Six nations: a clinical scenario comparison of systems for prisoners with psychosis in Australia, Bolivia and four European nations.

This paper compares across six nations the mental health systems available to prisoners with the highest acuity of psychosis and risk combined with the lowest level of insight into the need for treatment. Variations were observed within and between nations. Findings highlight the likely impact of factors such as mental health legislation and the prison mental health workforce on a nation's ability to deliver timely and effective treatment close to home for prisoners who lack capacity to consent to treatment for their severe mental illness.

Impact of COVID-19 on mental health: Update from the United Kingdom.

In January 2020, the World Health Organisation (WHO) declared the outbreak of a new corona virus disease, COVID-19 to be public health Emergency of International concern and by March 2020 it had progressed rapidly across several continents to be a pandemic. After COVID-19 was declared a global pandemic the U.K.

A service improvement report of blood-borne virus screening in a high secure mental hospital.

Background: Patients in a high secure hospital are a high-risk population for exposure to blood-borne viruses (BBV) because of previous lifestyles.

Objective: This service improvement study intends to improve patients care by the Infection Prevention and Control Team (IPCT) coordinating the BBV screening and vaccination programme within the hospital.

Methods: A retrospective review of patients' notes in 2007 and 2016 was used.

Personality Disorder Traits, Trauma, and Risk in Perpetrators of Domestic Violence.

Crimes committed against partners and family members have devastating effects on victims. Unfortunately, recidivism rates for offenders are high, and there is a need to establish risk factors that may be potential treatment targets. This study aimed to investigate childhood maltreatment, symptoms of trauma, and personality disorder (PD) traits in males convicted of domestic violence (DV) offences.

The Relationship Between Childhood Maltreatment and Violence to Others in Individuals With Psychosis: A Systematic Review and Meta-Analysis.

Background: There is a growing body of literature identifying a relationship between experiences of child abuse and symptoms of psychosis in adults. However, the impact of this relationship on risk of violence has not been systematically explored.

Aims: This meta-analysis aimed to consider the influence of childhood abuse on the risk of violence among individuals with psychosis.

Patient characteristics and outcome measurement in a low secure forensic hospital.

Background: Health services are increasingly required to measure outcomes after treatment, which can be reported to the funding body and may be scrutinised by the public. Extensive high-quality measurements are time consuming. Routinely collected clinical data might, if anonymised, provide good enough evidence of useful change consequent on service received.

Klinefelter's syndrome and sexual offending - A literature review.

Background: Klinefelter's syndrome is a sex chromosome abnormality affecting approximately 1 in 1000 men. There have been suggestions that it is associated with a higher than average prevalence of sexual offending but to what extent does research evidence support this assertion?

Aims: This study aimed to conduct a systematic review of published research to establish the prevalence of sexual offending in men with Klinefelter's syndrome.

Method: The databases MEDLINE, PsycINFO and EMBASE were searched from inception until 31 December 2016 by using a range of terms for Klinefelter's syndrome and for sexual offending.

Clozapine combined with different antipsychotic drugs for treatment-resistant schizophrenia.

Background: Between 40% and 70% of people with treatment-resistant schizophrenia do not respond to clozapine, despite adequate blood levels. For these people, a number of treatment strategies have emerged, including the prescription of a second anti-psychotic drug in combination with clozapine.

Objectives: To determine the clinical effects of various clozapine combination strategies with antipsychotic drugs in people with treatment-resistant schizophrenia both in terms of efficacy and tolerability.

Lived experience of working with female patients in a high-secure mental health setting.

Women's secure hospitals are often considered to be stressful and demanding places to work, with these environments characterized as challenging and violent. However, the staff experience of working in this environment is not well represented in the literature. The present study is the first to examine the 'lived experience' of seven nurses working in the National High Secure Healthcare Service for Women.

Institutional abuse - Characteristics of victims, perpetrators and organsations: A systematic review.

Background: Abuse of vulnerable adults in institutional settings has been reported from various countries; however, there has been no systematic review of the characteristics of the victims and their abusers. Our aim was to identify and synthesise the literature on victims, perpetrators and institutions where abuse occured in order to inform interventions to prevent such abuse.

Methods: Searches of MEDLINE (OVID), CINHAL (EBSCO), EMBASE (OVID) and PsychINFO (OVID) databases identified 4279 references.

Mental health pharmacists views on shared decision-making for antipsychotics in serious mental illness.

Background People diagnosed with serious mental illnesses (SMIs) such as schizophrenia and bipolar affective disorder are frequently treated with antipsychotics. National guidance advises the use of shared decision-making (SDM) in antipsychotic prescribing. There is currently little data on the opinions of health professionals on the role of SDM.

Development of a self-report measure of social functioning for forensic inpatients.

Despite increasing interest in the measurement of social functioning in people with personality disorder, there are currently no social functioning measures specifically for forensic or other inpatients with a diagnosis of personality disorder. This paper describes the development and validation of the Hospital Social Functioning Questionnaire (HSFQ), a self-report measure of social functioning for forensic inpatients. A sample of fifty four male inpatients in a forensic personality disorder treatment unit completed the HSFQ and a range of measures indicative of social functioning, namely self-report measures of psychological wellbeing and symptoms, recorded incidents of self-harm and aggression.

Anxiety and avoidance in psychogenic nonepileptic seizures: the role of implicit and explicit anxiety.

This study examined implicit and explicit anxiety in individuals with epilepsy and psychogenic nonepileptic seizures (PNESs) and explored whether these constructs were related to experiential avoidance and seizure frequency. Based on recent psychological models of PNESs, it was hypothesized that nonepileptic seizures would be associated with implicit and explicit anxiety and experiential avoidance. Explicit anxiety was measured by the State-Trait Anxiety Inventory; implicit anxiety was measured by an Implicit Relational Assessment Procedure; and experiential avoidance was measured with the Multidimensional Experiential Avoidance Questionnaire.

Pharmacotherapy for personality disorder-prescribing practice at a high secure hospital: a preliminary report.

The aim of this study was to examine the prescription of psychotropic medication for patients with a primary diagnosis of personality disorder (PD) detained at Rampton High Secure Hospital, compared with that for patients with a primary diagnosis of mental illness. The name and the dose of psychotropic medication prescribed for each patient in the sample, on 2 July 2010, were examined. Although nearly all patients with a primary diagnosis of mental illness were prescribed psychotropic medication (98%), the percentage within the Personality Disorder (73%) and the Dangerous and Severe Personality Disorder services (62%) was also high, with the most commonly prescribed drug being an antipsychotic in all groups.

A comparison of anger in offenders and non-offenders who have intellectual disabilities.

Background: There is growing evidence of the effectiveness of cognitive behavioural therapy to treat anger in offenders with intellectual disabilities. The aim is to lower anger levels; the rationale is that this will reduce recidivism. However, the hypothesis that anger levels amongst offenders are higher than non-offenders has not been tested.

Cognitive behavioural treatment for anger in adults with intellectual disabilities: a systematic review and meta-analysis.

Background: The cognitive behavioural treatment for anger in adults with intellectual disabilities has received increasing interest. The current study aims to review the current literature and provide a meta-analysis.

Method: A literature search found 12 studies eligible for the quality appraisal.

Personality traits as predictors of inpatient aggression in a high-security forensic psychiatric setting: prospective evaluation of the PCL-R and IPDE dimension ratings.

The Dangerous and Severe Personality Disorder (DSPD) initiative in England and Wales provides specialized care to high-risk offenders with mental disorders. This study investigated the predictive utility of personality traits, assessed using the Psychopathy Checklist-Revised (PCL-R) and the International Personality Disorder Examination, with 44 consecutive admissions to the DSPD unit at a high-security forensic psychiatric hospital. Incidents of interpersonal physical aggression (IPA) were observed for 39% of the sample over an average 1.

An empirical evaluation of reasons for non-completion of treatment in a dangerous and severe personality disorder unit.

Background: Individuals deemed to be of high risk to others, and diagnosed with severe personality disorders have become the focus for developing clinical services in England. Such services often require highly secure accommodation and labour-intensive therapeutic interventions. There is, however, uncertainty about the capacity to engage such patients effectively in therapies.

A retrospective evaluation of the impact of total smoking cessation on psychiatric inpatients taking clozapine.

Objective: To investigate the effect of a complete smoking ban on a group of psychiatric inpatients maintained on the antipsychotic medication clozapine.

Method: Retrospective data on clozapine dose and plasma levels were collected from a three month period before and a six month period after the introduction of the smoking ban.

Results: Before the ban only 4.

The EssenCES measure of social climate: a preliminary validation and normative data in UK high secure hospital settings.

Background: The social climate of forensic units is important but little investigated, in part because of the unavailability of a clinically practical and statistically sound measure.

Aims: To provide preliminary psychometric and normative data for the English version of the Essen Climate Evaluation Schema (EssenCES) in UK high-security hospital settings.

Method: A total of 324 staff and patients from three high-security hospital services completed the EssenCES, and a subgroup completed a range of other questionnaires related to therapeutic milieu and working environment (GMI, WAAM, WES-10).

Structural, item, and test generalizability of the psychopathy checklist--revised to offenders with intellectual disabilities.

The Psychopathy Checklist-Revised (PCL-R) is the most widely used measure of psychopathy in forensic clinical practice, but the generalizability of the measure to offenders with intellectual disabilities (ID) has not been clearly established. This study examined the structural equivalence and scalar equivalence of the PCL-R in a sample of 185 male offenders with ID in forensic mental health settings, as compared with a sample of 1,212 male prisoners without ID. Three models of the PCL-R's factor structure were evaluated with confirmatory factor analysis.

Recorded incidents in a high-secure hospital: a descriptive analysis.

Background: Incidents of violence, self-harm and security are of concern in psychiatric hospitals with regard to both patient and staff welfare.

Aim: The purpose of this study was to examine the frequency and nature of incidents in all directorates in a high-security psychiatric hospital.

Methods: Data were collected from the hospital's incident recording forms for the period 1 June 2007 to 30 September 2008.

The function of aggression in personality disordered patients.

It has been suggested that psychological interventions for personality disorders should focus on improving adaptive expression of the functional needs expressed through problematic behaviors such as aggression. The measurement of function is a necessary condition for devising a function-based treatment approach. Two studies that employ a method for assessing the functions of aggressive behavior in personality disordered patients are described by: (a) a retrospective analysis, through file review of inpatient aggressive behaviors and of the index offenses of patients admitted for treatment, and (b) an analysis of inpatient aggressive incidents where staff and patients were interviewed to elicit functions.