Social Psychiatry

Social Psychiatry

Edited by Vladimir Hudolin "Dr. M. Stojanovic" University Hospital Zagreb, Yugoslavia

With the assistance of

John L. Carleton World Association for Social Psychiatry Santa Barbara, California

SPRINGER SCIENCE+ BUSINESS :MEDIA, LLC

Library of Congress Cataloging in Publication Data

World Congress of Social Psychiatry (8th: 1981: Zagreb, Yugoslavia) Social psychiatry.

"Proceedings of the Eighth World Congress of Social Psychiatry, held August 16-22, 1981, in Zagreb, Yugoslavia."

Bibliography: p. Includes index. 1. Social psychiatry-Congresses. 1. Hudolin, Vladimir. Il. Carleton, John L., 1925-

III. Title. [DNLM: 1. Community psychiatry-Congresses. W3 W05385M 8th 1981s] RC455.W68 1981 616.89 83-4058 ISBN 978-1-4684-4537-4 ISBN 978-1-4684-4535-0 (eBook) DOI 10.1007/978-1-4684-4535-0

Proceedings of the Eighth World Congress of Social Psychiatry, held August 16-22, 1981, in Zagreb, Yugoslavia

© 1984 Springer Science+ Business Media New York Originally published by Plenum Press, New York in 1984 Softcover reprint ofthe hardcover lst edition 1984

AII rights reserved

No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher

PREFACE

It is becoming more and more difficult to publish papers from international and world scientific meetings. The causes are partly financial; in addition the number of meetings held is so large that it is impossible to find the necessary time for the enormous amount of work involved in preparing and publishing these materials. Also the scientific and professional quality of these meetings is often poor as the same points of view as well as more or less the same papers, with only slight modifi­cations, are usually presented. The educational system is also responsible since professionals are required to publish papers in order to get promoted in their pro­fession and in their institutions. Overproduction of meetings and papers is often mentioned by many pro­fessionals, but when we look at the professional activi­ties of the critics of these meetings and papers, we can see that they also behave in the stereotypic way - they write papers, read them at congresses and publish in periodicals. The number of periodical publications of some medical branches - including psychiatry - is enor­mous.

In the light of such thoughts it seems opportune to evaluate the 8th World Congress of Social Psychiatry and the papers presented - the papers you are now holding in your hands. Although such an evaluation is a delicate and difficult task, I think it should be at least attempted in this Editorial.

The papers presented at the congresses of the World Association of Social Psychiatry have not often been published in full. The complete proceedings were pub­lished of the Congress held in Zagreb in 1971 and now of this 8th Congress held again in Zagreb. Thus, it could be concluded that there has been no overproduction of papers from the World Congresses of Social Psychiatry.

v

vi PREFACE

It has always been most difficult to assess the scien­tific and professional value of a congress and of the publication of its proceedings. In order to do this at least in terms of its general traits, it is necessary to review briefly the reasons for founding the International and, later on, the World Association of Social Psychiatry (W.A.S.P.) as well as the professional and scientific concept of social psychiatry in general.

Today when we look at social psychiatry and the W.A.S.P. from a long time perspective, the whole thing looks as simple as Columbus' egg. But, at the beginning it was not so simple and obvious and we should give due honor to Joshua Bierer and a group of enthusiastic pro­fessionals, his collaborators, who founded and promoted the Association.

The idea of social psychiatry appeared after the Second World War when the entire field of health protec­tion underwent a turbulent period. Psychiatry has not yet overcome this crisis situation but it still seeks out the best ways to organize and practice mental health pro­motion and protection.

The end of the war saw psychiatry in most countries still limited to psychiatric hospitals. Although psy­chiatry obtained the status of a branch of medicine after the Second World War, in many Medical Faculties psychi­atric clinics were not founded.

Repressive character and protection of society from the so-called mental patients caused psychiatry to be attacked from various sides. It was attacked by society, by the patients and even by the medical profession, psy­chiatrists and others. Suddenly, a great number of other professionals (nurses, psychologists, social workers, sociologists) became engaged in psychiatry as it became obvious that psychiatry, although having significant medical aspect, was not entirely a medical branch. Social and even political interest in psychiatry increased.

Psychiatry found itself in a difficult situation without an elaborated scientific basis, without scien­tific methodology and without a scientifically-based therapy. Every new specialist brings in his own new ideas, elaborates his own methodology, his own therapy and his own terminology, thus creating a modern Tower of Babel. Latterly the positive influences of W.H.O. have begun to be felt as it attempts to establish mutual under­standing and agreement in order to resolve the existing chaos.

PREFACE vii

Psychiatry is also under attack from the so-called antipsychiatric movements, although this is only another attempt at a specific developmental path in this diffi­cult scientific field which observes man as a whole -somatically, sociologically, politically and spiritually.

From all these dynamic occurrences an idea is crystal­lized that man is primarily a part of general social systems, from his family to the widest social groups. Importance of communication and interaction in the family and in the society for mental health is being noted; thus, the idea has emerged that a man, whether healthy or ill, cannot be viewed outside the context of these general systems - in the first place, his family and society. Accordingly, health protection and promotion should be incorporated in the basic human community.

Such considerations gave rise to group procedures, therapeutic community, sector psychiatry, community psy­chiatry etc. But none of these systems succeeded to manage health promotion and protection successfully. Besides, resistance from traditional psychiatry conflicts with new attitudes appearing in practice and requested by society.

Social psychiatry, thus, gradually developed as a comprehensive system in an attempt to organize mental health protection and promotion, including the treatment and rehabilitation at the local community level.

What in the beginning looked like a revolutionary movement has become today the one and only psychiatry as it has become obvious that there cannot be any other psychiatry but Social Psychiatry.

Social psychiatry, conceived in this way, includes all professional and scientific activities of contempor­ary psychiatry.

The scientific, professional and human levels of social psychiatry are most suitable for the possi­bilities, needs and knowledge of today. It is obvious that, regardless of the various theoretical viewpoints, a better psychiatry than this does not exist. In the mean­time, the societies of numerous countries have undertaken measures to make legislation more suitable to existing needs and possibilities. In many countries health legis­lation has developed and the organization of the practice of mental health protection has changed. Some countries have gone so far in this respect that it has caused a lot

viii PREFACE

of problems, while in some other countries legislation lags behind the possibilities and the needs of the society. This also causes considerable trouble.

Any world congress in any scientific field and thus also social psychiatry, should present the real situation and achievements in that respective field as well as indicating the direction of future developments. This must not be presented as better or worse than actual reality because any forging of reality has a bad effect upon heaith protection.

For that reason, the 8th World Congress of Social Psychiatry presents our needs, our possibilities and our achievements. No matter how much we wish the situation in mental health promotion and protection to be better than the Congress papers presented in it, that is only wishful thinking. The Congress has made us see where we are, enabled us to evaluate the trends in comparison with our past congresses, as well as to visualize our future devel­opment.

That is why this Congress was organized and a multi­professional group of participants was invited. They were given the opportunity to present the conditions of their particular fields as well as their views upon social psychiatry. Considering the choice of papers for this book, our criterium was to include all the papers which satisfied minimal technical and professional require­ments. Some papers have not been included, only because the authors did not send their papers prepared according to the provided instructions in time. It is obvious that because of the great number of papers presented it was impossible to evaluate in detail individual papers and that they do not reflect the work of the editorial board. The professional and editorial board does not share all the views presented in these papers but has tried only to present the level reached by the Congress and by contem­porary mental health protection.

Finally I would like to thank Mrs. Elisabeth Cann for correcting the papers and succeeding, at least in general, to correct the language, which in such an inter­national meeting having the participation of people from various countries, is extremely difficult.

I must also thank Plenum Press who has shown interest and willingness in undertaking such a difficult and responsible task. My acknowledgements also to Renata Biondic and Jurica Vucicevic for typing the material,

PREFACE ix

then to the members of the editorial board, especially to Dr. John Carleton. Finally my thanks to Djurdjica Cerinic who prepared the typescripts and coordinated and super­vised the typing.

Vladimir Hudolin

CONTENTS

Social Psychiatry Today Vl. Hudolin

Evolution of Social Psychiatry: Impact on Civilization

J. L. Carleton

Education for Living: Overall Goal of Social Psychiatry

G. Vassiliou

Resolution Against Nuclear War J. H. Masserman

A Message Delivered on Behalf of the Special Representative of the United Nations Secretary-General for the International Year of Disabled Persons at the Special Seminar at 8th World Congress on Social Psychiatry

Politicization of Psychiatry and Political Psychiatry

Vl. Hudolin

Unconscious Approaches to World Suicide J. H. Masserman

The Scientific Status of Psychiatric Diagnosis

J. H. Masserman

xi

1

9

19

23

27

31

37

49

xii

Diagnosis and the Concept of Mental Illness

N. Rosenzweig

Advantages of Psychodynamic Theory for Psychiatric Diagnosis

T. sikic-sivik

The Prevalence of Psychiatric Symptoms Among the Yoruba

0. A. Erinosho

Psychiatric Therapies and Their Presumed Effects

J. H. Masserman

The Common Dynamics of Psychiatric Therapies

J. H. Masserman

Psychiatry and Psychotherapies: Evolving Evolutionary General Systems for "Change"

W. Gray

A Trial of the Idea of Intrafamilial Insight for Family Therapy and Social Understanding of Mental Disorders

Y. Sakamoto

An Integrative Approach to Family Therapy P. Kymissis

Towards Integrative Concept of Therapeutic Objective

Y. Ishizuka

Reinventing the Wheel of "Therapeutic Process"

Y. Ishizuka

The Non-working Patient in Therapy: A Confrontational Approach

I. v. Colett

Confrontation in Ther?PY With the Non­working Patient: The Process

I. v. Colett

CONTENTS

67

77

83

93

115

129

145

151

165

175

185

195

CONTENTS

Free Psychotherapy: The Therapist's and the Patient's View

N. Manos

A Survey of Forty Licensed Psychotherapists in Private Practice in Northern California - The Effect of Treatment on Treater

D. E. Gibson and B. Taylor

An Interpersonal Approach to Creativity J. Pearce

Music Therapy in Schizophrenia H. Naukkarinen

Music Therapy in Finland H. Naukkarinen

Therapeutic Community as Part of Integrated Psychotherapy

F. Knobloch and J. Knobloch

Therapeutic Communities: The Treatment of Choice for Adolescents

S. Schneider

Borderline Patients in the Therapeutic Community

I. Fazekas, L. Dome, and Gy. Altomare

Large Group Therapy - With Young People J. M. Lomax-Simpson

Work and Mental Health I. V. Colett

Developmental Issues and Intervention Strategies in a Community Mental Health Center in Greece

M. Madianos and c. Stefanis

A Psychiatric Day Hospital P. c. Misra and J. Cameron

Community Psychiatry in Scotland P. c. Misra

xiii

207

215

223

231

237

243

255

263

267

273

283

291

297

xiv

Forms of Cooperation Between the Hospital Therapeutic Team and Members of the Primary Health Protection Team in the Light of the New Health Law

s. Vidovic, D. Skvarc, and z. Marinic

The Social Network as an Etiological Factor in Mental Illness and as a Therapeutic Approach

R. J. Kleiner

Residential Conditions for Long-term Psychiatric Patients: Its Implication for Subjective Reported Quality of Life

T. S¢rensen

Network Participation and Network Anchorage Among Long-term Psychiatric Patients

T. S¢rensen

Evaluation of Psychiatric Emergencies in Athens Greater Area

M. Madianos, E. Lykouras, G. Papadimitriou, A. Martinos, and C. Stefanis

Crisis Prevention at a Hungarian Student Health Service

I. P~tkai, M. Jen6ne, and G. Arat6

Attitudes of the Staff Versus Borderline and Neurotic Patients

L. Dome, I. Fazekas, and Gy. Altomare

Psychiatric Morbidity in a Normal Work Force Population

K. J. Alderman, J. M. C. Holden, E. G. L. Lucas, and C. J. Mackay

Membership, Types of Illness and Relationship Between the Incidence of Bringing Sick and Disturbed Persons for Healing Among Adherents of an Aladura Church in Benin City, Nigeria

G. I. Odiase

Past Experiences with the Register of Patients at the Rab Psychiatric Hospital z. Marinic and M. Juric

CONTENTS

301

307

329

339

349

361

371

375

383

399

CONTENTS

The Role of the Individuation Process In Suicide

B. Buda

Epidemiological and Social Aspects of the Suicidal Acts

J. Tzankov and M. Atanassov

Concerning the Epidemiology of Suicide in Upper Austria

w. Schony, G. Hofmann, and M. Sommereder

Geomagnetic Storm Fluctuations and Self­poisoning Attempted Suicides

D. Mihov and V. Milev

Health Organization and Epilepsy - A Social-psychiatric Approach?

H. Smits

Percentages of Ictal and Non-ictal Psychiatric Disorders in 3000 Epileptics: Social Situation

L. Oller-Daurella

Epilepsy and Suicidal Attempts in Children and Adolescents z. Martinovic

Effects of Sex Disorders on Marital and Family Relationships

v. Szilagyi

How to Reduce Communication Difficulties in Sex Counseling (A review of the Suggested Practices for Family Physicians)

M. Seidl

Family, Personality, Miscarriage J. Lorincz, A. Varga, and J. Domotori

"Divorce" - Can and Should it be Prevented? Y. Ishizuka

The Family Survival Project for Brain­damaged Adults and Their Families

D. E. Gibson

XV

403

409

425

433

439

453

465

475

483

491

495

519

xvi

Some Consequences of Cramped Housing and Crowding on Children

M. L. Podolsky

Immigration and Mental Health B. Konstantinovich and C. A. Phillips

Acculturation and Mental Health of Greek Immigrants in USA

M. Madianos

Frequency of Development of Depressive Condition Among Yugoslav Economic Migrants in The Netherlands - The Causes and Consequences

A. Dosen

The Need for Sex Counselling in an Ethnic Medical Practice

M. Seidl

Being a Near Traffic Fatality in Greece D. E. Gibson

The Handicapped Child and Its Family from the Aspect of the Psychiatrist

M. Stojcevic-Polovina

Interaction of Families of Handicapped Children

H. R. Soboloff

Parents and a Premature Child B. Stampar-Plasaj, Lj. Schmutzer,

M. Vlatkovic-Prpic, and Lj. Benic

Prevention of the Development of Cerebral Palsy According to the Concept of Vojta: The Family as Co-therapist

C. Avalle and V. Vojta

Medical Rehabilitation of Arthrogrypotic Children and Their Relations on the Psychosocial Stability of the Family

T. Matasovic, R. Toth, and v. Becic

The Effects of Heart Disease on Children and Their Families

v. Fabecic-Sabadi

CONTENTS

531

537

549

559

567

573

581

595

601

605

611

617

CONTENTS

The Use of Music to Facilitate Learning in a Class of Multihandicapped Cerebral Palsy Preschool Children

M. Berel

Review of the Current Problems of the Social Care of Handicapped Children

N. Novakovic

Experiences with a Community Mental Health Center in the Rehabilitation of Psychiatric Patients in Graz

H. Lechner and R. Danzinger

The Community Care of Chronic Psychiatric Patients as Developed by PRA in East London

G. Ross

Vocational Rehabilitation with Emotionally Disturbed Adolescents

s. Schneider

The Value of the Psychosociotherapeutic Approach in the Treatment of Long­term Hospitalized Psychotic Patients: A Retrospective Study

N. Manos, J. Gkiouzepas, and G. Lavrentiadis

Vocational Rehabilitation of Schizophrenic Patients

D. Koreti6

The Life of the People with the Diagnosis of Schizophrenia in the 8th District of Budapest

I. Kappeter

New Long-stay Psychiatric Patients - Possible Implications for Hospital Planning

A. o. A. Wilson

Some Problems with the Concept of "Normal Aging"

I. v. Colett

Alcoholism Vl. Hudolin

xvii

627

631

639

649

659

667

677

683

687

697

707

xviii

Systems Approach to Behavioral Theory N. Lazic

Are the Present Activities to Prevent Alcoholics' Disability Sufficient?

L. Pavicevic and M. Mimica

The Formation of Staff in a Program for the Control of Alcoholism-linked Problems in Friuli-Venezia Giulia

R. Buttolo, G. C. Lezzi and G. C. Miglio

The Religious and Christian Element in Therapy in Alcoholism and Drug Addiction

J. K. Lawton

Therapeutic Community and Social Drama in Treated Alcoholics

B. Lang, D. Breitenfeld, I. Biocic, B. Galoic, s. Pintaric, and J. Wolff

Specific Features of Women's Alcoholism s. Padelin

Alcohol Related Psychiatric Emergencies: A Two Year Controlled Study

E. Lycouras, G. Papadimitriou, A. Martines, and M. Madianos

Characteristics of Delirium Tremens in our Material

P. Vidinovski, J. Jovev, I. Tulevski, and B. Gajdov

Occupational, Social and Personal Correlates of Alcoholic Liver Disease

J. M. C. Holden, K. J. Alderman, E. G. L. Lucas, and c. J. Mackay

Attitude to Smoking Among Primary School Pupils

D. Krapac, M. Malinar, and L. Krapac

Comparative Study on the Opinion About Mental Illness of Two Differentially Sensitized Rural Populations -"Helen's Case"

G. Trikkas, E. Varsou, M. Repapi, G. Giannaka, and c. Stefanis

CONTENTS

713

723

729

733

741

747

755

763

773

781

787

CONTENTS

Prevention of the State of Social Dependence of Patients Afflicted with Aphasia

M. Kuzak Pachalska

What to Tell the Cancer Patient: Socio­psychiatric Aspects

A. Jarema and M. Jarema

The Influence of Socio-economic Factors on Rehospitalization of Schizophrenic Patients

v. Markes-Marinic and z. Marini6

Bodily Complaints with no Identified Organic Cause Among Women: Psychosocial Resources as a Buffer

u. Aviram, Z. Ben-Sira, I. Shoham, and I. Stern

Contributors

Index

xix

797

805

815

821

843

853