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Biomedical subjects

Julio Arboleda-Flórez

Publications and source records attributed to Julio Arboleda-Flórez.

14 recordsLinked to original sources
PubMed2006

Cluster analysis of a forensic population with antisocial personality disorder regarding PCL-R scores: differentiation of two patterns of criminal profiles.

Fifty six cases of a forensic population were submitted to a cluster analysis to observe the aglomerative behavior in relation to the total scores of the items comprising the PCL-R Psychopathy Checklist Revised [R.D. Hare, Manual for the Hare Psychopathy Checklist-Revised, Multi-Health System, Toronto, 1991]. The analysis indicated two independent types of antisocial personality disorders, not identified in the PCL-R in its standardized form, one of them being strongly associated with criminal conduct and the other with psychopathic personality. Such clusters were stable when the analysis was replicated with other hierarchical algorithms, and also, they were independently extracted via the k-means method without having previously fixed the value for k. One of the clusters concentrated the PCL-R highest scores, indicating that it is the prototypical psychopathic character determinant.

Adolescent↗
PubMed2006

[Canadian mental health rights in an international perspective].

This article surveys the status of people with mental disorders in the light of international human rights law and assesses if their rights are respected in the Canadian context. The authors recognize that although the national systems of countries such as Canada provide significant civil and constitutional protections on the positive rights of its citizens, including those who suffer from intellectual disability, the same cannot be said with respect to entitlements to the provision of social services. The authors argue that this shortcoming must be remedied. Finally, the authors conclude that it is paramount to closely monitor the apparent dissonance between internationally recognized rights to adequate healthcare and freedom from discrimination and their strict application in the Canadian context.

Canada↗
PubMed2006

Forensic psychiatry: contemporary scope, challenges and controversies.

Forensic psychiatry is the branch of psychiatry that deals with issues arising in the interface between psychiatry and the law, and with the flow of mentally disordered offenders along a continuum of social systems. Modern forensic psychiatry has benefited from four key developments: the evolution in the understanding and appreciation of the relationship between mental illness and criminality; the evolution of the legal tests to define legal insanity; the new methodologies for the treatment of mental conditions providing alternatives to custodial care; and the changes in attitudes and perceptions of mental illness among the public. This paper reviews the current scope of forensic psychiatry and the ethical dilemmas that this subspecialty is facing worldwide.

Journal Article↗
PubMed2005

Identifying the cutoff score for the PCL-R scale (psychopathy checklist-revised) in a Brazilian forensic population.

This study introduces a Portuguese-language version of psychopathy checklist-revised (PCL-R) [Harv. Mental Health Lett. 12 (1995) 4] in the Brazilian penitentiary system. Hare's scale is used extensively in many other countries. In a forensic population sample of 56 male subjects classified as psychopaths and non-psychopaths [Manual for the Hare Psychopathy Checklist-Revised, Multi-Health System, Toronto, 1991], 33 correlated to global personality disorder (GPD) and 23 to partial personality disorder (PPD), respectively, subtypes of antisocial personality disorder [Manual for the Hare Psychopathy Checklist-Revised, Multi-Health System, Toronto, 1991]. Subjects were evaluated through psychiatric and neurological examinations, review of judicial records, Rorschach and PCL-R. A control group of 30 subjects without criminological or psychiatric history was also evaluated with the same instruments. PCL-R validation and identification of cutoff score for Psychopathy (GPD group) was assessed through the concurrent use of the Rorschach. PCL-R cutoff score for the Brazilian population was set at 23. Sensitivity was determined at 84.8%, and reliability was high (Kappa index = 0.87). GPD individuals were characterized as clearly psychopathic according to PCL-R criteria while PPD individuals can only be considered mildly psychopathic, with better chance of rehabilitation.

Adult↗
PubMed2005

Competence to be sentenced.

PURPOSE OF REVIEW: Competence to be sentenced, or lack thereof, is not frequently claimed in legal proceedings. This paper reviews the concept and possible forensic psychiatric applications. RECENT FINDINGS: This topic has achieved prominence because of recent rulings imposed by the US Supreme Court that prohibit execution of mentally impaired and under-age individuals. The most recent contributions focus on standards for evaluating competence to be sentenced and on analyzing the need for involuntary treatment of those who for psychiatric reasons have lost the capacity to stand trial. SUMMARY: Competence to be sentenced may be defined as a component of a general capacity to undergo legal proceedings, beyond just fitness to stand trial. It applies specifically to the time between the moment the process ends and the moment a sentence is rendered. This paper reviews general capacity to participate in legal proceedings as a concept that allows a person to intervene fully in his or her defence in a trial that is just and fair, and the different moments at which mental capacity to proceed may be limited or absent. There are no specific guidelines for evaluating competence to be sentenced, so instead we review the basic criteria for general capacity to participate in legal proceedings, including the capacity to mount a defence, to be sentenced and to serve a sentence. Because forensic evaluations are needed for assessment of capacity, the paper provides guidelines on how to organize the assessment and the report.

Journal Article↗
PubMed2003

Epidemiology of major depression in a predominantly rural health region.

BACKGROUND: Several large-scale cross-sectional studies have evaluated the prevalence of major depression in Canadian populations. Few studies have employed prospective methods, which are necessary to evaluate incidence, and few have focused on predominantly rural areas. METHODS: Subjects who had participated in a cross-sectional general health survey were invited to participate in a second wave of data collection 6 months later. These subjects were recontacted using a telephone interview. A brief diagnostic instrument for major depression was used in both waves,and a variety of other variables relevant to the epidemiology of major depression were measured. RESULTS: Of 801 subjects initially enrolled, 666 (83.1 %) consented to be recontacted, and 501 (75.2 %) of these were successfully reached. The incidence of major depression was 3.8%. The incidence was higher in women, although this difference did not attain statistical significance. Having a past history of depression and having a high level of perceived stress were predictors of risk. An exploratory comparison with data collected using similar methods in a nearby urban centre determined that the rural prevalence was lower than urban, and that a variety of factors (street drugs, deficits in social support, unemployment, recent life events) may contribute have to this difference. CONCLUSIONS: The 6-month cumulative incidence of depressive disorder was much higher than that reported by most previous studies. This may be a result of the diagnostic instrument employed, which captures a broader spectrum of depressive morbidity than the instruments used in most previous studies. Also, as the study did not exclude subjects with previous depressive episodes during their lifetime, the incidence rate reflects risks of major depressive episodes rather than major depressive disorders.

Adult↗
PubMed2003

Mental disorders and reasons for using complementary therapy.

OBJECTIVE: To compare patients with and without mental disorders who seek services from a complementary therapy practitioner with regard to quality of life, reasons for seeking complementary therapies, complaints, and physical conditions. METHOD: We studied new patients who attended a complementary therapy clinic offering acupuncture treatment between July 1, 1993, and March 31, 1995. We collected data from a self-administered questionnaire and from a physician-conducted psychiatric assessment. RESULTS: Of the 826 new patients at the clinic, 578 (70%) presented with a mental disorder. Patients with a mental disorder perceived their quality of life as poorer and reported greater levels of stress than did those without a mental disorder. However, the groups did not differ in their self-reported reasons for seeking complementary therapies, in their complaints, or in their physical conditions. Among patients with a mental disorder, the major reasons for choosing complementary therapies were personal preference, interest, or belief in complementary therapies (44.3%) and perceiving complementary therapies as a last resort (30.7%). Most patients with a mental disorder saw a complementary practitioner for musculoskeletal and connective-tissue disorders (44.1%), fatigue (26.6%), and headache (15.2%). The most frequent physical illnesses among patients with a mental disorder were diseases of the musculoskeletal system and connective tissue (42.6%). CONCLUSION: Like their counterparts without a mental disorder, individuals with a mental disorder use complementary therapies because of personal beliefs. The wide use of complementary therapies among individuals with a mental disorder may be ascribed to a poor quality of life and high levels of distress.

Acupuncture Therapy↗
PubMed2003

Integration initiatives for forensic services.

Poorly implemented mental health reform policies are often given as reasons for the growth in demands for forensic psychiatric services and the steady increase of mental patients in prison systems. However, in this paper, additional reasons are advanced to explain the growth of forensic psychiatry, such as an expansion in the types of "psychiatric defences" in courts of law; public concerns about violent behaviour attributed to the mentally ill; the community management of paraphilias, especially pedophilia; the development of risk assessment methodologies and the halo of super-specialization. The net result of these developments is that patients who receive a label of "forensic" enter into a mental health ghetto with little connectivity or integration with the general mental health system. The forensic label increases the stigma and decreases opportunities for reintegration and full social recovery. The paper provides guidelines to reverse these trends.

Journal Article↗
PubMed2002

Association between physical illness and suicide among the elderly.

BACKGROUND: Only a few small studies have explored the association between various physical illnesses and suicide in the elderly and they have produced inconsistent results. Thus, we undertook this larger study to more definitively assess the association between elderly suicide and physical illness. METHODS: This case-control study compared the proportion with physical illnesses among 822 cases who committed suicide with that among 944 controls who died due to motor vehicle accident at age 55 years or over in Alberta, Canada. RESULTS: Compared to the motor vehicle accident deaths, the elderly who committed suicide were more likely to have cancer, ischemic heart disease, chronic pulmonary disease, peptic ulcer, prostatic disorder, depression and other psychiatric illnesses. There was no significant difference in the proportion of cerebrovascular disease and diabetes mellitus between the case and control groups before adjustment of demographic and clinical characteristics. After adjustment of these variables, the elderly with any of the following illnesses were more likely to die by suicide than those without the illness: cancer (adjusted odds ratio [95% confidence interval]: 1.73 [1.16-2.58]), prostatic disorder (excluding prostatic cancer, 1.70 [1.16-2.49]), chronic pulmonary disease among the married (1.86 [1.22-2.83]), depression (6.70 [4.72-9.50]) or other psychiatric illness (2.16 [1.68-2.76]). There was no evidence that ischemic heart disease, cerebrovascular disease, peptic ulcer and diabetes mellitus might be associated with suicide in the elderly. CONCLUSIONS: Cancer, prostatic disorder, chronic pulmonary disease among the married and psychiatric illness appear to be associated with suicide among the elderly.

Aged↗