ABSTRACT
This paper is designed to assist forensic psychiatrists/psychologists who evaluate adults who commit sexual crimes against children on the Internet. The typical offender is an adult male who logs onto the Internet and enters a chat room in which children congregate. Unbeknownst to the offender, undercover police officers are posing as minors in the chat rooms. The undercover officer (pretend kid) and offender engage in increasingly explicit, sexual conversation; the offender may transmit erotic photographs to the undercover officer and/or arrange to meet at a motel in order to have sexual intercourse. The authors will discuss the relevant legal, clinical, and ethical aspects of examining these offenders, and describe specific cases that the author (2) evaluated.
Subject(s)
Child Abuse, Sexual/legislation & jurisprudence , Child Abuse, Sexual/psychology , Forensic Psychiatry/methods , Internet/legislation & jurisprudence , Adolescent , Adult , Child , Female , Forensic Psychiatry/legislation & jurisprudence , Humans , MaleSubject(s)
Antipsychotic Agents/therapeutic use , Dystonic Disorders/drug therapy , Pirenzepine/analogs & derivatives , Adult , Antipsychotic Agents/adverse effects , Benzodiazepines , Dystonic Disorders/chemically induced , Humans , Male , Olanzapine , Pirenzepine/therapeutic use , Schizophrenia/drug therapy , Treatment OutcomeABSTRACT
This paper describes an epidemic of uncommon psychiatric symptoms among nine criminal defendants charged under California's new "Three Strikes and You're Out" law. The defendants were facing a minimum sentence of 25 years to life in prison. The defendants exhibited the following uncommon psychiatric symptoms: coprophagia (eating feces), eating cockroaches and many reported seeing little green men. The defendants, all of whom we believe were malingering, were evaluated by the authors for competency to stand trial. Thus far, eight of the nine defendants were found competent to stand trial; only one defendant was found incompetent to stand trial. The authors created a database which included information on the defendants from court documents and from our interview with the defendants. We summarized the data and outcomes of the case. Also included is a brief review of the "Three Strikes Law" and a paradigm for how we ruled out relevant psychiatric diagnoses before we arrived at our opinion of malingering.
Subject(s)
Criminal Law/legislation & jurisprudence , Forensic Psychiatry/methods , Hallucinations/psychology , Human Coprophagia/psychology , Malingering/diagnosis , Adult , California , Databases, Factual , Deception , Humans , MaleSubject(s)
Amenorrhea/drug therapy , Hypogonadism/drug therapy , Pituitary Hormone-Releasing Hormones/administration & dosage , Polycystic Ovary Syndrome/drug therapy , Drug Therapy/instrumentation , Female , Humans , Male , Pituitary Hormone-Releasing Hormones/adverse effects , Pituitary Hormone-Releasing Hormones/deficiency , PregnancySubject(s)
Aged , Clinical Trials as Topic , Drug Industry , Humans , United States , United States Food and Drug AdministrationABSTRACT
Penicillamine is known to be effective therapy for Wilson's disease. However, the clinical consequences of the abrupt and permanent withdrawal of penicillamine have not been investigated. We studied 11 patients who stopped their own treatment after having been treated successfully with penicillamine (1 to 2 g per day) for periods of 3 to 19 years. Eight died of hepatic decompensation or fulminant hepatitis after an average survival of only 2.6 years. In another 13 patients, penicillamine was discontinued by the physician because of serious adverse reactions. In these patients, penicillamine was replaced with trientine (1 to 1.5 g per day), a newer chelating agent. All but one of these patients (who was killed accidentally) are alive at this writing, from 2 to 15 years later. Our observations suggest that discontinuation of penicillamine in patients with Wilson's disease results in rapid clinical deterioration, which is often fatal. The replacement of penicillamine with trientine appears to prevent this adverse clinical course.
