Pub Date : 1978-12-01DOI: 10.1177/070674377802300803
P McLean, J Fleming
One hundred and seven psychiatric residents, postgraduate program directors and Royal College Examiners returned questionnaires which inquired into the areas of training programs, interim performance checks and the Certification Examination. There was relatively little dissatisfaction expressed with the written examination. However, most residents, program directors and examiners felt there were better ways to evaluate clinical competence than by means of the oral examination which was considered to lack validity and reliability. Respondents were very constructive in the suggestions they offered which focused on two main areas: the need to provide examiners with a larger work sample of a candidate's performance (for example, through a sample of the candidate's treatment audio-visual tapes), and the desirability of explicit performance criteria from the Royal College as to their expectations in the areas of knowledge, skill, judgment and ethics, so that the examination could be the final step in a shaping process rather than a high risk, single trial, pass/fail situation.
{"title":"Evaluation of clinical competence in psychiatry by the Royal College Examination.","authors":"P McLean, J Fleming","doi":"10.1177/070674377802300803","DOIUrl":"https://doi.org/10.1177/070674377802300803","url":null,"abstract":"One hundred and seven psychiatric residents, postgraduate program directors and Royal College Examiners returned questionnaires which inquired into the areas of training programs, interim performance checks and the Certification Examination. There was relatively little dissatisfaction expressed with the written examination. However, most residents, program directors and examiners felt there were better ways to evaluate clinical competence than by means of the oral examination which was considered to lack validity and reliability. Respondents were very constructive in the suggestions they offered which focused on two main areas: the need to provide examiners with a larger work sample of a candidate's performance (for example, through a sample of the candidate's treatment audio-visual tapes), and the desirability of explicit performance criteria from the Royal College as to their expectations in the areas of knowledge, skill, judgment and ethics, so that the examination could be the final step in a shaping process rather than a high risk, single trial, pass/fail situation.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 8","pages":"521-9"},"PeriodicalIF":0.0,"publicationDate":"1978-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300803","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11919438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1978-12-01DOI: 10.1177/070674377802300805
W O McCormick, G Voineskos
Medical students' views of the subjects: Psychiatry, Neurology and Surgery were studied before and after a nine week course which included Psychiatry and Neurology. Surgery was not being taught and was regarded as a control subject. Visual analogue measures of each subject as a career possibility, its importance and its interest were obtained in addition to a ranking for career choice of eight specialties. In addition, students' attitudes to psychiatrists, neurologists and surgeons (as control) were studied using semantic differential scores. The scores on the subjects showed changes favourable to Psychiatry after teaching which were not paralleled in Neurology or Surgery. The semantic differential scores clearly discriminated the three specialists; there were small changes after teaching but the broad differences in attitude to the specialists remained. Some evidence is presented that the more favourable changes towards Psychiatry were related to the quality and intensity of teaching.
{"title":"Medical students' views of psychiatry. Does teaching have any effect?","authors":"W O McCormick, G Voineskos","doi":"10.1177/070674377802300805","DOIUrl":"https://doi.org/10.1177/070674377802300805","url":null,"abstract":"Medical students' views of the subjects: Psychiatry, Neurology and Surgery were studied before and after a nine week course which included Psychiatry and Neurology. Surgery was not being taught and was regarded as a control subject. Visual analogue measures of each subject as a career possibility, its importance and its interest were obtained in addition to a ranking for career choice of eight specialties. In addition, students' attitudes to psychiatrists, neurologists and surgeons (as control) were studied using semantic differential scores. The scores on the subjects showed changes favourable to Psychiatry after teaching which were not paralleled in Neurology or Surgery. The semantic differential scores clearly discriminated the three specialists; there were small changes after teaching but the broad differences in attitude to the specialists remained. Some evidence is presented that the more favourable changes towards Psychiatry were related to the quality and intensity of teaching.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 8","pages":"541-7"},"PeriodicalIF":0.0,"publicationDate":"1978-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300805","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11919441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1978-12-01DOI: 10.1177/070674377802300810
M V Seeman
For the borderline patient, clothes confer the possibility of stepping out of a shakily held sense of self and of temporarily becoming another person. With this possibility, which is enhanced by current day permissiveness in styles of dress, come many clothes-related symptoms. Identity conflicts and transitional crises are expressed by these symptoms, as illustrated by the case examples.
{"title":"Am I what I wear? Identity conflicts in borderline patients.","authors":"M V Seeman","doi":"10.1177/070674377802300810","DOIUrl":"https://doi.org/10.1177/070674377802300810","url":null,"abstract":"For the borderline patient, clothes confer the possibility of stepping out of a shakily held sense of self and of temporarily becoming another person. With this possibility, which is enhanced by current day permissiveness in styles of dress, come many clothes-related symptoms. Identity conflicts and transitional crises are expressed by these symptoms, as illustrated by the case examples.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 8","pages":"579-82"},"PeriodicalIF":0.0,"publicationDate":"1978-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300810","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11919450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1978-12-01DOI: 10.1177/070674377802300820
J Matas
Dear Sir: The Seventh Annual Conference of the Canadian Schizophrenic Foundation was held in Saskatchewan on the weekend of Friday, June 2, 1978. I was attracted by the title, "Nutrition and Behaviour" and attended. We know now that behaviour is influenced by chemical events at the synapses; therefore I believe that psychiatrists should show a greater interest in substances ingested or inhaled. I assume also that few, if any, psychiatrists ever attend a meeting of this nature and so might be interested in the reaction of one of their colleagues to the event. There were about 100 people present: approximately 85% were women. This apparently represents the proportion of women in the organization. The vast majority were non-professional people, former patients, relatives of patients, and others interested in diets for prevention or treatment of illness. The men, on the other hand, were largely a professional group, mostly "orthomolecular" (3) physicians, some of whom were psychiatrists. I was interested in the kind of meals served at the meeting. The members called these meals "orthomolecular" and were able to persuade the hotel to adhere to their guidelines. The main difference, it seems, between orthomolecular meals and what might otherwise have been served was that there were no sweets. Dessert was fruit and cheese and the only bread available was whole wheat. The emphasis at "Nutrition Breaks" (no coffee breaks) was on fruit juice, but there was a coffee substitute served, and there was no bar. The group was pleasant, friendly, and cohesive, messianically radiating a message about its ideas. The attitude to the medical profession and to the establishment nutritionists appeared more one of sorrow than anger. Having read a number of issues of the "Journal of Orthomolecular Psychiatry", I had expected more anger to be expressed towards the medical profession. Society members were pleased when there was some indication that the medical establishment had accepted any of their ideas. There was little talk, in spite of the name of the organization, about schizophrenia or its treatment. The speakers, for the most part, were concerned with the use of nutrition as treatment.
{"title":"Nutrition and behaviour.","authors":"J Matas","doi":"10.1177/070674377802300820","DOIUrl":"https://doi.org/10.1177/070674377802300820","url":null,"abstract":"Dear Sir: The Seventh Annual Conference of the Canadian Schizophrenic Foundation was held in Saskatchewan on the weekend of Friday, June 2, 1978. I was attracted by the title, \"Nutrition and Behaviour\" and attended. We know now that behaviour is influenced by chemical events at the synapses; therefore I believe that psychiatrists should show a greater interest in substances ingested or inhaled. I assume also that few, if any, psychiatrists ever attend a meeting of this nature and so might be interested in the reaction of one of their colleagues to the event. There were about 100 people present: approximately 85% were women. This apparently represents the proportion of women in the organization. The vast majority were non-professional people, former patients, relatives of patients, and others interested in diets for prevention or treatment of illness. The men, on the other hand, were largely a professional group, mostly \"orthomolecular\" (3) physicians, some of whom were psychiatrists. I was interested in the kind of meals served at the meeting. The members called these meals \"orthomolecular\" and were able to persuade the hotel to adhere to their guidelines. The main difference, it seems, between orthomolecular meals and what might otherwise have been served was that there were no sweets. Dessert was fruit and cheese and the only bread available was whole wheat. The emphasis at \"Nutrition Breaks\" (no coffee breaks) was on fruit juice, but there was a coffee substitute served, and there was no bar. The group was pleasant, friendly, and cohesive, messianically radiating a message about its ideas. The attitude to the medical profession and to the establishment nutritionists appeared more one of sorrow than anger. Having read a number of issues of the \"Journal of Orthomolecular Psychiatry\", I had expected more anger to be expressed towards the medical profession. Society members were pleased when there was some indication that the medical establishment had accepted any of their ideas. There was little talk, in spite of the name of the organization, about schizophrenia or its treatment. The speakers, for the most part, were concerned with the use of nutrition as treatment.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 8","pages":"592-3"},"PeriodicalIF":0.0,"publicationDate":"1978-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300820","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11919451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1978-12-01DOI: 10.1177/070674377802301s05
N I Rae-Grant
{"title":"Arresting the vicious cycle: care and treatment of adolescents displaying the Ovinnik syndrome.","authors":"N I Rae-Grant","doi":"10.1177/070674377802301s05","DOIUrl":"https://doi.org/10.1177/070674377802301s05","url":null,"abstract":"","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 Spec Suppl ","pages":"SS22-40"},"PeriodicalIF":0.0,"publicationDate":"1978-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802301s05","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11929697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Laidlaw Workshop on \"The 'Impossible' Child\": an overview.","authors":"P D Steinhauer","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 Spec Suppl ","pages":"SS61-74"},"PeriodicalIF":0.0,"publicationDate":"1978-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11929699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1978-12-01DOI: 10.1177/070674377802300809
K Reed, H R McKim
ECG changes occur with therapeutic doses of tricyclic antidepressants and cardiovascular conduction alteration is the lethal effect in overdoses on these drugs. These ECG changes depend on the plasma level and metabolism of the particular antidepressant. Information about the relative toxicity and metabolism characteristics can be obtained by studying overdoses if the attempt simply involves one tricyclic and no other drug ingestion. Such a case report involving a known quantity of imipramine is presented. The early toxic signs leading to cardiac arrest and the recovery from coma are discussed. The ECG along with corresponding plasma levels of imipramine and its metabolite desmethylimipramine are given as a function of time after ingestion. The relative toxicity of these metabolites and the use of anticholinesterase in the acute management is considered.
{"title":"ECG changes in pure impramine overdose as function of plasma level.","authors":"K Reed, H R McKim","doi":"10.1177/070674377802300809","DOIUrl":"https://doi.org/10.1177/070674377802300809","url":null,"abstract":"ECG changes occur with therapeutic doses of tricyclic antidepressants and cardiovascular conduction alteration is the lethal effect in overdoses on these drugs. These ECG changes depend on the plasma level and metabolism of the particular antidepressant. Information about the relative toxicity and metabolism characteristics can be obtained by studying overdoses if the attempt simply involves one tricyclic and no other drug ingestion. Such a case report involving a known quantity of imipramine is presented. The early toxic signs leading to cardiac arrest and the recovery from coma are discussed. The ECG along with corresponding plasma levels of imipramine and its metabolite desmethylimipramine are given as a function of time after ingestion. The relative toxicity of these metabolites and the use of anticholinesterase in the acute management is considered.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 8","pages":"573-7"},"PeriodicalIF":0.0,"publicationDate":"1978-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300809","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11919449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1978-12-01DOI: 10.1177/070674377802300801
J D McLean
To stand before the membership of our Association and deliver the Presidential Address has generally been regarded by my predecessors as the zenith of the presidential year. And indeed, in many ways it is. It is probably the most challenging task which the president faces, even though for me, it may not be the most stimulating. For myself, the stimulation and the rewards, as well as the frustrations and the failures, have been spread throughout the year. What is left for today is the challenge. The challenge obviously lies not only in the immediacy of the moment, but more particularly has been in all of the processes that constitute the preparation for the moment. Throughout my year as president, whenever there was a period of leisure, an awareness of this address would nibble at the corners of my consciousness, coupled with self-admonitions for time being used in a non-productive manner. In theearlier months of my year in office, these selfadmonitions were immediately followed by self-defensive responses responses centering on my own rights to leisure and also on the significance of the Presidential Address, attempting to relegate it into the category of a ritual, serving political processes, and hence of no great import. However, this self-deceptive, selfdefensive and self-defeating manoeuvre was short-lived. By the middle of the year
{"title":"Presidential address. Rights, rituals and the political process.","authors":"J D McLean","doi":"10.1177/070674377802300801","DOIUrl":"https://doi.org/10.1177/070674377802300801","url":null,"abstract":"To stand before the membership of our Association and deliver the Presidential Address has generally been regarded by my predecessors as the zenith of the presidential year. And indeed, in many ways it is. It is probably the most challenging task which the president faces, even though for me, it may not be the most stimulating. For myself, the stimulation and the rewards, as well as the frustrations and the failures, have been spread throughout the year. What is left for today is the challenge. The challenge obviously lies not only in the immediacy of the moment, but more particularly has been in all of the processes that constitute the preparation for the moment. Throughout my year as president, whenever there was a period of leisure, an awareness of this address would nibble at the corners of my consciousness, coupled with self-admonitions for time being used in a non-productive manner. In theearlier months of my year in office, these selfadmonitions were immediately followed by self-defensive responses responses centering on my own rights to leisure and also on the significance of the Presidential Address, attempting to relegate it into the category of a ritual, serving political processes, and hence of no great import. However, this self-deceptive, selfdefensive and self-defeating manoeuvre was short-lived. By the middle of the year","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 8","pages":"513-8"},"PeriodicalIF":0.0,"publicationDate":"1978-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300801","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11919435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1978-12-01DOI: 10.1177/070674377802300804
P P Leichner
Almost half the candidates of the 1976-77 certification examination in psychiatry answered a questionnaire seeking their opinions about the examination after they had experienced it. Opinions varied markedly depending upon whether the candidates were taking the examination for the first time or whether they were repeating it. The first-time group had the highest passing rate. This group also tended to feel adequately trained towards the examination and to like its present format. Those candidates who were repeating the examination tended to feel inadequately prepared and disliked the present format. Half the candidates in this sample had negative comments about this experience. A high level of anxiety and preoccupation with the examination were most often commented upon. A number of candidates did however find it easier and more fair than they had expected. The candidates, after taking the examination, tended as a group to feel better prepared and more positive toward the examination than the fourth year residents about to take the examination. The recommendations suggested focused on changing the task and image of the Board of Examiners, improving the examination and improving examination passing skills.
{"title":"The certification examination. Viewpoints of past candidates.","authors":"P P Leichner","doi":"10.1177/070674377802300804","DOIUrl":"https://doi.org/10.1177/070674377802300804","url":null,"abstract":"Almost half the candidates of the 1976-77 certification examination in psychiatry answered a questionnaire seeking their opinions about the examination after they had experienced it. Opinions varied markedly depending upon whether the candidates were taking the examination for the first time or whether they were repeating it. The first-time group had the highest passing rate. This group also tended to feel adequately trained towards the examination and to like its present format. Those candidates who were repeating the examination tended to feel inadequately prepared and disliked the present format. Half the candidates in this sample had negative comments about this experience. A high level of anxiety and preoccupation with the examination were most often commented upon. A number of candidates did however find it easier and more fair than they had expected. The candidates, after taking the examination, tended as a group to feel better prepared and more positive toward the examination than the fourth year residents about to take the examination. The recommendations suggested focused on changing the task and image of the Board of Examiners, improving the examination and improving examination passing skills.","PeriodicalId":9551,"journal":{"name":"Canadian Psychiatric Association journal","volume":"23 8","pages":"531-40"},"PeriodicalIF":0.0,"publicationDate":"1978-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/070674377802300804","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11919439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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