Chaplains' medical approach to psychiatric patients

Chaplains' understanding of people's psychiatric and medical problems may aid them in dealing with people's spiritual problems. However, exploratory interviews and observations of chaplains and inpatients at a VA psychiatric facility indicate that chaplains take a medical model perspective with patients, often attempting to treat patients' psychiatric problems rather than focusing on their reliigious needs. Chaplains avoid one-on-one religious discussions despite the importance of these conversations to patients. Discussed are implications for the utilization of health services and for the formation of treatment teams.This paper is a revised version of a paper presented at the Society for Applied Anthropology meetings held in Lexington, Kentucky, March 1982.     

Hospitalized psychiatric and medical patients and the clergy

Earlier research suggested that persons in a community with significant psychiatric disorders seek relief from their clergy as often as from trained mental-health professionals. In this research, contacts with clergy about current hospitalization by matched samples of inpatient psychiatric (N=51) and medical/surgical (N=50) patients were compared, as were responses to structured interviews about the importance of religion, religious affiliation, and participation, spiritual needs, and spiritual well-being. The findings suggest that the two groups were similar in demographics, the degree to which religion was a source of strength and comfort in their lives, and percentages reporting as having a clergy person; the group of hospitalized psychiatric patients was significantly less likely, however, than the sample of medical/surgical patients to have discussed their current hospitalization with their clergy persons. Possible causes for this difference as well as areas of further research are discussed.     

The Marxist-Leninist concept of personality and its significance for the integration of psychiatric patients

The Marxist view of man as the "ensemble of social relations" is a prerequisite for understanding the personality of the mentally handicapped. The dialectic relationship between biological and social events permits the conclusion that restrictedly developed versions of the personality must be accepted as natural. The particular obligation of society is to ensure the all-round integration, encouragement and care of such handicapped persons. The task of the medical fraternity is to establish a comprehensive system to prevent such handicaps.     

Shyness: relationship to social phobia and other psychiatric disorders

The relationship between shyness, social phobia and other psychiatric disorders was examined. The prevalence of social phobia was significantly higher among shy persons (18%) compared with non-shy persons (3%). However, the majority of shy individuals (82%) were not socially phobic. A significant and positive correlation was found between the severity of shyness and the presence of social phobia, but the data suggest that social phobia is not merely severe shyness. Social phobia was also positively and moderately correlated with introversion and neuroticism. Thus, shy persons with social phobia were shyer, more introverted, and more neurotic than other shy people, but none of these factors was sufficient to distinguish shy persons with social phobia from those without social phobia. The proportion of the shy group with psychiatric diagnoses other than social phobia was significantly higher than among the non-shy group, indicating that various diagnostic categories are prominent among the shy. The results are discussed in terms of the overlap in shyness and social phobia and the relationship of shyness to other psychiatric diagnoses and personality dimensions.     

Catatonic signs in medical and psychiatric catatonias

Patients with psychiatric catatonias vs those with medical catatonias may differ in catatonic phenomenology. To determine if these could be distinguished, the following methods were used: 1) a review of the literature; 2) a chart review; and 3) a prospective series. The literature review of 467 reports of medical catatonias yielded 240 cases that met research criteria. A chart review of 47 episodes of catatonia revealed a higher frequency of negativism in patients with medical catatonias. Prospective data obtained from rating scales revealed an increased frequency of echophenomena in patients with medical catatonias; however, no discriminate pattern of catatonic signs for medical catatonias arose. Overall, catatonic signs appear to share a similar distribution. These findings suggest that psychiatric and medical catatonias are indistinguishable based upon catatonic sign.     

Depression and suicide in schizophrenic patients

This study supports the idea that schizophrenic patients represent a distinctive subgroup of patients who can suffer from a major depressive illness and also can commit suicide. The study showed that 22.4% of the schizophrenic population in a medium-sized psychiatric facility showed severe depressive symptoms that met the criteria for the diagnosis of a major depressive episode according to the DSM-III classification. Seven patients committed suicide during the acute phase of the illness--five during hospitalization, and two within a year of discharge. Nine patients attempted suicide during the hospitalization period, and 10 attempted suicide within a year of discharge. Nearly one-third (215) of the patients were readmitted during that year because of a recurrence of acute schizophrenic symptoms; of these, 84 were having severe depressive symptoms. The study also provides indications of the causes of suicide in these patients.     

The problem of apparent schizophrenic symptoms in juveniles]

In the clinic we frequently come across cases of indistinct accentuated schizophrenic behaviour in youth. We mention here a casuistry which can be considered as a juvenile asthenic denial syndrome with coenaesthetic symptoms. This picture can be differentiated from coenaesthetic schizophrenia, hebephrenia, neurotic symptoms and physical psychoses which can be proven. The problem of differential diagnosis is considered with particular regard to progressive diagnosis.