[Structured psychiatric assessment of risk for violent recidivism in juvenile offenders]. / Psychiatrische Beurteilung des Gewaltrisikos im Jugendalter.

The psychiatric assessment of violence in youth represents a critical and essential part of forensic expertise and clinical practice. New methodical approaches are offered by structured risk rating scales and checklists which encompass psychopathy. The recently translated German version of Structured Assessment of Violence Risk in Youth (SAVRY), which is based on the Historical, Clinical, Risk Management Scheme (HCR 20), was evaluated in a sample of forensically assessed youth (n=83) regarding the predictive validity for criminal recidivism. Receiver operating characteristic (ROC) analyses attested medium (general delinquency), moderate (violent reoffending) and high (serious violent reoffending) effect strength, depending of the type of offence. Survival analyses showed that juveniles rated as high risk for violence were significantly faster and in a higher proportion recidivistic than those with a moderate or low risk. The results indicate the applicability of risk assessment instruments for German juveniles. Approaches for preventive, therapeutic and reintegrating measures are demonstrated, taking relapse patterns and dynamic risk aspects into consideration.

[Aspects of the legal concession and its procedures concerning the commitment of juveniles to safe custody institutions in youth welfare care according to German (section sign) 1631 b BGB -- an Inquiry into 101 cases of adolescent psychiatric expertise]. / Rechtliche Aspekte im Verfahren der geschlossenen Unterbringung Minderjähriger in der Jugendhilfe gemäss section sign 1631 b BGB -- Untersuchung anhand 101 jugendpsychiatrischer Gutachten.

OBJECTIVES: Legal procedures concerning the legal concession of juveniles to safe custody care in youth welfare according to German section sign 1631 b BGB were to be examined. METHOD: 101 cases of adolescent psychiatric expertise were retrospectively examined. RESULTS: Legal procedures were unsatisfactory. A guardian ("Verfahrenspfleger" according to German law) was usually not named (79.2 %), especially not in cases of juveniles under 14 years of age (94 %) who cannot take part in the procedure on their own right, and not in cases of foreigners (89 %). In a number of cases the adolescence psychiatrist did not agree with statement of the youth welfare office regarding the juvenile confinement. In cases where the expert's counsel was a "process diagnosis" evaluating the juvenile's concrete ability to cooperate and to accept alternative forms of placement, closed commitment could be reduced significantly. Experts did not precisely term of commitment in a number of cases (15.9 %). CONCLUSIONS: Legal procedures concerning the legal commitment of juveniles to safe custody care in youth welfare institutions are partly unsatisfactory, especially according to the juvenile's rights regarding the legal procedure and the ways, how these rights are safeguarded.

[Tourette's syndrome and antidepressant therapy: exacerbation of nervous tics with paroxetine]. / Tourette-Syndrom und Antidepressiva-Therapie: Exazerbation einer Ticstörung unter Paroxetin.

One possible side effect of selective serotonin re-uptake inhibitors (SSRI) is the exacerbation of nervous tics in a 12-year-old boy treated with tiapride following prescription of paroxetine for a depressive syndrome. Potential causal factors include residual cholinergic activity of paroxetine, the observably increased drive under paroxetine, metabolic properties, and protein binding. The problem of side effects under selective serotonin re-uptake inhibitors, as well as the issues of co-morbidity and co-medication in the treatment of nervous tics and Tourette's Syndrome are discussed.

[Homicide and hebephrenia-like syndrome in metachromatic leukodystrophy]. / Kindstötung und hebephrenes Syndrom bei metachromatischer Leukodystrophie.

We report a patient with metachromatic leukodystrophy (MLD) with a first manifestation of homicide. On admission the patient showed a hebephrenia-like syndrome with inappropriate affect, thought disorder and behavioral changes. Magnetic resonance tomography (MRT) findings suggested a diagnosis of MLD, which was confirmed by a decreased activity of leucocyte arylsulfatase A and an excessive urinary sulfatide excretion.

[Differentiation of suicide and parasuicide. A study of the last letters of suicidal patients]. / Zur Differenzierung von Suizid und Parasuizid. Eine Untersuchung an Abschiedsbriefen suizidaler Patienten.

The paper presents a content-analytical comparison between "last letters" of suicidals (SUI) and parasuicidals (PARA). So far studies on this topic are mostly performed by "external" parameters, e.g. sociodemographic or anamnestic data. The content-analytical approach provides to describe the presuicidal situation on base of "internal" variables. Compared with the suicidal notes the parasuicidal communication can be evaluated as more ambivalent, emotionally disturbed, and cognitively restricted. The successful reclassification of the notes into the two samples by a stepwise discriminant analysis supports the hypothesis, that both groups are distinct even on base of internal variables.

[Maturity criteria in youth jurisprudence--on the problem of paragraphs 1, 3 and 105 of the youth penal code from the viewpoint of adolescent psychiatry]. / Reifungskriterien im Jugendstrafrecht--Zur Problematik der Sections 1,3 und 105 JGG aus der Sicht der Jugendpsychiatrie.

The youth psychiatrist is regularly asked to assess the maturity of juvenile offenders. The criteria are laid down by German criminal legislation. The present articles deals with the individual factors that enable such assessment, especially if the offender is between 18 and 20 years of age.