No abstract

SYNOPSISThe psychiatric status and social and family backgrounds of 154 schizophrenic patients were assessed in order to determine the degree to which interpersonal relations, social factors or the psychotic state itself were predominant factors in the promotion of hospitalization. It was found that the psychiatric status of the patient was the most important factor in determining admission to hospital. An unwarranted extrusion of a patient from a family setting was noted in very few cases, and this most often in the face of adverse effects of the patient's illness on the family.

Substance use, in the context of severe and enduring mental illness, is a growing problem particularly among young men and is likely to have implications for the way mental health services are used. The current study compared service utilisation, psychiatric symptomatology and social support among 16 clients with psychotic illness who were regular substance users, with 16 clients attending the same service who did not use substances. The groups were matched on age and gender. The case group evidenced higher rates of in-patient care and intensive crisis support. Their use of the Day-Service was chaotic and reflected social difficulties, such as housing instability, financial and legal issues rather than mental health problems. The findings highlighted the need for an integrated and accessible service which could provide long-term, intensive and practical support. J Ment Health Downloaded from informahealthcare.com by University of Wales Swansea on 11/05/14 For personal use only. J Ment Health Downloaded from informahealthcare.com by University of Wales Swansea on 11/05/14 For personal use only. J Ment Health Downloaded from informahealthcare.com by University of Wales Swansea on 11/05/14 For personal use only.

The English “ward‐in‐a‐house” for new long‐stay patients (NLS) is described. NLS are usually defined as (a) aged between 18 and 65, (b) continuously in hospital for between 1 and 5 years, and (c) individuals for whom it has not been possible to find alternative accommodation outside hospital, despite repeated attempts to do so. The “ward‐in‐a‐house” combines the best features of high quality hospital care with the best features of community‐based residential units. The “Koike‐dormitory” which was set up more than 20 years ago in Maebashi city had many of the characteristics of the English “ward‐in‐a‐house” and this is also described. The possibility of developing a “ward‐in‐a‐house” in Japan is then discussed.

Neurosurgical treatment for psychiatric disorders features a long and controversial history. This article explores a ‘spectrum of psychosurgery,’ describing how old-fashioned and controversial prefrontal lobotomy gradually evolved into modern day, mainstream scientific deep brain stimulation (DBS). We focus on the rise, fall and possible re-emergence of psychosurgery as a therapeutic intervention today.We journey through historic indiscriminate use of prefrontal lobotomy, which evoked stern criticism from both public and professionals, through to the development of modern day DBS - performed for patients suffering from severe, treatment resistant symptoms of obsessive-compulsive disorder (OCD), epilepsy and movement disorders.We hope this article will provide a basis for understanding the availability of existing treatment options and potential future opportunities, whilst simultaneously challenging any public/professional preconceptions of psychosurgery, which may indirectly be obstructing patient care.Additionally, we carried out a qualitative survey displayed in WordCloud Format, capturing the intellection of 38 mental health professionals working for North West Boroughs NHS Healthcare Foundation Trust, on ‘psychosurgery,’ ‘prefrontal lobotomy’ and ‘DBS’, which may well reflect wider public opinion.In summary, the article provides a brief, yet comprehensive overview of the controversial history of psychosurgery, present-day practice, and future trends of neurosurgery for psychiatric disorders.