Medicine and Health Sciences Commons^™

The Dual Faces Of Misery, Arden Moscati

Theses and Dissertations

Major Depression (MD) and Generalized Anxiety Disorder (GAD) are psychiatric disorders that arise from dysfunction of the core human capacities for emotion. Sapience is inextricably bound up with the potential for feelings of regret, worry and concern. When these emotions lead to clinically significant impairment or distress, they may result in one or both of the disorders of MD and GAD. The occurrence of MD and GAD in the same person, known as comorbidity, is remarkably high; substantially higher than would be expected by chance.

MD and GAD have been studied since the mid-20^th century, resulting in a substantial …

Healer, Witness, Or Double Agent? Reexamining The Ethics Of Forensic Psychiatry, Matthew U. Scherer

Journal of Law and Health

In recent years, psychiatrists have become ever more prevalent in American courtrooms. Consequently, the issue of when the usual rules of medical ethics should apply to forensic psychiatric encounters has taken on increased importance and is a continuing topic of discussion among both legal and medical scholars. A number of approaches to the problem of forensic psychiatric ethics have been proposed, but none adequately addresses the issues that arise when a forensic encounter develops therapeutic characteristics. This article looks to the rules governing the lawyer-client relationship as a model for a new approach to forensic psychiatric ethics. This new model …

Science, Symptoms, And Support Groups:Adhd In The American Cultural Context, Kealy D. Fallon

Theses and Dissertations

This thesis is a cultural analysis of the behaviorally- and psychiatrically-defined disorder ADHD, socio-historically contextualizing it in the United States and exploring ethnographically how people affected by it talk about and organize their experience of its symptoms.

Applying The Information-Motivation-Behavioral Skills Model Of Hiv- Risk To Youth In Psychiatric Care, Geri Donenberg, Rebecca Schwartz, Erin Emerson, Helen Wilson, Fred Bryant, Gloria Coleman

Fred B. Bryant

This study examined the utility of cognitive and behavioral constructs (AIDS in-formation, motivation, and behavioral skills) in explaining sexual risk taking among 172 12–20–year-old ethnically diverse urban youths in outpatient psy-chiatric care. Structural equation modeling revealed only moderate support for the model, explaining low to moderate levels of variance in global sexual risk taking. The amount of explained variance improved when age was included as a predictor in the model. Findings shed light on the contribution of AIDS informa-tion, motivation, and behavioral skills to risky sexual behavior among teens re-ceiving outpatient psychiatric care. Results suggest that cognitive and behavioral factors …

Subjective Measures Of Mz And Dz Twins During Anxiety-Provoking Tasks, Sravya Uppalapati

Undergraduate Research Posters

Temporary anxiety is a healthy response to stress; however, continuous anxiety can threaten an individual’s day-to-day living by eliciting negative responses. In the study, monozygotic 84 (MZ) and 153 dizygotic (DZ) adolescent twins pairs, ages 15 to 20 years, participated in anxiety-provoking tasks and subjective experiences of anxiety were measured using subjective units of distress (SUDS). The twin participants were recruited through the Mid-Atlantic Twin Registry (MATR) at Virginia Commonwealth University. The twins participated in a carbon dioxide (CO₂) breathing task and a trier social stress task (TSST). The study aims were to evaluate the relationship between anxiety-provoking …

The Danger Zone: How The Dangerousness Standard In Civil Commitment Proceedings Harms People With Serious Mental Illness, Sara Gordon

Scholarly Works

Almost every American state allows civil commitment upon a finding that a person, as a result of mental illness, is gravely disabled and unable to meet their basic needs for food and shelter. Yet in spite of these statutes, most psychiatrists and courts will not commit an individual until they are found to pose a danger to themselves or others. All people have certain rights to be free from unwanted medical treatment, but for people with serious mental illness, those civil liberties are an abstraction, safeguarded for them by a system that is not otherwise ensuring access to shelter and …

Large Scale Genetic Research On Neuropsychiatric Disorders In African Populations Is Needed, Shareefa Dalvie, Nastassja Koen, Laramie Duncan, Catherine Abbo, Dickens Akena, Lukoye Atwoli, Bonginkosi Chiliza, Kirsten A. Donald, Eugene Kinyanda, Christine Lochner

Internal Medicine, East Africa

In recent years there have been significant insights into the complex aetiologies of neurodevelopmental brain disorders. For example, neuropsychiatric genetics has achieved success with the identification of 108 loci for schizophrenia (Schizophrenia Working Group of the Psychiatric Genomics Consortium, 2014). Furthermore, meta-analyses of genomewide association study (GWAS) results encompassing thousands of samples have been completed for other psychiatric disorders including attention-deficit/hyperactivity disorder (ADHD), autism

Behavioural Charactertics Of Patients Vulnerable For Repeated Hospitalisation, Amresh Srivastava, Coralee Berlmont, Miky Kaushal, Avinash Desouza, Robbie Campbell, Larry Stitt

Amresh Srivastava

Background

Re-hospitalization which takes place in about 30 to 50% postdischarge patienst, leads to poor outcome, increased rate of mortality and consumes more than 2/3 of budgetary allocations. Inability to identify vulnerable candidates for repeated admissions limits our options for strategic treatment.

Methods

In this prospective study conducted at Regional Mental Health Care ( Presently Parkwood Institute) 101 patienst ( 51 feamles, mean age 43 years), were examined using standard psychometric tools on parameters of clinical, psychopathological, suicide behaviour and resiliency for their risk and preventive characerstics.

Results

We assessed 101 subjects (51 females) with mean age of 42 years. …

How Clinicians Feel About Working With Spouses Of The Chronically Ill, Douglas Ingram

NYMC Faculty Publications

Clinicians who provide psychotherapy to spouses or partners of the chronically ill were solicited through listserves of psychodynamic and other organizations. The current report excluded those therapists working with spouses of dementia patients. Interviews were conducted with clinicians who responded. The interviews highlight the challenges commonly encountered by psychotherapeutic work with this cohort of therapy patients. A comparison is drawn that shows both overlap and distinctions between the experiences of those therapists engaging with spouses of chronically ill patients without a dementing process and those working with spouses of chronically ill patients who do suffer from a dementing process.

Should Suicide Behaviour Be An Outcome Parameter For Mental Disorder, Amresh Srivastava

Amresh Srivastava

Suicide and mental illness are closely related to each other. A high number of people who commit suicide suffer from a mental illness, and a high number of mentally ill patients exhibit suicide behavior. Suicide behavior is a significant aspect of mental illness. It is consistently observed throughout the course of illness, seen in the prodromal stage, during acute phase of remission, in residual phase and whenever illness relapses. A number of times, mental disorder improves but suicide behavior persists. 10-15% patients attempt suicide in the initial phase of an illness. More than half of the patients get hospitalized due …

The Flip-Side To Readmission: Focused After-Care, Amresh Srivastava

Amresh Srivastava

paper 1. Suicidality in hospitalized early psychosis patients at time of discharge

The purpose of this study was to investigate the presence and nature of suicidal risk among early psychosis patients at the time of discharge from hospital. Is it only related to the involvement of a suicidal attempt at admission? Thirty such patients, who were admitted after a suicide attempt were compared with 30 patients similarly diagnosed, but admitted for clinical reasons not involving a suicide attempt. Dependent measures of psychopathology, adjustment and suicidality were used. It was found that the two groups did not differ in suicidality, which …

Is Psychiatry Only Neurology? Or Only Abnormal Psychology? Déjà Vu After 100 Years, Jose De Leon

Psychiatry Faculty Publications

Forgetting history, which frequently repeats itself, is a mistake. In General Psychopathology, Jaspers criticised early 20th century psychiatrists, including those who thought psychiatry was only neurology (Wernicke) or only abnormal psychology (Freud), or who did not see the limitations of the medical model in psychiatry (Kraepelin). Jaspers proposed that some psychiatric disorders follow the medical model (Group I), while others are variations of normality (Group III), or comprise schizophrenia and severe mood disorders (Group II). In the early 21st century, the players' names have changed but the game remains the same. The US NIMH is reprising both Wernicke's brain mythology …

Co-Occurring Substance Use Disorder And Mental Illness In Criminal Offenders, Jayme M. Reisler

Jayme M Reisler

The high rate of comorbid substance use disorder and other mental illness (“dual diagnosis”) poses an enormous obstacle to public policy and sentencing in criminal cases. It is estimated that almost half of all Federal, State, and jail inmates suffer from dual diagnosis – a significantly higher prevalence than in the general population. Yet such inmates lack access to proper and effective treatments for their conditions. Several etiological theories have been put forth to explain the occurrence of dual diagnosis in general. However, virtually no studies have explored possible etiological reasons for the higher prevalence of dual diagnosis specifically in …

Frequency Of Metabolic Syndrome In Psychiatric Patients, Is This The Time To Develop A Standardized Protocol To Reduce The Morbidity From An Acute Care Psychiatry Unit., Tariq Munshi, Archana Patel, Mir Nadeem Mazhar, Emaduddin Siddiqui

Department of Emergency Medicine

OBJECTIVE:

To determine the frequency of Metabolic Syndrome among psychiatric patients and to look for the correlation between the two medical conditions.

METHODS:

The cross-sectional study was conducted from February to April 2013 at the acute care psychiatry in-patient unit at Kingston General Hospital, Ontario, Canada, and comprised adult patients of both genders diagnosed under the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. For Metabolic Syndrome, definitions outlined by the International Diabetes Federation were used. The patients were divided into two groups on the basis of presence or absence of the Syndrome and were compared for clinical and …

Resilience : An Independent Psychobiological Mental Health Construct (Guest Editorial), Amresh Srivastava

Amresh Srivastava

Survival against trauma is a unique characteristic of all human beings. While a number of factors contribute in building this capacity, resilience appears to be the most important one. Interest in studying resilience arises from number of areas which are of utmost clinical significance such as such as exploring the possibility of at-risk individuals who developing a mental illness]. Resilience is a human capacity to adapt swiftly and successfully to stressful or traumatic events and revert back to a positive state. It is commonly conceptualized as the ability to thrive despite experiencing adversity

Paradoxes Of Us Psychopharmacology Practice In 2013: Undertreatment Of Severe Mental Illness And Overtreatment Of Minor Psychiatric Problems, Jose De Leon

Psychiatry Faculty Publications

No abstract provided.

Psychiatry And Efforts To Build Community In Iraq., Amir A Afkhami

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

European Society For The History Of The Human Sciences (Eshhs), Conference 2014, Oulu (Finland), Paper: “Dangerous Passions. The Construction And Cultural And Social Impact Of The ‘Psychiatric’ Framework Of The Passions In France (1790-1830)”, July 22-25 (23th), 2014., Marco Solinas

Marco Solinas

Numerous excellent works have been written on the formation process of ‘psychiatry’ and its concomitant impact on society and culture at the end of the eighteenth century and in the first three decades of the nineteenth century, in particular with regard to France. From Gladys Swain to Dora Weiner, from Jacques Postel to Jan Goldstein, from Jackie Pigeaud to Juan Rigoli, the issue has been analysed in depth and from a variety of different perspectives. However, despite constantly and inevitably resurfacing in these studies, no particular attention has been paid to the passions and emotions drawn up by nascent psychiatry. …

Newcastle And Northumbria Universities, Conference “Fashionable Diseases. Medicine, Literature And Culture, Ca. 1660-1832", Paper: “On The End Of Fashionable Melancholy”, July 3-5 (4th), 2014., Marco Solinas

Marco Solinas

The paper analyze the crucial moment of rupture in the history of the definitions, descriptions and classifications of melancholy within the ambit of medicine that occurred between the end of the Eighteenth- and beginning of the Nineteenth-century, in particular in France. That is the point at which Philippe Pinel, absorbing the contributions of Seventeenth-century British psychiatry, proceeded to abandon both the humoral doctrine and the old Renaissance conception of the dual character – melancholy as a psycho-physiological illness and as a literary and philosophical mood. Pinel now locates melancholy only among forms of mental alienation. I will proceed with the …

Improving Trainee Psychiatrist’S Handover: Standard Setting And Audit, Arun Gupta, Ruth Bevan, Akshya Vasudev

Psychiatry Publications

No abstract provided.

A New Brief Scale To Assess Suicidality: Scale For Impact Of Suicidality-Management, Assessment And Planning Of Care (Sis-Map- Brief Scanner), Amresh Srivastava, Megan Johnston, Miky Kaushal, Robbie Campbell, Charles Nelson

Amresh Srivastava

Purpose: In this study we examine merit of a short version (Brief Interview Screener (SIS-MAP-scn )of a previously developed and validated 108 item scale, known as ‘ Scale for Impact of Suicidality-Management, Assessment and Planning of Care ( SIS MAP), for rapid assessment in challenging clinical settings e.g. primary care and emergency room. Background: Generally suicide risk is assessed clinically and structured assessments optimize the direction for decision-making across various settings e.g. inpatient care, emergency rooms and crisis centers. We believe that measures with accurate and valid information should be based upon multifactorial risk-constituent domains, e.g. biological, social, psychological, environmental …

One Hundred Years Of Limited Impact Of Jaspers’ General Psychopathology On Us Psychiatry, Jose De Leon

Psychiatry Faculty Publications

Jaspers, a German psychiatrist, published General Psychopathology in 1913. Jaspers, Schneider, and Mayer-Gross were members of the Heidelberg school. General Psychopathology, indirectly through Schneider’s and Mayer-Gross’ textbooks and directly by its English translation in 1963, led to a narrow set of schizophrenia criteria in the United Kingdom. General Psychopathology had very limited direct impact on US psychiatry, which adopted a broader schizophrenia definition. The difference between UK and US schizophrenia was a key element in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, and the neo-Kraepelinian revolution. General Psychopathology contains two essential interrelated ideas: a) psychiatry is …

Global Mental Challenges: Response To Local Needs, Amresh Srivastava

Amresh Srivastava

Global mental Challenges: Response to local needs 1Amresh Shrivastava Running Title: Mental health: beyond Geo-political Boundaries 1Department of Psychiatry, Elgin Early Intervention Program for Psychosis, The University of Western Ontario, Ontario, Canada, and Mental Health Resource Foundation, Mumbai, Maharashtra, India, e-mail: dr.amresh@gmail.com.

The health of the people determines athe health of a society and a country. Reference to ‘health’, more often than not, directs one’s thinking towards physical health, without realizing that physical health is inseparable from mental health. Physical disorders co-exist with mental disorders and mental disorders are a significant risk factor for physical illnesses. The WHO agenda on …

Finding Solutions To Institutional Corruption: Lessons From Cognitive Dissonance Theory, Lisa Cosgrove, Robert Whitaker

Counseling and School Psychology Faculty Publication Series

The American Psychiatric Association and academic psychiatry in the United States have two conflicts of interest that may affect their assessment of psychiatric drugs and their development of diagnostic and clinical care guidelines: payments from pharmaceutical companies and guild interests. Until recently, the proposed solution to industry-academic relationships has been transparency. However, cognitive dissonance research reveals that disclosure is not a solution because cognitive biases are commonplace and difficult to eradicate. Indeed, bias is most often manifest in subtle ways unbeknownst to the researcher or clinician, and thus is usually implicit and unintentional. Also, recent studies suggest that disclosure of …

Dsm V: Hope Or Hype?, Amresh Srivastava

Amresh Srivastava

DSM V: HOPE OR HYPE?

Amresh Shrivastava,

MD,MPM,MRCPsych,FRCPC

Associate professor of Psychiatry

Western University

London, Ontario

Since more than 50 years psychiatric diagnostic is being developed by a number of organisations. As research has advanced in understanding mental illnesses,need for a common language has been felt in order to provide best possible care to our patients.

The process of psychiatric diagnosis has evolved significantly. WHO as well APA both have made significant advances in developing diagnostic systems. DSM 5 recently approved by board of trustees by Americal psychiatric Association is scheduled to be released on 18th of May. This document …

Warum Gesunde Menchen Immer Häufiger Fur Psychisch Krank Erklärt Werden, Lisa Cosgrove

Counseling and School Psychology Faculty Publication Series

zuerst einmal nicht schaden": Das ist der wohl wichtigste Grundsatz der Medizin. Aber diese Mission droht durch den Einfluss großer Pharmafirmen unterhöhlt zu werden. Der Vorwurf einer Verstrickung von Ärzten und Arzneimittelherstellern ist schon in fast allen medizinischen Fachrichtungen aufgekommen. Vor allem aber die Psychiatrie steckt in einer Glaubwürdigkeitskrise. Das zeigt sich in der aktuellen Debatte um die neue Auflage des "Diagnostischen und Statistischen Manual Psychischer Störungen" (DSM).

Dieses von der US-Psychiater-Vereinigung APA herausgegebene Handbuch definiert, was eine psychische Erkrankung ist. Die Bedeutung dieser Wertung geht weit über die USA hinaus - das Handbuch nimmt oft Definitionen der Weltgesundheitsorganisation vorweg. …

Baseline Serum Prolactin In Drug-Naive, Firstepisode Schizophrenia And Outcome At Five Years: Is It A Predictive Factor?, Amresh Srivastava, Megan Johnston, Yves Bureau, Nilesh Shah

Amresh Srivastava

Objective: Serum prolactin is influenced by antipsychotic use but its relationships with psychopathology and general functioning are not clear. This study aimed to assess these relationships. Design: Serum prolactin levels were measured in patients with schizophrenia before being treated with antipsychotics and at various follow-up points. Setting: The study was conducted in a nongovernmental psychiatric treatment center in Mumbai, India. Participants: The participants included 30 male and 30 female drug-naïve patients with schizophrenia and 31 control participants. Measurements: The severity of psychopathology at baseline, three weeks, six weeks, and five years following treatment was assessed using a modified Brief Psychiatric …

Psychosis In Indigenous Populations Of Cape York And The Torres Strait, Ernest M. Hunter, Bruce D. Gynther, Carrick J. Anderson, Leigh-Ann L. Onnis, Jeffrey R. Nelson, Wayne Hall, Bernhard T. Baune, Aaron R. Groves

Aboriginal Policy Research Consortium International (APRCi)

Objective: To describe and characterise treated psychotic disorders in the Indigenous populations of Cape York and the Torres Strait.

Design: Cross-sectional analysis of patients with a psychotic disorder identified by treating psychiatrists.

Setting and participants: Indigenous patients aged 􏰀 15 years in Cape York and Torres Strait communities receiving treatment for a psychotic disorder over 3 months in 2010.

Main outcome measures: Prevalence of psychosis diagnoses, intellectual disability, and substance use comorbidities.

Results: 171 patients were included. The prevalence rate in this population was 1.68%, higher for males (2.60%) than females (0.89%), and twice as high in the Aboriginal (2.05%) …

Suicide From A Global Perspective, Amresh Srivastava

Amresh Srivastava

This book is in 5 volumes, Hard cover and e-book, with 110 Chapters and contributions from more than 30 Countries

Amresh Shrivastava (ed), Megan Kimbrell and David Lester Handbook of Suicide From Global Perspective

Preface by Professor N. Sartorius, MD, PhD

Suicide is the cause of death for nearly one million people a year. Death by suicide is often reported as being due to other causes to avoid stigmatization and other negative consequences of suicide for the family: it can therefore be assumed that the number of people who commit suicide is much higher than this number. Attempts of suicide …

Supplier-Induced Demand For Psychiatric Admissions In Northern New England, Bradley V. Watts, Brian Shiner, Gunnar Klauss, William B. Weeks

Dartmouth Scholarship

The development of hospital service areas (HSAs) using small area analysis has been useful in examining variation in medical and surgical care; however, the techniques of small area analysis are underdeveloped in understanding psychiatric admission rates. We sought to develop these techniques in order to understand the relationship between psychiatric bed supply and admission rates in Northern New England. Our primary hypotheses were that there would be substantial variation in psychiatric admission across geographic settings and that bed availability would be positively correlated with admission rates, reflecting a supplier-induced demand phenomenon. Our secondary hypothesis was that the construction of psychiatric …