"It Had Only Been a Matter of Time Before I Had Relapsed Into Crime": Aspects of Care and Personal Recovery in Forensic Mental Health

Introduction Forensic psychiatry has the dual task of focusing on the prevention of reoffending as well as maintaining psychiatric rehabilitation. No previous studies addressing the patients' own views on reducing their risk of serious reoffending were found. Aim This study describes forensic psychiatric inpatients' own views on what aspects of care and personal recovery are important in reducing their risk of serious reoffending. Methods A structured qualitative approach was used. Data were collected from semistructured interviews and analyzed with a systematic qualitative content analysis. Results The results highlight aspects of care and personal recovery. Four themes emerged: “time: opportunity for change,” “trust: creating a context with meaningful relations,” “hope: to reach a future goal,” and “toolbox: tools needed for recovery.” Discussion The themes present with a continuum. At one end, there are patients who appreciated possibilities to participate actively in care and treatment. At the other end, patients felt they had no use for their care. Interestingly, although patients in our study were asked for their opinion on how they could reduce their dangerousness, all themes fit into established personal recovery processes found in general psychiatric populations. The theme “time: opportunity for change” seems to have an overarching importance. Implications for Practice By understanding the specific content along these themes, relevant to the individual patient, carers may be able to better support their personal recovery journey. Because time spent as inpatients in forensic psychiatry is an overarching issue, carers need to be persistent over time

S-nitrosylation of cysteine 289 of the AT(1) receptor decreases its binding affinity for angiotensin II

1. Nitric oxide (NO) is known to affect the properties of various proteins via the S-nitrosylation of cysteine residues. This study evaluated the direct effects of the NO donor sodium nitroprusside (SNP) on the pharmacological properties of the AT(1) receptor for angiotensin II expressed in HEK-293 cells. 2. SNP dose-dependently decreased the binding affinity of the AT(1) receptor without affecting its total binding capacity. This modulatory effect was reversed within 5 min of removing SNP. 3. The effect of SNP was not modified in the presence of the G protein uncoupling agent GTPγS or the soluble guanylyl cyclase inhibitor 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one. 4. The binding properties of a mutant AT(1) receptor in which all five cysteine residues within the transmembrane domains had been replaced by serine was not affected by SNP. Systematic analysis of mutant AT(1) receptors revealed that cysteine 289 conferred the sensitivity to SNP. 5. These results suggest that NO decreased the binding affinity of the AT(1) receptor by S-nitrosylation of cysteine 289. This modulatory mechanism may be particularly relevant in pathophysiological situations where the beneficial effects of NO oppose the deleterious effects of angiotensin II