Peter B. C. Fenwick

Electroencephalography, computed tomography and violence ratings of male patients in a maximum-security mental hospital

A retrospective study of brain investigations of 372 male patients in a maximum‐security mental hospital patients is described. All computed tomography (CT) scan and electroencephalography (EEG) reports were collected and rated blind; patients were subsequently divided into 3 groups according to the violence rating of their pre‐admission offending behaviour. The 3 groups were similar in their mean age, psychiatric diagnosis, Wechsler Adult Intelligence Scale score and proportions of patients investigated with EEG and CT. In the most violent group, 20% had focal temporal electrical abnormalities on EEG (slowing and/or sharp waves) and 41% had structural abnormalities localised to temporal lobe on CT (dilated temporal horn and/or reduced size of temporal lobe). The corresponding figures for the least violent group are 2.4% and 6.7% respectively. These results suggest that high violence rating scores are associated with temporal lobe abnormalities on CT and abnormal temporal electrical discharges on EEG.

Positron emission tomography in male violent offenders with schizophrenia

The FDG PET brain scans from 31 offenders with schizophrenia and schizoaffective disorder from a maximum security mental hospital were compared with those of normal controls (N = 6) in terms of relative FDG uptake in a range of regions covering frontal and temporal regions. The patient sample was divided into those who had a history of repetitive violent offending (RVO, N = 17) and those without a repetitive violent history (NRVO, N = 14) according to the violence rating of their pre-admission convictions. Reduced FDG uptake was noted at both the right and left anterior inferior temporal (R and L AIT) regions in NRVOs but only at LAIT in RVOs. NRVOs had significantly lower FDG uptake at RAIT than RVOs. The findings suggest that metabolic changes at AIT may be related to different patterns of violent offending in patients with schizophrenia.

Elderly offenders in a maximum security mental hospital

Elderly offenders aged 60 and above constitute less than 8% of the population in a maximum security mental hospital, These offenders fall into 2 groups: 1) first admission at or after the age of 50 and 2) first admission before 50, Fewer first time offenders committed homicide in the first group than those in the second group, Neuropsychiatric disturbance and sex offending was common among male first time offenders in the first group; in contrast, schizophrenia and violent offending against persons was found more often in the second group, It is argued that elderly first time offenders should be given adequate neuropsychiatric assessment.

Petechial haemorrhage following a partial seizure with secondary generalization: atypical presentation and differential diagnosis

A case is reported of a patient who had a respiratory arrest on a high dependency ward in a High Security Hospital with an unusual presentation. The patient had head and upper abdominal petechial haemorrhages with extensive conjunctival haemorrhaging. A considered antecedent for this potentially life-threatening presentation was strangulation. Analysis of all the available clinical information supports the hypothesis that he had a single tonic-clonic seizure with a focal-motor onset. This constitutes an unusual consequence of a partial seizure with secondary generalization.

Violence ratings of female patients in broadmoor hospital

Abstract A study is described which characterised the female population of Broadmoor Special Hospital on a scale (Robertson et al., 1987) which rates violence associated with the index offence and previous episodes of violence both in terms of prosecuted violence and unprosecuted incidents. This scale has been applied recently to the male population of Broadmoor (Wong et al., 1993). The findings here confirm the notion that the female population of a Special Hospital are less violent than the males in terms of rating of violence associated with the index offence and in previous convictions for violent offending. The females contain a larger proportion of patients convicted of the offence of Arson (index offence) and patients transferred from other hospitals because of being unmanageable in these settings (under Section 3 of the Mental Health Act). Extreme ratings of violence amongst the females is associated with a diagnosis of personality disorder rather than schizophrenia or psychosis.

PET and MEG imaging of the CNV

Mental imagery has been investigated mainly in the visual modality. However, imagery is practicable also in other sensory modalities, e.g. as acoustic or tactile sensations. In the present study, ten healthy subjects created mental pictures, sounds or tactile sensations based on words presented on a computer screen. Twenty-one channel (10-20 system, bandpass 0.3-70 Hz, A/D-rate 256 Hz) EEG-recordings were obtained. After careful artifact rejection, off-line averaging and a space-oriented segmentation of the evoked potentials was performed. Within the time interval from 250 to 450 ms post-stimulus, six topographically stable segments were found. In all segments, the orientation of the brain electrical fields differed significantly for the three imagery modalities (ANOVA, P < 0.05). In post-hoc tests, the posterior centroids of the first segment differed between visual/tactile and visual/acoustic (P < 0.02), and between acoustic/tactile ( P = 0.07). The results support the hypothesis that mental imagery in different sensory modalities involves topographically distinct neuronal cell ensembles. Normal planum temporale asymmetry in familial schizophrenia: a volumetric MRI study S. Frangou a, T. Sharma a, P. Barta b, G. Pearlson b, R.M. Murray a aDepartment of Psychological Medicine, Institute of Psychiatry, London, UK. bDepartment of Psychiatry and Behavioral Sciences, John Hopkins University, Baltimore, USA