Crime and mental disorders among native Dutch and ethnic minority juvenile defendants in the Netherlands

We examined the prevalence of mental disorders and the recommendations regarding criminal responsibility and treatment in pre-trial mental health evaluations requested by Dutch juvenile courts for youths between the ages of 12 to 17. Youths of native Dutch (n = 2694) and of ethnic minority background (n = 1393) were compared. The prevalence of mental disorders was similar for both groups (76.8% versus 74.4%). Criminal responsibility in native Dutch youth was more often considered ‘diminished’ or ‘strongly diminished’ than in ethnic minority youth. Admission to a juvenile institution was more often recommended for ethnic minority juveniles than for native Dutch juveniles. It remains unclear from our data whether these differences reflect a false stereotype of ethnic minority populations as being more dangerous and threatening.     

Diagnosis of antisocial personality disorder and criminal responsibility

The present study empirically investigates whether personality disorders and psychopathic traits in criminal suspects are reasons for diminished criminal responsibility or enforced treatment in high security hospitals. Recently, the tenability of the claim that individuals with personality disorders and psychopathy can be held fully responsible for crimes has been questioned on theoretical bases. According to some interpretations, these disorders are due to cognitive, biological and developmental deficits that diminish the individual's accountability.The current article presents two studies among suspects of serious crimes under forensic evaluation in a Dutch forensic psychiatric observation clinic. The first study examined how experts weigh personality disorders in their conclusions as far as the degree of criminal responsibility and the need for enforced forensic psychiatric treatment are concerned (n = 843). The second study investigated associations between PCL-R scores and experts' responsibility and treatment advisements (n = 108).The results suggest that in Dutch forensic practice, the presence of a personality disorder decreased responsibility and led to an advice for enforced forensic treatment. Experts also take characteristics of psychopathy concerning impulsivity and (ir)responsibility into consideration when judging criminal accountability. Furthermore, they deem affective deficiencies sufficiently important to indicate suspects' threat to society or dangerousness and warrant a need for forensic treatment.     

Pseudoxanthoma elasticum and sudden death

Pseudoxanthoma elasticum (PXE) is a generalized connective tissue disorder in which there is calcification of elastic fibers within arteries, eyes, and skin. Characteristic features include yellow-orange papular skin lesions, angioid streaks radiating out from the optic discs, and arterial calcification. The prevalence in the general population varies widely from 1/70,000 to 1/160,000. PXE has an autosomal recessive inheritance pattern and results from mutations in the ATP-binding cassette transporter C6 (ABCC6) that has been mapped to 16p13.1. Over 300 loss-of-function mutations have been identified. Individuals with PXE may come to forensic attention because of sudden death involving accelerated coronary atherosclerosis with acute myocardial ischemia, systemic hypertension, mitral valve prolapse, restrictive cardiomyopathy, gastrointestinal hemorrhage, and cerebral ischemia or hemorrhage. Because of the heritable nature of the disease, family counseling and screening are in order when previously unsuspected cases are encountered at autopsy.     

国家赔偿中精神损害抚慰金的适用问题——以《国家赔偿法》第35条后半段为分析对象

精神损害抚慰金的适用原则应当是赔偿法定、适当限制、平等对待以及区分类型,认定"造成严重后果"应根据生命权、健康权、身体权、人身自由权、名誉权等权利具体分析认定。在操作程序上,确定抚慰金数额可分为五个步骤。在适用对象方面,认定精神痛苦应以理性第三人标准与具体当事人标准有机统一,我国目前还不宜将精神损害赔偿的请求权人扩展到特定第三人,无感受能力之人的赔偿数额应低于正常受害人。     

Psychological autopsy in the investigation of serial neonaticides

While the use of psychological autopsies has at least a 50-year history in the investigation of equivocal deaths and suicides, we report a case where, after the discovery of a woman who died of natural causes, a subsequent search of her home found three deceased newborn infants. The infants were born on three separate occasions; the most recent was delivered approximately 2 weeks before the death of the mother. Using her own diaries and interviews with family and friends along with the physical autopsy and scene investigation data, we built a psychological autopsy that addressed the mother's mental state over the period of time when the infants' deaths took place. While the use of the psychological autopsy was not employed to distinguish the manner of death of the mother, it did provide explanatory power over circumstances of the crime scene and the behavioral disturbance of the mother.     

芪白平肺胶囊治疗慢性阻塞性肺疾病

目的 探讨芪白平肺胶囊治疗慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）合并抑郁障碍的疗效。方法 将58例COPD合并抑郁障碍患者随机分为治疗组（29例）与对照组（29例）,在常规治疗基础上,治疗组与对照组分别加用芪白平肺胶囊与氟哌噻吨美利曲辛,观察两组患者血液流变性、T淋巴细胞亚群及汉密尔顿抑郁量表（Hamilton depression scale,HAMD）评分的变化。结果 治疗组在降低COPD合并抑郁患者的HAMD评分,降低全血高切、低切黏度及血浆比黏度,升高CD4+细胞百分比,降低CD8+细胞百分比方面显著优于对照组（P<0.05,或P<0.01）。结论 芪白平肺胶囊能改善COPD抑郁障碍患者血液流变性,调节T淋巴细胞亚群,降低HAMD评分,对COPD患者有较好疗效。     

Appeals against detention in conditions of excessive security: outcomes and decision-making

The Mental Health (Care and Treatment) Scotland Act 2003 introduced the right for patients to appeal against detention in conditions of excessive security initially to those in high security. Aim: to further investigate appeal outcomes and to examine Tribunal decision-making. Results: responsible medical officer support, being on the transfer list and not having a diagnosis of learning disability increased the chances of a successful appeal. Qualitative analysis of the Tribunal’s decision-making produced 5 themes and 17 subthemes. These were used to develop a ‘checklist’ framework to improve understanding of relevant appeal factors. Conclusions: Neither appeal outcomes nor patient characteristics have changed over time. The checklist may be useful as a training tool and clinical guide. This study is timely given that the Mental Health (Scotland) Act 2015 extended the right of appeal against excessive security to patients detained within medium secure units from November 2015.     

Anxiety disorders and intimate partner violence: can the association be explained by coexisting conditions or borderline personality traits?

Intimate partner violence (IPV) is a serious, preventable public health problem. IPV perpetration is strongly associated with Anxiety disorders at the population level. We investigated whether the association could be explained by coexisting psychiatric conditions or Borderline personality traits, using a combined data-set of two National Household Surveys (n = 15,973). Results showed women were more likely to report perpetrating IPV than men. Anxiety disorders were associated with IPV. When coexisting psychiatric conditions together with a categorical diagnosis of Borderline Personality Disorder (BPD) were investigated as explanatory variables, 19.2% of the association between Anxiety disorders and IPV was explained. Using individual Borderline traits in place of a categorical diagnosis of BPD, 58.3% of the association was explained. In conclusion, the association between Anxiety disorders and IPV was partly, but not fully, explained by coexisting psychiatric conditions and individual Borderline traits. Perpetrators of IPV should be screened for Anxiety disorders and among those with Anxiety disorders, Borderline traits are important.     

Working with personality disordered women in secure care: the challenge of gender-based service delivery

Abstract

Working with women in secure services is an infrequent subject of research and discussion in the forensic mental health literature. There are several reasons for this, which will be considered in the introduction to this paper. However, a consequence of this situation is that there remains a lack of clarity in key areas of practice in relation to working with women in secure services, and working with women with personality disorder specifically: how women with personality disorder may present in secure services compared to men, therefore, the particular skills required of the practitioners who work with women and the main design features of the services within which they are managed. The body of this paper attempts to summarise important issues in each of these areas in order to inform future debate and developments in the field.