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1.
Nervenarzt ; 88(Suppl 1): 1-29, 2017 Aug.
Article in German | MEDLINE | ID: mdl-28776213

ABSTRACT

People who have been convicted of a crime due to a severe mental disorder and continue to be dangerous as a result of this disorder may be placed in a forensic psychiatric facility for improvement and safeguarding according to § 63 and § 64 of the German Criminal Code (StGB). In Germany, approximately 9000 patients are treated in clinics for forensic psychiatry and psychotherapy on the basis of § 63 of the StGB and in withdrawal centers on the basis of § 64 StGB. The laws for treatment of patients in forensic commitment are passed by the individual States, with the result that even the basic conditions differ in the individual States. While minimum requirements have already been published for the preparation of expert opinions on liability and legal prognosis, consensus standards for the treatment in forensic psychiatry have not yet been published. Against this background, in 2014 the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) commissioned an interdisciplinary task force to develop professional standards for treatment in forensic psychiatry. Legal, ethical, structural, therapeutic and prognostic standards for forensic psychiatric treatment should be described according to the current state of science. After 3 years of work the results of the interdisciplinary working group were presented in early 2017 and approved by the board of the DGPPN. The standards for the treatment in the forensic psychiatric commitment aim to initiate a discussion in order to standardize the treatment conditions and to establish evidence-based recommendations.


Subject(s)
Commitment of Mentally Ill/legislation & jurisprudence , Commitment of Mentally Ill/standards , Interdisciplinary Communication , Intersectoral Collaboration , Mental Disorders/rehabilitation , National Health Programs/legislation & jurisprudence , Substance-Related Disorders/rehabilitation , Ambulatory Care/ethics , Ambulatory Care/legislation & jurisprudence , Ambulatory Care/standards , Commitment of Mentally Ill/ethics , Ethics, Medical , Expert Testimony/ethics , Expert Testimony/legislation & jurisprudence , Germany , Humans , National Health Programs/ethics , Patient Admission/legislation & jurisprudence , Patient Admission/standards , Prisoners/legislation & jurisprudence , Prisoners/psychology , Prognosis
2.
Nervenarzt ; 77(5): 576-86, 2006 May.
Article in German | MEDLINE | ID: mdl-15944853

ABSTRACT

BACKGROUND: The aim of this study was to assess the potential for future violent behaviour comparing patients recruited from forensic and general psychiatric wards in Germany. PATIENTS AND METHODS: Fifty patients were recruited from a forensic hospital and 29 from a general psychiatric hospital. In the weeks preceding discharge, structured assessments of the future risk of violent behaviour were completed using the HCR-20. RESULTS: There was little difference in the risk presented by the two groups. Forensic patients presented an elevated risk of violence because of historical factors, while the risk among patients from general psychiatry was due to clinical symptoms. CONCLUSION: Some criminal offences could be prevented if more time and effort were spent in general psychiatric practice in identifying patients at high risk for violence and in reducing symptoms of psychoses before discharge.


Subject(s)
Forensic Psychiatry/methods , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Personality Assessment/statistics & numerical data , Psychiatry/methods , Risk Assessment/methods , Violence/statistics & numerical data , Germany/epidemiology , Humans , Incidence , Risk Factors , Violence/prevention & control , Violence/psychology
3.
J Appl Physiol (1985) ; 90(6): 2238-44, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11356788

ABSTRACT

We sought to extract additional physiological information from the time-dependent left ventricular (LV) pressure contour and thereby gain new insights into ventricular function. We used phase plane analysis to characterize high-fidelity pressure data in selected subjects undergoing elective cardiac catheterization. The standard hemodynamic indexes of LV systolic and diastolic function derived from the time-dependent LV pressure contour could be easily obtained using the phase plane method. Additional novel attributes of the phase plane pressure loop, such as phase plane pressure loop area, graphical representation of the isovolumic relaxation time constant, and quantitative measures of beat-to-beat systolic-diastolic coupling were characterized. The asymmetry between the pressures at which maximum isovolumic pressure rise and pressure fall occur, as well as their load dependence, were also easily quantitated. These results indicate that the phase plane method provides a novel window for physiological discovery and has theoretical and applied advantages in quantitative ventricular function characterization.


Subject(s)
Hemodynamics/physiology , Ventricular Function, Left/physiology , Algorithms , Blood Pressure/physiology , Cardiac Catheterization , Coronary Circulation/physiology , Heart Ventricles/anatomy & histology , Humans , Models, Theoretical , Stroke Volume
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