Providentia

Echoes of 9-11, Part 1

The July issue of the Journal of Nervous and Mental Disease includes the results of a study examining the psychological impact of the World Trade Center Disaster in residents of New York City.  In a two-part survey of 2,368 respondents administered one and two years after the disaster, key risk factors for Post-traumatic Stress Disorder (PTSD) symptoms were identified including age, gender, negative life events, and level of self-esteem.  Cases of immediate and delayed PTSD were found to differ both in terms of incidence of negative life events, ethnic background, and changes in self-esteem over time.  The researchers conclude that psychosocial context can play an important role in dealing with community disasters and traumatic stress. 

The abstract for the study can be found here.  The full-text version is also available. 

Losing Your Identity

In October of last year, Joe Bieger, a 59-year old assistant high school athletic coach and devoted family man, left his home in Dallas, Texas and apparently vanished from the face of the earth.  After 25 days of frantic worry, his family received word that Bieger was alive and well although the story of what had happened to him is still unfolding.

For reasons that remain unknown, Bieger lost all recollection of his name and identity and wandered the streets of Dallas.  In what is believed to be a case of psychogenic fugue, Bieger continues to lack any memory of how he survived during this period and what he ate although packets from fast food restaurants were found on him.  Despte searching by an army of police and volunteers and extensive media exposure relating to the case, no clear trace of him could be found over the 25-day period.  Over the course of his wanderings, he eventually found his way to a Dallas suburb twenty miles from his home where he was recognized by a construction foreman who helped him to remember his identity.  He had lost 25 pounds, had a full white beard, and holes in the soles of both of his shoes. but was otherwise in good health.  He has now returned to work and is currently under the care of a specialist in fugue cases.  His cell phone now has a GPS tracker.    

Although cases of psychogenic fugue are rare, they are believed to be linked to episodes of personal stress it remains unclear why some people are more susceptible than others.  More details on this story can be found here.   

HIV Dementia Rate Skyrocketing in Africa

An international team of researchers led by a John Hopkins neurologist have concluded that new HIV dementia cases in sub-Saharan Africa are adding an enormous burden to the already overtaxed health-care systems of some of the world's most impoverished nations.  The study results indicated that 31% of a HIV-positive patients at a medical clinic in Uganda met the criteria for HIV-dementia, i.e., debilitating memory, learning, behavioural, and motor disabilities.  While the symptoms of HIV-dementia are largely reversible through the use of antiretroviral medication which is commonly available in the West, only 20% of HIV patients in the world have access to such medication.  Based on the study results and the known prevalence of HIV in Africa, there may be more than 8,000,000 HIV-dementia cases throughout the sub-Saharan region alone. 

Dr. Ned Saktor, senior author of the study, reported that there is little accurate information about the prevalence of HIV-dementia in other parts of the world but that estimates range from 9 per cent to 54 per cent of those infected with HIV.

More information on the study can be found here.

Ten Days in a Mad-house

In 1887, police were called to a run-down boarding house in New York City due to complaints surrounding the bizarre behaviour of a young female boarder.  The police were told that this frail young woman was being disruptive, refusing to go to bed, and telling the other boarders that she was afraid of them.  Police took her into custody but were stymied by her insistence that she could not recall her own name.  Several prominent doctors of the area, including the director of the local Bellevue Hospital declared her to be insane and in need of special care  Newspaper ran stories asking anyone who knew the "insane girl" to come forward to no avail and she was sent to the Women's Lunatic Asylum on Blackwell's Island for her own safety.

Which, as it happened, was exactly what Elizabeth Jane Cochrane, better know as Nellie Bly had in mind.  She was a reporter, newly hired by Joseph Pulitzer, publisher of the New York World, who had been assigned to investigate reports of patient abuse in the Women's Asylum.  After carefully practicing bizarre facial expressions to get her part just right, Bly put her plan into action.  Over the course of the next ten days, she made careful note of the appalling conditions that female patients were forced to endure including abusive staff and substandard food and accomodations.  She also encountered patients that she was convinced were as sane as she was.  After being released at the request of the New York World, Bly reported on her experiences (which were later published in a book titled Ten Days in a Mad-House).  In addition to cementing her own fame as one of the world's first female investigative journalists, Bly's reporting led to a grand jury investigation into the conditions of the asylum (in which she was asked to participate).  The subsequent reforms led to major changes in how the mentally ill would be treated in New York State. 

While posing as a mental patient is not an approach that could be easily repeated these days, Nellie Bly's expose still has relevance given that the allegations of abuse of mental patients continue to be heard even today.

Does Early Weaning Lead to Alcoholism?

In an intriguing study by a group of Danish and American researchers reported in the April, 2006 edition of the American Journal of Psychiatry, a significant relationship was found between early weaning (termination of breast feeding) and later hospitalization with an alcohol-related diagnosis.  The study involved a prospective longitudinal analysis of available records on 6,562 men and women born in Copenhagen between October 1959 and December 1961.  Although a number of risk factors were identified including gender, parental alcoholism, and maternal smoking during pregnancy, the link between shortened length of breastfeeding and later alcoholism in both men and women was quite apparent.

The research study abstract can be viewed online through the American Journal of Psychiatry using the above link.   

Radio Psychiatrist Suspended for Medical Infraction

A well-known Quebec psychiatrist with a popular phone-in radio show has been suspended by the Quebec College of Physicians for "putting the protection of the public in danger".  Dr. Pierre Mailloux, commonly known as "Doc" to his radio fans, was charged with over-prescribing psychiatric medication to two patients at a hospital in the Trois-Rivieres area near Montreal as well as "unprofessional conduct" with respect to the medical, personal, and professional advice that he gave out during his show.

Dr. Mailloux has come under fire in the past for making controversial statements on his show including pronouncements on the intelligence level of blacks and the use of castration for sex offenders.  During the course of his suspension period, he will be unable to prescribe medication or bill the province for medical services.  He is expected to appeal the decision. 

More information on the ruling can be found here.

Blaming the Victim

More than four years following his disappearance in 2002,  Shawn Hornbeck is now safely home after being found alive with another child in January of this year.  With one ordeal being over, another one seems well underway.  The inevitable question of why Shawn failed to escape his kidnapper has led to verbal attacks from numerous directions.  Shawn's parents have come under fire for daring to speculate publicly that their son was abused and Shawn himself has drawn fire from Bill O'Reilly who vilified him for failing to escape with all the nasty insinuations that he could muster. 

Certainly, blaming the victim (especially a child victim) is nothing new.  In a 19th century short story written by Guy de Maupassant titled Madame Baptiste, a woman lives her entire life under the stigma of having been molested as a child and is given the nickname of "Madame Baptiste" (Baptiste being the name of the man imprisoned for molesting her) by her fellow villagers.   In the story, it is said of her:

The little girl grew up, stigmatized by disgrace, isolated, without any companions; and grown-up people would scarcely kiss her, for they thought that they would soil their lips if they touched her forehead, and she became a sort of monster, a phenomenon to all the town. People said to each other in a whisper: 'You know, little Fontanelle,' and everybody turned away in the streets when she passed. Her parents could not even get a nurse to take her out for a walk, as the other servants held aloof from her, as if contact with her would poison everybody who came near her

There is a sense of forboding as the story winds down to its tragic, inevitable end and you get the impression that the author knew of all too many real-life Madame Baptistes in his lifetime.  While attitudes may have changed somewhat, there is still a tendency to turn child victims into pariahs.  Thish often translates into a reluctance by parents to having their children come forward at all for fear of what they would face.  Ultimately, it is this sort of attitude and the notion that a child who has "lost his or her innocence" should be shunned for it that can be a greater source of trauma for the victim than the actual abuse.

Shawn Hornbeck and all others like him deserve better than this.   

The Coming Alzheimers Explosion

In a recent article in the Hamilton Spectator, a Hamilton-based specialist in geriatric medicine warned that the number of Alzheimer's disease patients can be expected to explode in number as the baby boom generation ages.  Dr. Willie Molloy, who holds the St. Peter's Hospital McMaster Chair in Aging, has pointed out that the prevalence of Alzheimer's cases can be expected to double every five years and that that disease that affects eight percent of those over 65 now can be expected to affect sixteen per cent of those over 70 five years from now.  Dr. Molloy has been quoted as saying that the Ontario Ministry of Health and Long-term Care is not ready to address the additional drain on available resources that the increasing number of Alzheimer's and other dementa patients will require.

It is currently estimated that there are 100,000 Alzheimer's patients in Ontario and 90 per cent of them are over 65.  There are likely many more in the early, mild cognitively impaired stage who remain undiagnosed. 

Woman Convicted of Harassing Psychiatrist

A UK court has handed down a nine-year sentence on 45-year old Maria Marchese who targeted noted psychiatrist Jan Falkowski and his fiancee for a "uniquely disturbing hate campaign".   Marchese met Dr. Falkowski in 2001 while he was treating her then-partner and apparently developed an infatuation that led to an anonymous campaign of text messages, phone calls, and emails directed at both him and his then-fiancee.  After the long campaign of harassment and death threats caused the couple to break up, Marchese was arrested and released under a restraining order.  She then turned to a new tactic: finding a used condom in Dr. Falkowski's trash, she accused him of drugging and raping her in his office. 

Dr. Falkowski was only exonerated after a lengthy investigation and last minute evidence which spared him from a trial.  Maria Marchese was then arrested and charged with harassment and threatening to kill as well as for "perverting the course of justice" for the false rape allegation.  She has stated that she will appeal the conviction.   

The harassment and the ordeal that followed is scheduled to be made into a television drama.  More information on this story can be found here.   

"Dog Collar" Psychologist on Trial

In a courtroom in Perth, Australia, the courts were provided initial details in a case involving noted psychologist, Bruce Beaton, 64, who allegedly sexually assaulted and humiliated a 22-year old female patient during the course of a series of therapy sessions in 2005.  The patient, who was being treated for bulimia reported that Beaton asked her invasive questions about her sex life, forced her to wear a dog collar, ordered her to take off her clothes and often whipped her when she refused to do so.  After laying a complaint over this bizarre "treatment", the police recorded her phone conversations with Beaton and placed a hidden camera in her bag to record one of the treatment sessions.  The police arrested him during the course of a session with her in 2005.  Beaton has pleaded not guilty. 

More details can be found here.