Adenosine deaminase alleles and autistic disorder: case-control and family-based association studies.

Adenosine deaminase (ADA) plays a relevant role in purine metabolism, immune responses, and peptidase activity, which may be altered in some autistic patients. Codominant ADA1 and ADA2 alleles code for ADA1 and ADA2 allozymes, the most frequent protein isoforms in the general population. Individuals carrying one copy of the ADA2 allele display 15 to 20% lower catalytic activity compared to ADA1 homozygotes. Recent preliminary data suggest that ADA2 alleles may be more frequent among autistic patients than healthy controls. The present study was undertaken to replicate these findings in a new case-control study, to test for linkage/association using a family-based design, and to characterize ADA2-carrying patients by serotonin blood levels, peptiduria, and head circumference. ADA2 alleles were significantly more frequent in 91 Caucasian autistic patients of Italian descent than in 152 unaffected controls (17.6% vs. 7.9%, P = 0.018), as well as among their fathers. Family-based tests involving these 91 singleton families, as well as 44 additional Caucasian-American trios, did not support significant linkage/association. However, the observed preferential maternal transmission of ADA2 alleles, if replicated, may point toward linkage disequilibrium between the ADA2 polymorphism and an imprinted gene variant located in its vicinity. Racial and ethnic differences in ADA allelic distributions, together with the low frequency of the ADA2 allele, may pose methodological problems to future linkage/association studies. Direct assessments of ADA catalytic activity in autistic individuals and unaffected siblings carrying ADA1/ADA1 vs ADA1/ADA2 genotypes may provide stronger evidence of ADA2 contributions to autistic disorder. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:784-790, 2000.

Malingering a challenge for the forensic examiner.

After pointing out that spoken and non-verbal language are the primary means of communication in interpersonal dialogue, and especially in a forensic criminological examination, the authors present malingering in a legal context from an historical and psychodynamic- ontogenetic point of view. Diagnostic characteristics of malingering are reported in a review of previous studies. Latest psychological testing is presented. The authors express their professional opinion that malingering in a criminological forensic setting should be divested of the aura of deviousness and manipulation acquired throughout the past years. They propose that it is a defensive reaction to which a person charged with a crime resorts when under the stress of facing the legal consequences of wrongdoing. They view malingering in a forensic setting as regressive behavior to a childhood or adolescent stage, not to condone or justify it, but in an attempt to bring about better communication between examiner and examinee.

Death by inmate--multiple murder in a maximum security prison.

The authors report the killing of two inmates by a third inmate in a maximum security prison in the State of Wisconsin. All three had been sentenced to life imprisonment for murder, and one as a notorious serial killer. They touch on the variables of jail/prison overcrowding, the psycho-social traits and psychopathology of inmates, and their ethnicity as potential factors in violent crimes. They conclude that the selection of inmate housing should take into consideration the past history, the personality and the possible psychopathology of the inmate.

On the predictability of violent behavior: considerations and guidelines.

Following a semantic discussion of dangerousness, and having established its dynamic concept, the authors define the prediction of dangerous behavior as the anticipation of an antisocial act towards others. The present-day dilemma of predicting dangerous behavior is discussed. An extensive review of sociological and psychiatric studies is presented. Further, the authors stress the vital importance of predicting violent behavior in view of statistical data concerning rampant violent crime in the United States. They encourage more cooperation between psychiatric experts and the judicial system in view of the common social problem all are faced with. Better diagnostic procedures and more logically deductive factual expert reports are hoped for. The authors postulate that prediction is strictly connected with the possible prevention of dangerous behavior and the continuation of a civilized, secure society.

Clinical diagnostic considerations on cocaine abuse.

Following a review of the research literature on the psychophysiological effects of cocaine, a study is described of a group of 120 cocaine addicts. Of the 120 patients, 10 (8.33%) exhibited fleeting, unformed, organic delusions and hallucinations. Case reports of the 10 cases are presented. The quality of the adverse subjective effects of cocaine is emphasized, and the differential diagnosis between Cocaine Delusional Disorder and Paranoid Schizophrenia is discussed. Guidelines for a more accurate differential diagnosis are provided.