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PubMedDate not supplied

Parade and prejudice.

Nurses at Craigavon hospital near Drumcree braved bomb threats and violence during the Orange parades weekend to carry on with their work. Adrian O'Dowd was invited to join them.

Civil Disorders↗
PubMed1998

[Robert's story].

Explore the source record for details and available documents.

Adolescent↗
PubMed1977

[Contact disorders as a problem of the civilized society].

Emotional chillness of human living together in modern civilized societies is provoking not only an increasing amount of neurotic diseases on the one hand and unsteadiness on the other, but also beyond that some distinct kinds of mental disorders. Psychodynamic sources of those disturbances are discussed, guided by case reports on paranoic reaction, cardiac neurosis, depressive reaction, delusion of being beloved, alcoholism after getting widowed, and paranoid hallucinatory Psychosis as a result of loneliness.

Adult↗
PubMed1999

[Neuroendocrine disorders cause stress-related disease. "Civilization syndrome" is a growing health problem].

Although the relationship between stress and serious diseases, such as ischaemic heart disease, is well known, the underlying mechanisms have proved difficult to identify. With a new technique available today, the hypothalamic-pituitary-adrenocortical axis can be shown to constitute a central physiological factor in the interplay between stress and disease. This technique opens up new diagnostic possibilities, and thus therapeutic and preventive options, in stress-related diseases which represent a growing health problem in modern society.

Environmental Illness↗
PubMed1993

A case that biomedicine is unduly negative to radical hypotheses and to theorizing--evidence based on cardiology's reaction to the spasm of resistance vessel concept and on the nature of scientific research.

This communication will attempt to make a case that biomedicine is unduly negative to radical hypotheses and to theorizing. Evidence will be based on a proposed undue negativity by cardiology to a radical hypothesis I first described two and a half decades ago--the spasm of resistance vessel (S-RV) concept of ischemic heart disease (IHD). The theory is regarded as an alternate paradigm and deals with basic pathogenetic mechanisms of IHD, the most significant disorder of Western civilization. The concept, if valid, might help in reducing the impact of this disorder, and I believe that the evidence for the theory and the importance of IHD support a more open minded attitude toward the idea. Cardiology's negativity is attributed to the nature of research; the most important factor is considered to be the Kuhnian negativity of scientific communities to hypotheses which are destructive of conventional wisdom, and a second factor is the special nature of biomedical research. Biomedicine is regarded as special because a low level of specific information about complex biomedical processes has fostered an essentially total study-based approach. Such an approach is assumed to have resulted in biomedicine's use of induction as 'the' method of scientific inquiry, and prompted negativity towards the hypothetico-deductive method used to develop and test the theory. Also, the study-based nature of biomedicine appears to have fostered an intuitive reliance on only newly performed studies to test hypotheses, which led to ignoring evidence for the concept derived from known information about IHD. Biomedicine is also regarded as special because its infrequent use of paradigm-change has resulted in unfamiliarity with this method, and because the practical method of training in biomedical research has worsened the general unfamiliarity of scientists with theoretical aspects of science. Because of these factors, the S-RV concept has not yet been properly evaluated--a quarter of a century after it was first created.

Cardiology↗
PubMed1996

When Munchausen becomes malingering: factitious disorders that penetrate the legal system.

Psychiatrists and other physicians are usually familiar with factitious disorders, but attorneys and judges usually are not. Cases involving factitious disorders may enter the civil legal system in a number of ways and cause incorrect judgements, financial costs, and inappropriate medical care if these disorders are not identified. Psychiatric consultants may play a key role in identifying these cases and educating legal personnel about factitious disorders. This article describes three cases in which persons with factitious disorders entered the civil litigation system. The role of the psychiatrist in these cases is discussed. Clues to the identification of factitious disorders are described. The article also discusses the differentiation of factitious disorders from malingering and other forms of abnormal illness behavior, such as conversion, hypochondriasis, and somatization disorders. The concepts of primary and secondary gain in relationship to illness behaviors are elaborated.

Adult↗
PubMed2006

The application of civil commitment law and practices to a case of delusional disorder: a cross-national comparison of legal approaches in the United States and the United Kingdom.

Legal approaches to civil commitment in the United States and the United Kingdom are compared. A concise overview of the historical evolution of civil commitment in both countries precedes a discussion of the present scheme of commitment standards in each system. These current standards in U.S. and U.K. jurisdictions are then applied to a hypothetical case of delusional disorder. A discussion of the constructive use of civil commitment in patients with delusional disorder who may be dangerous focuses on its value as a preventive measure against potential harm to self or others, as well as the pros and cons of coercive assessment and treatment. Despite the many differences in approach to commitment, the authors concur that in both countries the patient with delusional disorder was committable before the commission of a serious criminal offense.

Commitment of Persons with Psychiatric Disorders↗
PubMed2001

[Investigation of verdicts of civil suits brought against hospitals involving crimes committed by mental hospital inpatients with psychotic disorders].

The author investigated 11 verdicts of Japanese civil suits brought against hospitals involving crimes committed by mental hospital inpatients with psychotic disorders, principally by victims of injuries or by surviving relatives of homicide victims. About the half of the verdicts are based on the same logic. First, a detailed, case-specific investigation was performed. In some cases it was proven that the accidents could not have been predicted, and the suits were dismissed. In others the plaintiffs won the suits, because it was found that the violent acts were predictable and that the hospital staff had the means to prevent them. These verdicts require the hospital staff to predict the patient's actions according to the psychiatric history and present condition and then to make an appropriate response. This process is similar to the clinical decision-making process, although there have been some dubious findings in some of the court cases. However, the author also found that some verdicts were inappropriate and insufficient in that there was no individual investigation of the offender. Examining all 11 verdicts, the author found that the type of admission procedure adopted for the offender, whether they had a past history of violence, and whether the hospital was public or private did not seem to be significant to the judges in making their decisions.

Adult↗
PubMed1988

Civil commitment in the psychiatric emergency room. II. Mental disorder indicators and three dangerousness criteria.

Proponents of return to a "need for treatment" standard for civil commitment contend that the current dangerousness standard forces psychiatrists to neglect severely ill patients in favor of those who are less ill but dangerous to others. Among 198 psychiatric emergency patients in five facilities, those rated as most dangerous on Three Ratings of Involuntary Admissibility, a reliable index of indicators employed by clinicians in evaluating danger to self, danger to others, and grave disability, were also most severely ill on diagnostic and symptomatic assessments of mental disorder. Clinicians' Global Ratings of patient dangerousness on the three criteria were similarly related to severity of diagnosis and symptoms. Perceived dangerousness was associated with major mental disorder and severity of most symptom types, especially impulsivity. Danger to self was the criterion related to the fewest indicators of mental disorder.

Adolescent↗
PubMed1978

The effects of mental and physical stress on the incidence of skin disorders.

The effect of civil unrest and terrorism in Northern Ireland from 1969 on skin diseases which are generally accepted to be aggravated by stress and strain has been studied (1) by reporting cases making claims against the government for skin diseases developed as the result of violence and (2), studying changes in the pattern of skin diseases at skin clinics in Northern Ireland over the last 10 years. There has been little change in the pattern of skin diseases which could be attributed to mental or physical stress.

Adult↗
PubMed1984

Mental disorder and dangerousness.

Psychiatrists are called upon to make judgements on the future dangerousness of mentally disordered subjects in civil commitment procedures, in the criminal courts, and during the decision process on the release of offenders on indeterminate sentences or committals. The ability of psychiatrists to make these judgements is increasingly under challenge. The difficulties of making useful predictions when the base rate for the event to be predicted is low, is now well recognised. Less obvious are the problems attendant upon making socially useful predictions on psychiatric grounds in populations with a high base rate for future offending. The evidence pertaining to the level of violence amongst the mentally disordered is reviewed. The lesson to be drawn from the empirical evidence is that mental abnormality of and in itself contributes little to the prediction of the predisposition to act violently. The question remains as to whether there are definable groups or classes within the generality of mentally abnormal individuals for whom there is an increased risk of future violence. It would be compatible with both the research studies and common clinical impression if the mentally abnormal contained subgroups with unusually violent predispositions balanced by larger groups with less than average propensities to aggression. The literature is largely inadequate to delineate such high risk groups with the degree of certainty ideally needed to instruct clinical decisions, but does suggest that such groups exist and are capable of further empirical definition.

Commitment of Persons with Psychiatric Disorders↗
PubMed2000

Minimally invasive approaches to antireflux surgery.

Gastroesophageal reflux disease is one of the most common disorders affecting western civilization. Historically, surgical antireflux therapy was reserved for patients who had failed medical therapy, typically in the presence of refractory ulcers or difficult-to-manage strictures. More recently, with improvements in acid control, these acid-pepsin-related complications of reflux have been replaced by the malignant complications of reflux disease, with emphasis now on total control of reflux. Recent developments in surgical technique and the demonstrated effectiveness of a variety of minimally invasive treatment options have changed our approach to these patients. This article summarizes the recommended diagnostic evaluation of patients with reflux symptoms and the current indications for antireflux surgery. The techniques of commonly performed minimally invasive antireflux procedures are described along with a review of the results to be expected. Future prospects for improving the management of reflux are discussed; these include recently described nonsurgical methods for restoring competency to the lower esophageal sphincter.

Cost-Benefit Analysis↗