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Delusional disorder: Treatment and the Restoration of Adjudicative Competence.

机译：妄想障碍：审判能力的治疗和恢复。

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摘要

Delusional disorder has long been recognized in the psychiatric nomenclature, however, low prevalence rates and prevailing clinical views about the seemingly refractory nature of delusional disorder have restricted data on clinical treatment outcomes for this illness. Similar perspectives have been noted in forensic settings where minimal data is available to guide standards of care for incompetent to stand trial (IST) delusional pretrial defendants. Rationale. While the factors explicated in Sell provide guidelines for the involuntary medication of defendants found IST, numerous questions are left unanswered regarding the restorability of pretrial delusional detainees. The proposed study investigated the competency restoration rates of defendants with delusional symptoms and, more broadly, using the Brief Psychiatric Rating Scale (BPRS) assessed how these symptoms impact competency related abilities. Method. Data were gathered from competency restoration reports at a federal medical center. A total of 232 cases were drawn with replacement from a five year span, and then coded for demographic, clinical, and psycholegal variables. Results. Nearly 60% of defendants suffered with one or more delusions, and the delusional ideation for those who met the BPRS threshold for a delusional disorder (DD) classification was more pervasive than for those in either the schizophrenia or mood with psychosis subgroups. Defendants in the DD subgroup were also more likely to refuse treatment. The logistic regression model showed adequate overall classification (63.4%) and one static variable, i.e., prior psychiatric treatment, reached statistical significance; indicating that those with such a history were less likely to be restored. Discussion. The high rates of treatment refusal for DD defendants meant that most of these defendants were opined IST after their first statutorily determined competency restoration period, however, this group was no less likely to be opined restorable by forensic examiners given an adequate trial of involuntary treatment with antipsychotic agents.
机译：妄想症早已在精神病学术语中得到认可，但是，这种疾病的低患病率和关于妄想症看似难治性的流行临床观点限制了该病临床治疗结果的数据。在法医环境中，已经注意到了类似的观点，在法医环境中，只有很少的数据可用来指导无能力接受审判的（IST）妄想性审前被告的护理标准。基本原理。尽管《卖出》中阐明的因素为发现IST的被告提供了非自愿性药物治疗的指南，但有关审前妄想性被拘留者的可恢复性方面的许多问题仍未得到解答。拟议的研究调查了有妄想症状的被告的能力恢复率，并且更广泛地，使用简短精神病评定量表（BPRS）评估了这些症状如何影响与能力相关的能力。方法。数据是从联邦医疗中心的能力恢复报告中收集的。在五年的时间里，共抽取了232例病例进行了替换，然后进行了人口统计学，临床和心理法律变量的编码。结果。将近60％的被告患有一种或多种妄想，对于达到BPRS妄想症（DD）分类的患者，其妄想观念比精神分裂症或精神病性亚组的人更为普遍。 DD组的被告也更有可能拒绝接受治疗。 Logistic回归模型显示适当的总体分类（63.4％），并且一个静态变量（即先前的精神病治疗）达到了统计显着性；表明具有此类历史记录的人恢复的可能性较小。讨论。 DD被告拒绝治疗的比例很高，这意味着大多数被告在其第一个法定确定的能力恢复期后被判定为IST，但是，在经过充分的非自愿治疗的法医检验之后，这一组也不会被法医认为可以恢复原状。抗精神病药。

著录项

  • 作者

    Kassen, Martin.;

  • 作者单位

    City University of New York.;

  • 授予单位 City University of New York.;
  • 学科 Clinical psychology.;Law.;Psychology.
  • 学位 Ph.D.
  • 年度 2016
  • 页码 121 p.
  • 总页数 121
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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