scholarly journals FORENSIC PSYCHIATRY AND DUAL DIAGNOSIS

2021 ◽  
Author(s):  
Beatriz Jorge ◽  
Juliana Carvalho ◽  
Catarina Pedro ◽  
Sara Carneiro
Keyword(s):  
Dual Diagnosis ◽  
Criminal Behavior ◽  
Integrated Approach ◽  
Clinical Approach ◽  
Additional Risk ◽  
Lifetime Trauma ◽  
Younger Age ◽  
Dual Disorder ◽  
Offending Behaviour ◽  
Substances Of Abuse

1.Objective: Dual diagnosis patients perpetrate crime more often than healthy individuals and is of great importance for forensic mental health services. However, in dual diagnosis patients, very little is known about factors explaining criminal behavior. This work aims to summarize the epidemiological and clinical approach of dual diagnosis patients, focusing on the Iberian Peninsula scope. Aditionaly, it aims to analyse the state of the art regarding associations between demographic and clinical factors and perpetration of crime in dual disorder patients. 2. Method: A non-systematic review of the literature is presented. Bibliographic selection was carried out through keyword research in MEDLINE and Google Scholar. 3. Results and conclusions: Perpetration of violence was independently associated with younger age, severity of alcohol use problems, lifetime trauma exposure, and higher manic symptom scores. The three drugs most commonly associated with the drugs–crime connection are heroin, crack and cocaine. A study conducted in penitentiary centers of the Interior in Spain found a high percentage of dual pathology (81.4%) In the portuguese largest security ward, in Coimbra, 40.5% of the sample had dual diagnosis disorders. Forensic units must take an integrated approach to addressing substance-use disorders. It is needed to consider not only the complexities of the substance misuse and the mental disorder, but also the offending behaviour that brought them into the forensic services. Also, social skills can effectively be improved in dual diagnosis patients. Further research is required to identify additional risk factors, such as individual substances of abuse, and establish a causal model leading to criminal perpetration.

Alcohol and dual disorder. Paliperidone palmitate effectiveness

2016 ◽  
Vol 33 (S1) ◽  
pp. S314-S315
Author(s):  
M.R. Raposo ◽  
V. Ivanov ◽  
I. Martínez ◽  
A.L. González ◽  
M.D. Piqueras ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Dual Diagnosis ◽  
Extended Release ◽  
Health Centre ◽  
Total Sample ◽  
Paliperidone Palmitate ◽  
First Episode ◽  
Mental Health Centre ◽  
Dual Disorder ◽  
Competing Interest

IntroductionAlcohol use is a common behavior in most people in our society. A first episode of alcoholism can be fully recovered through specialized treatment and other protective factors and need not become a relapse later.ObjectivesWhether there are differences in alcohol use after 1, 3 and 6 months after the administration of paliperidone palmitate extended-release injectable suspension in a sample of patients.Material and methodsThis is a descriptive study that analyzed the differences observed with respect to alcohol use after administration of paliperidone palmitate in a sample of 98 patients attending in a Mental Health Centre, in the Unit for drug dependency to present pathology dual.ResultsThe percentage of alcohol use at baseline is 56.1% of the total sample.One month after treatment with paliperidone palmitate the percentage of use is reduced to 31.6%. At 3 months of treatment the reduction is more significant assuming only the 6.1% of the total sample. Finally after 6 months of treatment the percentage of patients maintaining alcohol use is 4.1%, which represents a 52% reduction compared to the initial rate of use.ConclusionsThe data reflect a 92% reduction in alcohol use after 6 months of the administration of paliperidone palmitate.We can say that paliperidone palmitate is effective in reducing alcohol use in patients with dual diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The clinical approach to criminology

1980 ◽  
Vol 10 (4) ◽  
pp. 619-631 ◽  
Author(s):  
D. J. West
Keyword(s):  
Political Change ◽  
Social Problems ◽  
Individual Characteristics ◽  
Clinical Approach ◽  
Crucial Importance ◽  
Political Factors ◽  
Treatment Interventions ◽  
Wide Range ◽  
Reducing Recidivism ◽  
Offending Behaviour

SYNOPSISThe crucial importance of economic, social and political factors in the definition and incidence of crime is undeniable, as is the need for socio-political change, but the part played by individual characteristics in determining who becomes labelled a criminal should not be neglected. Clinical criminology studies offenders as individuals, examines their peculiarities and their social problems and seeks ways to help them to lead less troubled lives. A wide range of treatment interventions is required, the psychiatric approach is not always the most appropriate.In view of the lack of success in reducing recidivism by means of treatment, penologists see little justification for continuing to try. More successes might be recognized if treatment schemes were applied with greater realism and discrimination, and if proper evaluations were made more often. In any event, some offenders need treatment regardless of the effect upon their offending behaviour.

scholarly journals The Conceptual Framework of Dual Disorders and Its Flaws

2020 ◽  
Vol 9 (7) ◽  
pp. 2098
Author(s):  
Matteo Pacini ◽  
Angelo G. I. Maremmani ◽  
Icro Maremmani
Keyword(s):  
Cultural Context ◽  
Clinical Approach ◽  
Dual Disorders ◽  
Heroin Use ◽  
Heroin Use Disorder ◽  
Scientific Approach ◽  
Dual Disorder ◽  
Multiple Treatments ◽  
Opioid Medications

When psychiatric illness and substance use disorder coexist, the clinical approach to the patient is, unsurprisingly, awkward. This fact is due to a cultural context and, more directly, to the patient’s psychiatric condition and addiction behaviors—a situation that does not favor a scientific approach. In dual disorder facilities, several types of professionals work together: counselors, social workers, psychologists, and psychiatrists. Treatment approaches vary from one service to another and even within the same service. It is crucial to provide dual disorder patients with multiple treatments, comprising hospitalization, rehabilitative and residential programs, case management, and counselling. Still, when treating dual disorder (DD) heroin use disorder (HUD) patients, it is advisable to follow a hierarchical algorithm. First, we must deal with addiction: by detoxification, whenever possible. This means starting most patients on anti-craving pharmacological maintenance, though aversion therapy may be appropriate for a few of them. Opiate antagonists may be used with heroin-addicted patients as long as those patients are only mildly ill. In contrast, agonist opioid medications, i.e., buprenorphine and methadone suit moderately and severely ill patients, respectively. Achieving control of mood instability or psychotic episodes is the next step, to be followed by a prevention strategy to counteract residual cravings and dominate mood disorders or psychotic episodes through long-term pharmacological maintenance that is focused on a double target.

scholarly journals Loneliness and Social Networks in Europe

2021 ◽  
Vol 51 (3) ◽  
pp. 381-407
Author(s):  
Željka Tonković ◽  
Dražen Cepić ◽  
Ivan Puzek
Keyword(s):  
Social Networks ◽  
Social Trust ◽  
Age Groups ◽  
Integrated Approach ◽  
European Countries ◽  
Sociocultural Factors ◽  
East European ◽  
Younger Age ◽  
Fresh Perspective ◽  
Social Causes

The paper analyses social causes of loneliness in Europe using cross-national data from the 2017 International Social Survey Programme (ISSP) module “Social Networks and Social Resources” from 13 countries categorised as Northern Europe, Continental Europe, and Central and Eastern Europe. The paper aims to examine loneliness with regard to three specific groups of predictors, related to network, sociocultural and sociostructural aspects. The results suggest that sociability patterns and personal networks are the most important predictors of loneliness. While the frequency of contacts with family members and close friends and the overall number of contacts showed significance, loneliness was primarily related to the quality of personal relationships. Considering sociocultural factors, the obtained findings showed that social trust is consistently associated with lower levels of loneliness. Furthermore, people from Continental Europe were, in general, less lonely than North and East Europeans. Age was an important factor here as respondents from younger age groups were lonelier in Nordic countries than in the other two blocs of countries, while older respondents were lonelier in Central and East European countries. Finally, sociostructural indicators in general showed less predictive value compared to sociability patterns and sociocultural variables. However, when it came to socioeconomic exclusion, this aspect showed a stronger connection with loneliness for the individuals from the Nordic group of countries. The findings of this paper contribute to the vibrant field of contemporary scholarship on loneliness with a fresh perspective based on comparing three large blocs of European countries and an integrated approach to various predictors of loneliness.

Alcohol Involvement in Suicide and Self-Harm

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 413-422 ◽  
Author(s):  
Celine Larkin ◽  
Eve Griffin ◽  
Paul Corcoran ◽  
Carmel McAuliffe ◽  
Ivan J. Perry ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Suicidal Behavior ◽  
Alcohol Misuse ◽  
Significant Risk ◽  
Psychiatric Ward ◽  
Clinical Approach ◽  
Out Of Hours ◽  
Alcohol Involvement ◽  
Younger Age ◽  
Self Harm

Abstract. Background: Alcohol misuse and alcohol consumption are significant risk factors for suicidal behavior. Aims: This study sought to identify factors associated with alcohol consumption in cases of suicide and nonfatal self-harm presentations. Method: Suicide cases in Cork, Ireland, from September 2008 to June 2012 were identified through the Suicide Support and Information System. Emergency department presentations of self-harm in the years 2007–2013 were obtained from the National Self-Harm Registry Ireland. Results: Alcohol consumption was detected in the toxicology of 44% out of 307 suicide cases. Only younger age was significantly associated with having consumed alcohol among suicides. Alcohol consumption was noted in the case notes in 21% out of 8,145 self-harm presentations. Logistic regression analyses indicated that variables associated with having consumed alcohol in a self-harm presentation included male gender, older age, overdose as a method, not being admitted to a psychiatric ward, and presenting out-of-hours. Limitations: Data was limited to routinely collected variables by the two different monitoring systems. Conclusion: Alcohol consumption commonly precedes suicidal behavior, and several factors differentiated alcohol-related suicidal acts. Self-harm cases, in particular, differ in profile when alcohol is consumed and may require a tailored clinical approach to minimize risk of further nonfatal or fatal self-harm.

Meaning in adjustment to cancer: A model of care

2008 ◽  
Vol 6 (1) ◽  
pp. 61-70 ◽  
Author(s):  
Carrie Lethborg ◽  
Sanchia Aranda ◽  
David Kissane
Keyword(s):  
Health Care Professionals ◽  
Integrated Approach ◽  
Clinical Approach ◽  
Life Changes ◽  
Theoretical Understanding ◽  
Goals Of Care ◽  
Therapeutic Modalities ◽  
Life Threatening Illness ◽  
Life Threatening

ABSTRACTObjectives:In the clinical setting of cancer, meaning may well have a central role in the life changes the illness experience brings about. As health care professionals working with people with life-threatening illness, we are exposed to one of the major turning points in life and the ways people confront this transition. Meaning can assist coping by offering a framework, perspective, and counterbalance to the challenge of illness. However, the absence of meaning can be a precursor to profound despair.Methods:This article brings together the clinical implications of two studies conducted by the authors that explored the role of meaning in adjustment to cancer, presenting a theoretical understanding of the experience of meaning in cancer and identifying some potential approaches to intervention.Results:Our findings point to some specific goals of care as well as a number of therapeutic modalities aimed to meet these goals. We examine four goals of care—acknowledging suffering, encouraging a search for meaning, strengthening connection with others, and ensuring optimal physical care—as foundational in any clinical approach and then examine the key models of therapy that assist the clinician in pursuing these goals.Significance of results:Our aim is to create an integrated approach to care provision that locates meaning centrally in any patient's adaptation.

Dual Diagnosis: An Integrated Approach to Treatment

2002 ◽  
Vol 53 (10) ◽  
pp. 1334-1334 ◽  
Author(s):  
Robert E. Drake
Keyword(s):  
Dual Diagnosis ◽  
Integrated Approach
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