Prevalence of dissociative symptoms and disorders in an adult psychiatric inpatient population in Canada.

OBJECTIVE: This study attempted to estimate the prevalence of dissociative symptoms and disorders in a Canadian adult psychiatric inpatient population and also attempted to determine the extent to which dissociative disorders were recognized by the attending clinical staff. METHOD: All appropriate and consenting adult psychiatric inpatients at the Kingston Psychiatric Hospital in Kingston, Ontario, were given the Dissociative Experiences Scale. Patients scoring 25 or greater were interviewed with the Dissociative Disorders Interview Schedule and the Structured Clinical Interview for DSM-IV Dissociative Disorders. Admission or discharge diagnoses data were used to determine whether or not dissociative disorders were being recognized. RESULTS: A total of 48 patients completed the Dissociative Experiences Scale and 14 (29%) scored 25 or greater. The prevalence of dissociative disorders in this hospital population was estimated to be 17%. Dissociative identity disorder was found in six percent, dissociative amnesia in eight percent and dissociative disorder not otherwise specified in two percent of the population. These disorders tended to be under-recognized. CONCLUSION: Research on more extensive populations is required to establish the true prevalence of dissociative symptoms and disorders in psychiatric inpatients.

Relationship of body-image distortion to sex-role identifications, irrational cognitions, and body weight in eating-disordered females.

Thirty-one eating-disordered (ED) women and 11 normal women completed tests of sex-role identity, dysfunctional cognitions, and body image. Anorexics, not bulimics, exhibited body-image distortion. All EDs (distorters and nondistorters) showed "hyperfeminine" identifications. Maladaptive cognitions were present in all EDs, but more marked in "overestimators." Body weight predicted BID better than other measures of eating pathology, which suggests important effects of weight per se in producing BID.

Psychiatric residents' experience and career interest in geriatric psychiatry: implications for training programs.

A survey of residents' experience and career interest in geriatric psychiatry was carried out in Canadian training centres. Residents' exposure to specific training experiences in geriatric psychiatry has been steadily increasing, although a large proportion of residents continue to report insufficient amount of experience and supervision in this area. Residents viewed geriatric psychiatry as involving special skills and knowledge and half were in favour of a compulsory rotation in this area. Geriatric psychiatry was an infrequent career choice along with other areas of psychiatry that have had difficulty in recruiting. Alternative approaches to service provision and recommendations for meeting the manpower needs are discussed.

Effects of a psychiatric rotation on psychiatric knowledge and attitudes towards psychiatry in rotating interns.

The attitudes of trainees toward Psychiatry affect their career choice and ability to properly identify and manage emotional disorders in their patients. These attitudes are determined by several factors which include preclinical and clinical training among others. We report here a study of the attitude of interns toward psychiatry using the 30 item attitude toward psychiatry (ATP-30) scale. The ATP-30 and a multiple choice questionnaire examination (MCQE) in psychiatry were completed by 96 interns at the beginning and end of their compulsory four week psychiatry rotation. The degree of satisfaction of the trainees was rated in four areas--orientation, teaching/learning experience, overall rating of rotation and relevance of rotation to career choice. There was no significant change in the mean ATP-30 scores (N = 55) during the four week rotation, but the MCQE scores (N = 74) improved significantly (P less than 0.0001). A repeated analysis of variance for the four satisfaction variables by change score in MCQE and change score in ATP-30 did not show any significant main effects or significant interactions between these change scores except with relevance of rotation. Reasons for the absence of changes in the ATP-30 scores during this rotation were explored. The implications of the improved knowledge during this rotation are also discussed. We also conclude that attitudinal change and knowledge are two independent factors which should be assessed independently in trainees.

Sex-role ideology among self-identified psychotherapists.

Analysis of the sex-role ideology of 1,258 self-identified psychotherapists from nine occupations indicated that: the sample was representative; as a group, self-identified psychotherapists were moderately feminist; there were significant differences among occupations; and results were not due solely to the effects of age or sex distributions among occupations.

Filling the need for emergency psychiatrists: is better education the answer?

Although the need for specialists in emergency psychiatry is increasing, little attention is given to this field by American psychiatric residency programs, and few psychiatrists choose emergency psychiatry as a career. Like their American counterparts, few Canadian psychiatric residents also choose this specialty. To determine Canadian patterns of emergency education and Canadian residents' opinions of their emergency psychiatry experience, the authors distributed a 41-item questionnaire to 190 psychiatric residents across Canada. The results showed that most residents worked long hours alone, with little complementary education or evaluation. Residents in programs with formal education and evaluation components and on-call assignments no more than once a week found the emergency psychiatry experience most rewarding. The authors make a series of recommendations to strengthen the educational aspects of the emergency psychiatry experience.

Interpersonal effects of marijuana. A model for the study of interpersonal psychopharmacology.

The effect of marijuana on affective changes and interpersonal skills, including empathy, acceptance, warmth, and genuineness, was studied in 20 dyadic relationships in which the experimental subject smoking marijuana containing 6 mg of delta-9-tetrahydrocannabinol and a placebo in separate trials. Marijuana caused a relative decrease in the ratings of the interpersonal skills of the experimental subjects and decreased affective resonance between the experimental subjects and their partners.