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1
BURSTEIN, ALLAN. "Discipline for Psychiatrists." American Journal of Psychiatry 159, no. 1 (January 2002): 152. http://dx.doi.org/10.1176/appi.ajp.159.1.152.
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Carr, Vaughan J. "The Australasian Society for Psychiatric Research (ASPR)." Australasian Psychiatry 5, no. 6 (December 1997): 290–91. http://dx.doi.org/10.3109/10398569709082288.
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In 1970, the late Professor Cecil Kidd and Scott Henderson discussed ways of strengthening psychiatric research in Australia. Being both from Aberdeen, the Scottish Society for Psychiatric Research was taken as a model. This model involved an annual forum for committed researchers, irrespective of discipline, and thus included psychologists, psychiatrists, statisticians, economists, basic scientists and so on. In Australia, the Royal Australian and New Zealand College of Psychiatrists (RANZCP) was not regarded, at that time, as a suitable organisation for this purpose as it then had other priorities and included only psychiatrists within its membership. Thus, gathering together individuals from all relevant disciplines with an interest in psychiatric research would not have been possible under the auspices of the RANZCP.
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Beveridge, Allan. "Relevance of the history of psychiatry to practising clinicians." Advances in Psychiatric Treatment 5, no. 1 (January 1999): 46–52. http://dx.doi.org/10.1192/apt.5.1.46.
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Do busy psychiatrists need to pay any attention to the history of their discipline? Surely clinicians should concentrate on keeping up-to-date with the latest developments in their field. Medical history may provide amusing anecdotes about practice in the past, but can it inform modern treatment? Such a response, although familiar, seems rather strange, coming from psychiatrists, who, after all, spend their clinical day, taking ‘histories'. By doing so, they seek to understand their patients' problems in the context of their life history. They try to make sense of the present by reference to the past, whether it be events in the patient's childhood, previous conflicts or the individual's genetic inheritance. Given such a perspective, it seems reasonable that psychiatrists might also take an interest in the history of their profession. By attending to the history of its development, its past disputes and its intellectual inheritance, the psychiatrist can reach a deeper understanding of the current state of psychiatry.
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Sartorius, N. "Starting a career as a psychiatrist." European Psychiatry 64, S1 (April 2021): S69. http://dx.doi.org/10.1192/j.eurpsy.2021.214.
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Abstract BodyThere are several sets of skills first set of skills which psychiatrists should acquire before or as early as possible after starting their career. THe first of those are communication skills – including those of listening, speaking clearly and convincingly, negotiating and writing scientific and other types of documents. A second set of skills are those that will enable psychiatrists to understand and use legal documents and materials. The third set of skills that is likely to be useful are skills necessary to function as a physician. These sets of skills combined with the knowledge of the subject of psychiatry should help in building a career in any of the areas open to psychiatrists.. Yet, more important than any of the skills or bits of knowledge that a candidate psychiatrist should have to build a career and be happy with it are the motivation to do psychiatry and the acceptance of a style of work marked by empathy, willing acceptance of ethical principles of medicine and if at all possible infectious optimism. The above array of skills, knowledge style of work are not easily developed and those educating future psychiatrists should be careful in their selection of trainees and resourceful in the provision of training that will create psychiatrists who can advance the health of their patients as well as their discipline and will have a chance to live a rewarding life.DisclosureNo significant relationships.
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Jamieson, Michelle. "Between the Sciences Psychosomatic Medicine as a Feminist Discipline." Catalyst: Feminism, Theory, Technoscience 3, no. 2 (October 19, 2017): 1–28. http://dx.doi.org/10.28968/cftt.v3i2.28845.
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Psychosomatic medicine was an interdisciplinary medical field established in the late 1930s in response to growing dissatisfaction with the Cartesianism assumed in both general medicine and psychiatry. Seeking a method that could address the many health conditions that fell outside the scope of any particular specialisation, advocates of this movement were doctors, psychiatrists and psychoanalysts who insisted on treating the organism as a whole. Among these was Helen Flanders Dunbar, an enigmatic psychiatrist and philosopher, who insisted that the success of medicine rested on its ability to apprehend the interrelationality of mind and body as an object in its own right. This article shows that Dunbar’s ambition to develop a practice of medicine that would more faithfully address the organism as whole, rather than fragment, evokes the larger issue of how we can know and study life objectively. Drawing on the works of feminist STS scholars Karen Barad and Donna Haraway, I show that Dunbar grappled with the situatedness of knowledge practices – and specifically, the relationship between object and method – as a central concern of her discipline. I argue that psychosomatic medicine is an example of feminist thought as science because its very practice relies on holding alive questions about the nature of objectivity, truth and the ontological entanglement of ‘what’ and ‘how’ we know
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McDonald, Carrick, and Simon McDonald. "Neural networks and psychiatry." Psychiatric Bulletin 15, no. 4 (April 1991): 211–13. http://dx.doi.org/10.1192/pb.15.4.211.
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This paper draws the attention of psychiatrists to the developing field of neural networking in the belief that the models created in this discipline demonstrate several functions central to cerebral performance.
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Suibhne, Seamus Mac. "Threshold Concepts and Teaching Psychiatry: Key to the Kingdom or Emperor's New Clothes?" Irish Journal of Psychological Medicine 29, no. 2 (2012): 132–34. http://dx.doi.org/10.1017/s0790966700017456.
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AbstractPsychiatry, more than most medical specialties, must engage with undergraduate medical education to prevent the further marginalisation of mental health within medicine. There is an urgency to the need for psychiatrists and educationalists to communicate, and for psychiatrists to be aware of developments in educational theory. The idea of ‘threshold concepts’ is currently widely discussed by educationalists. Threshold concepts are described as areas of knowledge without which the learner cannot progress, and which, when grasped, lead to a transformation in the learner's perspective and understanding. Threshold concepts have been criticised on conceptual grounds, and there is a lack of clarity as to how to identify them empirically. While they may represent a fruitful approach to the task of engaging medical students in psychiatry teaching, it is suggested that further development of the idea is required before it could be usefully applied. However empirical studies in other disciplines suggest that there may be associated benefits to the teaching of the discipline from trying to identify threshold knowledge.
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Henderson, J. A., C. J. Simpson, and J. D. Mumford. "The use of car telephones by psychiatrists." Psychiatric Bulletin 16, no. 12 (December 1992): 756–57. http://dx.doi.org/10.1192/pb.16.12.756.
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As community services develop, medical staff are increasingly spending more time outside the hospital, despite the most severely ill patients still being in hospital. This may lead to junior medical staff and nurses feeling unsupported by the consultant. In addition, as more disturbed patients are kept out of hospital, the general practitioner and community health workers may require to contact the psychiatrist more often to talk about patients or to request urgent assessment. Therefore the importance of communication with consultants is increased both from the hospital and from the community while they are spending increasing amounts of time in their cars. In a discipline where communication is of paramount importance, a failure to meet this growing need would undermine the effectiveness of the service as a whole.
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Janse van Rensburg, Bernard, Carla Kotzé, Karis Moxley, Ugasvaree Subramaney, Zukiswa Zingela, and Soraya Seedat. "Profile of the current psychiatrist workforce in South Africa: establishing a baseline for human resource planning and strategy." Health Policy and Planning 37, no. 4 (December 7, 2021): 492–504. http://dx.doi.org/10.1093/heapol/czab144.
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Abstract The World Health Organization Global Health Observatory Data Repository reports South Africa with 1.52 psychiatrists per 100 000 of the population among other countries in Africa with 0.01 psychiatrists per 100 000 (Chad, Burundi and Niger) to more than 30 per 100 000 for some countries in Europe. The overall situation, while being cognizant that mental health care is not only provided by specialist psychiatrists and that the current treatment gap may have to be addressed by strategies such as appropriate task sharing, suggests that there are actually too few psychiatrists to meet the country’s mental health care needs. To address the need to develop a strategy to increase the local specialist training and examination capacity, a situational review of currently practicing psychiatrists was undertaken by the [BLINDED] and the [BLINDED] using the South African Society of Psychiatrists membership database. The number, distribution and attributes of practicing psychiatrists were compared with international figures on the ratio of psychiatrists per 100 000 population. In April 2019, there were 850 qualified psychiatrists actively practicing in the country and based on the national population figure of 55.6 million people (2016 Census), the psychiatrists per 100 000 ratio was 1.53. This indicates no improvement between 2016 to 2019. From the South African Society of Psychiatrists database, we determined that about 80% of psychiatrists are working in the private sector—a much higher proportion than is usually quoted. As the vast majority of psychiatrists are practicing in urban areas in two provinces, Gauteng (n = 350) and Western Cape (n = 292), the ratio of psychiatrists per 100 000 in these areas is relatively higher at 2.6 and 5.0, respectively, whereas rural areas in South Africa are largely without specialist mental health expertise at a rate of 0.03 per 100 000 population. This investigation provides a discipline-specific situational review of the attributes and distribution of the current workforce of specialists in the country.
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Johnson, Harriette C., and Edwin F. Renaud. "Professional Beliefs about Parents of Children with Mental and Emotional Disabilities: A Cross-Discipline Comparison." Journal of Emotional and Behavioral Disorders 5, no. 3 (September 1997): 149–61. http://dx.doi.org/10.1177/106342669700500303.
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The views of social workers, child psychiatrists, and psychologists about parents of children with mental, emotional, and behavioral disorders were compared in this study. The Providers’ Beliefs About Parents questionnaire was used to measure views about parents’ competence, parents’ pathology, parents’ credibility, parents’ role in the etiology of children's problems, information sharing with parents, giving explicit directives to parents about how to help their children, and related child mental health issues such as use of psychotropic medication with children and adolescents and perceived importance of research-based knowledge about child and adolescent psychopathology. Variables most associated with parent-friendly beliefs and attitudes were endorsement of a neuropsychological orientation and familiarity with parent support groups. Views of respondents did not differ by ethnicity, gender, or parental status. Child psychiatrists were most in agreement with parent-friendly attitudes and beliefs, clinical social workers were least in agreement, and psychologists were midway between the other two groups.
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Harrison, Paul J., David S. Baldwin, Thomas R. E. Barnes, Tom Burns, Klaus P. Ebmeier, I. Nicol Ferrier, and David J. Nutt. "No psychiatry without psychopharmacology." British Journal of Psychiatry 199, no. 4 (October 2011): 263–65. http://dx.doi.org/10.1192/bjp.bp.111.094334.
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SummaryThe use of psychotropic medication is an important part of most psychiatrists' clinical practice. We propose here that psychiatry needs to give more prominence to psychopharmacology in order to ensure that psychiatric drugs are used effectively and safely. The issue has several ramifications, including the future of psychiatry as a medical discipline.
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Chur-Hansen, Anna, and Damon Parker. "Is Psychiatry an Art or a Science? The Views of Psychiatrists and Trainees." Australasian Psychiatry 13, no. 4 (December 2005): 415–18. http://dx.doi.org/10.1080/j.1440-1665.2005.02221.x.
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Objective: It is generally considered by many practitioners that psychiatry is an art, that is, one of the humanities, as well as being a science. We systematically collected the views of practitioners and trainee psychiatrists regarding the question ‘Is psychiatry an art or a science?’ Method: Eleven supervisors and nine trainees were interviewed and their responses analysed, using a qualitative method, the modified framework approach. Results: Several themes emerged from the data: that ‘art’ and ‘science’ are different; psychiatry as a discipline is difficult to define; psychiatry demands a broader range of skills than other medical specialties; the relationship of psychology to psychiatry; supervisor cynicism to the ‘science’ of psychiatry; and the ‘art’ and ‘science’ of the assessment process. Conclusions: The tension that exists within the profession's identity as a discipline has important implications for teaching, learning, and clinical and research practices.
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Henckes, Nicolas, and Lara Rzesnitzek. "Performing doubt and negotiating uncertainty." History of the Human Sciences 31, no. 2 (February 12, 2018): 65–87. http://dx.doi.org/10.1177/0952695118755619.
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In the 20th century, the boundaries of psychosis emerged as an area in which psychiatric judgement faced numerous and profound uncertainties. Between obvious neuroses and personality and reactive disorders on the one hand, and unquestionable psychoses on the other, psychiatrists faced a world of suspected cases of schizophrenia, doubtful personality disorder diagnoses or probable cases of psychosis constituting a garden of equivocal clinical presentations in which both individual psychiatrists and the discipline as a whole were confronted with the limits of their knowledge. This article examines how psychiatrists from two German university clinics managed the multiple uncertainties involved in diagnosing cases of early psychosis between 1950 and 1980. Based on the analysis of a sample of records, we propose a pragmatic interpretation of the ways in which these uncertainties were recorded by psychiatrists. How were uncertainties and doubts expressed in the records and managed by clinicians? What means were used to dispel doubt? What were the consequences for patients of these diagnostic uncertainties? The article defines an uncertainty diagnosis as a diagnosis expressed with reservations by its author and recorded as such in a medical file. Depending on the nature of the uncertainty, the types of evidence used by the professionals and how this evidence was dealt with, we have identified three types of uncertainty diagnoses: suspicion, plausibility and probability diagnoses. The article then reflects on the role of the patients themselves in shaping these uncertain situations.
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Singh, Rakesh, Anoop Krishna Gupta, Babita Singh, Pragyan Basnet, and S. M. Yasir Arafat. "History of psychiatry in Nepal." BJPsych International 19, no. 1 (October 13, 2021): 7–9. http://dx.doi.org/10.1192/bji.2021.51.
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The history of psychiatry as a discipline in Nepal has been poorly studied. We have attempted to summarise historical landmarks to explore how it began and its evolution over time in relation to contemporary political events. Although Nepal has achieved several milestones, from establishing a psychiatric out-patient department with one psychiatrist in 1961 to having more than 500 psychiatric in-patient beds with 200 psychiatrists by 2020, the pace, commitment and dedication seem to be slower than necessary: the current national mental health policy dates back to 1996 and has not been updated since; there is no Mental Health Act; the number of psychiatric nurses and in-patient psychiatric beds has increased only slowly; and there is a dearth of professional supervision in rehabilitation centres. Thus, despite making significant progress, much more is required, at greater intensity and speed, and with wide collaboration and political commitment in order to improve the mental health of all Nepali citizens, including those living in rural areas and or in deprived conditions.
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Reynolds, E. H. "Structure and Function in Neurology and Psychiatry." British Journal of Psychiatry 157, no. 4 (October 1990): 481–90. http://dx.doi.org/10.1192/bjp.157.4.481.
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In the 19th century the triumphs of neuropathology and the clinico-anatomical method led to the evolution of neurology as a separate ‘organically’ based discipline associated with the concept of functional localisation. At the same time the growth of psychodynamic psychiatry contributed to the progressive separation of the two disciplines, with neuropsychiatry sitting uneasily in the middle. Psychiatrists are now showing increasing interest in the structure and function of the nervous system, but are having difficulty in integrating their findings into ‘functional’ diseases. This may be because disorder of function in the nervous system is much more complex than previously envisaged. The function of the nervous system is profoundly affected by psychological and social factors. The view that neurology is wholly ‘organic’ and synonymous with structural disease of the nervous system is fallacious. Neurological patients have complex dynamic disorders of function in the nervous system whether or not structural disease is present.
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Sartorius, N. "The future of psychiatry: The perspectives from a senior psychiatrist." European Psychiatry 64, S1 (April 2021): S37. http://dx.doi.org/10.1192/j.eurpsy.2021.127.
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The future of psychiatry as a discipline (and as the main source of knowledge in the construction and functioning o mental health services) can best be grasped on the basis of an examination of the development of psychiatry over the past century in the light of current options for its functioning. Such an examination demonstrates that psychiatrists will have to expand their field of work to include the management of comorbidity of mental and physical disorders and public health approaches to the primary prevention of mental and other brain disorders. Their engagement in research will have to become restricted to psychopathology and participation in the formulation of hypotheses which will be tested in laboratory and field work;; and their involvement in teaching about mental health and illness will have to undergo a fundamental change in terms of content, methods and evaluation of effects of education which they will organize. The presentation will focus on the future tasks of psychiatrists in these areasDisclosureNo significant relationships.
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Höschl, C. "Leadership in a Changing Europe." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70359-1.
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Psychiatry as a medical discipline plays an important role in mental health care (MHC). Hand in hand with increasing demand for MHC transformation toward more individualized, personalized, and patient oriented service, the integrity of psychiatry, the role of psychiatric staff, the stigma, and identity of psychiatry become important questions to be tackled. These questions are related to the leadership role of coming generation of psychiatrists. Is it a challenge or just a myth? We should not deny the fact that in important documents of global importance (e.g., Green paper and other WHO/EU MH documents) there is almost zero occurrence of the word “psychiatry”. So it seems psychiatry is rather marginalized than promoted to be the leading force in MHC policy. EPA YPP program could become a suitable platform to prevent such an undesired process and to formulate ways how to increase motivation, skills and chances of psychiatrists to take control of their own destiny.
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Caldas de Almeida, J. M. "The future role of psychiatrists in Europe in the light of the European Pact for Mental Health and Well-being." Die Psychiatrie 11, no. 01 (January 2014): 19–26. http://dx.doi.org/10.1055/s-0038-1670732.
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SummaryThe European Pact for Mental Health and Well-being, launched in 2008, expresses a commitment of the EU and Member States to implement a mental health strategy in Europe. Recognizing that the level of mental health and well-being in the population is a key resource for the success of the EU as a knowledge-based society and economy, the Pact concludes that action for mental health and well-being at EU-level needs to be developed by involving policy makers and all relevant stakeholders. Given the specific content of their discipline and the prestige they have in our societies, psychiatrists will certainly have a key role in the development of the strategies proposed by the Pact. The purpose of this paper is to review the background, objectives and outcomes of the European Pact for Mental Health and Well-being, and reflect on the future role of psychiatrists in the light of its implementation.
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Pienaar, Willie. "Developing the language of futility in psychiatry with care." South African Journal of Psychiatry 22, no. 1 (October 24, 2016): 7. http://dx.doi.org/10.4102/sajpsychiatry.v22i1.978.
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In psychiatric practice, treatment success is, in many instances, not an achievable goal. Psychiatrists may often not acknowledge treatment failure in their patients and seldom consider that patients may be in situations that share similarities with end-of-life dilemmas in general somatic medicine. In such instances, futile treatment may be continued and patient suffering may be prolonged. Doctors should play a leading role in patient education, diagnosis, promoting best treatment options, motivation and support, but patients should be given the opportunity to take ownership of their illness and their future. In the discipline of psychiatry, physician-assisted suicide may be an option but warrants careful consideration. Contemporary psychiatrists may act paternalistically, refusing to accept the limitations of their scientific skills and/or struggle with the moral good of ‘letting go’ when required. It is arguably the seeming complexity of gauging patients’ understanding (competency, capacity) to make informed decisions that perpetuates futile treatment. Most patients, even in the presence of ongoing serious psychiatric illness, are able to give consent. Psychiatrists should be aware of the difference between <em>being alive</em> and <em>living</em>. Ongoing suffering cannot be condoned. The <em>personhood</em> of every patient and his/her bio-psycho-social and spiritual needs should, as far as possible, be respected. Psychiatrists should embrace the realisation of treatment futility and, in some cases, end-of-life decisions and take on the challenge as well as the responsibility of serving patients with mental illness in the best way possible.
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Toot, Sandeep, Martin Orrell, Joanna Rymaszewska, and Ralf Ihl. "A survey of geriatric psychiatry training across Europe." International Psychogeriatrics 24, no. 5 (January 6, 2012): 803–8. http://dx.doi.org/10.1017/s1041610211002341.
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ABSTRACTBackground: Training, practice, and continuing professional development in old age psychiatry varies across Europe. The aims of this study were to survey current practice and develop recommendations to begin a debate on harmonization.Methods: A survey was sent out to 38 European countries via email. The survey was sent to members of the European Association of Geriatric Psychiatry (EAGP) Board, members of the World Psychiatric Association, and key old age psychiatrists or other psychiatrists with a special interest in the area for countries where old age psychiatry was not formally a specialty.Results: Through a process of networking, we identified a key individual from each country in Europe to participate in this study, and 30 out of 38 (79%) representatives responded. Training programs and duration varied between countries. Eleven countries reported that they had geriatric psychiatry training programs and most of these required geriatric psychiatry trainees to complete mandatory training for two years within old age psychiatry. Representatives from ten countries reported having specific Continuing Professional Development (CPD) for old age psychiatrists at consultant level.Conclusion: There is a clear indication that the recognition of geriatric psychiatry as a specialist discipline in Europe is on the rise. The training procedures and processes in place vary considerably between and sometimes within countries. There are several options for harmonizing old age psychiatry training across Europe with advantages to each. However, support is required from national old age psychiatry bodies across Europe and an agreement needs to be reached on a training strategy that encompasses supervision, development, and appraisal of the knowledge and skills sets of old age psychiatrists.
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Stein, Dan J., Soraya Seedat, Robin A. Emsley, and Benjamin O. Olley. "HIV/AIDS in Africa - a role for the mental health practitioner?" South African Journal of Psychiatry 11, no. 1 (April 1, 2005): 2. http://dx.doi.org/10.4102/sajpsychiatry.v11i1.88.
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In the last few decades psychiatric discourse has undergone an important change in its scope and focus. During the heady days of psychoanalytic hegemony, psychiatrists were willing to prognosticate or pontificate on just about anything, from individual neurosis through to social maladies, from medicine to literature, from the unconscious to the conscious. Nowadays, psychiatry self-consciously emphasises its origins as a medical discipline, focuses its diagnostic efforts on operationally defined psychiatric disorders, and argues the value of specific pharmacotherapies and psychotherapies in treating these conditions.
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Bassetti, C. "EAN Perspective." European Psychiatry 64, S1 (April 2021): S7. http://dx.doi.org/10.1192/j.eurpsy.2021.41.
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29th European Congress of Psychiatry (EPA 2021) „You can tell a good workman by his tools: The instruments of psychiatrists, psychologists and neurologists: Why so different?“ The term psychology („the study of the soul“) appeared for the first time in a printed book of Freigius in 1578, while the term neurology („the study of the form and function of the nervous system“) was coined by Willis in 1664 and that of psychiatry („the medical treatment of the soul“) by Reil in 1808. First physicians to devote entirely to neurology appeared in the midst of the 19th century in France, Germany, and England. Around this time neurology, (biological) psychiatry and (experimental) psychology converged to share similar roots in the brain. The three disciplines separated (again) at the beginning of the 20th century. Neurology remained for over 100 years mainly a diagnostic discipline, in which history and clinical examination were expected to lead to the identification of a topographic syndrome (or lesion) and eventually its etiology. In the last 30 years neurology underwent a revolution. While the importance (and validity) of phenotypical diagnoses remained, new (e.g. neuroimaging, genetic) tools have made precise diagnoses and causal treatments increasingly possible, transforming neurology into a treating discipline. The author will discuss why the separation between neurology, psychiatry and psychology is artificial (and even harmful for patients), how the multidimensional tools developed over the years by these disciplines can be of common interest, and what the EAN does to promote interdisciplinary scientific, educational, and political collaborations.DisclosureNo significant relationships.
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Scharff Smith, Peter. "“Degenerate Criminals”." Criminal Justice and Behavior 35, no. 8 (August 2008): 1048–64. http://dx.doi.org/10.1177/0093854808318782.
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Inspired by the breakthrough of the discipline of criminology and biological theories of degeneration, prison psychiatry became a flourishing field during the latter decades of the 19th century. This is reflected in the history of the Vridsløselille penitentiary in Denmark, which operated as a Pennsylvania-model institution with strict solitary confinement from 1859 to the early 1930s. Throughout the period, this prison experienced extensive problems with inmate mental health, and as the discipline of psychiatry developed, mental disorders were given new names and old diseases disappeared. Although prison authorities were willing to acknowledge the damaging effects of the isolation regimes being employed, a number of psychiatrists located the causes of mental disorders among biological dispositional traits rather than situational factors. In doing so, they downplayed the power of the prison context and offered biological “degeneration” among criminals as an alternative explanation.
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Timmons, Suzanne, Anna de Siún, Emer Begley, and Mary Manning. "184 A National Survey of Clinicians who Assess People with Suspected Dementia: Service Characteristics and Practice." Age and Ageing 48, Supplement_3 (September 2019): iii1—iii16. http://dx.doi.org/10.1093/ageing/afz102.42.
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Abstract Background The Irish National Dementia Strategy (2014) identified timely diagnosis and intervention as a priority area. The National Dementia Office established a Dementia Diagnostic Project to develop a framework for diagnostic services nationally. As part of preparatory work, a national survey explored baseline peri-diagnostic practice in geriatric medicine, neurology and psychiatry of old age services. Methods A survey was developed by the project steering group, piloted, and then distributed to all 86 Geriatricians, 39 Neurologists, and 34 Psychiatrists of Old Age Psychiatrists in Ireland. Two reminder e-mails were sent. Results In total, 56 clinicians responded (response rate 35%). The majority (74%) saw 1-20 people with suspected dementia (PwSD) per month. Most referrals came from General Practitioners or other physicians; but rarely from Health and Social Care Professionals. Most people were referred specifically for their memory complaint, rather than a co-morbidity. Waiting times for urgent review varied between 24 hours and 4 years; neurology services had the longest waiting times. Only 30% saw PwSD in a dedicated clinic; about the same proportion saw PwSD in their own home; or in residential care settings. About half reported assessing people with intellectual disability and suspected dementia, mainly the neurologists. The Montreal Cognitive Assessment was the most commonly used cognitive tool (89%), followed by the Addenbrook’s Cognitive Examination (56%). Only 17% commonly used functional brain imaging in diagnosis, mainly neurologists; half of respondents ‘never’ or ‘rarely’ used cerebrospinal fluid analysis. Multidisciplinary input was mainly from Occupational Therapists (61%), Psychology/Neuropsychology (52%), and Nursing disciplines (33%). When asked which discipline would most benefit their diagnostic service, neurologists all chose psychology input; geriatricians selected a range of disciplines. Conclusion The significant variability within current services who see PwSD, in terms of multidisciplinary involvement, waiting times, setting, and supporting investigations, supports the need for a national diagnostic framework.
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Ng, Lillian, Chris Bampton, Seonaigh Stevens, and Penny Woods. "The infant observation task as a tool in psychiatric practice." Australasian Psychiatry 25, no. 3 (September 27, 2016): 236–38. http://dx.doi.org/10.1177/1039856216671656.
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Objective: The objective of this study was to describe the method and relevance of infant observation as a unique and powerful learning tool for psychiatrists. Conclusion: Infant observation provides a privileged entry into an infant’s internal world to observe its earliest mental life. Weekly consecutive observations of the mother–baby dyad, combined with the process of supervision, enable identification of emergent and changing patterns in the relationship. The discipline of observation encourages attunement to the nuances of relationships, which provides a potent tool for application in other clinical settings.
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WIEVIORKA, Michel. "PREVENTING AND EXITING VIOLENCE: ADOMAIN FOR SOCIOLOGY?" Monitoring of public opinion economic&social changes, no. 5 (November 10, 2018): 0. http://dx.doi.org/10.14515/monitoring.2018.5.08.
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Preventing and exiting violence is a central problem of social sciences. Violence-related information mainly comes from medical specialists, consultant psychiatrists, experts, lawyers, diplomatic officials, representatives of NGO and others. Today this area of knowledge needs a separate discipline operating at individual and group level (recovery of victims or punishment for abusers), national level (building democracy or justice during the interregnum) and global level (for example, how the ISIL activities will shape the situation in the Middle East). Nonetheless, the idea of transformation of violence, crisis logic, discourse and institutional conflicts is core.
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Rae-Grant, Quentin. "Child Psychiatrists in the 90's: Who will want us, who will Need Us." Canadian Journal of Psychiatry 31, no. 6 (August 1986): 493–98. http://dx.doi.org/10.1177/070674378603100603.
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Child Psychiatry is now a well recognized and established sub-speciality in Canada. It has gone through a period of vigorous and healthy growth. Like psychiatry in general it now faces a number of challenges which provide potential threat but which may lead to better definition of priorities and of its most effective function. Other disciplines, medical and non-medical, increasingly compete for a place on the therapeutic spectrum. Within psychiatry the rhetoric between different schools of thought provides ammunition for those who have no use for any form of psychiatry however it may be provided. The challenge is to develop more effective ways of using the skills of the child psychiatrist within a recognition that the number of practitioners will never approach what would be required to have child psychiatry alone cover the treatment needs of children and adolescents. The field requires the adoption of a more flexible metaphor for training and practice with competence in the different schools of theory and of therapy. Attention needs to be paid to the consumer movement, to the impact of better informed parents and public and to the developing of a parsimonious and selective approach to the use of scarce professional time. The healthy growth of research in child psychiatry is a development long overdue and places the discipline on a scientific rather than a clinical practice base. At a time when funding and the cost of health care are crucial issues the development of a secure knowledge base, efficient methods of service delivery and the integration with other mental health care providers are opportunities and grounds for optimism about the future of the sub-speciality.
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Zajicek, Benjamin. "Soviet psychiatry and the origins of the sluggish schizophrenia concept, 1912–1936." History of the Human Sciences 31, no. 2 (February 5, 2018): 88–105. http://dx.doi.org/10.1177/0952695117746057.
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This article seeks to understand the origins of the Soviet concept of ‘sluggish schizophrenia’, a diagnostic category that was used to imprison political dissidents in the post-WWII era. It focuses on the 1920s and 1930s, a period when Soviet psychiatrists attempted to find ways to diagnose schizophrenia at its earliest stages. The new Soviet state supported these efforts, funding new institutions where clinicians encountered types of patients they had not previously studied. Conceptual disagreements arose about what symptoms could be used to diagnose schizophrenia, and how it could be differentiated from other ‘borderline’ mental disorders such as neurosis and psychopathy. Several research groups used their findings to propose new clinical concepts, including ‘mild schizophrenia’ and sluggish schizophrenia. By the early 1930s Soviet psychiatrists no longer shared a basic consensus about schizophrenia. At the same time, the priorities of the Soviet government under Joseph Stalin ceased to support preventative psychiatry. The result was a 1936 ‘discussion’ at which the concept of mild schizophrenia was criticized and sluggish schizophrenia was held up as a model for how the discipline should develop in the future.
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KEMPLEY, EILÍS. "Julian Trevelyan, Walter Maclay and Eric Guttmann: drawing the boundary between psychiatry and art at the Maudsley Hospital." British Journal for the History of Science 52, no. 4 (October 1, 2019): 617–43. http://dx.doi.org/10.1017/s0007087419000463.
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AbstractIn 1938, doctors Eric Guttmann and Walter Maclay, two psychiatrists based at the Maudsley Hospital in London, administered the hallucinogenic drug mescaline to a group of artists, asking the participants to record their experiences visually. These artists included the painter Julian Trevelyan, who was associated with the British surrealist movement at this time. Published as ‘Mescaline hallucinations in artists’, the research took place at a crucial time for psychiatry, as the discipline was beginning to edge its way into the scientific arena. Newly established, the Maudsley Hospital received Jewish émigrés from Germany to join its ranks. Sponsored by the Rockefeller Foundation, this group of psychiatrists brought with them an enthusiasm for psychoactive drugs and visual media in the scientific study of psychopathological states. In this case, Guttmann and Maclay enlisted the help of surrealist artists, who were harnessing hallucinogens for their own revolutionary aims. Looking behind the images, particularly how they were produced and their legacy today, tells a story of how these groups cooperated, and how their overlapping ecologies of knowledge and experience coincided in these remarkable inscriptions.
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Adams, Clare, and Maria O'Kane. "Consultant psychotherapists: who needs them?" Irish Journal of Psychological Medicine 16, no. 2 (June 1999): 41–42. http://dx.doi.org/10.1017/s0790966700005127.
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“The idea of a psychotherapeutically informed psychiatry seems such a simple and obvious one and yet the divide between psychotherapy and general psychiatry – between ‘brainlessness’ and ‘mindlessness’ has, until recently, seemed unbridgeable”.The Psychotherapy section of the Royal College of Psychiatrists has the largest membership in the college. Since psychotherapy became recognised as a discipline within psychiatry in 1975 the Royal College of Psychiatrists has recommended one consultant psychotherapist for each 200,000 of the population. In Northern Ireland there are only 1.9 whole time equivalents rather than the eight expected and in the Republic of Ireland there is none. According to the recent document produced by the Royal College of Psychiatrists' Psychotherapy Faculty Executive Committee in December 1998, The development of psychological therapy services: Role of the consultant psychotherapist, there has been no net growth in the last five years in the numbers of psychotherapists in England and Wales. The future looks equally gloomy in Ireland.This is rather surprising given that recent government documents have highlighted both the importance and the effectiveness of psychological therapies. There is a growing evidence base underpinning the use of psychotherapy in the management of a wide variety of conditions including psychoses, eating disorders and severe personality disorders.Psychotherapy has high public acceptability and finds itself in the unusual position of having both government and public demanding the provision of extra psychological therapies, but not receiving the full support of psychiatry and the purchasers of healthcare.
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Boiton-Malherbe, Sylvie. "Communication in the world today: one-way distribution or two-way sharing." International Review of the Red Cross 30, no. 276 (June 1990): 177–90. http://dx.doi.org/10.1017/s0020860400075525.
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A hazy or changeable concept, communication in its modern form as a technique for sending and receiving messages does not fit into any single or standard discipline. It extends outside the areas in which attempts are made to confine it, from the range of application of the humanities to the operational zones of telecommunications empires. After the ethnologists and sociologists, the linguists and the systems experts, the cyberneticists and the psychiatrists had attributed diverse meanings to it, communication in the broad sense and in its day-to-day reality entered its operational period in the 1980s with the new technology of information and communication.
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Kosmowski, W. "Pastoral psychiatry – towards new understanding." European Psychiatry 65, S1 (June 2022): S548. http://dx.doi.org/10.1192/j.eurpsy.2022.1404.
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Introduction Cultural psychiatry is an area of psychiatry that has been growing in importance recently. According to the new definition, mental health requires harmony with the universal values of society (Galderisi et al., 2017). Faith is considered an important factor in culture. Theology can enable a better understanding of psychiatric problems and distinction between spiritual and mental issues. “Pastoral theology aims at constructing models of redeeming activity of the Church which are current in these days, and will be current in the nearest future” (Przygoda, 2013). This discipline must recognize and evaluate the impact of contemporary sciences, including psychiatry, on theology and ecclesiastical activity. Objectives This study aims to prepare a modern concept of pastoral psychiatry, which will be used to prepare a textbook, teaching aids and teaching plan for this discipline. Methods Textbooks and articles in psychiatry, psychology and related disciplines, and pastoral theology monographs were analyzed. This was followed by the conceptualization of areas of interest and methodological standards. Results Textbooks on this problem were published several decades ago (Gabriel, 1933; Bless, 1949; Polish edition issued in 1980, translated with amendments by Kaczmarek). Since then, knowledge has advanced considerably. Textbooks of psychiatry and psychology only selectively consider the Christian perspective. Conclusions “Pastoral Psychiatry” should be helpful for priests, theologians, believers, doctors, psychologists. It requires the work of authors with theological and psychiatric competence. It will create ways of agreement, facilitate understanding of different perspectives, increase competence: theologians, priests – to better understand modern psychiatry; psychiatrists, psychologists – to better help religious patients. Disclosure No significant relationships.
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Guilera, G., M. Barrios, O. Pino, D. Salas, and J. Gómez-Benito. "Internet-based survey applied to experts in schizophrenia: Socio-demographic and professional variables associated to response pattern." European Psychiatry 33, S1 (March 2016): S570. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2112.
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IntroductionIn the framework of the development of the International Classification of Functioning, Disability and Health Core Set for schizophrenia, we conducted a cross-sectional, internet-based survey using open-ended questions. An international pool of experts from diverse health care disciplines was surveyed to identify problems in functioning experienced by individuals with schizophrenia.ObjectivesThe purpose of the study is to explore possible associations between experts’ socio-demographic and professional profiles, and whether they answered or not the survey.MethodsOut of 307 invited experts, 189 (61.56%) filled in the survey. However, 37 experts were excluded in the data analysis as they had completed only a part of the questionnaire. Thus, there were 152 of the experts classified as “respondents” and the remaining 155 as “non-respondents”. The association between the response pattern and the socio-demographic and professional variables (i.e., gender, World Health Organization region, discipline, and years of experience) was analysed by means of Chi2 tests.ResultsThere was a statistically significant association between the response pattern and the gender of the expert (χ2(1) = 4.927, P = 0.026; V = 0.127), showing that 56.3% of female and 43.6% of male experts answered the survey. When comparing the response pattern in terms of discipline, a statistically significant association was also found (χ2(4) = 10.101, P = 0.039; V = 0.183), showing that those who tend to answer the survey are occupational therapists (71.4%), followed by psychologists (58.0%), social workers (52.6%), nurses (52.0%), and psychiatrists (41.3%).ConclusionsFemales and occupational therapists presented the higher response rate to the expert survey.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Hanlon, Phil, and Sandra Carlisle. "What can the science of well-being tell the discipline of psychiatry – and why might psychiatry listen?" Advances in Psychiatric Treatment 14, no. 4 (July 2008): 312–19. http://dx.doi.org/10.1192/apt.bp.107.004499.
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There is a field of knowledge that speaks of the promotion of positive mental health, well-being and happiness yet it may not be well-known to all psychiatric practitioners. Economists, geneticists, positive psychologists, evolutionary psychologists, neuroscientists and sociocultural researchers have all contributed to what might be termed the emerging science of well-being. This article provides a brief introduction to this complex topic. We outline some of the findings, theories and arguments from this comparatively new but burgeoning research area. We also rehearse some critical responses to this field which indicate that both the evidence on well-being and the implications for practice and policy might be less straightforward than researchers sometimes imply. We conclude by suggesting that psychiatrists, as leaders in the field of mental health, might want to consider the implications (positive and negative) of well-being research for the development of their own discipline and professional practice.
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Cerejeira, J. Gonçalves, C. Rivera Jiménez, I. Santos Carrasco, C. Capella, and E. Rodríguez. "Narrative psychiatry: Healing through storytelling." European Psychiatry 64, S1 (April 2021): S447. http://dx.doi.org/10.1192/j.eurpsy.2021.1193.
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IntroductionWe all have the innate ability to tell our story and the way we do it can determine the impact that each problem has on our lives. Storytelling can play a critical role in psychiatric practice and, from this premise, a new way of practicing psychiatry has recently emerged: narrative psychiatry.ObjectivesThe objective is to offer a unified vision of narrative psychiatry, providing details on the historical and academic context of this approach.MethodsA narrative-type literary review focused on narrative psychiatry will be presented.ResultsNarrative psychiatry is an innovative clinical approach in line within narrative medicine and with a specific subtype of postmodern psychotherapy, the narrative therapy of Michael White and David Epston. This novel way of practicing psychiatry arises from critical movements within the discipline but it is an integrative and collaborative perspective: the position of each problem in the patient’s personal narrative is discussed and different therapeutic proposals are addressed, including for instance psychotropic drugs. This integrative posture gives the narrative psychiatrist enough flexibility to equally integrate the scientific achievements of biological psychiatry and the humanizing component of narrative practice. In this literature review, the key tools proposed by the main narrative psychiatrists worldwide for the narrative clinical interview will be exposed.ConclusionsNarrative psychiatry is a novel approach that narrows the therapeutic relationship and that puts in evidence the history of resistance of the consultant, healing through its own storytelling.
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Eminson, D. M., and J. M. Green. "Role conflict and barriers to learning for senior registrars in child and adolescent psychiatry." Psychiatric Bulletin 21, no. 6 (June 1997): 339–42. http://dx.doi.org/10.1192/pb.21.6.339.
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The landscape of training in child psychiatry is changing fast. In recent years the content of theory and practice within the discipline has evolved rapidly and the latest Royal College guidelines for higher training (Royal College of Psychiatrists, 1995) show a daunting array of training areas to be encompassed in four years or less. The Caiman proposals (Department of Health, 1993) will abbreviate and so inevitably further intensify postgraduate training in the speciality. We argue in this paper that the fact of entering such an intensive training at the level of senior registrar can, under certain circumstances, create barriers to learning. We describe the efforts of trainees, consultants/trainers and scheme coordinators to adapt to these difficulties as they arise.
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Javelot, Hervé, Clara Gitahy Falcao Faria, Frederik Vandenberghe, Sophie Dizet, Bastien Langrée, Mathilde Le Maout, Céline Straczek, et al. "Clinical Pharmacy in Psychiatry: Towards Promoting Clinical Expertise in Psychopharmacology." Pharmacy 9, no. 3 (August 21, 2021): 146. http://dx.doi.org/10.3390/pharmacy9030146.
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Although clinical pharmacy is a discipline that emerged in the 1960s, the question of precisely how pharmacists can play a role in therapeutic optimization remains unanswered. In the field of mental health, psychiatric pharmacists are increasingly involved in medication reconciliation and therapeutic patient education (or psychoeducation) to improve medication management and enhance medication adherence, respectively. However, psychiatric pharmacists must now assume a growing role in team-based models of care and engage in shared expertise in psychopharmacology in order to truly invest in therapeutic optimization of psychotropics. The increased skills in psychopharmacology and expertise in psychotherapeutic drug monitoring can contribute to future strengthening of the partnership between psychiatrists and psychiatric pharmacists. We propose a narrative review of the literature in order to show the relevance of a clinical pharmacist specializing in psychiatry. With this in mind, herein we will address: (i) briefly, the areas considered the basis of the deployment of clinical pharmacy in mental health, with medication reconciliation, therapeutic education of the patient, as well as the growing involvement of clinical pharmacists in the multidisciplinary reflection on pharmacotherapeutic decisions; (ii) in more depth, we present data concerning the use of therapeutic drug monitoring and shared expertise in psychopharmacology between psychiatric pharmacists and psychiatrists. These last two points are currently in full development in France through the deployment of Resource and Expertise Centers in PsychoPharmacology (CREPP in French).
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Mojović, Marina. "Serbian reflective citizens and the art of psychosocial listening and dialogue at the caesura." Journal of Psychosocial Studies 12, no. 1 (July 1, 2019): 81–95. http://dx.doi.org/10.1332/147867319x15608718110934.
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‘Serbian reflective citizens’ is a psychosocial community practice and a new discipline conceived in Belgrade amidst Yugoslavia’s ‘Horrible Nineties’ by Dr Marina Mojović (the author) and Dr Jelica Satarić, both psychiatrists and psychotherapists in various Yugoslav public health psychiatric institutions. The therapeutic communities seemed to open a way for new paradigms to shed light and hope on overwhelming social despair, however, besides the Belgrade therapeutic community, ‘Serbian reflective citizens’ has a multitude of roots and ancestors in professional and wider social communities.The author explains the development of ‘Serbian reflective citizens’ using a metaphor of caesura at birth, discussing the history and methodology, its grassroots style, numerous ancestors, ways (and spaces) of being, its building blocks, names and other identity aspects of this new community practice and discipline, with particular mention of a recent example of a newly-formed reflective citizens branch in Italy. The mentioned caesura of birth is also considered by the author as a transitional space, a place where, as Marina Abramović would say, ‘The artist is present’. The Northfield experiments are seen as transcending the caesura and, as such, particularly mentioned at the 2nd International Belgrade Conference on Reflective Citizens in 2014, ‘Learning through Experience about Inclusion/Exclusion Phenomena in and between Traditions of Bion, Foulkes and Main’.
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Ginsburg, Lynne, Pam Hamilton, Patti Madora, Leah Robichaud, and Jan White. "Geriatric Psychiatry Outreach Practices in the Province of Ontario: The Role of the Psychiatrist." Canadian Journal of Psychiatry 43, no. 4 (May 1998): 386–90. http://dx.doi.org/10.1177/070674379804300407.
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Objective: To determine the mode of practice of multidiscliplinary and interdisciplinary teams in the field of geriatric psychiatry in the province of Ontario with specific reference to the role of the psychiatrist on the teams. Method: Teams were identified, and a simple questionnaire was developed and submitted to every team at an annual conference. Results: Responses were obtained from 38 out of 47 teams. The composition of the teams is variable as regards size and represented discliplines. Nine teams do not have psychiatrists directly affiliated with them. Eighteen teams, 4 of which are based in teaching hospitals, have fewer than 1 full-time equivalent (FTE) psychiatrist. Among these teams, 4 have fewer than 0.1 FTE psychiatrist and 10 have fewer than 0.5 FTE psychiatrist. Eleven teams include between 1 and 1.5 FTE psychiatrists on their staff. Four teams (10.5%) require that the initial assessment of all patients be undertaken by a psychiatrist. In 18 (47%) of the teams, assessment by a psychiatrist can be infrequent or nonexistent. Discussion of the referral with a psychiatrist occurs in the majority of teams, but in a significant minority (10 [27%]), this occurs quite infrequently or not at all. Conclusion: Geriatric psychiatry outreach practices in Ontario involve many different disciplines in the assessment and follow-up of geriatric psychiatry patients, often without the ready availability of psychiatric input. We applaud the expanding roles of different disciplines in this practice. We are concerned, however, at the paucity of psychiatrists working in this field.
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Antić, Ana. "Transcultural Psychiatry: Cultural Difference, Universalism and Social Psychiatry in the Age of Decolonisation." Culture, Medicine, and Psychiatry 45, no. 3 (April 27, 2021): 359–84. http://dx.doi.org/10.1007/s11013-021-09719-4.
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AbstractIn the mid-twentieth century, in the aftermath of WWII and the Nazi atrocities and in the midst of decolonisation, a new discipline of transcultural psychiatry was being established and institutionalised. This was part and parcel of a global political project in the course of which Western psychiatry attempted to leave behind its colonial legacies and entanglements, and lay the foundation for a more inclusive, egalitarian communication between Western and non-Western concepts of mental illness and healing. In this period, the infrastructure of post-colonial global and transcultural psychiatry was set up, and leading psychiatric figures across the world embarked on identifying, debating and sometimes critiquing the universal psychological characteristics and psychopathological mechanisms supposedly shared among all cultures and civilisations. The article will explore how this psychiatric, social and cultural search for a new definition of ‘common humanity’ was influenced and shaped by the concurrent global rise of social psychiatry. In the early phases of transcultural psychiatry, a large number of psychiatrists were very keen to determine how cultural and social environments shaped the basic traits of human psychology, and ‘psy’ practitioners and anthropologist from all over the world sought to re-define the relationship between culture, race and individual psyche. Most of them worked within the universalist framework, which posited that cultural differences merely formed a veneer of symptoms and expressions while the universal core of mental illness remained the same across all cultures. The article will argue that, even in this context, which explicitly challenged the hierarchical and racist paradigms of colonial psychiatry, the founding generations of transcultural psychiatrists from Western Europe and North America tended to conceive of broader environmental determinants of mental health and pathology in the decolonising world in fairly reductionist terms—focusing almost exclusively on ‘cultural difference’ and cultural, racial and ethnic ‘traditions’, essentialising and reifying them in the process, and failing to establish some common sociological or economic categories of analysis of Western and non-Western ‘mentalities’. On the other hand, it was African and Asian psychiatrists as well as Marxist psychiatrists from Eastern Europe who insisted on applying those broader social psychiatry concepts—such as social class, occupation, socio-economic change, political and group pressures and relations etc.—which were quickly becoming central to mental health research in the West but were largely missing from Western psychiatrists’ engagement with the decolonising world. In this way, some of the leading non-Western psychiatrists relied on social psychiatry to establish the limits of psychiatric universalism, and challenge some of its Eurocentric and essentialising tendencies. Even though they still subscribed to the predominant universalist framework, these practitioners invoked social psychiatry to draw attention to universalism’s internal incoherence, and sought to revise the lingering evolutionary thinking in transcultural psychiatry. They also contributed to re-imagining cross-cultural encounters and exchanges as potentially creative and progressive (whereas early Western transcultural psychiatry primarily viewed the cross-cultural through the prism of pathogenic and traumatic ‘cultural clash’). Therefore, the article will explore the complex politics of the shifting and overlapping definitions of ‘social’ and ‘cultural’ factors in mid-twentieth century transcultural psychiatry, and aims to recover the revolutionary voices of non-Western psychiatrists and their contributions to the global re-drawing of the boundaries of humanity in the second half of the twentieth century.
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van Praag, H. M. "Biological psychiatry marching towards the future and the perils of progress." Acta Neuropsychiatrica 3, no. 3 (September 1991): 36–41. http://dx.doi.org/10.1017/s0924270800034190.
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SummaryThe study of the biological determinants of abnormal behavior is not anymore psychiatry's stepchild, but a respected branch of that discipline. There is every reason to be optimistic over the future of biological psychiatry. The brain sciences are developing with astounding speed and the systematic attention for psychiatric-diagnosis and differential diagnosis renders biological psychiatry an unprecedented vitality.One should, however, not ignore some disquieting prospects. The following points of concern are discussed: the alarming shortage of young research psychiatrists; the deficiencies in the teaching of biological psychiatry; the hesitancy to utilize the fruits of brain and behavior research in clinical practice; the shortcomings in psychiatric diagnosing; nosological tunnel vision and, finally, the danger of overrating biological psychiatry with the inevitable disappointment reaction that will follow. The scientific maturation of psychiatry is contingent on a balanced development of its constituents.
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Warner, James. "Wither old age psychiatry?" International Psychogeriatrics 26, no. 7 (April 8, 2014): 1055–58. http://dx.doi.org/10.1017/s1041610214000544.
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I think it is fair to say that the UK was one of the first countries to develop dedicated old age psychiatry services. The first such documented service was set up in the Crichton Royal Hospital in Dumfries in 1958 (Robinson, 1965). This arose after decades of recognition that older people with mental illness get a raw deal if they are managed in adult services (Hilton, 2012). Following a slow start, specific old age services began to burgeon. The discipline got recognition as a separate faculty in the Royal College of Psychiatrists in 1988, and throughout the eighties and nineties, virtually all areas of the UK developed their own specialist old age psychiatry services; multi-disciplinary teams working with people over the age of 65 generally providing community-based services with input to people's homes as the norm.
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Salihi, Imane, and Jiann Lin Loo. "Postgraduate Psychiatry Training Programme in Morocco." BJPsych Open 8, S1 (June 2022): S26—S27. http://dx.doi.org/10.1192/bjo.2022.134.
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AimsThe field of psychiatry in Morocco has grown significantly since the 1970s, from less than 10 psychiatrists to the current number of around 400. The increased number of practising psychiatrists has enabled the expansion of local residency training programmes, which has been set up since 1974 to cater for the population needs of more than 36 million population of Morocco. This study is aimed to describe the current medical educational approach of the Moroccan postgraduate psychiatry training programme.MethodsThis descriptive medical educational study was based on official training documents and interviews with local faculty members involved in the training.ResultsThe entry requirement of the four-year Moroccan postgraduate psychiatry residency programme includes the completion of 1 year of foundation training and passing the entrance examination consisting of psychiatric semiology and pharmacology. The postgraduate residency programme is run by the local universities in collaboration with the Ministry of Health and accredited by the Moroccan government. Trainees have the option of taking up a voluntary or contractual position with the government or University Hospitals. All trainees will go through 34 months of general adult outpatient and inpatient, while liaison psychiatry training starts from the second year until the end of the training. On top of the core rotation, a trainee can opt for two months in old age and neuropsychiatry postings. Child and adolescent rotation is currently not available. Addiction psychiatry training is optional and can be done through a university diploma. The 4th year is a 12-month elective posting in any discipline that is relevant to psychiatry, which can be done either locally or abroad. Teaching methodologies involve lectures, seminars, ward rounds, case conferences, journal clubs, and skill training workshops. Formative assessments included case-based discussions and mini-clinical evaluation exercise. There are multiple high stakes summative assessments at year 1, year 2, year 3, and year 4. The summative assessment strategies includes modified essay question, clinical short case and long case. Viva voce is used to assess competency in research. Different mandatory skill competencies include electroconvulsive therapy, psychotherapy, and research.ConclusionThe advancement of local postgraduate psychiatry residency training in Morocco has improved the access of local trainees to quality training. Similar to other developing countries, Morocco requires more psychiatrists to improve the psychiatrists to population ratio so that the mental service can become more accessible to the local population.
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Snyder, Jane C., and Eli H. Newberger. "Consensus and Difference Among Hospital Professionals in Evaluating Child Maltreatment." Violence and Victims 1, no. 2 (January 1986): 125–39. http://dx.doi.org/10.1891/0886-6708.1.2.125.
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The decision-making process in suspected cases of child maltreatment involves reaching interprofessional consensus. Interprofessional consensus in seriousness ratings of maltreatment incidents for the welfare of the child was examined by surveying 39 case vignette ratings by 295 pediatric hospital professionals from five occupations. The survey instrument was derived from research by Giovannoni and Becerrra (1979). An exploratory factor analysis yielded five categories of maltreatment: physical abuse, sexual abuse, general failures in care, minor neglect/discipline, and lifestyles/ values. A sixth category, parental sexual preference, was rated not very serious and did not appear to belong in the maltreatment domain. Nurses and social workers rated incidents as most serious, differing significantly from psychiatrists and, often, from physicians and psychologists. Professions agreed on rank ordering of categories by seriousness. Variables such as sex, parenthood status, years of experience, and medical specialty showed some relationship to ratings within some professional groups.
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Krzanowski, Jacob. "The need for biodiversity champions in psychiatry: the entwined crises of climate change and ecological collapse." BJPsych Bulletin 45, no. 4 (June 9, 2021): 238–43. http://dx.doi.org/10.1192/bjb.2021.44.
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SummaryThe past 20 years have seen the disappearance and degradation of biodiversity on earth at unprecedented rates. This phenomenon shares similar drivers to those behind climate change yet requires its own solutions. The twin catastrophes of climate change and biodiversity loss demonstrate how our health is bound up in the vitality of this planet. There has been an increasing effort on the part of healthcare professionals to appreciate this relationship, as evidenced by the growing influence of planetary health as a discipline. However, the health impacts of biodiversity loss have been less focused on than those brought on by climate change. Psychiatry's appreciation of the interface between environments and our health, alongside the evidence for the connection between nature and mental health specifically, prompt psychiatrists to ensure that the institution of healthcare throws its influence equally behind solutions to climate change as well as biodiversity loss.
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Freeman, Hugh. "The Environment." British Journal of Psychiatry 153, no. 4 (October 1988): 579–82. http://dx.doi.org/10.1192/s0007125000282391.
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There has been a surprising lack of interest in - and an even greater lack of worthwhile research on - the relationship between the physical environment and human life in its psychological-behavioural aspects. Following up the outcome of interventions is a basic investigatory task for psychiatrists, but has had little attraction for planners or architects, any more than for lawyers. It is ironic, though, that psychiatry should so often be attacked for taking too clinical or mechanistic a view, considering that hardly any other discipline (except social work) devotes so much attention in everyday practice to the objective circumstances of peoples' lives. Perhaps this bad press has something to do with the failure of social psychiatry to construct a coherent environmental offshoot, or to intervene usefully in that kind of public issue - a gap which I have tried to start filling in Mental Health and the Environment (Freeman, 1985).
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Christodoulou, G. "Cultural and Economic Factors in European Psychiatry Guidance." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70502-4.
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Europe can hardly be considered as homogeneous. There are gross historical, climatological, cultural, developmental, religious, political and economic differences that render generalizations inappropriate and European “globalization” a mission impossible (and, by and large, undesirable).Psychiatry is no exception to the above and in the historical evolution of our discipline, psychiatric practice has varied. Because this evolution has followed a different course and has occurred at a different pace in the various parts of Europe, the present situation reflects all these developmental stages, thus rendering homogeneity questionable.In spite of these differences, however, there is a degree of consensus regarding the basic requirements for the practice of our discipline and the desired competencies of its practitioners. The development of a common language through the modern classification systems, the organizations of specialist psychiatrists (e.g. the UEMS) the WPA and the European Psychiatric Associations have played a useful role in the harmonization of psychiatric practices and are expected to play a more useful role in the future.In conclusion, what is required (and what can be realistically achieved) is consensus on some basic clinical, research, administrative and teaching requirements, in association with agreement on the basic ethical principles of our profession and, basically, the beneficence and non maleficence principles. European Psychiatry Guidance should involve these basic requirements that can be achieved by all European countries.
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Rigby, D. "Digital psychiatry and COVID-19: a potential recruitment opportunity." European Psychiatry 64, S1 (April 2021): S39. http://dx.doi.org/10.1192/j.eurpsy.2021.132.
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Psychiatry has long been battling with a recruitment crisis in the UK which is also reflected across much of Europe. Covid-19 has brought about widespread changes to our ways of working, as well as driving technological developments, which provides potential opportunities for the profession to draw people into the speciality. Covid-19 has brought interest in digital psychiatry from the peripheries to the mainstream. Mental health professionals are currently using sophisticated technologies such as Virtual Reality, Artificial Intelligence and Natural Language Processing in the diagnosis and treatment of mental health disorders. Highlighting the ways in which our profession is at the cutting edge of innovation to junior doctors offers a fruitful avenue to improve recruitment into the speciality. Many outpatient clinics have made the move to online service delivery during the pandemic to varying degrees. For many clinicians this has allowed more flexible and efficient ways of working. Psychiatry is better placed than most other medical disciplines to retain online patient contact in future clinical practice, post pandemic and may provide an attractive proposition for future psychiatrists. This talk will review some of the ways in which developments in digital psychiatry have been used to help generate interest for recruitment into the discipline as well as evaluating the benefits and challenges of the shift to telepsychiatry during Covid-19 and will offer some suggestions what the profession can learn from this to help future recruitment.DisclosureNo significant relationships.
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Yonge, Keith A. "Reflections on the Epistemology of Psychiatry." Canadian Journal of Psychiatry 33, no. 8 (November 1988): 686–90. http://dx.doi.org/10.1177/070674378803300802.
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A re-examination of the theoretical basis of our practice of psychiatry (that is, its epistemology) reveals the insufficiency of the empirical, inductive approach which we have come to regard, too myopically, as the sine qua non of our science. Traditionally in psychiatry, the discipline of philosophy, of which epistemology is one of its major fields of endeavour, has generally come to be regarded as irrelevant or unreliable as a source of true knowledge. But an objective look at our variegated practice of psychiatry — roughly divided into two groups — the biological on the one side and the psychosocial on the other — reveals a glaring lack of integration, cohesion, or synthesis in basic theory. While analysis is the prime modus operandi of science, synthesis is the main objective of philosophy. While we subscribe to various operational theories to explain how our various procedures work, we lack an overarching, unified, general theory to subsume them. Hence we lack a truly holistic concept of the person who is our patient. In this we are much in need of the discipline of philosophy, which promotes clarity of thought, breadth of comprehension, and systematic (logical) reasoning. Psychiatrists acquire more of this philosophic expertise through collaboration with professional philosophers (epistemologists in particular) and through the introduction into our graduate psychiatric training programs of some specific course content from the literature of philosophy. As a preliminary suggestion for this, an “Annotated Reading List” is appended.
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Brown, Juliette. "Psychiatry, power and the person." European Journal for Person Centered Healthcare 8, no. 3 (October 21, 2020): 363. http://dx.doi.org/10.5750/ejpch.v8i3.1865.
Full textAbstract:
Psychiatry treats human problems expressed through bodily symptoms and aims to be person-centred, but is often not experienced as such. Experience of mental healthcare care can be profoundly traumatising. The aim of this article is to explore some of the barriers to person-centred care in psychiatry, and to explore ways of integrating the knowledge held by patients with that held by psychiatrists. Barriers include a lack of acknowledgement of the centrality of trauma experiences in the development of mental illness. Other factors include the effects of exposure to psychological trauma as a doctor, being unconsciously motivated by one’s own early life experiences, and internalising the stigma around mental ill-health in patients and in clinicians, as a clinician. The discipline suffers from limitations on the knowledge base. Phenomenological accounts and lived experience research must have higher priority in psychiatric education in order for the discipline to gain both scientifically and ethically. One of the aims of this article is to explore philosophical ideas around reconciliation of apparently opposing narratives and explanatory models in psychiatry, ideas which have the potential to shift power relations and enable renewed focus on what is most meaningful to patients. There is an argument for subjecting psychiatry to ongoing critique of purpose as well as method. In conclusion the form of psychiatry most likely to deliver person-centredness is one that can attend to its own prejudice, its unconscious, its values and those of its subject.