Recidivism in female offenders: PCL-R lifestyle factor and VRAG show predictive validity in a German sample.

A clear and structured approach to evidence-based and gender-specific risk assessment of violence in female offenders is high on political and mental health agendas. However, most data on the factors involved in risk-assessment instruments are based on data of male offenders. The aim of the present study was to validate the use of the Psychopathy Checklist Revised (PCL-R), the HCR-20 and the Violence Risk Appraisal Guide (VRAG) for the prediction of recidivism in German female offenders.

[Evidence-based expert testimonies on psychiatric disorders--risk factors for invalidity].

Psychiatric symptoms often lead to a claim for disability pension. Surprisingly, there is very little empirical data available on which variables may predict permanent job disability. A new empirically based risk assessment instrument was developed to predict the final pension outcome.

Assessing measurement invariance of PCL-R assessments from file reviews of North American and German offenders.

Cross-cultural research on psychopathy necessitates assessment methods that are generalizable across linguistic and cultural differences. Multiple-group confirmatory factor analysis was used to compare the factorial structure of Psychopathy Checklist-Revised (PCL-R) assessments obtained from file reviews of North-American (N=2622) and German (N=443) male offenders. The analyses indicated that the 18 item, 4-factor model of the PCL-R obtained with the standard PCL-R protocol (interview and file review) also holds for file review data.

[Risk factors for invalidity in psychiatric disorders--development of an empirically based assessment tool].

The staggering amount of health-related disability associated with psychiatric disorders is increasing medical claim costs. Government-run health systems and social health insurances are under pressure in almost every developed country. The complex interrelationship of these disorders and disability pensioning poses a number of challenges and emphasises the need for specialists in psychiatric medicine.

[Structured psychiatric assessment of risk for violent recidivism in juvenile offenders].

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.

[Assessment of sexual deviance by forensic psychiatrists].

The article reviews the legal changes in dealing with sexual offenders in Germany during the last ten years. The developments described are in many respects comparable to other countries of Northern and Western Europe and to Austria. The laws, which regulate the penal aspects for sexual deviance, have been drastically tightened up.

[Extent to which a claimant's loss-mitigation and cooperation obligations towards the insurer are enforceable--requirements for an expert medical opinion].

A policyholder claiming an annuity benefit on the grounds that, he is no longer able to pursue his occupation must meet certain obligations vis-à-vis the insurer, e.g. duty to mitigate the loss, duty to cooperate with the insurer.

The validity of the Violence Risk Appraisal Guide (VRAG) in predicting criminal recidivism.

Introduction: The VRAG is an actuarial risk assessment instrument, developed in Canada as an aid to estimating the probability of reoffending by mentally ill offenders.

Aim: To test the predictive validity of the VRAG with a German sample.

Method: The predictive validity of the VRAG was tested on a sample of 136 people charged with a criminal offence and under evaluation for criminal responsibility in the forensic psychiatry department at the University of Munich in 1994-95.

[Evaluation of risk assessment instruments for sex offenders].

In order to evaluate risk assessment instruments for sex offenders in Germany, we compared the predictive validity of the Static-99, HCR-20, SVR-20, and PCL-R scales for 134 sex offenders. The mean follow-up time was 9 years (range 1-340 months), using the first entry into the National Register of Criminal Convictions as endpoint variable. For the estimate of predictive power, the area under the curve (AUC) of receiver operating characteristic (ROC) analysis was calculated.

[Psychiatric disorders and the prognosis for criminal recidivism].

The risk for criminal recidivism of mentally ill offenders is, unlike the general risk of delinquency, not well established. The relationship between psychiatric diagnosis and criminal recidivism was examined in the context of the Munich project on risk assessment. A total of 185 offenders had been examined on the question of culpability between 1992 and 1993.

[Alcohol and drugs and their relation to criminal recidivism].

This report assesses the influence of alcohol- and drug- induced disorders on criminal recidivism. A sample of 185 delinquents was examined for their criminal responsibility in the department of forensic psychiatry in the years 1992 and 1993. Official criminal records were obtained in December 2001.

[Criteral for assessing quantitative disability in expert determination of functional physical disorders. Review of the literature].

The assessment of individuals with somatoform disorders seeking payments or compensation is a major challenge for psychiatrists, insurers and the social welfare system. It is difficult to examine these disorders objectively and to quantify the impairment people experience in their work or private life. In order to develop more rational criteria for the assessment of these patients, we first reviewed the relevant literature and extracted the criteria mentioned by the respective authors.

[Assessment and psychotherapeutic options of patients with somatoform disorders and a claim for invalidity pensioning].

Difficulties in the assessment of patients with somatoform disorders and a claim for social security benefits or invalidity pensioning pose a considerable challenge to the medical community. Within the process of delivering a medical expert's opinion, psychiatric and psychological factors often are underestimated. There are ample recommendations to apply specific criteria within the medical expert's report, but there are no empirical studies confirming that these criteria are really used and prognostically valuable.

A switch from propofol to etomidate during an ECT course increases EEG and motor seizure duration.

Introduction: Of 58 patients treated at our electroconvulsive therapy (ECT) unit early in the year 2000, 12 patients under propofol did not achieve a seizure duration of >30 s [electroencephalogram (EEG)] with a maximum stimulation charge of 504.0 mC (100%).

Method: A switch from propofol to etomidate was therefore undertaken in these patients at the next treatment to achieve longer seizure duration.

Bupropion as add-on strategy in difficult-to-treat bipolar depressive patients.

Bupropion, a selective norepinephrine and dopamine reuptake inhibitor, has been suggested for the treatment of bipolar depression, not only because of its efficacy, but also because of a probably lower risk of inducing switches to hypomania or mania. Most studies on bupropion treatment in bipolar patients have been performed in moderately ill out-patients. In contrast, we report on a sample of difficult-to-treat, predominantly severely ill, co-morbid, psychotic or therapy-refractory bipolar depressive in-patients.