Psychiatrists and community partners examine religion and spirituality

ABSTRACT

The commentary reflects on the definition of spirituality and religion and further implications for the practice of psychiatry. These include the possibilities to partner with spiritual and religious practitioners to support education and research, provide access to care for people with or at risk of mental ill health, and also consider how to the reduce the risks to the well-being of vulnerable people and families from some practices and settings. The World Psychiatric Association sees the possibilities for collaborating with its member societies and community partners including service users and family carers to develop resources on working with faith groups and spiritual healers in high- and low-income countries.     

Psychiatry and religion: consensus reached!

ABSTRACT

In December 2015 the Executive Committee of the World Psychiatric Association accepted a position statement on spirituality and religion in psychiatry. In this contribution the author will (briefly) sketch the background of the development of this position statement, and the criteria it needs to fulfil. The aim of the final result will be explained, and some desiderata with regard to its future will be expressed. The full text of the Position Statement as it has been published in World Psychiatry (February 2016) is added as appendix (permission granted by the editor).     

Clarifying boundaries of binge eating disorder and psychiatric comorbidity: a latent structure analysis

Binge eating disorder (BED) presents with substantial psychiatric comorbidity. This latent structure analysis sought to delineate boundaries of BED given its comorbidity with affective and anxiety disorders. A population-based sample of 151 women with BED, 102 women with affective or anxiety disorders, and 259 women without psychiatric disorders was assessed with clinical interviews and self-report-questionnaires. Taxometric analyses were conducted using DSM-IV criteria of BED and of affective and anxiety disorders. The results showed a taxonic structure of BED and of affective and anxiety disorders. Both taxa co-occurred at an above-chance level, but also presented independently with twice-as-large probabilities. Within the BED taxon, diagnostic co-occurrence indicated greater general psychopathology, lower social adaptation, and greater premorbid exposure to parental mood and substance disorder, but not greater eating disorder psychopathology. Eating disorder psychopathology discriminated individuals in the BED taxon from individuals in the affective and anxiety disorders taxon. Diagnostic criteria of BED were more indicative of the BED taxon than were criteria of affective and anxiety disorders. The results show that at the latent level, BED was co-occurring with, yet distinct from, affective and anxiety disorders and was not characterized by an underlying affective or anxiety disorder.     

The Impact of Social and Political Changes on Survivors of Political Persecutions in Rural Russia and Ukraine

Differences in depressive symptoms and attitudes about political and social changes were examined for individuals with and without family histories of Stalinist persecution in several small villages in Russia and Ukraine. In a sample of 422 villagers, there were 37 family members of survivors of Stalinist purges. In comparison to villagers with no family history of persecution, those who had such history perceived their social life with other villagers and their life in general to be much improved in the late 1990s. They also reported much lower levels of depression than those without a history of persecution. Differences that were discovered could not be accounted for by demographic characteristics of the respondents. The results suggest that individuals with a history of family trauma related to political persecution may perceive their environment as more positive as a result of political changes and may cope with political transitions differently than persons who have no history of family persecution.     

The tell-tale tasks: a review of saccadic research in psychiatric patient populations

This review focuses on saccade research with adult psychiatric patients. It begins with an introduction of the various types of saccades and the tasks used to evoke them. The functional significance of the different types of eye movements is briefly discussed. Research findings regarding the saccadic performance of different adult psychiatric patient populations are discussed in detail, with particular emphasis on findings regarding error rates, response latencies, and any specific task parameters that might affect those variables. Findings regarding the symptom, neurocognitive, and neural correlates of saccadic performance and the functional significance of patients’ saccadic deficits are also discussed. We also discuss the saccadic deficits displayed by various patient groups in terms of circuitry (e.g. cortical/basal ganglia circuits) that may be implicated in the underlying pathophysiology of several of these disorders. Future directions for research in this growing area are offered.     

A Longitudinal Analysis of Psychiatric Severity upon Outcomes Among Substance Abusers Residing in Self-Help Settings

A longitudinal analysis of psychiatric severity was conducted with a national sample of recovering substance abusers living in Oxford Houses, which are self-run, self-help settings. Outcomes related to residents' psychiatric severity were examined at three follow-up intervals over one year. Over time, Oxford House residents with high versus low baseline psychiatric severity reported significantly more days using psychiatric medication, decreased outpatient psychiatric treatment, yet no significant differences for number of days abstinent and time living in an Oxford House. These findings suggest that a high level of psychiatric severity is not an impediment to residing in self-run, self-help settings such as Oxford House among persons with psychiatric comorbid substance use disorders.     

Debunking Antipsychiatry: Laing,Law, and Largactil

The term “psychiatry” refers to two radically different ideas and practices: curing–healing “souls” and coercing–controlling persons. It is important that critics of psychiatry clarify whether they object to the former or the latter or both, and why. Because I believe coerced psychiatric relations are like coerced labor relations called “slavery,” and like coerced sexual relations called “rape,” I spent the better part of my professional life criticizing involuntary-institutional psychiatry and the insanity defense. In 1967, my effort to undermine the medical-political legitimacy of the term “mental illness” and the moral-legal legitimacy of depriving individuals of liberty by means of psychiatric rationalizations suffered a serious blow: the creation of the antipsychiatry movement. Despite their claims, “antipsychiatrists” rejected neither the idea of mental illness nor coercion practiced in the name of “treating” mental illness. Sensational claims about managing “schizophrenia” and pretentious pseudophilosophical pronouncements diverted attention from the crucial role of the psychiatrist as an agent of the state and as an adversary of the denominated patient. The legacy of the antipsychiatry movement is the creation of a catchall term used to delegitimize and dismiss critics of psychiatric fraud and force by labeling them “antipsychiatrists.”

Psychiatric Disorders in Clinical Genetics I: Addressing Family Histories of Psychiatric Illness

This is the first article of a two-part professional development series addressing genetic counseling for personal and family histories of psychiatric disorders. It is based on an Educational Breakout Session presented by the Psychiatric Special Interest Group of the National Society of Genetic Counselors at the 2006 Annual Education Conference. This article examines issues that arise in addressing family histories of psychiatric illness, while the second article in the series considers the generation and provision of individualized recurrence risks for psychiatric disorders. In this article we discuss the importance of managing uncertainty for affected individuals and their close family members who have been referred to genetics for a number of different indications. We then use four simulated cases to make recommendations about the scope and timing of discussions related to the psychiatric family history.     

福柯与《临床医学的诞生》

《临床医学的诞生》是20世纪法国著名学者福柯的一部医学史研究专著,主要从空间、语言和死亡三个方面探讨了现代医学也就是临床医学诞生的可能性条件,兼具历史与批判的性质。它揭示了隐藏在医学话语背后的权力关系,反映了福柯瓦解传统、颠覆理性的新型历史观。     

EDUCATION SECTION: Infant observation in Britain:The Tavistock approach

The author draws attention to something distinctive in the psychoanalytic 'air' from the early 1960s onwards: the strong emphasis upon the very early psychological, emotional and cognitive view of infants and young children. She focuses on the work of two analysts in particular, Esther Bick and Wilfred Bion, and the comparable, though differently expressed, centrality of the observational method in their work. Each explored not only the pathological picture but also the nature and integrative function of psychic containment in earliest mental life. Each also shared a preoccupation with what constituted a psychoanalytic attitude and with the process of becoming a psychoanalyst and, in Bick's case, a child analyst or psychotherapist. The author provides an historical background to the idea of observation, followed by an account, with detailed examples, of the nature of infant observation and the observational method as taught and practised at the Tavistock Clinic, London since the late 1940s, and subsequently in many other training institutions. Here the themes of Bick and Bion are constantly interrelated such that the prototype or model for the creation of emotional meaning and thought can be appreciated and learning from experience can take place.