Canadian journal of psychiatry. Revue canadienne de psychiatrie
-
A twelve month period of the functioning of a psychiatric intensive care unit in a general hospital is reviewed. The unit has actually been functioning for about three and a half years. Although there were growing pains initially, the unit has become an integral part of the psychiatric inpatient service. ⋯ It also reduces the number of disturbed patients on the two general units. Very disturbed patients are expertly managed by the staff and a surprisingly low percentage of patients have to be transferred to the local mental hospital under certification. The experience demonstrates that a psychiatric intensive care unit based on a general medical intensive care unit model can function well with benefit both to patients and staff.
-
When a pregnant woman or nursing mother requires psychotropic medication, one must consider the effect of such medications on the fetus or baby. The authors review the evidence for teratogenic effects of such drugs given during pregnancy, toxic or withdrawal effects in the newborn and dangers to the breast-fed baby. Suggestions are made for judicious use of psychotropic drugs in pregnant or nursing women.
-
Patients for whom medical and surgical management has failed to relieve chronic pain were treated in a multimodal programme which included interpretive psychotherapy. Dynamic conflicts were identified in all cases and utilized in the psychotherapy and programme design. Examined in the light of ego functioning, pain that was previously considered intractible, yielded to psychological treatment. Further research is planned to identify the parts played by the different modalities and to study outcome.
-
A survey of the opinions of Canadian psychiatric residents (N = 199) and their residency directors (N = 13) was conducted regarding six hypothesized reasons for the decline in psychiatric career choice by medical students. The residents felt that the adverse effects of undergraduate education and the negative socialization experience in medical school were particularly important. ⋯ The experience of negative socialization was found to be significantly more important to Canadian medical school graduates than foreign graduates. The residency directors placed less emphasis on the importance of undergraduate education than did the residents.