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van de Vorst M, Martier J, Linkels H, Matroos GE, Hoek HW, Vinkers DJ. The validity of the BDHI translated into Papiamento in pre-trial defendants in Curaçao. Int J Law Psychiatry 2023; 88:101890. [PMID: 37119565 DOI: 10.1016/j.ijlp.2023.101890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/01/2023] [Accepted: 04/15/2023] [Indexed: 06/01/2023]
Abstract
The Buss-Durkee Hostility Inventory (BDHI) is an important assessment scale of hostility in forensic psychiatry. We analyzed the validity and reliability of a Papiamento translation of the BDHI in 134 pre-trial defendants in Curaçao using Exploratory Structural Equation Modeling (ESEM). The reliability of the Direct and Indirect Hostility BHDI-P subscales were good and the reliability of the Social Desirability poor. There was a negative correlation between Direct Hostility and Agreeableness and a positive correlation between Indirect Hostility and Anxiety. We conclude that the BDHI-P has an acceptable measurement quality when used in defendants.
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Affiliation(s)
| | | | | | | | - H Wijbrand Hoek
- Parnassia Psychiatric Institute, The Hague, the Netherlands; University of Groningen, University Medical Center Groningen, the Netherlands; Columbia University, School of Public Health, New York, USA
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van de Vorst M, Heijtel FGM, Matroos GM, Vinkers DJ. Psychometric characteristics of the Dutch Personality Assessment Scale in Papiamento-speaking prisoners. Crim Behav Ment Health 2022; 32:279-283. [PMID: 35751847 DOI: 10.1002/cbm.2253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although personality disorders are common among offenders, there is no validated translated questionnaire for the assessment of personality disorders in Papiamento, a Portuguese-Spanish influenced creole language, which is widely spoken on the former Dutch Antilles. AIM To evaluate the Dutch Personality Scale as translated into Papiamento in the prison of Bonaire. METHODS The Dutch Personality Assessment Scale was translated into Papiamento by two independent experts and retranslated back into Dutch by two other fully bilingual and independent experts. Twenty-four Papiamento-speaking prisoners agreed to participate in the study. RESULTS There was good agreement on translation of the assessment items. The prisoner participants reported no difficulties in answering the questions. The internal consistency was acceptable for the seven subscales except for 'egoism' (α 0.21) and very good for 'inadequacy' and 'social inadequacy' (0.88 and 0.82 respectively). The scores of neuroticism, rigidity, egoism and dominance were higher than in the general Dutch population. CONCLUSION Translation of the Dutch Personality Scale into the creole language Papiamento proved feasible. The cross-cultural translation and validation of personality assessment scales may be helpful in assessment of personality disorders in offenders speaking creole languages.
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Vinkers DJ, Van de Vorst M, Hoek HW, Van Os J. Social Defeat, Psychotic Symptoms, and Crime in Young Caribbean Immigrants to Rotterdam. Front Psychiatry 2021; 12:498096. [PMID: 33897475 PMCID: PMC8058196 DOI: 10.3389/fpsyt.2021.498096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 02/22/2021] [Indexed: 11/29/2022] Open
Abstract
Background: The negative experience of being excluded from the majority group (social defeat) may be associated with psychosis in immigrants. The social defeat hypothesis is supported by the high frequency of perceived discrimination and acculturation problems in psychotic immigrants. In addition, social defeat may lead to crime through social problems such as unemployment, school dropout, a broken family structure, or psychotic symptoms. Methods: We assessed the association between social defeat and acculturation on the one hand and broadly defined psychotic symptoms and crime on the other in Caribbean immigrants to Rotterdam who are aged 18-24 years. The municipality of Rotterdam provided data about Caribbean immigrants to Rotterdam. Acculturation, social defeat (perceived discrimination, sense of control, and evaluation of self and others), psychotic symptoms, and crime were assessed using online questionnaires. Results: Social defeat was associated with psychotic symptoms in women (β = 0.614, p < 0.001). This relation applied particularly to the negative self-perception domain of social defeat. Acculturation was associated with neither social defeat nor psychotic symptoms or crime and did not mediate the association between social defeat and psychosis. Conclusion: The social defeat hypothesis of psychosis may be gender-specific valid but does not extend to crime.
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Affiliation(s)
- David J Vinkers
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | | | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, Netherlands.,Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.,Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Jim Van Os
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Koopmans AB, Vinkers DJ, Hoek HW, van Harten PN. [CYP2D6 and CYP2C19 genotyping: effectivity in psychiatric practice]. Tijdschr Psychiatr 2021; 63:570-577. [PMID: 34523710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND International guidelines recommend in patients with an in- or decreased CYP2D6 and CYP2C19 metabolism to adjust the dose of medication metabolized by these enzymes. This is in purpose to increase effectiveness and to lower the risk of side-effects of this medication. However, it is still unclear if dose adjustment based on genotype results in better clinical outcomes. AIM To provide an update regarding CYP2D6 and CYP2C19 genotyping in psychiatry in relation to ethnic diversity.To provide an update regarding CYP2D6 and CYP2C19 genotyping in psychiatry in relation to ethnic diversity. METHOD We conducted a comprehensive meta-analysis to the prevalence of non-normal metabolizers as the equivalent of the sum-prevalence of poor, intermediate and ultrarapid metabolizer CYP2D6 and CYP2C19 predicted phenotypes. For the prevalence and effectiveness study, a total of 166 Antilleans living in the Netherlands and 269 psychiatric patients (on the island Curaçao) were genotyped for CYP2D6 and CYP2C19. Of the psychiatric patients, 45 non-normal CYP2D6 metabolizers using medication metabolized by CYP2D6, were included for dose adjustment and were matched with 41 normal metabolizers. All 45 patients were using antipsychotic medication for a minimum of two years. Four months after dose adjustment they were reassessed. RESULTS The mean total probability estimates of having a non-normal predicted phenotype worldwide were 36% and 62% for CYP2D6 and CYP2C19, respectively. There was a large interethnic variability (min-max 2.7-61.2% (CYP2D6) and minmax 31.7-80.1% (CYP2C19)). No significant difference was found in the phenotypes of psychiatric patients, Dutch Caribbean subjects from the general population, and European populations. There were no beneficial effects of dose adjustments to phenotype in the non-normal CYP2D6 metabolizers. CONCLUSION More than 75% of the world population has a non-normal CYP2D6 and/or CYP2C19 phenotype. Dose adjustment to the CYP2D6 phenotype according to international guidelines in patients on long-term antipsychotic treatment showed no beneficial effect. Further research to CYP genotyping in psychiatry is warranted.
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Koopmans AB, van Hoeken D, Clarke DE, Vinkers DJ, van Harten PN, Hoek HW. Proxy WHO Disability Assessment Schedule 2.0 Is Clinically Useful for Assessing Psychosocial Functioning in Severe Mental Illness. Front Psychiatry 2020; 11:303. [PMID: 32351419 PMCID: PMC7174765 DOI: 10.3389/fpsyt.2020.00303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/26/2020] [Indexed: 11/17/2022] Open
Abstract
AIMS This study explores how well the World Health Organization Disability Assessment Schedule (WHODAS 2.0) assesses problems with psychosocial functioning in patients with severe mental illness (SMI). Further, we assessed the relationships between psychosocial functioning and psychopathology, medication side effects, treatment setting, and quality of life. METHODS We performed an observational, cross-sectional study on the island of Curaçao to assess psychosocial functioning in 77 patients with SMI; they mainly had psychotic disorders. We interviewed their healthcare providers using the proxy version of the WHODAS 2.0. In addition, patients were examined for psychiatric symptoms, medication side effects (including drug-induced movement disorders), and quality of life. Associations were examined with Spearman's rank correlation (ρ). RESULTS Difficulties in psychosocial functioning were reported by patients with SMI in the WHODAS 2.0 domains of understanding and communicating [mean (M)=34.5, standard deviation (SD)=18.6), participation in society (M=25.5, SD=15.6), and getting along with people (M=24.1, SD=16.1)]. Notably, outpatients had more problems participating in society than inpatients (M=33.6, SD=18.5 versus M=23.2, SD=14.1, p=0.03). A positive correlation was observed between drug-induced parkinsonism and the WHODAS 2.0 total score (ρ =0.30; p=0.02), as well as with various subscales, getting around, and household activities. CONCLUSION The proxy version of the WHODAS 2.0 is clinically useful for patients with severe mental illness. The highest scores on the WHODAS 2.0 were found in domains related to interactions with other people and to participation in society. Inpatient status appeared to aid participation in society; this might be due to living in the sheltered clinic environment and its associated daily activities. We further found that drug-induced parkinsonism was associated with a broad spectrum of psychosocial disabilities. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT02713672; retrospectively registered in February 2016.
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Affiliation(s)
- Anne B Koopmans
- Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Daphne van Hoeken
- Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands
| | - Diana E Clarke
- Division of Research, American Psychiatric Association, Arlington, VA, United States.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - David J Vinkers
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Peter N van Harten
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands.,Innova, Psychiatric Centre GGz Centraal, Amersfoort, Netherlands
| | - Hans W Hoek
- Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands.,Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
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Koopmans AB, Vinkers DJ, Poulina IT, Gelan PJA, van Schaik RHN, Hoek HW, van Harten PN. No Effect of Dose Adjustment to the CYP2D6 Genotype in Patients With Severe Mental Illness. Front Psychiatry 2018; 9:349. [PMID: 30131727 PMCID: PMC6090167 DOI: 10.3389/fpsyt.2018.00349] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/10/2018] [Indexed: 12/12/2022] Open
Abstract
Background: The CYP2D6 enzyme is involved in the metabolism of numerous psychopharmacological drugs. Guidelines recommend how to adjust the dose of medication based on the CYP2D6 genotype. Aims: To evaluate the effect of dose adjustment to the CYP2D6 genotype and phenotype, in patients with severe mental illness (SMI) already receiving psychopharmacological treatment. Methods: A total of 269 psychiatric patients (on the island Curaçao) receiving antipsychotic treatment were genotyped for CYP2D6. Of these, 45 patients were included for dose adjustment according to the clinical guideline of the Royal Dutch Association for the Advancement of Pharmacy, i.e., 17 CYP2D6 poor metabolizers, 26 intermediate metabolizers, and 2 ultrarapid metabolizers. These 45 patients were matched for age, gender, and type of medication with a control group of 41 patients who were CYP2D6 extensive metabolizers (i.e., with a normal CYP2D6 function). At baseline and at 4 months after dose adjustment, subjective experience, psychopathology, extrapyramidal side-effects, quality of life, and global functioning were assessed in these two groups. Results: At baseline, there were no differences between the groups regarding the prescribed dosage of antipsychotics, the number of side-effects, psychiatric symptoms, global functioning, or quality of life. After dose adjustment, no significant improvement in these parameters was reported. Conclusion: In psychiatric patients with SMI already receiving antipsychotic treatment, dose adjustment to the CYP2D6 genotype or phenotype according to the guidelines showed no beneficial effect. This suggests that dose adjustment guidelines are currently not applicable for patients already using antipsychotics. ClinicalTrials.gov: Cost-effectiveness of CYP2D6 and CYP2C19 Genotyping in Psychiatric Patients in Curacao; Identifier: NCT02713672; https://clinicaltrials.gov/ct2/show/NCT02713672?term=CYP2D6&rank=5.
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Affiliation(s)
- Anne B Koopmans
- Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands.,School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - David J Vinkers
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Igmar T Poulina
- Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands
| | | | - Ron H N van Schaik
- Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Hans W Hoek
- Parnassia Academy, Parnassia Psychiatric Institute, The Hague, Netherlands.,Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Peter N van Harten
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands.,Innova, Psychiatric Centre GGz Centraal, Amersfoort, Netherlands
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Koopmans AB, Vinkers DJ, Gelan PJ, Hoek HW, van Harten PN. CYP2D6 and CYP2C19 genotyping in psychiatric patients on psychotropic medication in the former Dutch Antilles. Pharmacogenomics 2017. [PMID: 28639468 DOI: 10.2217/pgs-2017-0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM This study was aimed to asses the prevalence of CYP2D6 and CYP2C19 polymorphisms in psychiatric patients and in volunteers from Dutch caribbean origin. METHODS In total, 435 individuals were genotyped for CYP2D6 and CYP2C19. Of these, 269 were psychiatric patients on psychotropic medication, living in Curaçao and 166 were volunteers from the Dutch Caribbean population. RESULTS No differences in prevalence of alleles were found. CONCLUSION Although prevalence of alleles appeared to be very different from African and Caucasian populations, the distribution into predicted phenotypes shows an equal distribution as in Caucasians.
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Affiliation(s)
- Anne B Koopmans
- Parnassia Psychiatric Institute, Department of Research, The Hague, The Netherlands.,University of Maastricht, School for Mental Health and Neuroscience, The Netherlands
| | - David J Vinkers
- University of Maastricht, School for Mental Health and Neuroscience, The Netherlands
| | | | - Hans W Hoek
- Parnassia Psychiatric Institute, Department of Research, The Hague, The Netherlands.,University Medical Center Groningen, University of Groningen, The Netherlands.,Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Peter N van Harten
- University of Maastricht, School for Mental Health and Neuroscience, The Netherlands.,Psychiatric Centre GGz Centraal, Innova, Research Department, Amersfoort, The Netherlands
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van de Vorst M, Vinkers DJ, Matroos GE, Heijtel F, Hoek HW. [Validation of tools for assessing the intelligence and the functional impairment of Papiamento speaking suspects]. Tijdschr Psychiatr 2016; 58:785-793. [PMID: 27868173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Although Antillean suspects in the Netherlands are often diagnosed as being intellectually impaired, there are no validated tests available Papiamento (the native language) for assessing intelligence or functional impairment. AIM To validate the use of the GIT 2 (Groninger Intelligentie Test 2) and the Barkley Functioning Impairment Scale (BFIS) for Antillean defendants detained by the Judicial Service of the Caribbean Netherlands in Bonaire. METHOD With the approval of the publishers, the GIT 2 and the BFIS were translated in Papiamento by two independent experts. The two translations were then re-translated into Dutch by two other independent experts. Defendants with both parents born in Bonaire who had been detained for at least 18 days by the Judicial Detention Centre of the Caribbean Netherlands (JICN) in Bonaire during the period 1 January 2013 until 1 July 2014 were examined with both tests. RESULTS The Papiamento GIT 2 and BFIS tests were taken by 23 Bonairian defendants who had been detained in the JICN in Bonaire. The internal consistency and inter-item correlation of the tests were found to be satisfactory. The IQ of 95% of the participants was reproduced as a score between 79.2 and 96.8 points. In the BFIS the question about self-care was a particularly sensitive item. The use of drugs was associated with increased functional impairment. CONCLUSION This study seems to be a promising first step towards the validation of the GIT 2 and the BFIS. Apparently, it has now become acceptable to use written Papiamento in assessment tools.
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Vinkers DJ, Bogaerts S, Van Schaik RH. MAOA, COMT and 5-HTTLPR frequencies in convicted and never convicted Afro-Caribbeans in the Netherlands. Crim Behav Ment Health 2014; 24:365-367. [PMID: 25510658 DOI: 10.1002/cbm.1908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 02/25/2014] [Indexed: 06/04/2023]
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Vinkers DJ, Selten JP, Hoek HW, Rinne T. Psychotic disorders are more common in ethnic minority than in Dutch native defendants. Soc Psychiatry Psychiatr Epidemiol 2013; 48:1399-404. [PMID: 23543339 DOI: 10.1007/s00127-012-0629-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 11/19/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The prevalence of psychotic disorders among prisoners from racial or ethnic minority groups remains uncertain. We therefore compared the frequency of psychotic disorder in ethnic minority and Dutch native defendants using the nationwide database of elaborate pre-trial reports. METHODS Analysis of a nationwide database of pre-trial reported defendants in the Netherlands between 2000 and 2006 (n = 12,752). RESULTS A diagnosis of a psychotic disorder was more common in ethnic minority than in Dutch native defendants (21.1 vs. 10.2%). The odds ratio of this diagnosis, adjusted for age, gender, IQ below 85 and abuse of cannabis or hard drugs, was 2.6 (95% CI 2.2-3.0). This odds ratio was highest for African defendants (OR = 5.2; 95% CI 3.7-7.4). CONCLUSIONS Psychotic disorders were more common among pre-trial reported defendants from ethnic minorities than among their Dutch native counterparts.
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Affiliation(s)
- David J Vinkers
- Netherlands Institute for Forensic Psychiatry and Psychology, Noordsingel 113, 3035 EM, Rotterdam, The Netherlands.
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Vinkers DJ. Pre-Trial Reported Defendants in the Netherlands with Intellectual Disability, Borderline and Normal Intellectual Functioning. J Appl Res Intellect Disabil 2013; 26:357-61. [PMID: 23925958 DOI: 10.1111/jar.12030] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/21/2013] [Indexed: 11/28/2022]
Affiliation(s)
- David J. Vinkers
- Netherlands Institute for Forensic Psychiatry and Psychology; Rotterdam Netherlands
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Liem MCA, Vinkers DJ. [Homicide committed by psychotic defendants in the Netherlands]. Tijdschr Psychiatr 2012; 54:509-516. [PMID: 22753183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Psychotic patients are 10 to 20 times more likely to commit homicide than persons in the general population. Internationally, the incidence of homicides committed by psychotic defendants is 0.02-0.36 per 100.000 inhabitants. So far, no-one has determined the nature and incidence of homicide by individuals with a psychotic disorder in the Netherlands. AIM To describe the nature and incidence of homicides committed by people with a psychotic disorder in the Netherlands in the period 2000-2006. METHOD We analysed the forensic mental health reports of all Dutch nationals suspected of committing homicide and found to be suffering from a psychotic disorder at the time of the offence. RESULTS According to the mental health reports, in the period under study 61 homicides were committed by people with a psychotic illness (8.7 annually), the average rate being 0.05 per 100,000. The majority of suspects did not have a violent criminal past and were not receiving treatment at the time of the crime. CONCLUSION Homicide committed by psychotic patients is relatively rare in the Netherlands, but it does occur. Early, continuous treatment of psychotic illness might help to prevent patients with a psychotic disorder from committing homicide.
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Affiliation(s)
- M C A Liem
- Instituut voor Strafrecht en Criminologie, Universiteit Leiden, Leiden, The Netherlands.
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Vinkers DJ, de Beurs E, Barendregt M, Rinne T, Hoek HW. The relationship between mental disorders and different types of crime. Crim Behav Ment Health 2011; 21:307-20. [PMID: 21755554 DOI: 10.1002/cbm.819] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 05/23/2011] [Accepted: 05/31/2011] [Indexed: 05/23/2023]
Abstract
BACKGROUND Previous studies of relationships between mental disorder and crime have tended to group the mental disorders, the crimes or both, leaving uncertainty about a more specific mental disorder: crime relationships. OBJECTIVE To examine the relationship between types of mental disorder and types of crime in pre-trial defendants. METHOD Data were extracted from 21,424 pre-trial forensic psychiatric reports made between 2000 and 2006 in the Netherlands. We compared the prevalence of axis I disorders, personality disorders, intellectual functioning and substance abuse in defendants charged with a range of crimes (homicide, attempted/threatened homicide, assault, battery, rape, sexual crimes, arson and/or property crimes) using chi-square tests. Relationships with diminished accountability, reflecting a direct relationship with underlying mental disorder, were calculated using multivariate regression models, adjusted for age, gender, ethnicity and history of judicial contact. RESULTS Arson had the strongest relationship with mental disorders in our sample, then assaults, then homicidal attempts or threats. Sexual and property crimes had the weakest relationship with diminished or absent accountability. Diminished accountability had the strongest relationship with psychotic disorders, followed by organic psychosyndromes and developmental disorders, whereas other axis I disorders, personality disorders or an IQ score of <85 points were only moderately related. These relationships varied little according to the type of crime, although tended to be weaker for defendants in property crimes. Cannabis and hard drugs were significantly associated with decreased accountability only in respect of arson. DISCUSSION Mental disorders are related to all types of crimes but especially to arson, battery and homicidal attempts or threats, with a court finding of diminished accountability providing some validation for perceived links between the disorder and crime in this study. IMPLICATIONS FOR PRACTICE Psychiatric assessment is likely to be the most useful for defendants under charges of arson, assault or attempted homicide, as these groups are most likely to suffer from a psychiatric disorder related to the alleged offence. Psychotic, organic and some developmental disorders appear to have the strongest relationship with diminished accountability. Findings with respect to illicit drug use are likely to have more varied implications between jurisdictions but, in the Netherlands, may sometimes be accepted as diminishing accountability in defendants of arson.
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Affiliation(s)
- David J Vinkers
- Netherlands Institute for Forensic Psychiatry and Psychology, Noordsingel 113, 3035 EM, Rotterdam, the Netherlands.
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Vinkers DJ, Duits N. Crime and mental disorders among native Dutch and ethnic minority juvenile defendants in the Netherlands. Int J Law Psychiatry 2011; 34:131-134. [PMID: 21420173 DOI: 10.1016/j.ijlp.2011.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We examined the prevalence of mental disorders and the recommendations regarding criminal responsibility and treatment in pre-trial mental health evaluations requested by Dutch juvenile courts for youths between the ages of 12 to 17. Youths of native Dutch (n=2694) and of ethnic minority background (n=1393) were compared. The prevalence of mental disorders was similar for both groups (76.8% versus 74.4%). Criminal responsibility in native Dutch youth was more often considered 'diminished' or 'strongly diminished' than in ethnic minority youth. Admission to a juvenile institution was more often recommended for ethnic minority juveniles than for native Dutch juveniles. It remains unclear from our data whether these differences reflect a false stereotype of ethnic minority populations as being more dangerous and threatening.
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Affiliation(s)
- David J Vinkers
- Netherlands Institute of Forensic Psychiatry and Psychology, The Netherlands.
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Vinkers DJ, Barendregt M, de Beurs E, Hoek HW, Rinne T. [Ethnic differences between pre-trial suspected offenders]. Tijdschr Psychiatr 2011; 53:801-811. [PMID: 22076852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Black and minority ethnic (BME) patients with a severe psychiatric disorder are compulsory admitted to psychiatric hospitals more often than Dutch native patients. AIM To describe ethnic differences with regard to (1) the prevalence of psychiatric disorders, (2) the degree to which 'suspects' are considered to be accountable for their actions and (3) recommended treatment for reported pre-trial suspects. METHOD 14,540 pre-trial reports in the Netherlands between 2000 and 2006 with a known ethnicity were assessed. Dutch native, Western, Turkish, Moroccan, Surinamese, Antillean, and other non-Western defendants were compared with chi-square tests and logistic regression models. RESULTS Psychotic and behavioural disorders were more prevalent among bme suspects, whereas all other psychiatric disorders occurred less frequently in the BME group. Compared to Dutch native suspects, BME suspects were more often deemed to be fully accountable for their actions. Antillean, Moroccan, Surinamese, and other non-Western suspects were more often recommended for compulsory admission to a psychiatric hospital or received no treatment and much less out-patient treatment. There were no ethnic differences with regard to the frequency with which suspects were recommended for compulsory admission to a penitentiary hospital or with regard to medication. CONCLUSION Compared to Dutch native suspects, BME suspects are, on one hand, more often deemed accountable for their actions but, on the other hand, are more often recommended for compulsory admission to a psychiatric hospital.
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Affiliation(s)
- D J Vinkers
- Nederlands Instituut voor Forensische Psychiatrie en Psychologie te Rotterdam.
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van der Mast RC, Vinkers DJ. [The link between vascular disease, depression and cognitive deterioration in the elderly. Has the vascular depression hypothesis proofed to be correct?]. Tijdschr Psychiatr 2011; 53:608-611. [PMID: 21898315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Vinkers DJ. [Borderline intellectual functioning in Antillean suspected offenders]. Tijdschr Psychiatr 2011; 53:9-14. [PMID: 21225574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND There is a high prevalence of borderline intellectual functioning in the pretrial reports on Antillean suspected offenders. AIM To describe the prevalence of borderline intellectual functioning and mental retardation in Antillean suspected offenders on the basis of IQ-tests applied and reports on limitations in adaptive functioning of these 'offenders'. METHOD A study was made of 249 psychological pre-trial reports of Antillean suspected offenders between 2003 and 2008 in one Dutch judicial district. RESULTS Borderline intellectual functioning was ascertained in 91 reports (36.6%) and mental retardation in 26 reports (10.4%). The prevalence of borderline intellectual functioning was lowest when the GIT-2 was used (19.7%) and highest when the WISC-III was used (47.8%). Limitations in adaptive functioning were not mentioned in any reports or questionnaires, although both these criteria are required to be met for a diagnosis of borderline intellectual functioning. CONCLUSION Pre-trial reports on Antillean suspected offenders need to state clearly whether these 'offenders' have exhibited limited adaptive functioning.
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Affiliation(s)
- D J Vinkers
- Nederlands Instituut voor Forensische Psychiatrie en Psychologie, Rotterdam.
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Vinkers DJ, de Vries SC, van Baars AWB, Mulder CL. Ethnicity and dangerousness criteria for court ordered admission to a psychiatric hospital. Soc Psychiatry Psychiatr Epidemiol 2010; 45:221-4. [PMID: 19396576 DOI: 10.1007/s00127-009-0058-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Accepted: 04/14/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Black and minority ethnic (BME) populations are disproportionately detained in psychiatric hospitals. AIM To examine the dangerousness criteria for compulsory court ordered admission to a psychiatric hospital in White and BME persons. METHOD We examined the psychiatric examinations for court ordered compulsory admissions in 506 White and 299 BME persons from October 2004 until January 2008 in Rotterdam, the Netherlands. The White and BME groups are compared using Chi-square tests and in case of significant differences with logistic regression models adjusted for age, gender, mental disorders and socio-economic background. RESULTS In BME persons, violence towards others and neglect of relatives were more often reasons to request court order admission as compared with Whites (39.8 vs. 25.3%, P < 0.001, respectively, 6.4 vs. 2.4%, P = 0.01). This remained true after adjustment for age, gender, mental disorders and socio-economic background [OR 1.56 (95% CI 1.12-2.18), P = 0.01, respectively; OR 3.08 (95% CI 1.31-7.26), P = 0.01]. The other reasons for a request of court order admission had a similar prevalence in both groups (suicide or self-harm, social decline, severe self-neglect, arousal of aggression of others, danger to the mental health of others, and the general safety of persons and goods). CONCLUSION Violence towards others and neglect of relatives are more often a reason to request court ordered admission in BME than in White persons. BME patients are more often perceived as potentially dangerous to others.
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Affiliation(s)
- D J Vinkers
- O3 Research Centre, Mental Health Care Rijnmond, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
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Vinkers DJ, van der Mast RC. [Reaction on 'apathy']. Tijdschr Psychiatr 2010; 52:675. [PMID: 20862652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- D J Vinkers
- Nederlands Instituut voor Forensische psychiatrie en psychologie, Rotterdam.
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Vinkers DJ, Heytel FGM, Matroos GM, Hermans KM, Hoek HW. [Pre-trial psychiatric reports on Antillean suspected offenders in the Netherlands and on the Dutch Antilles]. Tijdschr Psychiatr 2010; 52:745-752. [PMID: 21064017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The registered criminality among Antilleans living in the Netherlands is much higher than among Antilleans living on the Dutch Antilles (113 offences and 11 offences respectively, per year per 1000 persons, p<0.001). AIM To compare the prevalence of psychiatric disturbances among Antillean suspected offenders in the Netherlands (n=989) and on the Dutch Antilles (n=199) between 2000 and 2006. METHOD A careful study was made of pre-trial psychiatric reports on Antillean suspected offenders (referred to as suspects) in the Netherlands and of comparable reports on Antillean suspects on the Dutch Antilles. RESULTS There was no significant difference in the prevalence of mental disorders among Antillean suspects in the Netherlands (22.3%) and on the Dutch Antilles (20.3%). Abuse of drugs and cannabis was more prevalent on the Dutch Antilles where treatment for addiction is less frequently available than in the Netherlands. Mental retardation was ascertained more often among Antilleans in the Netherlands (22.4%) than among Antilleans on the Dutch Antilles (15.1%). Antillean suspects on the Dutch Antilles were more often found to be fully responsible for their actions than were Antillean suspects in the Netherlands (65.3% versus 19.1%, p<0.001) There was no significant difference in the frequency of ‘strongly diminished responsibility' and ‘a total lack of responsibility'. CONCLUSION On the basis of the pre-trail assessments there seems to be little difference in the prevalence of mental disorders in Antillean suspects in the Netherlands and on the Dutch Antilles.
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Affiliation(s)
- D J Vinkers
- Nederlands Instituut voor Forensische Psychaitrie en Psychologie te Rotterdam.
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Vinkers DJ. [Reaction on 'Explaining symptoms: body-object and body-subject']. Tijdschr Psychiatr 2009; 51:270-271. [PMID: 19434582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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van der Mast RC, Vinkers DJ, Stek ML, Bek MC, Westendorp RGJ, Gussekloo J, de Craen AJM. Vascular disease and apathy in old age. The Leiden 85-Plus Study. Int J Geriatr Psychiatry 2008; 23:266-71. [PMID: 17621380 DOI: 10.1002/gps.1872] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Apathy is defined as an important loss of motivation in all domains of daily functioning. Especially in old age, apathy might be a specific neuropsychiatric syndrome separate from depression. There are indications that apathy in elderly subjects is related to vascular disease. OBJECTIVE To assess the relation between vascular disease and apathy in subjects aged 85 years and older. METHODS The Leiden 85-plus Study is a prospective, population-based study of 500 elderly subjects. Vascular disease including myocardial infarction, angina pectoris or myocardial ischemia, claudicatio intermittens, and arterial surgery was determined at baseline. Symptoms of apathy were assessed annually from age 85 through 90 years using the apathy questions of the 15-item Geriatric Depression Rating Scale (GDS). Diagnostic accuracy of the apathy questions was validated using the Apathy Scale at age 90 years. The association between vascular disease and apathy was estimated both at baseline and longitudinally. RESULTS The apathy items of the GDS showed a sensitivity of 69% and a specificity of 85%. At baseline, 69 subjects with apathy but free of depression had significantly more cardiovascular pathologies compared to 287 subjects without apathy. In the 287 subjects who were free of apathy and depression, increase of apathy but not depression during follow-up was significantly higher for each additional cardiovascular pathology at baseline. CONCLUSION In community dwelling elderly, those with vascular disease were at higher risk of developing apathy but not depression. This suggests that apathy and depression in old age have different etiologies.
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Affiliation(s)
- R C van der Mast
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands.
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Vinkers DJ. [Reaction to 'The syndrome of Cotard: an overview']. Tijdschr Psychiatr 2008; 50:391-392. [PMID: 18548419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Vinkers DJ, van Rood YR, van der Wee NJA. [Prevalence and comorbidity of body dysmorphic disorder in psychiatric outpatients]. Tijdschr Psychiatr 2008; 50:559-565. [PMID: 18785103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is a somatoform disorder, characterized by a patient's preoccupation with the belief that some aspect of his/her physical appearance is abnormal. The prevalence of BDD in the general population is 0.7 - 1.7%. The prevalence of BDD in patients attending a Dutch general outpatient clinic has never been examined. AIM Examine the prevalence of BDD in patients attending a Dutch general outpatient clinic. METHOD All patients aged 18 to 65 who were referred between September 2003 and July 2007 to six general outpatients clinics for treatment of a depressive disorder, an anxiety disorder, or a somatoform disorder were assessed with the Mini International Neuropsychiatric Interview (mini). Patients with BDD were also assessed by means of the Body Dysmorphic Disorder - Yale- Brown Obsessive Compulsive Scale (BDD-YBOCS). results BDD was diagnosed in 45 out of 5848 patients (0.8% (0.6-1.0%)). The average age of these patients was 31.1. years and 69% were female. A comorbid depressive disorder was present in 35 patients (78%) and a comorbid anxiety disorder in 26 patients (58%). Of the anxiety disorders, social phobia was the most common, with a prevalence of 27%. The average score on the BDD-YBOCS was 22.5 points. The BDD-YBOCS score was significantly higher in patients with a comorbid obsessive-compulsive disorder (35.7 points; p = 0.01). CONCLUSION The prevalence of BDD in psychiatric outpatients who were referred for treatment of a depressive disorder, an anxiety disorder, or a somatoform disorder was 0.8%. There was a high comorbidity of BDD with depressive and anxiety disorders.
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Affiliation(s)
- D J Vinkers
- LUMC, afdeling Psychiatrie, Postbus 9600, 2300 RC Leiden.
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Vinkers DJ, van der Wee NJA. [Topiramate augmentation in treatment-resistant obsessive-compulsive disorder]. Tijdschr Psychiatr 2008; 50:747-750. [PMID: 18991236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A 45-year-old patient with a medication-resistant obsessive-compulsive disorder was treated successfully by topiramate augmentation. Obsessive-compulsive disorder is associated neurobiologically with overactivation of the cortico-striato-thalamo-cortical circuit. Because the neurotransmitter glutamate plays an important role in this circuit, medication that has glutamate antagonism, such as the antiepileptic drug topiramate, may reduce the symptoms of obsessive-compulsive disorder. Further study is needed to find out whether topiramate augmentation is more effective than placebos in patients with a medication-resistant obsessive-compulsive disorder.
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Affiliation(s)
- D J Vinkers
- Leids Universitair Medisch Centrum, afdeling Psychiatrie, Postbus 9600, 2300 RC Leiden.
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Vinkers DJ, van der Lubbe N, de Reus R, de Ruiter GCW, Pondaag W. [A 67-year-old woman who mistook her daughter for a double: differential diagnosis of misidentification delusion]. Ned Tijdschr Geneeskd 2007; 151:2841-2844. [PMID: 18237054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A 67-year-old woman developed a misidentification delusion after a right-sided frontally located recurrent convexity meningioma was removed by surgery. After antipsychotic therapy had been established, the patient recovered and the delusions disappeared within a few weeks. A misidentification delusion is a fixed, false beliefabout the identity ofa person, an object, a place, or the time. In the differential diagnosis, psychiatric diseases and neurological diseases are prominent. Patients with a psychiatric disease are usually younger than 40 years, often have a psychiatric history, and usually have other psychotic symptoms like paranoid delusions and hallucinations. Brain tumours and temporal lobectomy have previously been described as a neurological cause of a misidentification delusion; the surgical removal ofa meningioma as such has not been previously described. In patients with a misidentification delusion, the connection between the perception of an identity and its accompanying emotions and memories is disturbed. This connection primarily takes place in the right side of the brain, which is in accordance with the location ofthe removed meningioma in the described patient.
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Affiliation(s)
- D J Vinkers
- Rivierduinen, GGZ Leiden en omstreken, afd. Ouderen, Leiden.
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Vinkers DJ, Welschen YP, Keijzers AS, van der Mast RC. [Differential diagnosis of the Ganser syndrome. A case study]. Tijdschr Psychiatr 2007; 49:339-42. [PMID: 17492585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
According to the classical definition, someone with the Ganser syndrome gives 'approximate' answers, i.e. answers that are beside the point, has lowered consciousness, displays somatic conversion symptoms and suffers from pseudo-hallucinations. On the basis of the case of an 80-year-old female patient who gave approximate answers and by means of a systematic review of the literature, we give the differential diagnosis of the Ganser syndrome. The causes seem to be largely organic.
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Affiliation(s)
- D J Vinkers
- Leids Universitair Medisch Centrum te Leiden, The Netherlands.
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Vinkers DJ, van der Mast RC, Stek ML, Westendorp RGJ, Gussekloo J. [The relationship between atherosclerosis, cognitive impairment, and depression in old age]. Ned Tijdschr Geneeskd 2006; 150:2307-11. [PMID: 17089547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
It has been suggested in the literature that atherosclerosis is a common causal pathway of cognitive impairment and late-onset depression, which may explain their co-occurrence in old age. In both the 'Leiden 85-plus Study' and the literature, strong evidence is found for a causal relationship between atherosclerosis and cognitive impairment, but there is less evidence for a causal relationship between atherosclerosis and late-onset depression. In the 'Leiden 85-plus Study', cognitive impairment was a risk factor for the development of late-onset depression, but depression in old age did not predict cognitive decline. This means that the prevention of atherosclerosis might prevent cognitive impairment and hence late-onset depression in old age.
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van Bemmel T, Vinkers DJ, Macfarlane PW, Gussekloo J, Westendorp RGJ. Markers of autonomic tone on a standard ECG are predictive of mortality in old age. Int J Cardiol 2006; 107:36-41. [PMID: 16337495 DOI: 10.1016/j.ijcard.2005.02.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2004] [Revised: 02/10/2005] [Accepted: 02/15/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND To investigate markers of autonomic tone on a standard electrocardiogram in relation to mortality in old age. METHODS A total of 599 inhabitants of Leiden, the Netherlands, were enrolled in a population-based follow-up study at their 85th birthday. Electrocardiograms (ECGs) were taken on entry and annually thereafter. ECGs were analysed automatically to determine four markers of autonomic tone, i.e. heart rate, the occurrence of ventricular extrasystoles and two time domain measures of heart rate variability. All participants were followed up for mortality. RESULTS Participants with a heart rate in the highest quartile had a 1.8-fold increased total mortality risk (95% confidence interval (CI) 1.0-3.4), but not an increased cardiovascular mortality risk. The occurrence of at least one ventricular extrasystole was related with a 2.3-fold increased total mortality risk (95% CI 1.3-3.9) and a 3.6-fold increased cardiovascular mortality (95% CI 1.6-8.2). In stratified analyses, the prognostic effect was confined to males. Both measures of heart rate variability were not related to mortality. CONCLUSION High heart rate and the occurrence of a ventricular extrasystole, both markers of sympathetic dominance, were predictive of mortality in old age. Two short-term measures of heart rate variability as measured on a standard 10-s ECG were not related to mortality, and hence may not reflect autonomic tone in old age.
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Affiliation(s)
- Thomas van Bemmel
- Section of Gerontology and Geriatrics, Department of Internal Medicine, C1-R, Leiden University Medical Center, Leiden, The Netherlands.
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Stek ML, Vinkers DJ, Gussekloo J, van der Mast RC, Beekman ATF, Westendorp RGJ. Natural history of depression in the oldest old: population-based prospective study. Br J Psychiatry 2006; 188:65-9. [PMID: 16388072 DOI: 10.1192/bjp.188.1.65] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Despite its negative consequences, little is known about the natural history of depression in the oldest old. AIMS To study the incidence, course and predictors of depression in the general population of the oldest old. METHOD The Leiden 85-plus Study is a prospective population-based study of 500 people from their 85th to their 89th birthdays. Depressive symptoms were annually assessed with the 15-item Geriatric Depression Scale, using a cut-off of 4 points. RESULTS During a mean follow-up of 3.9 years, the annual risk for the emergence of depression was 6.8%. Poor daily functioning and institutionalisation predicted depression. Among the 77 participants with depression at baseline (prevalence 15%) the annual remission rate was ony 14%. In more than half of the participants with a remission of depression, we observed a relapse of depression during follow-up. No predictors of remission could be identified. CONCLUSIONS Among the oldest old, depression is frequent and highly persistent. More active case-finding and treatment would be potentially rewarding.
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Affiliation(s)
- Max L Stek
- Leiden University Medical Centre, Section of Gerontology and Geriatrics, C2-R, PO Box 9600, 2300 RC Leiden, The Netherlands.
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Vinkers DJ, Stek ML, van der Mast RC, de Craen AJM, Le Cessie S, Jolles J, Westendorp RGJ, Gussekloo J. Generalized atherosclerosis, cognitive decline, and depressive symptoms in old age. Neurology 2005; 65:107-12. [PMID: 16009894 DOI: 10.1212/01.wnl.0000167544.54228.95] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Atherosclerosis may be linked to cognitive decline and depression in old age. METHODS The Leiden 85-Plus Study is a prospective population-based study of 599 subjects from age 85 onward. The generalized atherosclerotic burden was rated by the number of cardiovascular pathologies at baseline, as assessed by history taking from treating physicians and EKG. Cardiovascular pathologies included myocardial infarction, angina pectoris or myocardial ischemia, claudicatio intermittens, and arterial surgery. Global cognitive function (Mini-Mental State Examination), attention (Stroop Test), processing speed (Letter Digit Coding Test), immediate recall memory (Word Learning Test-Immediate Recall), delayed recall memory (Word Learning Test-Delayed Recall), and depressive symptoms (15-item Geriatric Depression Scale) were assessed each year from ages 85 through 90. The prospective associations between both the generalized atherosclerosis rating and stroke with cognitive function and depressive symptoms were analyzed by linear mixed models adjusted for sex and level of education. RESULTS During follow-up, there was a significant cognitive decline and a significant increase of depressive symptoms. At baseline, a history of stroke was correlated with lower global cognitive function, slower processing speed, impaired immediate and delayed recall memory, and more depressive symptoms. In addition, a higher generalized atherosclerosis rating was correlated with impaired global cognitive function, lower attention, and a slower processing speed at baseline. During follow-up, a higher generalized atherosclerosis rating was associated with an accelerated decline of immediate recall memory and delayed recall memory. In contrast, there was no relation between the generalized atherosclerosis rating and depressive symptoms, either in the cross-sectional analysis or in the prospective analysis. CONCLUSION In the population at large, generalized atherosclerosis contributes to cognitive decline in old age but not to depression.
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Affiliation(s)
- D J Vinkers
- Department of Gerontology and Geriatrics, Leiden University Medical Center, C2-R, PO Box 9600, 2300 RC Leiden, The Netherlands.
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Vinkers DJ, Gussekloo J, Stek ML, van der Mast RC, Westendorp RGJ. Does Depression Specifically Increase Cardiovascular Mortality? ACTA ACUST UNITED AC 2005; 165:119; author reply 119-20. [PMID: 15642890 DOI: 10.1001/archinte.165.1.119-a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Abstract
OBJECTIVE The impact of depression and perceived loneliness in the oldest old is largely unknown. The authors studied the relationship between the presence of depressive symptoms and all-cause mortality in old age, especially the potential distorting effect of perceived loneliness. METHOD Within a prospective population-based study of 85-year-olds, the 15-item Geriatric Depression Scale and the Loneliness Scale were annually applied in all 476 participants with a Mini-Mental State Examination score of 18 points or more. RESULTS Depression was present in 23% and associated with marital state, institutionalization, and perceived loneliness. When depression and perceived loneliness were assessed during follow-up, neither depression nor perceived loneliness had a significant effect on mortality. However, those who suffered from both depression and feelings of loneliness had a 2.1 times higher mortality risk. CONCLUSIONS The data suggest that the increased mortality risk attributable to depression in the presence of perceived loneliness may result from motivational depletion.
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Affiliation(s)
- Max L Stek
- Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, The Netherlands.
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Abstract
OBJECTIVE To examine the temporal relation between depression and cognitive impairment in old age. DESIGN Prospective, population based study with four years of follow up. SETTING City of Leiden, the Netherlands. PARTICIPANTS 500 people aged 85 years at recruitment. MAIN OUTCOME MEASURES Annual assessments of depressive symptoms (15 item geriatric depression scale), global cognitive function (mini-mental state examination), attention (Stroop test), processing speed (letter digit coding test), and immediate and delayed recall (12 word learning test). RESULTS At 85 years old, participants' depressive symptoms and cognitive impairment were highly significantly correlated (P < 0.001). During follow up, an accelerated annual increase of depressive symptoms was associated with impaired attention (0.08 points (95% confidence interval 0.01 to 0.16)), immediate recall (0.17 points (0.09 to 0.25)), and delayed recall (0.10 points (0.02 to 0.18)) at baseline. In contrast, depressive symptoms at baseline were not related to an accelerated cognitive decline during follow up (P > 0.05). CONCLUSION Caregivers should be aware of the development of depressive symptoms when cognitive impairment is present. However, the presence of depression only does not increase the risk of cognitive decline.
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Affiliation(s)
- David J Vinkers
- Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, Netherlands
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Vinkers DJ, Stek ML, Gussekloo J, Van Der Mast RC, Westendorp RGJ. Does depression in old age increase only cardiovascular mortality? The Leiden 85-plus Study. Int J Geriatr Psychiatry 2004; 19:852-7. [PMID: 15352142 DOI: 10.1002/gps.1169] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Depression in old age is associated with an increased mortality risk of cardiovascular disease but the mortality risk from non-cardiovascular causes is disputed. OBJECTIVE To investigate the effect of depression on cardiovascular and non-cardiovascular mortality in old age. METHODS We prospectively followed 500 subjects from age 85 years onwards within the population-based Leiden 85-plus Study. Depressive symptoms were assessed annually with the 15-item Geriatric Depression Scale (GDS-15). Mortality risks were estimated in a Cox proportional-hazards model with the annual assessment of depression (GDS-15> or =4 points) as a time-dependent covariate. RESULTS During 1654 person-years of follow-up (mean per person, 3.2 years), depression was associated with a two-fold increase of all cause mortality [Relative Risk (RR), 1.83; 95% Confidence Interval (CI), 1.24-2.69] that was not explained by comorbid conditions. Both cardiovascular mortality and non-cardiovascular mortality contributed equally to the excess mortality (RR 1.95 and 1.75 respectively). CONCLUSION Depression in old age contributes to an increase of both cardiovascular and non-cardiovascular mortality. Motivational depletion may play an important role in the increased mortality in elderly with depression.
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Affiliation(s)
- David J Vinkers
- Department of General Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
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Vinkers DJ, Gussekloo J, Stek ML, Westendorp RGJ, Van Der Mast RC. The 15-item Geriatric Depression Scale (GDS-15) detects changes in depressive symptoms after a major negative life event. The Leiden 85-plus Study. Int J Geriatr Psychiatry 2004; 19:80-4. [PMID: 14716703 DOI: 10.1002/gps.1043] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The 15-item Geriatric Depression Scale (GDS-15) is a widely used screening instrument for depressive symptoms in the elderly, but its ability to detect alterations in depressive symptoms over time has not been established. OBJECTIVE To assess the change of the GDS-15 score after a major negative life event. METHODS Within the Leiden 85-plus Study, we prospectively followed a population-based cohort of 599 subjects from 85 years onwards. The GDS-15 was applied annually to participants with a Mini-Mental State Examination (MMSE) score above 18 points. The change in GDS-15 score of 32 subjects who had lost their partner during follow-up was compared with a control group of 32 subjects who had not lost their partner, matched for age, sex, and initial GDS-15 score. RESULTS At baseline, 241 subjects lived together with a partner. During a mean follow-up of 3.2 years, 55 participants (23%) lost their partner. Of those, 32 subjects completed the GDS-15 before and after the loss of their partner. All subjects reported the bereavement to be a major negative life event. The mean increase of the GDS-15 score after the death of a partner was 1.2 points (paired t-test, p = 0.013). This was significantly higher than the mean change of -0.06 points in the matched control group (independent t-test, p = 0.032), and independent of sex, level of education, pre-bereavement GDS-15 score, and time period since the loss of a partner. CONCLUSION This study shows that the GDS-15 detects change in depressive symptoms after loss of a partner, a negative life event that is the most important risk factor for depression in the elderly. Therefore, it may be concluded that the GDS-15 has the ability to measure longitudinal alterations in depressive symptomatology.
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Affiliation(s)
- David J Vinkers
- Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, The Netherlands.
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