Psychiatric Approach Research Articles

Euthanasia: the role of the psychiatrist

Belgium has become one of the few countries in the world where euthanasia is legally allowed within a specific juridical framework. Even more unique is the inclusion of grounds for requesting euthanasia on the basis of mental suffering. Further refinement of the legal, medical and psychiatric approach to the issue is required in order to clear up essential practical and ethical matters. Psychiatrists and their professional organisations need to play a greater role in this ongoing debate and contribute from a clinical, scientific and ethical point of view.

Bodily symptoms: New approaches to classification

Objective To examine the current approach to classifying bodily symptoms in both psychiatry and medicine and to suggest better alternatives. Methods Theoretical analysis, narrative review, and theoretical proposal. Results The assumptions that (a) bodily pathology can always explain bodily symptoms, (b) psychopathology can always explain bodily symptoms in the absence of bodily pathology, and (c) dichotomizing bodily symptoms into “medical” and “psychiatric” types is clinically useful were all found to have questionable validity and utility. Conclusion Alternative multiaxial diagnostic approaches for the classification of bodily symptoms are proposed. These are intended to (a) give greater prominence to bodily symptoms in their own right, (b) allow etiology to be conceptualized in terms of multiple factors, and (c) provide the basis for integrating medical and psychiatric approaches to patient care.

Psychiatric aspects of head injury management

Acute damage to the brain may lead to many changes in a patient's behaviour and some of these behavioural changes will lead to the involvement of a psychiatrist. This article emphasizes that the usual clinical psychiatric approach is still appropriate, within the constraints of the situation. The specific skill needed is to analyze the behaviour in terms of all the potential causative factors. This is best done within the illness model derived from the World Health Organization's International Classification of Functioning (outlined in this article). In essence, one needs to establish whether the person has any ‘hidden’ specific neurological impairments, and to consider their context (physical, social and personal). The main fact to bear in mind is that brain injury is rarely the specific direct cause of irrational or unacceptable behaviour. The important influences are usually the environment, the person's pre-existing behavioural patterns, drugs (licit and illicit), and less commonly perceptual or cognitive losses. Management of difficult behaviour occurring in the early stages after brain damage is largely one of preserving safety through providing a suitable environment, including one-to-one care if needed while recovery occurs. Later it is likely that the brain injury is a specific factor, and management will be as it would be for anyone else presenting with similar problems. Time spent understanding why a behaviour arises will usually ensure the optimal management.

Foucaulte o Poder

The purpose of this paper is to present some thoughts upon the ever pressing question of the role of justice in our societies, according to Michel Foucault. Centered upon Discipline & Punish: The Birth of the Prison, the paper draws the guidelines which Foucault developed about the aggiornamento of the exercise of power and its changing methods, from torture to the scientific methods which he named technologies of the self. Going from the exercise of violence centered upon the body to its submission by means of idea and mind control, power has associated itself to the scientific (psychiatric) approach of identity, leading to a controllable abnormality (present in prisons). All of this in the name of a population policy, a bio power which ensures the docility of individuals while optimizing their productive force. Hence the remaining epigraph quoted challenge where Plato provocatively States: justice is the same everywhere, it is the rule of the strongest.

A Cartography of Mental Health

A practicing psychoanalyst and clinical psychologist, the author offers a psychoanalytical perspective on psychic illness within a contras tive framework of twentieth-century Western psychiatric and psycho analytic outlooks on mental health. Drawing on Jaspers's exemplary discussion of the differences between psychiatric and phenomenologi cal-interpretative approaches to psychopathology, the author applies it to her exegesis of the Lacanian conceptions of the human unconscious, the dynamics of symptom formation, as well as the significance of mental malady for understanding the structure of the human subject. As differ ent forms of psychopathology express themselves in social phenomena, the author advocates a wider application of psychoanalytic ethnography or applied psychoanalysis to help subjects deal with natural disasters, personal crises, and everyday life. Taking into account the adversities that affect individuals and societies and the diversity of contexts, the dynamic process of applied psychoanalysis can make contributions toward achieving vital understanding.

Mérycisme infantile

Infantile rumination can be defined as self-induced regurgitation of previously swallowed food. Because it can lead to potential somatic complications and because it implies dysfunctional mother-child bonding, both a pediatric and psychiatric approach is needed. The treatment must be somatic (nutritional) and psychological (intensive nursing, mother-baby psychotherapy). Two case studies illustrate this rare but impressive picture.

Handbook of Clinical Alcoholism Treatment

Handbook of Clinical Alcoholism Treatment

A Psychiatric Approach to Chronic Dizziness

A Psychiatric Approach to Chronic Dizziness

American Psychiatric Publishing Textbook of Neuropsychiatry and Clinical Neurosciences, 4th ed. • Essentials of Neuropsychiatry and Clinical Neurosciences

Back to table of contents Previous article Next article Book Forum: Textbooks and HandbooksFull AccessAmerican Psychiatric Publishing Textbook of Neuropsychiatry and Clinical Neurosciences, 4th ed. • Essentials of Neuropsychiatry and Clinical NeurosciencesDAVID W. HODO, M.D., DAVID W. HODOSearch for more papers by this author, M.D., Selma, Ala.Published Online:1 Mar 2005https://doi.org/10.1176/appi.ajp.162.3.636AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The goal of these two large edited textbooks, with many contributors, is to present broad overviews of the bulging information based on the neural basis of behavior, alternately viewed as “neuropsychiatry and behavioral neurology.” For the Textbook, this represents a 15-year, fourth-edition evolution. Essentials is a newer, briefer, synoptic effort. Both are well-conceived, crisply written efforts useful as a general discussion of this hybrid science and as a resource on individual subjects. There is a reasonably successful argument toward synthesis with board certification, and there is organization, both essentials to cohesion and recognition. There is obviously an unending struggle for the soul and rights to the brain and its behavioral constitution among psychiatrists, neurologists, psychologists, neurophysiologists, geneticists, etc. There is also the ever-present devil, compensation. Psychiatrists must weave the science of their field into an effective force for comprehension and effective treatment to find a reputable and equal, if not preeminent, place in modern medicine. Is the psychiatric M.D. equal to other medical degrees? Can psychiatrists “deliver the mail”? These two volumes speak eloquently to the notion that psychiatry is a real science, with neuropsychiatry a subspecialty.Dr. Yudofsky and Dr. Hales have long labored in the field. The contributors—88 in the Textbook and 46 in Essentials—are impressive, leaders in their respective areas and representing multiple disciplines.Each chapter of both textbooks speaks to some essential area of a neural substrate of human development with its social and physical activity. Some areas, such as aphasia and delirium, are more closely associated with neurology but are open to a more psychiatric approach. Others, such as schizophrenia, seek neurological underpinnings. You can imagine the dendrites seeking new connections.Two chapters that are most pleasingly done are the long chapter on genetics and the short chapter on attention in the Textbook. These two subjects are dominant areas of modern interest. Both chapters are superbly written. There is apt praise for the radiological advances that produced the current excitement in the understanding of the brain at work. These images, beautifully pictured in both books, have become important substrates in the understanding and treatment of neuropsychiatric conditions not only with medication but with cognitive efforts as well.These companion volumes are important, timely, and comprehensive efforts. The Textbook is the more appealing volume. The breadth of the subject seems to cry for a more in-depth perusal. Essentials is also quite appealing, succinct, adequate to the task, and a lot lighter. These books are to be highly recommended to all physicians as well as to the general public interested in these subjects. The interest in how the brain works, from National Public Radio to friends without any scientific training, seems to be growing as the field explodes. These books corral the knowledge admirably and present it in an organized, understandable form.Edited by Stuart C. Yudofsky, M.D., and Robert E. Hales, M.D., M.B.A. Washington, D.C., American Psychiatric Publishing, 2002, 1,404 pp., $241.95. • Edited by Stuart C. Yudofsky, M.D., and Robert E. Hales, M.D., M.B.A. Washington, D.C., American Psychiatric Publishing, 2004, 770 pp., $69.00 (paper). FiguresReferencesCited byDetailsCited byNone Volume 162Issue 3 March 2005Pages 636-636 Metrics PDF download History Published online 1 March 2005 Published in print 1 March 2005

Trabalhadores em saúde mental: relações entre práticas profissionais e bem-estar físico e psicológico

Este estudo investiga o impacto da reforma psiquiátrica no bem-estar físico e psicológico dos trabalhadores de saúde mental. Participaram 201 trabalhadores em saúde mental de hospitais psiquiátricos e serviços substitutivos de Goiânia. Foram analisadas as correlações entre adesão ao modelo teórico de atenção em saúde mental (biológico versus psicossocial), satisfação com atividades desempenhadas, local de trabalho, tempo de serviço e carga horária trabalhada com o bem-estar físico e psicológico dos trabalhadores. Constatou-se que os trabalhadores que mais aderem ao paradigma biológico e estão mais satisfeitos com as atividades desempenhadas são os que apresentam os níveis mais altos de bem-estar físico e psicológico. Esses resultados são discutidos enfatizando-se a importância desse tipo de análise para a consolidação da reforma psiquiátrica no Brasil.

Between Institutional Psychiatry and Mental Health Care: Social Psychiatry in The Netherlands, 1916–2000

The term “social psychiatry” became current in the Netherlands from the late 1920s. Its meaning was imprecise. In a general way, the term referred to psychiatric approaches of mental illness that focused on its social origins and backgrounds. In this broad interpretation social psychiatry was connected to the psycho-hygienic goal of preventing mental disorders, but also to epidemiological research on the distribution of mental illness among the population at large. The treatment called “active therapy”, introduced in Dutch mental asylums in the 1920s and geared towards the social rehabilitation of the mentally ill (especially through work), was also linked with social psychiatry. In a more narrow sense social psychiatry indicated what before the 1960s was usually called “after-care” and “pre-care”: forms of medical and social assistance for patients who had been discharged from the mental asylum or who had not yet been institutionalized. This article focuses on the twentieth-century development of Dutch social psychiatry in this more narrow sense, without, however, losing sight of its wider context: on the one hand institutional psychiatry for the insane and on the other the mental hygiene movement and several outpatient mental health facilities, which targeted a variety of groups with psychosocial and behavioural problems. In fact, the vacillating position of pre- and after-care services was again and again determined by developments in these adjacent psychiatric and mental health care domains. This overview is chronologically divided into three periods: the period between and during the two world wars, when psychiatric pre- and aftercare came into being; the post-Second World War era until 1982, when the Social-Psychiatric Services expanded and professionalized; and the 1980s and 1990s, when they became integrated in community mental health centres.

"There but for the grace of God": moral responsibility and mental illness.

Setting the terms of praise- and blameworthiness has long dominated philosophers' discussions of responsibility. Analytic philosophy has most often looked to reason and the abstract relations between individual rational judgements and actions to advance the discourse on moral responsibility. Those whose capacity for reasoned judgement is impaired are deeply problematic. Is it proper to morally appraise "the mentally ill"? The philosopher T.M. Scanlon discusses moral responsibility as a precondition of moral appraisal and contends that it is not appropriate to appraise a person as (morally) praise- or blameworthy if that person cannot be held responsible for the action(s) for which he is being praised or blamed. What are the conditions, then, under which one can properly be said to be responsible for one's actions? Can one hold "the mentally ill" responsible for their actions? If not, can it in any way be reasonable to expect them to "take responsibility" for their actions and/or characters? The expectation that "the mentally ill" will attempt to control, i.e. take responsibility for their behaviour despite the fact of their mental illness is a pervasive feature of psychiatric approaches to the care and treatment of "the mentally ill". It would seem that such treatment approaches are coherent only to the degree "the mentally ill" can be considered responsible moral agents. This paper explores these issues with regard to that form of mental illness categorized as the personality disorders. It describes the morally and clinically relevant features of personality disorder, explains how they do not fit traditional analytic paradigms of "mental illness" and elaborates the argument that persons with this category of mental illness are fully moral persons who are rightly subject to praise and blame.

Supported Education: A Portrait of a Psychiatric Rehabilitation Intervention

This article provides a thorough overview of supported education, tracing its inception and evolution as an application of the psychiatric rehabilitation approach. A host of factors, including disability legislation, supported employment, recognition of stigma, expanded access to college campuses, and new research and dissemination initiatives have all helped to develop, define, and document the components of supported education (SEd). This article illustrates that the essence of SEd is the process of psychiatric rehabilitation, with its unique client-centered focus: a well-defined mission, principles and philosophy of strength and hope; individualized goal setting and readiness, skill, and support assessments; and personalized skill and resource development. An in-depth discussion of the process needed to choose, get, and keep an educational path illustrates the application of the psychiatric rehabilitation approach. SEd may also go beyond rehabilitation to assist in the process of recovery. New studies ...

Prise en charge de l'anorexie mentale en réanimation

During the course of anorexia nervosa, admission in an intensive care unit may be required because of organ failure or more frequently because of the severity of denutrition. The patients are exposed to three lifethreatening conditions: • Denutrition itself with the risk of severe cardiac complications including sudden death. • The eating underlying disorder especially in patients combining anorexia and bulimia who are often diuretic and laxative abusers. They are likely to develop fluid and electrolytes disturbances such as hypokaliemia and hyponatremia. • The refeeding syndrome, a potentially catastrophic side effect seen in patients who are refed too rapidly by parenteral or even enteral route. Profound hypophosphatemia plays a key role in this syndrome. It is characterized by muscle weakness, cardiac and respiratory failure and may lead to multiorgan failure and death. Management of severe malnutrition during eating disorder requires collaborative nutritional and psychiatric approach. Principles of treatment should be clearly established and presented to the patient on ICU admission. Unfortunately few clinical trials are available to guide precisely therapeutics and most of the treatments proposed have little or no documented efficacy. However cautious progressive enteral nutrition with careful monitoring of vital signs, fluid balance and electrolytes levels (primarily potassium and phosphorus) can be highly recommended.

Psychological impact of the new digital media

This review article starts from the hypothesis that the new digital media's impact on people's mental health, which in professional and private everyday life has become increasingly frequent and intense, is widely underestimated. The disturbances associated with media exposure, which have been already described and examined, are presented and discussed, while classifying them in three groups of disorders, namely dissocial, dissociative and impulse control disorders. In a second step, psychotherapeutic and psychiatric applications of the digital media are presented, especially, psychometric and neuropsychological testing, distribution of information and behavioral therapeutic tools. The positive and negative effects of the internet and cyberspace are applied to the multicausal understanding of the genesis and therapy of mental disturbances. Against this background, the opinion is held, that the paradigmatic medialization of the world has to be taken seriously and actively approached as a psycho-ecological factor with psychosocial, psychopathogenic and also neuroplastic effects. Therefore, also a psychiatric approach is needed to establish both research on media-associated disorders including their therapy and the development of quality standards in the therapeutic use of the Internet and Cyberspace.

Depression in Later Life: A Multidisciplinary Psychiatric Approach

Depression in Later Life: A Multidisciplinary Psychiatric Approach

Reconceptualizing the sequelae of political torture: limitations of a psychiatric paradigm.

A psychiatric model of traumatization has informed most research in psychology on the effects of human rights violations, including political torture, in South Africa. This article highlights some of the limitations of a hegemonic psychiatric approach to conceptualizing current sequelae of abuse experienced by political detainees during the apartheid era. It calls attention to the relevance of the South African social and political context in which survivors are located, methodological problems that characterize psychological research on trauma in South Africa and other developing countries, and the relevance of the meaning that survivors may attribute to their experience of detention and torture.

Development of the DPA Fidelity Scale: using fidelity to define an existing vocational model.

Psychiatric rehabilitation practices are often poorly defined, hindering implementation, research, and dissemination efforts. Documentation of adherence to a specific psychiatric rehabilitation approach is particularly important in conducting randomized controlled trials. This paper outlines steps taken to define and measure the Diversified Placement Approach (DPA), a well-regarded vocational program for people with severe mental illnesses. Details of scale development are described, and the scale's utility for model clarification and detection of experimental drift are discussed.

The couch and the clinic The cultural authority of popular psychiatry and psychoanalysis

This paper examines the discourse produced by psychiatrists and psychoanalysts who wrote for non-professional audiences. As professionals who reached out beyond their professions, their writing raises questions about the authority they invoked. The two factions in this popular psychology, psychiatry and psychoanalysis, staked out cultural authority using systematically different types of appeals. The psychiatric approach involved a ‘pure’ professionalism, invoking psychiatry’s similarities to medicine. The psychoanalytic approach involved an explicit dissociation from medical authority, and claimed a difference from medical expertise as a mark of intellectual transcendence. What becomes clear is that these standpoints were constructed through discourse as types of strategic positionings. Concluding notes address the idea that Antonio Gramsci’s labels of ‘organic’ and ‘traditional’ are not only types of intellectuals; they are also stakes in the game amongst competitors for cultural authority. This insight is then applied to broader considerations regarding public intellectuals.

ANKARA'DAKİ BEŞ EĞİTİM KURUMUNDA KENDİNİ YARALAMA DAVRANIŞI ÜZERİNE BİR ÇALIŞMA

The studies tnat are executed on the selfinjurious behavior show that this behavior usually appear in the adolescence period and that those who self-injurious behavior are in the dense depression sense and that their committing suicide possibility is high. Even there is not sufficient information, it also is thought that the life satisfaction levels of those individuals can be low. Assessing the self-injurious behavior by the social psychiatric approach vvithin the interdiscipline team will increase the effectiveness of the prevention and treatment vvorks that are directed to this behavior, since its etiology has a complex and multi-factor structure. The aim of this research is to investigate life satisfactions, suicide possibilities and depression levels of individuals who behaved to injure themselves at five educational institutions in Ankara. At the result of this research vvhich has been seen that there are differences betvveen those who were in a self-injurious behavior and those who were not in a self-injurious behavior in their life satisfactions, possibility of suicide and depression levels.