This is a movie used for the presentation of symptoms of Schizophrenia in some medical schools. I also use a lot of fragments from Hollywood movies to teach psychiatric symptoms and diseases to medical students. Since recent there’s Symptom Media. It’s a non-profit organization created in the spring of 2009 for the creation and distribution of specialized video content. The videos are all about psychiatric and psychological phenomena.
The intention of these clips are to be used in the classroom setting as visual compliments to the written description of symptoms for psychological phenomena found in the DSM handbook. Some are exaggerated to convey the symptoms of a particular phenomena. In the future, we will also have series, short films and short documentaries to be unveiled. We are currently doing market research and wanted to poll you and your readers – educators and professionals – to see if there would be interest in purchasing a yearly subscription reminiscent of Netflix.
The clips are very good, and in English. Check them out and let us know what you think.
Depressed patients often do not respond to there first antidepressant or have to quit the antidepressant due to side effects. Switching to another antidepressant is often a solution. Nevertheless switching from one to the other depressant can be difficult. How do you switch, which taper scheme and which built up scheme do you use. How is this influenced by the cytochrome P450 system?
Based on two psychiatric assessment procedures, a computer program investigating the presence of a psychotic disorder and a personality questionnaire, Salvador Dali was found to have a personality disorder for DSM Cluster A and B. He was also found to meet the diagnostic criteria for psychotic illnesses.
You can’t diagnose psychiatric illness without doing a face to face psychiatric examination. Usually personality diagnosis takes even more than one diagnostic interview. Distributing psychiatric diagnoses solely based on “circumstantial evidence”, hear say or news stories is obsolete. Nevertheless these authors from `oxford digested a lot of information on which they based the above conclusions.
Information on his behaviour and art comes from various sources such as his autobiography; literary texts; published interviews with friends, family, and the artist himself; letters; and data on his family history. Here, in addition to a descriptive analysis of such data, a formal diagnosis exercise was attempted, using two psychiatric assessment procedures….
Moreover, their findings are consistent with prior findings in visual artists. Based on biographical information the rate of psychosis in one study was far greater (35%) than in the normal population (2%). Affective disorders were 10 times more prevalent and the rate of suicidal behavior three times greater in a group of New York impressionists. Compared to non art students artists were found to be more deviant on certain personality traits but this didn’t correlate with the individual’s talent. This led to the conclusion that originality with antisocial type of behavior lead to creative achievement, originality alone is not enough.
….whether particular visual artists are more creative than average or not, as a group they do have a propensity to respond antisocially with taboo responses that shock.
Sounds very much like Salvador Dali.
Working through all the information about Salvador Dali the authors claim a lot of symptoms of which he might suffer. From exhibitionism to unusual sexual behavior, paranoia and temper tantrums. His mental symptoms worsened after he was left by Gala.
More objective information such as mental illness in the family revealed that Dali’s grandfather committed suicide. His uncle from fathers side also tried to kill himself.
Although Salvador Dali was not “a normal person”, it is still possible that he consciously created an “artistic” personality. Some people say he did all this for the money and in order to succeed. Whatever was or was not wrong with him he still was one of the greatest artists.
it cannot be stated too strongly that Dalí’s deviation from the norm should not be allowed take away any of his greatness. It is too easy to react negatively when the term ‘disorder’ is used, in any context. Dalí and his contribution to the history of art is a perfect example for highlighting the fact that abnormality is not necessarily disagreeable – or to be so readily dismissed as a sign of neurological disease. For without his instability, Dalí may not have created the great art that he did.
More pregnant and postpartum mothers die because of suicide than die from infection, high blood pressure and hemorrhage combined. Furthermore depressive and anxiety states are very common during pregnancy.
The American Journal of Psychiatry has three articles on borderline personality disorder by some of the leading experts. Mostly about the development of the concept which is sumarized by Otto F. Kernberg and Robert Michels as:
…we have made tremendous strides in only a few decades, beginning with a theoretical concept in psychoanalysis that was ridiculed by most other psychiatrists, and progressing to a widely recognized clinical entity; from a pejorative label for disliked patients to a carefully defined diagnostic category; from the subject of almost no systematic study to one of the most intensively researched personality disorders—in terms of diagnosis, epidemiology, genetics, developmental psychology, biological correlates, pathophysiology, and treatment—and perhaps most important, from a hopeless prognosis to a hopeful one, and particularly one for which we have several evidence-based effective treatments.
The most progress is made in the last decades.
Borderline personality is a serious psychiatric disorder, with a prevalence of about 4% in the community, but as high as 20% in many clinical psychiatric populations
It is difficult to treat (both in the sense of responding poorly and as personally troubling to the therapist and the treatment team) and poorly understood
Borderline personality disorder has 68% heritability. This invalidated the theories about borderline personality disorder’s etiology that had focused exclusively on environmental causes. Also discussed in a recent blog post by Gene Expression. Is it a brain disease? Partly, these heritable risk factors, in turn, interfere with the normal attachment process during development, and this disruption can be magnified when there is inadequate parental support
Borderline personality disorder has an unexpectedly good course, 4% each year looses the diagnosis.
The guidelines for the treatment of borderline personality disorder retained a primary role for psychotherapy, but they emphasized the need to enroll patients as collaborators, the need for a primary (i.e., administratively responsible) clinician, and the value of psycho education, family involvement, and the use of an algorithm for medications
The “stress-vulnerability” model of disease is a useful guide to a biopsychosocial concept of borderline personality disorder patients
The authors conclude with the importance of training residents in treating these patients especially since psychotherapy has lost it’s attractiveness to teachers, residents and insurance companies. Skills needed in psychotherapy need a lot of training and supervision. I agree with one of their shocking statements about psychiatric curricula.
More remarkable is that borderline personality disorder still lacks a standing presence in psychiatric training curricula. Appropriate teaching—both academic and clinical—for residents is nonexistent in all but a few institutions.
Kernberg, O., & Michels, R. (2009). Borderline Personality Disorder American Journal of Psychiatry, 166 (5), 505-508 DOI: 10.1176/appi.ajp.2009.09020263 Oldham, J. (2009). Borderline Personality Disorder Comes of Age American Journal of Psychiatry, 166 (5), 509-511 DOI: 10.1176/appi.ajp.2009.09020262
Conflict of interest, Dr Shock is one of the editors of this website; psychiatrynet.eu. It started of with a Dutch version of the website: psychiatrienet.
Psychiatrynet.eu is an open and free site. It is the property of The Journal of Psychiatry Foundation, an independent organization which generates revenues from subscribers to the journal of the same name. It also receives annual contributions from several Dutch national mental health care facilities, in exchange for which they may place help wanted notices on its website. The principal editors, consultants, and advisers participate on a personal (and voluntary) basis.
Every topic describes in its “editorial responsibility ” and “CV” how the topic is constructed, and on what (considerations) the selection is based. Conflicts of interest, if any, are noted.
It has a lot of information and links to information about psychiatric disorders, according to the DSM-IV classification,treatment of psychiatric disorders e.g. ECT, it also provides information on specific areas of interest, such as EBM and residency, as well as general information and news about psychiatry. Go check it out, objective valuable information.
You can find the different categories in the left frame.
The Soloist, a movie a bout a homeless man with Schizophrenia
The Soloist is the true story of Los Angeles journalist, Steve Lopez, who befriends a man named Nathaniel Ayers. Ayers happens to be a homeless Julliard trained musician who has Schizophrenia. It is a most special story about loss, friendship, understanding and redemption.
Much stigma surrounds Schizophrenia despite research that shows it holds a neurobiological origin for the disorder. Many still believe that those who have mental illness are unmotivated, lazy or are of weak character – and that their homelessness is by choice, not from circumstance.
From Dr Deb, she also offers some suggestions should you encounter a person living on the streets.
This discussion is also going on in the Dutch Psychiatric Association, they mostly follow the APA but will they follow them in this decision? They probably wait for the effect it has on the APA yearly conference.
The American Psychiatric Association has become one of the first professional societies to take a step away from the appearance of conflict of interest with a decision to repudiate industry-sponsored symposia.
The group’s board of trustees voted in mid-March to eventually phase out the acceptance of pharmaceutical or medical device industry funding for symposia and meals served at those gatherings during its annual meeting and a smaller conference that occurs each year, said APA President Dr. Nada L. Stotland in an interview.
The move was immediately hailed by Sen. Chuck Grassley (R-Iowa), who has been conducting multiple inquiries into alleged conflicts by individual psychiatrists and also sought information about industry support from the APA last summer.
“Steps taken by a medical society to ensure its independence is a good step, both for the credibility of the profession and for patients who rely on their doctors for medical advice,” said Sen. Grassley in a statement.
Dr. Stotland said the change in APA policy was the result of soul searching that began well in advance of Sen. Grassley’s investigations. A task force was convened early in 2008, and it recommended in the fall cutting the symposia tie-in. The board took it up at its annual meeting.
The symposia were targeted because they essentially were advertising masquerading as education, said Dr. Stotland. “We decided that it was important to separate professional education from the pharmaceutical industry,” she said.
Because of contractual obligations, there will still be symposia at the annual meeting in May. But even that support will be less than it has been in the past, because of the economy, Dr. Stotland said. She estimates that drug company symposia contribute about $1 million to the APA’s overall $50 million budget.
She expects the symposia sponsorship to be eliminated within 2 to 3 years because of pressure by the trustees and an expected loss in attendance.
Dr. Daniel Carlat, publisher of The Carlat Psychiatry Report, a continuing education newsletter, agreed that the lack of free meals and the larger taint associated with the symposia would likely severely cut down on attendance—and thus drive the companies to abandon the programs.
“This whole vote signals to these companies that we don’t want them around anymore,” said Dr. Carlat, also of the psychiatry department at Tufts University.
The APA will still be receiving industry money, primarily through advertising in its journals and fees for the annual meeting exhibit hall, Dr. Stotland. The symposia funds will be partly replaced “with thrift,” she said, noting that the APA is paring back its governance structure and reducing the frequency of association business meetings.
The APA’s decision “is a great piece of good PR for the organization and for psychiatry,” said Dr. Carlat, who has frequently criticized bias in the profession. “It will say [that] psychiatrists are responding to the pressure, to the criticism. That they’re not deaf and they’re taking action.”
A systematic, easy-to-use tool for physicians when appraising the quality and objectivity of information presented during educational presentations sponsored by the pharmaceutical industry. If you need them for these presentations that is. We have abolished these kind of presentations during residency training but residents also attend symposium with pharma sponsored speakers. So to enhance the instructions for appraisal of these talks the acronym PRESCRIBE was invented as I found in a recent publication in the Canadian Family Physician.
PRESCRIBE is an easy-to-remember “checklist” for physicians to use when attending a drug industry–sponsored presentation in order to gauge the degree to which they might have been influenced to prescribe the company’s product whether or not the product is truly indicated
PRESCRIBE stands for:
Presenter. Who is presenting? Is it a pharmaceutical representative speaking or showing a video? Is it an “expert” invited by the drug company?
Relationship building. During the educational session, how much time and energy is dedicated to formal and informal rapport building between the pharmaceutical representatives and the attendees?
Evidence base. Does the presented material reflect a balanced representation of the literature on the topic?
Samples. Do attendees receive drug samples or other company promotional materials? Print Moz’s vinyl banners are a good place to look for custom promo materials to be handed out.
Charts and graphs. Do the visual materials present study results in a misleading fashion?
Restrictions in funding. Did the drug company provide an unrestricted educational grant for the session?
Incentives. Is some kind of promotional incentive (eg, a meal, movie admission, round of golf) provided by the company to help increase attendance?
Branding. How strong is the presence of either company or product names and logos, or both, during the visual and spoken components of the session?
Emotional response. What is your overall gut reaction during and after the talk?
How to score these items?
When using the acronym, apply a subjective score of 0 to 2 to each item on the checklist. A lower total score likely reflects a presentation with a higher degree of objectivity and accuracy with respect to the content presented or fewer drug company promotional strategies to influence an audience member into prescribing or using its product.
I thinks this is useful for training residents and medical students to get the discussion going about big pharma and science. Furthermore I direct them to the Carlat Psychiatry Blog for further examples and instructions