ABSTRACT
Several states are changing legislation and treatment programs for mentally ill offenders without knowing how current laws and programs operate. To address this problem the authors linked data from police records, court reports, and clinical files for 2,735 psychiatric referrals from the criminal justice system of Alaska from 1977 through 1981. They found that only 0.2%-2.0% of all schizophrenic persons in the community were arrested for violent crimes each year, accounting for 1.1%-2.3% of all arrests for violent crimes; that psychiatrists agreed about competency and responsibility in 79% of the cases evaluated by more than one clinician; and that a successful insanity defense occurred in 0.1% or less of all criminal cases.
Subject(s)
Criminal Law , Forensic Psychiatry , Jurisprudence , Adolescent , Adult , Aged , Alaska , Child , Criminal Psychology , Dangerous Behavior , Female , Humans , Insanity Defense , Male , Mental Disorders/psychology , Middle Aged , Public Policy , Schizophrenic Psychology , Social Control, Formal , ViolenceABSTRACT
The authors performed a prospective double-blind study of 39 inpatients beginning high-potency neuroleptics. Patients were randomly assigned to a 7-day course of benztropine or placebo in addition to a neuroleptic. Of 17 patients receiving placebo, eight (47%) suffered an acute dystonic reaction; of 22 patients receiving benztropine, none suffered this reaction--a highly significant difference. The authors also found minimal anticholinergic toxicity attributable to the addition of benztropine to the neuroleptic regimen. These results suggest that an initial 7-day prophylaxis with benztropine is a high-benefit, low-risk adjunctive treatment to neuroleptic therapy.
