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RICKLES, NATHAN K.; KLEIN, J. J.; BASSAN, M. E.
doi: 10.1176/appi.ajp.106.11.845pmid: 15410875
A Report on 100 Unselected, Consecutive Cases NATHAN K. RICKLES M. D. 1 , J. J. KLEIN M. D. 1 , , and M. E. BASSAN M. D. 1 1 The Psychiatric Center, N. K. Rickles, M. D., Director. This statistical review has emphasized the following points: 1. Into the office of the private practicing psychiatrist come people from all walks and situations of life. They are in practically all respects average American citizens, undistinguishable from any others. Their only common denominations are nervous symptoms or emotional problems which they cannot handle themselves and for which they seek professional help. 2. The majority are in extremely modest financial circumstances, but they are willing to make certain sacrifices in order to receive psychiatric care. Since 12% of our 100 cases were obliged to forego therapy because they could not afford it or because they could not leave their jobs during working hours, it appears on the basis of this study that a prime requisite for the mental health of any community is the establishment of evening clinics for such people. They need and want treatment, they are willing to pay for it within the limits of their capabilities, and they are willing to give up their leisure time to obtain it. Surely, then, there should be facilities to meet their simple requirements. Clinics should also be established for daytime care on a reduced fee basis, where young psychiatrists under the capable supervision of older men would be able to render valuable psychiatric aid to those who need it, while at the same time adding to their own fund of knowledge and experience. As further inducement for young psychiatrists to identify themselves with such clinic procedures, the American Board of Psychiatry and Neurology should give proper credit for this experience, as being an essential part of their training period. In the realm of preventive psychiatry, we believe that the teen-age group offers a tremendous and fertile field for education, and that the precepts of mental hygiene should be inculcated in a wholesome way by making them an integral part of the accepted school curriculum. If adult problems, such as marriage and the choice of a career, are clarified for young people before they actually have to face them, many traumatic experiences would be avoided in later life. In regard to the acute psychotics, we feel that modern psychiatric procedures have proved that they can be cured at about the same ratio as people suffering from acute physical disorders, and that proper facilities should be made available for their care. There should be more beds for acute psychiatric patients, both in general hospitals and in small, homelike sanitariums. Our experience has shown that large institutions have a tendency to defeat their purpose, as the individual loses his identity and suffers from the lack of security and warmth. With this in view, it is recommended that in the future, in planning for inpatient psychiatric care, both public and private facilities be established on a cottagelike basis. Whenever possible, these patients should be accepted in the various group medical insurance plans on a par with other medical disorders. Finally, we wish to urge—in common with practically all our confreres—that a public education program be actively pursued in order that people be informed and kept abreast of the developments and improvements in psychiatric services.
doi: N/Apmid: N/A
STERN, KARL; BOULANGER, J. B.; CLEGHORN, SHEENA
doi: 10.1176/appi.ajp.106.11.851pmid: 15410876
A Comparative Study of English, French, and German KARL STERN M. D. 1 , J. B. BOULANGER M. D. 1 , , and SHEENA CLEGHORN B. A. 1 1 The Allan Memorial Institute and the Department of Psychiatry, McGill University. A comparative linguistic study of English, French, and German was made. The purpose was to investigate the mode in which the nouns for organs and the verbs for organ functions are employed in grammatical units with emotional connotation. It was found that these grammatical units can be grouped in the following way: (1) Expressions implying a conscious awareness of the autonomic concomitants of emotional reactions. (2) Expressions in which the noun for an organ is employed as a substitute for an emotional attitude. (3)Idiomatic patterns with implications which have been proved accurate only with recent psychoanalytical methods of investigation. (4)Expressions which indicate a longstanding awareness of psychosomatic relationships, the reality of which has recently been proved. (5) Expressions whose scientific connotations are still uncertain. Different body areas are semantically employed along definite trends. Grammatical units referring to oral and nasal mechanisms are related to the antithesis of love-hatred, numerically much more to hatred. Some words expressing hostility have an etymology associated with oral organs and oral functions. We were unable to find etymological roots which would demonstrate a connection between anal functions and expressions of hostility. Expressions in which anal functions are implied are used intentionally and consciously in "vulgar" slang words to express hostility. There is a striking parallel between the three languages. The meaning of these findings from the point of view of social and genetic psychology is discussed.
doi: 10.1176/appi.ajp.106.11.801pmid: 15410867
WILLIAM L. SHARP M. D. 1. Mild psychoneurotics (if they are dispersed among stable personalities) and mild psychopathic personalities (if they can direct their aggression mostly toward the enemy instead of toward their comrades), can be utilized with combat troops. 2. Only 9 cases of an original group of 395 mild neuropsychiatric problems, taken overseas and into combat by the 99th Infantry Division, had to be evacuated subsequently as NP casualties during the first 50 days of combat. The latter 15 days of this combat period included such stress as the Battle of the Ardennes (Battle of the Bulge). 3. A total of 35 former NP problems salvaged from the precombat training period appeared on the A&D (Admission & Disposition) sheet for December 1944, as requiring evacuation for conditions other than neuropsychiatric. 4. Hence, the group of 395 potential NP casualties did very well in the first 50 days of combat, losing only 9 due to the same NP condition as diagnosed in precombat training and only 35 for conditions other than neuropsychiatric (battle wounds 14; trenchfoot 10, etc.). Therefore a total of 44 of these men were lost by evacuation from the original 395. 5. Thus, 351 mild psychoneurotic and psychopaths (who had been considered potential NP combat casualties) remained on duty for the first 50 days of combat as effectives.
CLAPP, JOHN S.; LOOMIS, EARL A., JR.
doi: 10.1176/appi.ajp.106.11.821pmid: 15410871
Observations on the Use of Prolonged, Deep, Continuous Narcosis in Mental Disorders JOHN S. CLAPP M. D. 1 , and EARL A. LOOMIS JR. M. D. 1 1 The Western State Psychiatric Institute and Clinic and the Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pa. Experience with 70 applications of prolonged narcosis in psychotic and psychoneurotic disorders is presented. One fatality occurred in the series as a result of pulmonary emboli. Special attention was given to the study of bronchopneumonia, an outstanding complication of prolonged narcosis therapy, and a suggested technique is presented that effectively reduces this and other hazards. Psychotic excitements, both manic and schizophrenic, respond to narcosis therapy. Of 7 cases of dementia præcox less than one year in duration, 6 responded well to treatment. Experience with psychoneurotic patients is not sufficient to warrant conclusions; therapeutic results, however, were sufficient to suggest the possibility that this procedure might be of value in various psychoneuroses, particularly severe anxiety states with prominent phobic features. The outstanding disadvantage of narcosis is the necessity of constant nursing attention during treatment.
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