Self-harm among inmates of the Berlin prison system.

Introduction: Self-harming behavior in prisoners is a prevalent phenomenon, with international studies estimating a 4% prevalence rate. However, studies on self-injurious behavior in the German prison system are currently lacking. Therefore, our study aims to conduct an initial assessment.

Availability of opioid agonist treatment and critical incidents in Forensic Clinics for Dependency Diseases in Germany.

Background: Prevalence of substance use disorders, especially opioid use disorders, is high in patients admitted into forensic psychiatric settings. Opioid agonist treatment is a safe, well-established, and effective treatment option for patients that suffer from opioid dependence. Surprisingly, data on the availability and practice of opioid agonist treatment (OAT) options in German Forensic Clinics for Dependency Diseases is rare.

Criminal responsibility evaluations: Benchmarking in different countries.

Forensic mental health experts play a crucial role in criminal responsibility evaluations. However, the quality of these assessments has at time come under scrutiny and has been heavily criticized. A literature review revealed significant differences between countries concerning legal frameworks and procedures for conducting these assessments.

Prevalence of Opioid Dependence and Opioid Agonist Treatment in the Berlin Custodial Setting: A Cross-Sectional Study.

Background: Among people living in detention, substance use is highly prevalent, including opioid dependence. Opioid agonist treatment (OAT) has been established as an evidence-based, first-line treatment for opioid dependence. Despite high prevalence of opioid dependence, conclusive data regarding its prevalence and the OAT practice in German prisons is scarce; rather, the existing data widely diverges concerning the rates of people in detention receiving OAT.

Psychosis in German prisoners: Comparison of the clinical appearance of psychotic disorder of an imprisoned population with a not detained community group.

Surveys confirm risk factors for the incarceration of patients with psychosis including homelessness and comorbidity. There is also agreement that severe psychosis can lead to violence. Data describing prisoners with psychosis in Germany are scarce.

[Compulsory medication of people with mental disorders in the penal system : The situation in Germany and recommendations for clinical practice].

Background: Coercive medical measures always represent an encroachment on the patient's basic right to physical integrity and right to self-determination. If a patient is imprisoned, his basic rights are already severely restricted, and the coercive measure must also take place in a correctional facility. This amounts to a special challenge for everyone involved-but especially for the psychiatrist in charge.

Applicability of two violence risk assessment tools in a psychiatric prison hospital population.

The risk of violent behavior is known to be higher for patients who suffer from a severe mental disorder. However, specific prediction tools for clinical work in prison psychiatry are lacking. In this single-center study, two violence risk assessment tools (Forensic Psychiatry and Violence Tool, "FoVOx," and Mental Illness and Violence Tool, "OxMIV") were applied to a prison hospital population with a primary psychotic or bipolar disorder and subsequently compared.

[On the Situation of Inpatient Forensic Psychotherapy in Germany - Results of a Survey in Forensic Psychiatric Institutions].

The Federal Constitutional Court has emphasized the necessity of psychotherapy for offenders. Little is known about the actual situation of this field of work. Thus, an online survey was initiated.

Medicine in the Penal System.

Background: Infectious diseases, substance dependencies, and dental diseases are the most important health problems affecting incarcerated persons. In Germany, for example, prisoners are 48 to 69 times more likely to be infected with the hepatitis C virus (HCV) than the general population, and 7 to 12 times more likely to be infected with the human immunodeficiency virus (HIV). The prevalence of mental illnesses is also markedly higher in the incarcerated than in the general population.

Paraphilias.

Purpose Of Review: The concept of paraphilia still carries an 'unwanted burden' of sexual norms because the pathologization of some sexual practices as paraphilic disorders is still based on the assumption that normal sexuality should be genitally organized with the aim of reproduction. The aim of this review is to give an impression of the ongoing discussion about the changes introduced with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the results of recent research in this area.

Recent Findings: The release of DSM-5 in the spring of 2013 introduced a distinction between paraphilias and paraphilic disorders, implying a destigmatization of consenting adults engaging in unusual sexual behaviour.

Treating substance abuse is not enough: comorbidities in consecutively admitted female prisoners.

Introduction: Several studies have pointed to high rates of substance use disorders among female prisoners. The present study aimed to assess comorbidities of substance use disorders with other mental disorders in female prisoners at admission to a penal justice system.

Methods: A sample of 150 female prisoners, consecutively admitted to the penal justice system of Berlin, Germany, was interviewed using the Mini-International Neuropsychiatric Interview (MINI).

Forensic psychiatric expert witnessing within the criminal justice system in Germany.

In recent years, the number of occupied beds in German forensic-psychiatric hospitals has continued to rise. Diversion refers to the removal of offenders from the criminal justice system at any stage of the procedure and court proceedings. There are no specific diversion programs in Germany but diversion does in fact happen via legal regulations that are based on the construct of legal responsibility.

Prison psychiatry.

Purpose Of Review: Prison psychiatry is a secluded area of the psychiatric care system, which in fact often provides treatment for those who do not have access to community-based healthcare systems. The aim of this review is to give an impression of the special challenges of psychiatric work behind bars and to emphasize current trends in prison psychiatry.

Recent Findings: In prisoners, mental disorders are more common than in the general population.

An evaluation of expert reports with regard to adherence to current quality standards.

In early 2008 the penal system of Lower Saxony established a specialised department responsible for risk assessment regarding all prison inmates in that state. The department generates approximately 200 risk assessment expert reports per year, mainly on questions such as the inmates' aptitude for social therapy, relaxation of imprisonment conditions, and transfer to an open prison. Prof.

Inpatient treatment in the psychiatric department of a German prison hospital.

Objective: Although the construct of psychic incompetence can prevent severely mentally disturbed persons from being imprisoned in Germany, the prevalence of mentally disordered persons who are detained is high. Data describing the characteristics of mentally disturbed detainees in Germany are scarce. The following study uses data from a psychiatric care institution in a prison to examine the distribution of psychiatric diagnoses in relation to age, nationality and legal status.

Dealing with the mentally ill in the criminal justice system in Germany.

Mentally disordered prisoners in Germany are subject to special legal regulations, which can be traced back to the 1933 "Dangerous Habitual Offenders and their Detention and Rehabilitation Act". There are no special diversion programs in Germany but diversion does in fact happen via legal regulations that are based on the construct of legal responsibility. Diversion refers to the removal of offenders from the criminal justice system at any stage of the procedure and court proceedings.

Ethical issues in forensic psychiatry in penal and other correctional facilities.

Purpose Of Review: Forensic mental health practitioners, especially psychiatrists working in jails, prisons or other correctional facilities, face special problems that are unlike others encountered in bioethics.

Recent Findings: Literature published during the past year shows that the forensic psychiatrist has to adhere to role clarity: as a physician, he is primarily obligated to the treatment and well being of the incarcerated patients and is not exclusively an agent of social control. Moreover, the general conditions in a therapeutic setting (e.