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PubMed1995

Los Angeles County after the 1992 civil disturbances: degree of exposure and impact on mental health.

The impact of the 1992 Los Angeles (L.A.) civil disturbances on psychosocial functioning was assessed as part of a larger project investigating the views and attitudes of residents in L.A. County. Random digit dialing methodology identified a household probability sample of 1,200 adults (age 18 or older) from L.A. County. Respondents completed a telephone interview 6 to 8 months after the disturbances. Respondents' degree of exposure to the disturbances, mental health impact of the disturbances, and mental health effects of chronic versus acute exposure to violence were assessed. Consistent with hypotheses, the impact of the disturbances was the worst in the South Central communities. Higher rates of posttraumatic stress disorder (PTSD; both diagnostic level and subclinical symptomatology) were found among respondents who reported disturbance-related experiences. Exposure to an acute event (i.e., the disturbances) was predictive of current PTSD symptomatology after controlling for demographics, lifetime trauma, and other types of stressful events.

Adolescent↗
PubMed1991

The dangerousness criterion for civil commitment: the problem and a possible solution.

The dangerousness criterion for civil commitment fails to specify which mental disorders justify commitment. This ambiguity is highlighted by the fact that there are patients with personality disorders or substance abuse who may be dangerous but for whom we have few effective treatments. A possible solution might be provided by adopting the American Psychiatric Association guidelines which consider severity of mental disorder and treatability in its criteria.

Commitment of Persons with Psychiatric Disorders↗
PubMed2004

Comparing aspects of mental health legislation of Israel and Massachusetts.

This paper compares the manner in which two sets of mental health laws, that of Massachusetts, U.S.A., and that of the State of Israel, deal with specific areas of civil enforced commitment. The definition of psychiatric disorder that justifies commitment is broader in Massachusetts, in Israel psychosis alone is considered, excluding conditions such as severe non-psychotic depression, obsessive-compulsive disorder and anorexia. In Israel, commitment is possible only when there is a risk of danger that is immediate. In Massachusetts, only a judge can make decisions beyond the first four days, while in Israel they are made by a District Psychiatrist. Unlike Massachusetts, there is no possibility of enforced commitment of alcoholics or drug addicts in Israel, even in the presence of impaired judgement and severe family distress. The changing trends are presented, as Israel seems to be drawing slowly toward the Massachusetts position in some of these issues. The role of consumers in these processes is considered, as is the possibility of enforced commitment of people with severe personality disorders.

Commitment of Persons with Psychiatric Disorders↗
PubMed1990

[Dermatologic aspects of anorexia and bulimia nervosa].

Anorexia and bulimia nervosa are common in western civilized countries. They are frequently associated with disorders of the skin. Up to now, no dermatological studies of large numbers of patients with eating disorders have been published. We examined 145 patients with eating disorders (65 anorexia nervosa, 80 bulimia nervosa) regarding skin alterations. Simultaneously we controlled the moisture content and the superficial lipids of the skin. Several symptoms relevant to dermatology were found. In detail we report on: xerosis, hair changes, nail disorders, pathognomonic hand lesions, sialadenosis, lesions of the oral mucosa and the teeth, peripheral oedema, acrocyanosis, petechiae and artefacts.

Adult↗
PubMedDate not supplied

[The civil legal procedural competence of schizophrenia patients].

Discusses the methodological problems of forensic psychiatric evaluations of mental disorders in the structure of the most incident endogenous psychosis, schizophrenia, under conditions of expert evaluation in a civil process. Presents criteria permitting the differentiation between pathological states.

Civil Rights↗
PubMed1993

Stories from the sealed rooms: patient interviews during the Gulf war.

The mass deployment of gas masks to an entire population, which occurred in Israel prior to the Persian Gulf crisis and their use in early 1991, were phenomena without precedent. In addition to the historical significance, there were considerable health and psychological ramifications. This research examines the experiences of the Israeli public during the Gulf war using a qualitative methodological approach, narrative analysis. Interviews of a convenience sample of 60 patients attending primary care clinics were audio-recorded by three family physicians using an open-ended interview guide. Encounters took place at sites located in the north, south and centre of the country during the period of Iraqi missile attacks. Patients' stories were analysed using a multistep narrative analysis protocol. Seventy per cent of subjects reported deleterious health effects related to the missile attacks or civil defence measures, mainly psychological and neurological complaints, sleep disorders, gastrointestinal and respiratory symptoms. Recurrent themes and metaphors in the narratives most often focused on the difference of this war to others, the central involvement of the family, concern for children and identification and connection to the nation. The Scud missile attacks combined with the civil defence measures had significant impact on the population, as manifested in subjects' stories, symptoms, symbols and behaviour. Narrative analysis provided an efficient method to capture the rich texture of patients' experiences.

Adolescent↗
PubMed1981

Some clinical aspects of criminology: a study of criminal psychiatric patients at the Lantoro Psychiatric Institution.

Mentally ill criminals at Lantoro Institution (an annex of Aro Neuropsychiatric long-stay Hospital, Abeokuta, Nigeria) were studied. Thirty-six (67.9%) of the 53 patients had committed homicide while 11 (22.7%) had been involved in other offenses against the person. Forty (75.5%) of the 53 patients were diagnosed as schizophrenic patients with the paranoid subtypes predominating. All the 10 epileptics had committed homicide whereas the few cases of organic psychosis had committed less grievous offenses such as disorderly behaviour and stealing. In comparison with the civil (voluntary) admissions to the institution, a greater percentage of the involuntary patients (mentally ill criminals) were found to have lost social contacts especially with their key relatives. Some of the factors thought to be responsible for this phenomenon were the long duration of hospitalization and the social implications of the offenses committed. Measures for rehabilitating the mentally ill criminals in Nigeria were suggested.

Adult↗
PubMed1975

[Psychology of war (civilization as Thanatos or civilization as Eros)].

Freud saw war as the prevailing of death over love, this being a metapsychological concept whose roots lie in the dynamics of urges within the individual and civilisation in general. In his opinion, this dialectic tension could not be overcome. Reich noted that the analytic theory was in conflict with practice. Freud's premisses concerning the philosophy of civilisation and their implications have been taken up by Marcuse, who solves the conflict between the love-death urges by treating work as reduced to love or a game, in which death is merely the negative to be overcome.

Adolescent↗
PubMed2005

Patients with affective disorders admitted to maximum secure care (1999--2003).

The State Hospital, Carstairs, is a special secure psychiatric facility for Scotland and Northern Ireland. This study describes the background, illness and offence (where appropriate) characteristics of 25 patients admitted between 1999 and 2003 with a diagnosis of any affective disorder. Patients were, on average, 37 years old and had a lengthy history of psychiatric contact. Patients with an affective disorder were more likely to be admitted under civil proceedings, following a transfer from hospital, as opposed to being admitted under criminal procedure. Sixty per cent were discharged to prison, court or local hospitals within one year of their admission to special secure care. Significant violence during an episode of mania or hypomania (even in the presence of psychotic symptoms) appears rare. Recurrent unipolar depression resistant to first and second line treatments in women, and lithium withdrawal mania in male bipolar patients were the most common clinical problems. Treatments aimed at reducing co-morbid substance misuse, and improving compliance with mood stabilisers, appear important in managing this patient group.

Adult↗
PubMed2000

Trends in special (high-security) hospitals. 1: Referrals and admissions.

BACKGROUND: Special hospitals in England provide psychiatric care and treatment in high security. Their future is often questioned. AIMS: To test for variation in demand for high-security psychiatric services over one 10-year period. METHOD: This study was from the special hospitals' case registers and hospital records. The main measures were numbers and annual rates for referrals and beds offered; the Mental Health Act 1983 (MHA) classification of mental disorder; adjusted population rates by health region; admission episodes; legal category of detention; admission source and type of offence. RESULTS: Referrals to special hospitals showed no decrease during the 10 years; an apparent increase may reflect underrecording before 1992. Admissions fell by about 16% over the 10 years, but with regional variation. Women, civil cases, admissions under the MHA classifications of psychopathic disorder or mental impairment and directly from a court on a hospital order were most affected. There was an increase in admissions of pre-trial and sentenced male prisoners, and of transferred hospital order patients from other hospitals. CONCLUSIONS: There is continuing demand from all parts of the country for high-security hospital beds. The smaller numbers admitted appear to include more demanding cases.

Commitment of Persons with Psychiatric Disorders↗