Evaluation and treatment of insanity acquittees in the community

This paper describes the monitored outpatient treatment program for Psychiatry Security Review Board (PSRB) clients in the largest single community treatment agency in the Oregon system. We describe 161 persons referred to this agency for evaluation and treatment. Ninety-one PSRB clients received treatment and of this group 51% had their conditional release revoked by the PSRB. The most frequent cause of revocation was noncompliance with treatment. There were only 11 crimes committed during the study period, four of which were in the felony range. The majority of PSRB clients are chronically mentally ill persons. We discuss both the treatment approach and our results in light of a recently published research agenda for insanity acquittees.     

Citizen response to regional integration in the Americas: The cases of Costa Rica and El Salvador

This study examines public opinion in Costa Rica and El Salvador regarding regional integration in Central America. Recent efforts at regional integration as well as the response of the governments of the above countries to those efforts are reviewed. Public opinion toward regional integration is significantly more positive but less structured in El Salvador than in Costa Rica. Differences in the international and domestic contexts help to explain the differential responses in these two countries. Likewise, contextual factors help to account for differences between Central American and European publics in attitudes toward regional integration. Charles L. Davis is associate professor of political science at the University of Kentucky. His interests are Latin American politics and comparative political behavior. Matthew J. Gabel is assistant professor of political science at the University of Kentucky. His interests are European politics and the politics of regional integration. Kenneth M. Coleman is a former professor at the University of Kentucky, the University of North Carolina-Chapel Hill, and the University of New Mexico. His interests are Latin American politics and public opinion.     

Suicide in Fulton County, Georgia (1975-1984)

Demographic and trend analysis of 881 consecutive suicides in blacks and whites is presented. For the years 1975 through 1984, the suicide rate was 15.1/100 000 and did not significantly change. White males were overrepresented in all age groups, had an overall suicide rate of 34.9, and showed a small but statistically significant increase in rate which was not accounted for by any specific age group. White females, in general, were represented in proportion to their prevalence in the population, and those ages 20 to 24 demonstrated an increasing suicide rate which was small. Black males were at highest risk in their twenties, showed no significant trends, and were also represented near their prevalence in the population. Black females of all ages were underrepresented, and had low suicide rates which decreased with time. No significant rate changes were noted for teenagers or the elderly. Firearms was the method of choice in all groups, although methods varied with age, race, and sex, and male children preferred hanging. Small but significant increases were noted for the prevalence of nondrug methods in females and carbon monoxide deaths in white males. Similarities and differences to larger scale studies are discussed. Suicide may have characteristics unique to given geographical areas and pervasive to all areas. The authors advocate study and publication of local data to clarify further the nature of suicide.     

3-Methoxytyramine in the putamen as a gauge of the postmortem interval

The armamentarium of the forensic thanatologist includes the examiner's subjective assessment of bodily changes together with comprehensive evaluation of environmental and associated factors to estimate the postmortem interval (PMI). Of the various objective means, postmortem accumulation of potassium in vitreous humor is a widely used gauge. In view of the considerable variability inherent in these techniques, an additional marker with greater accuracy would be a welcome supplement to these indices. We have developed a method of estimating PMI from the level of 3-methoxytyramine (3-MT) in the dorsal putamen of the brain. The supernatant of a sample of putamen, sonicated in 6 volumes (weight/volume) of 0.1 M perchloric acid and centrifuged at 51 000 times gravity for 10 min, was analyzed for 3-MT using high-pressure liquid chromatography with electrochemical detection. The change of 3-MT in the putamen is linearly related to the PMI (range: 5.5 to 60 h), irrespective of patient age (1 to 84 years). This observation is attributable to several factors, including high substrate (dopamine) concentration, preservation of catechol-O-methyl transferase activity, and an inactivation of monoamine oxidase activity, as a result of a decrease in tissue pO2.     

Ethics and the psychiatric determination of competency to be executed

For the last several centuries, most jurisdictions using capital punishment have had formal or informal rules that prohibit the execution of the mentally ill. In this article, the procedures for such exclusions in Florida are examined. The article begins by attempting to answer the question of why legislators and judges, at least nominally, have prohibited the execution of the mentally ill. Next, Florida's criteria for defining and procedures for excluding mentally ill prisoners are examined and found to be vague. We then turn attention to the ethical problems created by the statute and its implementation that face the participating psychiatrists and the profession. These problems are compounded because the physician's findings are not acted upon by politically neutral authorities and the inmate has no opportunity to challenge the findings with his own panel of experts. Finally, since any exclusion of the mentally ill from execution is temporary and the patient will be executed if he recovers, the dilemmas facing the treatment staff if the death sentence is not commuted to life imprisonment before treatment are discussed.     

论冯友兰的"文化三说"观

冯友兰是中国近现代史上著名的哲学家和哲学史家。他从中国文化和中国社会发展方向的前提出发，比较中西文化之间的差异，形成了关于文化问题和社会发展问题的一系列观点。他所提出的以“文化类型”说、“继往开来”说和“道统新续”说为内容的“文化三说”观，对于妥善处理中西文化冲突与融合过程中的时代性和民族性的关系，以及如何弘扬中国传统文化的精华与吸收外国文化的长处等问题，仍然具有积极的现实启迪意义。