Mental illness: psychiatry's phlogiston

In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness.     

预检分诊护士抗击新型冠状病毒肺炎认知体验的质性研究

〔目的〕了解预检分诊护士在新型冠状病毒肺炎(新冠肺炎)疫情中的心理状态及对科室相关配套设施的需求,为护理人文关怀提供参考依据.〔方法〕采用目的抽样方法,选取2020年1月20日至8月20日在河南省肿瘤医院预检分诊处工作的11名护士为研究对象,分别对每位护士进行半结构访谈,访问内容包括个人基本情况、对新冠肺炎的认知情况、...     

Murder,mercury, mental illness: infanticide in nineteenth-century Ireland

Background  Infanticide has been described in almost every human society. Aims  To present a case of infanticide from nineteenth-century Ireland and explore related diagnostic, therapeutic and judicial issues. Methods  This paper uses original archival material from the Central Mental Hospital, Dublin to present a case of infanticide and inform an exploration of related issues. Results  In 1892, ‘Dora’, a thirty-four year old servant from Dublin, was found guilty of the murder of her eight-month old child and sentenced to indefinite detention at the Central Mental Hospital, Ireland’s only inpatient forensic psychiatry facility. The subsequent experiences of Dora (“a case of melancholia”) illustrate many of the diagnostic, therapeutic and judicial issues surrounding infanticide in nineteenth-century Ireland. Conclusions  There were strong links between social circumstances and infanticide in nineteenth-century Ireland, compounded by myriad diagnostic and therapeutic challenges associated with forensic psychiatric committal and lengthy detention in poorly-therapeutic facilities .     

William Wilde and the early records of consumption in Ireland

Absence of documentary or bony evidence before the seventeenth century in Ireland is not conclusive evidence of freedom from tuberculosis. Clear records begin with Bills of Mortality kept in Dublin, the city at the centre of English administration of Ireland, and they show that the basis for an epidemic was firmly established therein before 1700. In the middle of the nineteenth century the cataclysmic Famine opened the floodgates of poverty and urban overcrowding that resulted in an alarming death rate that continued to increase until the early years of the twentieth century. It is to William Wilde (1815-1876) we owe the nuanced investigation of the earliest numerical records of consumption and related disorders in Ireland.     

Smoking and mental illness: A population-based prevalence study

CONTEXT: Studies of selected groups of persons with mental illness, such as those who are institutionalized or seen in mental health clinics, have reported rates of smoking to be higher than in persons without mental illness. However, recent population-based, nationally representative data are lacking. OBJECTIVE: To assess rates of smoking and tobacco cessation in adults, with and without mental illness. DESIGN, SETTING, AND PARTICIPANTS: Analysis of data on 4411 respondents aged 15 to 54 years from the National Comorbidity Survey, a nationally representative multistage probability survey conducted from 1991 to 1992. MAIN OUTCOME MEASURES: Rates of smoking and tobacco cessation according to the number and type of psychiatric diagnoses, assessed by a modified version of the Composite International Diagnostic Interview. RESULTS: Current smoking rates for respondents with no mental illness, lifetime mental illness, and past-month mental illness were 22.5%, 34.8%, and 41.0%, respectively. Lifetime smoking rates were 39.1%, 55.3%, and 59.0%, respectively (P<.001 for all comparisons). Smokers with any history of mental illness had a self-reported quit rate of 37.1% (P =.04), and smokers with past-month mental illness had a self-reported quit rate of 30. 5% (P<.001) compared with smokers without mental illness (42.5%). Odds ratios for current and lifetime smoking in respondents with mental illness in the past month vs respondents without mental illness, adjusted for age, sex, and region of the country, were 2.7 (95% confidence interval [CI], 2.3-3.1) and 2.7 (95% CI, 2.4-3.2), respectively. Persons with a mental disorder in the past month consumed approximately 44.3% of cigarettes smoked by this nationally representative sample. CONCLUSIONS: Persons with mental illness are about twice as likely to smoke as other persons but have substantial quit rates. JAMA. 2000;284:2606-2610.     

阜阳市新型冠状病毒肺炎疫情首批一线护士工作体验的质性研究

目的 了解阜阳市传染病医院作为抗击突发重大突发公共卫生事件新型冠状病毒肺炎疫情的首批一线护士工作体验,为日后突发其他重大传染病疫情提供战略支持。 方法 从不同层次护士中采用目的抽样法抽取2020年1月20日至2月4日在疫情一线工作的15名护士进行半结构式访谈,对访谈资料运用Colaizzi七阶段分析法进行提炼分析。 结果 总结出三个层面的主题,一为一线护理人员的正性、负性两种心理体验:包括职业自豪感、社会责任感和个人归属感;焦虑与恐惧、面对病人痛苦时的无能为力感。二为一线护理工作人员的负性生理体验:躯体极度疲惫感。三为一线工作人员生活方面的顾虑:担心被歧视,影响下班后的生活;担心家人的生活安排。 结论 要重视重大疫情下一线护理人员的负性心理体验,强化正性心理体验,合理安排休息和生活,对有困难的护士进行个性化指导和支持。