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PubMed1981

Criminal acts among schizophrenics in French mental hospitals.

This paper reports a questionnaire study of 116 schizophrenic subjects. A group without history of crime (N = 53) was found to have considerably better relations with their families than a group with histories of criminal acts (N = 63). An interesting finding was that negative relations with the father were reported more frequently in the noncriminal group than in the criminal group, whereas negative relations with the mother were more frequent in the criminal group than in the noncriminal group. Within the criminal group several differences were found between the criminal behavior of chronic undifferentiated and paranoid schizophrenics. Although subjects of both diagnoses often acted with premeditation, paranoid schizophrenics were more likely to commit crimes against persons, to be under the influence of their illness during the crime, to be secretive about plans, to admit their guilt, and to cite vengeance as a motive than chronic undifferentiated schizophrenic subjects.

Antisocial Personality Disorder↗
PubMed1991

[Cholinergic modulation on stereotyped behavior and behavioral hypersensitivity (reverse tolerance) in rats].

The failure in the mutual balance between striatal/mesolimbic dopaminergic neurons and the inhibitory system, and a decreased activity of mesocortical dopaminergic neurons may account for biological base of paranoid schizophrenia. We tested this hypothesis by investigating stereotyped behavior and "reverse tolerance" in dopaminergic supersensitivity co-existing with a low-level activity of the inhibitory cholinergic system induced by the chronic administration of methamphetamine (MAP) 4 mg/kg in combination with scopolamine (SCOP) 0.5 mg/kg, in male Wistar rats. For investigating the influence of mesocortical dopaminergic neurons, experiments were designed to compare these behavioral responses in isolated rats, in which the activity of mesocortical dopaminergic neurons seemed to be reduced, to those in group-housed rats. The treatment with MAP plus SCOP produced significantly more potent effect in enhancing stereotyped behavior and "reverse tolerance" than the treatment with MAP only. Stereotyped behavior and "reverse tolerance" induced by the MAP plus SCOP treatment were more intense in isolated rats than in grouped rats. Effects of haloperidol (1 mg/kg) and pimozide (2 mg/kg or 5 mg/kg) on stereotyped behavior were less in MAP plus SCOP treated rats and isolated rats. The data may support a working hypothesis.

Animals↗
PubMed2000

Diagnostic evaluation of the violent child and adolescent.

The diagnostic evaluation of the violent child and adolescent is a collaborative exercise, requiring diverse expertise. Ironically, after systematic, comprehensive psychiatric, neurologic, psychologic, neuropsychologic, psychoeducational, family, and social evaluations have been completed, the clinician probably will not be able to make a hard and fast DSM-IV diagnosis; that is, unless the clinician is satisfied with fitting the behavioral pieces into the Conduct Disorder category and ignoring the rest of the clinical data. From time to time the clinician will be able to diagnose a bipolar mood disorder underlying a violent youngster's behavior. Occasionally the clinician will recognize paranoid schizophrenia motivating a particularly heinous or bizarre violent act. Most often the clinician will be faced with a variety of different kinds of psychiatric, neurologic, cognitive, and environmental vulnerabilities that have come together and created a violent child or adolescent. That's fine because almost invariably each discovered vulnerability has implications for treatment. The clinician evaluating a violent child or adolescent must overcome his or her initial disgust or anger at the youngster's behaviors and resist the impulse to dismiss the child as conduct disordered, as an incipient psychopath. That diagnosis leads nowhere. The identification of vulnerabilities leads to specific interventions and ultimately to the prevention of future violence.

Adolescent↗
PubMed1986

Paradoxical effects of amitriptyline on borderline patients.

A paradoxical increase in suicide threats, paranoid ideation, and demanding and assaultive behavior occurred among 15 borderline inpatients receiving amitriptyline in a double-blind study. This pattern differed significantly from that of 14 nonresponding patients receiving placebo.

Aggression↗
PubMed1998

The relationship between personality psychopathology and aggressive behavior in research volunteers.

Theorists and clinicians have long believed that personality psychopathology is a risk factor for aggressive behavior. Previous investigations in this area, however, have provided mixed results. In this study, the relationship between personality psychopathology and aggressive behavior was examined in 137 research volunteers. The influences of gender and coexisting major mental disorders were statistically controlled. Aggressive behavior was associated with criteria for 7 of the 11 personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.). Except for schizoid criteria, all relationships with aggressive behavior were in the positive direction. When all personality disorders were considered simultaneously, paranoid and passive-aggressive criteria were significant predictors of aggressive behavior.

Adolescent↗
PubMed1976

Delinquency, psychomotor epileptic symptoms and paranoid ideation: a triad.

In a retrospective chart-review study, the author found psychomotor epileptic symptoms in 6% (N=18) of children referred to a juvenile court over a 2-year period. Abnormalities appeared in 11 of the 14 available EEGs, but temporal lobe foci were noted in only 3 cases. Of these 18 children, 16 experienced paranoid symptoms that led to aggressive behavior. The incidence of offenses against persons was 50% in this sample, compared to 2--3% in the population of children referred to the juvenile court. The author suggests that psychomotor epilepsy may be far more common among delinquent children than has been reported previously and should therefore be included in the differential diagnosis of court-referred children.

Aggression↗
PubMed1999

Suicide victims with schizophrenia in different treatment phases and adequacy of antipsychotic medication.

BACKGROUND: To investigate clinical characteristics and adequacy of antipsychotic treatment in different phases of illness and treatment among suicide victims with schizophrenia. METHOD: As part of the National Suicide Prevention Project, a nationwide psychological autopsy study in Finland, all DSM-III-R schizophrenic suicide victims with a known treatment contact (N = 88) were classified according to the phase of illness (active/residual) and treatment (inpatient/recent discharge/other). Characteristics of victims in terms of known risk factors for suicide in schizophrenia, as well as adequacy of the neuroleptic treatment, were examined. RESULTS: Fifty-seven percent of suicide victims with active phase schizophrenia were prescribed inadequate neuroleptic treatment or were non-compliant, and 23% were estimated to be compliant nonresponders. Inpatient suicide victims had the highest proportion of negative or indifferent treatment attitudes (81%), whereas recently discharged suicide victims had the highest prevalence of comorbid alcoholism (36%), paranoid subtype (57%), and recent suicidal behavior or communication (74%), as well as the highest number of hospitalizations during their illness course and shortest last hospitalization. CONCLUSION: Suicide risk factors in different treatment phases of schizophrenia may differ. Substantial numbers of suicide victims with schizophrenia are receiving inadequate neuroleptic medication, are noncompliant, or do not respond to adequate typical antipsychotic medication. Adequacy of psychopharmacologic treatment, particularly in the active illness phase, may be an important factor in suicide prevention among patients with schizophrenia.

Adult↗
PubMed1976

Psychiatric aspects of temporal lobe epilepsy.

This study is an attempt to investigate cases of temporal lobe epilepsy, the starting point being a large number of psychiatric patients. The data presented in this study suggest that a certain number of schizophrenic-like psychoses are produced by temporal seizural activity. There is some evidence that if there is a centrencephalic seizure at the beginning of such a psychotic state, the patient's behavior will have confusional characteristics (perhaps a postictal centrencephalic state). Some findings suggest that the side localization of the temporal lobe focus affects the feature of the psychotic state. None of the nine patients with periodic psychoses had schizoid or paranoid premorbid personality. As to the interictal behavioral disorders of epileptics, we have noticed that two patients with hysteroepilepsy and two with compensation neurosis had dominant temporal lobe focus. Of 10 cases with behavior disorders, all had grand mal or petit mal epilepsy, and none had a temporal lobe focus. Although this study is not based on sufficient data, it may provide working hypotheses for further research.

Bipolar Disorder↗
PubMed2004

Medico-legal implications of mobbing. A false accusation of psychological harassment at the workplace.

Mobbing, or psychological harassment at the workplace, is usually defined as a situation in which a person or a group of people engage in extreme psychological violence against another person. In Spain, the number of reports for mobbing has increased extraordinarily in the last years. The reports are increasing dramatically not only before the Labour Courts, but also before the Civil Courts, with claims for damages, and before the Penal Court for offences causing physical or moral injury, etc., since at the present time this figure is not typified as an offence in the Spanish Penal Code. The high degree of complexity of this situation has given rise to frequent misuse of the term and to a number of false accusations of mobbing. A recent European Parliament Resolution on harassment at the workplace addressed the devastating consequences of false accusations. In this paper we present a case in which the "false" victim was mentally ill (paranoia) but succeed in generating an extreme dangerous environment of great harassment against the "false" assailants that were "falsely" accused of mobbing. Forensic diagnosis of the psychiatric disorder suffered by the "false" victim was essential to clarify the issue at the Penal Court.

Adult↗
PubMed2000

Antipsychotic medication and smoking prevalence in acutely hospitalized patients with chronic schizophrenia.

The atypical antipsychotic, clozapine, has been reported to reduce smoking in schizophrenic patients. We sought to determine whether other atypical antipsychotics would also be associated with a decreased prevalence of smoking in this population. Data were obtained from three groups of chronic, hospitalized, schizophrenic patients, receiving either a typical antipsychotic (n=15), clozapine (n=6), or another atypical antipsychotic (n=18). In addition to smoking prevalence, the groups were compared with regard to demographics (age, education), medication (doses, duration of treatment, side-effects), clinical (diagnosis, duration of illness) and behavioral (Wide-Range Achievement Test, Wechsler Adult Intelligence Scale) variables. Smoking prevalence differed significantly among the three groups (P<0.001). Clozapine was associated with a significantly lower incidence of smoking than either typical drugs (P<0.003) or other atypical antipsychotics (P=0. 042). The groups did not differ on demographic or other medication variables or on any of several behavioral measures. However, a diagnosis of paranoid schizophrenia was also significantly correlated with smoking (P<0.01), but not with medication class. Although the cause is still unknown, these results are consistent with reports that clozapine reduces smoking and provide new data on smoking prevalence associated with other atypical agents.

Acute Disease↗
PubMed2002

The relationship between predisposing factors, premorbid function and symptom dimensions in psychosis: an integrated approach.

BACKGROUND: Increasing evidence suggests psychosis may be more meaningfully viewed in dimensional terms rather than as discrete categorical states and that specific symptom clusters may be identified. If so, particular risk factors and premorbid factors may predict these symptom clusters. AIMS: (i) To explore, using principal component analysis, whether specific factors for psychotic symptoms can be isolated. (ii) To establish the predictors of the different symptom factors using multiple regression techniques. METHOD: One hundred and eighty-nine inpatients with psychotic illness were recruited and information on family history, premorbid factors and current symptoms obtained from them and their mothers. RESULTS: Seven distinct symptom components were identified. Regression analysis failed to identify any developmental predictors of depression or mania. Delusions/hallucinations were predicted by a family history of schizophrenia and by poor school functioning in spite of normal premorbid IQ (F = 6.5; P < 0.001); negative symptoms by early onset of illness, developmental delay and a family history of psychosis (F = 4.1; P = 0.04). Interestingly disorganisation was predicted by the combination of family history of bipolar disorder and low premorbid IQ (F = 4.9; P = 0.003), and paranoia by obstetric complications (OCs) and poor school functioning (F = 4.2; P = 0.01). CONCLUSION: Delusions and hallucinations, negative symptoms and paranoia all appeared to have a developmental origin though they were associated with different childhood problems. On the other hand, neither mania nor depression was associated with childhood dysfunction. Our most striking finding was that disorganisation appeared to arise when a familial predisposition to mania was compounded by low premorbid IQ.

Adolescent↗
PubMed1981

Suicide pacts: a review.

Suicide pacts, though occurring infrequently, are neglected occurrences. They have features distinguishing them from single suicides which can be seen as residing in the characteristics of the pact relationship. Dyadic, family and collective suicides are reviewed and found to have several common features, including exclusivity and isolation, the threat of dissolution of the relationship, and the presence of a powerful initiator.

Diagnosis, Differential↗