Treating impulsivity, irritability, and aggression of antisocial personality disorder with quetiapine

There are few effective treatments of antisocial personality disorder (APD). Preliminary work suggests that the atypical antipsychotic quetiapine can decrease irritability, impulsivity, and aggressiveness. Data were collected from 4 patients with APD who were referred to a maximum-security inpatient psychiatric facility for pretrial evaluation and were treated with quetiapine. Quetiapine was effective in these patients as was indicated by a decrease in symptoms such as impulsivity, hostility, aggressiveness, irritability, and rage reactions. Typical dosage was 600 to 800 mg per day. Patients attributed their willingness to comply with quetiapine treatment to both the effectiveness of the drug and its favorable adverse-event profile. Quetiapine was successfully combined with mood stabilizers, particularly gabapentin, in patients with prominent affective instability. Quetiapine has demonstrated efficacy in aggression, impulsivity, and irritability and has proved to be an effective medication in these patients with APD. In addition, its favorable adverse-event profile makes patients willing to comply.     

What we know and what we still need to learn

Research has changed the conceptualization of the causes and consequences of violence. Yet some questions remain unanswered. Infants and young children have largely been overlooked, and intraethnic and cultural group variations have not been addressed. There is still a need to address macro-level systematic discrimination in the health care system along with the intrapersonal physiological changes that result from exposure to violence. Fortunately, studies are beginning to show how longitudinal and intervention research can be safely conducted.     

Agency Fever? Analysis of an International Policy Fashion

In the last 15 years, the governments of many OECD countries have transferred a wide range of functions to new, agency-type organizations. Allowing for the fact that, for comparative purposes, it is difficult precisely to define agencies, and further acknowledging that in many countries agencies are far from being new, it nevertheless remains the case that there seems to have been a strong fashion for this particular organizational solution.This article investigates the apparent international convergence towards agencification. It seeks to identify the reasons for, and depth of, the trend. It asks to what extent practice has followed rhetoric. The emerging picture is a complex one. On the one hand, there seems to be a widespread belief, derived from a variety of theoretical traditions, that agencification can unleash performance improvements. On the other hand, systematic evidence for some of the hypothetical benefits is very patchy. Furthermore, the diversity of actual practice in different countries has been so great that there must sometimes be considerable doubt as to whether the basic requirements for successful performance management are being met.     

Expert Evidence Pertaining to Battered Women: The Impact of Gender of Expert and Timing of Testimony

The present study investigated the impact of two variables relating to general expert testimony pertaining to battered women on juror decision processes. Specifically, the gender of the expert, as well as the timing of the presentation of the testimony, were investigated in a simulated homicide trial involving a battered woman who had killed her abuser. Results indicated that when the expert was female and the testimony was presented prior to the defendant's testimony, jurors' verdicts were more lenient. Moreover, across a range of case judgments, male jurors' perceptions were more favorable to the defendant when the expert was female as opposed to male. On two of the judgments this latter pattern of results was only evidenced when the testimony was presented early as opposed to late. The significance of these findings is discussed.