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PubMedDate not supplied

[Human values and respect of human rights in oppressive conditions].

Human rights, an issue of political debates in the last decades, listed in the United Nations Declaration of 1946 are rooted in the humanistic tradition of philosophy and religion. The UN declared their universal character and made state organizations responsible for their observation. Among all human rights that for freedom is usually perceived as crucial. Psychiatry developed in Europe primarily a caring function. The medical model developed in psychiatry through the 19th c. supplied the criteria for medical diagnosis of mental disturbance, and elaborated a system of treatment which included long term hospitalization. Medicalization of psychiatry (recently coming back) is a force which gives courage to those who suffer, to their families, and to professionals as well. This power however, can be easily abused, when a psychiatrist adopts a position of someone who knows better that which is good for his/her patient. Legal regulations of the circumstances of psychiatric treatment, especially treatment against the patient's will should prevent the abuse of the mentally disturbed person's right for freedom. The goal is usually achieved by clear description of clinical and other conditions under which a person can be committed, and by establishing the committed person's right to claim the decision to be unjust. Poland is a country without legal regulation in the area of mental health (there are only administrative acts). For more than sixty years several projects on mental health law have been worked on. The last one which came to the Sejm (parliament) in 1980 was withdrawn by the "Solidarity" Trade Union. At present, the membership of Poland in international organizations makes an introduction of mental health law an obligation. Having no legal regulation, Polish psychiatry has been a self-regulating system. It is worth to note that even in the hard Stalinist period (1947-1956) there was no abuse of psychiatry for political reasons. The main reason for Polish psychiatry staying free from political abuse is seen in the role of internalized norm of human dignity. But others should also be taken into account. It was a specificity of the political situation that the ruling powers did not insist that psychiatrists cooperate. On the other hand the integration of the Polish psychiatric community was helpful in observing the rule of non-collaboration. One of the most important factors is seen as the experience and memory of NAZI crimes in the field of psychiatry in Poland. Extermination of psychiatric patients had to leave the feeling of the importance of psychiatrist's own responsibility.(ABSTRACT TRUNCATED AT 400 WORDS)

Civil Rights↗
PubMed1997

Kansas v. Hendricks.

The U.S. Supreme Court considered an appeal by the State of Kansas that arose from the Kansas Supreme Court's invalidation of the Kansas Sexually Violent Predator Act. The Act establishes procedures for the civil commitment of persons who, due to a "mental abnormality" or "personality disorder," are likely to engage in "predatory acts of sexual violence." The Supreme Court held that the Act's definition of "mental abnormality" satisfies substantive due process requirements. The Court further held that since the Act does not establish criminal proceedings, it does not violate the Constitution's double jeopardy prohibitions or its ban on ex post facto lawmaking. The Court's holding and its implications are discussed.

Adult↗
PubMed1998

Changes in public psychiatric hospitalization in Oregon over the past two decades.

OBJECTIVE: In 1988 a governor's commission in Oregon recommended dramatic changes in the state's approach to public psychiatric hospitalization. To evaluate the effect of the recommendations, this study examined characteristics of hospitalization for patients with schizophrenia and bipolar disorder in public psychiatric facilities between 1981 and 1984 and between 1991 and 1994. METHODS: Patients with schizophrenia and bipolar disorder (N=621) were identified as part of a larger study that examined civil commitment in one of Oregon's state hospitals in 1986. Data on the patients' hospitalizations were obtained from a statewide computerized mental health information system. RESULTS: The legal status of hospitalized patients differed between the two time periods, with voluntary hospitalizations overrepresented in 1981-1984 and civil commitments overrepresented in 1991-1994. The locus of hospitalization varied greatly between the two time periods. All hospitalizations in 1981-1984 took place in one of Oregon's three state hospitals. In 1991-1994, subjects were hospitalized in 13 different institutions, including state and community hospitals and specially designed nonhospital inpatient facilities. CONCLUSIONS: Patterns of inpatient hospitalization for public psychiatric patients changed dramatically from 1981-1984 to 1991-1994. The extensive use of community and nonhospital facilities raises questions about monitoring of quality of care in these diverse and decentralized facilities.

Adult↗
PubMed1979

Psychological factors in the health of South African blacks.

Aspects of mental disorder in developing communities are considered. The effects of changes precipitated by modern living conditions are expounded and these are related to the nature of, and impediments to, effective treatment strategies. An explosion in the need for treatment is predicted, and suggestions are made to handle the phenomenon.

Black or African American↗
PubMed1990

Section 47 and its use with mentally disordered people.

This paper reports a survey of implementations of Section 47 of the National Assistance Act (1948) in four Regional Health Authorities between 1983 and 1986. The majority of those compulsorily removed from their homes under the Section were elderly people in poor physical health suffering from a major psychiatric disorder. The initial mortality was very high, and 41 per cent of the sample died within three months of removal. There is no mechanism for appeal or review for people removed under Section 47. The Mental Health Act (1983), which does have these safeguards, could have been used in many of these instances, but was not because of misunderstandings about its scope and poor liaison between geriatric and psychiatric services. It is recommended that the Mental Health Act should be used where it is appropriate and that Section 47 should be reformed to provide an equivalent protection of civil liberties.

Aged↗
PubMed2005

For an anthropology of eating disorders. A pornographic vision of the self.

In reading the considerations of the leading contemporary sociologists, attentive observers of the metamorphosis of identity in the post-modern age, a game came to my mind: "what if I mixed up quotes from these scholars' papers with extracts from patients' clinical reports, especially people suffering from so-called "eating disorders"? The objective of this game is to show how difficult it is to pick out the clinical fragments from the sociologists' descriptions of the "never ending task of assembling our Self". The game is to try to separate psychopathology from the Late Modern physiology of identity. The great psychopathologists from the last century offered us two major meaning organizers of identity and its disorders: the Freudian and the Jaspersian. Freud's notion of the "discontents with civilization" served to explain that widespread sense of malaise that characterizes the modern condition. As civilization has been built on our restraining our drives, civilized man ended up "trading in a part of his chances for happiness for a bit of security". Security is guaranteed by our submitting to norms of civilized living together. Neurosis, that feeling that permeates modern human beings who neither belong to themselves nor to others, is the agonizing result. The Jaspersian concept of the Ego consciousness is mainly based on the Kantian Self, the identity pole of subjectivity, standing above the stream of changing experience. It is a necessary condition for coherent experience. Also the Jaspersian Self presupposes coherence, since its main features include identity through time, a sense of unity and one of demarcation from the external world, and a feeling of being actively involved in one's own experiences and performances. In late modernity, identity is a task. Post-modern people have the task and necessity to be perpetually constructing themselves. Being, Self, are organized in a reflexive way. Individuals are forced to choose their own life style among a multitude of alternatives. Are the Freudian and the Kantian/Jaspersian models of the Self now still proving to be suitable for an adequate psychopathological analysis?

Culture↗
PubMed2006

Justice and equality in mental health law: the European experience.

This is the text of a lecture delivered at the World Conference of the International Academy of Law and Mental Health in Sydney in September 2003 on the occasion of the award to the author of the Prix Philippe Pinel. Its theme is the potential of the European Convention on Human Rights to secure the human rights of people with mental disorders and disabilities, viewed in the context of the legislation on mental health and mental incapacity in England and Wales. Its conclusion is that the Convention is better at protecting them from unwanted or unnecessary treatment and care than it is at securing for them equal access to the treatment and care they want or need. The lecture has been updated to reflect developments in the United Kingdom since 2003.

Civil Rights↗
PubMed1994

The use of the 'Appropriate Adult' Scheme (a preliminary report)

Details of a research study, funded by MENCAP, on the use of Appropriate Adults are given. A great deal of attention has been given recently to diverting the mentally disordered from the criminal justice system. This preliminary report discusses what happens to those who stay in the system--i.e. who are kept in police custody and eventually appear at court. Facilities are available under the Appropriate Adult Scheme for offenders seen to be mentally disordered or handicapped to have with them a 'responsible person' when they are interrogated by the police. The questions now posed are: does such a scheme work, and is the offender given protection under it?

Adult↗
PubMed1995

Prevalence of seasonal difficulties in mood and behavior among Japanese civil servants.

OBJECTIVE: Most prevalence studies of seasonal changes in mood and behavior have come from Western countries. The authors' goal was to determine the prevalence of seasonal changes in mood and behavior in a randomly selected group of Japanese workers. METHOD: They administered a Japanese translation of the Seasonal Pattern Assessment Questionnaire to 1,276 civil servants in Nagoya, Japan. RESULTS: The estimated prevalence of winter seasonal affective disorder was 0.86%, the estimated prevalence of winter subsyndromal seasonal affective disorder was 0.86%, the estimated prevalence of summer seasonal affective disorder was 0.94%, and the estimated prevalence of summer subsyndromal seasonal affective disorder was 2.12%. CONCLUSIONS: The authors conclude that seasonal changes in mood and behavior occur in Japan, but at a lower frequency and with a different profile than in the United States or Europe.

Adult↗
PubMed1993

Association between physical and psychological morbidity in the Whitehall II Study.

Mechanisms for the association between psychiatric disorder measured by the General Health Questionnaire and subjective and objective indices of physical illness are examined among 6900 male and 3414 female civil servants aged between 35 and 55 yr from the cross-sectional results of the Whitehall II Study. It was hypothesized that the association between physical illness and psychiatric disorder might be because psychiatric disorder was either secondary to the pain and disability of physical illness, or related to the somatic presentation of psychiatric disorder, or to common causes of both physical and psychiatric illness. Overall health status, and self-reported physical symptoms were strongly associated with psychiatric disorder. Angina in men and severe chest pain in men and women were significantly associated with psychiatric disorder, but electrocardiographic abnormalities were not. Established risk factors for physical illness: alcohol intake in women and men and smoking habit in men were related to psychiatric disorder. Fibrinogen was related to self reported physical symptoms but not psychiatric disorder. The association between psychiatric disorder and self-reported physical symptoms is most likely explained by somatisation and plaintive set. However, psychiatric disorder is likely to be secondary to the pain and disability of conditions such as angina.

Adult↗
PubMed2002

The role of stress in the onset of depressive disorders. A controlled study in a Spanish clinical sample.

BACKGROUND: We conducted the present study to evaluate the impact of stressful events on the onset of depressive disorders in a Spanish clinical sample, compared to a control group matched for age, sex, civil status and social class. We compared our results with those of other studies carried out with samples that were both clinically and culturally similar to ours. METHOD: Fifty depressed patients that were diagnosed with a depressive episode in the 6 months prior to the interview and 50 healthy controls were included in the study. Both groups were compared on the "Life Events and Difficulties Schedule" (LEDS). RESULTS: Of the depressive patients, 68 % compared to only 18 % of the control individuals experienced at least one provoking agent in the 12 months prior to the onset of the symptoms. The risk of developing a depressive disorder was 9.7 % greater in subjects exposed to such provoking agents. Chronic difficulties are equally important to the genesis of depressive disorders as severe life events. No significant differences were seen between the two diagnostic subgroups of depressed patients in the accumulation of severe events, major difficulties or provoking agents. CONCLUSION: The results support the view that stress is a major factor in the aetiology of depressive disorders. The amount of stress suffered by the patients, however, was less than that found in our healthy sample. Important issues about the model of interaction between stress and depression are discussed.

Adolescent↗