Are psychiatrists an endangered species? Observations on internal and external challenges to the profession — Heinz Katsching (Vienna, Austria)

Key words: future of psychiatry, diagnosis, treatment, user and carer criticism, professional competition

Abstract: Based on recently voiced concerns about a crisis in psychiatry, six challenges to our profession are identified and discussed. As we approach the revisions of ICD-10 and DSM-IV, the validity of psychiatry’s diagnostic definitions and classification systems is increasingly questioned also from inside psychiatry. In addition, confidence in the results of therapeutic intervention studies is waning. A further challenges is the existence of de facto subgroups with opposing ideologies, a situation which is responsible for an unclear role profile of the psychiatrist. Challenges from outside include mounting patient and carer criticism, intrusion of other professions into psychiatry’s traditional field of competence, and psychiatry’s low status within medicine and in society in general. Studies suggest that the decline of the recruitment into psychiatry, as it is observed in many countries, might be related to problems arising from these challenges. It is unclear whether psychiatry will survive as a unitary medical discipline or whether those segments which are more rewarding, both financially and in status, will break away, leaving the unattractive tasks to carry out by what remains of psychiatry. The demise of the generalist and the rise of the specialist in modern society may contribute to this development. Attempts are underway by professional bodies to define the profile of a “general psychiatrist”. Such discussion should be completed by an analysis of the incentives which contribute to the centrifugal tendencies in psychiatry.

Heinz Katsching – Medical University of Vienna and Ludwig Boltzmann institute for Social Psychiatry? Lazarettgasse 14A-912, A-1090 Vienna, Austria

Three stages of falsification: resume from office – selection of documents for court by regional chief – the leaders of the RF Ministry of Health

Key words: falsification, forensic psychiatric evaluation, Russian version of the ICD-10

Abstract: The subject of the article is outpatient’s clinic forensic-psychiatric evaluation by the Serbski Center, which having found no clinically significant mental disorders and guided by obviously tendentious reference “couldn’t reach” a decision. And there a sensational fact was revealed: in six month after publication of book variant of the Russian version of ICD-10 which had been approved by the RF Ministry of Health it was included into the ministerial order under heading “Models of diagnostics and treatment of mental and behavior disorders” not in the original form, but with blatant distortions of the criteria of organic disorders of personality (F 07.0) depriving it of all borders. And all this since 1999. And what in our country means to rely on presumption of trust to the Ministry.

Editorial Board of the IPA, doorway 3, Luchnikov lane 4, Moscow-101000; +7-495-625-0620; E-mail: info @ npar.ru

Psychiatric Expert, Counsel and American Legal Process — V.V. Motov

Key words: American expert-psychiatrist, standard courtroom procedure, admissibility of expert testimony, effectiveness of presentation style

Abstract: The objective of the article is to expose Russian forensic psychiatrists to basic functions their American colleagues perform in courts as expert – witnesses. Topics like how attorney locate potential experts, fee arrangements with the attorney, standard courtroom procedures, admissibility of expert testimony, Daubert criteria, expert’s credible presentation style, goals of direct and cross exams, typical pitfalls cross-examining attorneys employ are discussed among others.

Motov Vladimir, Head of the IPA Forensic Psychiatry Program; Karbysheva str. 10, apt. 45, Tambo392005; +7-4752-47-82-53; E-mail: vladimir_motov @ mail.ru, vlad_motov @ yahoo.com

“With a single claw stuck the bird itself will perish”- A.Yu.Magalif

Key words: analysis of own mistakes, involuntary hospitalization, psychiatric misuse in Soviet epoch

Abstract: “With a single claw stuck the bird itself will perish”. This Russian proverb in the headline opens up the first article in a new column of the Journal dedicated to remarkable pre-revolution Pirogov’s tradition of ruthless analysis of own mistakes. The author recollected how he had hospitalized without sufficient grounds the founder of human rights movement in the Soviet Union who was the leading specialist in mathematic logic and one of those which case history marked “not to discharge from the hospital” without coordination with KGB.

Magalif Alexander Yu., Candidate of Medical Sciences, Moscow Research Institute of Psychiatry, scientific head of Magalif Clinic of Psychological Adaptation; +7-499- 468-2520; E-mail: magalif @ mail.ru

On psychoanalytical understanding of etiology, pathogenesis, and clinical picture of dependence on gambling — D.A. Avtonomov

Key words: gambling, gambler, etiology, pathological addiction, psychoanalytical approach, S.Freud, regression

Abstract: The author discussed etiology, pathogenesis, and clinical picture of dependence on

gambling from the point of view of psychoanalysis. The evolution of psychoanalytical views on

the problem is shown. Initial hypothesis about pathological addiction to gambling discussed in psychoanalytical literature are underlined. The author presents an approach based on the concept of regression, intra-psychical conflict, drives, and pleasure principle, according to that the process of gambling for the pathological gambler represents a surrogate sexual excitement, and the gain becomes and equivalent of orgasm. Five clinical examples illustrate the views.

Avtonomov Denis A., clinical psychologist, Moscow narcological out-patient center # 12; 10-A Shvernika str., Moscow-117449; +7-495-126-2501; E-mail: d-avtonomov @ yandex.ru

Professor Vladimir Jakovlevich Anfimov — the organizer of Kuban psychiatry (strokes to the portrait) — A.P. Petryuk, P.T. Petryuk

Key words: J.V.Anfimov, Velimir Khlebnikov

Abstract: On the basis of sources of the special literature new information is resulted about the vital and creative way of professor V.J. Anfimov – the known domestic psychiatrist, neurologist, representative of Kharkiv psychiatric school, which at one time worked on the Saburova dacha, which brought in ponderable payment the scientific achievement in development of domestic psychiatric school. The questions are lighted up of his mutual relation with a famous poet V. Khlebnicov.

Petryuk Alexander P., Petryuk Petr T. — Institute of Neurology, Psychiatry and Narcology of AMS of Ukraine, Kharkiv Regional Clinical Psychiatric Hospital № 3 (Saburova dacha), Kharkiv city benevolent fund of psychosocial rehabilitation of persons with the problems of psyche; Academician Pavlov str., 46, Kharkov-61068, Ukraine; + 38-057-738-51-42; ppetryuk @ ukr.net

наверх >>>