{"title":"Seroprevalence of human immunodeficiency virus among inpatient pretrial detainees.","authors":"D Schwartz-Watts, L D Montgomery, D W Morgan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Medical records of inpatients discharged from a forensic unit in Columbia, South Carolina, from January 1991 to December 1991 were reviewed to determine the incidence of human immunodeficiency virus (HIV) seropositivity. Results were linked to age, gender, ethnicity, history of intravenous drug use, and Axis I diagnoses. HIV status was obtained for 74 percent of patients 18 to 55 years of age. The incidence of HIV seropositivity among patients tested was 5.5 percent, which is greater than 40 times the incidence for the general population in South Carolina. Intravenous drug use was reported for 33 percent of the seropositive males. We conclude that inpatient pretrial detainees are at increased risk for HIV infection. HIV testing should be mandated at all facilities housing detainees. Further studies are needed to determine any factors about these patients that can be linked to seropositivity.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 2","pages":"285-8"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19585337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Proposed federal legislation jeopardizes patient privacy.","authors":"S K Hoge","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the last year there has been a move to enact federal legislation concerning private health-care information. This move has been fueled by a growing trend toward the computerization and electronic transmission of health-care information. These advances in technology call for appropriate new protections of patients' privacy. Unfortunately, the proposed legislation has not received adequate attention in the medical community. Physicians and patients in general are not aware of the legislation and have not been engaged in shaping its contents. In its current form, the legislation would seriously undermine traditional protections of confidentiality that are ensured by physicians. The flaws of the proposed legislation are examined in this article.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 4","pages":"495-500"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19617181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incurable psychopaths?","authors":"M Kristiansson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Treatment, comprising pharmacotherapy and an educational program based on cognitive behavior therapy, of four psychopathic, criminal men fulfilling the criteria for borderline personality disorder and antisocial personality disorder is described. The diagnoses were made during a forensic psychiatric evaluation. An estimation of the capacity of the central serotonergic system was performed by analysing the platelet monoamine oxidase (MAO) activity. The pharmacotherapy was combined with an educational program involving strategies for developing better impulse control. All four men had earlier been regarded as resistant to conventional therapy. In the present cases, a combined psychosocial and biological approach seemed to be effective in developing an increased control of impulses, leading to improved coping strategies. Controlled studies are needed in order to clarify whether the described treatment program proves beneficial.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 4","pages":"555-62"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19617883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Screening prison inmates for mental disorder: an examination of the relationship between mental disorder and prison adjustment.","authors":"F DiCataldo, A Greer, W E Profit","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The rapidly expanding population of prison inmates has severely challenged the prison system's ability to effectively screen incoming inmates for mental disorders and mental health service needs. This study describes a comprehensive mental health screening of inmates at a maximum security prison, using a modified version of the Referral Decision Scale (RDS), a screening measure developed from the Diagnostic Interview Schedule. Modified items and adjusted cut-off scores were used in order to reduce the rate of false positives. Survey results indicate that this modified version of the RDS may be an effective screening measure for correctional settings. Subjects who were positive on the RDS were compared to negative subjects on a variety of offense and prison adjustment variables. Findings indicate that while subjects who were positive on the RDS experienced some initial adjustment problems within the prison, they were generally not found to be involved in an elevated rate of prison violence and were not more often remanded to disciplinary units than those subjects who were negative on the RDS.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 4","pages":"573-85"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19617885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Running scared: therapists' excessive concerns about following rules.","authors":"W Bernet","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mental health professionals sometimes excessively follow rules and regulations to the point of neglecting or even injuring their clients. Five vignettes are presented that illustrate how this problem might occur in clinical or administrative decisions. The vignettes involve confidentiality, informed consent, reporting of sexual abuse, and other issues. Several specific recommendations are made that emphasize common sense and clinical reasoning, rather than relying merely on legal reasoning.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 3","pages":"367-74"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19812828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neonaticide, infanticide, and filicide: a review of the literature.","authors":"S E Pitt, E M Bale","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article summarizes and reviews the literature on neonaticide, infanticide, and filicide. A literature review was conducted using the Medline database: the cue terms neonaticide, infanticide, and filicide were searched. One hundred-fifteen articles were reviewed; of these, 51 are cited in our article. We conclude that while infanticide dates back to the beginning of recorded history, little is known about what causes parents to murder their children. To this end, further research is needed to identify potential perpetrators and to prevent subsequent acts of child murder by a parent.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 3","pages":"375-86"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19813975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Countertransference in court interpreters.","authors":"L A Mellman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Transference and countertransference are important concepts in the therapist-patient relationship in psychiatry. They are also important elements of the courtroom setting and the court interpreter's verbalizations. Transference and countertransference are defined and illustrated in both the psychotherapeutic setting and the courtroom setting with interpreters. The role of the forensic psychiatrist as consultant in interpreter countertransference is discussed in this article.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 3","pages":"467-71"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19813983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J K Boehnlein, R M Parker, R M Arnold, C F Bosk, L F Sparr
{"title":"Medical ethics, cultural values, and physician participation in lethal injection.","authors":"J K Boehnlein, R M Parker, R M Arnold, C F Bosk, L F Sparr","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Capital punishment by lethal injection has been discussed in the literature, but there has been no consideration of the sociocultural foundations of the ethical issues related to medical aspects of capital punishment. Lethal injection represents the inappropriate medicalization of a complex social issue whereby medical skills and procedures are used in ways that contradict established medical practice. Although physicians are socialized to their healing role during medical education and training, their behavior is influenced by social and cultural values that both precede and coexist with their professional life. Because of this dynamic interplay between professional and sociocultural values, physicians can neither exempt themselves from societal debate by merely invoking professional ethics, nor can they define their professional role exclusively in terms of societal values that potentially diminish personal and collective professional responsibility. It is essential that physicians have a broad historical perspective on the development of the profession's standards and values in order to deal effectively with present and future complex ethical issues.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 1","pages":"129-34"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18605386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adapting symptom validity testing to evaluate suspicious complaints of amnesia in medicolegal evaluations.","authors":"R I Frederick, M Carter, J Powel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Symptom validity testing was adapted to assess suspicious complaints of amnesia. In the adaptation, two-alternative, forced-choice memory questions were generated for subject matter claimed to be forgotten. The number of questions correctly answered was then compared to the expected number of questions to be correctly answered if no knowledge actually existed. Three case studies are presented, two of competency-to-stand-trial evaluees and one of an insurance medical examinee. In each case, the use of this procedure generated the conclusion that the knowledge claimed to be forgotten was actually remembered; however, not all individuals were classified as malingerers.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 2","pages":"231-7"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19584791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Differential use of admission status in a psychiatric emergency room.","authors":"J Rabinowitz, M Slyuzberg, I Salamon, S E Dupler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The goal of this study is to understand how different admission statuses of varying degrees of restrictiveness (informal, voluntary, emergency admission, and involuntary admission on medical certification) are used in the psychiatric emergency room. The study included 656 consecutively admitted patients from a psychiatric emergency room over 28 months. Data were analyzed univariately and using two discriminant function models. Only six (0.9%) patients were informal admissions. Voluntary admissions (24.9%, n = 163) tended to be for patients with affective disorders, those who were self-referred, suicidal risks, those who had a marital or family problem, and those who were over age 60. Nonvoluntary admissions (74.2%) tended to be for patients with schizophreniform symptoms and those referred by police or court. Involuntary admission on medical certification (53.2%, n = 349) tended to be for patients who were family referred, younger than 20 years old, had social interpersonal nonfamily stressors, were suicidal risks, were or had been married, had organic psychotic disorder, history of violence, and manic episode or schizophrenia. Emergency admission patients (21%, n = 138) were characterized by being between 40 to 50 years old, having a diagnosis of psychoactive substance abuse, having previous outpatient treatment, and having been referred by emergency service. The major difference between involuntary admissions and voluntary was that the former were more often actively psychotic or referred by police or court. The major difference between emergency admission and involuntary admission on medical certification seemed to be that patients with a more available support system, whose primary diagnoses was not substance abuse and who were suicidal, were preferred for involuntary admission on medical certification.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 4","pages":"595-606"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19617887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}