admin, Author at searchfortruth.info - Page 25 of 109

Fatal Toxicity Of Drugs Used In Psychiatry.

November 20, 2018October 14, 2017 by admin

Abstract

Certified deaths from fatal poisoning (accidents, suicides and open verdicts) in England and Wales have declined steadily (from 3952 in 1979 to 2565 in 2004). There was also a small annual reduction in suicides in males and in females over this period. In 2004, self-poisoning accounted for 25% of suicides and open verdicts in males (n = 862) and 45% in females (n = 540). Poisoning death rates per million prescriptions were about 10 times higher for tricyclic antidepressants (TCAs) than for selective serotonin reuptake inhibitors (SSRIs), England and Wales, 1993-2004. However, despite the increased prescription of SSRIs and related compounds in recent years, there has been only a slight decrease (some 10%) in the annual number of antidepressant-related poisoning deaths, in line with the reduction in suicides (all methods) over this period. Citalopram appears to have higher overdose toxicity than other SSRIs. Of newer non-SSRI antidepressants, the overdose...

Industry Sponsorship And Financial Conflict Of Interest In The Reporting Of Clinical Trials In Psychiatry.

November 20, 2018October 14, 2017 by admin

Abstract

OBJECTIVE: Financial conflict of interest has been reported to be prevalent in clinical trials in general medicine and associated with a greater likelihood of reporting results favorable to the intervention being studied. The extent and implications of industry sponsorship and financial conflict of interest in psychiatric clinical trials have not been investigated, to the authors' knowledge.

METHOD: The authors examined funding source and author financial conflict of interest in all clinical trials published in the American Journal of Psychiatry, the Archives of General Psychiatry, the Journal of Clinical Psychopharmacology, and the Journal of Clinical Psychiatry between 2001 and 2003.

RESULTS: Among 397 clinical trials identified, 239 (60%) reported receiving funding from a pharmaceutical company or other interested party, and 187 studies (47%) included at least one author with a reported financial conflict of interest. Among the 162 randomized, double-blind, placebo-controlled studies examined, those that reported conflict of interest were 4.9...

The Role of Stimulants in Late-Life Depression

November 20, 2018October 14, 2017 by admin

In this issue, Lavretsky and colleagues report the results of a controlled study to determine whether the addition of methylphenidate to citalopram would accelerate and enhance antidepressant response in older adults (1). This was a 16-week, double-blind, three-arm, parallel-design study comparing the combination of methylphenidate and citalopram and either drug plus placebo. The study builds on previous work by the authors. The study participants had a mean age of 69 years, and all had a diagnosis of major depressive disorder. The authors found that the combination treatment accelerated response and increased the remission rate, and the differences were statistically significant and clinically meaningful. The authors also examined whether adjunctive methylphenidate improved cognition. Although cognition improved with treatment, there were no significant differences between treatments. This is a high-quality study, both in design and in the careful reporting of results.

Figure 1, from the online data supplement of the Lavretsky et al...

The Noncompliant Patient in Psychiatry: The Case For and Against Covert/Surreptitious Medication

November 20, 2018October 14, 2017 by admin

Abstract

Nonadherence to treatment continues to be one of psychiatry’s greatest challenges. To improve adherence and thus improve the care of patients, clinicians and patients’ family members sometimes resort to hiding medication in food or drink, a practice referred to as covert/ surreptitious medication. The practice of covert drug administration in food and beverages is well known in the treatment of psychiatrically ill world-wide but no prevalence rates exist. Covert medication may seem like a minor matter, but it touches on legal and ethical issues of a patient’s competence, autonomy, and insight. Medicating patients without their knowledge is not justifiable solely as a shortcut for institutions or families wishing to calm a troublesome patient and thus alleviate some of the burdens of care giving. The paramount principle is ensuring the well-being of a patient who lacks the competence to give informed consent. Ethically, covert/surreptitious...

Disgust And Psychiatric Illness: Have We Remembered?

November 20, 2018October 14, 2017 by admin

Abstract

It has been argued that disgust has been forgotten by psychiatry. An overview of recent research on disgust is provided. Findings suggest that disgust is a predictor of the development of specific psychiatric conditions.

Research suggesting that disgust has a role in psychiatric illness has emerged (Phillips et al, 1998). Although a well-developed theory of disgust exists in the literature (Rozin & Fallon, 1987), it does not indicate how extreme disgust reactions relate to psychopathology. Briefly, disgust is readily distinguished from other emotions, has robust behavioural correlates such as avoidance and distinct facial expressions, and has specific physical effects such as nausea. Disgust follows a developmental pattern whereby the aforementioned reactions are taught by caregivers, generally as a defence against oral ingestion of items considered contaminated.

At its core, disgust means ‘bad taste’. The notion that disgust might have evolved from the food rejection system is evidenced by the gagging...

Law & Psychiatry: Mental Illness, Police Interrogations, and the Potential for False Confession

November 20, 2018October 14, 2017 by admin

Recently, an alarmingly high incidence of wrongful convictions has been documented in the United States, in large part because of "Innocence Projects" that use DNA analyses from crime scenes to exonerate innocent persons. The best-known Innocence Project, administered through the Benjamin N. Cardozo School of Law in New York, has helped to free 138 people who had been wrongfully incarcerated. Approximately 25 percent of these cases involved false confessions arising from inappropriate police interrogations. Among these false confession cases, persons with mental impairment appear to be disproportionately represented. The Innocence Project's Web site notes, "Truly startling is the number of false confession cases involving the mentally impaired and the mentally ill. Police interrogation in the [false confession] cases reveals a lack of training and a disregard for mental disabilities" (1).

An example of where this situation can lead is the case of Eddie Joe Lloyd, who spent 17 years

Psychological Debriefing: Theory, Practice and Evidence

November 20, 2018October 14, 2017 by admin

The history of psychological trauma is littered with episodes of knowledge and forgetting, just as post-trauma memory is scattered with episodes of remembering and amnesia. This authoritative text goes some way towards the prevention of the threatened but premature death-knell for psychological debriefing. Few issues in mental health are as controversial as psychological debriefing, with polarised views common. The term ‘psychological debriefing’ has been used for different types of intervention, and this book highlights the range of conceptualisations, methodologies and interventions that constitute the area of debriefing, with single sessions superseded by critical-incident stress management (the Cochrane Collaboration review examined only randomised controlled trials incorporating one-off sessions (Rose et al, 2001)).

The editors, Raphael & Wilson, have an impressive track record in their International Handbook of Traumatic Stress Syndromes (1993), a seminal text on psychological trauma. Here, they precede each chapter with an editorial commentary, which provides a helpful overview.

Debt and Deliberate Self-Poisoning.

November 20, 2018October 14, 2017 by admin

Abstract

This study is a descriptive survey of financial difficulties in a consecutive series of patients who deliberately poisoned themselves. Over three months 160 such patients presented to the liaison psychiatry service at Leeds General Infirmary. Information was available on 147 of these patients, of whom 54 (37%) had problem debts. Patients in debt were more likely to harm themselves with greater suicidal intent and, after the episode, to report more symptoms of depression and hopelessness. Psychiatrists were more likely to diagnose mental illness in those in debt...

Psychostimulants in Psychiatry.

November 20, 2018October 14, 2017 by admin

Abstract

The use of the psychostimulants in psychiatry is reviewed. A brief historical perspective on dextroamphetamine is presented, and a brief review of the psychopharmacology of dextroamphetamine, methylphenidate and magnesium pemoline is given. The literature on the use of stimulants in the treatment of resistant depression, apathetic geriatric patients and patients medically ill with a secondary depression is summarized and two case histories given to illustrate the clinical usefulness of the stimulants. The literature on the use of stimulants as an adjunct to antidepressant therapy and as a diagnostic test is also discussed. Finally the use of stimulants in obsessional illness and adult attention deficit disorder is summarized. The writer concludes by commenting that the stimulants have a very useful role in the treatment of certain categories of depression...

The Case of the Confidential Confession: Psychiatry

February 21, 2019October 14, 2017 by admin

The law, medicine, and theology trilogy uniting these Essays, addressing the ethical response to information a professional gains in confidence about a wrongful conviction and an impending execution, raises an overarching question: How does the role of a professional affect our ethical duties as members of society? Likely, few would seriously argue that if the same disclosure about an impending wrongful execution were made to a friend wearing no professional garb that we would find an ethical duty to prevent the friend from disclosing a confidence, rather than an ethical duty compelling the friend to come forward to avoid the wrongful execution. Does the role of a professional displace personal moral standards? Implicit in the problem is the assumption that professionals should act differently. Attempts to articulate a profession's sense of its unique ethical responsibilities are contained, in part, in its ethical code. Psychiatric ethics draw from the field of medical ethics...

Deception And Self-deception In Shamanism And Psychiatry.

November 20, 2018October 14, 2017 by admin

Abstract

The author argues that both shaman and psychiatrist are obliged to use a degree of self-deception in assuming their roles. The shaman must rationalize his use of trickery to impress his patients, and the psychiatrist deceives himself that his psychotherapeutic techniques have specific healing properties in the face of evidence which suggests that he often merely mobilizes the general effects of placebo and suggestion. Shaman and psychiatrist appear to use the same mental mechanisms in deceiving themselves. Inadequate method and theory may be supported by reference to personal experience and unrelated data or defended by circular reasoning or comparison with an even more inadequate system. The practitioner may also allow his perception of his abilities to be moulded by social consensus...

Handgun Wounding Factors and Effectiveness

February 10, 2019October 14, 2017 by admin

FORWARD

The selection of effective handgun ammunition for law enforcement is a critical and complex issue. It is critical because of that which is at stake when an officer is required to use his handgun to protect his own life or that of another. It is complex because of the target, a human being, is amazingly endurable and capable of sustaining phenomenal punishment while persisting in a determined course of action. The issue is made even more complex by the dearth of credible research and the wealth of uninformed opinion regarding what is commonly referred to as "stopping power".

In reality, few people have conducted relevant research in this area, and fewer still have produced credible information that is useful for law enforcement agencies in making informed decisions. This article brings together what is believed to be the most credible information regarding wound ballistics. It cuts through the haze and confusion,..

To Flee or Not: Postkilling Responses Among Intimate Partner Homicide Offenders in Hong Kong

November 20, 2018October 14, 2017 by admin

Abstract

Among 112 homicides involving sexual intimates that occurred in Hong Kong between 1989 and 2002, 38% ( n = 42) of offenders remained voluntarily at the homicide scene, 21% (n = 24) committed suicide, 20% (n = 22) escaped and denied involvement, 13% (n = 14) disposed or hid the body of their victim, and 9% (n = 10) escaped but later voluntarily surrendered. This study used police investigation reports, coroner’s reports, witness statements, and other relevant documents to compare these five types of postkilling behavior. The type of response was explained by the offender’s characteristics, the strength of attachment to the victim, and situational factors. The offender’s prior criminal conduct or history of violence was not significant in predicting the type of postkilling response...

A Typology of Multiple-Perpetrator Rape

November 20, 2018October 13, 2017 by admin

Abstract

Some consistency in existing typologies of rape has been found, which have extended from lone to multiple perpetrator offenses. The current study sought to explore the facets of multiple-perpetrator rape (MPR) in a sample representative of one geographical area. Seventy-five victim statements of MPR reported to an urban police force in the United Kingdom were classified into a qualitative model denoting offender actions in MPR. Four types from pathways through the model were produced: violence, criminality, intimacy, and sexuality. Analysis of the crime scene variables provided additional evidence of the four types. Finally, the associations between the four types and offense characteristics, such as victim and perpetrator age, were explored. Implications of these findings for the prevention and investigation of MPR are discussed along with suggestions for future research directions....

The Role of Marijuana in Homicide

November 20, 2018October 13, 2017 by admin

Abstract

In this paper we examine the relationship between marijuana use and homicide. Data derive from interviews with 268 individuals incarcerated in New York State correctional facilities for homicides that occurred in 1984. We found that in terms of lifetime use, marijuana was the most commonly used illicit drug in this sample; that about one-third of respondents who had ever used marijuana used the drug in the 24-hour period before the homicide; and that almost three-quarters of those respondents were experiencing some type of effect from the drug when the homicide occurred. A total of 18 respondents (7% of the total sample) said that the homicide was related to their marijuana use. We examine the reasons these respondents gave for this relationship and the other substances they reported using at the time of the homicide. We also demonstrate that from the perspective of a conceptual framework that specifies the ways...

Establishing the Victim–Offender Relationship of Initially Unsolved Homicides Partner, Family, Acquaintance, or Stranger?

November 20, 2018October 13, 2017 by admin

Abstract

This analysis examines the extent to which homicides initially reported as unknown offender in end-of-year reports, once cleared, are more likely to have been perpetrated by strangers than other cleared homicides. Using solved and unsolved homicides in Indianapolis (N = 829), we determined victim–offender relationships in homicides reported as unsolved in year-end reports, when solved, were not significantly different from homicides reported as having a suspect in year-end reports. Indianapolis homicides were classified disproportionately as acquaintances. Findings help negate the ongoing myth that unsolved homicides are disproportionately stranger homicides. Results suggest decreased homicide clearance rates are not due to increased stranger homicides....