Subject(s)
Interprofessional Relations , Psychiatry/trends , Canada , Forecasting , Forensic Psychiatry/trends , Humans , Mental Disorders/diagnosis , Mental Disorders/psychology , Mental Disorders/therapy , Neuropsychology/trends , Psychotherapy/trends , Psychotropic Drugs/adverse effects , Psychotropic Drugs/therapeutic useSubject(s)
Confidentiality , Education, Medical, Undergraduate , Psychiatry/education , Canada , CurriculumABSTRACT
Recent advances in the methodology of epidemiology in psychiatry are briefly reviewed, along with remaining problems, such as the defining of a "case" of depression. Findings from recent studies of the epidemiology of depression are outlined.
Subject(s)
Depressive Disorder/epidemiology , Canada , Cross-Sectional Studies , Depressive Disorder/diagnosis , Female , Humans , Male , United StatesABSTRACT
Three videotaped practice clinical, oral examinations were rated by 9, 9 and 11 raters respectively. Raters were all certified specialists engaged in training residents for the certification examinations. In two of the simulated examinations considerable differences in rating scores, to the extent of pass/fail disagreement, were found. The significance of the findings, including the possibility that one examiner may "contaminate" another, is discussed. Further work is essential to develop reliable instruments for rating certification examinations, whatever their format, as the Royal College policies evolve.
Subject(s)
Certification , Psychiatry/education , Specialty Boards , Canada , Humans , Internship and Residency , Interview, Psychological , Videotape RecordingABSTRACT
Renal function was assessed in 42 stable outpatients who had been taking lithium for an average of 4 1/2 years. Impaired ability to concentrate the urine was found in 61% of the 41 patients who provided a urine sample for an osmolality measurement, and a moderate reduction in creatinine clearance was present in 12% of the entire group; 1 patient showed both defects. Urine microscopy revealed an excess of cells in 40%. It is suggested that lithium therapy produces a self-limiting lesion of the distal nephron that does not usually progress to chronic renal failure. The lesion is not dangerous, except that it may predispose to acute neurotoxic effects in the event of intercurrent illness or dehydration.
Subject(s)
Kidney Diseases/chemically induced , Kidney/drug effects , Lithium/adverse effects , Female , Glomerular Filtration Rate/drug effects , Humans , Hydrogen-Ion Concentration , Kidney Concentrating Ability/drug effects , Male , Mental Disorders/drug therapy , Time FactorsABSTRACT
The Ontario Mental Health Act, as amended in November 1978, provides strictly defined criteria for involuntary commitment for psychiatric assessment; the assessment can last up to 5 days. These criteria fail to cover a number of patients who are, in the author's opinion, in need of compulsory assessment or treatment. Four cases in which there was serious difficulty in giving proper care are described in this paper. The difficulties are discussed and improvements in the criteria for involuntary assessment recommended.
Subject(s)
Commitment of Mentally Ill/legislation & jurisprudence , Forensic Psychiatry/legislation & jurisprudence , Adolescent , Adult , Bipolar Disorder/diagnosis , Canada , Dementia/diagnosis , Depression/diagnosis , Female , Humans , Male , Middle Aged , Schizophrenia, Paranoid/diagnosis , ViolenceABSTRACT
Reasons are presented for believing that the skill of formulation is inadequately covered in textbooks. A survey was made of 57 psychiatric training centres in Canada, the U.S.A. and the United Kingdom and Republic of Ireland (in which 1324 doctors are trained). Of North American respondents only a minority give written guidelines about how a formulation should be undertaken. In the United Kingdom and Ireland 55% issue written guidelines. Only 31% of all centres polled give references on the topic. The results are discussed and a brief schema to help trainees formulate cases is proposed.
