The emergence of psychiatry at McGill.

Psychiatric services in Canada lagged behind other medical disciplines until World War II emphasized the need for psychiatrists in the Armed Forces. This led to steps being taken to fulfil this need. At McGill, a new Department of Psychiatry, centered at the Allan Memorial, was established in 1943, due to the vision of Dean Jonathan Meakins and the influence of Dr. Wilder Penfield. P. Ewen Cameron was chosen as the first Director and set up services in affiliation with the Royal Victoria Hospital and McGill. His energy and organizational abilities led to the creation of an Institution which had a pathfinder function for post war services in clinical psychiatry, embracing also biological and social research. He soon recruited such able European scholars as Miguel Prados and Karl Stern and shortly thereafter the eminent psychologist R.B. Malmo and as physician endocrinologist, myself. Forward looking programs such as the day hospital, an open door policy, teaching programs and units for research in geriatric psychology and biochemistry were set up. By the 50's, psychiatry units were also established in other general hospitals and a close affiliation with the Verdun Protestant Hospital was fostered. Therefore H.E. Lehmann pushed clinical psychiatry into a new phase, as he led the field in psychopharmacology. Senior staff expanded with the acquisition of Eric Wittkower and V.A. Kral and the psychoanalysts, J. and F. Aufreiter, Macleod and W.C.M. Scott. The success of the training system was such that able graduates moved to positions of responsibility in the rest of Canada.(ABSTRACT TRUNCATED AT 250 WORDS)

The development of psychiatric research in Canada up to 1964.

Systematic developments in psychiatry came later than in modern medicine, in Canada as elsewhere. Empirical discoveries of significance for the latter occurred in the 18th century, those for psychiatry only in the 20th, depending on much more sophisticated technology. The emergence of an appreciation of emotion as a central factor in mental illness was spurred initially by Freud and then emphasized by the social disasters of two world wars. Physical methods of therapeutic value were followed by the application of chemical agents having phrenotropic effects. From such developments and the devising of chemical methods for the deeper understanding of body chemistry have emerged a psychiatry closer to the medical model. Simultaneously more sophisticated attitudes and criteria have risen. All these changes have depended in large measure on the application of research methods. The early employment of research in the Canadian scene are examined up to 1964 for those centers which have led the way.

Psychosomatic disorders in the elderly.

There is no agreement on the incidence or prevalence of psychosomatic disorders in the elderly. This is due in large part to the methodological difficulties of the epidemiological studies which have not employed the same diagnostic criteria and classification. Drawing on the literature and on clinical experience, a classification is offered, and using the diagnostic criteria explicit in this classification, probable trends are identified. Pseudodementia may well be the only stress-related disorder that is peculiar to the elderly.