Religion, Spirituality, and Mental Health

January 10, 2010  |  Posted by Psychiatric Times | No Comments
Until the early 19th century, psychiatry and religion were closely connected. Religious institutions were responsible for the care of the mentally ill. A major change occurred when Charcot1 and his pupil Freud2 associated religion with hysteria and neurosis. This created a divide between religion and mental health care, which has continued until recently. Psychiatry has a long tradition of dismissing and attacking religious experience. Religion has often been seen by mental health professionals in Western societies as irrational, outdated, and dependency forming and has been viewed to result in emotional instability.3

Introduction: Cross-Cultural Psychiatry

January 10, 2010  |  Posted by Psychiatric Times | No Comments
During the past 2 decades, there has been enormous growth of interest in and visibility of cultural psychiatry. Much of this is due to the steady increase in migration of the world’s population from low-income to higher-income regions and countries.

Levels of Evidence

January 9, 2010  |  Posted by Psychiatric Times | No Comments
The term “evidence” has become about as controversial as the word “unconscious” had been in its Freudian heyday, or as the term “proletariat” was in another arena.

To Sleep, Perchance to Reset Your Body Clock

January 9, 2010  |  Posted by Psychiatric Times | No Comments
Not long ago, I was consulted on the case of an 11-year-old boy with bipolar disorder who was not able to go to sleep before 1 am. The problem did not seem to stem from ongoing symptoms of bipolar disorder. I did not have the benefit of detailed information about the boy’s endogenous circadian rhythms, but I thought a phase-resetting intervention might be helpful. I recommended a 0.3-mg dose of melatonin to be taken daily at 3 pm. For most people, this would be the time when melatonin is most effective in promoting earlier sleep onset (a so-called phase advance). A few days later, to my chagrin, the boy’s parents reported that his condition had worsened! Fortunately, after moving the melatonin dose to 7 pm, there was a marked change in the boy’s bedtime to a more reasonable hour.
The image of conscience in medicine has been tarnished of late, owing to its association with refusals of certain forms of treatment based on presumptive value judgments.1 In this book, the ancient role of conscience as a moral pilot is rejuvenated, and its neglected function as a spiritual daemon is refurbished for more psychologically minded modern readers.