The journal of the American Academy of Psychiatry and the Law
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Both veterans and jail/prison inmates face an increased risk of suicide. The incarcerated veteran sits at the intersection of these two groups, yet little is known about this subpopulation, particularly its risk of suicide. A Pubmed/Medline/PsycINFO search anchored to incarcerated veteran suicide, veteran suicide, suicide in jails/prisons, and veterans incarcerated from 2000 to the present was performed. ⋯ However, striking similarities and overlapping characteristics link the data on veteran suicide, inmate suicide, and incarcerated veterans, suggesting that the veteran in jail or prison faces a level of suicide risk beyond that conferred by either veteran status or incarceration alone. There is a clear need for a better characterization of the incarcerated veteran population and the suicide rate faced by this group. Implications for clinical practice and future research are offered.
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J. Am. Acad. Psychiatry Law · Jan 2009
Case ReportsGun laws and the involuntarily committed: a California road map.
The 2007 incident at Virginia Tech brought the question of gun ownership by the mentally ill to the forefront of public attention. Moreover, it underscored the potentially devastating consequences of the imperfect connection between federal and state laws that apply to the right of gun ownership by a psychiatric patient. The laws are complex, and, as demonstrated in this article, conflicting. We present a case report of an involuntarily committed patient in the state of California, and discuss details of state and federal laws that applied to him.
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J. Am. Acad. Psychiatry Law · Jan 2009
Comparative StudyViolent crime and dimensions of delusion: a comparative study of criminal and noncriminal delusional patients.
Some aspects of delusional disorders appear to be related to the occurrence of violent crime. A retrospective study was conducted comparing two groups of 30 psychotic, delusional patients. The study group consisted of delusional patients imprisoned in a high-security forensic hospital in the state of São Paulo, Brazil, and the patients in the comparative group were enrolled in common psychiatric wards. ⋯ Regarding the dimensions of delusions, the study group had lower scores in two categories: refraining from acting because of belief, and negative affect. Delusions that induce inhibition of actions apparently also reduce the potential for violent acts and, contrary to current beliefs, delusional patients who are frightened or who have other negative affects associated with delusional ideas appear to commit fewer violent acts. Intrinsic factors inherent in some dimensions of delusion may be relevant in the occurrence of violent crimes committed by psychotic patients.
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J. Am. Acad. Psychiatry Law · Jan 2009
Commentary: doing time in maximum security--the pains of separation.
Suicide is a leading cause of death among prison inmates. A recent study found that nearly half of the inmates who committed suicide in a state prison system during the study period did not have a major mental disorder. This prompts the question of why a person in prison who has no mental illness decides to end his or her life by committing suicide. Stressors associated with maximum security settings that may contribute to the high incidence of suicide found in segregated housing units are explored through a description of the author's experience and inmate anecdotes.
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The increased need for organs has led to greater acceptance of stranger or unrelated kidney donation. This broadening of the donor pool introduces challenges to the evaluation of such donors. Questions are raised regarding the obligation of an evaluator to explore the depth of the donor's intentions. The concept of altruism is explored as well as its impact on the consent process.