亚洲文化价值观对西方心理咨询的影响

多元文化论的兴趣,引发了咨询心理学家对亚洲文化价值观的关注。本文介绍了文化价值观产生的背景和意义,以及亚洲文化价值观对心理咨询的挑战。     

2004年中国精神分析年会征文

“2004中国精神分析年会”将于2004年9月1-3日在上海举行。会议由中国心理卫生协会心理咨询和心理治疗专业委员会主办,上海市精神卫生中心承办,上海市心理卫生协会协办。会议主题为精神分析在中国,届时来自德国、美国等国的资深专家作专题报告。期间,将正式成立中国精神分析专业委员会并制订工作规划。大会竭诚邀请国内精神分析治疗同道和     

2004年中国精神分析年会征文通知（首轮）

“2 0 0 4中国精神分析会”将于 2 0 0 4年 9月 1日至 3日在上海举办。本次会议由中国心理卫生协会心理咨询和心理治疗专业委员会主办 ,上海市精神卫生中心承办 ,上海市心理卫生协会协办。本次大会将全力构筑中国精神分析治疗学术交流平台 ,促成精神分析理论与实践在中国的茁壮成长和持续发展。大会竭诚邀请国内精神分析治疗同道和各方相关专家学者参加本次学术交流 ,届时来之德国、美国等国家的资深国外专家也将参与会议并作专题报告。本次会议在举行学术交流的同时 ,将正式成立中国精神分析专业委员会 ,并起草组织制度章程、中国精神分析…     

中国元素在西方现代家具中的发展与地位

家具是中西方文化交流历程中的重要见证。西方家具中的中国元素,不仅是西方家具设计观念的演变的重要见证,也对西方世界如何观看、想象与解读中国文化有着不可替代的作用。本文试图通过实例,考察19世纪至20世纪中期中国元素在西方家具中的使用情况与地位,并试图通过这一工作梳理出这一进程中的发展脉络及其背后的种种动因。     

2004中国精神分析年会简报

9月1日至3日，2004中国精神分析年会在上海华夏宾馆胜利举行。本次会议由中国心理卫生协会心理咨询和心理治疗专业委员会主办，上海市精神卫生中心承办，上海市心理卫生协会协办，主题为“精神分析在中国”。与会代表近200名。除国内同道外，另有来之德国、荷兰、美国、阿根廷、法国，以及香港和台湾地区的共计20余名代表参加。     

国际学术会议通知——国际文化精神医学大会：文化多样性、社会变迁和心理健康

随着全球社会对精神卫生服务的需求持续增长，文化精神医学正从边缘走向主流，从西方人的探险猎奇活动转变为临床工作者必备的通识与技能，从少数专家探讨异族文化扩展为对心理健康问题的深刻反思，而中国文化与精神卫生实践也渐成为学术界的注意焦点。因此，世界精神病学协会跨文化分会（WPA—TPS）决定与中华精神科学会合作，于2010年4月18日-20日在中国上海浦东紫金山大酒店举办此次跨国、跨专业深度交流的国际精神医学会议。会议的主要内容是与精神卫生相关的医学、心理学、社会学、文化人类学议题。     

心理治疗设置的作用及其意义

我国心理治疗事业目前正处于迅速发展阶段。但和西方发达国家相比,我国在实际心理治疗的过程中仍存在许多问题。除了从事心理治疗的工作人员缺乏系统的培训之外,在实际心理治疗的工作中缺乏严格的心理治疗设置也是一个突出的问题。查阅有关国外参考书籍尤其是有关精神分析治疗的书籍,尽管都强调心理治疗设置的重要性,但对究竟什么是心理治疗设置以及心理治疗设置究竟有什么作用和意义,似乎均缺乏系统的描述。通过精神分析的实践,我对心理治疗设置有以下粗浅的理解,并希望能由此抛砖引玉,和同行们共同讨论。     

《认知领悟疗法》

精神分析治疗在西方社会的实践已逾百年,但它是否适用于中国这一最具东方文化特色的国度。换言之,精神分析对于正常人心理和病理心理的阐述,是否具有跨文化的普遍意义?这是至今没有明确回答的问题。 要回答这一问题仅停留于理论上的争论是纸上舌战,空洞无用。惟有通过大量的实践分析进行验证,方能解决。 在中国,较系统地将精神分析理论用于临床实践,有较丰富临床经验者首推钟友彬先生。继《中国人心理分析——认知领悟心理疗法》之后,近来,钟先生又推出了《认知领悟疗法——一个中国医生的心理分析实践》(以下简称为“认知领悟”)一书。     

心理咨询中的保密与解密

保密是心理咨询的一项重要原则,既是建立良好治疗关系与互信的核心,也是法律和道德问题。本文就心理咨询中保密的必要性、保密的内容以及保密的例外情况进行了讨论。     

加强医院文化建设促进医院健康发展

医院文化作为一种管理理论和管理方法,其本质是文化管理,它与经验管理、科学管理相比,是一种更高层次的管理思想和管理方法,是加强医院管理的重要环节,是医院向更高层次发展的灵魂。医院文化建设决定着医院明天的发展,要在激烈的医疗市场竞争中立于不败之地,就必须高度重视医院     

Treatment Considerations in Anticonvulsant Monotherapy

Summary: The long-standing practice of polypharmacy in treating epilepsy is giving way to use of monotherapy. Monotherapy can improve seizure control as well as reduce the risk of serious idiosyncratic reactions, dose-related side effects, and complex drug interactions. Monotherapy also offers improved compliance and cost-effectiveness. The basis of monotherapy is accurate diagnosis and assessment of the patient's seizure type(s), followed by selection of a single appropriate anticonvulsant drug. Many patients currently treated with multiple anticonvulsants can be successfully converted to monotherapy with a carefully monitored program in which troublesome and redundant drugs are gradually withdrawn from the therapeutic regimen.     

Diagnostic Difficulties and Treatment Implications

Summary: Differentiation between types of epileptic seizures has been aided in recent years by the introduction of intensive neurodiagnostic techniques and the development of increasingly detailed classification systems. Paradoxically, these developments have not simplified the task of matching the appropriate antiepileptic drug to a particular seizure type. It is reasonable to assume that anticonvulsant drugs will have different effects on different types of seizures, but faulty, circular reasoning can enter the picture if one also assumes that responses of seizures to different drugs signify different seizure types. There are several examples of differential diagnoses that can fall prey to this problem, including the diagnosis between partial seizures with secondary generalization and generalized tonic-clonic seizures, and the diagnosis between complex partial seizures and absence seizures with automatisms, among others. Considerations of etiology in future classification systems can further complicate the problem: should one then choose an anticonvulsant drug on the basis of individual seizure type or on the basis of the type of epilepsy? Ramifications of this issue extend even to the drug approval process. Official sanction is not given for use of a drug for a seizure type not included in the original efficacy studies, even if later scientific evidence shows that seizure type to be related to a type that is included. New trials must be undertaken. These problems arise from how we choose to classify seizures.     

Cognitive Dysfunction Associated with Antiepileptic Drug Therapy

Summary: Epilepsy is frequently associated with cognitive dysfunction. However, the reasons for this correlation are unclear. Possible influential factors include patient age; duration, frequency, etiology, and type of seizures; hereditary factors; psychosocial issues; and antiepileptic drug (AED) therapy. Whereas many of these factors are beyond the physician's control, AED therapy is one element that can be addressed in treatment decisions by recognizing the potential cognitive effects of particular AEDs. For example, phenobarbital impairs memory and concentration; phenytoin affects attention, problem solving ability, and performance of visuomotor tasks. In contrast, carbamazepine may affect concentration, while valproate would appear to have minimal effects on cognition. Moreover, cognitive effects of AEDs are amplified with coadministration of multiple anticonvulsants (polytherapy). A review of studies on the cognitive effects of monotherapy with AEDs, as opposed to those of polytherapy, provides evidence that drug-related cognitive dysfunction can be reversed if patients are switched to a simpler therapeutic regimen. Future research should be directed toward developing reliable measures for assessing and monitoring cognition, and understanding the particular cognitive side effects of each AED. Physicians also need to revise their opinions about which side effects are "tolerable" for epileptic patients.     

Dextromethorphan: Cellular Effects Reducing Neuronal Hyperactivity

Summary: Dextromethorphan is a dextrorotary morphinan without affinity for opioid receptors, commonly used as an antitussive medication. During the past 5 years, interest in the compound and its demethylated derivative, dextrorphan, has been revived because additional neuroprotective and an-tiepileptic properties were found in in vitro studies, animal experiments, and a few clinical cases. Both morphinans are able to inhibit N -methyl-D-aspartate (NMDA) receptor channels and voltage-operated calcium and sodium channels with different potencies. The inhibition of the NMDA receptor is believed to be the predominant mechanism of action responsible for the anticonvulsant and neuroprotective properties of the compounds.     

Carbamazepine Efficacy in Adults With Partial and Generalized Tonic-Clonic Seizures

Summary: Carbamazepine and phenytoin are drugs of choice in initial monotherapy for adult partial and secondarily generalized tonic-clonic seizures. These designations reflect the results of the Veterans Administration Epilepsy Cooperative Study Group of 1985. An earlier comparative study of carbamazepine and phenytoin by Ramsay and associates found both drugs equally effective in controlling new-onset seizures. Among the advantages of carbamazepine is that it causes relatively few cognitive and dysmorphic side effects. Its disadvantages are its unavailability in parenteral formulation and its metabolic autoinduction. The latter must be compensated for by planned dosage increases to maintain therapeutic plasma steady-state levels during the first 2 or 3 months of treatment. Carbamazepine is judged a drug of choice in the treatment of these secondarily generalized tonic-clonic seizures, and the drug of choice in children, adolescents, and women susceptible to the dysmorphic side effects associated with other anticonvulsant agents.     

Etiologic and Preventive Aspects of Epilepsy in the Child–Bridging the Gap Between Laboratory and Clinic

Summary: Four broad categories of basic phenomena are pertinent to developing ways to prevent epilepsy. These include mechanisms of epileptogenesis, ictal initiation and temporary entrainment by the seizure discharge of normally functioning brain, seizure propagation, and control mechanisms that function both to restrain the cascade of epileptic events culminating in a seizure and to arrest the epileptic event and restore the interictal state. In newborns and children, hypoxia-ischemia is a major factor leading to epileptogenesis, and several schemes are proposed to classify, quantify, and prevent hypoxic-ischemic encephalopathy. Control mechanisms must be better understood in order to develop prophylactic recommendations for epilepsy, and an experimental model of "kindling antagonism" may increase our understanding of these. Programs of prevention of seizures in children will evolve only if basic researchers and clinicians work productively together to develop an adequate understanding of factors important in epileptogenesis and antiepileptogenic control mechanisms.     

Pediatric Epilepsy Surgery

Summary: The use of implantable arrays of epidural electrodes has made it possible to carry out extraoperative electrocorticography (ECoG) and functional localization in the awake child. This has permitted cortical excisions that are determined by criteria similar to those obtained during surgical procedures performed under local anesthesia in adults. In addition, the method also permits simultaneous ECoG and video monitoring during the child's symptomatic seizures, providing additional important localizing information that is impractical to obtain in operations under local anesthesia. We report our experience with 75 children, ages 5 months to 15 years, whom we have managed with epidural electrode arrays. The method of extraoperative ECoG is described and illustrative cases are presented to demonstrate its feasibility and utility in children. In addition, we call attention to gliomas as a common cause of chronic focal seizures in children. Of 49 children undergoing resection and followed for from 1 to 14 years (mean of 5.8 years), 32 (65%) are either seizure free or have had a significant reduction in seizure frequency that has unambiguously improved their quality of life. The results are analyzed further by relating the surgical outcome to each of the pathologic entities that caused the seizures. This analysis reveals the variety of neurological conditions that commonly cause intractable focal seizure disorder in children and distinguishes those pathologic entities in which the seizure disorder is apt to respond to surgical intervention from those that will not.     

Predisposing and Causative Factors in Childhood Epilepsy

Summary: We review information from large studies of defined populations, examining the role of known factors and especially of prenatal and perinatal factors in contributing to nonfebrile seizure disorders of early childhood. We depend especially, but not exclusively, on the recently completed analyses from the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke, the NCPP. About 4% of children in the NCPP who had at least one non-febrile nonsymptomatic seizure by the age of 7 years had a previous seizure during acute neurologic illness, such as meningitis or during the acute illness after trauma. Many such seizures should potentially be preventable. Of children with seizures, 10% had had a neonatal seizure and 13% had had a febrile seizure. Among the hundreds of prenatal and perinatal factors explored as predictors of childhood seizure disorders, the principal predictors identified were congenital malformations of the fetus, cerebral and noncerebral; family history of certain neurologic disorders; and neonatal seizures. In agreement with the British National Child Development Study, labor and delivery factors in the NCPP appeared to contribute very little to childhood seizure disorders. Maldevelopment, rather than damage at birth to an initially intact nervous system, appeared to be the more common mechanism. Most seizure disorders of early childhood remained unexplained by the large set of prenatal and perinatal characteristics examined.     

Anticonvulsant Drugs and Cognitive Function: A Review of the Literature

Summary: Alterations of cognitive function are separate from disturbances of behavior seen in association with epilepsy. The nature of the cognitive disability may to a certain extent depend on the seizure type. Partial seizures, mainly derived from a temporal lobe focus, impair memory tasks, while generalized seizures seem to have more effect on attentional abilities. A number of studies, reviewed in this paper, suggest that anticonvulsant drugs further impair cognitive function. Maximal impairments are seen in patients receiving polytherapy: rationalization of polytherapy improves cognitive abilities. Studies in children and adults have allowed differentiation of the effects of various commonly used antiepileptic agents. Maximal cognitive deficits are seen with. phenytoin, while phenobarbital and sodium valproate induce moderate disturbances, and carbamazepine seems relatively free from such toxicity. Further research is needed on the interrelationship between types of seizure disorders, types of anticonvulsant medications, and cognitive function.