Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “INSANITY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed1988

Disposition of insanity acquittees in Illinois.

Little attention has been paid to the processing of insanity acquittees subsequent to criminal trial. This study first obtained descriptive data on new insanity acquittees (N = 137) in Illinois between January 1982 and July 1984 and then examined the criminal commitment criteria used by evaluating psychiatrists and criminal courts in the disposition of insanity acquittees. Acquittees in Illinois were largely male, chronic schizophrenics who had been acquitted for murder or attempted murder. Judges tended to use criminal criteria that were more demanding than those which had been recommended by psychiatrists. Stepwise discriminant analyses revealed that psychiatric diagnosis was the most influential factor in determining psychiatrists' recommendations and court dispositions. Psychiatrists and committing judges failed to comply with the requirements of the committment law in one quarter of the cases.

Adult↗
PubMed1995

A comparison of female versus male insanity acquittees in Colorado.

This study was undertaken to investigate the authors' clinical impression that there are significant differences between the male and female insanity acquittees in Colorado, and that these differences result in significantly different treatment needs. The study sample included 149 patients: 112 men and 37 women committed to the Colorado Mental Health Institute at Pueblo as not guilty by reason of insanity (NGRI). Data were collected from a computerized data system and from chart reviews. The study provides descriptive data regarding demographic, legal, and mental health parameters of these acquittees. Demographic items included prior history of incarceration, age at first arrest, type of NGRI crime committed, and severity of NGRI crime. Mental health variables included prior psychiatric hospitalization history of suicide attempts, substance abuse history, inpatient substance abuse treatment history, diagnoses, escape history and length of stay. Percentages of male and female subjects were calculated for those variables with discrete categories. Means and medians were calculated for continuous variables. Results indicate that women are significantly more likely to be given a diagnosis of mood disorder or borderline personality disorder, are significantly older than men at the time of commitment, and are statistically more likely to have committed a single violent crime than men. Men were found to have a significantly higher rate of prior and current substance abuse, a significantly higher rate of antisocial personality disorder, a significantly greater history of violent crime prior to the NGRI offense, and arrests beginning at a significantly younger age than women. Despite the higher severity of crime rating for women, their length of stay was significantly shorter than for men. The implications of the findings with regard to different treatment needs are discussed, and the findings are compared to four other studies addressing female versus male insanity acquittees in other states.

Adult↗
PubMed2000

Dysfunctional domesticity: female insanity and family relationships among the West Riding poor in the mid-nineteenth century.

"Dysfunctional domesticity" contributes to the growing reevaluation of the importance of the history of the family to understanding the history of insanity. Using patient case histories from the West Riding Pauper Lunatic Asylum, this article examines representations of family life among poor in England in the 1830s and 1840s. Among the so-called moral causes of insanity, family relationships held a prominent place. Female patients more than male patients had their mental illnesses attributed to their domestic circumstances: the poverty of their home lives, grief over a death of friends and family, love and marital relationships gone wrong, and violence in their homes. The case histories reveal that poor women experienced many pressures in the domestic sphere, and insanity may have been one way to escape dysfunctional domesticity.

England↗
PubMed2003

Disappointment and desolation: women, doctors and interpretations of puerperal insanity in the nineteenth century.

Taking case notes as the key source, this paper focuses on the variety of interpretations put forward by doctors to explain the incidence of puerperal insanity in the nineteenth century. It is argued that these went far beyond biological explanations linking female vulnerability to the particular crisis of reproduction. Rather, nineteenth-century physicians were looking at other factors to explain the onset of insanity related to childbirth; stress and environmental factors linked to poverty, family circumstances, poor nutrition, illegitimacy, fear and anxiety, and the strains of becoming a mother. The main focus is on female asylum patients, but all mothers were seen as being susceptible to puerperal insanity.

Birth Certificates↗
PubMed1975

Is the insanity defense "unconscionable"?

The debate over the meaningfulness and utility of the insanity defense has continued unabated ober the years. President Nixon has referred to the "unconscionably abuse" of the defense. This paper, presented as part of a panel on the subject, has propounded the view that the defense is unconscionable, using that aspect of the definition dealing with unreasonableness. The historical antecedents and the religious and social philosophy of the concept of responsibility and nonresponsibility have been reviewed. In addition to the inapplicability of the concept to current social problems, and the difficulties of applying current psychiatric knowledge to effect a rational delineation between the two legal entities encompassed under the rubric of responsibility and nonresponsibility, the potential problems and the potential opportunities which may result from the abolition of the plea are presented. With these factors in mind, as well as the obvious failure of the legal-social-penal system in handling the problems of the behaviorally deviant, I believe that the use of the current system has hampered the development of possibly more reasonable alternative systems and that, therefore, the maintenance of the insanity defense is unreasonable and harmful to our society. The insanity defense, as currently constituted and institutionalized, has evolved into a rigid and archaic vestige of the legal system of an earlier era and therefore its use has, in the sense defined, indeed become "unconscionable" and lacking in social meaningfulness.

Ethics↗
PubMed1998

[The insane in Turkish oral tradition].

In this research, information on oral folk tradition about the insane and insanity were collected. The proverbs and locations where folkloric information was collected is also studied. Amongst Turkish people it is believed that the insane are ingenuous, honest and that they do not have any ulterior motives; therefore, the fact that people tolerate their obsurdity, must be taken into consideration.

History, 20th Century↗
PubMed2004

[From circular insanity (in double form) to the bipolar spectrum: the chronic tendency for depressive recurrence].

From a cycling standpoint, "circular insanity" (Falret) and "dual-form insanity" (Baillarger), both described in hospital patients in 1854, are at the severe end of the spectrum of what we now call "bipolar disorders". Falret was prescient in suggesting that circular insanity was rare in the community, where depressive cycles are prevalent. These disorders are now respectively referred to as the "hard" (manic-depressive) and "soft" (bipolar spectrum) phenotypes of the disorder. This paper focuses on the latter, more prevalent depressive expressions of the spectrum, which share with the manic and circular forms a lifelong tendency to recur. Their cyclicity may involve putative "clock genes". The genetics of psychotic mania overlaps somewhat with the genetics of schizophrenia. As regards depressive recurrence, putative genetic factors have been identified, including a polymorphism of the serotonin transporter, which significantly increases the subject's vulnerability to stress; a mediating pathogenetic variable appears to be temperamental dysregulation (e.g. neuroticism and cyclothymic lability), which produces hyperemotional reactivity to such stressors. The growing recognition that many depressive recurrences belong to a broad spectrum, affecting 5-10% of the population, represents a new public health challenge. Although the new class of serotoninergic antidepressants offer a practical approach to the management of depressive episodes, further research is needed to determine the point of the spectrum at which mood-stabilizing therapy should be started--and in what combinations--in order to prevent recurrence and suicide.

Bipolar Disorder↗
PubMed1981

Two cases of induced insanity. Helene Deutsch, Cambridge, Mass.

"Two cases of induced insanity", hitherto untranslated, was Helene Deutsch's first (1918) psychoanalytic paper; she presented Freud with a copy of it during the beginning of her analysis with him. As an experienced clinician who had studied under both Wagner von Jauregg in Vienna and Emil Kraepelin in Munich, Deutsch observed these cases during World War I as the University of Vienna's psychiatric facilities. Although the general reading public knows her best for her The Psychology of Women, she also wrote some well-known clinical papers; and it is characteristic of her that she brought these two cases without excessive theoretical speculation. In "Two cases in induced insanity" Deutsch described some of the strains of the wartime situation, and how whole families could join in hysterical confabulations in order to cope with emotional distress. One of her most famous later clinical contribution had to do with the emotional impoverishment of 'as if' personalities and their specific suggestibility. In other papers she continued her early concern with disturbed identification. As one examines Deutsch's work it is possible to fill out the history of psychoanalytic psychology. Without ignoring her later increase in theoretical sophistication, in "Two cases of induced insanity" we find Deutsch remarkably tolerant in her willingness to suspend judgement about the sources and fate of morbid thinking. A key therapeutic recommendation of hers was to separate the family members to allow their reality to return. Like some recent critics of undue diagnostic name-calling she advocated hesitation in discerning of disease entities as well as cautionary approach to treatment. The nature of familial love may leave everyone "normal" prone to disturbances which are not necessarily to be treated as a psychiatric illness. This example of one of Deutsch's first professional essays reflects the early thinking of a giant in psychoanalysis. She followed Freud in the conviction that the exceptional can highlight the everyday. The paper is a tentative groping and illustrates how far she came when she published her mature work.

Adolescent↗
PubMed1992

Murder, insanity, and medical expert witnesses.

Recent advances in the ability to study brain anatomy and function and attempts to link these findings with human behavior have captured the attention of the legal system. This had led to the increasing use of the "neurological defense" to support a plea of not guilty by reason of insanity. This article explores the history of the insanity defense and explores the role of the medical expert witnesses in integrating clinical and laboratory findings, eg, computed tomographic scans, magnetic resonance scans, and single-photon emission computed tomographic scans. Three cases involving murder and brain dysfunction are discussed: the first case involves a subarachnoid hemorrhage resulting in visual perceptual and memory impairment; the second case, a diagnosis of Alzheimer's disease; and the third case, the controverted diagnosis of complex partial seizures in a serial killer.

Aged↗
PubMed1999

The mental disability requirement in the insanity defense.

This paper offers a discussion of some of the nuances of mental disease or defect as required for the insanity defense in criminal law. It also compares and contrasts the mental disease or defect definitions of criminal law with those definitions used in clinical practice. It points out a general pattern of vagueness and dispute regarding the proper interpretation of the mental disability requirement in the insanity defense and in other legal provisions. It reports a variety of interpretations by courts and commentators regarding the meaning of these phrases, and it reports attempts by state legislatures to narrow the range of applicable conditions by excluding various mental or emotional states.

Antisocial Personality Disorder↗
PubMed1983

The RCRAS and legal insanity: a cross-validation study.

Examined the RCRAS as an empirically based approach to insanity evaluations. Previous research has been encouraging with regard to the RCRAS' interrater reliability and construct validity. The present study, with a larger data base (N = 111), sought to cross-validate these findings. Results from five forensic centers established satisfactory reliability for the RCRAS (mean kappa r = .80 for decision variables for criminal responsibility) and differentiating patterns for four of the five scales between sane and insane patient-defendants. Results further suggested that the RCRAS was generalizable across age, sex, criminal behavior, and location of the forensic evaluation. These findings were discussed with respect to the potential clinical utility of the RCRAS.

Commitment of Persons with Psychiatric Disorders↗
PubMed1984

Use of the SADS diagnostic interview in evaluating legal insanity.

Examined clinical usefulness of the SADS diagnostic interview in evaluations of criminal responsibility. Findings, based on 78 SADS evaluations from a specialized forensic clinic, indicated that SADS successfully differentiated between sane and insane evaluatees. These differences were found primilarily in the severity of psychotic symptoms and overall level of psychological impairment. In addition, preliminary data on institutionalized and outpatient Ss suggested the potential applicability of the SADS for assessing the general psychological functioning of insane patients in treatment.

Adaptation, Psychological↗
PubMed1977

Punishing the not guilty: hospitalization of persons acquitted by reason of insanity.

Some of the mystique surrounding persons acquitted of crimes on insanity grounds (NGIs) is being dispelled by arguing that they should be treated as are other mental patients in all phases of their contact institutions. The courts have moved along the road to equalization but still have a way to go. It is concluded that there is no basis for any differentiation between persons who are acquitted of crime by reason fo insanity and other civil patients with respect to commitment, treatment, and discharge. Any other approach sacrifices not only constitutional rights but also impairs the likelihood of rehabilitation and productive return to society for these patients who have been adjudge not guilty of their antisocial acts and from whom no punishment may be exacted.

Commitment of Persons with Psychiatric Disorders↗
PubMed1995

The hidden effects of Montana's "abolition" of the insanity defense.

Montana abolished the affirmative insanity defense in 1979. In this article we examine the effect of this change by focusing on all defendants who raised mental health in his/her defense from 1976 to 1985. We found that while post-reform insanity acquittals did dramatically decline, there was a corresponding rise in findings of incompetent to stand trial with charges dismissed, perhaps negating the desired impact. We also compared the defendants and the legal process, finding no significant differences pre to post reform.

Adult↗
PubMed1994

Abraham Lincoln and the insanity plea.

A confederate civilian physician shot and killed a white Union officer who was drilling Negro troops in Norfolk, Virginia. With no question as to guilt, President Abraham Lincoln decided to have a medical expert conduct a professional sanity/insanity examination. Documentation indicates that legal and political factors may have influenced Lincoln's decision. As a lawyer, Lincoln prosecuted a case where the insanity plea was used as a defense. Two influential Cabinet members, William H. Seward and Edwin M. Stanton, also had legal experience involving the insanity plea. Politically, Lincoln faced serious issues such as the draft riots, the military necessity to recruit slaves into the army, the impact of Union Negro soldiers upon the border states, the morale and discipline of the army and the upcoming presidential election. Upon Seward's recommendation, Lincoln chose a physician who had a reputation for finding the accused sane and who did so in this case. As the southern physician was hanged, Lincoln's means achieved the desired legal and political ends.

Famous Persons↗
PubMed2006

The differing views on insanity of two nineteenth century forensic psychiatrists.

Dr. Charles H. Nichols and Dr. John P. Gray were the two foremost forensic psychiatrists in the latter half of the nineteenth century in the U.S. However, their rationales differed dramatically. They were involved in four notable murder trials where insanity issues arose: one was a trial for the murderer of a Union officer during the Civil War; in another, a conspirator was tried for the assassination of President Abraham Lincoln; in the third, a temporary insanity plea was supported by a medical expert for the first time in a U.S. courtroom; and the fourth was the trial of the assassin of President James A. Garfield. Pointedly, their differing viewpoints still remain controversial today.

Expert Testimony↗
PubMed2006

The review panel process: an algorithm for the conditional release of insanity acquittees.

The release of insanity acquittees requires making informed decisions regarding both the presence and severity of an individuals' mental illness and the dangerousness of these individuals. This study evaluated the usefulness of employing structured assessments of mental health and violence risk factors in the conditional release decision-making process. All persons found Not Guilty by Reason of Insanity at East Louisiana Mental Health System, Forensic Division who underwent a review panel between July 1, 1997 and July 1, 1999 were included in this study. The Classification and Regression Tree analysis was utilized to arrive at cutpoints that would optimize the predictive ability of the decision tree analysis. The results indicated that the Community Outpatient Treatment Readiness Profile score was the strongest predictor -- all patients receiving a score of 62 or greater on this scale were recommended to remain at the facility. When women were recommended for release, it was to civil facilities and with moderate levels of symptoms. For males with moderate symptoms, low PCL-R scores were associated with recommendations for release, whereas high scores were associated with recommendations for continued commitment. Our data suggests that algorithms may be useful to governing bodies when making release decisions.

Adult↗
PubMed2005

The Alabama Structured Assessment of Treatment Completion for insanity acquittes (The AlaSATcom).

The most complex and risky decisions made by forensic psychiatrists revolve around the decision to release insanity acquittes from custody. This decision has several levels of risk, including the potential liability to the psychiatrist as well as the possible risk to the community. A single bad outcome, even if not predictable, can have disastrous results, not only for victims, but also for the releasing facility. Since predicting violence has so many problems, we chose to look at completeness of treatment instead, so we could say to the Court, "We don't know about violence, but we do know that he has vastly improved." Since many NGRI (Not Guilty by Reason of Insanity) patients spend years in the hospital, they are also expensive. They have rights, as well; therefore the complex assessment must be done as quickly and as accurately as possible. We have developed a spread sheet program to compare these multiple factors, and have compared it against the clinical decisions we have made in more than 100 discharges. We believe this gives a framework for decision-making that will increase the consistency of this process.

Adult↗