ABSTRACT
Two groups of patients with affective disorders, one group with a coexistent axis II diagnosis of borderline personality disorder and one group without, were compared to determine if the presence of borderline personality disorder affects the hospital course of patients with affective illness. Response to hospital treatment was assessed using standard psychiatric rating scales administered at admission, after one week of hospitalization, and before discharge. Although the patients with borderline personality disorder were more severely impaired than the comparison group, they were as likely as patients without the disorder to improve over the course of hospitalization.
Subject(s)
Borderline Personality Disorder/therapy , Mood Disorders/therapy , Social Environment , Adult , Borderline Personality Disorder/psychology , Combined Modality Therapy , Female , Humans , Male , Mood Disorders/psychology , Personality Tests , Prognosis , Psychiatric Department, Hospital , PsychopathologyABSTRACT
White House Case subjects typically are schizophrenic patients who have been psychotically preoccupied with a prominent political figure. The authors report the arrest rates for murder, aggravated assault, other assault, and robbery among 192 male White House Case subjects 20-59 years old who were discharged from civil commitments in the early 1970s. These rates were compared with those for the same crimes in a random matched sample of arrested subjects and with the general population arrest rates. When rates were covaried for prior violent crime arrests, White House Case subjects with prior arrests had a significantly higher rate of total posthospitalization violent crime arrests than the matched control sample.
Subject(s)
Crime/statistics & numerical data , Schizophrenic Psychology , Social Control, Formal , Violence , Adult , Commitment of Mentally Ill , District of Columbia , Homicide/statistics & numerical data , Humans , Male , Middle Aged , Politics , Schizophrenia/diagnosis , United StatesABSTRACT
The authors studied arrest records and clinical data on 217 persons formerly hospitalized as "White House Cases" because they were psychotically preoccupied with prominent political figures. Prior arrest for violent crime was the variable most strongly associated with arrest for violent crime after hospital discharge. Male gender and a history of weapons possession were also correlated with future violence. For those with prior violent crime arrests, hospital incidents requiring seclusion were also associated with later violence. For those without prior arrests, subsequent violence was associated with threats, living outside Washington, and command hallucinations. For those previously arrested for nonviolent crimes, only persecutory delusions were associated with later violence.
Subject(s)
Homicide , Mental Disorders/psychology , Politics , Social Control, Formal , Violence , Commitment of Mentally Ill , Delusions/psychology , District of Columbia , Hallucinations/psychology , Humans , Male , Mental Disorders/diagnosis , Residence Characteristics , Risk Factors , Schizophrenia, Paranoid/diagnosis , Schizophrenia, Paranoid/psychology , Sex Factors , United StatesABSTRACT
We have previously reported on typically paranoid schizophrenic patients who attempted to see the President or other prominent American political figures based on hallucinations or delusional beliefs. By obtaining arrest records on these White House Cases (WHCs), we were able to determine which individuals had murder or assault arrests before and/or after their WHC hospitalizations. During the 9-12 years following discharge, 31 of the 217 male WHCs (for whom adequate clinical records were available) had murder or assault arrests. Demographic characteristics such as prior violent crime arrest and male gender proved to be much better predictors of future violence than clinical symptom, history, or behavior items. Hospital incidents requiring seclusion and a history of weapons possession were both associated with later violence in WHCs with prior violent crime arrests, while certain clinical symptoms (e.g., persecutory delusions and command hallucinations) may be linked to future violence in WHCs without prior violent crime arrests. These data need replication in other patient samples.
Subject(s)
Crime , Politics , Schizophrenia, Paranoid/psychology , Violence , Chronic Disease , Delusions/psychology , District of Columbia , Hospitalization , Humans , Male , Recurrence , Schizophrenia, Paranoid/rehabilitationABSTRACT
Delusional visitors to the White House or other government offices (often seeking a personal audience with the President) are interviewed by the Secret Service and then sent to Saint Elizabeths Hospital if they are considered mentally ill and potentially dangerous to themselves or others. A review of the demographic characteristics and diagnoses of 328 of these "White House Cases" treated at the hospital between 1970 and mid-1974 showed that these patients were most commonly unmarried, white, and male, and most had a diagnosis of paranoid schizophrenia. Although 22% of this group have threatened some prominent political figure, to date none of this study's patients has attempted to assassinate any such government official.
