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At least 613 records · Page 34Linked to original sources
PubMed1994

Reckless behaviour related to the use of 3,4-methylenedioxymethamphetamine (ecstasy): apropos of a fatal accident during car-surfing.

A 26-year-old man died from severe brain contusion after falling from a moving car during an attempt at car-surfing. Toxicological urine screening was positive for amphetamines, the blood analysis revealed a MDMA level of 0.63 mg/l and a blood alcohol concentration of 1.23 g/l. The case is another example of the bizarre and reckless behaviour which may result from the euphorogenic activity of ecstasy and the circumstances in which it is commonly used.

Accidents, Traffic↗
PubMed1991

The evaluation of homicidal patients by psychiatric residents in the emergency room: a pilot study.

The authors report the results of a preliminary prospective study involving 110 patients who were involuntarily committed from the emergency room. The study was designed to clarify the process of how psychiatric residents evaluate homicidal patients. Eighteen patients (16%) were committed for homicidal ideation, of whom 89% were psychotic. Surprisingly, for patients committed because of a risk of homicide, vital signs were obtained for only 11%, during a mean evaluation time of 2.5 hours. Aspects of an appropriate physical examination and laboratory studies that enable the clinician to distinguish organic from functional illness are described. The authors conclude that patients with homicidal ideation may receive inadequate assessment prior to their involuntary commitment. Possible explanations and solutions for this, and recommendations for further studies are offered.

Adolescent↗
PubMed2004

[Regulation on preventive detention according to section sign 66 of the German Penal Code. Principles and differential indication compared with the regulation according to section sign 63 of the German Penal code].

Preventive detention is imposed by court order if a dangerous criminal shows a disposition to relapse. The negative criminal prognosis should be given by a psychiatric expert based on considerations about the criminal's personality traits. Matters of preventive detention are important for forensic psychiatry, but so far have rarely been discussed. This article presents related problems and offers-under special consideration of problematic personality traits or personality disorders-practical guidelines for expert testimony. Our considerations should serve as a thought-provoking stimulus for further psychiatric discussions about this topic.

Antisocial Personality Disorder↗
PubMed2006

[Suicidality and the Internet. Danger from new media].

The Internet has a powerful effect on society and thereby also on psychiatric patients. It offers suicide prevention services but also is a source of information and exchange of thoughts on how to commit suicide. This paper describes an 18-year-old female who learned about methods of suicide in the Internet and then ordered barbiturates. She survived because of early intervention.

Adolescent↗
PubMed2005

[Forensic psychiatry. Its relations to clinical psychiatry and criminology].

A basic task of psychiatry is to identify and treat mentally disordered persons at risk of committing crimes. Psychiatry has an important function in preserving social peace, law, and order. How the psychiatric world handles this duty has changed with time. There have been very important changes from asylums to mental hospitals and from voluntary or involuntary inpatient treatment to outpatient care; but clinical psychiatry cannot give up forensic psychiatry. As a result of developments, inpatient care in mental hospitals often concentrates on crisis management, risk assessment, and risk management. On the other hand, forensic psychiatry has made great efforts in recent decades with special therapies for mentally disturbed criminals and collaborated closely with criminologists in developing instruments for risk assessment and prognosis of repeat offenses.

Commitment of Persons with Psychiatric Disorders↗
PubMed2005

[On the relationship between psychiatry and criminal law from a legal standpoint].

Psychiatry and penology are responsible together for adequate therapy of mentally ill and disordered criminals. The increased security demands of current criminal policy on the penal and forensic hospital treatment have to be moderately counteracted. The considerable increase in deculpation according to Section 21 of the German Penal Code (StGB) during the past 30 years should be balanced by more limited application, especially regarding antisocial personality disorder, borderline personality disorder, and sexual identity disorder (paraphilia).

Commitment of Persons with Psychiatric Disorders↗
PubMed2007

[The effects of stalking on psychiatrists, psychotherapists and psychologists. Prevalence of stalking and its emotional impact].

Stalking in the psychiatric context describes a pathological behaviour which is characterized by repeated persecution, harassment, or menacing of or assault on a person. Because of the association between stalking and mental disorders, psychiatrists, psychologists and psychotherapists belong to particularly exposed professions. If they fall victim to stalking during their career, disruptive impacts up to posttraumatic stress disorder (PTSD) can be the consequence. A total of 117 psychiatrists, psychologists or psychotherapists in Graz participated in an anonymous interview. To register possible experiences with stalking defined behaviour, a modified version of the questionnaire of Kamleiter was used. The prevalence and severity of posttraumatic stress symptoms were determined using the Impact of Event Scale of Horowitz. The study showed an incidence of stalking of 38.5%. The rate of female stalkers (60%) was extraordinary high. Most victims (68.9%) experienced non-violent threats. Most of the offenders (41.9%) were diagnosed as suffering from schizophrenia, schizotype and delusional disorders (F2) followed by disorders of adult personality and behaviour (F6) (30.2%). Some 44.4% of the victims developed symptoms of PTSD, which were usually only slight. The analyses suggest that stalking, in the psychiatric field of activity, is a common and serious phenomenon, and that strategies for the prevention and protection of potentially affected professions have to be developed.

Adult↗
PubMed2007

[Multiaxial classification of stalking. Guidelines for the assessment of criminal liability and prognosis].

Stalking is a widespread phenomenon describing a pattern of intrusive and threatening behaviour that leads to the victim's perception of being harassed and of him or her being rendered fearful. Physical assault and even homicide may occur in the context of stalking. Anglo-Saxon studies have revealed a lifetime prevalence of being a victim of stalking ranging from 4-7% in men and 12-17% in women. Recently, these rates have been confirmed by the first community based study carried out in Germany. As a stalker can have a number of victims during his or her lifetime, the prevalence of stalkers may be less than this, although at present data for this are lacking. Although the phenomenology of stalking appears to be rather homogenous, fairly distinct stalker typologies and perpetrator-victim relationships have to be considered. Requests for psychiatric and forensic assessment of stalkers are increasing. According to the German penal code, psychiatrists must provide expert opinion on criminal responsibility and the placement of stalkers. So far, all typologies of stalkers refer to the Anglo-Saxon cultural background and do not consider the special needs of German forensic psychiatry. In particular, the psychopathological dimension is widely neglected in common typologies. The present paper proposes a multiaxial typology of stalking that considers the psychopathological dimension, the relationship between stalker and victim and motivational aspects. Consequences for the forensic psychiatric assessment according to section 20, 21 StGB are outlined. It should be pointed out that stalking is not a new diagnostic category, but only involves, at a descriptive level, deviation from a normal behavioural pattern. The central components of the forensic psychiatric assessment remain the known diagnostic categories, the effects of which on behaviour can be analysed.

Crime Victims↗
PubMed1997

[Compulsory treatment in psychiatry from the viewpoint of the patient. A prospective study].

During a 6-month period all patients who had been treated involuntarily in a state-funded mental mental health unit were studied prospectively. They were interviewed after the first compulsory measure and at the end of treatment. A control group of patients (not experiencing involuntary treatment) were interviewed as well. The aim of the study was to establish whether the groups differed with respect to judgement of subjective well-being and satisfaction with treatment. The stability of these judgements over time and especially changes in perception and acceptance of involuntary treatment during the course of treatment were also monitored. the 36 patients in the study group perceived themselves as being far less ill at both time points and were less satisfied with treatment than the 29 control patients. At the end of treatment, all patients judged themselves to be significantly more ill retrospectively and patients of the study group were more satisfied with treatment than at the beginning. When questioned in the days after an involuntary measure, 25% of the patients concerned denied that any measure had taken place against their will; at the end of the hospital stay this figure had increased to 42%. In contrast, four control patients complained that they had been involuntarily subjected to treatment. In discordance with the previously published literature, the acceptance of involuntary treatment declined over time.

Adult↗
PubMed2002

Attitudes about schizophrenia from the pilot site of the WPA worldwide campaign against the stigma of schizophrenia.

BACKGROUND: A series of surveys were conducted to assess the attitudes of the public, and other groups, toward those with schizophrenia. The aim of these surveys was to aid in the planning and evaluation of the WPA anti-stigma initiative in Alberta, Canada. METHOD: A questionnaire was devised and administered via telephone to over 1,200 individuals in three Alberta cities, and in paper and pencil format to 40 members of the Schizophrenia Society of Alberta and 67 medical students. RESULTS: In contrast to some earlier findings, "loss of mind" was rated to be more disabling than any other handicapping condition. In general, respondents showed a relatively sophisticated understanding of schizophrenia and a higher level of acceptance than might have been predicted. Nonetheless, this acceptance was not as high for situations where closer personal contact was likely, and fears of dangerousness continue to be associated with schizophrenia. The majority of respondents, however, felt that treatment aided those with schizophrenia, expressed support for progressive programmes for the mentally ill, and stated that they would be willing to pay higher taxes so that programming could be improved. CONCLUSIONS: The results do not support the utility of a broad approach for an anti-stigma campaign, but rather suggest a more specific focus, such as perceived dangerousness.

Adolescent↗
PubMed2004

Social exclusion and risk of emergency compulsory admission. A case-control study.

BACKGROUND: Emergency detentions under section 4 of the Mental Health Act 1983 are more frequent in socially deprived areas of England and Wales. However, it is not clear whether individual socio-economic disadvantage increases likelihood of emergency detention. Therefore, this study tests the hypothesis that a higher proportion of people who are socially excluded will be admitted to hospital under section 4 than those who are not. METHODS: A total of 300 mental health act assessments in two London boroughs with different rates of section 4 admissions were studied by retrospective case note review in a case-control design. An index of social exclusion was created and piloted for this study. RESULTS: The logistic regression analysis discovered four risk factors for section 4 admissions: presenting with a risk to self or others at the mental health act assessment, bi-polar affective disorder, non-White British ethnicity and low social support. There were no significant differences between the two boroughs on these variables. Risk factors for any compulsory admission were: presenting with a risk, psychosis and non-White British ethnicity. CONCLUSION: This study found low social support to be the only social exclusion indicator that increases likelihood of admission under section 4. While individual-level variables explain some of the variation in section 4 rates, it is likely that, as indicated by other studies, different configurations of mental health services affect rates to a greater degree.

Adult↗
PubMed2005

The impact and patterns of hazardous drinking amongst male industrial workers in Goa, India.

AIMS: The aim of this study was to describe the impact and patterns of drinking in hazardous drinkers in a male industrial worker population in India. METHOD: A case-control design was used, and 234 subjects (75 hazardous drinkers, 78 casual drinkers and 81 abstinent workers) were randomly selected from a population of male workers who had participated in a survey of drinking behaviour. The definition of these categories was based on the scores of subjects on the Alcohol Use Disorders Identification Test (AUDIT). Subjects were interviewed with a semi-structured social and health impact questionnaire, Revised Clinical Interview Schedule (CISR) and Brief Disability Questionnaire (BDQ). A total of 184 spouses of consenting workers were also interviewed with a semi-structured interview, the CISR,BDQ and AUDIT. A sub-group of 55 hazardous drinkers participated in a descriptive study of patterns of drinking, recording drinking behaviour using a daily drink diary over a 1-month period. FINDINGS: Hazardous drinkers have significantly poorer physical and mental health and show trends for adverse social outcomes such as violence. Casual drinkers, on the other hand, were no different from abstinent subjects on any of the key outcomes. As compared to casual drinkers, hazardous drinkers tend to drink alone, in bars, and prefer non-commercial alcoholic beverages which are cheaper and have high alcohol concentration. CONCLUSIONS: Hazardous drinking has a significant adverse impact on drinkers and their families. Hazardous drinkers display unique drinking patterns suggesting the role of stigma and preference for higher alcohol-containing, but cheaper, drinks available in India.

Adult↗
PubMed2005

Labeling--stereotype--discrimination. An investigation of the stigma process.

AIM: Using Link and Phelan's concept of the stigma process, public attitudes towards people with schizophrenia are examined. METHOD: In the spring of 2001, a representative population survey was conducted in Germany (n=5025). A fully structured personal interview was carried out, beginning with the presentation of a case vignette. RESULTS: Labeling as mental illness increased the likelihood that someone suffering from schizophrenia was considered as being unpredictable and dangerous. This, in turn, led to an increase of the preference for social distance. Although much weaker, labeling also had a positive effect on public attitudes insofar as it was associated with a decrease of the tendency to attribute the responsibility for the occurrence of the disorder to the afflicted person. However, this had no significant impact on the desire for social distance. There was no significant association between labeling and the anticipation of poor prognosis. There were some differences between respondents who are familiar with mental illness and those who are not. CONCLUSION: Our findings have some implications for the planning of interventions aimed at reducing stigma and discrimination because of schizophrenia. These interventions should primarily address the stereotypes of unpredictability and dangerousness since they are most likely to have a negative impact on the public's willingness to engage in social relationships with those suffering from this disorder. The interventions should also be tailored according to whether the target population is familiar with mental illness or not.

Adolescent↗