Prevalence of mental disorders among sexual offenders in forensic psychiatry and prison

The objective of this study was to compare the prevalence of mental disorders among sexual offenders in forensic psychiatry (SF) with the prevalence of such disorders among sexual offenders in prison (SP) and violent offenders in prison (VP). In a cross-sectional study, 40 of 47 SF detained in forensic psychiatry in Baden-Wuerttemberg, Germany, could be included. They were compared with 30 SP and 26 VP. All study participants were interviewed by means of SCID I and SCID II and assessments of functioning (GAF, BSS). There was a high prevalence of mental disorders (DSM-IV: Axis I) in all three groups (SF: 80%, SP: 63%, VP: 73%). Among SP and VP, this was attributed mainly to substance use disorders. The prevalence and comorbidity of personality disorders was significantly higher in the group of the SF (prevalence: SF: 85%, SP: 27%, VP: 39%). In a psychopathological view, SP were all together more similar to the imprisoned non-sexual delinquent VP than to the SF.     

Motor vehicle accident with complete loss of consciousness due to vasovagal syncope

Vasovagal syncope (VVS) is one of the most common causes of complete or partial loss of consciousness, thus it might cause harm to the patients themselves or innocent bystanders while driving a car. In our case report we introduce the case of a 60-year-old man who was admitted to hospital after a serious motor vehicle accident due to loss of consciousness. We demonstrate the process and results of complete cardiologic and neurological assessment. Our case report illustrates the importance of recognition of patients with a high risk for incapacitating symptoms due to VVS, and the use of head-up tilt-table tests to determine the diagnosis and to guide therapy with beta-blocking agents. As transient loss of consciousness during driving may cause potentially fatal accident, it has to be taken into consideration during decision making for issue of driving licenses to patients with VVS.     

A systematic review of suicide rating scales in schizophrenia

In spite of a substantial number of suicides in patients with schizophrenia, this area of research has until very recently been the Cinderella of schizophrenia research. Both clinical and research practices have been hampered by a lack of assessment tolls specifically designed to measure suicidality in patients with schizophrenia. This has partly been because of uncertainty about what constitutes reliable risk factors for suicide in schizophrenia. A literature search following evidence-based guidelines was carried out. A number of relevant articles were found, which were then critically reviewed. The majority of rating scales used for patients with schizophrenia were actually based--at least partly--on patients with other diagnoses than schizophrenia (affective conditions, schizoaffective disorder). This procedure could result in misleading conclusions as a result of the heterogeneity of the different mental illnesses. We conclude that, at present, only one rating scale measuring suicidality specifically designed for patients with schizophrenia (the InterSePT-scale) is based on both sound methodology and has clinical relevance. Suicide in patients with schizophrenia remains a pressing problem in the treatment of this high-risk group.     

A Comparative Test of Alternative Theories of the Determinants of Italian Public Deficits (1950–1998)

The paper assesses the relative explanatorypower of the Keynesian, the optimalfinance, the contingent liability andseveral public choice theories of thedeterminants of public deficits on Italian1950–1998 data. A vector error correctionmodel suggests that deficits are sensitiveto unemployment levels, interest groups'preferences (especially the elderly),government fragmentation, changes in thedegree of stringency of budget rules andexternal economic constraints. Data insteadprovide a weak or no support to thehypotheses that deficits respond to outputgrowth and electoral events. Theimplications of the optimal finance and ofthe contingent liability theory arerejected as well.