|  Psychiatric Illness Associated With Criminality -
14-04-2006, 01:24 AM
No surgical, medical, or pharmacological interventions can treat criminality because it is not a medical or psychiatric illness. However, many psychiatric illnesses, examples of which are listed below, are characterized by symptoms that make individuals prone to behaviors that can lead to criminal charges. Such symptoms include impaired judgment, lack of impulse control, suspiciousness, disinhibition, paranoia, inability to trust others, delusions, hallucinations, hyperactivity, irritability, inability to concentrate, and impairment in ability to communicate or engage in social interaction. The principal types of psychiatric disorders characterized by such symptoms include the following list of illnesses. All of these illnesses are covered in detail in the eMedicine journal. Readers should click on the link to learn more about the illness, treatments (including medications), and specific advice to families.
Personality Disorders
Schizophrenia
Depression
Bipolar Affective Disorder
Pervasive Developmental Disorder: Autism
Paraphilias
Adjustment Disorders
Aggression
Amphetamine-Related Psychotic Disorders
Cannabis Compound Abuse
Cocaine-Related Psychiatric Disorders
Alcohol-Related Psychosis
Brief Psychotic Disorder
Delusional Disorder
Schizoaffective Disorder
Schizophreniform Disorder
Shared Psychotic Disorder
Traumatic brain injury: Definition, Epidemiology, Pathophysiology
Mental Disorders Secondary to General Medical Conditions
These psychiatric disorders, often comorbid with substance abuse, comprise the principal psychiatric illnesses found in persons currently detained within the criminal justice system. Those disorders defined by behaviors more directly linked to criminality include antisocial personality disorder, impulse control disorders (intermittent explosive disorder, kleptomania, pyromania, pathological gambling), and paraphilias (voyeurism, exhibitionism, frotteurism, pedophilia).
People with such illnesses are not criminal by virtue of having the disorder. Rather, such disorders are considered more closely linked to criminality because the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for diagnosing these disorders include symptoms that more directly lead to behaviors that are destructive and/or violate the rights of others. These disorders are the focus of the remainder of this article. Further detail on the other psychiatric disorders may be found in the appropriate article as referenced above.
Criminality, defined as that which is deemed injurious to the public welfare, morals, or interests of the state and is legally prohibited, is a social concept. To avoid ”medicalizing” social concepts, maintaining a distinction between criminality and psychiatric illness is important. Knowledge of the association between symptoms of psychiatric illness and antisocial behavior allows treatment that may decrease antisocial or criminal behavior before it occurs or may allow successful rehabilitation of individuals with treatable psychiatric illness who are currently within the criminal justice system. Incorporation of medical/psychiatric perspectives in public policy would allow more effective use of public resources and would produce social institutions more responsive to needs of the citizens, ie, treatment facilities rather than jails for behaviors that result directly from illness.
Advice to families
The primary advice to families of individuals who exhibit criminal or violent behavior is to promote safety. Violence is not acceptable, and living in fear of violence is not acceptable. Families may need practical advice and support in coping with violent behavior. Actual advice depends on the situation, but it could include removing guns and knives from the household, calling emergency service phone numbers (ie, 911) in emergencies, obtaining restraining orders, or going to a safe house for battered women. Families should be advised that criminality and violent behavior are not psychiatric illness, per se, but that sometimes criminality may be a symptom of a mental illness. If criminality is associated with any symptoms of mental illness, psychiatric evaluation certainly is indicated. If the general physician or family is unsure whether symptoms are present, psychiatric evaluation is advisable.
Family members who know that another family member is behaving in a criminal manner due to previously diagnosed mental illness should be supported in efforts to obtain treatment for the family member, rather than punishment. If the family member has been incarcerated, efforts should be made to obtain treatment within the jail or prison. Sometimes this requires forceful advocacy within the criminal justice system  |
nice post -
14-04-2006, 08:14 AM
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