Women as torture victims.

This paper reports a retrospective study of the frequency, severity, modalities and mental health consequences of torture in 28 Latin American refugee women in Toronto. The data on these women and a comparison group of male torture victims were retrieved from case records in a hospital outpatient clinic. The results support the hypotheses implicit in the scanty literature available that the frequency and effects of torture in women differ from those found in men. In female victims, as in their male counterparts, the severity of the torture was related to the degree of their political involvement. However, torture was more frequently sexual, and its consequences more often affected the women's sexual adaptation.

PIP: This study investigates the frequency, severity, modalities, and mental health consequences of torture in 28 Latin American refugee women in Toronto, Canada. Information on these women was gathered from case records in a hospital outpatient clinic. The case histories of 28 male Latin American refugees and victims of political persecution and torture were used as control for this study. The findings support the hypotheses presented. Women, who are politically persecuted, are tortured less frequently than men are. There is also an association between the sex of the victim and the techniques employed in torture. Findings also indicate that the occurrence and severity of torture in women depend on the degree of political participation. Lastly, sexually tortured women manifest greater psychological and sexual dysfunction.

Estimates of the prevalence of bipolar affective disorder. Methods based on treatment with lithium.

During this century the epidemiology of the affective disorders has been studied, several classifications have been described and effective treatment measures have been introduced. Difficulties have been encountered in the epidemiology area due to inconsistent use of the terminology of measurement and varying types of classification; although it is possible to arrive at a broad consensus of agreement if the data are examined restrictedly. The clinical need for accurate rates of illness has become greater since the inception of the prophylactic drug lithium carbonate. While not used specifically for bipolar affective disorder, it is only for this disorder that its use has been demonstrated beyond doubt. The occurrence of mania in this disorder enables this aspect of the condition to be used as a marker. This paper describes three measures of the period prevalence of bipolar affective disorder, based upon treatment with lithium, two of which are of the "unobtrusive' type. Agreement was found between the three approaches and the utility of these for general use is discussed.

Planning for psychiatric emergencies.

Hospital emergency services have been used increasingly in recent years. This has resulted in questions as to the true nature of patients' complaints and the appropriateness of this type of care. Since the increase in the number of psychiatric emergency patients has paralleled that for patients at other types of emergency clinics a study was conducted at the Clarke Institute of Psychiatry, Toronto, to examine the situation prior to the inception in 1977 of a crisis intervention unit. It was found that most patients had both psychiatric and social difficulties, and it was considered that planning should concentrate on strategies for efficient management of the clinical problems.

Psychiatric disorder, hospital admission, and season.

Psychiatric disorder has been considered to have seasonal variation for a long time. The studies to date have suffered frequently from small samples and imprecise terminology, and the results have been inconclusive. This study has attempted to overcome these difficulties by examining hospital admissions to all facilities in the province of Ontario for a six-year period, with each year carefully divided into seasons. Statistically significant seasonal variation, with peaks in the spring and fall, was found overall for neurotic and endogenous depression. Alcoholism also showed a spring peak. No other diagnoses, overall, showed seasonality, although personality disorders, drug addictions, and transient situational disturbances exhibited trends similar to neurotic depression for certain age and sex groups. The findings are discussed in terms of their clinical and research significance.

The use of electroconvulsive therapy.

Electroconvulsive therapy is a treatment procedure in psychiatry which has frequently come under considerable critical scrutiny. This paper describes its use mainly in a postgraduate institute of psychiatry and, for comparative purposes, two other types of psychiatric facilities in Toronto. The treatment is given conservatively, varying to hospital, and is prescribed for 11 percent of patients at a postgraduate institute. However, it is used largely for those with depressive disorders as recommended in standard textbooks. Diagnosis and age are the key variables affecting ECT prescription. It is suggested that ECT practice is effective by and large and now efforts should concentrate on making it efficient.