Canadian journal of psychiatry. Revue canadienne de psychiatrie
-
This article is a brief and selected overview of pediatric psychopharmacology, a field which links medicine, behavioural sciences, and neurosciences to child psychiatry. It will summarize current knowledge and recent advances related to the indications, effects, limitations and research issues of psychostimulants, antidepressants, antipsychotics, anxiolytics, anticonvulsants and diets used in the treatment of child and adolescent psychiatric disorders.
-
There is a greatly increased risk of a woman developing a psychiatric illness requiring hospital admission during the early postpartum period. Admission of the mother has usually meant separating her from her infant at a time when bonding and attachment are developing. Nearly 40 years ago English psychiatrists began admitting infants with their mentally ill mothers, and although the theoretical basis for this is sound, there are few systematic studies of the practical problems encountered, or the outcomes. ⋯ The women admitted with their infants were more likely to be older, living with the infants' father, in a stable residence and job, in hospital for a longer time, and caring for their babies at 2 year follow-up in contrast to the women who were admitted without their infants. The two groups were diagnostically different with joint admission mothers likely to suffer from an affective psychotic illness, while the mothers without infants were more likely to suffer from personality disorder or substance abuse. The effects of mother-infant admission and some of the practical problems encountered are discussed.
-
One hundred consecutive cases of delirium seen in a psychiatric consultation service of a general hospital are discussed. Two thirds of the patients came from pneumology and cardiology since the hospital serves as a regional thoracic center. The frequency of delirium was 12.6% of consultations: three men were seen for every one woman; 80% of cases were over fifty years of age. The clinical aspects of delirium are studied according to DSM-III criteria to evaluate: a) the frequency of the symptoms, b) the temporal course of the disorder, c) any clinical characteristic of delirium linked with potential etiological factors, d) the role of anxiety.
-
A comparison of numbers of women psychiatrists with faculty appointments and women residents in Departments of Psychiatry in Canada in 1975 and 1985 showed that the average percentage of women faculty has increased from 11.4% to 14.3% and of women residents from 23.5% to 43.4%. Some departments appeared to be oblivious to the special educational role of women faculty and had not discussed the discrepancy between the numbers of faculty and residents. ⋯ Barriers to recruiting women faculty include lack of academic role models, job advertising not specifically designed to attract women candidates, rigid requirements for appointments, women's lack of access to male corridors of power, pervasive underlying doubts about women's abilities and competence based on cultural stereotypes, female socialization which does not lend itself readily to roles of authority, assertiveness and leadership, and the role strain that ensues when women psychiatrists try to combine career, marriage and motherhood. If women psychiatrists are to fill some of the positions in Departments of Psychiatry, which will fall vacant over the next decade, much more attention must be paid to eliminating or diminishing the multiple obstacles for women who chose a career in academic psychiatry.
-
Inviolability of the person is the basic principle underpinning the concept of consent to treatment. Although it is not a new concept, consent has become a major medico-legal issue because of a shift, within the doctor/patient relationship, towards more autonomy for the patient and less paternalism from the doctor. This change has been given further impetus by legal decisions such as Reibl v. ⋯ This right is not absolute: it may be abrogated by the state for health or judicial reasons, or the person may not be in a position to exercise it, such as when unconscious or because of mental disability. This paper will review present Canadian laws on consent. It will contrast the legal approach to consent to the ethical-humanistic approach which could be developed within the context of the doctor/patient relationship.