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Objectives: Launched in 1989, the Scottish Motor Neuron Disease Register (SMNDR) has provided a resource for prospective clinical data collection. However, in 2015 we aimed to evolve a system to allow: i) A patient-centered approach to care based on recognized standards, ii) Harmonized data sharing between Scottish health professionals in "real-time", iii) Regular audit of care to facilitate timely improvements in service delivery, and iv) Patient participation in a diverse range of observational and interventional research studies including clinical trials. Methods: We developed a standardized national electronic data platform-Clinical Audit Research and Evaluation of MND (CARE-MND) which integrates clinical audit and research data fields. Data completion pre- and post-CARE-MND were compared, guided by recently published National Institute for Clinical Excellence (NICE) recommendations. Statistical difference in data capture between time periods was assessed using Z-test of proportions. Results: Data field completion for the historical 2011-2014 period ranged from 4 to 95%; median 50%. CARE-MND capture ranged from 32 to 98%; median 87%. 15/17 fields were significantly more complete post-CARE-MND (p < 0.001). All MND nurse/allied health specialists in Scotland use the CARE-MND platform. Management of MND in Scotland is now coordinated through a standardized template. Conclusions: Through CARE-MND, national audits of MND care and interventions have been possible, leading to protocols for harmonized service provision. Stratification of the MND population is facilitating participation in observational and interventional studies. CARE-MND can act as a template for other neurological disorders.

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This article presents background to, and the text of an organizational meeting of, a historic Chestnut Lodge seminar organized by Frieda Fromm-Reichmann and including herself and Marvin Adland, Donald Burnham, Harold Searles, and Alberta Szalita. It forms the foundation for Szalita's interest in empathy, which then was the organizing concept of her paper given as the 18th Frieda Fromm-Reichmann Memorial Lecture. The transcript gives us an opportunity to observe these great contributors to our understanding of the psychodynamics of schizophrenia as they exchange ideas and reactions regarding the transcript of recorded sessions.

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This paper reviews the history of psychodynamic treatment of psychosis in the United States, emphasizing the current severe problems in this area, and exploring their causes. It recommends that we bring back the older interpersonal, humanistic approaches, recognizing that reliance on salience-muting medications is both short-sighted and dangerous.

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El artículo planea los cambios progresivos que se están produciendo en la atención a la salud mental, sobre todo a partir de la creciente medicalización de los trastornos psiquiátricos. En este sentido recoge diferentes aportaciones sobre la enorme presión que ejerce la industria farmacéutica y sus consecuencias directas en la práctica clínica, que llevan a una sobreutilización de los psicofármacos para el tratamiento de los pacientes psicóticos o en riesgo de desarrollar una psicosis (AU)

This paper reviews the progressive changes that are taking place in mental health care, stemming from the increased medicalization of psychiatric disorders. It gathers different contributions referring to the enormous pressure exerted by the pharmaceutical industry and the direct consequences it has on clinical practice, leading to an overuse of drugs for the treatment of psychotic and at-risk of psychosis patients (AU)

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Dynamic psychotherapy of psychosis works through gradually diminishing terror, replacing this with a clearer and shared understanding of the patient's life history, its traumas and its strengths. It is diametrically opposed to our current push for efficiency and an assumption of an underlying brain disorder that responds to our current medications. Over the course of a long treatment, this patient became a scholar of psychoanalytic contributions to understanding psychosis and is now a philosopher of this field, developing an understanding of anorexia psychosis. She draws on the writings of Freud, Bion, Lacan, and Julian Jaynes, placing the core of psychosis not in primary process but in a preceding, non-self phase of development. She relates this individual development to the history of human development.

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This article reviews the author's teaching experiences regarding the treatment of patients with severe emotional disorders, provides guidelines for such work, and offers specific recommendations regarding reading assignments. It closes with a recommendation for a return of Balint groups, particularly welcoming newly trained psychiatrists and psychiatrists specializing in medication management.

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The contributions of Silvano Arieti to the psychodynamic treatment of schizophrenia were pivotal at the time he wrote and lectured, but regretfully, they have slipped from current attention. They bear reviewing given the current era of biological reductionism in the treatment of psychoses in general. To illustrate Arieti's approach, he is imagined as the supervisor of a patient who was treated by the author during her psychiatric residency. Other clinical examples highlight the relevance of Arieti's philosophy for current work with patients suffering from psychotic disorders.

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This article advocates for training in interpersonal insight-enhancing psychotherapy of schizophrenia, and recommends against chronic reliance on medications. It presents efforts in progress which debate the message of pharmaceutical initiatives.

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This article summarizes events surrounding the closing of Chestnut Lodge, as a backdrop to the author's reactions on reading Frieda Fromm-Reichmann's biography. This anecdotal piece forms a complementary essay with the 2000 Frieda Fromm-Reichmann Lecture, "The Current Relevance of Fromm-Reichmann's Works." It illustrates aspects of treatment of schizophrenia and of the individuals involved in such work.

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