A series of 153 adult arsonists is described with particular reference to motives for fire-raising and psychiatric diagnosis. All had been referred for pretrial psychiatric reports and were assessed by routine clinical methods, supplemented where possible by the Personality Assessment Schedule. The series comprised mainly men, and most were relatively young, although these are also the characteristics of criminals in general. Most suffered from some form of mental disorder. Half of them had a personality disorder and a tenth were mentally handicapped. In addition to the mentally handicapped, a further 13 per cent had a history of special schooling, so that arsonists with some educational or learning difficulties made up a quarter of the total. Revenge was the most common motive, although present in only a third of the total, and the sexual element in motivation was much less common than appears to have been the case in the past. The motive of re-housing, not previously identified, was more common in women than in men. Almost two-thirds of the properties set on fire were domestic dwellings, and over a third of arsonists were intoxicated when they started the fires. Suggestions are made for further research focusing on personality characteristics which may be associated with fire-setting.
The geriatric population is growing and trauma providers are often tasked with caring for injuries in the elderly. There is limited information regarding injury patterns in geriatric trauma patients stratified by mechanism of injury. This study intends to investigate the comorbidities, mechanisms, injury patterns, and outcomes in geriatric blunt trauma patients. A retrospective study of the 2012 National Trauma Databank was performed. Adult blunt trauma patients were identified; geriatric (>/=65) patients were compared with younger (<65) patients regarding admission demographics and vital signs, mechanism and severity of injury, and comorbidities. The primary outcome was injuries sustained and secondary outcomes included mortality, length of stay in the intensive care unit and hospital, and ventilator days. There were 589,830 blunt trauma patients who met the inclusion criteria, including 183,209 (31%) geriatric and 406,621 (69%) nongeriatric patients. Falls were more common in geriatric patients (79 vs 29%, P < 0.0001). Geriatric patients less often had an Injury Severity Score >/=16 (18 vs 20%, P < 0.0001) but more often a head Abbreviated Injury Scale >/=3 (24 vs 18%, P < 0.0001) and lower extremity Abbreviated Injury Scale >/=3 (24% vs 8%, P < 0.0001). After logistic regression older age was an independent risk factor for mortality for the overall population and across all mechanisms. Falls are the most common mechanism for geriatric trauma patients. Geriatric patients overall present with a lower Injury Severity Score, but more often sustain severe injuries to the head and lower extremities. Injury patterns vary significantly between older and younger patients when stratified by mechanism. Mortality is significantly higher for geriatric trauma patients and older age is independently associated with mortality across all mechanisms.
Twenty-three patients who believed they suffered from food allergy were studied at the time of their presentation to an allergy clinic. The presence of organic food hypersensitivity could not be confirmed in 19 who attributed common neurotic symptoms to allergy; this group was almost identical, in terms of psychiatric symptomatology and general characteristics, with a group of new psychiatric out-patient referrals. There was no evidence of psychiatric disorder of food-related psychological symptoms in four patients with proven food-related atopic symptoms. The study failed to find evidence that psychological symptoms might be the result of organic reactions to foods.
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