

    PubMed

    Huys, Quentin J M; Maia, Tiago V; Frank, Michael J

    2016-03-01

    Translating advances in neuroscience into benefits for patients with mental illness presents enormous challenges because it involves both the most complex organ, the brain, and its interaction with a similarly complex environment. Dealing with such complexities demands powerful techniques. Computational psychiatry combines multiple levels and types of computation with multiple types of data in an effort to improve understanding, prediction and treatment of mental illness. Computational psychiatry, broadly defined, encompasses two complementary approaches: data driven and theory driven. Data-driven approaches apply machine-learning methods to high-dimensional data to improve classification of disease, predict treatment outcomes or improve treatment selection. These approaches are generally agnostic as to the underlying mechanisms. Theory-driven approaches, in contrast, use models that instantiate prior knowledge of, or explicit hypotheses about, such mechanisms, possibly at multiple levels of analysis and abstraction. We review recent advances in both approaches, with an emphasis on clinical applications, and highlight the utility of combining them. PMID:26906507

  20. Beyond the DSM: The Perspectives of Psychiatry Approach to Patients

    PubMed Central

    Taylor, Jacob; Lyketsos, Constantine G.; Chisolm, Margaret S.

    2012-01-01

    This article presents an alternative approach to the DSM for the understanding and treatment of patients with psychiatric conditions. This alternative approach, based on The Perspectives of Psychiatry, requires a systematic consideration of the patient's psychiatric condition from 4 perspectives: disease, dimensional, behavior, and life story. The Perspectives approach offers a way of understanding the nature and origin of clinical presentations and provides a clear structure for developing personalized treatment plans. Although the approach was originally articulated at Johns Hopkins University, a review of the literature shows significant dispersion of elements of the model to other institutions in several countries. The Perspectives approach is increasingly used as a method for the diagnosis and treatment of patients with psychiatric disorders and is a valuable educational tool for teaching psychiatry to students. PMID:22690367

  1. Sexual assault, irresistible impulses, and forensic psychiatry in Sweden.

    PubMed

    Bergenheim, Asa

    2014-01-01

    After forensic psychiatry was firmly established in Sweden in the 1930s, many rapists and individuals charged with assaulting children underwent a forensic psychiatric examination. The physicians found that most of them had not been "in control" of their senses or not "in complete control" of their senses at the time of the crime. If the court ordered a forensic psychiatric examination, the defendant had a very good chance of either being discharged or having his sentence reduced considerably. By the 1950s psychological perspectives began to dominate in forensic psychiatry. In the forensic records of the 1950s we can notice a shift from a biomedical to a socio-psychological perspective, and crime was increasingly related to conditions that were not seen as mental derangement from a legal point of view. As a result, it became less and less common, from the 1950s onwards, for sentences to be commuted or defendants discharged. PMID:24315847

  2. Psychiatry as an internal medicine subspecialty: an educational model.

    PubMed

    Shemo, J P; Withersty, D J; Spradlin, W W; Waldman, R H

    1980-04-01

    Psychiatry has been integrated into the Department of Internal Medicine at the West Virginia University School of Medicine as a means of ameliorating the educational and patient care deficiencies engendered by the traditional mind-body dichotomy in medical education. A major project derived from this merger of clinical and teaching activities has been the transformation of the university hospital psychiatric ward in to the Conjoint Medicine Service. This service, to which patients with a variety of emotional and medical problems are admitted, is staffed by medical house officers and a general internist in a close collaborative relationship with the Department of Psychiatry. The nursing care is oriented toward patient education, exemplified by group sessions. House staff and students are trained to recognize and evaluate the underlying emotional and interrelational factors which affect each patient's health status and prognosis as a routine part of a comprehensive medical work-up. Student and patient acceptance of this integrated approach has been enthusiastic.

  3. Attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient units

    PubMed Central

    2014-01-01

    Background In psychiatry, most of the focus on patient aggression has been in adolescent and adult inpatient settings. This behaviour is also common in elderly people with mental illness, but little research has been conducted into this problem in old age psychiatry settings. The attitudes of clinical staff toward aggression may affect the way they manage this behaviour. The purpose of this study was to examine the attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient settings. Methods A convenience sample of clinical staff were recruited from three locked acute old age psychiatry inpatient units in Melbourne, Australia. They completed the Management of Aggression and Violence Scale, which assessed the causes and managment of aggression in psychiatric settings. Results Eighty-five staff completed the questionnaire, comprising registered nurses (61.1%, n = 52), enrolled nurses (27.1%, n = 23) and medical and allied health staff (11.8%, n = 10). A range of causative factors contributed to aggression. The respondents had a tendency to disagree that factors directly related to the patient contributed to this behaviour. They agreed patients were aggressive because of the environment they were in, other people contributed to them becoming aggressive, and patients from certain cultural groups were prone to these behaviours. However, there were mixed views about whether patient aggression could be prevented, and this type of behaviour took place because staff did not listen to patients. There was agreement medication was a valuable approach for the management of aggression, negotiation could be used more effectively in such challenging behaviour, and seclusion and physical restraint were sometimes used more than necessary. However, there was disagreement about whether the practice of secluding patients should be discontinued. Conclusions Aggression in acute old age psychiatry inpatient units occurs

  4. The practice of child and adolescent psychiatry: a survey of early-career psychiatrists in Japan

    PubMed Central

    Tateno, Masaru; Uchida, Naoki; Kikuchi, Saya; Kawada, Ryosaku; Kobayashi, Seiju; Nakano, Wakako; Sasaki, Ryuji; Shibata, Keisuke; Shirasaka, Tomohiro; Suzuki, Muneyuki; Uehara, Kumi; Saito, Toshikazu

    2009-01-01

    Background Child and adolescent psychiatry (CAP), a subspecialty of psychiatry in Japan, is facing a serious workforce shortage. To resolve this situation, the Japanese government has organized a task force and has been working to increase psychiatrists' clinical skills to improve care for children and adolescents with mental health problems. Using an online questionnaire system, the authors have conducted a survey to investigate the perceptions, experiences, and interests of early-career psychiatrists in CAP. Methods The subjects of this study were 182 psychiatrists in Japan whose individual clinical experiences did not exceed 15 years. The authors of this study created an online questionnaire system and e-mailed the URL and login password to all subjects. Respondents anonymously answered the questions. Most questions required an answer indicating a level of agreement scored on a nine-point scale. Responding to the questionnaire was considered to constitute consent, and all respondents' privacy was carefully protected. Results The mean age and clinical psychiatric experience of the subjects were found to be 33.1 ± 4.5 years and 5.43 ± 3.5 years, respectively. On a nine-point scale (with nine being the highest), experience and interest in CAP measured 3.05 ± 1.9 and 5.34 ± 2.5, respectively; further, these two factors showed significant correlation (r = 0.437, p < 0.0001). The mean score for the early-career psychiatrists' confidence in their ability to diagnose and appropriately treat was notably low, at 3.13 ± 1.9. Conclusion Our results demonstrated that early-career psychiatrists self-evaluated their CAP clinical experience as insufficient, and these clinicians' CAP experiences and interests correlated significantly. Therefore, in order to improve child and adolescent medical care, we need to expose young psychiatrists to sufficient CAP cases and explore the factors that could attract them to this field. PMID:19785745

  5. Attitude of young psychiatrists toward coercive measures in psychiatry: a case vignette study in Japan

    PubMed Central

    Tateno, Masaru; Sugiura, Kanna; Uehara, Kumi; Fujisawa, Daisuke; Zhao, Yueren; Hashimoto, Naoki; Takahashi, Hidehiko; Yoshida, Naofumi; Kato, Takahiro; Nakano, Wakako; Wake, Yosuke; Shirasaka, Tomohiro; Kobayashi, Seiju; Sato, Soichiro

    2009-01-01

    Background Every psychiatrist must pay careful attention to avoid violating human rights when initiating coercive treatments such as seclusion and restraint. However, these interventions are indispensable in clinical psychiatry, and they are often used as strategies to treat agitated patients. In this study, we investigated young psychiatrists' attitudes toward psychiatric coercive measures. Methods A total of 183 young psychiatrists participated as subjects in our study. A questionnaire with a case vignette describing a patient with acute psychosis was sent to the study subjects via the Internet or by mail. This questionnaire included scoring the necessity for hospitalization, and the likelihood of prescribing seclusion and/or restraint, on a 9-point Likert scale (with 9 indicating strong agreement). Results There was general agreement among the study subjects that the case should be admitted to a hospital (8.91 ± 0.3) and secluded (8.43 ± 1.0). The estimated length of hospitalization was 13.53 ± 6.4 weeks. Regarding the likelihood of prescribing restraint, results showed great diversity (5.14 ± 2.5 on 9-point scale); psychiatrists working at general hospitals scored significantly higher (6.25 ± 2.5) than those working at university hospitals (5.02 ± 2.3) or psychiatric hospitals (4.15 ± 2.6). A two-group comparison of the length of inpatient care revealed a significant difference between those psychiatrists who scored 1-3 (n = 55, 14.22 ± 7.4 wks) and those who scored 7-9 (n = 62, 12.22 ± 4.0) regarding the need to use restraint. Conclusion Our results may reflect the current dilemma in Japanese psychiatry wherein psychiatrists must initiate coercive measures to shorten hospitalization stays. This study prompted its subject psychiatrists to consider coercive psychiatric treatments. PMID:19772614

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

    PubMed

    Sondheimer, Adrian

    2015-10-01

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

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

    PubMed

    Bergoets, M; Pieters, G

    2009-01-01

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

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

    PubMed

    Sondheimer, Adrian

    2010-01-01

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

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

    PubMed

    Tarsitani, Lorenzo; Tarolla, Emanuele; Pancheri, Paolo

    2006-03-01

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

  10. [Forensic psychiatry: contradictions between clinical practice and justice].

    PubMed

    Küchenhoff, J

    1988-03-01

    All the different branches in forensic psychiatry have to face identical handicaps resulting from the difficulties in cooperation with the law-court. For the psychiatrist, his identity as a therapist is contradictory to his forensic tasks. The paper deals with the resulting dilemmata (partiality v. neutrality; diagnostic approach v. legal consequence; psychiatric v. legal methodology and scientific standard). The best way for both sciences to cooperate is by reflecting these handicaps and dilemmata rather than denying them.

  11. The legal basis of forensic psychiatry: statutorily mandated psychiatric diagnoses.

    PubMed

    Bloom, J D; Rogers, J L

    1987-07-01

    Using the Oregon statutory scheme as an example, the authors review certain areas of the law where psychiatric expertise is mandated by statute. This review points out the diversity of determinations where forensic psychiatric expertise is required by law. The authors' thesis is that forensic psychiatry draws its vitality from the law. Legal requirements, however, should not dictate psychiatric response, which should be guided by psychiatric knowledge and ethical concerns.

  12. [Specialized training in geriatric psychiatry during residency in France].

    PubMed

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

    2014-09-01

    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.

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

    PubMed

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

    2015-01-01

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

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

    PubMed

    Freitas, Fernando Ferreira Pinto de

    2004-01-01

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

  15. [Subsyndromal delirium -- experience in psychiatry -- expectations for postoperative management].

    PubMed

    Brinkers, Michael; Pfau, Giselher; Gerth, Nico; Hachenberg, Thomas

    2014-07-01

    The phenomenon of delirium is well known since over 100 years. The anesthesiology has recognized that early detection and therapy results in significant improvement of postoperative clinical state of health of the patients. In the following article it will be discussed that it could be profitable to make a further step: threatening the subsyndromal delirium. Because there are only few experiences in anesthesiology, this thesis will be substantiated by datas from psychiatry.

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

    PubMed

    Li, Wenjing; Schmiedebach, Heinz-Peter

    2015-09-01

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

  17. [Psychiatry with open doors. Part 2: Therapeutic challenges].

    PubMed

    Sollberger, D; Lang, U E

    2014-03-01

    In the previous part of the issue we argued that opening the doors of acute psychiatric inpatient wards is actually one of the anchor points on the way to an innovative psychiatry. It focuses on the patient's personality in a sense that this is taken as seriously as the psychiatric disorder itself. Patients and relatives should be enabled to participate in treatment decisions as they should experience that treatment teams are concerned about reliance, liability and security in therapeutic relationships in an empathetic way. The second part of the issue contributes to the therapeutic measures, the different skills and modifications of treatment frameworks in acute psychiatry (e.g. prevention of crowding in acute psychiatric inpatient units, education of staff, assessment of the risks of violence, de-escalation strategies and coping with suicidality). They might be helpful in implementing the outlined confidence about the essence of therapeutic relationships, autonomy and codetermination of patients in treatment. These suggestions might enhance a professional approach particularly with respect to prevention and also concerning acute interventions in situations of endangerment to self and others and of aggression and violence in the units. In this way they help to achieve the goal of open doors in psychiatry.

  18. Racism in psychiatry: paradigm lost--paradigm regained.

    PubMed

    Bhugra, D; Bhui, K

    1999-05-01

    Racism and psychiatry have been 'linked' in the public imagination, largely because psychiatry is seen as an instrument of social control, and racism as a different form of oppression which permeates society at large. Racism in psychiatry is often believed to be the mediating factor in cases of 'psychiatric misdiagnosis' and 'mismanagement.' Misdiagnosis includes underdiagnosis and overdiagnosis; this can account for the non-delivery of appropriate treatments because of an erroneous diagnostic label. In some instances this leads to a deferred intervention, or in some ethnic groups, help-seeking is delayed for unnecessarily long periods. Racism is not a recent phenomenon. The blunt application of the word 'racism' perpetuates conceptual confusion about what is meant by the term, what processes are taking place, how much of the processes are institutionalized or individual and to what degree individuals are aware of the impact of their actions. We propose a way of understanding racism in psychiatric practice, and suggest that within such a framework, the therapist/professional and the patient can work together towards improving patient care.

  19. The Role of Lead and Cadmium in Psychiatry

    PubMed Central

    Orisakwe, Orish Ebere

    2014-01-01

    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. PMID:25210669

  20. How Animal Models Inform Child and Adolescent Psychiatry

    PubMed Central

    Stevens, Hanna E.; Vaccarino, Flora M.

    2015-01-01

    Objective Every available approach should be utilized to advance the field of child and adolescent psychiatry. Biological systems are important for the behavioral problems of children. Close examination of non-human animals and the biology and behavior they share with humans is an approach that must be used to advance the clinical work of child psychiatry. Method We review here how model systems are used to contribute to significant insights into childhood psychiatric disorders. Model systems have not only demonstrated causality of risk factors for psychiatric pathophysiology but have also allowed child psychiatrists to think in different ways about risks for psychiatric disorders and multiple levels that might be the basis of recovery and prevention. Results We present examples of how animal systems are utilized to benefit child psychiatry, including through environmental, genetic, and acute biological manipulations. Animal model work has been essential in our current thinking about childhood disorders, including the importance of dose and timing of risk factors, specific features of risk factors that are significant, neurochemistry involved in brain functioning, molecular components of brain development, and the importance of cellular processes previously neglected in psychiatric theories. Conclusion Animal models have clear advantages and disadvantages that must both be considered for these systems to be useful. Coupled with increasingly sophisticated methods for investigating human behavior and biology, animal model systems will continue to make essential contributions to our field. PMID:25901771

  1. [Psychiatry with open doors. Part 2: Therapeutic challenges].

    PubMed

    Sollberger, D; Lang, U E

    2014-03-01

    In the previous part of the issue we argued that opening the doors of acute psychiatric inpatient wards is actually one of the anchor points on the way to an innovative psychiatry. It focuses on the patient's personality in a sense that this is taken as seriously as the psychiatric disorder itself. Patients and relatives should be enabled to participate in treatment decisions as they should experience that treatment teams are concerned about reliance, liability and security in therapeutic relationships in an empathetic way. The second part of the issue contributes to the therapeutic measures, the different skills and modifications of treatment frameworks in acute psychiatry (e.g. prevention of crowding in acute psychiatric inpatient units, education of staff, assessment of the risks of violence, de-escalation strategies and coping with suicidality). They might be helpful in implementing the outlined confidence about the essence of therapeutic relationships, autonomy and codetermination of patients in treatment. These suggestions might enhance a professional approach particularly with respect to prevention and also concerning acute interventions in situations of endangerment to self and others and of aggression and violence in the units. In this way they help to achieve the goal of open doors in psychiatry. PMID:23579876

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

    PubMed

    Horwitz, Allan V; Grob, Gerald N

    2016-08-01

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

  3. Palliative Care Psychiatry: Update on an Emerging Dimension of Psychiatric Practice

    PubMed Central

    Fairman, Nathan

    2013-01-01

    Palliative care psychiatry is an emerging subspecialty field at the intersection of Palliative Medicine and Psychiatry. The discipline brings expertise in understanding the psychosocial dimensions of human experience to the care of dying patients and support of their families. The goals of this review are (1) to briefly define palliative care and summarize the evidence for its benefits, (2) to describe the roles for psychiatry within palliative care, (3) to review recent advances in the research and practice of palliative care psychiatry, and (4) to delineate some steps ahead as this sub-field continues to develop, in terms of research, education, and systems-based practice. PMID:23794027

  4. Talking about stigma towards mental health professionals with psychiatry trainees: a movie club approach.

    PubMed

    Kalra, Gurvinder

    2012-09-01

    Psychiatry as a discipline is often perceived as 'different' by other medical professionals as much as by a common man. This perception of 'difference' may give rise to stigma both towards mental illness and to mental health professionals. Mental health professionals are thus both recipients of stigma and agents who can de-stigmatize psychiatry. A psychiatry movie club approach can be a very useful learning experience to understand various aspects of this stigmatization process. This paper presents a brief account of such an endeavour in which the film Gothika (2003) was used to help psychiatry trainees talk about their experiences with stigma towards mental illness as well as their profession.

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

    PubMed

    Lerner, Vladimir; Margolin, Jacob; Witztum, Eliezer

    2012-06-01

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

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

    PubMed

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

    2011-07-01

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

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

    PubMed

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

    2011-07-01

    Switching antipsychotics is common in the clinical practice setting and is associated with potential clinically relevant complications. An expert group selected by Spanish Society of Psychiatry and the Spanish Society of Biological Psychiatry has reviewed the evidence provided by randomized clinical trials and other relevant information to reach consensus recommendations for switching antipsychotics. In this article, we will review all the information that has led to those recommendations and which includes: indications and contraindications for switching antipsychotics, pharmacological issues, switching strategies, switching antipsychotics due to efficacy problems, switching antispychotics due to tolerability issues (including extrapyramidal symptoms and tardive dyskinesia, weight gain, metabolic disorders, hyperprolactinemia, sexual dysfunction, persistent sedation, and QT prolongation), switching antypsychotics due to lack of treatment compliance, and switching antipsychotics in patients with bipolar disorders. PMID:23446195

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

    PubMed

    Aoki, Tsutomu

    2015-01-01

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

  9. Attracting young academics into the field of psychiatry and psychotherapy in Switzerland--the Zurich 'Study Focus on Psychiatry' and training concept for medical psychotherapy.

    PubMed

    Gerke, Wolfgang; Rufer, Michael; Schnyder, Ulrich

    2013-08-01

    For several years the demand regarding psychiatrists in Switzerland can only be satisfied by recruiting colleagues from other countries. Given the global increase of mental disorders, initiatives encouraging young academics to choose psychiatry as their speciality, and enhancing the attractiveness of our field, are urgently needed. Two projects for the promotion of young academics are presented in this paper, one working with medical students, the other with residents in psychiatry. The Zurich 'Study Focus on Psychiatry' provides medical students with knowledge and key competencies in psychiatry at an early stage of their undergraduate training. This way, students are offered an opportunity to have a thorough look into psychiatry as a clinical specialism and as a science. The three-year psychotherapy training curriculum in medical psychotherapy provides residents in psychiatry and psychotherapy with specific training in either cognitive behavioural, or psychodynamic, or systemic psychotherapy. Additionally, and independent of the psychotherapeutic orientation they have chosen, all trainees attend joint sessions focusing on generic elements of psychotherapy and facilitating a hands-on transfer of psychotherapeutic principles into their clinical routine. These two projects aim at enhancing the attractiveness of psychiatry and psychotherapy as a speciality, and thus contributing to the promotion of young academics.

  10. [Use of ROC analysis in psychiatry].

    PubMed

    Fombonne, E; Fuhrer, R

    1992-01-01

    The fundamental principles of ROC analysis are described. This method provides a means to assess the overall discriminant power of psychiatric rating scales for the full range of their scores. For each cut-off, an instrument has a sensitivity (true positive rate) and a specificity (true negative rate). High values of these coefficients are desirable although they are inversely related. ROC curves can be obtained by plotting the false positive rate and the true positive rate for different thresholds of the rating scale. The curves which would be obtained with a perfect, a worthless and a typical instrument are drawn to illustrate various situations found in ROC analysis. Among the several indices proposed, the area under the curve (AUC) is the most commonly used index to assess the overall discriminant power of an instrument. To calculate this area, the non parametric trapezoidal method is advocated. The area under the curve varies between 0.50 which corresponds to the chance line up to 1.0, a value associated with perfect accuracy. This parameter can be interpreted as the probability of classifying correctly the subjects of a pair where one is normal and one is diseased. Then, the appropriate statistic to compare several ROC indices is provided for the general case of independent observations. When the observations are paired, the standard error of the difference between two areas needs to be corrected.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Posttraumatic polarization in psychiatry and law.

    PubMed

    Beahrs, J O

    1999-01-01

    Psychological trauma heightens and rigidifies the penchant of humans for dichotomizing others into allies and enemies. With today's "adult delayed recall" controversy a case in point, traumatized individuals tend to unite into tightly knit in-groups that resemble cults and to denigrate others as enemies. This process creates new enmities where objective interests otherwise clash only minimally. The trauma response is reinforced by the neurobiology of avoidance and reenactment. Among all protagonists, polarized beliefs are mutually shaped by suggestive interactions that resemble hypnosis. The end result is to reenact and perpetuate the trauma response on a large scale. In the contemporary milieu, this process presents a formidable obstacle to cooperative problem solving. Discussion focuses on strategies by which clinical and forensic psychiatrists can help to master this obstacle. These strategies include balancing interests, extending the role of informed consent, and overall, striving to mitigate the unwitting reinforcement and transmission of the trauma response. PMID:10400440

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

    PubMed

    Pezard, L; Nandrino, J L

    2001-01-01

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

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

    ERIC Educational Resources Information Center

    Al-Taiar, Hasanen

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Zigman, Daniel; Young, Meredith; Chalk, Colin

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Retamero, Carolina; Ramchandani, Dilip

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Brenner, Adam M.

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Touchet, Bryan K.; Coon, Kim A.

    2005-01-01

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

  4. The Career Development Institute for Psychiatry: An Innovative, Longitudinal Program for Physician-Scientists

    ERIC Educational Resources Information Center

    Kupfer, David J.; Schatzberg, Alan F.; Grochocinski, Victoria J.; Dunn, Leslie O.; Kelley, Katherine A.; O'Hara, Ruth M.

    2009-01-01

    Objectives: The Research Career Development Institute for Psychiatry is a collaboration between the University of Pittsburgh and Stanford University to recruit and train a broad-based group of promising junior physicians by providing the necessary skills and support for successful research careers in academic psychiatry. Methods: Participants…

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Agyapong, Vincent Israel Opoku; McLoughlin, Declan

    2012-01-01

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

  8. Forensic psychiatry in nineteenth-century Saxony: the case of Woyzeck.

    PubMed

    Steinberg, Holger; Schmidt-Recla, Adrian; Schmideler, Sebastian

    2007-01-01

    In contrast to other areas of psychiatry, little work has been done on the history of forensic psychiatry, and such work is especially scarce regarding the first half of the 19th century, when forensic psychiatry began to develop together with the neurosciences. One newly discovered archival source bears immediate witness to the genesis of forensic psychiatry and is presented for the first time in this study. That source helps us to better understand, in particular, one of the most important cases in 19th-century German forensic psychiatry - namely, that of Johann Christian Woyzeck, the murderer who became the lead figure and the decisive model for the famous eponymous drama by German poet Georg Büchner. Duke Friedrich August, the heir to the throne of the German kingdom of Saxony, submitted a separately recorded special vote (or, very roughly speaking, a brief) that denied the criminal responsibility of the murderer since he had committed his crime out of jealousy and in an emotionally agitated state of mind that eliminated the offender's free will. Though possessing no relevant professional training, the duke applied, and argued in support of, a syndrome - partial mania - that was then the subject of ongoing controversy in general psychiatry. In that context, his vote and analysis can be seen a part of the conceptual development not only of forensic psychiatry, but also of German psychiatry and criminal law.

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed

    Cohen, Mark

    2016-02-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  15. Teaching Evidence-Based Psychiatry: Integrating and Aligning the Formal and Hidden Curricula

    ERIC Educational Resources Information Center

    Agrawal, Sacha; Szatmari, Peter; Hanson, Mark

    2008-01-01

    Objective: The authors argue that adopting evidence-based psychiatry will require a paradigm shift in the training of psychiatry residents, and offer some suggestions for how this transformation might be achieved. Methods: The authors review the growing literature that addresses how best to teach evidence-based medicine and highlight several…

  16. [Philippe Pinel and the psychiatry of late XVII--early XIX centuries].

    PubMed

    Yakushev, I B; Sidorov, P I

    2013-01-01

    The article analyzes the social economic premises promoting the psychiatry to distinguish to independent medical specialty with its own ideological base and methodological filling. The ideological concepts and methodological priorities of psychiatry prevailing in this epoch using the example of views of F. Pinel, his disciples and contemporaries are considered. PMID:23672075

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed

    Higuchi, Teruhiko

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Malloy, Erin; Hollar, David; Lindsey, Anthony

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Reardon, Claudia L.; Walaszek, Art

    2012-01-01

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

  2. A plea for symptom-based research in psychiatry

    PubMed Central

    Schmidt, Ulrike

    2015-01-01

    Background The significant proportion of patients suffering from subthreshold diagnoses such as partial posttraumatic stress disorder (PTSD) shows that today's diagnostic entities do not fully meet the reality and needs of clinical practice. Moreover, as stated also in the recently announced concept of research domain criteria (RDoC), the use of today's traditional diagnostic systems in psychiatric research does not sufficiently promote an integrative understanding of mental disorders across multiple units of analysis from behavior to neurobiology. Besides RDoC, core symptom-based research concepts have been proposed to bridge the translational gap in psychiatry, but, unfortunately, have not yet become the rule. Objective/method First, this article briefly reviews literature on subthreshold PTSD (as an example for subthreshold diagnoses) and, second, pleas for and proposes a modified symptom-based research concept in psychiatry. Results Subthreshold PTSD has, like other subthreshold psychiatric diagnoses, not yet been clearly defined. Diagnostic entities such as subthreshold PTSD are subject to a certain arbitrariness as they are mainly the result of empiricism. This fact stresses the urgent need for neurobiologically-informed psychiatric diagnoses and motivated the here-presented proposal of a symptom-based research concept. As proposed here, and before by other researchers, symptom-based research in psychiatry should refrain from studying patient cohorts compiled according to diagnoses but, instead, should focus on assessing cohorts grouped according to chief complaints or predominant psychopathological symptoms. Conclusions The linkage of the RDoC concept and symptom-based psychiatric research might probably speed up the definition of biologically or symptom-based psychiatric diagnoses, which might replace the auxiliary constructs of “traditional” diagnoses such as full and subthreshold PTSD, and promote the development of novel psychological and

  3. [Fundamental problems of therapeutic teamwork in psychiatry (author's transl)].

    PubMed

    Rose, H K

    1981-08-01

    Certain institutional and organizational prerequisites are fundamental in present-day translation into reality of essential concepts of psychiatric therapy and rehabilitation. These include, for example, the basic structure of therapeutic co-operation and the form of such co-operation as practices by a multiprofessional team. The creation and shaping of facilities based on the principle of mutual therapeutic co-operation and joint working of team members engaged in therapy, are innovations and are representative of a development by which a specific style in psychiatry gradually takes shape and by which it becomes adequately conscious of its social tasks. As with all innovatory developments there is an inherent danger that individual elements of such innovations assume of life of their own and undergo mystification. The concept "team" in psychiatry form of co-operation can solve many more problems than it can cope with. Hence it is definitely useful to investigate critically into the structure of teamwork in psychiatry, into its possibilities and prerequisites and into the extent to which teams are superior to conventional forms of organization in meeting the specific demands made by treating the mentally diseased. It becomes evident that among the basic conditions of teamwork are significant attitudes to therapy and that the therapeutic approaches derived therefrom can be successful only on teamwork basis. At the same time, however, limitations become apparent beyond which teamwork - now no longer understood as a problem-related principle of co-operation, but as an ideology - threatens to become dysfunctional and anti-therapeutic, creating compulsions which are diametrically opposed to the very essence of therapy and also to the needs of the therapist group.

  4. The Application of Psycho-Analytic Principles in Psychiatry

    PubMed Central

    Glover, Edward

    1935-01-01

    Psychiatrists are inclined to follow the lead of their medical colleagues in regarding psycho-analysis mainly as a method of psychological treatment. The fact is thus obscured that the main contributions of psycho-analysis to science are in terms of the structure and function of mind. Of most importance to psychiatrists are the fundamental conceptions of a mental apparatus, of its differentiated parts, of mental mechanisms, and of the developmental order of these parts and mechanisms. The view is maintained that systematic application of these genetic views to the field of psychiatry (which has as yet been explored mainly from the descriptive point of view) would not only illuminate many obscure problems of mental origins, but lead to a more orderly and comprehensible arrangement of psychiatric (clinical) entities. Coöperation between the sciences of psycho-analysis and psychiatry is essential, but cannot be achieved without pooling the methods of investigation. Too much time and energy are spent in fighting old battles regarding the validity of methods of analytical approach. This is particularly true of quarrels regarding the interpretation of material. Unless the psychiatrist exercises the right of interpretation (which has been won for him by the psychoanalyst) descriptive methods of approach will soon lose whatever research value they have attained. The atmosphere of distrust existing between the sciences is due in part to unresolved conflict over the claims of “conscious” and “unconscious” psychology respectively, and in part to unresolved doubt regarding the relations of body and mind. These more fundamental forms of distrust show themselves most readily in the therapeutic field and tend to hinder the progress both of psychiatry and of psycho-analysis. PMID:19990248

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

    PubMed

    Pies, Ronald W

    2016-02-01

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

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

    PubMed

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

    2015-03-01

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

  7. Policies and Consequences: How America and Psychiatry Took the Detour to Erewhon.

    PubMed

    Becker, Robert E

    2015-10-01

    In the mid-1960s, federal legislation provided psychiatry with funds for construction and initial staffing of local community mental health programs and funded university psychiatry departments to support research, innovations, and education in social-community psychiatry. Psychiatry gained resources for treating diseases and for addressing the disabilities that accompany mental illnesses. Abrupt losses of federal funding in the following decades, combined with restrictive insurance reimbursements and the expanding influence of the pharmaceutical industry, undermined psychiatry's abilities to address the needs of persons with severe mental illness. The author describes the perverse shift in social priorities that has occurred-with persons who have chronic mental illness housed in jails and heightened public perceptions that mass murders are the acts of persons with mental illness. PMID:26073412

  8. Policies and Consequences: How America and Psychiatry Took the Detour to Erewhon.

    PubMed

    Becker, Robert E

    2015-10-01

    In the mid-1960s, federal legislation provided psychiatry with funds for construction and initial staffing of local community mental health programs and funded university psychiatry departments to support research, innovations, and education in social-community psychiatry. Psychiatry gained resources for treating diseases and for addressing the disabilities that accompany mental illnesses. Abrupt losses of federal funding in the following decades, combined with restrictive insurance reimbursements and the expanding influence of the pharmaceutical industry, undermined psychiatry's abilities to address the needs of persons with severe mental illness. The author describes the perverse shift in social priorities that has occurred-with persons who have chronic mental illness housed in jails and heightened public perceptions that mass murders are the acts of persons with mental illness.

  9. Overview of integrative medicine in child and adolescent psychiatry.

    PubMed

    Simkin, Deborah R; Popper, Charles W

    2013-07-01

    Complementary and alternative medicine (CAM) defies simple definition, because the distinction between CAM and conventional medicine is largely arbitrary and fluid. Despite inconclusive data on the efficacy and safety of many CAM treatments in child and adolescent psychiatry, there are enough data on certain treatments to provide guidance to clinicians and researchers. CAM treatments, as adjunctive therapy or monotherapy, can be clinically beneficial and sensible. The low stigma and cost-competitiveness of many CAM psychiatric treatments are highly attractive to children and parents. Physicians need to be knowledgeable about CAM treatments to provide clinically valid informed consent for some conventional treatments.

  10. The phenomenological method in qualitative psychology and psychiatry.

    PubMed

    Englander, Magnus

    2016-01-01

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

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

    PubMed

    Frank, J D

    1984-11-01

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

  12. Ulysses arrangements in psychiatry: a matter of good care?

    PubMed

    Gremmen, I; Widdershoven, G; Beekman, A; Zuijderhoudt, R; Sevenhuijsen, S

    2008-02-01

    This article concerns the issue of how an ethic of care perspective may contribute to both normative theory and mental health care policy discussions on so called Ulysses arrangements, a special type of advance directives in psychiatry. The debate on Ulysses arrangements has predominantly been waged in terms of autonomy conceived of as the right to non-intervention. On the basis of our empirical investigations into the experiences of persons directly involved with Ulysses arrangements, we argue that a care ethics perspective may broaden and deepen the debate on Ulysses arrangements, by introducing additional concepts, such as vulnerability, responsibility and mutuality, and by refining familiar concepts, such as autonomy. PMID:18234942

  13. Psychiatry, subjectivity and emotion - deepening the medical model

    PubMed Central

    Yakeley, Jessica; Hale, Rob; Johnston, James; Kirtchuk, Gabriel; Shoenberg, Peter

    2014-01-01

    Morale among psychiatrists continues to be seriously challenged in the face of recruitment difficulties, unfilled posts, diagnostic controversies, service reconfigurations and public criticism of psychiatric care, in addition to other difficulties. In this article, we argue that the positivist paradigm that continues to dominate British psychiatry has led to an undervaluing of subjectivity and of the role of emotions within psychiatric training and practice. Reintegrating the subjective perspective and promoting emotional awareness and reflection may go some way towards restoring faith in the psychiatric specialty. PMID:25237517

  14. Working life and mental health - A challenge to psychiatry?

    PubMed Central

    LEVI, LENNART

    2005-01-01

    According to the World Health Organization, "mental health problems and stress-related disorders are the biggest overall cause of early death in Europe". Some of the root causes of this morbidity and mortality are related to living and working conditions that are accessible to preventive and therapeutic interventions, individual as well as collective ones. A political mandate for such interventions is now developing. Members of the WPA Section on Occupational Psychiatry have contributed to this development and we now invite the readers to join the Section in its endeavours. PMID:16633507

  15. Private in-patient psychiatry in the USA

    PubMed Central

    Russakoff, L. Mark

    2014-01-01

    The US healthcare system is in the midst of major changes driven by four forces: the growing consensus in the country that the current system is financially unsustainable; managed care and parity legislation; the Affordable Care Act 2010; and the ageing of the ‘baby boomer’ generation. How these forces will combine and interact is unclear. The current state of in-patient psychiatric care and trends affecting the private practice of in-patient psychiatry over the next few years will be described. PMID:25285222

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

    SciTech Connect

    Frank, J.D.

    1984-11-01

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

  17. Salem witchcraft and lessons for contemporary forensic psychiatry.

    PubMed

    Friedman, Susan Hatters; Howie, Andrew

    2013-01-01

    In 1692 and 1693, in Salem, Massachusetts, more than 150 colonists were accused of witchcraft, resulting in 19 being hanged and one man being crushed to death. Contributions to these events included: historical, religious and cultural belief systems; social and community concerns; economic, gender, and political factors; and local family grievances. Child witnessing, certainty of physician diagnosis, use of special evidence in the absence of scholarly and legal scrutiny, and tautological reasoning were important factors, as well. For forensic psychiatry, the events at Salem in 1692 still hold contemporary implications. These events of three centuries ago call to mind more recent daycare sexual abuse scandals.

  18. Resolution of the Polarisation of Ideologies and Approaches in Psychiatry

    PubMed Central

    Singh, Ajai; Singh, Shakuntala

    2004-01-01

    The uniqueness of Psychiatry as a medical speciality lies in the fact that aside from tackling what it considers as illnesses, it has perchance to comment on and tackle many issues of social relevance as well. Whether this is advisable or not is another matter; but such a process is inevitable due to the inherent nature of the branch and the problems it deals with. Moreover this is at the root of the polarization of psychiatry into opposing psychosocial and biological schools. This gets reflected in their visualization of scope, in definitions and in methodology as well. Whilst healthy criticism of one against the other school is necessary, there should be caution against hasty application of one's frame of reference to an approach that does not intend to follow, or conform to, one's methodology. This should be done within the referential framework of the school critically evaluated, with due consideration for its methods and concepts. Similarly, as at present, there is no evidence to prove one or the other of these approaches as better, aside from personal choice. We can say so even if there is a strong paradigm shift towards the biological at present. A renaissance of scientific psychoanalysis coupled with a perceptive neurobiology which can translate those insights into testable hypotheses holds the greatest promise for psychiatry in the future. This suggests the need for unification of diverse appearing approaches to get a more comprehensive and enlightened worldview. It requires a highly integrative capacity. Just as a physicist thinks simultaneously in terms of particles and waves, a psychiatrist must think of motives, emotions and desires in the same breath as neurobiology, genetics and psychopharmacology. However, the integration must be attempted without destroying the internal cohesiveness of the individual schools. This will give a fair chance for polarization in which a single proper approach in psychiatry could emerge, which may be a conglomerate of

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

    PubMed

    Rzesnitzek, L

    2014-09-01

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

  20. [A testimony procedure of forensic psychiatry used for criminal cases].

    PubMed

    Chen, X S

    1991-04-01

    A testimony procedure of forensic psychiatry containing of the following steps as: "to set-up the medical diagnosis-to clarify the criminal motive-to determine the property of criminal legal ability damage-to evaluate the criminal responsibility" is recommended, and upon them "to clarify the criminal motive" is of importance. The property of criminal legal ability damage can be determined through the criminal motive and then the degree of criminal responsibility can be evaluated objectively through the criminal motive and criminal legal ability effected by the disease.