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Dhari S, Slemon A, Jenkins E. The Subaltern: Illuminating matters of representation and agency in mental health nursing through a postcolonial feminist lens. Nurs Inq 2024:e12661. [PMID: 39038194 DOI: 10.1111/nin.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/24/2024]
Abstract
Inpatient mental health nursing operates with an overarching goal to support people living with mental health challenges by managing risk of harm to self and others, decreasing symptoms, and promoting capacity to live outside of hospital settings. Yet, dominant, harmful stereotypes persist, constructing patients as less than, in need of saving, and lacking self-control and agency. These dominant assumptions are deeply entrenched in racist, patriarchal, and Othering beliefs and continue to perpetuate and (re)produce inequities, specifically for people with multiple intersecting identities relating to race, class, gender, and culture. This paper explores the relevance of postcolonial feminism, particularly Gayatri Spivak's concept of Subaltern-conceptualized as groups of people who are denied access to power and therefore continue to be systematically oppressed and marginalized-in illuminating the problematic and dominant assumptions about people living with mental health challenges as lacking agency and requiring representation. Through an understanding of Subalternity, this paper aims to decenter and deconstruct dominant colonial, patriarchal narratives in mental health nursing, and ultimately calls for mental health nursing to fundamentally reconsider prevailing assumptions of patients as needing representation and lacking agency.
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Affiliation(s)
- Shivinder Dhari
- School of Nursing, University of British Columbia, Vancouver, Canada
- School of Nursing, Camosun College, Victoria, Canada
| | - Allie Slemon
- School of Nursing, University of Victoria, Victoria, Canada
| | - Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, Canada
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Rinaldi F, Sacchetto S, Di Francia A, Siracusano A, Niolu C, di Michele F. The "Hysterical Psychosis" Dilemma: A Narrative Review. Psychopathology 2024:1-11. [PMID: 38442702 DOI: 10.1159/000536377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/20/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND Hysteria in its most severe expression may reach psychotic manifestations. Such symptomatology has been occasionally described by various authors starting from the 19th century and defined as "hysterical psychosis" (HP) by Hollender and Hirsch in 1964. Currently, diagnostic psychiatric manuals such as DSM and ICD do not include the diagnosis of HP, although this term is commonly used in clinical practice. This raises a well-known problem with case definition due to an inconsistent use of terminology. SUMMARY Here, we propose a review of the literature that aims to highlight the clinical features of HP endorsed by the majority of authors, such as histrionic premorbid personality, acute reactive onset, short duration, altered state of consciousness, unstable delusions, typical hallucinations, labile mood, lack of flat affect. In the discussion, we focus on the differential diagnosis between HP and other diagnoses such as brief psychosis and schizophrenia, trying to point out aspects of distinction and continuity. KEY MESSAGES The debate about this nosographic entity still remains a huge dilemma and needs further contributions.
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Affiliation(s)
| | | | | | - Alberto Siracusano
- Psychiatry and Clinical Psychology Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Cinzia Niolu
- Psychiatry and Clinical Psychology Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
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Milano BA, Moutoussis M, Convertino L. The neurobiology of functional neurological disorders characterised by impaired awareness. Front Psychiatry 2023; 14:1122865. [PMID: 37009094 PMCID: PMC10060839 DOI: 10.3389/fpsyt.2023.1122865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
We review the neurobiology of Functional Neurological Disorders (FND), i.e., neurological disorders not explained by currently identifiable histopathological processes, in order to focus on those characterised by impaired awareness (functionally impaired awareness disorders, FIAD), and especially, on the paradigmatic case of Resignation Syndrome (RS). We thus provide an improved more integrated theory of FIAD, able to guide both research priorities and the diagnostic formulation of FIAD. We systematically address the diverse spectrum of clinical presentations of FND with impaired awareness, and offer a new framework for understanding FIAD. We find that unraveling the historical development of neurobiological theory of FIAD is of paramount importance for its current understanding. Then, we integrate contemporary clinical material in order to contextualise the neurobiology of FIAD within social, cultural, and psychological perspectives. We thus review neuro-computational insights in FND in general, to arrive at a more coherent account of FIAD. FIAD may be based on maladaptive predictive coding, shaped by stress, attention, uncertainty, and, ultimately, neurally encoded beliefs and their updates. We also critically appraise arguments in support of and against such Bayesian models. Finally, we discuss implications of our theoretical account and provide pointers towards an improved clinical diagnostic formulation of FIAD. We suggest directions for future research towards a more unified theory on which future interventions and management strategies could be based, as effective treatments and clinical trial evidence remain limited.
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Affiliation(s)
- Beatrice Annunziata Milano
- Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
- Faculty of Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Michael Moutoussis
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom
- National Hospital of Neurology and Neurosurgery (UCLH), London, United Kingdom
| | - Laura Convertino
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- National Hospital of Neurology and Neurosurgery (UCLH), London, United Kingdom
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
- *Correspondence: Laura Convertino,
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Coutinho L, Caeira MW, Paola LD, Walusinski O, Cardoso FEC, Lima PMGD, Teive HAG. Les démoniaques dans l'art: Charcot and the "hysterical saints". ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:1178-1181. [PMID: 36577418 PMCID: PMC9797261 DOI: 10.1055/s-0042-1759709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Professor Jean-Martin Charcot was the founder of clinical neurology and one of the prominent researchers in the field of hysteria in the 19th century. His book Les démoniaques dans l'art is a representation of hysterical symptoms in religion and religious art. This paper aims to discuss Charcot's descriptions of hysteria in religion and his "hysterical saints".
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Affiliation(s)
- Léo Coutinho
- Universidade Federal do Paraná, Serviço de Neurologia, Unidade de Distúrbios do Movimento, Curitiba PR, Brazil.,Universidade Federal do Paraná, Programa de Pós-Graduação em Medicina Interna, Grupo de Doenças Neurológicas, Curitiba PR, Brazil.,Address for correspondence Léo Coutinho
| | - Marlon Wycliff Caeira
- Universidade Federal do Paraná, Serviço de Neurologia, Unidade de Epilepsia, Curitiba PR, Brazil.
| | - Luciano de Paola
- Universidade Federal do Paraná, Serviço de Neurologia, Unidade de Epilepsia, Curitiba PR, Brazil.
| | | | - Francisco Eduardo Costa Cardoso
- Universidade Federal de Minas Gerais, Hospital das Clínicas, Serviço de Neurologia, Departamento de Medicina Interna, Belo Horizonte MG, Brazil.
| | | | - Hélio A. Ghizoni Teive
- Universidade Federal do Paraná, Serviço de Neurologia, Unidade de Distúrbios do Movimento, Curitiba PR, Brazil.,Universidade Federal do Paraná, Programa de Pós-Graduação em Medicina Interna, Grupo de Doenças Neurológicas, Curitiba PR, Brazil.
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Coutinho L, Walusinski O, Teive HAG. Désiré Bourneville: A Socialist in Charcot's Inner Circle. Eur Neurol 2021; 85:79-84. [PMID: 34537765 DOI: 10.1159/000518846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/27/2021] [Indexed: 11/19/2022]
Abstract
Désiré Bourneville was one of Jean-Martin Charcot's most important disciples. His previous works as an alienist allowed him to influence his master's interest in hysteria, which led to the creation of a service regarded as a neurological mecca. During his time under Charcot, Bourneville, a passionate left-wing radical, had to coexist with characters representative of the conservative, bourgeois Parisian society. The aim of this study is to describe Bourneville's life and work, as well as the ambiguity of a progressive man such as him, immersed within the economic and cultural elites.
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Affiliation(s)
- Leo Coutinho
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil,
| | | | - Helio A Ghizoni Teive
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil.,Neurological Diseases Group, Graduate Program of Internal Medicine, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil
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Abstract
PURPOSE OF REVIEW This review traces amnesia's history from its earliest eighteenth century classification as a medical disorder to the present. Sophisticated depictions in the nineteenth century literature containing elaborate compilations of causal factors, including neurologic, consider pathogenesis, course, duration, durability, and temporal features. RECENT FINDINGS Severe amnesia, especially anterograde involving new learning, found archetypal expression in the twentieth century, in the case of H.M. The "pure" amnesia confirmed an independent memory disorder distinct from other cognitive disturbances, with functional dissociations illustrating nuanced manifestations and highlighting the role of some discovered structural correlates (e.g., hippocampal and associated MTL regions). Moreover, neural networks and interconnections have also notably been implicated. Although concepts of illness change across cultures and centuries, portrayal of amnesia remained consistent as it spread internationally. Amnesia's groundbreaking original nosology laid a foundation for contemporary paradigms of the multifactorial nature, specificity, and complexity of a poignantly thought-provoking disorder.
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Affiliation(s)
- Karen G Langer
- Department of Rehabilitation Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
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