Factors associated with violence among male psychiatric patients admitted at the forensic psychiatry ward (pavilion 4) of the National Center for Mental Health factors

OBJECTIVE:This study seeks to describe the clinical profile of the male patients admitted to the Forensic Psychiatric Ward of the National Center for Mental Health as well as determine what demographic and clinical factors are associated with violence of the patients. METHODOLOGY: This cross sectional study was conducted in the Pavilion 4 of the NCMH with 158 subjects whose records were reviewed. Crimes were categorized as either violent or non-violent and patient's symptoms were clustered into 8 categories. To test for association, chi-square test and relative risk was computed to determine the degree of association. RESULTS: Most patients were between 30-39 years old (46.2%), single (78.5%), Catholic (84.2%) and had undergone at least an elementary education (51.9%). Majority (55.7%) came from the Luzon Provinces outside Metro Manila and 77.8% had psychiatric disorders prior to being admitted to Pavilion 4. Most (68.4%) of the violent crimes committed were committed against persons and 52.5% were committed against non-relatives. The more frequent symptoms noted were hallucinations in 56.3% and speech disturbances in 53.2%. of the psychiatric patients. The only significant factor associated with violence among the male psychiatric patients in Pavilion 4 of NCMH were depressive symptoms e.g. blank stares, crying spells, being quiet and withdrawn with a relative risk of 0.67 at a confidence interval of 0.43-1.06, which means that being depressed can prevent one from committing a crime. Majority (65.8%) had a relapse of their psychiatric illness, with Schizophrenia being the most common diagnosis (51.9%). CONCLUSION: Depressive symptoms can be considered as a protective factor against committing violent crimes.

Is there a seasonal pattern of bipolar mood disorder among patients admitted at the neuro-psychiatric unit in the Philippines?

OBJECTIVES: The focus of this study is to establish Filipino data on the seasonality of bipolar mood disorder. METHODS: The seasonal pattern of 293 psychiatric hospital admissions and referrals for treatment of hypomanic, manic, depressed, and mixed bipolar episodes over a 3-year period were analyzed on a quarterly and bi-annual distribution of wet and dry season, using statistical analyses. RESULTS: No significant differences in frequency of admissions for hypomanic, manic, and depressed episodes were noted using quarterly and bi-annual distribution. Although there was no significant difference noted in the quarterly occurrence of mixed episode bipolar disorder for the years 2001 and 2002 respectively, when the over-all distribution of mixed episode bipolar disorder was compared, a significant difference was noted (Goodness of fit X2 =6.00; p 0.05 and Goodness of fit X2 = 2.00; p 0.05 respectively). A pattern was noted in that the peak occurrence was during the first quarter -January to March-and a nadir on the third quarter -July to September, which, was the same for the year 2000. CONCLUSION: The findings from this study of the Filipino sample is suggestive that proposed chief mechanism of seasonality of mood disorder which is the neurobiologic changes associated with the photoperiod may not adequately apply to occurrence of episodes of bipolar mood disorder in tropical geographic locations where there are no extreme variations in photoperiods, temperature, and climate.