Rikoksesta epäillyn tutkimus

Teema : oikeuspsykiatria. Vertaisarvioitu. Näin tutkin.Rikoksesta epäillyn kliininen tutkimus tehdään yleensä poliisin virka-apupyynnön perusteella päivystyksellisesti. Lääketieteellinen asiantuntemus on välttämätöntä henkeen ja terveyteen kohdistuneen rikoksen vakavuuden arvioinnissa. Joskus joudutaan arvioimaan myös hoidon tarvetta. Rikoksesta epäillyn tutkimus sisältää tutkimuksen, näytteenoton, tietojen kirjauksen ja lausunnon. Erityisesti väkivaltarikoksen kohteen tutkimiseen suunniteltu pahoinpitely- ja kehokarttalomake (PAKE-lomake) tukee tutkimuksen suorittamisessa ja kirjaamisessa. Valokuvien ottaminen oikeuslääketieteellisesti tutkittavasta henkilöstä on erittäin suositeltavaa. Psykiatrisen statuksen arviointi, sen kirjaaminen ja päihdenäytteet ovat tarpeellisia mahdollisen tulevan mielentilatutkimuksen kannalta. Psykiatrisen hoidon tarve arvioidaan normaalin kliinisen käytännön mukaan

Rikoksesta epäillyn tutkimus

Teema : oikeuspsykiatria. Vertaisarvioitu. Näin tutkin.Rikoksesta epäillyn kliininen tutkimus tehdään yleensä poliisin virka-apupyynnön perusteella päivystyksellisesti. Lääketieteellinen asiantuntemus on välttämätöntä henkeen ja terveyteen kohdistuneen rikoksen vakavuuden arvioinnissa. Joskus joudutaan arvioimaan myös hoidon tarvetta. Rikoksesta epäillyn tutkimus sisältää tutkimuksen, näytteenoton, tietojen kirjauksen ja lausunnon. Erityisesti väkivaltarikoksen kohteen tutkimiseen suunniteltu pahoinpitely- ja kehokarttalomake (PAKE-lomake) tukee tutkimuksen suorittamisessa ja kirjaamisessa. Valokuvien ottaminen oikeuslääketieteellisesti tutkittavasta henkilöstä on erittäin suositeltavaa. Psykiatrisen statuksen arviointi, sen kirjaaminen ja päihdenäytteet ovat tarpeellisia mahdollisen tulevan mielentilatutkimuksen kannalta. Psykiatrisen hoidon tarve arvioidaan normaalin kliinisen käytännön mukaan

Psykoterapian haitat - ei vain ruusutarhaa

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The copycat phenomenon after two Finnish school shootings: an adolescent psychiatric perspective

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Psychiatric staff on the wards does not share attitudes on aggression

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Schizophrenia and induced abortions : A national register-based follow-up study among Finnish women born between 1965-1980 with schizophrenia or schizoaffective disorder

Background: The objectives of this study were to investigate, in women with schizophrenia or schizoaffective disorder, the number and incidence of induced abortions (= pregnancy terminations performed by a physician), their demographic characteristics, use of contraceptives, plus indications of and complications related to pregnancy termination. Methods: Using the Care Register for Health Care, we identified Finnish women born between the years 19651980 who were diagnosed with either schizophrenia or schizoaffective disorder during the follow-up period ending 31.122013. For each case, five age- and place-of-birth- matched controls were obtained from the Population Register of Finland. Information about births and induced abortions were obtained from the Medical Birth Register and the Induced Abortion Register. Results: The number and incidence of induced abortions per 1000 follow-up years did not differ between cases and their controls. However, due to fewer pregnancies, cases exhibited an over 2-fold increased risk of pregnancy termination (RR 228; 95% CI 2.20-2.36). Cases were younger, were more often without a partner at the time of induced abortion, and their pregnancies resulted more often from a lack of contraception. Among cases, the indication for pregnancy termination was more often mother-to-be's medical condition. Induced abortions after 12 weeks gestation were more common among cases. However, cases had no more complications related to termination. Conclusions: The incidence of induced abortions among Finnish women with schizophrenia or schizoaffective disorder is similar to the general population, but their risk per pregnancy over two-fold. They need effective, affordable family planning services and long-term premeditated contraception. (C) 2017 Elsevier B.V. All rights reserved.Peer reviewe

Influence of patient characteristics on duration of seclusion/restrain in acute psychiatric settings in Japan

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Psychopathic traits among a consecutive sample of Finnish pretrial fire-setting offenders

Background: Psychopathy, a severe disorder of personality, is well represented in the criminal and forensic psychiatric population and is significantly associated with increased risk of violence and crime. Fire-setting is a major source of property damage, injury, and death in many Western countries. The primary aim of this study was to evaluate psychopathic traits in a consecutive sample of Finnish male pretrial fire-setting offenders. Further, we wanted to investigate whether fire-setting recidivists show higher traits of psychopathy than one-time firesetters and whether exclusive firesetters show lower traits of psychopathy than those with criminal versatility. Methods: The forensic psychiatric examination statements for male firesetters who underwent a pretrial forensic psychiatric evaluation during a 10-year period (1989 - 1998) were reviewed. The sample comprised 129 firesetters with normal IQ, 41 of whom were fire-setting recidivists. Fifty men were exclusive firesetters. Assessment of psychopathy-like personality character was performed using the 20-item Hare Psychopathy Checklist-Revised. Results: Two individuals (1.6%, 95% CI: 0.0-3.7) scored >= 30 points and 19 (14.7%, 95% CI: 8.6-20.8) >= 25 points on the PCL-R. The mean PCL-R total score was 16.1 (SD 6.88), the mean Factor 1 score 5.0 (SD 3.41), and the mean Factor 2 score 9.9 (SD 3.86). No significant differences emerged between the recidivists and the one-time firesetters. The versatile firesetters exhibited significantly higher mean total and factor scores than the exclusive ones. Conclusion: Among firesetters, there is a subgroup of persons with significant psychopathic traits, which should be recognized in legal and health care organizations. Although psychopathy was associated with greater criminal versatility, it bore no relationship to fire-setting recidivism.Peer reviewe

Interventions following a high violence risk assessment score : a naturalistic study on a Finnish psychiatric admission ward

Background: Patient aggression and violence against staff members and other patients are common concerns in psychiatric units. Many structured clinical risk assessment tools have recently been developed. Despite their superiority to unaided clinical judgments, staff has shown ambivalent views towards them. A constant worry of staff is that the results of risk assessments would not be used. The aims of the present study were to investigate what were the interventions applied by the staff of a psychiatric admission ward after a high risk patient had been identified, how frequently these interventions were used and how effective they were. Methods: The data were collected in a naturalistic setting during a 6-month period in a Finnish psychiatric admission ward with a total of 331 patients with a mean age of 42.9 years (SD 17.39) suffering mostly from mood, schizophrenia-related and substance use disorders. The total number of treatment days was 2399. The staff assessed the patients daily with the Dynamic Appraisal of Situational Aggression (DASA), which is a structured violence risk assessment considering the upcoming 24 h. The interventions in order to reduce the risk of violence following a high DASA total score (>= 4) were collected from the patients' medical files. Inductive content analysis was used. Results: There were a total of 64 patients with 217 observations of high DASA total score. In 91.2% of cases, at least one intervention aiming to reduce the violence risk was used. Pro re nata (PRN)-medication, seclusion and focused discussions with a nurse were the most frequently used interventions. Non-coercive and non-pharmacological interventions like daily activities associated significantly with the decrease of perceived risk of violence. Conclusion: In most cases, a high score in violence risk assessment led to interventions aiming to reduce the risk. Unfortunately, the most frequently used methods were psychopharmacological or coercive. It is hoped that the findings will encourage the staff to use their imagination when choosing violence risk reducing intervention techniques.Peer reviewe