RESUMO
Historically, the use of the insanity defense has been limited although not exclusively to those with a psychotic mental disorder at the time of the crime. Occasionally, an insanity acquittee may primarily suffer from a personality disorder at the time of commitment to the psychiatric hospital. Such examples can include someone with a personality disorder who malingers psychosis and legal insanity or who at the time of the crime may have been suffering from a drug-induced or brief reactive psychosis. One such case will be presented as well as dilemmas created for the clinician and forensic evaluator. In addition, pertinent medical and psychological literature and legal case precedents will be discussed. Finally, a proposed guideline for the treatment and evaluation of the personality-disordered insanity acquittee will be offered, focusing specifically on the aspects of the personality disorder that contribute to the individual's dangerousness.
Assuntos
Transtorno da Personalidade Antissocial/reabilitação , Comportamento Perigoso , Defesa por Insanidade , Adulto , Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Personalidade Antissocial/psicologia , Internação Compulsória de Doente Mental/legislação & jurisprudência , Prova Pericial/legislação & jurisprudência , Feminino , Humanos , Psicoses Induzidas por Substâncias/diagnóstico , Psicoses Induzidas por Substâncias/psicologia , Psicoses Induzidas por Substâncias/reabilitação , Esquizofrenia/diagnóstico , Esquizofrenia/reabilitação , Psicologia do EsquizofrênicoRESUMO
Nine depressed subjects and nine comparison subjects completed a study of abnormalities in adrenal androgen and cortisol metabolism. Serum levels of cortisol and dehydroepiandrosterone (DHA) at 8:00 a.m. and 4:00 p.m. revealed hypercortisolemia and loss of diurnal DHA variation but not cortisol variation in the depressed group. These findings suggest that in depression, adrenal androgens, in contrast to cortisol, are partially regulated by mechanisms independent of ACTH.
