Search results

The number of juvenile offenders admitted to Malaysian prisons is alarming. The purpose of this paper is to determine the presence of any psychiatric disorders and their association with personal characteristics of juvenile detainees in prisons across Peninsular Malaysia.

Detainees were recruited from five different prisons in Peninsular Malaysia and interviewed by a psychiatrist using the MINI-Kid and FACES-IV, relevant personal and family information was also collected.

A total of 105 detainees participated in the study. Almost all of the offenders (93.3 per cent) had at least one diagnosable psychiatric disorder and more than half (76.2 per cent) had two or more psychiatric diagnoses. Conduct disorder (CD) was the commonest disorder (59.0 per cent), while substance use disorders (SUD) was the commonest co-morbidity. A significant correlation was found between presence of CD, education level and SUD. Almost all (61/62, 98.4 per cent) of the detainees with CD, had not completed schooling (OR 8.03, 95 per cent CI 1.01-71.35), and detainees with this disorder were more likely to use substances than detainees without CD (OR 4.35, 95 per cent CI 1.90-9.99). Detainees with any psychiatric diagnosis were more likely to have four or more siblings in their families (OR 5.5, 95 per cent CI 1.1-26.9).

There is a high prevalence of psychiatric disorders among juvenile offenders in Malaysian prisons, detection and intervention would be important.

The purpose of this paper is to delineate the overall theoretical framework on the topic of internet addiction through the comprehensive narrative review to make readers aware of the conceptual growth and development in the respective field. The paper evolves theoretically from the historical foundation, phenomenology, clinical feature, etiological model to the treatment outcome of internet addiction. Multiple studies have been done in the field of mental health but dearth of work given head to toe theoretical overview for understanding of this trendsetter research area in mental health.

Extensive review of literature has been carried out to make a systematic layout for conceptual paper.

The internet has been a source of gratification for several behavioral addictions as well as psychiatric disorders. Mainly because of the lack of established diagnostic criteria and a dearth of large sample surveys, the prevalence of problematic internet use (PIU) in general population has not been established. Still, from all the consolidated data, PIU seems to have a male preponderance and manifests itself in late adulthood. Symptoms of PIU can easily be masked with signs of dependence, tolerance and withdrawal which is quite similar to the phenomenology of substance addiction. Psychiatric co-morbidities are more of a norm than the exception in case of PIU. Even though the clinical status of PIU is doubtful, still there is a significant demand for its treatment all over the world. Overall, the excessive use of internet has been strongly debated in literature from PIU to a positive addiction. Only time will tell how it affects our civilization as a phenomenon of evolutionary significance.

The paper is providing a general conceptual framework for internet addiction/PIU to enable readers to know about the topic in depth from the evolution of the concept to the recent developments in the area.

The proportion of those over the age of 65 years in black and minority ethnic (BME) groups in England and Wales is increasing. The prevalence of dementia and depression among BME elders from different groups in the United Kingdom is generally similar to or higher than in indigenous white British elders. Two methods were used to provide a conservative estimate of the absolute number of cases of dementia and depression among BME elders. Data on prevalence from published studies of different BME elderly groups and the number of those over the age of 65 years from different BME groups in the general population in the 2001 population census were used for analysis. The most conservative estimates of the absolute number of cases of dementia among BME elders were 7270 and 10,786 for the two methods of analysis; the corresponding figures for depression were 33,559 and 52,980. There is a significant amount of psychiatric morbidity among the elderly from BME groups. A multi‐faceted approach is needed to ensure that commissioning, design, development and delivery of culturally capable, appropriate and sensitive old age psychiatry actually occurs and improves the equity of service access by BME elders.

Background: Post‐traumatic stress disorder (PTSD) is over represented in the prisoner population and is predictive of violence and suicide. This raises issues in relation to prisoner management, as well as theoretical issues such as why there is a range of vulnerability for PTSD. The current study examines the relationship between PTSD and personality profiles of prisoners. Method: Data from 1305 participants in the NSW survey of health in prisoners are examined to identify relationships between personality profiles derived from the Temperament and Character Inventory (TCI) and PTSD. Participants are grouped as experiencing no trauma; with a trauma history but no PTSD; and being diagnosed with PTSD. A logistic regression modelled significant predictors of PTSD. These data indicated that women prisoners report PTSD at twice the rate of males. An increased risk for PTSD is associated with high Harm Avoidance, low Self‐Directedness, high Persistence and high Self‐Transcendence. Conclusions: A combination of both temperament and character traits influences the trajectory towards PTSD development. Targeted treatment of these traits is needed in addressing the problems of prisoners with PTSD and managing the associated risks of violence and suicide.

The purpose of this paper is to identify psychotropic medication being prescribed for people with intellectual disability “as and when required” (PRN); the indications, frequency of use, rate of poly-pharmacy and contribution of PRN medication towards this. The paper also aimed to identify individual and environmental factors associated with PRN medication prescribing.

Data were collected from nursing and medical records for the 119 service users in the acute assessment and treatment unit and NHS residential care settings managed by specialist intellectual disability services covering Leicester, Leicestershire and Rutland over a month period. Data were analysed using descriptive statistics and logistic regression to calculate adjusted odds ratios for predictor variables.

In total, 72 per cent of the service users were prescribed and 25 per cent were administered PRN medication over the study period. The most common indications for PRN prescribing were aggression and agitation. Lorazepam and chlorpromazine were the most frequently prescribed PRN medications. The rate of poly-pharmacy was 41 and 38 per cent of this was attributable to PRN medication. Male gender and history of challenging behaviour were found to be significant factors associated with PRN medication prescribing.

PRN medications are commonly prescribed in people with intellectual disabilities and contribute to poly-pharmacy. Whilst PRN medication continues to remain an effective therapeutic option in situations where environmental and behavioural approaches are proving insufficient, their use should always be in conjunction with effective review mechanisms.

Senior individuals are far more commonly the victims of aggression than the perpetrators, but a small minority of older adults do commit crimes. This paper describes the case of a male older adult who battered his wife to death and presented with amnesia about the attack. It describes the neuropsychological, risk and personality assessment procedures adopted to assess functioning, evaluate risk of re‐offending and formulate about the offence. It proposes formulations for the offence and illustrates the treatment provided to ameliorate distress and enhance memories of what had taken place. Finally it highlights areas for future research and service development. With a growing older adult population, the need for specialist assessment and risk management of older adults who offend is likely to increase, so more resources should be allocated to meeting the needs of such individuals.

Over the last few years increasing numbers of Autism Spectrum Disorder (ASD) services have been established across the country. The different services use varying models and the level of complexity seen in each is unclear. The paper aims to discuss this issue.

In order to facilitate the development of the next phase of service provision the three geographical areas covered by SABP ASD services were compared. Modified Global Assessment of Functioning (mGAF) scores were calculated for 75 patients from each area before being compared across various domains to identify the complexities in each area covered.

Overall high levels of complexity were seen, with 85 per cent presenting with a serious or major functional difficulty based on, mGAF scores.

This has planning implications both for commissioners and future service development as previously not identified at a time when services are continuing to expand.

This paper will present the mental health needs that women in prison have, both in terms of the mental health problems they have prior to going into prison and those that they may develop while in prison. These issues will be discussed in the context of the international research data. This paper will also provide information on the special needs that Aboriginal and non‐Australian born women in Australian prisons may have.

Studies have reported increased psychiatric morbidity among young detainees, with as many as three‐quarters reported to have one or more psychiatric disorders. Despite this, however, there is a dearth of published work among young inmates of prisons, remand homes or borstal institutions in Nigeria. The aim of this study was to assess possible psychiatric morbidity among young inmates of a borstal institution in Nigeria and to determine the factors that may be associated with this morbidity. Fifty‐three inmates of one of the two existing borstal institution in Nigeria were assessed for psychiatric morbidity using the 12‐item General Health Questionnaire (GHQ‐12). The GHQ‐12 scores were compared with the socio‐demographic factors of the respondents. Twenty‐eight (52.8%) of the inmates were over 18 years old, 35.8% were in the middle position within the family, 62.3% were of Christian faith, and 64.2% had their parents still living together. Seventeen (32.1%) of the inmates were from Hausa ethnic extraction, 58.5% stayed for more than 6 months at the borstal institution, and 81.1% were brought to the institution by their parents. The mean age of the inmates was 17.3 years (range, 14‐23 years) and 26 (49.1%) of them were GHQ‐positive. There was no statistically significant difference between the mean age of GHQ‐positive and GHQ‐negative inmates (F=1.73, p=0.19), and none of the socio‐demographic variables were significantly associated with psychiatric morbidity (i.e. GHQ‐12 positivity). The study observed a high prevalence of undetected psychiatric morbidity among inmates at the borstal institution. Efforts should be intensified by the authority responsible for managing the Nigerian prison services (including the borstal institutions) to improve mental health services.