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PubMed2000

Community care and criminal offending in schizophrenia.

BACKGROUND: The introduction of community care in psychiatry is widely thought to have resulted in more offending among the seriously mentally ill. This view affects public policy towards and public perceptions of such people. We investigated the association between the introduction of community care and the pattern of offending in patients with schizophrenia in Victoria, Australia. METHODS: We established patterns of offending from criminal records in two groups of patients with schizophrenia over their lifetime to date and in the 10 years after their first hospital admission. One group was first admitted in 1975 before major deinstitutionalisation in Victoria, the second group in 1985 when community care was becoming the norm. Each patient was matched to a control, by age, sex, and place of residence to allow for changing patterns of offending over time in the wider community. FINDINGS: Compared with controls, significantly more of those with schizophrenia were convicted at least once for all categories of criminal offending except sexual offences (relative risk of offending in 1975=3.5 [95% CI 2.0-5.5), p=0.001, in 1985=3.0 [1.9-4.9], p=0.001). Among men, more offences were committed in the 1985 group than the 1975 group, but this was matched by a similar increase in convictions among the community controls. Those with schizophrenia who had also received treatment for substance abuse accounted for a disproportionate amount of offending. Analysis of admission data for the patients and the total population of admissions with schizophrenia showed that although there had been an increase of 74 days per annum spent in the community for each of the study population as a whole, first admissions spent only 1 more day in the community in 1985 compared with 1975. INTERPRETATION: Increased rates in criminal conviction for those with schizophrenia over the last 20 years are consistent with change in the pattern of offending in the general community. Deinstitutionalisation does not adequately explain such change. Mental-health services should aim to reduce the raised rates of criminal offending associated with schizophrenia, but turning the clock back on community care is unlikely to contribute towards any positive outcome.

Adult↗
PubMed1998

Forensic applications of mitochondrial DNA.

Human mitochondrial DNA has become a useful tool in forensic investigations. Its polymorphic nature and maternal inheritance are characteristics that have, combined with its sequence information, enabled investigators to identify missing persons, war casualties and individuals involved in mass disasters and criminal cases. Various screening procedures have been developed to reduce the need to sequence samples that do not match, but DNA-sequence information is still necessary to verify a match. Even though several challenges remain before mitochondrial-DNA-sequence information can be used unambiguously, comparative mitochondrial-DNA-sequence analysis appears to be a reliable and powerful means for human identification.

DNA, Mitochondrial↗
PubMed2002

Attitudes of Hungarian students and nurses to physician assisted suicide.

In Hungary, which has one of the highest rates of suicide in the world, physician assisted suicide (PAS) and euthanasia are punishable criminal acts. Attitudes towards self destruction and assisted suicide are, however, very controversial. We investigated the attitudes of medical students, nurses and social science students in Hungary towards PAS, using a twelve item scale: the total number of participants was 242. Our results indicate a particular and controversial relationship between attitudes towards assisted suicide in Hungary and experience with terminally ill people. The social science students, who had the fewest personal experiences with terminally ill patients, are characterised by the most permissive attitudes towards assisted suicide. Nurses, who had everyday contact and experience with these patients, were the most conservative, being least supportive of assisted suicide. The attitudes of medical students, the would be physicians, are somewhere between those of nurses and social science students.

Adult↗
PubMed1989

The allocation of drug addicts to different types of treatment. An evaluation and a two-year follow-up.

In Denmark the official aim has been to reduce methadone treatment, even though no effort is made to directly forbid this therapy. A multiprofessional committee was established to regulate and limit methadone treatment. There were no specific guidelines for what type of drug addict should be treated with methadone. We found that allocation for the Regional Narcotic Committee of the Municipality of Copenhagen during 1982-1984 did not serve the desires of the addicts because only 41% followed it. Allocation also did not follow the principles of research in this field. In a 2-year follow-up investigation we found that drug addicts had a mortality rate of 6.3/year, rising criminality (significant), and falling availability to the labor market (nonsignificant). We therefore came to the conclusion that the efforts of the committee did not improve the conditions of drug addicts. Only those drug addicts who had been under almost constant methadone treatment had a low lethality and a falling number of criminal convictions (significant). Finally, it is concluded that limited research within this field prevents more specific treatment and improved use of financial resources.

Adult↗
PubMed1989

[100 years of identification (from man to his genome)].

It is a set of descriptive features or traits characterising an individual that serves as the basic for the identification of his person. Some of these traits are of interest mainly in police investigations; others, of which the interest is more particularly scientific, are rapidly gaining recognition. Anthropometric methods enable the identification of recidivist criminals. Anthropometric description is based on bone measurements taken in conjunction with the spoken portrait and recorded distinguishing marks--the features concretely represented in the descriptive photograph. This method was first supplemented and then supplanted, both for description and identification, by dactyloscopy. Investigations involving corpses are often extremely difficult. Several facts concerning bone and/or teeth could be relevant in determining the race, sex, height and age of the person whose remains are examined. Traces and stains as "clues" of hereditary and congenital properties of blood (erythrocytic, enzymatic, plasmic and leucocytic systems, factors and groups) and of sperm (with, in this case, secretor and non secretor properties) do provide and increasingly precise description of an individual but only a certain degree of probability for his identification; at best, they can only exclude an individual, but cannot prove his involvement. A knowledge of the patterns of the nucleotides in the Deoxyribo Nucleic Acids, which are the same in all the cells of an individual but differ from individual to individual, provides an ultimate means of arriving at certainty in the comparison: samples-suspect.(ABSTRACT TRUNCATED AT 250 WORDS)

Base Sequence↗
PubMed1999

Medical negligence in Italy: the criminal inquiry.

In the past decade, there has been an exponential increase in legal proceedings against doctors due to allegations of medical negligence. The via crucis of the doctor under investigation for alleged medical negligence in Italy is little known beyond the Alps. The authors hope this paper will bring to the attention of medical and legal colleagues this complex issue of the process followed by the justice machinery in Italy where the criminal route in pursuit of justice is the norm.

Humans↗
PubMed1997

Genocide in Bosnia: the case of Dr. Radovan Karadzic.

From 1992 to 1995 the Republic of Bosnia-Herzegovina experienced a war of genocidal proportions between the Bosnian Serbs, the Bosnian Croats, and the Bosnian Muslims. The international Criminal Tribunal for the Former Yugoslavia has indicted Dr. Radovan Karadzic--former President of the Bosnian Serb Republic, psychiatrist, and poet--as a suspected war criminal for his role in war crimes, crimes against humanity, and genocide. Karadzic remains enigmatic and poorly understood. Psychological profiling highlights in Karadzic's case the complex coalescence of the psychology of a genocide perpetrator with that of a charismatic narcissistic political leader. Such a profile may possess usefulness in forensic psychiatric investigations and legal proceedings.

Bosnia and Herzegovina↗
PubMed2000

Low serum cholesterol in violent but not in non-violent suicide attempters.

Many previous studies have suggested that low or lowered serum cholesterol levels may increase the risk of mortality not due to somatic disease: principally, suicide and violent death. Because violent death is rare, some studies have investigated afterwards the relation between cholesterol levels and either suicide attempts in psychiatric populations or violence in criminally violent populations. However, none of these studies have compared cholesterol levels in violent and non-violent suicide attempters. The blood of 25 consecutive drug-free patients following a violent suicide attempt and of 27 patients following a non-violent suicide attempt by drug overdose was drawn in the 24 h following admission. Patients with a diagnosis of alcohol abuse and with cholesterol-lowering therapy were excluded. Age, sex, body mass index, psychiatric diagnosis and the physical conditions of the suicide attempt were investigated. Thirty-two healthy subjects were used as a control group. There were no differences between the groups in age, frequency of psychiatric diagnoses or body mass index. There was more women in the group of non-violent suicide attempters than in that of violent suicide attempters (P<0.001). In analyses controlling for sex and age, the serum cholesterol concentration was 30% lower (F(2,82)=15.8; P<0.0001) in the group of violent suicide attempters (147+/-54 mg/dl) than in the group of non-violent suicide attempters (209+/-38 mg/dl) or control subjects (213+/-46 mg/dl). Our results showed that low serum cholesterol level is associated with the violence of the suicide attempt and not with the suicide attempt itself. Further investigations are necessary to determine the usefulness of this easily accessible parameter as a potential risk indicator for violent acts such as violent suicidal behavior in susceptible individuals.

Adult↗
PubMed2006

The judicial view of bitemarks within the United States Criminal Justice System.

When examining most traditional sciences a thorough review of the relevant primary literature is usually sufficient to provide the investigator with a sound insight into the discipline. Forensic science differs in this regard, as it is presented in two main arenas: the peer-reviewed forensic journals and the Courts of Law where testimony is proffered. Because of this duality of scientific assessment the following legal review is presented. The review analysed Appellate Court rulings from the United States and identified trends of objections to bitemark testimony. Nine major trends were identified within the cases assessed: bitemark evidence not sufficiently reliable or accepted, arguments regarding the uniqueness of the human dentition, constitutional arguments, inflammatory photographs, inaccuracy of techniques and errors in protocol, use of historical bitemarks and previous biting behavior, funds for defence witnesses and objections pertaining to witness credibility.

Bites, Human↗
PubMed1995

Offending by adults with learning disabilities and the attitudes of staff to offending behaviour: implications for service development.

The aims of this study were: (I) to identify all adults with learning disabilities living in residential homes or attending day services in the Cambridge Health District in contact with the criminal justice system during 1992; (2) to evaluate the responses of services involved; and (3) to investigate the attitudes of staff and the policies of the services to 'offending behaviour'. Details of offences committed and the response of the police, health and social services, and other agencies were obtained by direct interview with the senior staff and through examination of case records. The attitudes of staff to offending behaviour was investigated by the use of a semi-structured questionnaire. Seven (2%) out of 358 adults with learning disabilities were reported to have had contact with the police during 1992. The eight offences allegedly committed by the seven people were two acquisitive offences, two sexual offences, one assault, one wasting of police time, one offence against the Public Order Act and one traffic offence. One offender was cautioned after the Crown Prosecution Service discontinued the case because of lack of evidence, while the other alleged offenders received informal warnings. None of the seven alleged offenders were prosecuted. Three alleged offenders lived in hostel accommodation, yet hostel accommodation only accounts for 7.8% of adults with learning disabilities living in the Cambridge Health District. Because of a lack of operational policies on offending behaviour, there were no existing referral structures for people who might need specialist health service support. Referrals tended to be inconsistent, with a considerable time-lag between offence and referral. Tolerance levels towards offending behaviour were extremely high in the two hostels, 20 group homes and day centres which were included in this study. Theft and criminal damage was hardly ever reported. Thirty establishments were visited during the course of this study. Of these establishments, staff in 12 said they would always report a major assault. In only three would a sexual assault or indecent exposure always be reported if it was to occur. Staff at one residential establishment said they would hesitate to report rape and the staff in another two would consider the circumstances before reporting it to the police.

Adult↗
PubMed1990

A combined factor analysis of the Millon Clinical Multiaxial Inventory and the MMPI in an offender population.

The Millon Clinical Multiaxial Inventory (MCMI) is a recently introduced instrument designed to measure both symptomatology and long-standing patterns of personality disorder in clinical populations. Because it is designed to assess clients who are similar to those with whom the MMPI is often used (e.g., adjudicated offenders), a question may arise as to whether the two instruments measure the same aspects of clients' function. This study investigated this question by conducting a combined factor analysis of the two instruments in a criminal offender population (N = 2,245). Results indicated that although there are important areas of overlap between the two instruments, each also contains unique sources of variance. The results are interpreted as supporting the use of both instruments as part of an objective assessment battery, as has been suggested by several authors.

Adolescent↗
PubMed2005

Predicting the residential location of a serial commercial robber.

Residential location of a serial offender can potentially be predicted by using models created from home to crime site journeys of solved crimes in the area [N. Levine, Journey-to-crime estimation, retrieved 23 October 2003 from http://www.icpsr.umich.edu/NACJD/crimestat/CrimeStatChapter.9.pdf, last visited 1 February 2005]. Aims of this study were: (1) to examine the accuracy of this technique, (2) to explore relation of modus operandi (m.o.) to the distance the crime was committed from home and (3) to analyse whether the accuracy of prediction is enhanced by taking the m.o. into account. Data consisted of 76 commercial robbery series from the Greater Helsinki area. Accuracy of prediction was tested by using leave-one-out technique: the series which the predicting function was applied to was never part of the function used to predict. The functions allowed limiting the area to be searched to 4.7% (Mdn, IQR = 31.0%) of the study area generally, and to 1.0% (Mdn, IQR = 2.6%) when the suspect's spatial behaviour conformed to the circle hypotheses presented by Canter and Larkin [D. Canter, P. Larkin, The environmental range of serial rapists, J. Environ. Psychol. 13 (1993) 63-69]. Significant correlations between m.o. and the length of the journey-to-crime were found, but this information did not enhance accuracy of prediction. Low percentage of marauder style perpetrators in the data gives support to the possible separation of hypotheses of underlying spatial behaviour in instrumental crimes versus crimes of interpersonal violence or arson. Suggestions for development of investigative tools are presented.

Adult↗
PubMed1994

Alcohol and drug intoxication during police interrogation and the reasons why suspects confess to the police.

This study investigates the effects of alcohol, drug intoxication and withdrawal symptoms on the mental state of criminal suspects and the nature of their confession. A total of 359 sentenced prisoners were approached on admission and 96% agreed to participate in the study. They completed a specially designed Confession Questionnaire, which asked them questions about their reasons for confessing to the police, their attitude towards their confession, their mental state at the time of the confession and the extent to which they had been under the influence of alcohol and drug intoxication at the time of crime and police interview. The confession rate for the sample was very high (92%), with serious traffic violators having the highest confession rate (95%) and sex offenders the lowest (83%). The findings illustrate that the "perception of proof", "internal need to confess" and "external pressure" are the main reasons why suspects confess. However, subjects were identified who had experienced a typical "prisoner's dilemma" phenomenon during the police interview because of a co-defendant. Alcohol and drug intoxication was very commonly reported both at the time of the offence and the police interview, but these were related to the nature of their offence. Although intoxication and withdrawal symptoms did not appear to seriously impair their coping during the police interview it was consistently reported as having made them confused.

Adolescent↗
PubMed2004

Depression and hostility as predictors of long-term outcomes among opiate users.

AIMS: This study used data from the national Drug Abuse Treatment Outcome Studies (DATOS) to investigate the associations that pre-treatment depression and hostility have with drug use and criminal behavior at 1 year and 5 year follow-up in patients with and without additional treatment involvement in the year prior to each follow-up. DESIGN: Following a naturalistic, non-experimental evaluation design, admissions to methadone treatment were followed up approximately 1 and 5 years later. Data analysis was conducted using multiple logistic regression. SETTING: Eighteen programs from DATOS were included. PARTICIPANTS: An analytic sample consisting of 727 patients at 1 year follow-up and 432 patients at 5 year follow-up was included. FINDINGS: Multiple logistic regression analyses revealed that greater depression predicted less drug use in the year preceding each follow-up, whereas greater hostility predicted increased drug use and more arrests at each follow-up. Furthermore, these predictive relationships appeared only among individuals not involved in additional treatment. CONCLUSIONS: Depression and hostility showed opposite associations with outcomes, underscoring the need to assess these psychological conditions separately and tailor treatment plans appropriately.

Adult↗
PubMed1991

Spouse assault on mentally disordered wives.

To assess the prevalence and associated features of wife assault in psychiatric patients, 152 married women who had a psychiatric disorder and who were consecutively seen at or admitted to a psychiatric unit were assessed using a structured questionnaire. Forty-nine percent of the patients had been assaulted by their husbands. There was a significant relationship between hospital admission and recent assault. Parental violence and whether or not the husband had a criminal record were strongly related to wife assault. The wives' responses to the assaults were investigated.

Adult↗
PubMed1976

The veridicality of addicts' self-reports in social research.

This report examines the accuracy or veridicality of information obtained through interviews with drug addicts. Comparisons were made between the self-reports on six items of the interview and official records of the Baltimore City Police Department, the Baltimore City Juvenile Court, and the Federal Bureau of Investigation. The findings provide no evidence of systematic distortion intended to "cover-up" the criminal side of addict life. While errors of recall probably do affect self-reports, the incomplete status of official records frequently used to validate self-reports should be of equal concern.

Age Factors↗
PubMed2003

Substance use, substance use disorders, and comorbidity patterns in a representative sample of incarcerated male Dutch adolescents.

The aim of this study was to investigate the prevalence of substance use and substance use disorders (SUDs) among incarcerated boys, and comorbidity patterns and the relationship between SUDs and violent offending and criminal recidivism. The presence of SUDs and other psychiatric disorders was assessed in a representative sample of 204 incarcerated boys aged 12 to 18 years using the Diagnostic Interview Schedule for Children (DISC). Ninety-two percent had used alcohol, 86% had used cannabis, and 33% had used other substances. The 6-month prevalence of SUDs was 55%, and 22% reported polysubstance abuse or dependence. SUDs were positively associated with comorbid externalizing and psychotic disorders. Substance dependence was negatively associated with violent offending but not with criminal recidivism. These high prevalence rates call for more attention to diagnosis and management of SUDs among incarcerated male adolescents. The negative association between substance dependence and the violent nature of the index offense needs further investigation.

Adolescent↗