Publications by authors named "Patrick Heller"

17 Publications

  • Page 1 of 1

Associations of executive and functional outcomes with full-score intellectual quotient among ADHD adults.

Psychiatry Res 2020 12 22;294:113521. Epub 2020 Oct 22.

Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland; Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.

Associations between executive and functional impairment, intelligence, and attention deficit hyperactivity disorder (ADHD) have been scarcely investigated among adult populations and lead to inconsistent results. This study tested the impact of intellectual level on executive and functional impairment in a clinical sample of adults diagnosed with ADHD. Participants were recruited in a specialized center for the diagnosis and treatment of ADHD (n=66, mean age=27.9 ± 10.8). Measures included intellectual quotient (IQ, Wechsler Adult Intelligence Scale) categorized as ≤110 or >110, the continuous performance test (CPT3), grade retention, educational attainment, and having an activity (job or studies). Participants with a higher IQ had significantly better functional outcomes than participants with a standard IQ: higher educational attainment, lower grade retention, and often having an activity. Participants with higher IQ performed significantly better on all CPT variables assessing executive functioning. Intelligence seemed to work as a protective factor for executive and functional outcomes in a clinical population of ADHD adults and might reduce long-lasting detrimental consequences in life.
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http://dx.doi.org/10.1016/j.psychres.2020.113521DOI Listing
December 2020

[Child or adult ? Transdisciplinary reflections on forensic age-assessments].

Rev Med Suisse 2020 Apr;16(691):773-777

Unité de psychiatrie pénitentiaire, Service de médecine pénitentiaire, Département de médecine de premier recours, et Service de psychiatrie adulte, Département de psychiatrie, HUG, 1211 Genève 14.

Forensic age assessments are carried out in Switzerland at the request of the administrative or judicial authorities, with the aim of determining whether an individual is a minor or an adult. This -article first recalls the context in which these assessments are -produced, and the challenges that arise from them. Then it details the current procedure for age assessments and summarizes some of the criticisms that can be made, along with the answers proposed by experts of the « Centre Universitaire Romand de Médecine -Légale ». Finally, the article presents various medical and political position statements regarding forensic age assessments and provides some suggestions for improvements.
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April 2020

Reducing recidivism using the Reasoning and Rehabilitation program: a pilot multi-site-controlled trial among prisoners in Switzerland.

Int J Public Health 2020 Jul 21;65(6):801-810. Epub 2020 Apr 21.

Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland.

Objectives: This study evaluated whether the Reasoning and Rehabilitation (R&R2) program was effective in reducing recidivism, minimizing dropout rates, and improving outcomes related to attitudes, behaviors, and personality among people living in detention.

Methods: Data were collected in eight Swiss German-speaking prisons among males detained for violent offenses using a quasi-experimental controlled design (R&R2: n = 129, treatment as usual [TAU]: n = 84). Measures included recidivism, dropout rate, and self-report questionnaires (hostile attribution bias, aggressiveness, interpersonal problems, and willingness to accept responsibility). Data were analyzed using mixed-effect models.

Results: Participants in the R&R2 group were less likely to reoffend in comparison with the TAU group in the intention-to-treat (n = 51, odds ratio = 0.75, p = .060) and the per-protocol (excluding dropouts; n = 38, odds ratio = 0.65, p = .068) analyses. They also had lower self-reported scores of spontaneous and reactive aggressiveness (p = .047 and p = .070) and excitability (p = .086).

Conclusions: The findings of this pilot project were promising, with the R&R2 program leading to reduced recidivism and dropout rate. Even though these results should be considered preliminary, the R&R2 program appeared to be a relevant approach in reducing recidivism after prison.
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http://dx.doi.org/10.1007/s00038-020-01372-9DOI Listing
July 2020

Screening for alcohol use disorder among individuals with comorbid psychiatric disorders: Diagnostic accuracy in a sample of young Swiss men.

Addict Behav 2020 07 15;106:106354. Epub 2020 Feb 15.

School of Health Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Route des Arsenaux 16a, 1700 Fribourg, Switzerland.

Alcohol use disorder (AUD) is frequently comorbid with other psychiatric disorders. However, few studies investigated the psychometric properties of AUD screening tools in presence of co-occurring disorders. This study examined the diagnostic accuracy of a short AUD screening tool among young adults, in the presence of high vs. low or moderate symptomatology of other common psychiatric disorders. Data were collected among young Swiss men (n = 233) between 2016 and 2018. Measures included a diagnostic interview for AUD and screening tools for AUD and other psychiatric disorders (attention deficit hyperactivity disorder, antisocial personality disorder, bipolar disorder, borderline personality disorder, major depressive disorder, and social anxiety disorder). We computed receiver operating characteristic curves to test whether the AUD screening tool was an accurate indicator of AUD for groups with high vs. low or moderate symptomatology of each psychiatric disorder. The results showed that the optimal cut-off score was ≥3 (the original cut-off of the scale) for participants with a low or moderate symptomatology and ≥4 for participants with a high symptomatology. Our findings highlighted the urgent need for an integrated approach to screening. Psychiatric comorbidities should be included in the screen for AUD to obtain accurate results.
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http://dx.doi.org/10.1016/j.addbeh.2020.106354DOI Listing
July 2020

Body pack in sick bodies: a retrospective study of somatic and psychiatric comorbidities among body-packers.

Int J Prison Health 2019 09;16(1):45-55

Division of Prison Health, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.

Purpose: Body-packing means concealing packets of illicit psychoactive substances in the digestive or genital system. The purpose of this paper is to investigate profiles of body-packers and comorbidities associated with body-packing.

Design/methodology/approach: A retrospective study (2005-2016) was conducted among all patients hospitalized for suspicion of body-packing in the Geneva hospital prison unit (=287). Data were extracted from medical records and included demographics, somatic/psychiatric diseases, suicidal ideation and psychological distress.

Findings: Body-packers were mostly young men (mean age=33.4). A total of 42.2 percent of the participants had at least one psychiatric or somatic comorbidity reported during incarceration (somatic: 28.2 percent, psychiatric: 18.8 percent). The most frequent somatic diseases were infectious (10.5 percent), cardiovascular (10.1 percent), and endocrinological (4.2 percent) diseases, and more precisely HIV (4.5 percent), hepatitis B (3.5 percent), hepatitis C (1.4 percent), high blood pressure (8.0 percent) and diabetes (4.2 percent). The most frequent psychiatric conditions were substance use disorders (10.5 percent) and mood disorders (8.0 percent). Depressed mood/psychological distress and suicidal ideation were frequently reported during hospitalization (27.2/6.6 percent). Comorbidities were associated with demographics: Females were more likely to have somatic and psychiatric diseases detected during hospitalization in detention and participants from Western, educated, industrialized, rich and democratic countries were more likely to report diseases known before detention.

Originality/value: Body-packers bear a heavy burden of disease and psychological distress. This vulnerable subgroup of incarcerated people has been overlooked in previous research and their health needs are not correctly understood. This study was a first step to improve their health care and reintegration.
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http://dx.doi.org/10.1108/IJPH-03-2019-0016DOI Listing
September 2019

Do Overcrowding and Turnover Cause Violence in Prison?

Front Psychiatry 2019 24;10:1015. Epub 2020 Jan 24.

Division of Prison Health, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.

Violence is common in prison and its individual risk factors are well documented. However, there is a mixed evidence on the relationship between prison violence and institutional factors, such as overcrowding and turnover, and recent research suggested that these factors may not be important or relevant. This study investigated the association between prison violence and institutional factors in a Swiss pre-trial prison between 2013 and 2018. Measures included violence (assaults requiring immediate medical attention) as well as the annual overcrowding and turnover rates. Using a meta-regression, the results showed that prison violence was higher when overcrowding and turnover increased. Overall, our study highlighted that institutional prison factors might have notable detrimental effects on prison life. Reduction of prison overcrowding and turnover appear critical to reduce prisoners' vulnerability. Turning prison into safe places designed to promote desistance would probably not be achievable without considering these crucial factors.
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http://dx.doi.org/10.3389/fpsyt.2019.01015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6992601PMC
January 2020

Identifying an accurate self-reported screening tool for alcohol use disorder: evidence from a Swiss, male population-based assessment.

Addiction 2020 03 12;115(3):426-436. Epub 2019 Dec 12.

School of Health Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Fribourg, Switzerland.

Background And Aims: Short screenings for alcohol use disorder (AUD) are crucial for public health purposes, but current self-reported measures have several pitfalls and may be unreliable. The main aim of our study was to provide empirical evidence on the psychometric performance of self-reports currently used. Our research questions were: compared with a gold standard clinical interview, how accurate are (1) self-reported AUD, (2) self-reported alcohol use over time and (3) biomarkers of alcohol use among Swiss men? Finally, we aimed to identify an alternative screening tool.

Design: A single-center study with a cross-sectional design and a stratified sample selection.

Setting: Lausanne University Hospital (Switzerland) from October 2017 to June 2018.

Participants: We selected participants from the French-speaking participants of the ongoing Cohort Study on Substance Use and Risk Factors (n = 233). The sample included young men aged on average 27.0 years.

Measurements: We used the Diagnostic Interview for Genetic Studies as the gold standard for DSM-5 AUD. The self-reported measures included 11 criteria for AUD, nine alcohol-related consequences, and previous 12 months' alcohol use. We also assessed biomarkers of chronic excessive drinking (ethyl glucuronide and phosphatidylethanol).

Findings: None of the self-reported measures/biomarkers taken alone displayed both sensitivity and specificity close to 100% with respect to the gold standard (e.g. self-reported AUD: sensitivity = 92.3%, specificity = 45.8%). The best model combined eight self-reported criteria of AUD and four alcohol-related consequences. Using a cut-off of three, this screening tool yielded acceptable sensitivity (83.3%) and specificity (78.7%).

Conclusions: Neither self-reported alcohol use disorder nor heavy alcohol use appear to be adequate to screen for alcohol use disorder among young men from the Swiss population. The best screening alternative for alcohol use disorder among young Swiss men appears to be a combination of eight symptoms of alcohol use disorder and four alcohol-related consequences.
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http://dx.doi.org/10.1111/add.14864DOI Listing
March 2020

[Clinical situations in detention settings].

Rev Med Suisse 2019 Feb;15(640):473-476

Service de médecine pénitentiaire, HUG, 1211 Genève.

Infectious diseases, substance use disorders, and psychiatric conditions are more prevalent in prisons than in the general population. There is relatively limited evidence regarding the medical management of non communicable diseases in prison settings. The clinical cases described in this article highlight specific dimensions to be considered when practicing medicine in detention settings : multidisciplinary work ; regular voluntary screening for infectious diseases that are prevalent in this population ; management of non communicable diseases ; availability of medical protocols for specific clinical situations (for example, body-packing) ; or proactive screening for mental health disorders.
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February 2019

Prevalence of Attention Deficit Hyperactivity Disorder in Detention Settings: A Systematic Review and Meta-Analysis.

Front Psychiatry 2018 2;9:331. Epub 2018 Aug 2.

Division of Prison Health, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.

Previous studies have reported a high prevalence of attention deficit hyperactivity disorder (ADHD) among people living in detention (PLD) corresponding to a five- to ten-fold increase compared to the general population. Our main study objective was to provide an updated ADHD prevalence rate for PLD, including PLD in psychiatric units. Sub-objectives included (i) comparing different ways of assessing ADHD, including DSM-5 criteria and (ii) identifying which types of PLD are more likely to have ADHD. We conducted a systematic review and meta-analysis following the PRISMA guidelines and the MOOSE checklist. PubMed/Medline, PsycINFO, and Web of Sciences were searched combining "ADHD" and "prison" keywords and synonyms for articles published between January 1, 1966 and January 2, 2018. Potential sources of variation to the meta-analytic ADHD prevalence rate were investigated using meta-regressions and subgroups analyses. The meta-analysis pooled 102 original studies including 69,997 participants. The adult ADHD prevalence rate was 26.2% (95% confidence interval: 22.7-29.6). Retrospective assessments of ADHD in childhood were associated with an increased prevalence estimate (41.1, 95% confidence interval: 34.9-47.2, < 0.001). There was no significant difference in the prevalence estimate between screenings and clinical interviews in adulthood. Only three studies used the DSM-5 definition of ADHD and results were non-significantly different with other DSM versions. We found no difference according to participants' characteristics. Our results confirmed the high prevalence rate of ADHD among PLD, corresponding to a five-fold increase compared to the general population. In light of such high ADHD prevalence, our results reinforce the importance of addressing this critical public health issue by (i) systematically offering ADHD screening and diagnosis to all individuals entering detention, and (ii) delivering treatment, monitoring, and care for ADHD during and after detention. These strategies may help reduce recidivism and reincarceration, as well as violence in detention settings, in addition to improving the health and wellbeing of people living in detention. Additionally, our study suggests that using screening scales may be a reliable way of assessing ADHD, although caution is needed because a complete evaluation by an experienced clinician is required to provide a formal diagnosis.
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http://dx.doi.org/10.3389/fpsyt.2018.00331DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6084240PMC
August 2018

Does level of attention deficit-hyperactivity disorder symptoms predicts poor transition into adulthood?

Int J Public Health 2019 Mar 25;64(2):165-172. Epub 2018 Jul 25.

Division of Psychiatric Specialties, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland.

Objectives: Transition into adulthood is a risky period for young people with attention deficit-hyperactivity disorder (ADHD), but empirical studies on this topic are scarce. This study investigated the association between the level of ADHD symptoms and transition into adulthood.

Methods: Data were collected in the Cohort Study of Substance Use and Risk Factors among a representative sample of young Swiss men (n = 4681) over three waves. Measures included the level of ADHD symptoms and emerging adulthood assessed with the Inventory of the Dimensions of Emerging Adulthood and indicators of successful transition into adulthood.

Results: The level of ADHD symptoms was associated with a lower success in the transition into adulthood. Young people with high level of ADHD symptoms had a reduced increase in indicators of successful transition over time. Inattention symptoms were more strongly associated with emerging adulthood measures in comparison with hyperactive symptoms.

Conclusions: The level of ADHD symptoms may delay the transition into adulthood, especially inattentive symptoms. Providing tailored interventions to emerging adults with ADHD symptoms may decrease the substantial impairments adults with ADHD experience in life.
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http://dx.doi.org/10.1007/s00038-018-1147-xDOI Listing
March 2019

Does level of attention deficit-hyperactivity disorder symptoms predicts poor transition into adulthood?

Int J Public Health 2019 Mar 25;64(2):165-172. Epub 2018 Jul 25.

Division of Psychiatric Specialties, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland.

Objectives: Transition into adulthood is a risky period for young people with attention deficit-hyperactivity disorder (ADHD), but empirical studies on this topic are scarce. This study investigated the association between the level of ADHD symptoms and transition into adulthood.

Methods: Data were collected in the Cohort Study of Substance Use and Risk Factors among a representative sample of young Swiss men (n = 4681) over three waves. Measures included the level of ADHD symptoms and emerging adulthood assessed with the Inventory of the Dimensions of Emerging Adulthood and indicators of successful transition into adulthood.

Results: The level of ADHD symptoms was associated with a lower success in the transition into adulthood. Young people with high level of ADHD symptoms had a reduced increase in indicators of successful transition over time. Inattention symptoms were more strongly associated with emerging adulthood measures in comparison with hyperactive symptoms.

Conclusions: The level of ADHD symptoms may delay the transition into adulthood, especially inattentive symptoms. Providing tailored interventions to emerging adults with ADHD symptoms may decrease the substantial impairments adults with ADHD experience in life.
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http://dx.doi.org/10.1007/s00038-018-1147-xDOI Listing
March 2019

Patterns of source monitoring bias in incarcerated youths with and without conduct problems.

Cogn Neuropsychiatry 2018 01 10;23(1):15-27. Epub 2017 Dec 10.

a Developmental Clinical Psychology Unit, Faculty of Psychology , University of Geneva , Geneva , Switzerland.

Introduction: Antisocial individuals present behaviours that violate the social norms and the rights of others. In the present study, we examine whether biases in monitoring the self-generated cognitive material might be linked to antisocial manifestations during adolescence. We further examine the association with psychopathic traits and conduct problems (CPs).

Methods: Sixty-five incarcerated adolescents (IAs; M age = 15.85, SD = 1.30) and 88 community adolescents (CAs; M age = 15.78, SD = 1.60) participated in our study. In the IA group, 28 adolescents presented CPs (M age = 16.06, SD = 1.41) and 19 did not meet the diagnostic criteria for CPs (M age = 15.97, SD = 1.20). Source monitoring was assessed through a speech-monitoring task, using items requiring different levels of cognitive effort; recognition and source-monitoring bias scores (internalising and externalising biases) were calculated.

Results: Between-group comparisons indicate greater overall biases and different patterns of biases in the source monitoring. IA participants manifest a greater externalising bias, whereas CA participants present a greater internalising bias. In addition, IA with CPs present different patterns of item recognition.

Conclusions: These results indicate that the two groups of adolescents present different types of source-monitoring bias for self-generated speech. In addition, the IAs with CPs present impairments in item recognition. Future studies may examine the developmental implications of self-monitoring biases in the perseverance of antisocial behaviours from adolescence to adulthood.
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http://dx.doi.org/10.1080/13546805.2017.1412947DOI Listing
January 2018

Does Citizenship Abate Class? Evidence and Reflections from a South Indian City.

Econ Polit Wkly 2017 Aug;52(32):47-57

Brown University.

Drawing on data from a large household survey in Bangalore, this paper explores the quality of urban citizenship. Addressing theories that have tied the depth of democracy to the quality and effectiveness of citizenship, we develop an index of citizenship and then explore the extent to which citizenship determines the quality of services and infrastructure that households enjoy. Our findings show that citizenship and access to services in Bangalore are highly differentiated, that much of what drives these differences has to do with class, but we also find clear evidence that the urban poor are somewhat better in terms of the services they receive than they would be without citizenship. Citizenship, in other words, abates the effects of class.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916647PMC
August 2017

Emotion Recognition and Perspective Taking: A Comparison between Typical and Incarcerated Male Adolescents.

PLoS One 2017 25;12(1):e0170646. Epub 2017 Jan 25.

Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.

Background: Previous research suggests that antisocial individuals present impairment in social cognitive processing, more specifically in emotion recognition (ER) and perspective taking (PT). The first aim of the present study was to investigate the recognition of a wide range of emotional expressions and visual PT capacities in a group of incarcerated male adolescents in comparison to a matched group of community adolescents. Secondly, we sought to explore the relationship between these two mechanisms in relation to psychopathic traits.

Methods: Forty-five male adolescents (22 incarcerated adolescents (Mage = 16.52, SD = 0.96) and 23 community adolescents (Mage = 16.43, SD = 1.41)) participated in the study. ER abilities were measured using a dynamic and multimodal task that requires the participants to watch short videos in which trained actors express 14 emotions. PT capacities were examined using a task recognized and proven to be sensitive to adolescent development, where participants had to follow the directions of another person whilst taking into consideration his perspective.

Results: We found a main effect of group on emotion recognition scores. In comparison to the community adolescents, the incarcerated adolescents presented lower recognition of three emotions: interest, anxiety and amusement. Analyses also revealed significant impairments in PT capacities in incarcerated adolescents. In addition, incarcerated adolescents' PT scores were uniquely correlated to their scores on recognition of interest.

Conclusions: The results corroborate previously reported impairments in ER and PT capacities, in the incarcerated adolescents. The study also indicates an association between impairments in the recognition of interest and impairments in PT.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0170646PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266284PMC
August 2017

Self-harm and overcrowding among prisoners in Geneva, Switzerland.

Int J Prison Health 2016 ;12(1):39-44

Division of Correctional Medicine and Psychiatry, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.

Purpose: Prison institutional conditions affect risk for self-harm among detainees. In particular, prison overcrowding may increase the likelihood of self-harm by creating competition for resources, space, and enhancing a "deprivation state." The purpose of this paper is to examine the association between overcrowding and prisoner acts of self-harm.

Design/methodology/approach: This cross-sectional study took place at Geneva's pre-trial prison (capacity:376) between 2006 and 2014. Outcomes were acts of self-harm that required medical attention, and self-strangulation/hanging events (combined into one group, as these are difficult to differentiate). Dichotomous predictors were overcrowding index- annual mean daily population divided by capacity ( > 200 percent vs < 200 percent), and year group (2006-2009 vs 2011-2014).

Findings: Self-harm and self-strangulations/hangings increased in 2011-2014 compared to 2006-2010 (p < 0.001). Overcrowding in excess of 200 percent was associated with self-strangulation/hangings (p < 0.001) but not with all self-harm events. In terms of pertinent demographics that would affect self-harm, there was no prison change in gender, area of origin, foreign residency, religion, or psychiatric treatment.

Research Limitations/implications: The present study is limited by the definition and identification of self-harm. The distinction between self-strangulation and self-hanging, and the precise classification of an intent to die is difficult to make in practice, especially with limited prison data records available. The relevant literature addresses the complexity of the association between non-suicidal and suicidal behavior. Despite this, the combined category self-strangulations/hangings gives some indication of severe self-harm events, especially since the methodology of categorization employed was consistent throughout the entire period of the study. Other limitations include the small sample size and the lack of individual patient data and prison data to help control for confounding factors. Despite these drawbacks, pertinent data (socio-demographics and number of prisoners treated for mental health and drug abuse) remained stable over the years. Thus, there are no apparent changes in the inmate population that could be linked to an increase in self-harm. High-security placements and mean prisoner stay have increased over time, with a decrease in staff to prisoner ratio - and these must be looked into further as contributors. Additionally, qualitative methods such as semi-structured interviews and focus groups could delineate the impact of overcrowding on prisoner well-being and self-harm potential.

Practical Implications: The authors observed a significant increase in self-harm and self-strangulation/hangings over time, and overcrowding was significantly associated with self-strangulation/hangings (but not with all self-harm events). Overcrowding can impose destructive effects on the psychological and behavioral well being of inmates in prison, influencing a myriad of emotional and livelihood factors that predispose to harmful behavior.

Originality/value: This report should alert public health and prison authorities to this issue, and garner resources to address such an alarming rise. The findings from this short report demonstrate the need for a further examination of the mechanisms affecting self-harm among prisoners in this population, particularly the relationship between self-strangulations/hangings and overcrowding.
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http://dx.doi.org/10.1108/IJPH-04-2015-0009DOI Listing
December 2016

Covariance and specificity in adolescent schizotypal and borderline trait expression.

Early Interv Psychiatry 2015 Oct 16;9(5):378-87. Epub 2014 Jan 16.

Adolescence Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.

Aims: The first aim of the present study is to assess the overlap between borderline and schizotypal traits during adolescence. The second objective is to examine whether some psychological factors (i.e. cognitive coping mechanisms, impulsivity and encoding style) are differentially related to borderline and schizotypal traits and may therefore improve the efficiency of clinical assessments.

Methods: One hundred nineteen community adolescents (57 male) aged from 12 to 19 years completed a set of questionnaires evaluating the expression of borderline and schizotypal traits as well as cognitive emotion regulation (CER), impulsivity and encoding style.

Results: Our data first yielded a strong correlation between borderline and schizotypal scores (r = 0.70, P < 0.001). Secondly, linear regression models indicated that the 'catastrophizing' CER strategy and the 'lack of premeditation' impulsivity facet accounted for the level of borderline traits, whereas an internal encoding style predominantly explained schizotypal traits.

Conclusions: Our results support the abundant literature showing that borderline and schizotypal traits frequently co-occur. Moreover, we provide original data indicating that borderline and schizotypal traits during adolescence are linked to different specific psychological mechanisms. Thus, we underline the importance of considering these mechanisms in clinical assessments, in particular to help disentangle personality disorder traits in youths.
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http://dx.doi.org/10.1111/eip.12120DOI Listing
October 2015

Mental health of young offenders in Switzerland: Recognizing psychiatric symptoms during detention.

J Forensic Leg Med 2012 Aug 6;19(6):332-6. Epub 2012 Mar 6.

University of Geneva, Department of Psychology, 40, Boulevard du Pont-d'Arve, 1211 Geneva 4, Switzerland.

We reviewed the medical records of the 118 adolescent detainees which had at least one consultation by a psychiatrist at the prison health facility during 2007. General practitioners used the International Classification of Primary Care (ICPC-2) for recording health problems. Psychiatrists used the International Classification of Diseases (ICD-10) for making psychiatric diagnoses. The concordance between the mental health assessment done by general practitioners using the ICPC-2 and the diagnoses proposed by psychiatrists was globally satisfying. The five most frequent ICD categories (conduct disorder, drug abuse, alcohol abuse, personality disorder, adjustment disorder) encompassed the most frequently reported ICPC-2 psychological symptoms. Several associations between psychological symptoms and socio-demographic characteristics were observed. Apart from providing a description of the mental health of adolescent detainees in one of Switzerland's largest detention centre for minors, results suggest that general practitioners can adequately identify frequent mental disorders in such contexts.
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http://dx.doi.org/10.1016/j.jflm.2012.02.013DOI Listing
August 2012