The appropriateness of the treatment setting for the inpatient post-acute treatment of alcohol dependence disorders in Switzerland

<p>Abstract</p> <p>Background</p> <p>In Switzerland, a total of 1'000 patients a year are treated for alcohol-dependence in specialized institutions. Though the current literature suggests favoring outpatient treatment, whether outpatient or inpatient treatment is more efficient cannot be answered generally. For Germany, "AWMF"-treatment guidelines were formulated in order to treat patients with substance use disorders in the appropriate treatment settings. The aim of the present study was to test the hypothesis that the majority of patients treated in the largest specialized institution for alcohol abuse treatment in Switzerland were treated in the appropriate setting.</p> <p>Methods</p> <p>All completed treatments conducted in the Forel-Hospital – the largest clinic of its kind in Switzerland – between the 1st of January 2004 and the 20th of December 2006 were included in the investigation (n = 915). Patient and treatment characteristics were gathered using the information from the PSYREC and act-info questionnaire. The AWMF criteria were operationalized on the basis of the questionnaire.</p> <p>Results</p> <p>Applying the AWMF criteria resulted in the emergence of three groups: 73.7% of the study sample could clearly be assigned to the inpatient treatment group, and for 7.5% there was evidence supporting the allocation to an outpatient treatment setting. In 18.8% of the cases, however, the AWMF criteria did not allow an assignment to either of the treatment settings. Of the total sample, 18.5% of all patients apparently did not profit from the inpatient treatment setting, whereas for the vast majority (81.5%), a therapeutic progress was documented. In those patients who, according to the AWMF guidelines, did not need an inpatient setting, a larger proportion improved than in the group of the patients who needed an inpatient treatment in a specialized hospital. Furthermore, the logistic regression analyses revealed that the less severe the clinical state of a patient upon admittance, the higher the odds of improvement during the hospital stay.</p> <p>Conclusion</p> <p>The results serve as evidence that for at least three out of four patients treated in the investigated specialized institution, an inpatient treatment was appropriate. The principal reason for the necessity of an inpatient treatment setting was that this hospital population showed severe psychiatric, somatic or social irregularities. Only a very limited number of patients hospitalized in a specialized institution for the treatment of alcohol-related disorders can be treated in an outpatient setting.</p

Legalbewährung junger Straftäter nach Entlassung aus Arbeitserziehungsmaßnahmen

Die Legalbewährung jugendlicher Straftäter nach ihrer Entlassung aus einer Arbeitserziehungsmaßnahme wurde überprüft. Die Stichprobe bestand aus allen 150 zwischen 1974 und 1986 in die Arbeitserziehungsanstalt (AEA) Uitikon, Kanton Zürich, eingewiesenen Jugendlichen. Der Katamnesezeitraum betrug zwischen 17 und 29 Jahren. Insgesamt wurden 71% der Täter rückfällig. Der Anteil der Täter, die mit einem Gewalt- oder Sexualdelikt rückfällig wurden, betrug 33%. Bivariate logistische Regressionen zeigten, dass die Art des Deliktes keinen Einfluss auf die Rückfallwahrscheinlichkeit hatte. Wenn die Einweisung in die AEA aufgrund einer einzelnen Tat erfolgte, war das Risiko für Rückfälligkeit gegenüber Tätern mit Serientaten um 71% reduziert (OR=.29). Die Ergebnisse sprechen dafür, dass junge Straftäter, die strafrechtlich verurteilt und in Arbeitserziehungsanstalten eingewiesen wurden, ein hohes Rückfallrisiko aufweisen. Zudem ergeben sich keine Hinweise dafür, dass die Arbeitserziehungsmaßnahmen nach dem seinerzeit praktizierten unspezifisch pädagogischen und einseitig auf berufliche Ausbildung ausgerichteten Konzept eine deliktpräventive Wirkung hatten. Darüber hinaus weisen die Ergebnisse auf die Bedeutsamkeit der Evaluation der deliktpräventiven Wirksamkeit von Maßnahmen hin. (ZPID

Domestic homicide and other violent crimes: The same or different phenomena?

This study investigated correlates of domestic homicide (DH) and other violent crimes. Data were collected retrospectively from criminal justice files on 617 persons in Switzerland (DH = 47). Multinomial logistic regressions revealed that, overall, DH perpetrators were more likely to be older, female, married, to have a psychiatric hospitalization history, and to be under the influence of delusions when they committed the crime. In addition, they were less likely to have prior convictions. Furthermore, the characteristics associated to DH perpetrators were more similar to domestic violence perpetrators than those of persons who committed nondomestic offenses. Based on the current sample, data, and methods, DH appears to be better explained by specialist theories than generalist views of crime, suggesting that DH and the homicide of non-family members are different phenomena. Therefore, domestic offenders may require specific assessment and intervention methods. However, replications of this study are necessary to generalize the current findings

Are behavioral problems in childhood and adolescence associated with bipolar disorder in early adulthood?

Several recent studies have found an association between conduct problems and bipolar disorder in adolescents. However, prospective studies are rare and most do not apply multivariable analysis strategies to control for important variables (e.g. socio-demographics). The aim of this study was to test the association between certain conduct problems and bipolar disorders. The sample consisted of 591 adolescents (male and female) representative for 2,600 persons from the Canton of Zurich in Switzerland. Data were prospectively collected through an interviewing procedure, with the first screening taking place at the age of 19-20. The incidence rate was computed using sampling weights, and risk factors of bipolar II disorder were estimated using a multivariable logistic regression model. The 9-year incidence rate of bipolar II disorder in the canton of Zurich was 8.4% (n=65). Adolescents and children showing behavior such as repeated running away from home and physical fighting were 2.6-3.5 times more likely to experience a bipolar II disorder than those with no indication of conduct problems. Sensitivity analysis showed that the conduct problems were not the result of low socio-economic statu

The prediction of criminal recidivism using routinely available file information

Objective. The aim of the present study was to cross-validate the investigation of Buchanan and Leese (2006) into the prediction of criminal recidivism. Method. The sample comprised offenders in the criminal justice system of the Canton of Zürich – Switzerland, who were discharged to the community. Participants were followed, and evidence of subsequent charges and convictions for both general and serious recidivism was investigated at fixed periods of 2.5, 6.5, and 10.5 years. The predictive validity of socio-demographic, criminal history, and legal class information was assessed using logistic regression as well as log-likelihood, receiver operating characteristic curve, and contingency analyses. Results. A multivariable model including age and criminal history information was found to produce the highest rates of predictive validity for general and serious recidivism. Conclusion. Information regularly accessible in forensic practice may be able to guide clinicians as to the recidivism risk level of their patients

A Comparison of Professional Traders and Psychopaths in a Simulated Non-Zero Sum Game

In a prior study psychopathic individuals showed a diminished level of cooperativeness but realized higher individual rewards in a prisoner’s dilemma game, compared with community controls. The present study replicated this finding with professional bank traders, who exhibited less cooperative behavior than both of the aforermentioned groups (community controls and psychopathic patients). While the bank traders did not obtain a higher gain than the psychopathic individuals at an absolute level, they maximized the discrepancy between their own profit and the yield of their anonymous computerized gaming partner. The bank traders were more prone than psychopathic patients to rely on strategies that considerably harmed the profit of their gaming partners without necessarily optimizing their own total profit. The community controls achieved the same overall gain as traders and psychopaths. Unlike traders and psychopathic patients, the normal controls balanced overall gains of themselves and their game opponent, which led to the highest overall profit, whereas the traders achieved the lowest overall profit

High Risk Sexual Fantasies and Sexual Offending: An Overview of Fundamentals and Interventions

Although deviant sexual fantasizing has been found to be an etiological factor for sexual offending, not all deviant sexual fantasies increase risk equally. The aim of the present overview is to provide readers with an introduction to key terminology, a primer on central clinical theories, and a summary of the research literature on “high risk” sexual fantasies over the past 50 years. First, the important difference between “sexual fantasy” and “sexual fantasizing” is described. Second, the link between sexual fantasizing and sexual offending is discussed, with a focus on principle moderators such as physiological reaction, personality profile, and offense-supportive beliefs. Third, the different methods used to assess sexual fantasies are discussed. Fourth, the principles and techniques behind four evidence-based approaches to treating “high risk” sexual fantasies are discussed: (1) the behavioral approach, (2) the cognitive approach, (3) the imagination approach, and (4) the mindfulness-based approach. Finally, a call is issued for practice-based quantitative and qualitative research to further explore this clinical phenomenon. The findings of such investigations would advance the field’s understanding of assessment, management, and monitoring best practices for this important forensic population

The prediction of criminal recidivism using routinely available file information La predicción de la reincidencia delictiva usando información de archivos rutinariamente disponibles

ABSTRACT Objective. The aim of the present study was to cross-validate the investigation o

COVID-19 Fears and Preventive Behaviors among Prison Staff.

This study focused on COVID-19 preventive behaviors and fears among prison staff members after the first wave of the pandemic. Cross-sectional data from 171 participants were collected in Switzerland. The level of fears (58.5%) and protective behaviors (100%) were high. Correctional officers adhered less to preventive measures than other staff members (p = .001). Fears were related to a reduction of social contacts (p = .006) and worries about physical health was related to preventive behaviors in general (p = .006). There is a need to raise prison staff awareness regarding their vulnerability to the SARS-CoV-2 in order to improve the effectiveness of health campaigns in prison settings. Special attention should be given to correctional officers

The consumption of Internet child pornography and violent and sex offending

Background: There is an ongoing debate on whether consumers of child pornography pose a risk for hands-on sex offenses. Up until now, there have been very few studies which have analyzed the association between the consumption of child pornography and the subsequent perpetration of hands-on sex offenses. The aim of this study was to examine the recidivism rates for hands-on and hands-off sex offenses in a sample of child pornography users using a 6 year follow-up design.Methods: The current study population consisted of 231 men, who were subsequently charged with consumption of illegal pornographic material after being detected by a special operation against Internet child pornography, conducted by the Swiss police in 2002. Criminal history, as well as recidivism, was assessed using the criminal records from 2008.Results: 4.8% (n = 11) of the study sample had a prior conviction for a sexual and/or violent offense, 1% (n = 2) for a hands-on sex offense, involving child sexual abuse, 3.3% (n = 8) for a handsoff sex offense and one for a nonsexual violent offense. When applying a broad definition of recidivism, which included ongoing investigations, charges and convictions, 3% (n = 7) of the study sample recidivated with a violent and/or sex offense, 3.9% (n = 9) with a hands-off sex offense and 0.8% (n = 2) with a hands-on sex offense.Conclusion: Consuming child pornography alone is not a risk factor for committing hands-on sex offenses at least not for those subjects who had never committed a hands-on sex offense. The majority of the investigated consumers had no previous convictions for hands-on sex offenses. For those offenders, the prognosis for hands-on sex offenses, as well as for recidivism with child pornography, is favorable