Among various mental disorders seen in shoplifters, the strongest association is seen for:
B. Shoplifting is different from kleptomania: the former is a broadly defined behaviour whereas the latter is a specific psychiatric diagnostic category. Data from a national study carried out in the USA (National Epidemiologic Survey on Alcohol and Related Conditions) have demonstrated that most individuals (nearly 90%) who admitted to at least one episode of lifetime shoplifting had a lifetime history of at least one psychiatric diagnosis, compared with nearly 50% in non-shoplifters. In both groups, the most prevalent disorders were nicotine dependence and alcohol use disorders, with nearly three or four times increased risk respectively; among shoplifters, the strongest associations were found for antisocial personality disorder and substance use disorders. Kleptomania is a rare condition and occurs in less than 5% of identified shoplifters and less than 0.6% of the general population.
Reference:
A 43-year-old patient with a diagnosis of delusional disorder reveals that he intends to ‘rip off’ his neighbour, with whom he believes that his wife is having an affair.
Which of the following is correct with regard to management of this patient?
C. In Tarasoff v The Regents of the University of California et al., a case was brought by the parents of Tatiana Tarasoff, who had been murdered by Prosenjit Poddar. Poddar had previously disclosed his violent feelings against Tarasoff to Dr Moore, the campus psychologist. Although Dr Moore notified the police of his concerns about Poddar, the police released him after questioning. Ms Tarasoff and her family were not warned of the danger she faced. The court ruled that the clinician had a duty to protect and warn a third party from risk of harm from his/her patient, even though that third party was not under the clinician’s clinical care. In the UK, a Tarasoff ruling does not apply directly; breach of confidentiality for the sake of public interest has been recognized. According to Tarasoff principles, the police and third parties must be warned of the risk as well as the wife.
The proportion of prisoners in English prisons with one or other diagnosable mental disorder is:
D. Data from Psychiatric Morbidity among Prisoners in England and Wales 1998 showed that a large proportion of all prisoners had several mental disorders. Only 1 in 10 or fewer showed no evidence of any of the fi ve disorders considered in the survey (personality disorder, psychosis, neurosis, alcohol misuse, and drug dependence). Thus the rate of psychiatric diagnosis was nearly 90% in prisons. Most prisoners who had a psychiatric diagnosis had more than one diagnosable condition; this was especially true if the primary diagnosis was psychotic illness. Rates for multiple disorders were higher among remand than sentenced prisoners. Despite this, most prisoners receive poor, if any, psychiatric services in prison.
All of the following are true with regard to suicide of a homicide perpetrator except:
D. Homicide–suicides are mostly family affairs, especially when the perpetrator is female. Barraclough and Harris (2002) studied all murder–suicides over a 4-year period in the UK and found that 3% of male, 11% of female, and 19% of child homicides were of this type. Similarly, of all suicides, 0.8% male and 0.4% female deaths occurred as homicide–suicides. The typical cases involved families of low socioeconomic status. Death or fatal injury occurred on the same day in nearly 90% of incidents; in atypical cases the maximum interval between suicide and homicide was 10 months. In elderly people such homicide–suicide combinations are often suicide pacts complicated by depression or dementia in a couple or one of the partners. They can be considered altruistic, as often elderly people believe that the world will be better off without them.
In UK prisons, the most common method of committing suicide is:
A. A 2-year national survey of prison suicides described the clinical and social circumstances of self-inflicted deaths among prisoners in England and Wales. Nearly one-third occurred within 7 days of arrival in prison. The commonest method (nearly 92%) was hanging or self-strangulation; nearly three-quarters had a history of mental disorder. The commonest primary diagnosis was drug dependence.
Click to expand