A tale of two cities

The authors are respectively parttime professor sociology at the University of Texas (San Antonio) as well as lecturer at the medical faculty of the State University Limburg (section psychiatry) and researcher at the Research and Documentation Centre of the Ministry of Justice, Schedeldoekshaven 100, 2511 EX The Hague, The Netherlands. Dorette Courtar, a mobility programme exchange student at the University of Maastricht and the Stockholm University, assisted in the basic research. We would like to thank Paulina Loennroth and the mayor of Hulst, dr. A.A.L.G.M. Kessen, both connected to the ECAD and Paul Vasseur, Urban Weber, Suzanne Schardt, all connected to the ECDP for their information and comments.     

Characteristics of adolescent incest sexual perpetrators: Preliminary findings

Adolescent incest sexual perpetrators seen at an out-patient clinic were interviewed regarding demographic characteristics and occurrence of deviant and nondeviant sexual behaviors. Results indicate that subjects (1) committed more sexual crimes than they had been arrested for, (2) reported a very early onset of sexual behavior, (3) had additional DSM-III psychiatric disorders, and (4) reported previous sexual victimization. Recommendations for future research are made.     

Palestinian state‐building: police and citizens as test of democracy

This article explores police‐society relations by assessing the impact of current state‐building efforts by the Palestinian National Authority (PNA) in the Gaza Strip and part of the West Bank. The article presents an outline of the emerging civilian policing model and its wider implications for citizens’ rights and the dominant political order. The specific focus of the paper rests on an examination of the potential tensions associated with the perceived need for strong coercive security structures (including the civil police) as part of state‐building efforts and the desire by the population for increased freedom and pluralism. This issue is further complicated by the ambiguous nature of the current experiment in limited autonomy underway in those areas of the West Bank and Gaza Strip where Israeli redeployment has taken place.     

Risk assessment and suicide prevention in primary care

General practitioners (GPs) are assumed to occupy an important position in the prevention of suicide through the introduction of risk assessment techniques commonly used in psychiatric practice. Despite this theoretical role for primary care services, it remains unclear how frequently GPs implement risk assessment in patients who may be vulnerable to suicide. To address this, a retrospective survey of probable suicides was conducted within a primary care setting utilizing a questionnaire of GPs who had experienced a patient suicide and was augmented by hospital and coroners' records. 85% of questionnaires were returned and 61 deaths were adjudged as suicides during the year long census period. 75% of suicides were male and 54% were aged under 35.28% were in contact with psychiatric services prior to death, although 60% had some diagnosis of mental disorder. GPs had little knowledge of a patient's life circumstances in up to half of cases. Recording of risk assessment occurred in 38% of subjects, was positively associated with prior psychiatric contact (p = 0.001) but negatively associated with presence of physical illness (p = 0.004), older patient age (p = 0.04), and GPs length in practice (p = 0.05). One GP felt their suicide case was preventable. The low rate of risk assessment and limited knowledge of patient lifestyle point to the need for active engagement of GPs in future suicide prevention strategies and should influence the content of training programs in primary care.