Psychiatric Treatment of Ruminative Vomiting and the Associated Weight Loss in an Adolescent Boy with Autism: A Case Report

We treated the persistent ruminative vomiting of a 13-year-old autistic boy by using a behavioral and psychopharmacological approach in a closed ward. Before the interventions, the patient had lost about 10kg of body weight due to very high-frequency ruminative vomiting. Together with psychopharmacological trials, the psychiatric treatment included a combination of a behavioral approach and food regulation that emphasized food restrictions, and we provided regular light meals. There was a considerable reduction of the ruminative vomiting and 2kg weight gain was achieved during the admission. These therapeutic gains were maintained at the 4-month follow-up assessment and the vomiting symptom reached a near-zero level and the weight loss were recovered by about 8kg. The issues related to the treatment approaches for ruminative vomiting with autism are discussed.

The Preliminary Research for Making Judgment on Not Guilty by Reason of Insanity and Guilty but Mentally Ill / 대한법의학회지

BACK GROUND: Our object is to conduct a questionnaire research with psychiatrists who have the experience of mental examination to suggest judgment standard for Not Guilty by Reason of Insanity and Guilty But Mentally Ill(diminished capacity). In addition, this study is expected to reduce the gap between the judgments on Not Guilty by Reason of Insanity and Guilty But Mentally Ill. METHODS: In making judgment on Not Guilty by Reason of Insanity and Guilty But Mentally Ill by experts, the questionnaire research is conducted through e-mail on the judgment standard on each mental disorders. According to the definition of mental disability, the item that shows higher percentage than the items of cognitional ability and volitional ability is considered as the requirement for judging mental disability. RESULTS: In all of 7 major mental disorders and disease groups, the symptoms and characteristics of the disease and the range of the influence of the symptom on the case were higher in 2-4 times than the induced standard (cognitional ability and volitional ability) from the legal and academic definitions of mental disability. CONCLUSIONS: The criteria for judging normal or mental disability is the cognitional ability and volitional ability. The criteria for judging Not Guilty by Reason of Insanity and Guilty But Mentally Ill in mental disability is the symptom and characteristics of the disease and the range of the influence of the symptom on the case.

Effect of Sex Offenders Treatment Programme on Cognitive and Emotional Characteristics of Mentally Ill Sex-Offenders / 신경정신의학

OBJECTIVES: This study was investigated to prove the effectiveness of Cognitive Behavior Treatment Program in mentally ill sex offenders and to be used as basic data for development of optimized treatment program for mentally ill sex offenders. METHODS: Cognitive Behavior Treatment Program was carried out over 10 weeks for 30 mentally ill sex offenders. With Interpersonal Responsiveness Index (IRI), UCLA Loneliness Scale (UCLALS), Coping Using Sex Inventory (CUSI) and Rape Myth Acceptance Scale (RMAS), the effectiveness of the treatment programme was evaluated. The data was analyzed with paired t-test. RESULTS: The results with 23 subjects showed no significant score changes after treatment program in IRI and UCLALS. However, there was a statistically significant improvement in the scores of CUSI and RMAS. CONCLUSION: Despite several limitations, this study showed significant effects of Cognitive Behavior Treatment Program on mentally-ill sex offenders. Therefore, treatment focused on the changes of cognitive and emotional characteristics of sex offenders along with the treatment for main psychiatric illness should be provided for mentally ill sex offenders to prevent recidivism. More studies to develope optimized treatment programme for mentally ill sex offenders are needed in the future.