Archives 1992-2013

Out of the total of 936 forensic-psychiatric opinions on individuals submitted to hospitalobservation,256 (27%) cases were analyzed inwhich the presence of psychotic disorders temporecriminis had been diagnosed. The disorders includedschizophrenia, delusional and delusional-hallucinatorypsychoses of various etiology, paranoid syndromesof various etiology, affective disorders andacute transient alcohol psychoses. The perpetratorscommitted the total of 286 punishable acts, amongwhich these against life and health, againstfreedom(punishable threats) and against property turned outto be the most frequent. A comparison of the findingswith data reported by Uszkiewiczowa (1960)indicated a similar proportion of perpetrators withpsychotic disorders in general and with schizophrenia,as well as an increase in the proportion ofthose with affective disorders. As regards perpetratorswith schizophrenia, the proportion of offencescommitted against life and health (including homicide)has decreased, while that against property hasrisen, with no change in the type of aggression directedat the environment (mother, close relatives).On the other hand, as regards perpetrators withaffective disorders, an increase was noted in theproportion of offences against life and health, as wellas against property. Patients committed these criminalacts (with one exception) in the manic phase ofthe disease, similarly as in the 1960s.

Out of256 offenders with psychoticdisorders, 236 (92%) were assessed as unaccountableby court experts who in 72 cases (32%) motioned for their preventive detention according to article 99of the penal code. Despite the diagnosed psychosis in17 (7%) cases greatly diminished accountability wasrecognized, while 3 (1%) cases were assessed as fully accountable. Such opinions were issued eitheron patients with negative symptoms of schizophreniaor with hypomania in the course of bipolar affectivedisorder, or pertained to cases in which the emphasiswas laid on the psychiatric diagnosis justificationonly, and not on accountability evaluation –which inour belief is not a correct procedure. Assessments of accountability and grave threat to legalorder inpsychotic perpetrators of punishable acts in expertopinions issued in the years 1995-1996 remainedsimilar to these from the 1960s.

The author presented her views on the impact of childbirth on the mother committing infanticide. In her opinion perinatal shock is equivalent to the acute stress disorder (by the criteria of the classification currently in force). The transient mental disorder being a response to the stress of childbirth may persist from over ten hours to three days in some cases. The onset of the acute stress response called perinatal shock is facilitated by a coincidence of other detrimental factors including a major malformation of the newborn or the mother's difficult personal situation. If the above-mentioned factors occur later than at the time of childbirth, their impact on the mother's mental stale should be assessed with view to the nature and severity of her disorders as well as to their possible effect on her accountability.

The paper outlines psychologicalproblems of patients suffering from schizophreniafor many years, whose mental state has improveddue to the administration of atypical antipsychoticmedication. The amelioration was accompanied bythe emergence of unconscious intrapsychic conflictsnot manifested before, unresolved developmentalproblems, difficulties in the sphere of controllingdrives, and some specific characteristics ofschizophrenic thinking and experiencing.

Physical phenomena underlying theMR imaging of the central nervous system structureand function are discussed in the article. Thepaper presents also a review of the literature on thefindings of studies on imaging of the brain inschizophrenic patients.

Basic assumptions and principles for the implementation of physical restraint on children and adolescents with mental disorders inpsychiatric hospitals and nursing homes are presented. (Ed.)

The role of aggression manifested by persons with mental disorders, characteristics of aggressive behavior perpetrators and victims, as well astypical circumstances of aggression release are discussed.Moreover, basic strategies allowing to reducethe risk of aggressive behavior are outlined.(Ed.)

The effect of a community team workon the family burden resulting from one of the familymembers' mental disorders was evaluated in the "Drewnica" hospital catchment area. Subjects in thestudy were 80 care providers examined with the "Family Burden Scale" twice –before the communityteam intervention and at 12-month follow-up. Familiesof the mentally disordered receiving the traditionaltreatment indicated the following domains asthe most burdensome: the experience of permanenttension and irritation evoked by their charges, managing for them their important affairs out of home, andthe necessity of keeping them company continuously.After a year of the patients' treatment by the communityteam a major relief of the family burden wasnoted: a significant reduction in the burden level was found in 70% of the families under study. (Ed.)

The paper presents a method of describing family communication, proposed by Wichström,Holte et al. The concept assumes that disqualifyingmessages undermine the individual'sdefinition of "self", thus negatively affecting theirpersonality development. Studies are reviewed indicatingthat disconfirming communication is relatedto anxiety level, social skills, and the risk of mental disorders.

The aim of the study was to find outwhether, and if so, to what extent, personal resources of family members (their life satisfactionand sense of coherence), as well as internal resourcesof the family system (perceived strong points of thefamily) differentiate between families with eithera healthy or mentally ill adult child. Subjects in thestudy were 124 non-clinical families living in Warsaw,and 40 families with an adult schizophrenicchild treated in the III Department of Psychiatry,Institute of Psychiatry and Neurology. Using questionnairetechniques it was found that life satisfactionof schizophrenic children and their parents wassignificantly lower than that in healthy families.Global sense of coherence of schizophrenic children as compared to their healthy peers was significantlylower. Family resources perceived by family memberswere lower in families with a schizophrenicadult child than these in healthy families. Parentalsense of coherence level did not differentiate betweenthe two compared groups of families.

In the study the vegetative systemtension in patients with somatoform neurotic disorderswas measured using the Holter spectral analysis.Moreover, their psychomotor performance wasassessed, and intercorrelations between the two data sets were computed. Since the measurementswere conducted twice, at baseline and after3-month psychotherapy, an attempt was made tofind out whether, and if so, in what way psychotherapyaffected the vegetative system tensionand/or psychomotor task performance.