Patient perceptions of schizophrenia in forensic and general adult psychiatry

This study explores the illness perceptions of patients with schizophrenia in forensic settings and contrasts their views with those of a general adult psychiatry sample. It was hypothesised that forensic psychiatric patients would have more negative illness beliefs than general adult patients. A cross-sectional survey was used. Forty forensic patients and 32 general adult patients with schizophrenia were recruited. They completed the Illness Perception Questionnaire for Schizophrenia (IPQS), a valid and reliable measure of illness perceptions in mental health problems. Forensic patients perceived their illness to be less chronic, less cyclical, and had a lower negative emotional response to illness. Our results did not support our original hypothesis and possible reasons are explored. Acknowledging patient’s views when formulating management plans could permit more effective individually tailored treatment.     

Motor-vehicle collision-related death due to delayed-onset subarachnoid hemorrhage associated with anticoagulant therapy

Delayed deaths following injury are not rare. Various mechanisms may be responsible for such deaths, including pulmonary thromboembolism, fat embolism, infection, systemic inflammatory response syndrome, and delayed hemorrhage. In the present case, we describe a death due to delayed subarachnoid hemorrhage following a motor vehicle collision, wherein the hemorrhage occurred ten days after the incident, while the patient remained hospitalized for skeletal trauma. At no time prior to the hemorrhage did the victim show any symptoms of brain injury. Autopsy revealed basilar subarachnoid hemorrhage arising from a cerebral cortical contusion. There was no evidence of aneurysm or arteriovenous malformation. A significant underlying contributing factor in the delayed hemorrhage was the victim's chronic anticoagulant therapy, which was required because of a mechanical heart valve.