Sociodemographic and psychiatric characteristics among homicide offenders in Serbia - the province of Vojvodina (1996-2005)

Introduction. Recent studies have shown a growing correlation between violence and mental illness, but there is a higher risk of violent crimes only in certain cases of mental disorders. This study presents sociodemographic and psychiatric characteristics of homicide offenders in Serbia, in the Province of Vojvodina in a 10-year period (1996-2005). Material and Methods. The obtained data are based on performed forensic and psychiatric expert investigations of 154 homicide offenders in preceding period, considering sociodemographic data, personal history and current psychiatric status. Data were analyzed using the statistical John?s Macintosh programe. Results. The male offenders were in the great majority (92%) as well as a low level of education (87%). A positive history of criminal acts was found in 24% of the subjects. Minority of subjects (21%) consumed alcohol on a daily basis. At the time of committing the crimes, 57% of homicide offenders were under the influence of alcohol, and just 2% of other psychoactive substances. Among the offenders who had previously received psychiatric treatment (31.2%), the most frequent diagnosis was alcohol addiction (25%) and anxiety disorders (22.9%). During the psychiatric examination 70.8% of the subjects were diagnosed with mental disorder: personality disorders (41%), alcohol addiction (84%), neurotic disorders (65%), schizophrenic psychosis (5.2%), affective disorders (3.2%), paranoid psychosis (2.6%), organic disorders (19%), psychoactive drug addiction (13%) and mental retardation (0.6%). Emotionally unstable personality disorder was dominant among personality disorders (55.6%). Diminished mental competency was established in 77.9% of subjects at the time of the homicide, being rather sever in most of them. All those diagnosed to have a psychotic disorder were mentally incompetent. Conclusion. Emotionally unstable disorders were the most common among the offenders who underwent forensic evaluation. A relatively low presence of psychotic disorders imposes the need for destigmatization particularly of the patients suffering from major mental illnesses.

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Paliperidone to Treat Psychotic Disorders

Neurology International ◽

10.3390/neurolint13030035 ◽

2021 ◽

Vol 13 (3) ◽

pp. 343-358

Author(s):

Hormazd D. Minwalla ◽

Peter Wrzesinski ◽

Allison Desforges ◽

Joshua Caskey ◽

Brittany Wagner ◽

...

Keyword(s):

Cognitive Impairment ◽

Schizoaffective Disorder ◽

Negative Symptoms ◽

Psychotic Disorders ◽

Drug Information ◽

The United States ◽

Mental Illnesses ◽

Positive Symptoms ◽

Review Of The Literature ◽

Second Generation Antipsychotics

Purpose of Review: This is a comprehensive review of the literature regarding the use of paliperidone in the treatment of schizophrenia and schizoaffective disorder. It covers the background and presentation of schizophrenia and schizoaffective disorder, as well as the mechanism of action and drug information for paliperidone. It covers the existing evidence of the use of paliperidone for the treatment of schizophrenia and schizoaffective disorder. Recent Findings: Schizophrenia and schizoaffective disorder lead to significant cognitive impairment. It is thought that dopamine dysregulation is the culprit for the positive symptoms of schizophrenia and schizoaffective disorder. Similar to other second-generation antipsychotics, paliperidone has affinity for dopamine D2 and serotonin 5-HT2A receptors. Paliperidone was granted approval in the United States in 2006 to be used in the treatment of schizophrenia and in 2009 for schizoaffective disorder. Summary: Schizophrenia and schizoaffective disorder have a large impact on cognitive impairment, positive symptoms and negative symptoms. Patients with either of these mental illnesses suffer from impairments in everyday life. Paliperidone has been shown to reduce symptoms of schizophrenia and schizoaffective disorder.

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Comorbidity of personality disorders and mental illnesses

Psychiatry ◽

10.1016/j.mppsy.2008.01.010 ◽

2008 ◽

Vol 7 (3) ◽

pp. 102-104 ◽

Cited By ~ 8

Author(s):

Marianne Hayward ◽

Paul Moran

Keyword(s):

Personality Disorders ◽

Mental Illnesses

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Advances in psychiatric treatment in primary care

Advances in Psychiatric Treatment ◽

10.1192/apt.7.1.1 ◽

2001 ◽

Vol 7 (1) ◽

pp. 1-8 ◽

Cited By ~ 8

Author(s):

Christopher Dowrick

Keyword(s):

Mental Health ◽

Primary Care ◽

National Health Service ◽

Health Service ◽

Health Professionals ◽

Depressive Disorders ◽

Mental Health Problems ◽

Psychiatric Treatment ◽

Mental Illnesses ◽

Breaking Work

Following ground-breaking work by Shepherd et al (1966) and, more recently, Goldberg & Huxley (1992), primary care is now recognised as the arena in which most contact occurs between the National Health Service (NHS) and people with mental health problems. General practitioners (GPs) remain the first, and in many cases the only, health professionals involved in the management of a whole range of conditions, from common anxiety and depressive disorders to severe and enduring mental illnesses.

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First Do No Harm: An Analysis of the Risk Aspects and Side Effects of Clinical Holistic Medicine Compared With Standard Psychiatric Biomedical Treatment

The Scientific World JOURNAL ◽

10.1100/tsw.2007.268 ◽

2007 ◽

Vol 7 ◽

pp. 1810-1820 ◽

Cited By ~ 5

Author(s):

Søren Ventegodt ◽

Isack Kandel ◽

Joav Merrick

Keyword(s):

Side Effects ◽

Psychiatric Treatment ◽

Treatment Method ◽

Mental Illnesses ◽

Holistic Medicine ◽

Treatment As Usual ◽

Philosophy Of Life ◽

Do No Harm ◽

Comparative Review ◽

Patients At Risk

Clinical holistic medicine (CHM) is short-term psychodynamic psychotherapy (STPP) complemented with bodywork and philosophical exercises, to be more efficient in treating patients with severe mental and physical illness. STPP has already been found superior to psychiatric treatment as usual (TAU) and thus able to compete with psychiatric standard treatment as the treatment of choice for all non-organic mental illnesses; we have found the addition of bodywork and philosophy of life to STPP to accelerate the process of existential healing and recovery (salutogenesis). In this paper we compare the side effects, suicidal risk, problems from implanted memory and implanted philosophy of CHM with psychopharmacological treatment. Method: Qualitative and quantitative comparative review. Results: In all aspects of risks, harmfulness, and side effects, we have been considering, CHM was superior to the standard psychiatric treatment. The old principle of “first do no harm“ is well respected by CHM, but not always by standard psychiatry. CHM seems to be able to heal the patient, while psychopharmacological drugs can turn the patient into a chronic, mentally ill patient for life. Based on the available data CHM seems another alternative to patients with mental illness. There seem to be no documentation at all for CHM being dangerous, harmful, having side effects of putting patients at risk for suicide. As CHM uses spontaneous regression there is no danger for the patient developing psychosis as, according to some experts, has been seen with earlier intensive psychodynamic methods. CHM is an efficient, safe and affordable cure for a broad range of mental illnesses.

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Medical Aspects of Management Problems in Maximum Security Prisons

Medicine Science and the Law ◽

10.1177/002580247901900208 ◽

1979 ◽

Vol 19 (2) ◽

pp. 111-117

Author(s):

P. J. Pope ◽

T. C. N. Gibbens

Keyword(s):

Mental Illness ◽

Personality Disorder ◽

Psychiatric Hospital ◽

Psychiatric Treatment ◽

Great Majority ◽

Psychopathic Personality ◽

Fair Share ◽

Mentally Disordered ◽

Maximum Security ◽

Management Problems

Much has been written, especially recently, about the difficulties presented in prisons by the inclusion of mentally disordered or even psychotic offenders who would be more appropriately placed in mental hospitals. This study, carried out in 4 maximum security prisons during 1972–3, concludes that such men do not constitute any more than their fair share of all those who are seen as either disruptive or presenting management problems, probably less. Altogether a fifth of those men identified by prison staff as management problems had had some kind of psychiatric treatment before the sentence began, 4.4 per cent showed evidence of overt mental illness during it and 45 per cent were labelled as having either a psychopathic personality or a personality disorder of some kind. The great majority (85 per cent) of those presenting management problems spent the bulk of their sentences in the general wings of the four prisons and only a handful were felt to be better located in a psychiatric hospital.

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Kernberg's Object-Relations Theory and the Group Psychotherapy of Psychosis

Group Analysis ◽

10.1177/0533316494274007 ◽

1994 ◽

Vol 27 (4) ◽

pp. 419-432 ◽

Cited By ~ 4

Author(s):

Charles F.A. Milders

Keyword(s):

Object Relations ◽

Personality Disorders ◽

Group Process ◽

Psychotic Disorders ◽

Personality Pathology ◽

Object Relations Theory ◽

Individual Group ◽

Psychotherapeutic Process ◽

Psychic Process ◽

The Individual

The application of object-relations theory to the psychotherapy of severe personality disorders owes much to the writings of Otto Kernberg. According to Kernberg, object-relations theory facilitates analysis of the psychotherapeutic process and the clarification of personality pathology. It is a concept that integrates theories of psychic process in the individual, group process and the organization of the clinical setting, and has found general support among Dutch (group) psychotherapists treating patients with borderline and psychotic disorders. However, the scope of object-relations theory is seldom addressed. When object-relations theory is separated from clinical psychiatry it can be overvalued as a universal explanatory model.

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Developmental mechanisms in the prodrome to psychosis

Development and Psychopathology ◽

10.1017/s0954579413000783 ◽

2013 ◽

Vol 25 (4pt2) ◽

pp. 1585-1600 ◽

Cited By ~ 20

Author(s):

Elaine F. Walker ◽

Hanan D. Trotman ◽

Sandra M. Goulding ◽

Carrie W. Holtzman ◽

Arthur T. Ryan ◽

...

Keyword(s):

Psychotic Disorders ◽

Preventive Intervention ◽

Disease Process ◽

Research Literature ◽

Mental Illnesses ◽

Critical Issues ◽

Research Findings ◽

New Research ◽

Postnatal Stress ◽

Adolescent Brain Development

AbstractPsychotic disorders continue to be among the most disabling and scientifically challenging of all mental illnesses. Accumulating research findings suggest that the etiologic processes underlying the development of these disorders are more complex than had previously been assumed. At the same time, this complexity has revealed a wider range of potential options for preventive intervention, both psychosocial and biological. In part, these opportunities result from our increased understanding of the dynamic and multifaceted nature of the neurodevelopmental mechanisms involved in the disease process, as well as the evidence that many of these entail processes that are malleable. In this article, we review the burgeoning research literature on the prodrome to psychosis, based on studies of individuals who meet clinical high risk criteria. This literature has examined a range of factors, including cognitive, genetic, psychosocial, and neurobiological. We then turn to a discussion of some contemporary models of the etiology of psychosis that emphasize the prodromal period. These models encompass the origins of vulnerability in fetal development, as well as postnatal stress, the immune response, and neuromaturational processes in adolescent brain development that appear to go awry during the prodrome to psychosis. Then, informed by these neurodevelopmental models of etiology, we turn to the application of new research paradigms that will address critical issues in future investigations. It is expected that these studies will play a major role in setting the stage for clinical trials aimed at preventive intervention.

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MON-252 Pituitary Tumor Apoplexy Presenting with Acute Psychosis

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1517 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Maria Mercedes Pineyro ◽

Patrica Agüero ◽

Florencia Irazusta ◽

Claudia Brun ◽

Paula Duarte ◽

...

Keyword(s):

Psychiatric Disorders ◽

Pituitary Tumor ◽

Psychiatric Treatment ◽

Psychiatric Symptoms ◽

Mental Illnesses ◽

Psychotic Symptoms ◽

Acute Psychosis ◽

Sellar Mass ◽

History Of ◽

Pituitary Tumor Apoplexy

Abstract Background: Pituitary tumors (PT) can present with neuropsychiatric symptoms. It has been associated with hormonal changes, as well as extension of the tumor to the diencephalon. Psychopathology has been reported in up to 83% in Cushing Disease (CD) and 35% in acromegaly (ACR). Psychiatric disorders (depression, anxiety and psychosis) have been reported up to 77% in CD and 63% in ACR. We present a rare case of a patient presenting with acute psychosis and a PT apoplexy. Case: A 27 year-old Caucasian female with a PMH of primary hypothyroidism presented with a 15-day history of delusions. She had delusional ideas on the subject of harm and prejudice, persecutory and mystical-religious. The mechanism was mainly intuitive and interpretive with false acknowledgments. She also had sleep disturbance, death ideation and subacute alteration of consciousness. There was no history of substance abuse or psychiatric disorders. She did not report headaches, visual disturbances, symptoms of hormone hypersecretion or hypopituitarism. She had regular menses on BCP. She had no family history of mental illnesses. Physical exam revealed reluctance, latency in responses and bradypsychia. She did not have acromegalic or cushingoid features. She was diagnosed with acute psychosis with atypical features so a brain CT was performed, which showed a sellar mass. Pituitary MRI revealed a sellar mass measuring 15x12x13 mm, with suprasellar extension, optic chiasm compression, hyperintense on T1- and hypointense on T2-weighted imaging compatible with subacute hemorrhage. She was treated with neuroleptics and benzodiazepines. Lab work revealed high prolactin (PRL) (114ng/dl), and normal 8 AM cortisol, FT4, LH, FSH and IGF-1 levels. Repeated PRL was 31,6 ng/dl after changing psychiatric treatment to aripiprazole. Her psychiatric symptoms improved. We postulate a diagnosis of PT apoplexy that presented with acute psychosis. In relation to the nature of the PT we postulate a non functioning pituitary adenoma (NFA) or a partial resolution of a prolactinoma after apoplexy. A follow up MRI is pending. Discussion: Infrequently, psychiatric symptoms may be the primary manifestation of brain tumors. Patients with PT have been reported to have altered quality of life, reduced coping strategies, increased prevalence of psychopathological alterations and maladaptive personality disorders. In addition, they can present with psychotic symptoms, mostly reported with hormone excess (GH and cortisol). Psychiatric symptoms such as anxiety and neurosis have been reported in NFA and prolactinomas. However, it is not clear a higher prevalence of psychiatric illnesses in these tumors. To our knowledge this is the first case of a pituitary tumor apoplexy presenting with acute psychosis. Conclusion: Psychiatric symptoms can be the first manifestation of PT, so atypical presentations should warrant further workup with brain imaging.

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Traditional faith healers as referral sources: A hospital-based descriptive study

Journal of Psychiatrists Association of Nepal ◽

10.3126/jpan.v7i2.24614 ◽

2018 ◽

Vol 7 (2) ◽

pp. 46-50

Author(s):

D.K. Thapa ◽

N. Lamichhane ◽

S. Subedi

Keyword(s):

Mental Illness ◽

Mental Disorders ◽

Psychotic Disorders ◽

Psychiatric Patients ◽

Descriptive Study ◽

Mental Illnesses ◽

General Observation ◽

Cross Sectional ◽

Faith Healer ◽

Common Notion

Introduction: Mental illnesses are commonly linked with a higher disability and burden of disease than many physical illnesses. But despite that fact, it is a general observation that a majority of patients with mental disorder never seek professional help. To elaborate further, the widely prevalent magico-religious beliefs associated with mental illness and lower literacy, poses significant social obstacles in seeking appropriate health care for psychiatric patients. In general, mental illness is seen as related to life stresses, social or family conflicts and evil spirits and the concept of biological causes of mental illness is rare even among the educated. The idea that illness and death are due to malevolent spirits is common notion that is shared practically by all level of society from the so-called primitive to modern industrialized societies, thus indicating the strong influences of cultural background. When there is a magico- religious concepts of disease causation, there is tendency to consult indigenous healers. Therefore, the patients with mental illness often either visit or are taken to faith healers by their relatives. The objective of the study was to determine the various psychiatric cases that were referred by the traditional faith healers to the authors. Material and Method: This is a cross- sectional, hospital- based descriptive study, conducted at the Psychiatric outpatient department of Pokhara Om Hospital, Pokhara, Kaski, Nepal for the period of one year, from June 2016 to May 2017. The total of 35 cases, referred by the traditional faith healers was included in the study. Subjects of any age, any gender, any literacy level, any caste, from any locality and religious background were included in the study after their consent. Subjects who refused to consent were not included in the study. The psychiatric diagnosis was based on the complete history and examination and ICD- 10 DRC criteria. Results: Though the sample size is small, it is interesting to note that patients with various kinds of mental disorders were referred by traditional faith healers. There were patients suffering from neurotic disorders, psychotic disorders, mood disorders, seizure, substance use disorder, intellectual disability etc seeking the treatment from traditional faith healers. Among the cases referred, predominantly were female and neurotic cases. Most patients were educated. Conclusion: The study shows that patients with various mental disorders visit traditional faith healer. This area surely requires further in-depth look as traditional faith healers can be an important source of referral of psychiatric patients.

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Mental illness versus mental disorder: Arguments and forensic implications

10.1093/med/9780198722373.003.0011 ◽

2016 ◽

Author(s):

Hans-Ludwig Kröber

Keyword(s):

Mental Illness ◽

Mental Disorder ◽

Personality Disorders ◽

Forensic Psychiatry ◽

Subjective Experience ◽

Psychotic Disorders ◽

Theoretical Concept ◽

Legal Responsibility ◽

Full Responsibility ◽

Forensic Implications

Modern psychiatry uses a theoretical concept of ‘disorder’: it describes various impaired functions without distinguishing pathological disorders from non-pathological disorders, or even from disorders similar to an illness. Of course, this usage eliminates neither illnesses nor the subjective experience of being ill, but it has implications for forensic psychiatry and for the assessment of a person’s legal responsibility. Having schizophrenic delusions constitutes a categorically different state from having only wishful illusions or a vivid imagination. In the context of medicine and psychiatry, we certainly encounter stages that signal fundamental differences. These differences are easily detected when assessing psychotic disorders or similar states, but a lot of differences also arise when assessing perpetrators with personality disorders or simply antisocial behavior. Where, in these states, are the borders that demarcate full responsibility from substantially reduced social responsibility?

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