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PubMed1986

The duty to warn.

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Confidentiality↗
PubMed1986

Civil commitment of the mentally ill: an overview.

This article discusses historical themes that led to the civil commitment reforms of the sixties and seventies. The changes in the substantive criteria for commitment are analyzed and critiqued. The author believes that the present criteria tend to focus so specifically on various external indicia of mental illness that they render commitment difficult for many seriously ill patients. An alternative commitment scheme is discussed.

Commitment of Persons with Psychiatric Disorders↗
PubMed1999

Are the mentally ill dangerous?

The author reviews studies that address the question, "Are the mentally ill dangerous?" She points out that as psychiatrists, we have the responsibility of evaluating the mentally ill and making judgments about their dangerousness that may restrict their civil liberties. Therefore, the more practical question for us is: "Which mentally ill, under what circumstances, are dangerous?" She discusses data from her research group and others that show that short-term predictions of violence can be relatively accurate, that we are better at predicting violence for some patients than for others, that specific symptom patterns in the acute phase of illness are related to violent acts, that the most likely victims of violence by decompensating psychiatric patients are caretakers rather than strangers, and that a history of violence, co-morbid substance abuse, and treatment noncompliance are related to a higher risk of violence in psychiatric patients.

Adult↗
PubMed1999

Public awareness of the effectiveness of psychiatric treatment may reduce stigma.

UNLABELLED: Stigmatization is of importance in mental disorders. It is widely believed that one of the most important factors in stigmatization is considering the patients as dangerous. This study aims at analyzing the impact of knowledge regarding the chances of treating mental illness. MATERIALS AND METHODS: 700 final year university students filled out the Dangerousness Scale and gave their opinions on whether mental illnesses are treatable. RESULTS: The results showed that the subjects who think that the chance of treatment for mental diseases does not exist find mentally ill people more dangerous than the subjects who declare the opposite. On the basis of this finding, it can be suggested that drawing public attention to the therapeutic advances in psychiatry may lead to a decrease in stigmatization.

Adolescent↗
PubMed1998

Measuring risk and related behaviour with the Behavioural Status Index (BSI): some preliminary psychometric studies.

British Special Hospitals are key caregivers for mentally disordered individuals who may display extreme anti-social and challenging behaviour. Assessment of risk and related diurnal behaviour is central to treatment planning for these patients. This paper describes a behaviourally based assessment instrument to assist in the process of the assessment of these 'risky' and related diurnal behaviour. Results of some early data analysis are reported.

Aggression↗
PubMed2000

A descriptive study of child and adolescent obsessional followers.

This study is a preliminary descriptive investigation of the phenomenon of stalking in children and adolescents. Data on offender characteristics, victim characteristics, and stalking patterns were examined in a sample of 13 obsessional followers ranging in age from 9 to 18. Many research findings from investigations on adults who stalk were replicated in this study, including the fact that most stalking offenders are male, most victims are female, and about half of stalking cases involve threats made toward the victim. In addition, the rate of violence was 31% in this sample of juvenile stalking offenders and the most common methods of stalking were physical approach, telephone calls, and letter writing. Some interesting trends in the data emerged which require further study and suggest some differences may exist between juvenile and adult stalking offenders. The results are preliminary and suggest directions for future research.

Adolescent↗
PubMed2000

Learning from discordance in patient and physician global assessments of systemic lupus erythematosus disease activity.

OBJECTIVE: Differences have been described between patient and physician assessments of well being in several chronic illnesses, and these differences may affect outcome. Disagreement may lead to dissatisfaction and to behaviors with dangerous consequences. We describe and identify predictors of patient-physician differences on ratings of disease activity in systemic lupus erythematosus (SLE). METHODS: Data collected on 154 patients included age, education, disease duration, and patient and physician global assessments of lupus activity on a 10 cm visual analog scale (VAS), the Health Assessment Questionnaire (HAQ), the Medical Outcome Study Short-Form 36 (SF-36), the Systemic Lupus Disease Activity Index (SLEDAI), the Systemic Lupus Activity Measure (SLAM-R), and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Multiple linear regression models were performed using patient VAS scores, physician VAS scores, and patient minus physician VAS scores as the dependent variables, and age, disease duration, selected SF-36 and SLAM-R subscales, and SDI as independent variables. RESULTS: Patients were 90% female and 80% Caucasian, with a mean education of 13 +/- 2.8 years and a mean age of 43.1 +/- 13.6 years. The overall mean disease duration was 10.5 +/- 7.8 years. Physicians overscored patients by 2.5 cm in 6% of the cases and patients overscored physicians in 16% of the cases. The best multivariate model to predict overall differences included SF-36 mental health and SLAM-R kidney scores. CONCLUSION: Patient-physician differences may result from a divergence in focus. Patients score lupus activity based on their psychological status, while physicians rely more heavily on the physical effect of the disease.

Adult↗