Biomedical subjects
Y Lamontagne
Publications and source records attributed to Y Lamontagne.
Shoplifting and mental illness.
A survey of 1,649 shoplifting convictions at a Montreal area municipal court found that a relatively low percentage (3.2%) of the cases involved mentally ill patients and that there is a comparatively closer link between shoplifting and affective disorders, alcoholism and drug addiction. The survey also showed that shoplifting is related more to mental illness than to the use of psychotropic drugs. The authors therefore reject the hypothesis of pharmacogenic shoplifting which has been reported in some studies on small numbers of shoplifters.
The public image of psychiatrists.
The image of psychiatry is directly related to the knowledge that the public has of psychiatry and to the psychiatrists role as a "public informer". The time has come for psychiatrists to organize and have their opinions on all aspects of the mental health care system and mental illness heard in the media. After a review of different causes of the negative public image of psychiatrists, the reasons for which psychiatrists need to change their public image are outlined with some suggestions for increase public recognition. The importance of developing more research on the effect of mass media on the mental health care system is also outlined.
[The young homeless of Montreal: a longitudinal study].
A transverse survey conducted in 142 young homeless (age: 18-30) shows that they mainly come from broken families where alcoholism, violence and mental illness hold an important place. Regarding work, the majority of the surveyed homeless have not worked more than 24 months in all their life and have nearly continuously been on welfare; those who had jobs lost them much more because of their alcohol or drug use and their problems of interpersonal relationships than because of unemployment. On a personal level, these young adults are particularly battling against two major problems: alcoholism and drug addiction, and mental illness. Although 23% of the surveyed subjects have already been hospitalized in psychiatry, the majority of these young homeless have never received any psychiatric care. Nevertheless, they show mental health problems which are often mistakenly dismissed as the effects of alcoholism or chronic drug abuse. The authors believe that means of detection and adequate treatment must be developed for this growing population instead of thinking of social measures which would only give the young homeless a meal and protection from the elements.
Private exposure and covert sensitization in the treatment of exhibitionism.
The present report describes the treatment of a long standing exhibitionism case by covert sensitization and private exposure in front of his wife within an A-BC-B-BC-C single case experimental design. The therapeutic phase of the treatment lasted 10 weeks. Results show that the combination of covert sensitization and private exposure seems to be an interesting technique for married exhibitionists and their wives. Covert sensitization was used to eliminate deviant fantasies and private exposure seemed to have rendered exhibitionism socially acceptable. The various measures of subjective responses indicated that there were no exhibitionist activities during baseline and treatment nor during the year's follow-up, and the patient has been asymptomatic for more than 2 years, as confirmed by a recent follow-up visit. Controlled studies with larger groups of patients are now needed to prove the efficacy of this active, nonaversive and economical treatment for exhibitionists and their wives.
The use of mass media in mental health.
This paper summarizes the theoretical aspects and the experimental studies on the efficacy of mass media in mental health information campaigns. In theory, most authors agree to give mental health information to the lay public but they caution against the overestimation of the power of mass media. Regarding research on the use of mass media in mental health very few experimental studies have been published and they refer mainly to primary prevention with children. The authors discuss reasons which may explain the mental health professionals' lack of interest in this area of research, suggest new approaches for the elaboration of educational programs for the population and emphasize the importance of secondary and tertiary prevention.
Clinical phobias and avoidant personality disorder among alcoholics admitted to an alcoholism rehabilitation setting.
One hundred seventy-three abstinent patients were screened for phobias and avoidant personality disorder. Ninety-six patients were interviewed and diagnosed by two independent assessors who were in agreement on 74% of the diagnoses. In DSM-III terms, over half of the sample (51.4%) met criteria for agoraphobia (8.5%), social phobia (7.8%) and avoidant personality disorder (35.1%). More than 70% of the patients in each diagnostic category were men. For the vast majority of the patients in the sample the disorder preceded the abuse of alcohol which was used by at least 40% of them to relieve their distress in the past. For many it had still a moderating effect on distress at the present but appeared to be mainly used out of "psychological dependence".
[Relaxation technics and anxiety].
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[Suicide and depression in college students].
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[Alcohol and drug consumption in students at the college level. A 1978-1984 comparison].
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[Therapeutic indications of behavior therapy].
Since the last decade, behavior therapy techniques have been used for a variety of psychiatric problems. This paper summarizes the therapeutic indications where behavior therapy appears to be the treatment of choice as well as those where behavioral techniques can be an adjunct. Contra-indications are described and examples of different combinations of treatment are reported.
[Toward a redefinition of community psychiatry in Quebec].
Community Psychiatry is in troubled waters in Quebec. Overwhelmed by their caseloads, community clinics do not see the end of the tunnel with their new long-term mentally-ill patients. The painful reality of the new asylum in the community raises questions about Community Psychiatry despite its remarkable progress. The authors analyze the state of the art about schizophrenia, which is mainly related to chronic mental patients and point out the discrepancy between the original ideals of Community Psychiatry and the clinical reality. They develop the four following propositions to redefine Community Psychiatry in the actual context: recognize the need for the asylum as a process; tolerate the paradox of the multidisciplinary work; narrow the target population and the type of therapy offered; and secure continuity with the community.
[Rape by 2 assaillants and gang rape in Montreal].
A survey was conducted in 230 cases of rape and rape attempts heard in the Judicial District of Montreal between January 1975 and May 1978. Data were compiled from the 30 assaults including two or more assaillants. Results show that in cases of rape committed by two men the aggressors are older than gang rapists, meet the victim mainly in her flat or in a bar, and rape her in her own home, in a car or a hotel. In these cases, voyeurism seems to be an important factor since, most of the time, rape is committed by only one of the two aggressors. On the other hand, gang rapists are younger, meet the victim in public places, on the street or when she is hitch-hiking and attack her in one of the aggressors' house, in public places or on the street. Exhibitionism seems more present in this group of rapists. For both groups the victims are mainly single, younger than the aggressors and have diverse occupations. Finally, regarding the legal outcome half of the subjects were liberated or acquitted in both groups. Rape committed by two men had never been studied or compared with gang rape up until now. Results of this survey show dynamic and demographic differences between these two groups of sexual delinquents.
[The palliative care unit: before, during and after].
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Alprazolam and diazepam in the treatment of generalized anxiety.
In a 4-week double-blind study comparing alprazolam with diazepam treatments, 48 outpatients suffering from mild to moderate generalized anxiety were evaluated after a 5-day placebo washout, and then after 1, 2, and 4 weeks of treatment. The optimal therapeutic doses without excessive sedation averaged 2 mg for alprazolam and 15.8 mg for diazepam. Results from the Hamilton Anxiety Rating Scale, the Clinical Global Impression Scale, a behavior checklist questionnaire, and a symptomatic patients' self-rating scale indicated that patients improved in both treatment groups. Results from the comparative phase suggest that diazepam is more efficient than alprazolam in the reduction of several symptoms of anxiety and depression in particular. Assuming that the first 2-week ratings depend on accuracy of dose adjustment and that week 4 ratings are an important evaluation of long-term efficacy, results from this study suggest that adequate control of anxiety is obtained more readily with diazepam and that symptoms of depression might benefit more from that drug. Few side effects were reported: mainly, drowsiness, tremor, light- headedness , and dry mouth. A toxic reaction to alprazolam, possibly allergic, was observed. Either alprazolam or diazepam appeared to be effective in the treatment of generalized anxiety disorder, and the statistically significant differences between the two drugs were not clinically striking.
[Attitude of the chronically ill towards psychiatric hospitals].
Three hundred chronic mental patients participated in a survey to evaluate their attitudes towards the 2,000 beds hospital where they were staying. The mean duration of the actual hospitalization was 12.1 years and most patients (77.9%) suffered from schizophrenia or other psychoses. On the whole, results show a relatively high level of patients' satisfaction. Single, non psychotic and self-sufficient patients who have not been hospitalized many times and do not want to leave the institution are more inclined to be positive towards the psychiatric milieu. The authors report that participation of chronic mental patients in a survey can be reliable and give helpful suggestions in relation with the evaluation of psychiatric care and the improvement of the quality of life in state hospitals. They conclude that it will always be difficult to discharge satisfied patients without offering the same support and community services that they find in a state hospital.
[Montrealers' attitudes to mental illness: an opinion survey].
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[Reflections on "medicinal drugs or magic potions"].
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