SciCombinator

Discover the most talked about and latest scientific content & concepts.

Concept: Moral treatment

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Although studies of co-occurring psychiatric disorders among methamphetamine (MA)-dependent persons have been conducted in treatment programs, none have examined them in service settings used to sustain long-term recovery, such as sober living houses (SLHs).

Concepts: Mental health, Mental disorder, Psychiatry, Recovery model, Psychiatric hospital, Psychiatric medication, Cross-cultural psychiatry, Moral treatment

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In the history of psychiatry, “schizophrenia” has often been portrayed as the discipline’s pars pro toto, which prototypically represents mental illness as such and which draws together the fundamental questions concerning psychiatric epistemology and practice. Taking a conceptual history approach, this essay examines how “schizophrenia” is represented in psychiatric discourse and what aspects of its representation account for the pars pro toto status. Three such aspects are identified: a pragmatic, an existential and a justificatory aspect. Following up these aspects in present day psychiatric discourse, it is concluded that “schizophrenia” is losing its special status as the representations of psychiatry and of mental illness have changed and become more diverse. Tentative conclusions regarding current debates about the abolition of “schizophrenia” are drawn.

Concepts: Psychology, Mental health, Greek loanwords, Mental disorder, Psychosis, Psychiatry, Psychotherapy, Moral treatment

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Like Hannah Decker, I too deplore the destructive battle of psychosocial and biological reductionisms that has bedeviled psychiatry. When I started my psychiatric training almost 50 years ago, the prevailing model for understanding mental disorders was broadly bio/psycho/social in the grand tradition of Pinel and Freud, brought to and adapted in America by Adolph Meyer. When psychiatry is practiced well, it integrates insights from all the different ways of understanding human nature. Unfortunately, the mental health field has since degenerated into a civil war between the biomedical and psychosocial models with little room for compromise or finding middle ground. The inflexible biological reductionists assume that genes are destiny and that there is a pill for every problem: they take a “mindless” position. The inflexible psychosocial reductionists assume that mental health problems all arise from unpleasant experience: They take a “brainless” position. I have spent a good deal of frustrating time trying to open the minds of extremists at both ends, though rarely making much headway. In my view, however, and where I differ from Decker, the reductionisms do not sort so neatly into alternating historical periods. (PsycINFO Database Record

Concepts: Psychology, Medicine, Mental health, Mental disorder, Psychiatry, Mental health professional, Psychiatric hospital, Moral treatment

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Individuals with a lifetime diagnosis of mental illness smoke at rates greater than the general population, and have more difficulty quitting. Cessation self-efficacy has been linked with positive cessation outcomes and can be assessed as either task (confidence to quit) or barrier self-efficacy (confidence to quit in the face of obstacles). We investigated differences in self-efficacy among smokers with a current, past or no lifetime diagnosis of psychiatric illness.

Concepts: Mental health, Mental disorder, Psychiatry, Mental illness, Psychiatric hospital, Psychiatric medication, Cross-cultural psychiatry, Moral treatment

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Mental illness has always been subject to stigma and discrimination. There are a number of studies on public attitudes towards people with mental illness. Long-term studies, however, examining changes over time are scarce.

Concepts: Psychology, Mental health, Mental disorder, Psychiatry, Psychiatric hospital, Psychiatric medication, Cross-cultural psychiatry, Moral treatment

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Many offenders treated for psychiatric disorders while incarcerated are paroled to counties where psychiatric care is limited, leading some correctional departments to offer psychiatric treatment via videoconferencing (“telepsychiatry”). However, the effectiveness of telepsychiatry for offenders with psychiatric disorders has not been rigorously evaluated.

Concepts: Mental disorder, Psychiatry, Moral treatment

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Stress is an established important contributor to the development of mental illness and stress related disorders. The biology implicated in the homeostasis of pathological stress mechanisms is not fully established. One of the difficulties with current techniques is the limitation in capturing chronic levels of cortisol as an expression of stress levels in humans. Hair samples can be used to evaluate cortisol levels averaged over relatively long periods of time, therefore providing a more valid measure of chronic levels of this hormone. A highly replicable technique to measure long-term cortisol could prove pivotal in improving our understanding of the role of stress in psychiatric disorders.

Concepts: Mental health, Mental disorder, Psychiatry, Mental illness, Psychiatric hospital, Psychiatric medication, Cross-cultural psychiatry, Moral treatment

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Psychiatric disorder (PsD) is rarely considered when evaluating perioperative risk factors. Studies on PsD are often limited by use of administrative coding, incomplete follow-up, and lack of preoperative data on psychopharmacological treatment.

Concepts: Mental health, Mental disorder, Psychiatry, Psychiatric hospital, Psychiatric medication, Cross-cultural psychiatry, World War II, Moral treatment

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The distinction between ‘passion’ and ‘emotion’ has been largely overlooked in the history of psychiatry and the psychopathology of affectivity. A version of the distinction that has gone completely unnoticed is the one proposed by Florentine physician Vincenzo Chiarugi (1759-1820). The purpose of the present discussion is to introduce this Italian version of the distinction and to inquire into its origins.

Concepts: Time, Psychology, Neuroscience, Psychiatry, Emotion, Italy, Moral treatment, Psychopathology

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Based on extensive ethnographic research in psychiatric custody for adolescents, this article uses the creation of, implementation of, and resistance to a treatment model to reveal issues of constraint in American psychiatric treatment. The treatment model is called Counter Response. As a model Counter Response shifts the treatment focus in a total institution for mentally ill youth from the youth themselves to the staff response to the youth. This article uses Counter Response as a case study to illustrate the close ties between constraint and autonomy in psychiatry. It also shows how models like Counter Response reflect the power of unregulated treatment paradigms in American adolescent institutional psychiatric intervention. Finally, the article demonstrates that resistance to Counter Response reveals a tension American practitioners have with psychiatry’s constraining power.

Concepts: Mental disorder, Psychiatry, Moral treatment