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P Kramp

Publications and source records attributed to P Kramp.

At least 19 recordsLinked to original sources
PubMed2003

Prevalence of mental disorders among 15-17-year-old male adolescent remand prisoners in Denmark.

OBJECTIVE: To determine the past year prevalence of mental disorders of 15-17-year-old adolescent remand prisoners in east Denmark. METHOD: One hundred 15-17-year-old boys from east Denmark consecutively remanded during 1 year were interviewed with diagnostic instruments to obtain ICD-10 diagnoses. All were screened in The Danish Psychiatric Case Register and The Danish Criminal Register. RESULTS: Past year prevalence of 'any mental disorder' was 69%, substance use disorders 41%. Two per cent had schizophrenia and 2% schizotypal disorder. Thirty-six per cent had 'probable personality disorder'. Conduct disorder was found in 31% and 1% had a hyperkinetic disorder. Ten per cent had previous registered psychiatric contact. CONCLUSION: The prevalence of mental disorders was found substantially higher compared with literature of population-based samples. With an association between mental disorders and violence, early detection and treatment of mental disorders in adolescent delinquents is of importance in the prevention of violence.

Adolescent↗
PubMed2003

Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses.

OBJECTIVE: To analyse how committed crimes and substance-related diagnoses are associated with the age on the first contact with the psychiatric hospital system and the age at diagnosing of schizophrenia among schizophrenics. METHOD: In a register-based study including all Danes diagnosed with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. RESULTS: Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when the diagnosis of schizophrenia was first given. In contrast, having a substance-related diagnosis was associated with a younger age on first contact but did not influence the age at which the diagnosis of schizophrenia was given. CONCLUSION: It is important that both psychiatrists and the judicial system are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment.

Adult↗
PubMed2001

[Serious criminality among adolescents. I. Twenty years of mental observations of 15-17 years old delinquents in greater Copenhagen].

The purpose of the study was to enlighten the background, psychopathology and criminality of young delinquents. Twenty years of reports for the court regarding young delinquents were analysed and information as to background, educational level, psychiatric diagnoses, criminal records and sentence was registered. Among 91 delinquents aged 15-17 years, 65% had not completed primary school and 50% were unemployed. Eighty percent had committed violent acts (homicide or attempted homicide, robbery, violence, rape). Twenty-two percent were sentenced to psychiatric treatment, and more than 50% were imprisoned. In conclusion young delinquents have severe social problems and a disproportionally high number suffer from psychiatric illness. The main part of the adolescents are convicted to prison, in spite of young age, and at present no institutions in Denmark are suitable for the treatment of young delinquents with severe criminal records.

Adolescent↗
PubMed2001

[Serious criminality among adolescents. II. Criminality, psychiatric morbidity and mortality 15-20 years after the first mental observation].

The purpose of the present study was to enlighten the prognosis for young delinquents, who had been subject to a mental report for the court, regarding later psychiatric illness, mortality and criminal relapse. The study was retrospective based on register information about psychiatric admissions, death courses and later criminal commitments. After less than 20 years, 11% were found psychotic, 22% had died and 90% of the survivors had committed a total of 831 criminal offences from drunk driving to homicide. We conclude, that at present no institutions in Denmark are suitable for the treatment of young delinquents with severe criminal records. Most of the young delinquents have psychological and behavioural disturbances from childhood, and early intervention is needed followed by careful documentation and follow-up studies in order to improve the prognosis for these young people.

Adolescent↗
PubMed2000

A longitudinal study of prisoners on remand: psychiatric prevalence, incidence and psychopathology in solitary vs. non-solitary confinement.

OBJECTIVE: To compare two levels of stress (solitary confinement (SC) and non-SC) among remand prisoners as to incidence of psychiatric disorders in relation to prevalent disorders. METHOD: Longitudinal repeated assessments were carried out from the start and during the remand phase of imprisonment. Both interview-based and self-reported measures were applied to 133 remand prisoners in SC and 95 remand prisoners in non-SC randomly selected in a parallel study design. RESULTS: Incidence of psychiatric disorders developed in the prison was significantly higher in SC prisoners (28%) than in non-SC prisoners (15%). Most disorders were adjustment disorders, with depressive disorders coming next. Incident psychotic disorders were rare. The difference regarding incidence was primarily explained by level of stress (i.e. prison form) rather than confounding factors. Quantitative measures of psychopathology (Hamilton Scales and General Health Questionnaire) were significantly higher in subjects with prevalent and incident disorders compared to non-disordered subjects. CONCLUSION: Different levels of stress give rise to different incidence of psychiatric morbidity among remand prisoners. The surplus of incident disorders among SC prisoners is related to SC, which may act as a mental health hazard.

Adult↗
PubMed1999

Psychopathy and psychopathological profiles in prisoners on remand.

A total of 178 Danish male remand prisoners were examined using comprehensive interviews and questionnaires on psychopathological, personality and social measures, and file data. These data were compared with scores on the Hare Psychopathy Checklist - Revised (PCL-R). Subjects were divided into four groups according to quartile PCL-R scores. In general there were high rates of psychiatric morbidity in all PCL-R quartile groups. The medium-high scorers represent a more vulnerable group with a high prevalence of dependence disorders, relatively high neuroticism score and relatively high prevalence of neurotic and stress-related disorders. The high scorers were more psychosocially maladjusted, had more often made previous suicidal attempts, and had a higher psychoticism score. Chronic psychotic disorders did occur, mostly in the high-scoring group. The population had lower scores on the PCL-R than in most previous studies, suggesting a lower prevalence of psychopathic features among Danish criminals and possibly a lower cut-off point when using the PCL-R as a categorical measure. Both findings are consistent with the results of other European studies. Further studies on cross-cultural differences with regard to PCL-R psychopathic features and on psychic vulnerability related to PCL-R scores and factor 1/factor 2 of the PCL-R are suggested.

Adolescent↗
PubMed1993

[Decrees of dangerousness].

According to the Danish Civil Commitment Law, very dangerous psychotic patients can be transferred from a general psychiatric department to the only psychiatric maximum security institution in Denmark. Denmark passed a new Mental Health Act in 1989, and according to this "decrees of dangerousness" are issued by the Ministry of Justice, followed by a court hearing. The Ministry of Justice asks the Danish Medico-Legal Council for a statement in all such cases. The number of patients who are transferred to the Maximum Security Institution according to these rules has increased greatly, the average number per year in the seventies being two to three patients, while in 1990, 11 patients were transferred. In the period 1985 to 1990, 39 cases concerning "decrees of dangerousness" were submitted to the Medico Legal Council. The Council did not find the conditions fulfilled in five cases, one case was invalidated by the court, and in two cases the requests were withdrawn. The increase in the number of "decrees of dangerousness" was equally divided between younger patients, i.e. up to 29 years old, the average duration of illness being about three years and elderly patients, i.e. 30 years or older the average duration of illness in this group being about 13 years. The majority of the patients suffered from schizophrenia. Among the younger patients, 11 of 18 had alcohol and/or drug abuse, which was only seen among three of the 21 elderly patients. Drug abuse increases the risk of dangerous behaviour among schizophrenics, and drug abuse among younger schizophrenics might be part of the explanation for the increasing number of "decrees of dangerousness".(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Increasing rates of homicide in Copenhagen from 1959 to 1983.

The increase in homicide in Copenhagen during the years from 1959 to 1983 was investigated in a material of 251 defendants of homicide examined by a psychiatrist. During the period the change in the pattern of female homicide was only slight. The rise in the consumption of alcohol and drugs in the general population was found related to the increase in the rate of homicide committed by male - mostly alcoholic - substance abusers. Further was noticed an increase in homicide involving victims outside the family of the defendant. This trend was most prominent among the youngest of the defendants. The results are commented by referring to recent changes in interpersonal relations and to the conditions for socialization of the rising generation of today.

Adolescent↗
PubMed1988

Delirium tremens and related clinical states: psychopathology, cerebral pathophysiology and psychochemistry: a two-component hypothesis concerning etiology and pathogenesis.

Clinically, patients with Delirium Tremens (DT) and acute alcohol hallucinosis (impending DT) appear excited with vivid false perception. Cerebral blood flow and eeg correspondingly point to hyperexcitability in the CNS during these conditions. Clinical trials with barbital treatment in alcohol withdrawal shows that the amount of drug and the drug plasma concentration is the same no matter whether the physical signs of withdrawal are accompanied by hallucinations and clouding of consciousness. The psychotic signs in DT and acute alcoholic hallucinosis develops after many years of alcoholism as does seizures. We hypothesize that physical withdrawal is determined by the degree of physical dependence developed during the most recent drinking period whereas the psychotic signs and seizures are due to a cumulated CNS hyperactivity developed over many years of repeated alcohol intoxication and withdrawal. Changes of electrolyte concentrations in plasma or CSF do not play an important role in the pathogenesis of DT and related clinical states except that changes in calcium and inorganic phosphate metabolism indirectly point to changes in membrane excitability. A new model for a study of rapidly repeated intoxication and withdrawal episodes in rats has shown that repetition of episodes augments the convulsive component of withdrawal whereas the non-convulsive signs are dependent on the most recent episode only. The augmentation of the convulsive component correlates with regional differences in brain glucose consumption. Furthermore, synaptic proteins and acidic phospholipids may be involved in the development of CNS hyperexcitability during alcohol withdrawal. In conclusion both clinical and experimental studies indicate that severe alcohol withdrawal reactions may consist of two components: 1) Physical withdrawal signs determined by recent physical dependence. 2) A long term cumulated CNS hyperexcitability relating to seizures and psychotic signs during withdrawal. This state is elicited by alcohol withdrawal but it represents a cumulated and permanent or long lasting CNS dysfunction in alcoholics. The precise biochemical/pathophysiological mechanisms for the development of the two-component dysfunction still remain to be clarified in detail.

Alcohol Withdrawal Delirium↗
PubMed1987

Psychotic homicides in Copenhagen from 1959 to 1983.

During the years from 1959 to 1983, 263 Copenhagen defendants of homicide underwent a psychiatric examination for the court. Twenty-three percent of the defendants were held to be psychotic at the time of the crime. The psychotic defendants differed from the non-psychotic by being older, less often substance abusing and by choosing victims inside their families. It is discussed whether a reduction in the available number of psychiatric beds could be a contributional reason for the increase in especially the number of schizophrenic defendants. About one third of all defendants were by the examining psychiatrists found in need of a sanction different from ordinary punishment; furthermore, a tendency towards sanctions of treatment instead of just placement in a psychiatric hospital was documented and is discussed. The increasing demand of capacity for forensic, psychiatric patients is mentioned.

Adult↗
PubMed1987

The practice of forensic psychiatry in cases of homicide in Copenhagen, 1959 to 1983.

During the years 1959 to 1983 a doubling in the rate of homicide took place in Copenhagen. This increase was exclusively due to an increasing number of male offenders. By comparing with another Danish material, the frequency of female homicide as well as that of homicide combined with suicide was found practically unchanged since 1946, indicating that both of these kinds of homicides seem to have a background different from those of other offences of fatal violence. During the years 1959 to 1983, the criteria of selection of the defendants for a psychiatric examination for the court were fairly consistent. Examinations were performed in practically all cases, where a charge of murder raised by the police was followed by a legal trial for homicide. Less and less of the defendants, however, were hospitalized for the examination, while more were examined in The Clinic of Forensic Psychiatry in Copenhagen.

Denmark↗
PubMed1984

Delirium tremens and related clinical states: changes in calcium and inorganic phosphate concentrations in plasma and cerebrospinal fluid.

Calcium and inorganic phosphate were measured in blood and cerebrospinal fluid (CSF) in 11 patients during impending delirium tremens (grade 2) and in nine patients with fully developed delirium tremens (grade 3). The initial sampling of blood and CSF was performed at admission before treatment was initiated. The blood sampling was repeated daily until recovery and at this time a second lumbar puncture was also performed. In grade 3 patients the plasma calcium concentration showed a transient increase after admission; in grade 2 patients the plasma calcium concentration was also somewhat elevated. The changes in plasma calcium concentration after admission correlated significantly with the changes in blood alcohol concentration. In grade 3 patients the CSF calcium concentration decreased between admission and recovery, this possibly relating to an increased cerebral binding capacity in the post intoxication period. No statistically significant changes were seen in either of the diagnostic categories as far as plasma inorganic phosphate concentrations are concerned. CSF inorganic phosphate concentration decreased in a fashion correlated with CSF alcohol concentration and, finally, CSF inorganic phosphate at admission was somewhat lower in grade 3 patients as compared to grade 2, this possibly reflecting a more severe disturbance of cerebral metabolism in grade 3 patients. Essentially, grade 3 patients had lower CSF concentrations of both calcium and inorganic phosphate as compared to grade 2 patients and thus there may exist real differences in the metabolism of these two ions when a severe withdrawal reaction (grade 2) is compared to fully developed delirium tremens (grade 3).

Alcohol Withdrawal Delirium↗
PubMed1983

The Hamilton Anxiety Scale. Evaluation of homogeneity and inter-observer reliability in patients with depressive disorders.

In the present study the Hamilton Anxiety Scale (HAS), originally constructed for patients with neurotic anxiety, has been applied to patients with diagnosis of depressive disorders. The inter-rater reliability and homogeneity are evaluated and total scale score has been correlated to the Bech-Rafaelsen Melancholia Scale (BRMES). Twenty-two patients entered the study, 13 with endogenous depressions, and 9 with non-endogenous depressions when classified according to the ICD-8. For both scales the inter-rater reliability was found statistically significant. Concerning the homogeneity of the HAS, statistical significance was obtained for 7 items reflecting psychic anxiety, whereas in the BRMES statistical significance was found in all items apart from 2. Total scale score on HAS correlated positively with total score on BRMES for all 2 patients. However, when the patients were classified according to the ICD-8 this correlation seemed to be due to the endogenously depressed group as no significant correlation was seen for the group of non-endogenous depression. On the other hand, when the patients were classified according to the MULTI-CLAD system no significant intercorrelation of the HAS and BRMES scores was found within the subtypes of depression.

Adjustment Disorders↗