bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structured clinical decision making: Is it different ?
Authors: Travers R. , Kumar A. 
Published: May 2011

IntroductionThe Psychiatrists are called to assess the level of risk in violent and sex offenders’ population. There are differing perceptions about formalising the severity and management of risk. The proponents of actuarial decision making propose that it is scientific and evidence based approach. The advocates of professional judgment however think that actuarial tools usually miss out on the interplay of compounding factors and can under or over estimate the level of risk.ObjectivesTo review consecutive patient assessments and qualitatively compare it with HCR-20 and RSVP tools for violent and sex offending patients.AimsTo report the difference in outcome in the domains of overall severity of risk, risk formulation and clinical decision making for management of the risk in these patient groups.MethodsWe aim to compare twenty consecutive patients where professional judgment of the clinician determined the severity of the risk, risk formulation and management. We then aim to use the information available to check for any differences in these areas when HCR-20 and RSVP are employed.ResultsThe comparison and benefits of professional judgment and actuarial decision making are reported.ConclusionsThe professionals (providers) are being increasingly compelled by commissioners(purchasers) to evidence base their clinical decision making. The professional judgments are more likely to be challenged in the courts. People are easily impressed by decisions which are evidence based though they may have limited understanding of research environment and population studied.
Marital therapy for the divorce-seeking couples in the legal systems, South Korea: Family systemic, mental health-related, and socio-economic analyses
Authors: Lee S.B. 
Published: May 2011

AimThis study was to analyze the sample data collected from divorce marital therapy sessions in the local court system in South Korea as well as diagnose typical symptoms in the divorcing couples.MethodsThe survey forms and marital therapy notes were collected from 200 divorce counseling cases in the local court systems, South Korea. The 200 divorce counseling cases were categorized as twelve major themes. Family therapy notes were utilized as an aid in verifying the divorcing couples’ self-reports. The research method was partially adopted from the article, “Working with Korean-American Families: Multicultural Hermeneutics” (Sang Bok Lee, 2003: The American Journal of Family Therapy, 31, 159 – 178). Multicultural hermeneutics was instrumental for explicating multiple layers of multicultural narratives, psychological dynamics, socio-economic systems, and of family systemic relations when dealing with the divorcing couples.ResultsThe results were summarized as: economic issues (20%); extra-marital relationship (16%); in-law conflict (12%); substance abuse, addiction & marital violence (12%); international marriage & cross-cultural differences (10%); personality difference (8%); re-marriage issues (6%); sexual conflict (6%); age gap (4%); personality disorder & mental disorder (2%); parenting & children issues (2%); pre-mature marriage (2%). The twelve categories were grouped as mainly(1)family systemic or relationship-related issues,(2)socio-economic issues, and(3)mental health-related issues.ConclusionPsychiatrists, family therapists, and mental health professionals who work with the divorcing couples need to be aware of the predominant causes for rapidly increasing divorce rates when conducting therapeutic assessment and implementing intervention for the divorcing couples.
Compulsory internment and treatment in mental health patients - legal implications in portugal
Authors: Pinto da Costa M. , Carneiro de Sousa M.J. , Pinto da Costa J. 
Published: May 2011

IntroductionThe possibility of detention for treatment of mental patients may be controversial since introduces the possibility of the judicial power to dominate one's private life.ObjectivesIt is made an analysis of the legal problems in compulsory internment and treatment in mental patients in Portugal.Material and MethodsThe diplomas mainly analysed were the Portuguese mental health law, Constitution and Penal Code. The study was based in four legal principles: necessity, proportionality, subsidiary and adequacy whenever a compulsory detention for mental treatment is imposed and the requisites for that decision.ResultsCompulsory internment may only be determined when it is the only way to guarantee that patient is submitted to treatment, and when is deemed proportional to the danger of the legally protected value in question. Restrictions on patient’s fundamental rights shall be those strictly necessary and suitable to the effectiveness of treatment. Compulsory internment may be petitioned by the Public Attorney, patient's legal representative, public health authorities or any person.ConclusionIn spite of the diversity of criteria for compulsory mental health care across several countries, Portuguese mental health law emphasizes the need for treatment as an essential condition for detaining patients with mental illness. The compulsory treatment is based on the judge decision supported in the psychiatric report. However, how can we be certain that a mental patient is going to practice a specific crime? Is it fair to punish without crime? Are there scientific criteria capable of ensuring that mental patients cause always violent behavior?
International evidence of who kill children? child protection-psychiatric interface
Authors: Pritchard C. , Williams R. , Davey J. 
Published: May 2011

This study will be controversial as it highlights the continuing link of violent deaths of children and psychiatric disorder and the forgotten/ hidden psychiatric-criminological child protection interface.We challenge the Child Protection assumption that there is a continuum of neglect into abuse that, at the extremes, leads to the death of a child. The avoidance of such tragedies has become the benchmark of the effectiveness of child protection, reflected in the high profile situations in every Western country.This has led to a practice culture of fearing the ‘worst case scenario’ with inevitable defensive bureaucratisation, hence the importance of answering the question’who kill children’?Based upon an analysis of the latest WHO mortality statistics in the 20 Western Countries, we juxtapose All forms of children’s (0–14) mortality against indices of relative poverty i.e. Income Inequalities, and answer the core question from a decade cohort of people who actually killed children,We show that whilst child neglect is related to poverty, statistically poverty is Not related to child-abuse-related-deaths (CARD).It will be shown that men with previous convictions for violence pose physical risk to children, followed by psychotic parents. Consequently, assailants’ problems are essentially ‘psychological/ criminological’, rather than socio-economic though poverty always compounds vulnerable situations.A more accurate risk assessment would enable psychiatric and child protection practitioners to differentiate the neglect and poverty interface from CARD, enabling each discipline to offer an optimal practice intervention earlier and more effectively.
Behavioral neurobiology in forensic psychiatry: Problems and prospects
Authors: Rocca G. , Bandini T. 
Published: May 2011

IntroductionIn recent decades, considerable progress has been made in the study of the biomolecular bases of violent behavior, so much so as to rekindle a heated debate on the notions of “free will” and “criminal responsibility”.AimsTo analyze the results of neurobiological research on violent behavior and to investigate the possible repercussions of their application in the field of forensic psychiatry.MethodsStarting from the analysis of a recent judgment by an Italian Court of Appeal, which reduced the sentence of a convicted murderer on the basis of he was a carrier of some alleles thought to be risk factors for the development of violent behavior, we reviewed the scientific literature on this issue.ResultsA growing number of studies have investigated the relationship between genetic polymorphisms and violent behavior. In particular, recent studies have indicated that the principal role is not played by mutations of single genes, but by modifications of several genes and their expression (epigenetics).ConclusionsWhile the presence of some specific polymorphisms may be associated to a higher risk of enacting violent behaviors, the phenotypic expression of this “vulnerability” should more properly be interpreted in terms of interference between the genome and the environment. From a forensic psychiatric standpoint, however, it must be remembered that the necessary condition whereby a mental disorder can take on the meaning of “insanity” is that it has caused, in the specific case, such “psychopathological functioning” of the acting subject as to compromise his capacity for cognition and/or volition.
Involuntary admission in psychiatric inpatient ward is related to antipsychotic polytherapy
Authors: Ruiz J. , Iniesta E. , Portela M. , Nieto K. , Romero P. , Tolosa M.T. , Moreno I. , Domato M. , Fraguas D. 
Published: May 2011

IntroductionInvoluntary admission of mentally ill patients tends to be related to clinical severity and worst therapeutic response.ObjectivesTo evaluate whether there is a relationship between involuntary admission and prescription of two or more antipsychotics (that is, polytherapy) among patients with schizophrenia and other psychosis.MethodsA total of 241 patients (40.2% females, mean age 39.7+/−13.0 years) consecutively admitted during 2009 to a psychiatric inpatient ward with diagnosis of schizophrenia and other psychoses were assessed.ResultsOut of the total sample, 150 (62.2%) patients were on polytherapy, and of the 241 patients 134 (55.6%) were involuntarily admitted. Involuntary admission was unrelated to age (p = 0.335), specific diagnosis (p = 0.452), or length of psychosis (p = 0.234). On the contrary, it was related to gender (61.8% of males vs. 46.4% of females were involuntary, p = 0.018) and to polytherapy/monotherapy prescription (62.0% of patients on polytherapy vs. 45.1% of patients on monotherapy were involuntarily admitted; and 53.3% of voluntary patients vs. 69.4% of involuntary were on polytherapy p = 0.010). After controlling for age, gender, specific diagnosis and length of psychosis the association between involuntary admission and being in polytherapy remained significant (p = 0.047).ConclusionsPatients involuntarily admitted are more prone to be on antipsychotic polytherapy.
Training of affect recognition (TAR) and its neurophysiological correlates in schizophrenia
Authors: Stroth S. , Frommann N. , Lüneborg F. , Kampka N. , Brinkmeyer J. , Luckhaus C. , Wölwer W. 
Published: May 2011

BackgroundSchizophrenia patients exhibit impairments in facial affect recognition associated with neurophysiological abnormalities. Using the Training of Affect Recognition (TAR) developed by our group behavioural performance in facial affect recognition improved significantly in schizophrenia patients [1]. Purpose of the presented work was to identify the underlying mechanisms and associated generators of neuroelectric activity.MethodsIn a randomized controlled (waiting group) design 19 schizophrenia patients received TAR. Concomitant to facial affect recognition performance, ERPs were recorded and analyzed with respect to underlying generators of cortical activity using low resolution brain electromagnetic tomography (LORETA) software.ResultsSchizophrenia patients showed noticeable deviations in neuroelectric correlates of emotion recognition associated with poorer performance in the administered task. As a result of TAR treatment no significant changes in event related potentials were found. However, LORETA results showed a significant increase of activity within relevant brain areas, specific for the processing stages associated with facial emotion recognition (N170 and P240).ConclusionsEEG findings of the present study indicate that neurophysiologic abnormalities corresponding with poorer performance in schizophrenia patients can be attenuated by training.
Drug-induced psychiatric disoders in prisoners
Authors: Tort V. , Vicens E. , Dueñas R. , Muro A. ,   Grupo Preca
Published: May 2011

IntroductionThe prevalence of psychiatric disorders in prison populations showed in other European countries has not been replicated in Spain.ObjectivesThe aim of the study was to estimate the lifetime and last month prevalence of mental disorders in a Spanish prison population sample. In this posetr we look a drug induced psychiatryc disorders found in this study.MethodThis is a descriptive cross-sectional epidemiological study. 783 male inmates were included in the study. Mental disorders were assessed with Structured Clinical Interview (SCID 1) for DSM-IV Axis 1 Disorders, clinical version and personality disorders were assessed by the Spanish version of the International Personality Disorders Examination.ResultsThe lifetime prevalence of mental disorder was 84.4%. Substance use disorder (abuse and dependence) was the most frequent disorder (76,2%): When look at substance induced diosder we found Mood induced disoder had lifetime prevalence of 15,8%(,13,2–18,5) and a last month prevalence of 2,8% (1,6–4,1), anxiety disoders were 16,1% (13,4–18,8) in lifetime prevalence and 5,9 (4,2–7,7) for last month prevalence and for subtance induce psychotic disoder lifetime prevalence was 7,1%(5,2–9,0) and last month prevalence was 2.0 (1.0–3.0). There is a 95 interval confidence on all these data.ConclusionsThe high prevalence of mental disorder and substance misuse is relevant both for the planning of health resource use in the prison environment and the prevention and approach to these disorders.
Lack of quality assurance in forensic psychiatry: false positive prevalence of antisocial personality disorder among norwegian inmates on preventive detention
Authors: Vaeroy H. 
Published: May 2011

IntroductionA Norwegian government publication (1) claims a prevalence of around 50% of Antisocial Personality Disorder (APD) in a small group of male detainees on preventive detention. The present study population is recruited from more or less the same population as those among whom a 50% prevalence of APD has been claimed (1). Norwegian forensic investigators rarely (17%) apply psychometric tools to confirm their clinical diagnosis (2).AimsTo confirm the diagnosis of APD applying SCID axis II. Methods: Fifty six inmates were available at the prison. Twenty eight were willing to participate (50%). Two were excluded. Thus, 26 (46%) inmates participated. DSM IV, SCID axis II was applied.ResultsNone of the 26/56 matched the APD criteria, mainly failing to fulfil the diagnosis of Conduct Disorder (CD) before the age of 15 years. All the inmates had a history of antisocial behaviour.ConclusionsTo explain the claim of around 50% APD in view of the present results, close to 100% APD should be found among the remaning thirty non-participating inmates. We consider this unlikely.A diagnosis of APD based on the history of antisocial behaviour alone represents a pitfall. Lack of quality assurance could lead to false positive diagnosis. The need for a standardized approach and quality assurance in Norwegian forensic psychiatric evaluations seems nevessary to avoid false positive diagnosis.
Assessing risk of violence: are only forensic patients aggressive?
Authors: Vladejic S.S. , Vladejic S.D. , Popovic I.N. 
Published: May 2011

Society has cherished its fear of psychiatrically ill over the ages. This fear is even more present if concerning mentally ill persons which have already shown socially unacceptable behaviour, or committed serious criminal act before, i.e. murder or rape. This kind of criminal acts, regardless of it's every - day presence in all social groups, gets all the media attention. It is a fact that there are no valid data regarding the rate of criminal activity among psychiatric patients and the percentage of that activity compared with «normal» population, nor can we find the information about the rate of recidivism in these two social groups. But, it is also a fact that criminality of mentally ill stays stabile trough the years, as well as that some diagnostic categories are more vulnerable for demonstrating violent behavior.The purpose of this study was to compare aggressiveness between two groups of patients: patients conducting security measures and control group - patients hospitalized because of exacerbation of psychosis. The study included 40 patients on security measures and 40 patients from control group, diagnosed according to ICD 10 diagnostic criteria. Risk of violence was assessed using instruments of clinical assessment: OAS, PCL:SV and HCR - 20 Scale, at the admission of patients. The results of statistical analysis are that there is no statistically significant difference between two groups regarding the violent behavior and risk for violence in the future. Two diagnostic categories are prominent in showing aggressive behavior: paranoid psychosis and paranoid schizophrenia.
Short intensive individual psychotherapy (SIIP) of the forensic patients at the acute forensic ward, within the first few days/weeks of the stay
Authors: Vukasovic-Radulovic S. 
Published: May 2011

Some forensic patients during their staying at the forensic acute ward about observation and exloration due to the forensic expertise, need and ask for therapy encounter and talk. The forensic patients,after the coming to the ward, live the general condition of various experiences: tension, anxiety, the reaction of aggression and/or wiithdrawal, shoting in the unknown, potentially dangerious surrounding, need to adaptation, adoption, some sort of activity and communication; also, the tragic experience of the commitment makes the varied psychosomathic/social/existential facts: the time - nearness of the commitment, nonacceptance and/or rejection of doing it, confusion, dillema, intensive and/or conflicting feelings of guilty, sorrow; trauma.Criteria for the SIIP:-the need and asking of the patient; the complete psychiatric/psychological observation and explorartion, some work in the social group;-the forms of addiction (alcohol, drugs), family violence, abigious and/proved homicides:-the structural neurosis, character disorders, psychotic reaction, addiction disorders, are the entities suitable for work;SIIP could be planned and realized within a week to a few weeks of sessions, a session or a few per week.The goals of therapy work are traced and evaluated in the changes of behaviour and inner experience of patient, also the protocol of therapy and “homework” of the patient are registered;The efficiency and quality of SIIP have been proved in the goals of tension reduction, better adaptation, selfacceptance, mood, communication and activities, the first period of SIIP work at the forensic ward of Psychiatric clinic in Sokolac, Bosnia and Herzegovina.
Personal, social, and clinical description of mentally ill persons who have committed dangerous assaultive acts, and preventive measures
Authors: Yeshimbetova S. 
Published: May 2011

IntroductionThe article is devoted to the analysis of aggressive criminal behaviour in mentally ill persons.ObjectivesTo develop effective measures to prevent committing dangerous assaultive acts in mentally ill persons.AimsTo study personal, social and clinical characteristics of the disease in mentally ill persons who have committed dangerous assaultive acts.MethodsWe examined 25 mentally ill persons that had committed dangerous assaultive acts and have been found insane as regards their offence. The research involved clinical psychopathological study and follow-up.ResultsIn 19 cases (76%), schizophrenia was diagnosed; in 3 cases (12%), organic cerebral lesions of traumatic or mixed etiology; in 1 case (4%), epilepsy; and in 2 cases (8%), delirium tremens.Of the subjects, 21 (84%) had a high education level; 3 (12%), a higher education level (university); and 1 (4%), incomplete high education.At the time of committing the offence, 9 subjects (36%) had a permanent job; 3 subjects (12%) had seasonal jobs; 10 subjects (40%) didn’t have any job at all; and 3 (12%) subjects were recognized as mentally disabled.At the time of committing the offence, 13 subjects (42%) were not registered in a public psychiatrist's office.ConclusionsThe personal and social characteristics of the mentally ill offenders have clearly demonstrated the prevalence of poorly educated, socially maladapted persons among them. Most of the subjects had not been registered in a psychiatrist's office. A vast majority of dangerous assaultive acts are committed by schizophrenics in an acute stage of the disease.
A comparative study related to the effects of alcohol, location and stranger on sexual assault in college women at university of northern colorado (UNC), USA
Authors: Kalar M.U. 
Published: May 2011

IntroductionAlcohol involves 50% of sexual assault among college students. Eighty-five percent of on-campus rapes are acquaintance rapes. According to Bohmer and Parrot 25% of college women have experienced forced sex at some time during their college careers.ObjectiveTo determine the relationship between alcohol, location and stranger with sexual assault in college women at UNC.AimTo compare sexual assault in which alcohol was consumed versus assault in which alcohol was not consumed, assault which occurred on campus versus off campus, and friend versus stranger assault.MethodsThis was a retrospective cohort study. Data was collected from 2003–2007. Students surveyed were undergraduates and graduates selected on the basis of non probability convenient sampling. Sample size calculation was done using the W.H.O. software where α = 0.05, 1-Beta = 90, Po = 0.55, Pa = 0.35, n (sample size) = 52. Binary logistic regression analysis was used to assess risk factors for the dependent variable of sexual assault with a threshold for selection of p < 0.05.ResultsFriend assault had a high prevalence of assault than stranger assault (35/84; 41.66% v 17/84; 20.23; p < 0.05). On campus assault had an increased prevalence of assault than off campus assault (33/84; 39.28% v 19/84: 22.61%; p < 0.05). Friend assault was the strongest predictor for assault and was 2.35 times (95% CI, 2.27 – 2.40) more as compared to stranger assault.ConclusionAlcohol increases the probability of sexual assault if the students are on campus and have friendship with the perpetrator.