The present study examined the prevalence of DSM IV axis I disorders and DSM IV personality disorders among sexual offenders in Forensic State Hospitals in Germany.

Current and lifetime prevalence rates of mental disorders were investigated based on clinical structured interviews among sexual offenders (n = 55). Additionally, subgroups were analyzed on the basis of diagnostic research criteria, with 30 sexual offenders classified as paraphiliacs and 25 sexual offenders as having an impulse control disorder (without paraphilia).

Anxiety disorders, mood disorders, and substance use disorders were common among sexual offenders, as were cluster B and cluster C personality disorders. While social phobia was most common among paraphilic sexual offenders, major depression was most prevalent in impulse control disordered sexual offenders.

The results replicate recent findings of high psychiatric morbidity in sexual offenders placed in forensic facilities. Furthermore, differential patterns of co-morbid mental disorders were found in paraphiliacs and impulse control disordered sexual offenders. With regard to an effective therapy and relapse prevention co-morbid mental disorders should be a greater focus in the assessment of subgroups of sexual offenders.

Clinical observations and a review of the literature led us to hypothesize that certain personality and character traits could provide improved understanding, and thus improved prevention, of suicidal behaviour among young women with eating disorders.

The clinical group consisted of 152 women aged between 18 and 24 years, with DSM-IV anorexia nervosa/restrictive type (AN-R = 66), anorexia nervosa/purging type (AN-P = 37), bulimia nervosa/non-purging type (BN-NP = 9), or bulimia nervosa/purging type (BN-P = 40). The control group consisted of 140 subjects. The assessment measures were the Minnesota Multiphasic Personality Inventory—second version (MMPI-2) scales and subscales, the Beck Depression Inventory (BDI) used to control for current depressive symptoms, plus a specific questionnaire concerning suicide attempts.

Suicide attempts were most frequent in subjects with purging behaviour (30.0% for BN-P and 29.7% for AN-P). Those attempting suicide among subjects with eating disorders were mostly students (67.8%). For women with AN-R the scales for ‘Depression’ and ‘Antisocial practices’ represented significant suicidal risk, for women with AN-P the scales for ‘Hysteria’, ‘Psychopathic deviate’, ‘Shyness/Self-consciousness’, ‘Antisocial Practices’, ‘Obsessiveness’ and ‘Low self-esteem’ were risk indicators and for women with BN-P the ‘Psychasthenia’, ‘Anger’ and ‘Fears’ scales were risk indicators.

This study provides interesting results concerning the personality traits of young women with both eating disorders and suicidal behaviour. Students and those with purging behaviour are most at risk. Young women should be given more attention with regard to the risk of suicide attempts if they: (a) have AN-R with a tendency to self-punishment and antisocial conduct, (b) have AN-P with multiple physical complaints, are not at ease in social situations and have antisocial behaviour, or (c) if they have BN-P and tend to be easily angered with obsessive behaviour and phobic worries. The MMPI-2 is an interesting assessment method for the study of traits indicating a risk of suicidal behaviour in young subjects, after controlling for current depressive pathology.

The objective of the study was to determine the level of involuntary treatment that mood disorder patients and their families wish in the event of a manic or hypomanic episode.

A survey was conducted within two self-help organizations during two conventions gathering over 500 patients, along with families and caregivers. A clinical vignette depicting an uncollaborative hypomanic patient beginning to endanger his professional and financial situation and to put undue stress upon his family was presented and followed by an eight-item questionnaire. The level of coercive treatment seen as appropriate was measured by visual analogue scales.

The 503 respondents disagreed partially with the statement that the patient should decide by himself about his hospitalization and partially favored some involuntary treatment over treatment refusal. There was no difference between patients, relatives and caregivers related to acceptance of coercive hospitalization and treatment. Respondents assigned a major role to treating teams and family members in decisions for coercive treatment.

Most respondents (including a majority of patients) support a moderate degree of coercive treatment in the event of a hypomanic or manic state. Surveys of opinions from concerned people could influence, practice, legislation and possibly advance directives that could be written by patients or patients organizations.

Since 01.01.1999 a reform of the health care system in Poland has been realised based on the general health insurance act. We attempt to use the pathway method, especially measuring of time intervals along pathways, as a way of making accessibility to mental health services operational.

In a period of 2 months all patients aged 15 and over who had not sought care from any public or private psychiatric service during the previous 365 days, were interviewed by psychiatrists, using the Polish version of the WHO Encounter Form.

A total of 228 patients were seen. The study reveals that the median interval between first seeing a primary care giver and arrival at a mental health service was 12 weeks, which is much longer than all other European centres in previous studies.

Making use of the pathway method and, in particular, median interval analysis between the onset of the mental health problem and seeing mental health professionals (MHPs) has shown practically limited access of patients, with a new episode of care to psychiatric services in both epidemiological catchment areas. This method seems to be a simple and inexpensive way of monitoring the accessibility to MHP in the period of health care reform.

To study the types of psychiatric problem encountered in children infected with the human immunodeficiency virus (HIV) and their relationship to central nervous system disorder and the severity of infection.

17 HIV-infected children presenting with psychiatric problems were included. Mental disorders were evaluated according to DSM-IV criteria. Neurological disorders and progressive encephalopathy (presence or absence) diagnosis were evaluated by clinical and radiological examination. The severity of infection was assessed by the percentage of CD4 lymphocytes.

The most frequent diagnoses were major depression (MDD: 47%) and attention deficit hyperactivity disorder (ADHD: 29%). Major depression diagnosis was significantly associated with neuroimaging or clinical neurological abnormalities (p < 0.01). In contrast, no association was found between hyperactivity diagnosed according to DSM-IV criteria and central nervous system disorder. Percentage of CD4 lymphocytes were close to 0 for more than 80% of children presenting with psychiatric complications.

The very low % of CD4 lymphocytes of these children suggest that the appearance of a psychiatric complication should be regarded as a factor indicating severe HIV infection. Depressive disorders may be a clinical form of encephalopathy.