psychiatry

Morsi cracks down on psychiatrists

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Last week, Dr. Manal Omar was summoned along with TV host Mahmoud Saad by the prosecution and questioned for seven hours over one of their TV episodes on Nahar TV. She is accused of insulting the president. A lawyer from the presidency filed the case on Morsi's behalf. In this video she made indirect references to Morsi, the Muslim Brotherhood and their number two, Khairat el-Shater.

Dr. Omar is a psychiatrist specialised in child and adolescent psychiatry. She started to appear on TV following the Mohamed Mahmoud clashes last year to inform the public about trauma, psychology and psychiatry in general. During my early training in psychiatry I used to attend her clinic. As trainees we used to consider ourselves lucky when we had time during our rotations to do so.

She was explaining why some victims of trauma may play the role of the victimizer. This is a very important and valid topic in psychology. As many violent criminals were originally abused during childhood, victims may feel the compulsion to harm themselves or others. This can be due to a number of psychological, social or biological explanations. For instance the traumatised individual may feel the compulsion to harm others as a way to have control over their lives, even for a brief period of time. This happens without total insight and may or may not be followed by guilt.

She was refuting the common misconception that victims will not perpetrate what they have experienced because they have seen how bad it is. This is again a very valid point and she meant to address the Muslim Brotherhood.

On Admitting Michael Nabil to a Mental Hospital

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I have to highlight how important it is that Michael Nabil is not a suspect in a violent crime. The military courts are trying him over a blog post that criticises the army, not killing or stabbing anyone.

Michael has passed the 50 days mark in his hunger strike.
Abassia hospital
He was referred to a mental hospital for observation for 45 days when his court appointed lawyers defended him saying that he is suffering from mental problems.

This is outrageous because:

  1. It politicises psychiatry,
  2. He isn't a suspect in a violent crime,
  3. Are we heading towards a society where someone who disagrees with the ruling class is stripped of his freedom and his mental/psychiatric conditions 'checked'?
  4. The hospital may get itself involved in involuntarily breaking his hunger strike.

The Abbaseya mental Hospital should have refused taking Michael Nabil in.

Without delving into the conditions of his stay inside the criminal suspects wards. This is abuse by the military court, which the Hospital has just become a partner in.

Today the media department of the General Secretariat of Mental Health released the following statement. Here is a snippet.

Gadafi's mental state

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Gadafi in a tuktuk holding an umbrella

Former head of the World Psychiatric Association professor Ahmed Okasha said today on OTV live that he doesn't have an exact diagnosis for Gadafi as he never examined him but says he should be treated involuntarily for being dangerous on others.

Said his last speeches showed thought disturbance, delusions of persecution 'the uprising being a plot by Osama Bin Laden' and other delusions like people of Libya are rats and all of them receive hallucinogens.

Zaha Hadid's Cairo Expo City will destroy Egypt's largest and most important Mental Health Hospital

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UPDATE Wed. Dec 29, 2010:The Supreme Council for Antiquities announced today that building housing the Abbaseyya Psychiatric Hospital will be listed as an Islamic heritage site.

UPDATE Mon. Apr 18, 2010:
The designs changed on Zaha's website to include the hospital. Thanks to Luiz for the tip.

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Award winning Iraqi architect Zaha Hadid will help the Egyptian government destroy Egypt's largest mental health hospital, the Abassia hospital situated in the middle of Cairo, to build something called Cairo Expo City.


Cairo Expo City

Opened in 1883, after a fire consumed a number of royal palaces except for one that was painted yellow and named the Yellow Palace (el-Saray el-Safra) it became Egypt's first modern hospital for the mentally ill.

Now it's in an area of 28 hectares and has around 3000 beds, offers almost all major psychiatric sub-specialities and an outpatient and emergency psychiatry services. The hospital serves around 60,000 patients each year.

Old street sign written on it 'the hospital of the deranged street'

History of PTSD in Google Books database

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Train accident in 1875 Sweden

In the 19th century, with the development of railway transportation, train accidents became a frequent source of death and serious injury.

Some of the victims claimed injury following an accident without a visible pathology. Jon Eric Erichsen, a British surgeon, in 1867 published a book called On Railway and Other Injuries of the Nervous System in it he argued that an unseen physical injury to the spine and brain caused the condition `railway spine.'

Railway spine was a concept that rooted the illness to the body and not the mind thus making it more legitimate and avoided stigma of mental illness.

Later, work by Jean-Martin Charcot, Piere Janet and Freud established the idea that overwhelming events can cause mental disorders.

Before WWI the terms “soldiers’heart,” “war neuroses” and “general nervous shock” were used to refer to the psychological casualties of combat. During WWI the term “shell shock” became widely accepted as it avoided the term hysteria. During World War II the U.S. military used the term “operational fatigue” or more often “combat fatigue.”

The neurons that shaped civilization

Madness constitutes only 15% of all psychiatric diagnoses

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Severe mental disorders constitute only 15% of all the psychiatric diagnoses in the ICD-10

The hypothetical column on the left is meant to show that as a result of the stigma of mental illness, most people think that mental illnesses are always severe.

Delirium is a totally reversible state, people with dementia need long term care and can never be more harmless. Lots of people recover from psychosis totally and some retain symptoms.

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