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Thread: Qi-Gong Psychotic Reaction: DSM-IV

  1. #16
    Hi dwid,

    I did not intend my comments to be taken in a negative respect. My clinical experience is very similar to the one one you have outlined, with the exception that mine took place in a Correctional setting. To be honest with you I have somewhat of a knack for Psych nursing so I did not find it stressing in the least. Most of my stress was caused by fixing the problems caused by inept or immature staff.

    I agree with you about about the Psychiatrist, it isn't their job to spend a great deal of time with the patients. That is left to the many others in the therpeutic team. I must also admit that many or maybe even most of the Psychiatrists I have worked with were as nutty as the patients, mostly neurosis though rather than psychosis, but some psychotic controled with meds, LOL!!

  2. #17
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    Quote Originally Posted by Scott R. Brown
    Hi dwid,

    I did not intend my comments to be taken in a negative respect. My clinical experience is very similar to the one one you have outlined, with the exception that mine took place in a Correctional setting. To be honest with you I have somewhat of a knack for Psych nursing so I did not find it stressing in the least. Most of my stress was caused by fixing the problems caused by inept or immature staff.
    I didn't really take your comments negatively, I just wanted to add my perspective to the mix. I've actually given thought to going to work in the Correctional system myself once I finish school. The pay is very good for NPs, and I think you probably see a broader spectrum of diagnoses than you do almost anywhere else. In the private sector, most psychiatric professionals compartmentalize and just treat a particular level of acuity, type of patient, etc..., but in Corrections you have acutely ill people and also people suffering from a mental illness that is subacute and requires treatment.

    Quote Originally Posted by Scott R. Brown
    I agree with you about about the Psychiatrist, it isn't their job to spend a great deal of time with the patients. That is left to the many others in the therpeutic team. I must also admit that many or maybe even most of the Psychiatrists I have worked with were as nutty as the patients, mostly neurosis though rather than psychosis, but some psychotic controled with meds, LOL!!
    LOL, I think it helps to be a little nutty in this field. And it takes a particular type of person to be suited to the environment. As far as the shrink with more severe mental illness, I think that's what gets some people into psychiatric work in the first place, just trying to figure themselves out
    The cinnabun palm is deadly, especially when combined with the tomato kick. - TenTigers

  3. #18
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    Ok ... i found it ... this is what DSM-IV says:

    “Qi-Gong Psychotic Reaction: DSM-IV General Information: Appendix I, Outline for Cultural Formulation and Glossary of Culture-Bound Syndromes:
    qi-gong psychotic reaction A term describing an acute, time-limited episode characterized by dissociative, paranoid, or other psychotic or nonpsychotic symptoms that may occur after participation in the Chinese folk health-enhancing practice of qi-gong ("exercise of vital energy"). Especially vulnerable are individuals who become overly involved in the practice. This diagnosis is included in the Chinese Classification of Mental Disorders, Second Edition (CCMD-2).”

    There is a new edition of CCMD-2 (CCMD-3) and say this:

    “42.1 Mental disorders due to Qigong [F43.8]
    In the tradition of our country, Qigong is a way to keep healthy and cure the sickness. The method is usually to keep special posture or practice some exercises, and keep concentration on some points, pondering and reading silently, relaxation and regulating respiration.
    Mental disorder due to Qigong refers to the phenomena that an exerciser is kept in a state of Qigong for so long as not to stop because of improper operation of Qigong (e.g., excessive exercise), the manifestations include symptoms of thought, emotion, and behavior, loss of ability of self-control.
    A. Symptom criteria:
    (1) Directly caused by Qigong exercise;
    (2) The symptoms are closely related to the content of Qigong books and periodicals, and exercise of Qigong. The patients show abnormally mental symptoms repeatedly and continuously, without self-control;
    (3) With at least 1 of the following:
    psychotic symptoms, e.g. auditory hallucination, delusion;
    hysteria-like syndrome;
    neurosis-like syndrome.
    B. Severity criteria:
    Impairment of social function;
    C. Course criteria:
    The course is transient, patients may recover immediately by being out of spot, stopping exercise and proper treatment.
    D. Exclusion:
    (1) Excluding similar manifestations regarded as tricks to cure the sickness for oneself or others, or tricks to obtain money or attain other goals, excluding similar manifestations that can be involuntarily self-induced or self-ended;
    (2) Excluding any kind of other disorders, especially hysteria or stress disorder due to psychological trauma.”

    I got the answer for my question, the symptoms for Qi-Gong Psychotic Reaction by western psychology in DSM and CCMD are:
    . Directly caused by Qigong exercise
    . an acute, time-limited episode characterized by dissociative, paranoid, or other psychotic or nonpsychotic symptoms
    . symptoms of thought, emotion, and behavior, loss of ability of self-control
    . abnormally mental symptoms repeatedly and continuously, without self-control
    . psychotic symptoms, e.g. auditory hallucination, delusion
    . hysteria-like syndrome
    . neurosis-like syndrome
    . Impairment of social function
    . Excluding any kind of other disorders, especially hysteria or stress disorder due to psychological trauma

    I think it will be better to start a new topic if you want to continue changing information about psychology so more people in the the forum will be able to share also they experiences

    Thank you for helping me ... cjurakpt, GLW, mawali and Scott

    Enjoy,
    Jorge

  4. #19
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    Thanks to Scott for posting that listing of the DSM description.

    It was something I had read earlier and my take was "Typical DSM IV - falls into the category of that's nice, but so what"

    The description doesn't tell you much and can be used to even describe a person who might describe seeing lights as brighter or haloed...or seeing auras after practicing Qi Gong. That does not mean that it WOULD be used that way.

    However, I HAVE seen such vague diagnosis areas used to keep people committed under a psychiatric warrant based upon ulterior motives in the family (like the rich male patient who didn't get along with his wife, left and spent all of his time living on his docked sailboat, drinking beer and fishing....and she would have him committed about once a year to try to get a power of attorney over his assets. He MAY have had a drinking problem but he was sharp as a tack and was still making money....and the only person he ever had an issue with was his wife.)

    Wouldn't it be just fine if such a diagnosis was also used by a husband to get his wife committed so then he could divorce her and keep custody of the kids? In such an instance, if the wife got upset and argumentative about being incarcerated, the nursing staff would log it as inappropriate behavior. If the wife were to take things in stride and then continue practicing Qi Gong, the doctors and nursing staff would probably mark that as "strange behavior" and still, it would be used to keep her hospitalized.

    Not that far fetched.

    For Qi Gong side effects, I would say it would be more valid to examine the things that are listed in TCM and totally ignore the DSM IV.
    Last edited by GLW; 06-23-2006 at 08:02 AM.

  5. #20
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    The point is really moot from the perspective of practice here in the U.S. No psychiatrist would ever use that diagnosis for inpatient documentation. At least from my perspective, most psychiatrists rely on the DSM as little as possible. Someone with psychotic symptoms and no history of schizophrenia or other psychotic illness would simply by written up as Psychosis NOS and that would be their diagnosis until a more useful or valid diagnosis could be obtained.

    As far as the other stuff re: commitment with ulterior motives. That's some wild stuff. I'm sure it happens, just like wives falsely accuse husbands of domestic violence to gain leverage, etc... A good staff would figure out the game pretty quick though. We don't just watch people and take copious notes on their behavior. We talk to the patients and try to understand what's going on from their perspective. In acute care, you can separate the people who belong on the unit from those who don't pretty easily in most cases just by spending some time with a person.
    The cinnabun palm is deadly, especially when combined with the tomato kick. - TenTigers

  6. #21
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    dale duro

    Jorge,

    The Western medical professional will probably see this as foolish (qigong psychotic reaction) and at best, that the individual is a nutcase. It will be a useless designation and the indiviudal will probably committed or undergo counselling!

  7. #22
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    i know that mawali ... i just wanted to know how western psychology classifies a Qigong Deviation ... just as simple as that ... i dont want to use it ... i dont care if its foolish or not ... i dont care if itīs useless ... but now i know what it means if someone come to me with a "Qigong Psychotic Reaction" from is psychiatrist ...

    Enjoy,
    Jorge

  8. #23
    In America or at least California it is for the most part illegal to lock someone up in a hospital against their will. They must be documented to be a clear danger to themselves or others. It is not illegal to be nuts!!

  9. #24
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    It is typical that the proof required for a mental health warrant for committment is "dangerous to themselves or others"

    However, that is pretty broad and open to interpretation. I have seen the dangerous part applied - in rality the danger was to the bank book or stocks...or that the family member was going to be cut off due to the 'crazy' one...and I have also seen those that were truly dangerous or suicidal NOT be committed because of having a lawyer or just flat out no one would start the process.

    It is a horribly flawed system.

    But, the benefit of the doubt lies with the psychiatrist and such when the hearing comes off. The judge issues a committment warrant, the person is put in the hospital for observation, there is then a committment hearing and the person is either released or committed for a period of time (usually 90 days in Texas..and then a re-examination takes place at those intervals).

    But once in the hospital - such things as anger, despondency over being in there, bewilderment over bieng there, feelings of betrayal for their family member that had them committed - are all taken as proof of needing to be there. While this may be true, In 5 years in the field...before I left it, I only saw TWO Patients come in on warrants and leave directly from their hearing. One was due to insurance and no bed space at the county ward - strange how he was deemed not so dangerous when they had no space in county and no way to pay for him otherwise. The other had a good lawyer and his wife had done this thing repeatedly. He was most pleasant and simply refused to talk with the staff about much of anything...on his lawyer's advice.

    I saw several asian patients come in for depression...and NONE of them had therapists that knew jack about their culture or how important their family would be in treatment.

  10. #25
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    a link to Qigong deviation

    One point of view

    pincha aqui:
    http://www.hkjpsych.com/Culture_bound.pdf#search='qigong%25pdf'

  11. #26
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    Quote Originally Posted by dwid
    At least from my perspective, most psychiatrists rely on the DSM as little as possible. Someone with psychotic symptoms and no history of schizophrenia or other psychotic illness would simply by written up as Psychosis NOS and that would be their diagnosis until a more useful or valid diagnosis could be obtained.
    I've been told, at least informally, that it's because of the difficulty to distinguish between actual illness and pre-established personality disorders. What's your perspective on that?
    Quote Originally Posted by Oso View Post
    AND, yea, a good bit of it is about whether you can fight with what you know...kinda all of it is about that.

  12. #27
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    Quote Originally Posted by mawali
    One point of view

    pincha aqui:
    http://www.hkjpsych.com/Culture_bound.pdf#search='qigong%25pdf'
    thank you mawali ... its a good link

    Enjoy,
    Jorge

  13. #28
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    Quote Originally Posted by Judge Pen
    I've been told, at least informally, that it's because of the difficulty to distinguish between actual illness and pre-established personality disorders. What's your perspective on that?

    Well, in the strictest sense, "personality disorders" are an axis 2 diagnosis in the DSM, while disorders such as Depression and Schizophrenia fall on Axis 1. But if I understand your question correctly, you mean the difference between what a person has become through his or her environment, upbringing, choices, etc... vs. what he or she is predisposed to biologically. In the current mental health system, it is particularly difficult with adult patients to differentiate what nature gave them and what lifestyle has given (or exacerbated) due to the extremely high comorbidity of mental illness and substance abuse. It turns into a kind of chicken and egg thing, though for the purpose of acute inpatient treatment, it's a largely academic point. Treatment is the same regardless of causal factors. Ultimately, you want to refer them for further substance abuse treatment following discharge, and it will effect some of the supplemental meds you give (you don't want to throw a lot of ativan at a junkie). However, the diathesis stress model has been widely accepted for a long time, and it suggests that biology combines with life stresses to create active mental illness in many cases. Stresses can be a bad childhood, substance abuse, homelessness, any number of things.

    Anyway, I think a big part of the reason why people tend to utilize the DSM in a limited fashion is because its greatest diagnostic clarity is in regards to the more commonly seen illnesses, such as Bipolar, Major Depression, Schizophrenia, and the Anxiety Disorders. A lot of the other stuff, the stuff you see greater changes in from one iteration of the DSM to the next, is maybe more to get you thinking of possibilities when you have a wtf kind of case. But this is largely conjecture on my part, just my thoughts based on my observation and experience.
    The cinnabun palm is deadly, especially when combined with the tomato kick. - TenTigers

  14. #29
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    abuse

    Another link
    Abuse of government authority in political way to intimate opponents.
    Psychiatric abuse:

    haga click:
    http://www.jaapl.org/cgi/reprint/30/1/126.pdf

  15. #30
    Quote Originally Posted by dwid
    ...acute inpatient care isn't really the time to begin therapy anyways. The only reason for a patient to be in inpatient psychiatric care is that they are in some kind of crisis, so on some level they are a threat to themselves or someone else. Once they're stable enough to leave, then they are in a good position to benefit from therapy, and if someone wants therapy, regardless of their ability to pay for it, their social worker can probably find something that is available to them. The fact is, many if not most patients would rather just take a pill...
    On the other hand, medication compliance, particularly with psychotic populations, can be extremely low. And this idea that it is the patient's responsability to put forth the effort to attend and benefit from therapy is part of a particular culture of therapy rather than a necessary principle of therapy in general. It's possible to do extremely beneficial therapeutic work with inpatients, it just takes a different mindset than therapists are typically trained to have.

    In my experience, it is not the psychiatrist's role to treat with therapy.
    Right, but the problem is that it isn't clearly anyone's role any more. Which is probably why active therapeutic approaches, such as that mentioned above, are so rare. Even clinical psychologists are largely abandoning psychotherapeutic roles for strictly psychodiagnostic ones. Good therapists typically have training as therapists alongside whatever profession they have, but this is preventing the development of 'therapist' as a professional identity, along with the benefits that this would bring.

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