Balance and Change in Forensic Psychiatry.

The practice of forensic psychiatry requires balance; the forensic psychiatrist encounters the need for balance routinely and in a variety of areas. Balance is necessary for sound judgment and objectivity when striving for excellence in the field. It is also necessary to effectively balance a career in forensic psychiatry with one's personal life.

MIS-C related to SARS-CoV-2 infection: a narrative review of presentation, differential diagnosis, and management.

Multisystem Inflammatory Syndrome in Children (MIS-C), a rare condition, has been reported approximately 2-4 weeks after the onset of COVID-19 in children and adolescents, causing inflammation in multiple systems, including cardiovascular and respiratory, digestive, and central nervous systems. This condition is also known as hyperinflammatory shock, Kawasaki-like disease, and Pediatric Inflammatory Multisystem Syndrome (PIMS). The signs and symptoms include but are not limited to fever, rash, peripheral edema, gastrointestinal symptoms, conjunctivitis, and shock.

Developing a Structural Intervention for Outpatient Mental Health Care: Mapping Vulnerability and Privilege.

The Mapping Vulnerability and Privilege (MVP) exercise is a clinical intervention based on a structural competency framework that emphasizes societal structures-social determinants of health and of biology, behavior, and culture-and their impact on health outcomes. The exercise comprises the MVP Tool, Visual Guide, and Processing Guide. It was created with the goals of helping clinicians to develop structural humility and introducing a structural lens for viewing the therapeutic milieu and the structural barriers that affect both intrapsychic experiences and interactions with the health care system, while encouraging patients and clinicians to take action to address the systemic and structural issues that affect patients' well-being.

A brief history of the criminalization of mental illness.

This article traces the history of the way in which mental disorders were viewed and treated, from before the birth of Christ to the present day. Special attention is paid to the process of deinstitutionalization in the United States and the failure to create an adequately robust community mental health system to care for the people who, in a previous era, might have experienced lifelong hospitalization. As a result, far too many people with serious mental illnesses are living in jails and prisons that are ill-suited and unprepared to meet their needs.

Racial Disparity in the Clinical Risk Assessment.

Implicit bias has been shown to impact care in many medical specialties. However, few studies examine its impact on psychiatry. Psychiatrists, especially in the Emergency Room, must assess patients' level of dangerousness when determining an appropriate disposition.

Open access journals and forensic publishing.

Open access (OA) publishing makes articles available over the Internet at no charge. The OA movement had its official start in 2002 with the establishment of the Budapest Open Access Initiative. The goal of the OA movement is to remove access barriers, accelerate research, and thereby achieve its broader mission of promoting global welfare.

Overview of serotonin syndrome.

Background: Serotonin syndrome (SS) is a rare and potentially life-threatening toxic state caused by an adverse drug reaction that leads to excessive central and peripheral serotonergic activity. This excessive serotonin hyperstimulation may be secondary to 1 standard therapeutic dose of a single agent, inadvertent interactions between various drugs, intentionally or unintentionally excessive use of particular drugs, deliberate self-harm, or recreational use of certain drugs. This review article serves as an overview of the epidemiology, pathophysiology, clinical features, diagnosis, differential diagnosis, management, and prevention of SS.

Characteristics of inmates who received a diagnosis of serious mental illness upon entry to New York State prison.

Objective: This study investigated the characteristics of inmates who received a diagnosis of serious mental illness upon entry to a New York State prison. The number has been rapidly increasing since the 1990s.

Methods: Chart review was performed for inmates who entered prison between May 15, 2007, and June 14, 2007, and received a diagnosis of serious mental illness.

State prison mental heath services recipients perception of care survey.

Background: Studies have demonstrated the importance of patient perceptions' of mental health service quality. No studies, however, could be found that surveyed recipients in prison, despite the rapid growth of patients, and litigation in these settings.

Method: Patients were asked to complete an anonymous survey in private, and sealed it in an envelope.

Diabetic ketoacidosis among patients receiving clozapine: a case series and review of socio-demographic risk factors.

Background: Diabetic ketoacidosis (DKA) has been associated with clozapine. The purpose of this study is to examine the clinical-demographic correlates of DKA among outpatients receiving clozapine.

Methods: A literature search was conducted from 1966 to present using Medline to identify 23 case reports of clozapine-associated DKA.

Mental health service recipients and prison work release: how do the mentally ill fare compared to other inmates in prison work release programs?

The objective of this study was to compare the success rate of the mentally ill and other inmates on prison work release within gender groups. Mentally ill (MI) men (n = 42) had a higher success rate (79%) than other men (NMI) (61%) (n = 49), but this difference only approached statistical significance (p = 0.07), and mental illness did not distinguish male success/failures in regression analyses.

Fibromyalgia-: a review for the psychiatrist.

Unlabelled: This paper is a review article that collects and synthesizes up-to-date information about the complex etiological theories and treatment regimens associated with Fibromyalgia. The authors have written the paper in an evidence-based model in order to show the reader where adequate data exist in regards to these pharmacological, psychological, and physical strategies. A thorough MEDLINE search was utilized to collect many papers dedicated to this topic spanning 1970-2005.

Relationships between patient, family, and significant other disposition preferences in psychiatric emergency services and the clinical symptom ratings and disposition decisions of psychiatrists.

A previous paper examined the relationship between 10 clinical ratings made by psychiatrists and 465 psychiatric emergency service (PES) dispositions. A logistic regression model explained 52% of the variance in the psychiatrist's decisions to admit to inpatient services or release. The 5 clinical ratings in the model, rated on 8-point scales, were severity of danger to self, psychosis, inability to care for self, impulse control, and depression.

The potential risks of commonly prescribed antipsychotics: during pregnancy and lactation.

Chlorpromazine, haloperidol, fluphenazine, clozapine, risperidone, quetiapine, olanzapine, ziprasidone, and aripiprazole are antipsychotics commonly used in psychiatric medicine. Approximately one third of pregnant women with psychotic symptoms use antipsychotics at least once. This review will discuss the effects of antipsychotic use during pregnancy and lactation on the fetus and infant.

Transfers to civil psychiatric inpatient services from a maximum security forensic hospital.

Objective: To examine inpatients discharged from a forensic psychiatric hospital to a civil hospital at the completion of their correctional sentence.

Method: Extract information from a patient database.

Results: About 20% of the discharges from the New York State forensic hospital that serves mentally ill state prison inmates, Central New York Psychiatric Center (CNYPC), are transferred to a civil psychiatric hospital; the remainder are returned to a correctional setting.

Correctional mental health services in New York: then and now.

This article chronicles the legislation, litigation, and the agency initiatives which have shaped the New York State correctional mental health system into what it is today. An historical perspective provides a context and framework for the examination of the current and future salient issues and challenges in providing a comprehensive range of mental health services in a correctional setting. The Central New York Psychiatric Center organization, which is comprised of a 206 bed maximum-security forensic hospital and a community support network of 23 prison-based mental health units was established in 1977.

Central New York Psychiatric Center: an approach to the treatment of co-occurring disorders in the New York State correctional mental health system.

Central New York Psychiatric Center operates a maximum security inpatient treatment hospital and outpatient mental health services for all of the 72 New York State prisons. In this article prevalence data, patient characteristics, and interventions offered to inmates diagnosed with co-occurring mental illness and substance abuse disorders in the New York State prison system are reviewed and discussed. Available interventions have resulted from the close collaboration of the State Department of Correctional Services and State Office of Mental Health.

An algorithm for the treatment of schizophrenia in the correctional setting: the Forensic Algorithm Project.

The Forensic Algorithm Project (FAP) was born of the need for a holistic approach in the treatment of the inmate with schizophrenia. Schizophrenia was chosen as the first entity to be addressed by the algorithm because of its refractory nature and high rate of recidivism in the correctional setting. Schizophrenia is regarded as a spectrum disorder, with symptom clusters and behaviors ranging from positive to negative symptoms to neurocognitive dysfunction and affective instability.