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PubMed1993

[Mania and melancholia in the writings of Aretaeus].

In antique medicine mania and melancholia were diagnosed as impairment of sense and imagination. Aretaeus considered that the difference between them was that melancholia was "partial" insanity (anxiety of the soul caused by a single idea), while mania was insanity of the "whole soul". This concept led to extension of both terms, in particular melancholia which composed also paranoid and hallucinatory symptomatology. This concept persisted to the beginning of the 19th century.

Bipolar Disorder↗
PubMed1997

[A case of folie à trois].

We examined a case of a family of induced insanity (folie à trois) which is characterized by its delusion of jealousy, and reported about the establishment and disappearance process of the delusion. We examined the background of the fact that the family members shared the same delusion and the family dynamics. We concluded that induced insanity is an extended expression of family illness which appears in the process in which the family expresses its problematic theme and tries to cope with it.

Adult↗
PubMed1997

[Emil Kraepelin and bipolar disorder: invention or over-extension?].

From 1899 to 1913, Emil Kraepelin (1856-1926) creates and elaborates the nosographical group of the "manic-depressive insanity". In the 50-60s, Leonhard splits off this homogeneous group and describes unipolar psychosis, bipolar psychosis and cycloïd psychosis (anxiety-elation psychosis, motility psychosis and confusion psychosis). Recent nosographical orientations seem to announce a come-back to Kraepelin's conception of "mood disorders". This paper presents the essential of Kraepelin's "manic-depressive insanity" theory-temperamental basis, integration of mixed states, epidemiological datas- and highlights its dialectical relations with today's theory of bipolarity.

Bipolar Disorder↗
PubMed1997

The origins of forensic psychiatry in the United States and the great nineteenth-century crisis over the adjudication of wills.

Forensic psychiatry emerged as a professional activity in the United States during the first third of the nineteenth century when four major factors coalesced: the medicolegal vision of early American physicians, the introduction of new theories about insanity, the concern of early state governments with mental health, and the advent of marketplace professionalism. From the outset, forensic psychiatry found itself involved in the adjudication of wills. The evidence suggests that postmortem diagnoses of insanity were employed through the middle decades of the nineteenth century to maintain stable and predictable patterns of property conveyance in the new republic. But such diagnoses then became something of a fad, a way to raid estates. Courts and legislatures reacted against that trend during the last decades of the nineteenth century, when fundamental social stability was no longer an issue, in order to protect individual testators and limit the power of forensic psychiatry. By the early decades of the twentieth century, patterns had emerged that have since been taken as normative.

Forensic Psychiatry↗
PubMed1999

MMPI-2 profiles of NGRI and civil patients.

Limited information is available comparing individuals found Not Guilty by Reason of Insanity (NGRI) to other psychiatric patients. This study examined the MMPI-2 profiles of 36 NGRIs and 35 civilly committed inpatients at 3 state psychiatric hospitals. The NGRI and civil patient groups differed in terms of race and gender with more minority individuals and fewer women in the NGRI group. Therefore, these demographic variables were used as covariates in a MANCOVA comparing the MMPI-2 validity and clinical scales for these 2 groups. NGRIs and civil inpatients produced significantly different mean MMPI-2 profiles, with NGRIs reporting less pathology overall compared to civil inpatients. Specifically, NGRIs had lower scores on scales F, 1, 2, 7, 8, and O and higher scores on scale K. Contrary to expectations, NGRIs and civil patients did not differ on scale 4, supplementary scale Re, and content scales ANG, CYN, and ASP, or Harris-Lingoes subscale Pd2. Overall, these results suggest that NGRI patients are functioning at a higher level than civil patients. These findings are considered in terms of previous results and potential selection bias. Implications for treatment and future research are also considered.

Adult↗
PubMed1998

Neurobiologic correlates of violence: relevance to criminal responsibility.

Studies addressing the relationship between neurotransmitter functioning and violent crime are reviewed. A rich literature exists to support the notion that monoamine (i.e., serotonin, dopamine, and norepinephrine) neurotransmitter functioning is related to human aggressive behaviour. Results from these studies provide, at best, indirect evidence that neurotransmitter abnormalities are involved in violent criminal behavior. Few studies have specifically addressed the role of neurotransmitter functioning in violent crime. To illustrate how current knowledge in this area has been applied in forensic settings, a case study in which neurotransmitter functioning was introduced as evidence to support an insanity defense is presented. Potential problems associated with such defenses are discussed.

Adult↗
PubMed1999

Craziness and criminal responsibility.

This article addresses why mental disorder is relevant to criminal responsibility. It begins by considering the meaning of criminal responsibility because it is impossible to understand the relevance of mental disorder unless one understands responsibility clearly. The next section provides a theoretical account of responsibility and excuse in general and addresses common misconceptions about these topics. The third section examines in detail why mental disorder can sometimes produce either a complete or partial excusing condition, such as legal insanity or "partial responsibility," and whether the U.S. Constitution requires the provision of an excuse based on mental disorder. The section proposes that mental disorder should produce an excusing condition in appropriate cases. The next section considers the relation of mental disorder to mens rea, the mental state "element" that is a definitional criterion of most crimes, and whether the U.S. Constitution requires that defendants be permitted to use evidence of mental disorder to negate mental state elements of the crime charged. This section argues that mental disorder rarely negates mens rea, but in those cases in which a plausible claim for negation could be made, defendants should be allowed to make this claim.

Crime↗
PubMed1999

Voluntary intoxication and criminal responsibility.

This paper reviews the law related to voluntary intoxication and criminal responsibility in the 50 United States, the District of Columbia, the US Virgin islands, and Puerto Rico. Statutory and case law citations are provided which govern the use of intoxication evidence in each jurisdiction to negate mens rea (i.e., to establish diminished capacity), to support an insanity defense, and to mitigate criminal sentencing. Factors that courts typically focus on when deciding whether to admit this evidence in a particular case are discussed, and these factors are related to clinically relevant criteria.

Alcoholic Intoxication↗
PubMed1999

An administrative model for close monitoring and managing high risk individuals.

The public expects central government to have immediate knowledge of the condition and circumstances of certain vulnerable or dangerous individuals such as insanity acquittees, and to take action in individual cases to protect the individual and the public. Therefore, such persons conditionally released to community settings require an unusual degree of close monitoring and management. Being immediately aware of the condition and circumstances of its assignees, together with other duties of a board or commission responsible for that monitoring and management, is largely an information management function. The Psychiatric Security Review Board in Oregon is used to illustrate this unique mission, operations, and information management. In this paper, the Psychiatric Security Review Board is described in terms of its core and secondary businesses, together with a model information system that is based on information and information management processes actually employed by the Board.

Commitment of Persons with Psychiatric Disorders↗
PubMed2001

The relationship between criminal charges, diagnoses, and psycholegal opinions among federal pretrial defendants.

This study analyzed data from 1710 criminal defendants referred by federal courts throughout the United States. We examined 12 categories of criminal charges with respect to diagnosed psychopathology and opinions related to competence to stand trial (CST) and criminal responsibility (CR) at the time of the alleged offense. Overall, 18% of the present sample were found to be incompetent to stand trial, while 12% were found to be not criminally responsible or 'insane.' In this study, crimes were associated with rates of psychopathology and rates of opinions regarding CST and CR. The findings of this study suggest that individuals who are charged with different crimes have different mental states and psychopathology and are therefore found to have differential rates of competence and sanity.

Adult↗
PubMed2003

Voluntariness, intention, and the defence of mental disorder: toward a rational approach.

This article addresses how mental disorder may be used in common law countries to negate the requirements of voluntariness and intention in serious criminal offences as well as to provide the basis for current versions of the insanity defence. The notion that mental disorder can cause conduct to become completely involuntary or unintentional is questionable, given current thinking in the behavioral sciences. This article argues that different forms of mental disorder should be subsumed within a separate defence of mental disorder. Providing that a range of dispositional options is available, the law in this complex area would be simplified and brought into line with current psychological notions of goal-directed behavior.

Behavior↗
PubMed2003

A mind to blame: new views on involuntary acts.

This article examines the legal implications linked to recent scientific research on human consciousness. The article contends that groundbreaking revelations about consciousness expose the frailties of the criminal law's traditional dual dichotomies of conscious versus unconscious thought processes and voluntary versus involuntary acts. These binary doctrines have no valid scientific foundation and clash with other key criminal law defenses, primarily insanity. As a result, courts may adjudicate like individuals very differently based upon their (often unclear) understanding of these doctrines and the science that underlies them. This article proposes a compromise approach by recommending that the criminal law's concept of voluntariness consist of three parts: (i) voluntary acts, (ii) involuntary acts, and (iii) semi-voluntary acts. The semi-voluntary acts category, which is new, incorporates modern ideas of consciousness and also advances the law. Using some actual criminal cases, this article applies this new three-part grouping and demonstrates how it enhances a more just outcome for defendants, victims, and society.

Adult↗
PubMed2002

Older criminals: a descriptive study of psychiatrically examined offenders in Sweden.

OBJECTIVE: We retrospectively examined psychiatric diagnoses of older offenders referred by court for psychiatric assessment in Sweden, and compared them with younger offenders. METHOD: In Sweden, structured court-ordered forensic psychiatric evaluations are undertaken by a forensic psychiatric team. Data on age, sex, citizenship, psychiatric diagnoses, offences, and legal insanity declarations were obtained for the years 1988-2000 (n = 7297). RESULTS: There were 210 forensic psychiatric evaluations in those aged 60 and over. 7% had a diagnosis of dementia, 32% psychotic illness, 8% depressive or anxiety disorder, 15% substance abuse or dependence, and 20% personality disorder. Older offenders were significantly less likely to be diagnosed with schizophrenia or a personality disorder, and more likely to have dementia or an affective psychosis compared to younger ones. Logistic regression analyses suggested that of the studied factors, the ones most typical of older offenders were a diagnosis of dementia and being charged with a sexual offence. CONCLUSION: There appear to be important differences in psychiatric morbidity between older offenders and younger ones who come into contact with forensic psychiatric services. This research may assist in the planning of forensic and therapeutic services for the increasing number of older adults passing through the criminal justice system.

Adult↗
PubMed1995

The criminal responsibility of people with multiple personality disorder.

Because multiple personality disorder (MPD) is more frequently diagnosed today than in the past, it is likely that more multiples will plead insanity. The courts are in a state of disarray as to how best to respond to these pleas. This article considers multiples' responsibility on three interpretations of the status of their alters: that they are different people; that they are different personalities; or that they are parts of one complex, deeply divided personality. On all three theories multiples are nonresponsible. Nevertheless, three rare circumstances exist under which multiples should be found guilty. The article concludes by indicating the kinds of issues psychiatry might explore to further assist the law in its analysis of the criminal responsibility of multiples.

Dissociative Identity Disorder↗
PubMed1995

Physical control of patients on an inpatient setting: forensic vs. civil populations.

The current study examines the use of physical control (seclusion and restraint) in a sample of patients hospitalized in a public mental hospital during 1989. A total of 243 patient records involving physical control were examined; of these, 124 had been civilly committed and the remaining 119 were forensic (Incompetent to Stand Trial or Not Guilty by Reason of Insanity). Some 870 physical control events occurred in the sample, a rate that is intermediate when compared with other facilities described in the literature. Seclusion was employed most often (46% of events), with the combination of seclusion and restraint used in 32% of events and the remaining 22% of physical control events being restraint. Seclusion tended to be used more often with civilly committed patients, with restraint more frequently employed with forensic patients. Forensic patients differed from civil subjects in their greater frequency of threats, agitation, and verbal hostility. However, civil patients were more frequently aggressive toward others and destructive of property. These findings are discussed in the context of previous evidence also describing forensic patients as being perceived as more dangerous, but behaving in a fashion no more physically aggressive than civil patients.

Adult↗
PubMed1999

["Pathological intoxication."Diagnostic artefact or a reliable psychiatric diagnosis?].

"Pathological intoxication" has been a matter of controversial discussions during the last years. On one hand diagnosis of "pathological intoxication" in forensic expertise often is associated with the assumption of legal insanity. On the other hand it has been suggested that the term "pathological intoxication" should be abandoned in favor of more accurate clinical diagnosis, and recently "alcoholic idiosyncratic intoxication" was canceled as a separate diagnosis in DSM-IV. In order to register the diagnostic habits connected with "pathological intoxication" we had sent a questionnaire to all psychiatric institutes (n = 541) in Germany. We were then able to evaluate 338 questionnaires (62.5%) relating to number of diagnoses and diagnostic criteria. In synopsis diagnostic habits turned out to be very inhomogeneous. Nearly two third of psychiatric institutes reported not to have used the diagnostic category between 1991 and 1993, whereas nearly 50% of diagnoses (210 out of 456) were reported by only 13 (3.9%) institutes. Diagnosis of "pathological intoxication" is based predominantly on vague and non-distinct criteria, such as "violent excitation" or "strange unusual behavior". In accordance to DSM-IV we therefore suggest that the diagnostic term "pathological intoxication" should be abandoned, especially in the context of forensic psychiatric expertise. Instead, assessment of intoxication must be based on individual somatic and psychopathological symptoms.

Academies and Institutes↗
PubMed2005

Infanticide: contrasting views.

BACKGROUND: The subject of infanticide is met with complex reactions. Paradoxically, the very same society that practices gender selection may also prosecute a mother for killing an infant. The author reviews historical, cultural, and political views on infanticide. OBJECTIVE: Using the case of Andrea Yates, the author illustrates the outcome of an infanticide case in American Judicial System in which a floridly psychotic mother serves a life in prison. This work explores contemporary worldwide experiences of infanticide and investigates culture specific attitudes towards causes, facilitation, and punishment of this tragic cause of infant mortality. The work illustrates the intricate relationship between a society's construction of parenthood and mothering, and its experience of infanticide. RESULTS: Infanticide is deeply embedded in, and responsive to the societies in which it occurs. Causes vary from poverty to stigma, dowry and insanity. The worldwide experience of infant murder reaches from facilitation of gender determination in China and Asia to lethal execution of mothers as perpetrators in the United States. CONCLUSION: Infanticide must be viewed against the political, cultural, social and legal backgrounds of societies that treat women with disregard. It is a reflection of social and cultural norms governing motherhood, a constant that links these seemingly disparate acts. The overall association of infanticide with crime, postpartum illness, population and sex selection speaks to unjust discrimination against women and children. We as a world society can do a far better job of protecting motherhood.

Capital Punishment↗