History of psychiatry in Nepal

The history of psychiatry as a discipline in Nepal has been poorly studied. We have attempted to summarise historical landmarks to explore how it began and its evolution over time in relation to contemporary political events. Although Nepal has achieved several milestones, from establishing a psychiatric out-patient department with one psychiatrist in 1961 to having more than 500 psychiatric in-patient beds with 200 psychiatrists by 2020, the pace, commitment and dedication seem to be slower than necessary: the current national mental health policy dates back to 1996 and has not been updated since; there is no Mental Health Act; the number of psychiatric nurses and in-patient psychiatric beds has increased only slowly; and there is a dearth of professional supervision in rehabilitation centres. Thus, despite making significant progress, much more is required, at greater intensity and speed, and with wide collaboration and political commitment in order to improve the mental health of all Nepali citizens, including those living in rural areas and or in deprived conditions.

Yawning in the history of psychiatry

Yawning is a fascinating physiological behaviour that has been poorly addressed except in old medical books. Whereas the purpose of this behaviour is still not clearly identified, the ancient authors made it a clinical symptom, especially a psychological one. After presenting some current notions about yawning, we review publications on yawning written by physicians, from antiquity to the twentieth century, and, in particular, those dealing with psychological and psychiatric aspects.

Values-based practice: how can history taking help psychiatrists explore the values involved in clinical decision-making?

SUMMARY Values-based practice (VBP) is a framework of clinical theory and skills to facilitate a good process whereby the (often conflicting) values involved in clinical decision-making can be recognised and balanced productively. Many of these values come from the personal histories of the patient and of the clinician, and the traditions and history of psychiatry. New developments in science lead to increasing choice and increasing complexity of values. Therefore, psychiatrists will need more skills in this area, as reflected by the inclusion of VBP in the Royal College of Psychiatrists’ training curricula. This article describes some tools for understanding and navigating this value diversity in applying science to clinical practice during history taking.

Book Review: "Titans of psychiatry of the twentieth century" by P.V. Morozov, R.A. Bekker, Yu.V. Bykov

This publication is an analysis of the book by P.V. Morozov, R.A. Becker, Yu.V. Bykov, dedicated to the four most significant persons, who had an invaluable influence on psychiatry in the XX century (Emil Kraepelin, Eugen Bleuler, Sigmund Freud, Karl Jaspers). Among the advantages of the book on the history of psychiatry, one can stress out a successful extrapolation of the ideas of the “titans” to the current state of psychiatric science and a discussion of their work with the use of the actual language of current clinical psychiatry. This makes it possible to recommend the book not only to experienced psychiatrists and researchers, but also to young specialists, as well as residents and students. Another important achievement of the book is the successful disclosure of not only ideas, but also biographies of the “titans” placed in the scientific, historical, political, cultural and personal contexts.