Sunday, May 20, 2012

Prison Psychiatry News Review - 5/20/2012 | “If you are going to put them in prison, you have to keep them safe.”: US Issues Far-Reaching Rules to Stem Prison Rape - New York Times | Mentally ill inmates sue to get out of solitary - Boston.com - 8:49 AM 5/20/2012 - Mike Nova's starred items

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Prison Psychiatry News Review - 5/20/2012

8:49 AM 5/20/2012 - Mike Nova's starred items

“If you are going to put them in prison, you have to keep them safe.”

US Issues Far-Reaching Rules to Stem Prison Rape - New York Times

via prisons - Google News on 5/17/12

New York Daily News








US Issues Far-Reaching Rules to Stem Prison Rape
New York Times
WASHINGTON — The Justice Department on Thursday issued the first comprehensive federal rules aimed at “zero tolerance” for sexual assaults against inmates in prisons, jails and other houses of detention. The regulations, issued after years of ...

Justice: Prisons to step up anti-rape effortsWashington Post




“Sexual violence, against any victim, is an assault on human dignity and an affront to American values,” President Obama said.

Obama announced that the Prison Rape Elimination Act would apply to all federal confinement facilities, and all other agencies with such facilities had to have protocols within a year to fight prison rape.  — Associated Press



Crimes in prisonWatertownDailyTimes.com

all 344 news articles »

via prisons - Google News on 5/19/12









New rules aim to reduce prison rapes
Lawrence Journal World
By Shaun Hittle New regulations issued by the Obama administration Thursday could affect how Kansas prisons handle sexual assaults. The new regulations — under development since the passage of the 2003 Prison Rape Elimination Act, or PREA — include ...

and more »

via prisons - Google News on 5/17/12









Justice: Prisons to step up anti-rape efforts
KSRO
WASHINGTON (AP) — The Obama administration ordered federal, state and local officials Thursday to adopt zero tolerance for prison rape as it issued mandatory screening, enforcement and prevention regulations designed to reduce the number of inmates ...

via Prison News on 5/18/12
The Obama administration ordered federal, state and local officials Thursday to adopt zero tolerance for prison rape as it issued mandatory screening, enforcement and prevention regulations designed to reduce the number of inmates who suffer sexual victimization at the hands of other prisoners and prison staff.

via prisons - Google News on 5/19/12

MLive.com








Law Talk: How President Obama plans to reduce prison rape
MLive.com
By Barton Deiters | bdeiters@mlive.com AP File Photo This week, the US Department of Justice announced it was stepping up efforts under the 2003 Prison Rape Elimination Act to end prison rape. The Justice Department recognized that prison rape is a ...
Feds: Prisons to step up anti-rape effortsLongview News-Journal
Crimes in prisonWatertownDailyTimes.com
Rape trial: Obama forces prisons to get tough on assaultsPittsburgh Post Gazette

all 344 news articles »

via prisons - Google News on 5/20/12


"The “war on drugs” cost billions of dollars and has been a failure. There is the same number of people addicted to drugs now as when this war began. The consequence of this war has been an ever-increasing rise in incarceration with a disproportionate number of people of color being arrested and incarcerated. For a sobering and startling examination of this phenomenon, please read Michelle Alexander’s book, “The New Jim Crow: Mass Incarceration in an Age of Colorblindness.”

There is hope, however.

The Kentucky General Assembly passed a bill last year that will begin relieving our overburdened corrections system. This will move those who need treatment for addiction into recovery and rehabilitation programs where they belong. This is only one small part of the solution."





For prisoners, hope and help behind bars and beyond
The Courier-Journal
Serving as pastor of Luther Luckett Christian Church (Disciples of Christ), the only prison congregation in Kentucky, I am faced with incarcerated men like Russell, the man in Mr. Pitts' column, who ask the very same question as he did: “What are you ...


"Grounded in the principles of restorative justice that hold people accountable for their actions as they seek to find healing and wholeness in their lives, we train small, faith-based groups of six to eight volunteers to work with men released from prison. These groups meet with one ex-offender weekly and contact him daily. They help him set goals, develop action plans and hold him accountable to the actions he takes. The groups listen, support and provide mentoring. In addition, the groups direct the ex-offender to helpful resources in the community. The goal is to equip, not enable.
It is working.
Each of us grows and matures through healthy relationships and with good role models. Many who have been incarcerated have never been blessed with either. One missing link in reducing recidivism and ending the cycle that has been sadly named “the school-to-prison pipeline,” is a compassionate community willing to work with those who have paid their debt to society. To expect them to turn their lives around without outside community support is naïve."

and more »

via forensic psychiatry international - Google Blog Search by Mike Nova on 5/13/12
Comprehensive interdisciplinary collection of links to news and journal articles on General, Forensic and Prison Psychiatry and Psychology and the issues of Behavior and Law with occasional notes and comments by Michael Novakhov, M.D. ( Mike Nova). .... Psychiatric Mislabeling Is Bad For Your Mental Hea... Introduction to this Issue: International Perspect... Psychopathic traits and change on indicators of dy... A Kindler, Gentler Psychiatrist « candidaabrahamso.

via prisons - Google Blog Search by Bert Useem on 5/19/12
U.S. Prisons and the Myth of Islamic Terrorism. by Bert Useem. There is a great deal of concern that U.S. prisons are generating high levels of Islamic extremism. Sociologist Bert Useem argues that the evidence fails to support this fear.

via Behavior and Law by Mike Nova on 5/19/12
Punishment Outside Prison - NYTimes.com

May 19, 2012

Punishment Outside Prison


By LINCOLN CAPLAN

Probation and parole for convicted offenders are complex and growing problems in criminal justice. Scholars and others with the American Law Institute, meeting in Washington this week, are to present draft proposals on ways to reform laws about offenders who serve these out-of-custody sentences.
The draft recommends fewer such community-based sentences, with shorter terms and fewer conditions imposed so that supervision is better defined. When finalized, the plan will be a model for state penal codes.
In 2010, more than 2.3 million people were behind bars in the United States. More than twice that number, 4.9 million, were under probation or parole. Such sentences — imposed either for lesser offenses like shoplifting, or after release from prison for more serious offenses — are considered easy time compared with incarceration and a first step toward a fresh start. But often, that turns out to be wrong.
Increasingly, these offenders are not reintegrated into society. Often, so many conditions are imposed on their probation or parole — like not being allowed to drink alcohol after being convicted of passing a bad check — that it is easy to violate just one and end up in custody. And the consequences of community sentences even for those never imprisoned — like not being permitted to vote or to qualify for, say, a beautician’s license — make it difficult to find a job. Under a sound justice system, most offenders should do their time and get a second chance. For many, probation and parole lead to prison, not back to a normal life.


Mike Nova's starred items

via forensic psychiatry international - Google Blog Search by Sam Snyder on 5/18/12
Relationship between comorbidity and violence risk assessment in forensic psychiatry – the implication of neuroimaging studies. (Link). • Relationship of IQ to suicide and homicide rate: an international perspective. (Link) ...

via prisons - Google News on 5/17/12

abc13.com








Prisons system ordered to release details on execution drugs
Austin American-Statesman
By Mike Ward In a victory for open government, Texas prison officials on Thursday lost their latest attempt to keep secret details about its stock and suppliers of lethal injection drugs. In an opinion dated Monday, Attorney General Greg Abbott ...
Texas prisons must disclose execution drug detailsKIII TV3
State Prisons Must Disclose Execution Drug InfoCBS Local

all 39 news articles »

via prisons - Google News on 5/17/12

Boston.com








Mentally ill inmates sue to get out of solitary
Boston.com
Prison officials defend the practice, saying administrative segregation, which can include up to 23 hours a day alone in a concrete cell, is a fundamental part of security. Art Leonardo, executive director of the North American Association of Wardens ...

and more »

via forensic psychiatry - Google News on 5/16/12









Army launches review of PTSD diagnoses
U.S. News & World Report
The latest reviews were triggered by revelations that the forensic psychiatry unit at Madigan Army Medical Center at Joint Base Lewis-McChord in Washington state may have reversed diagnoses based on the expense of providing care and benefits to members ...

via prison mental health - Google Blog Search by unknown on 5/17/12
They are glad not to be in a state prison, where there is more violence and where their mental health problems would go mostly untreated. Their fondest hope is to be transferred to a lower security facility, or, even better, to a ...

via forensic psychiatry - Google Blog Search by unknown on 5/17/12
The latest reviews were triggered by revelations that the forensic psychiatry unit at Madigan Army Medical Center at Joint Base Lewis-McChord in Washington state may have reversed diagnoses based on the expense of ...

via Faktensucher by curi56 on 5/18/12
<script type=”text/javascript” src=”http://video.foxnews.com/v/embed.js?id=1225132147001&w=466&h=263″></script><noscript>Watch the latest video at <a href=”http://video.foxnews.com”>video.foxnews.com</a></noscript>


via prisons - Google News on 5/17/12

BBC News








Inmate killed in fight inside Honduran prison
The Associated Press
TEGUCIGALPA, Honduras (AP) — Inmates at a violence-prone Honduran prison seized hostages and battled among themselves, leaving at least one inmate dead and 11 wounded, authorities said Thursday. Prison director Orlando Leyva said some women were held ...
Women held hostage in Honduran prison riotsNew Zealand Herald

all 89 news articles »

via forensic psychiatry - Google News on 5/18/12









Mental health an issue near end of stabbings trial
WSET
Brewer, who works at the state-run Center for Forensic Psychiatry, said whatever demons Abuelazam had two years ago shouldn't absolve him of responsibility in Minor's death. Abuelazam is accused of faking car trouble or seeking directions before he ...

and more »
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News and Journals Review - 7:49 AM 5/20/2012 - Mike Nova's starred items

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7:49 AM 5/20/2012 - Mike Nova's starred items

via Medicine JournalFeeds » Psychiatry by admin on 5/18/12
Effectiveness of transcranial magnetic stimulation in clinical practice post-FDA approval in the United States: results observed with the first 100 consecutive cases of depression at an academic medical center.
J Clin Psychiatry. 2012 Apr;73(4):e567-73
Authors: Connolly RK, Helmer A, Cristancho MA, Cristancho P, O’Reardon JP
Abstract

INTRODUCTION: Transcranial magnetic stimulation (TMS) is a US Food and Drug Administration-approved treatment for major depressive disorder (MDD) in patients who have not responded to 1 adequate antidepressant trial in the current episode. In a retrospective cohort study, we examined the effectiveness and safety of TMS in the first 100 consecutive patients treated for depression (full DSM-IV criteria for major depressive episode in either major depressive disorder or bipolar disorder) at an academic medical center between July 21, 2008, and March 25, 2011.

METHOD: TMS was flexibly dosed in a course of up to 30 sessions, adjunctive to current medications, for 85 patients treated for acute depression. The primary outcomes were response and remission rates at treatment end point as measured by the Clinical Global Impressions-Improvement scale (CGI-I) at 6 weeks. Secondary outcomes included change in the Hamilton Depression Rating Scale (HDRS); Quick Inventory of Depressive Symptomatology, self-report (QIDS-SR); Beck Depression Inventory (BDI); Beck Anxiety Inventory (BAI); and the Sheehan Disability Scale (SDS). Enduring benefit was assessed over 6 months in patients receiving maintenance TMS treatment. Data from 12 patients who received TMS as maintenance or continuation treatment after prior electroconvulsive therapy (ECT) or TMS given in a clinical trial setting were also reviewed.

RESULTS: The clinical cohort was treatment resistant, with a mean of 3.4 failed adequate trials in the current episode. Thirty-one individuals had received prior lifetime ECT, and 60% had a history of psychiatric hospitalization. The CGI-I response rate was 50.6% and the remission rate was 24.7% at 6 weeks. The mean change was -7.8 points in HDRS score, -5.4 in QIDS-SR, -11.4 in BDI, -5.8 in BAI, and -6.9 in SDS. The HDRS response and remission rates were 41.2% and 35.3%, respectively. Forty-two patients (49%) entered 6 months of maintenance TMS treatment. Sixty-two percent (26/42 patients) maintained their responder status at the last assessment during the maintenance treatment. TMS treatment was well tolerated, with a discontinuation rate of 3% in the acute treatment phase. No serious adverse events related to TMS were observed during acute or maintenance treatment.

CONCLUSIONS: Adjunctive TMS was found to be safe and effective in both acute and maintenance treatment of patients with treatment-resistant depression.
PMID: 22579164 [PubMed - in process]

via Medicine JournalFeeds » Psychiatry by admin on 5/18/12
Race and long-acting antipsychotic prescription at a community mental health center: a retrospective chart review.
J Clin Psychiatry. 2012 Apr;73(4):513-7
Authors: Aggarwal NK, Rosenheck RA, Woods SW, Sernyak MJ
Abstract

OBJECTIVE: There has been concern that racial minorities are disproportionately prescribed long-acting injectable antipsychotic drugs.

METHOD: Comprehensive administrative data and clinician survey were used to identify all patients with a DSM-IV diagnosis of schizophrenia who received long-acting antipsychotic prescriptions from July 2009 to June 2010 at a community mental health center. Charts were reviewed retrospectively to validate long-acting antipsychotic prescription (eg, medication, dosage) and merged with administrative data from all center patients documenting sociodemographic characteristics (ie, age, race, gender) and comorbid diagnoses. We used bivariate χ2, t tests, and multivariate logistic regression to compare the subsample of patients receiving long-acting injectable drugs (n = 102) to patients not receiving long-acting injectable drugs (n = 799) who were diagnosed with schizophrenia for the same period.

RESULTS: White patients were significantly less likely to receive long-acting antipsychotic prescriptions than minority patients (OR = 0.52, P < .007); ie, nonwhites were 1.89 times more likely to receive such drugs. Age, gender, and comorbid diagnoses, including substance abuse, were unrelated to long-acting injectable prescription, and race/ethnicity was not associated with use of specific agents (haloperidol decanoate, fluphenazine decanoate, or risperidone microspheres) (P = .73).

CONCLUSIONS: Racial minorities are more likely than other patients with schizophrenia to receive long-acting injectionable antipsychotics, a finding that suggests their prescribers may consider them less adherent to antipsychotic prescriptions.
PMID: 22579151 [PubMed - in process]

via Medicine JournalFeeds » Psychiatry by admin on 5/18/12
The psychiatric manifestations of mitochondrial disorders: a case and review of the literature.
J Clin Psychiatry. 2012 Apr;73(4):506-12
Authors: Anglin RE, Garside SL, Tarnopolsky MA, Mazurek MF, Rosebush PI
Abstract

OBJECTIVE: Mitochondrial disorders are caused by gene mutations in mitochondrial or nuclear DNA and affect energy-dependent organs such as the brain. Patients with psychiatric illness, particularly those with medical comorbidities, may have primary mitochondrial disorders. To date, this issue has received little attention in the literature, and mitochondrial disorders are likely underdiagnosed in psychiatric patients.

DATA SOURCES: This article describes a patient who presented with borderline personality disorder and treatment-resistant depression and was ultimately diagnosed with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) 3271. We also searched the literature for all case reports of patients with mitochondrial disorders who initially present with prominent psychiatric symptoms by using MEDLINE (from 1948-February 2011), Embase (from 1980-February 2011), PsycINFO (from 1806-February 2011), and the search terms mitochondrial disorder, mitochondria, psychiatry, mental disorders, major depression, anxiety, schizophrenia, and psychosis.

STUDY SELECTION: Fifty cases of mitochondrial disorders with prominent psychiatric symptomatology were identified.

DATA EXTRACTION: Information about the psychiatric presentation of the cases was extracted. This information was combined with our case, the most common psychiatric manifestations of mitochondrial disorders were identified, and the important diagnostic and treatment implications for patients with psychiatric illness were reviewed.

RESULTS: The most common psychiatric presentations in the cases of mitochondrial disorders included mood disorder, cognitive deterioration, psychosis, and anxiety. The most common diagnosis (52% of cases) was a MELAS mutation. Other genetic mitochondrial diagnoses included polymerase gamma mutations, Kearns-Sayre syndrome, mitochondrial DNA deletions, point mutations, twinkle mutations, and novel mutations.

CONCLUSIONS: Patients with mitochondrial disorders can present with primary psychiatric symptomatology, including mood disorder, cognitive impairment, psychosis, and anxiety. Psychiatrists need to be aware of the clinical features that are indicative of a mitochondrial disorder, investigate patients with suggestive presentations, and be knowledgeable about the treatment implications of the diagnosis.
PMID: 22579150 [PubMed - in process]

via Medicine JournalFeeds » Psychiatry by admin on 5/18/12
Are antipsychotics or antidepressants needed for psychotic depression? a systematic review and meta-analysis of trials comparing antidepressant or antipsychotic monotherapy with combination treatment.
J Clin Psychiatry. 2012 Apr;73(4):486-96
Authors: Farahani A, Correll CU
Abstract

OBJECTIVE: To perform a meta-analysis of antidepressant-antipsychotic cotreatment versus antidepressant or antipsychotic monotherapy for psychotic depression.

DATA SOURCES: We performed an electronic search (from inception of databases until February 28, 2011) in PubMed/MEDLINE, Cochrane Library, and PsycINFO, without language or time restrictions. Search terms were (psychosis OR psychotic OR hallucinations OR hallucinating OR delusions OR delusional) AND (depression OR depressed OR major depressive disorder) AND (random OR randomized OR randomly).

STUDY SELECTION: Eight randomized, placebo-controlled acute-phase studies in adults (N = 762) with standardized criteria-defined psychotic depression (including Research Diagnostic Criteria, DSM-III, DSM-IV, or ICD-10) were meta-analyzed, yielding 10 comparisons. Antidepressant-antipsychotic cotreatment was compared in 5 trials with 6 treatment arms (n = 337) with antidepressant monotherapy and in 4 trials with 4 treatment arms (n = 447) with antipsychotic monotherapy.

DATA EXTRACTION: Primary outcome was study-defined inefficacy; secondary outcomes included all-cause discontinuation, specific psychopathology ratings, and side effects. Using random effects models, we calculated relative risk (RR) with 95% confidence intervals (CIs), number-needed-to-treat/harm (NNT/NNH), and effect size (ES).

RESULTS: Antidepressant-antipsychotic cotreatment outperformed antidepressant monotherapy regarding less study-defined inefficacy (no. of comparisons = 6; n = 378; RR = 0.76; 95% CI, 0.59-0.98; P = .03; heterogeneity [I2] = 34%) (NNT = 7; 95% CI, 4-20; P = .009) and Clinical Global Impressions-Severity of Illness scores (no. of comparisons = 4; n = 289; ES = -0.25; 95% CI, -0.49 to -0.02; P = .03; I2 = 0%), with trend-level superiority for depression ratings (no. of comparisons = 5; n = 324; ES = -0.20; 95% CI, -0.44 to 0.03; P = .09; I2 = 10%), but not regarding psychosis ratings (no. of comparisons = 3; n = 161; ES = -0.24; 95% CI, -0.85 to 0.38; P = .45; I2 = 70%). Antidepressant-antipsychotic cotreatment also outperformed antipsychotic monotherapy regarding less study-defined inefficacy (no. of comparisons = 4; n = 447; RR = 0.73; 95% CI, 0.63-0.84; P < .0001; I2 = 0%) (NNT = 5; 95% CI, 4-8; P < .0001) and depression ratings (no. of comparisons = 4; n = 428; ES = -0.49; 95% CI, -0.75 to -0.23; P = .0002; I2 = 27%), while anxiety (P = .11) and psychosis (P = .06) ratings only trended toward favoring cotreatment. All-cause discontinuation and reported side-effect rates were similar, except for more somnolence with antidepressant-antipsychotic cotreatment versus antidepressants (P = .02). Only 1 open-label, 4-month extension study (n = 59) assessed maintenance/relapse-prevention efficacy of antidepressant-antipsychotic cotreatment versus antidepressant monotherapy, without group differences.

CONCLUSIONS: Antidepressant-antipsychotic cotreatment was superior to monotherapy with either drug class in the acute treatment of psychotic depression. These results support recent treatment guidelines, but more studies are needed to assess specific combinations and maintenance/relapse-prevention efficacy.
PMID: 22579147 [PubMed - in process]

via Medicine JournalFeeds » Psychiatry by admin on 5/18/12
Would broadening the diagnostic criteria for bipolar disorder do more harm than good? implications from longitudinal studies of subthreshold conditions.
J Clin Psychiatry. 2012 Apr;73(4):437-43
Authors: Zimmerman M
Abstract

BACKGROUND: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), is a categorical system that provides descriptive diagnostic criteria for psychiatric syndromes. These syndrome descriptions are imperfect representations of an underlying behavioral, psychological, or biological dysfunction; thus, the criteria could be conceptualized as a type of test for the etiologically defined illnesses. Accordingly, as with any other diagnostic test, diagnoses based on DSM-IV criteria produce some false positive and some false negative results. That is, some patients who meet the criteria will not have the illness (ie, false positives), and some who do not meet the criteria because their symptoms fall below the diagnostic threshold will have the illness and incorrectly not receive the diagnosis (ie, false negatives). In this context, I consider the controversy over whether the diagnostic threshold for bipolar disorder should be lowered.

METHOD: Longitudinal studies of the prognostic significance of subthreshold bipolar disorder are considered.

RESULTS: Subthreshold bipolarity is a risk factor for the future emergence of bipolar disorder, but the majority of individuals with subthreshold bipolarity do not develop a future manic or hypomanic episode.

CONCLUSIONS: The diagnostic threshold for bipolar disorder should not be lowered for 4 reasons: (1) the results of longitudinal studies suggest that lowering the diagnostic threshold for bipolar disorder will result in a greater increase in false positive than true positive diagnoses; (2) there are no controlled studies demonstrating the efficacy of mood stabilizers in treating subthreshold bipolar disorder; (3) if a false negative diagnosis occurs and bipolar disorder is underdiagnosed, diagnosis and treatment can be changed when a manic/hypomanic episode emerges; and (4) if bipolar disorder is overdiagnosed and patients are inappropriately prescribed a mood stabilizer, the absence of a future manic/hypomanic episode would incorrectly be considered evidence of the efficacy of treatment, and the unnecessary medications that might cause medically significant side effects would not be discontinued.
PMID: 22579144 [PubMed - in process]

via Behavior and Law by Mike Nova on 5/19/12
Punishment Outside Prison - NYTimes.com

May 19, 2012

Punishment Outside Prison

By LINCOLN CAPLAN
Probation and parole for convicted offenders are complex and growing problems in criminal justice. Scholars and others with the American Law Institute, meeting in Washington this week, are to present draft proposals on ways to reform laws about offenders who serve these out-of-custody sentences.
The draft recommends fewer such community-based sentences, with shorter terms and fewer conditions imposed so that supervision is better defined. When finalized, the plan will be a model for state penal codes.
In 2010, more than 2.3 million people were behind bars in the United States. More than twice that number, 4.9 million, were under probation or parole. Such sentences — imposed either for lesser offenses like shoplifting, or after release from prison for more serious offenses — are considered easy time compared with incarceration and a first step toward a fresh start. But often, that turns out to be wrong.
Increasingly, these offenders are not reintegrated into society. Often, so many conditions are imposed on their probation or parole — like not being allowed to drink alcohol after being convicted of passing a bad check — that it is easy to violate just one and end up in custody. And the consequences of community sentences even for those never imprisoned — like not being permitted to vote or to qualify for, say, a beautician’s license — make it difficult to find a job. Under a sound justice system, most offenders should do their time and get a second chance. For many, probation and parole lead to prison, not back to a normal life.

via psychiatry - Google Blog Search by Benedict Carey, NY Times on 5/18/12
The simple fact was that he had done something wrong, and at the end of a long and revolutionary career it didn't matter how often he'd been right, how powerful he once was, or what it would mean for his legacy. Dr. Robert L.

via psychiatry - Google Blog Search by Alan on 5/19/12
Dr. Robert L. Spitzer favored gay reparative therapy, but now realizes he was wrong. …he was at his computer, ready to recant a study he had done himself, a poorly conceived 2003 investigation that supported the use of ...

via psychiatry - Google News on 5/19/12

'Behavioral addiction' affects us all
ReporterHerald.com
Should the American Psychiatric Association expand its Diagnostic and Statistical Manual of Mental Disorders as proposed, then compulsive shopping, sex, time on the Internet and playing of video games could be considered medical conditions, ...
New Scientist reports on protest of psychiatric labelingExaminer.com
Can someone be mildly alcoholic? | The RepublicThe Republic
'Label jars, not people': Lobbying against the shrinksNew Scientist
The Conversation
all 9 news articles »

Mike Nova's starred items

via Medicine JournalFeeds » Psychiatry by admin on 5/19/12
Suicidality and sexual orientation among men in Switzerland: Findings from 3 probability surveys.
J Psychiatr Res. 2012 May 14;
Authors: Wang J, Häusermann M, Wydler H, Mohler-Kuo M, Weiss MG
Abstract

Few population-based surveys in Europe have examined the link between suicidality and sexual orientation. The objective of this study was to assess the prevalences of and risk for suicidality by sexual orientation, especially among adolescent and young adult men. Data came from three probability-based surveys in Switzerland from 2002: 1) Geneva Gay Men’s Health Survey (GGMHS) with 571 gay/bisexual men, 2) Swiss Multicenter Adolescent Survey on Health (SMASH) with 7,428 16-20 year olds, and 3) Swiss Recruit Survey (ch-x) with 22,415 new recruits. In GGMHS, suicidal ideation (12 months/lifetime) was reported by 22%/55%, suicide plans 12%/38%, and suicide attempts 4%/19%. While lifetime prevalences and ratios are similar across age groups, men under 25 years reported the highest 12-month prevalences for suicidal ideation (35.4%) and suicide attempts (11.5%) and the lowest attempt ratios (1:1.5 for attempt to plan and 1:3.1 for attempt to ideation). The lifetime prevalence of suicide attempts among homo/bisexual men aged 16-20 years varies from 5.1% in ch-x to 14.1% in SMASH to 22.0% in GGMHS. Compared to their heterosexual counterparts, significantly more homo/bisexual men reported 12-month suicidal ideation, plans, and attempts (OR = 2.09-2.26) and lifetime suicidal ideation (OR = 2.15) and suicide attempts (OR = 4.68-5.36). Prevalences and ratios vary among gay men by age and among young men by both sexual orientation and study population. Lifetime prevalences and ratios of non-fatal suicidal behaviors appear constant across age groups as is the increased risk of suicidality among young homo/bisexual men.
PMID: 22591853 [PubMed - as supplied by publisher]

via Behavior and Law by Mike Nova on 5/19/12
Johns Hopkins Experts Say Psychiatry’s Diagnostic Manual Needs Overhaul — Tri-City Psychology Services
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Saturday, May 19, 2012

Punishment Outside Prison - NYTimes.com

Punishment Outside Prison - NYTimes.com

May 19, 2012

Punishment Outside Prison

By LINCOLN CAPLAN
Probation and parole for convicted offenders are complex and growing problems in criminal justice. Scholars and others with the American Law Institute, meeting in Washington this week, are to present draft proposals on ways to reform laws about offenders who serve these out-of-custody sentences.
The draft recommends fewer such community-based sentences, with shorter terms and fewer conditions imposed so that supervision is better defined. When finalized, the plan will be a model for state penal codes.
In 2010, more than 2.3 million people were behind bars in the United States. More than twice that number, 4.9 million, were under probation or parole. Such sentences — imposed either for lesser offenses like shoplifting, or after release from prison for more serious offenses — are considered easy time compared with incarceration and a first step toward a fresh start. But often, that turns out to be wrong.
Increasingly, these offenders are not reintegrated into society. Often, so many conditions are imposed on their probation or parole — like not being allowed to drink alcohol after being convicted of passing a bad check — that it is easy to violate just one and end up in custody. And the consequences of community sentences even for those never imprisoned — like not being permitted to vote or to qualify for, say, a beautician’s license — make it difficult to find a job. Under a sound justice system, most offenders should do their time and get a second chance. For many, probation and parole lead to prison, not back to a normal life.

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Goodwin and Guzes Psychiatric Diagnosis von Carol S. North

Goodwin and Guzes Psychiatric Diagnosis von Carol S. North

Goodwin and Guzes Psychiatric Diagnosis
  • Autor: Carol S. North
  • Preis: EUR37,99
  • Subjekts: Französische Bücher > Medizin
  • Taschenbuch: 432 Seiten
  • Verlag: Oxford University Press, U.S.A.; Auflage: 0006
  • Sprache: Englisch
  • ISBN-10: 0195144295
  • ISBN-13: 978-0195144291
  • Größe und/oder Gewicht: 23,4x15,4x2,4cm

Pressestimmen

"This book has been and continues to be a superb contribution to psychiatry and medicine. Outstanding reviews of the literature for the various psychiatric disorders including mood, schizophrenic, panic and phobic, post-traumatic stress, obsessive-compulsive, eating, somatization, antisocial personality, borderline personality, alcoholism, drug dependence, delirium and dementia...should be required reading for all psychiatrists." -- Doody's Review Service
" . . . (the first edition) . . . . was one of the great dementia the field . . . The fifth edition of Psychiatric Diagnosis hews to the authors' previous high standards. Once again, we are treated to a clearly written, empirically based compilation of basic knowledge about 11 major categories of mental disorder. And, once again, the authors' commitment to agnosticism remains as pure as ever. In a field that continues to be tendentious, these authors steadfastly resist temptations to advance any agenda beyond the scientific."
-Contemporary Psychology
"Twenty-two years after first being published, this significant book continues its role as an important work in the area of psychiatric diagnosis. It offers conciseness, clarity, and simplicity while providing a quick overview of the most essential core of psychiatric disorders." -JAMA
"The book was clearly written, entertaining... The book retains its original style-readability combined with a no-nonsense approach that is refreshingly jargon-free. I highly recommend this book." -- ANNALS OF CLINICAL PSYCHIATRY

Kurzbeschreibung

With two new lead authors, the sixth edition of Psychiatric Diagnosis continues its thirty-five year tradition of providing a clear, critical and well-documented overview of major psychiatric syndromes, with minimum inclusion of unwieldy theories or clinical opinions. Medical students and psychiatric residents will continue to find this new edition to be a unique guide to the field-a volume that concisely yet comprehensively dissects major psychiatric disorders. Well-known for providing a thorough yet concise view of the natural history of basic psychiatric disorders, this popular text has been extensively updated, chapter by chapter, in this sixth edition. Terminology has been made consistent with DSM-IV-TR and updates made to include recent genetic and neurobiological findings. In the classification of psychiatric disorders, new data on follow-up and family/genetic studies, confirming and extending previous research, are provided. As in previous editions, each chapter systematically covers the definition, historical background, epidemiology, clinical picture, natural history, complications, family studies, differential diagnosis, and clinical management of each disorder.
Some specific areas of new material include the long term course of mood disorders, genetics and neuro-imaging of schizophrenia and mood and other disorders, cognitive changes in relation to depression and dementia, brain stimulation techniques, outcome studies of eating disorders, and epidemiology of drug use disorders. In accordance with current medical community interest and research, entirely new chapters on posttraumatic stress disorder and borderline personality disorder have been included. Additionally, a new introduction reviews the background of medical model psychiatry and the empirical approach to psychiatric nosology. With this new edition, medical students and psychiatric residents will continue to discover that no other text provides such a lucid, well-documented and critically sound overview of the major syndromes in psychiatry.
 
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Psychiatry’s Billing Bible Prompts ‘Bickering, Contention, Organized Revolt and finally, A Backdown’ « CCHR International

Psychiatry’s Billing Bible Prompts ‘Bickering, Contention, Organized Revolt and finally, A Backdown’ « CCHR International




Psychiatry’s Billing Bible Prompts ‘Bickering, Contention, Organized Revolt and finally, A Backdown’

Photo: Garry Mcleod; Origami: Robert Lang

Medical ‘bible’ squabble

The Australian – May 18, 2012
by Sue Dunlevy
EFFORTS to update the psychiatrists’ bible – the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – have led to bickering, contention, organised revolt and, finally, a backdown.
The association announced it has abandoned plans to class so-called attenuated psychosis syndrome and internet addiction as psychiatric disorders.
And four disputed additional criteria for diagnosing attention deficit hyperactivity disorder (ADHD) have been dumped: “impatience”, “acting without thinking”, “uncomfortable doing things slowly and systematically” and “finds it difficult to resist temptations or opportunities”.
The battle over the book used worldwide to define mental illness matters as it’s the arbiter of who is normal and who is mentally ill and, therefore, qualifies for special help with their education, subsidies for their medicines and access to treatment programs.
After more than 13,000 international psychiatrists signed a petition objecting to the way the manual was being revised, the US psychiatrist heading the review committee, in an opinion piece in The New York Times this week, called for a new independent process of defining mental illness.
“We need some equivalent of the Food and Drug Administration to mind the store and control diagnostic exuberance,” Allen Frances writes. “Experts always overvalue their pet area and want to expand its purview, until the point that everyday problems come to be mislabelled as mental disorders.”
The biggest concern among psychiatrists is that many of the proposed changes to diagnostic criteria and new mental health conditions run the danger of medicalising normal behaviour. They fear it could result in patients taking unnecessary, even harmful, prescription drugs.
Despite the squabbling, Australian anxiety expert Gavin Andrews – who heads one of the committees writing the fifth edition of the manual, or DSM-5 – argues the APA’s backdown this month shows the revision process is working. “Science says, here’s a good idea, let’s test it. Then science says, no, its unreliable, and you drop it,” he explains.
The committees updating the diagnostic criteria collected new research, carried out field trials of proposed new diagnostic criteria to see how they would be used by doctors on patients, and took criticism on board, Andrews says.
He adds that sometimes – as in the case of “early psychosis”, promoted but now abandoned by Australian psychiatrist Patrick McGorry – a proposed disorder is dropped because it would have led to large numbers of young people being medicated unnecessarily. For instance, Australian author, ADHD campaigner and Labor state MP Martin Whitely remains alarmed about the inclusion in the manual of a condition called “attention deficit hyperactivity disorder not elsewhere classified”. He says it would allow doctors to diagnose people who didn’t meet the ADHD criteria with the disorder.
Other new diagnoses that have survived the DSM-5 process include premenstrual dysphoric disorder, disruptive mood dysregulation disorder in children and autism spectrum disorder – a single condition combining the previous diagnoses of autism, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified.
Andrews says he’s fascinated by the interest in the debate in Australia. After all, technically DSM-5 is written by Americans for the US and has no legal standing here.
The World Health Organization’s International Classification of Diseases version 10 is the legal classification used in Australia.
However, Andrews admits that doctors here use DSM because it’s “more informative”.
It contains about 2000 words on each disorder and is more helpful to doctors.
According to Andrews, the WHO would be the ideal body to take on the job of developing a definitive diagnostic manual, but it needs the resources to do so.
The APA has so far spent more than $US35 million on developing DSM-5, but it will get its investment back as it can sell the manual all over the world.
In contrast, the WHO has limited funding and cannot charge for its more limited manual.
Flinders University child psychiatrist Jon Jureidini tells Weekend Health the to-ing and fro-ing over the DSM-5 diagnostic criteria for ADHD “highlighted the invalidity of the whole construct”.
The degree of debate indicates “we are not dealing with a valid disorder”, he claims.
And Frances says the body setting diagnostic criteria should include not just psychiatrists. Doctors, psychologists, counsellors, social workers and nurses should also be permitted to have some input.
“The broader consequences of changes should be vetted by epidemiologists, health economists and public-policy and forensic experts,” he says.
Andrews counters that psychologists, counsellors, social workers and nurses are already involved in the field trials of DSM-5 diagnoses.
Meanwhile, Whitely asks the fundamental question: why does Australia continue to follow the American lead?
“Are mental health outcomes in the US good enough to justify our continued devotion to the DSM model?” he says. “Or is it time to go it alone?”
Those interested have until June 15 to comment on the latest draft of DSM-5.
http://www.theaustralian.com.au/news/health-science/medical-bible-squabble/story-e6frg8y6-1226359242372
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Johns Hopkins Experts Say Psychiatry’s Diagnostic Manual Needs Overhaul — Tri-City Psychology Services

Johns Hopkins Experts Say Psychiatry’s Diagnostic Manual Needs Overhaul — Tri-City Psychology Services

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Tri-City Psychology Services » Mental Health » Johns Hopkins Experts Say Psychiatry’s Diagnostic Manual Needs Overhaul

Johns Hopkins Experts Say Psychiatry’s Diagnostic Manual Needs Overhaul

May 16, 2012
DSM IV TR Johns Hopkins Experts Say Psychiatry’s Diagnostic Manual Needs OverhaulThe Diagnostic and Statistical Manual of Mental Disorders (DSM), long the master reference work in psychiatry, is seriously flawed and needs radical change from its current “field guide” form, according to an essay by two Johns Hopkins psychiatrists published in the May 17 issue of the New England Journal of Medicine.
“A generation ago it served useful purposes, but now it needs clear alterations,” says Paul R. McHugh, M.D., a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and co-author of the paper with Phillip R. Slavney, M.D., a professor emeritus in the same department. “They say they can’t do any better. We disagree and can show how.”
The original DSM, published in the 1950s, was intended as a public health service documenting the incidence and prevalence of mental illnesses. By its third edition in 1980 (DSM-III), however, it had evolved into a reference book prescribing how clinicians should identify and classify psychiatric disorders.
Today, the Johns Hopkins psychiatrists say, DSM provides checklists of symptoms, offering few clues to the underlying causes of mental disease and making it difficult to direct treatment or investigate the disorders it details. A new edition, DSM-5, is due out in 2013.
The manual, put together by the American Psychiatric Association, currently identifies hundreds of conditions via lists of diagnostic criteria and symptoms, functioning exactly as does a naturalist’s field guide but for mental illness. It offers no way to make sense of mental disorders and no way to distinguish illnesses that appear to be similar but actually are quite different and require different treatments, the psychiatrists argue.
“If you just name things and don’t explain what the causes are, you do not know how to rationally treat or study the diseases,” says McHugh, former director of Hopkins’ psychiatry department. “The DSM gives everything a name but not a nature.”
Before DSM-III, McHugh and Slavney say, psychiatrists typically used a “bottom-up” method of diagnosis, based on a detailed life history, painstaking examination of mental status and corroboration from third parties. The new emphasis on symptoms, they say, has unfortunately encouraged a cursory “top-down” method that relies on checklists and ignores much of the narrative of the patients’ lives.
The causes of psychiatric disorders derive from four interrelated but separable categories: brain diseases, personality dimensions, motivated behaviors and life encounters, write McHugh and Slavney. The two physicians suggest that organizing mental illnesses based on these four causalities would “promote fruitful thought and, consequently, progress.”
“Psychiatrists would start moving toward the day when they address psychiatric disorders in the same way that internists address physical disorders, explaining the clinical manifestations as products of nature to be comprehended not simply by their outward show but by the causal processes and generative mechanisms that provoke them,” they write. “Only then will psychiatry come of age as a medical discipline and a field guide cease to be its master work.”
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4:35 PM 5/19/2012 - Psychiatry's* Billing Bible Prompts 'Bickering, Contention - Mike Nova's starred items

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