Skip to main content
×
×
Home

Kaleidoscope

  • Derek K. Tracy, Dan W. Joyce and Sukhwinder S. Shergill
Extract

We always hope you enjoy the free journal that comes with your Kaleidoscope subscription. A paper in this month's issue (pp. 429–436) showed that most scales assessing risk performed no better than the clinician/patient predictions following self-harm; this provoked a lively discussion on the journal's Twitter feed. A new paper by Seena Fazel's team explores their utility in criminal justice settings and forensic psychiatry. The authors note how such tools are used to inform critical aspects of patient management such as in-patient detention and discharge, custodial sentencing, parole, and post-release monitoring. This is despite a lack of reliable validation on predictive accuracy, especially in important groups such as women, ethnic minority populations, and those motivated by religious or political extremism. Furthermore, they find the literature is marred by significant publication and authorship bias, and suggest that better-quality data will allow better matching of relevant tools to clinical contexts. This is best exemplified by assessing the balance between optimising false positive v. false negative findings: highly sensitive tools (with low false negatives) may be optimal where ‘protecting the public’ is seen as key, whereas highly specific ones might best protect prisoner and patient rights and interests. Assessment tools have had accusations of implicit discrimination levelled against them, as they commonly capture sociodemographic data – age, gender, ethnicity, immigration status – that risk profiling and perpetuating stigma. But should this information be excluded, especially as some data may improve predictive accuracy? The analogy of racial profiling at airports is put forward: if this helps a limited, but highly contentious, screening resource prevent more atrocities, is it warranted? It's clearly a charged debate, and perhaps that is part of the problem, balancing emotion and fairness with science. In the absence of robust data, we walk the fine line between coarse variables that may perpetuate discrimination, and the risk of their politically driven removal.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Kaleidoscope
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Kaleidoscope
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Kaleidoscope
      Available formats
      ×
Copyright
References
Hide All
1 Douglas, T, Pugh, J, Singh, I, Savulescu, J, Fazel, S. Risk assessment tools in criminal justice and forensic psychiatry: the need for better data. Eur Psychiatry 2017; 42: 134–7.
2 Exbrayat, S, Coudrot, C, Gourdon, X, Gay, A, Sevos, J, Pellet, J, et al. Effect of telephone follow-up on repeated suicide attempt in patients discharged from an emergency psychiatry department: a controlled study. BMC Psychiatry 2017; 17: 96.
3 Dunlop, BW, Kelley, ME, Aponte-Rivera, V, Mletzko-Crowe, T, Kinkead, B, Ritchie, JC, et al. Effects of patient preferences on outcomes in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study. Am J Psychiatry 24 Mar 2017 (https://dx.doi.org/10.1176/appi.ajp.2016.16050517).
4 Dunlop, BW, Rajendra, JK, Craighead, WE, Kelley, MR, McGrat, CL, Choi, KS, et al. Functional connectivity of the subcallosal cingulate cortex and differential outcomes to treatment with cognitive-behavioral therapy or antidepressant medication for major depressive disorder. Am J Psychiatry 24 Mar 2017 (https://dx.doi.org/10.1176/appi.ajp.2016.16050518).
5 Li, D, Azoulay, P, Sampat, BN. The applied value of public investments in biomedical research. Science 2017; 356: 7881.
6 Culverhouse, RC, Saccone, NL, Horton, AC, Ma, Y, Anstey, KJ, Banaschewski, T, et al. Collaborative meta-analysis finds no evidence of a strong interaction between stress and 5-HTTLPR genotype contributing to the development of depression. Mol Psychiatry 4 Apr 2017 (https://dx.doi.org/10.1038/mp.2017.44).
7 Iyadurai, L, Blackwell, SE, Meiser-Stedman, R, Watson, PC, Bonsall, MB, Geddes, R, et al. Preventing intrusive memories after trauma via a brief intervention involving Tetris computer game play in the emergency department: a proof-of-concept randomized controlled trial. Mol Psychiatry 28 Mar 2017 (https://dx.doi.org/10.1038/mp.2017.23).
8 Dansinger, M. Dear Plagiarist: a letter to a peer reviewer who stole and published our manuscript as his own. Ann Intern Med 17 Jan 2017 (http://annals.org/aim/article/2592773/dear-plagiarist-letter-peer-reviewer-who-stole-published-our-manuscript).
9 Sorokowski, P, Kulczycki, E, Sorokowska, A, Pisansky, K. Predatory journals recruit fake editor. Nature 2017; 543: 481–3.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 14 *
Loading metrics...

Abstract views

Total abstract views: 41 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 24th April 2018. This data will be updated every 24 hours.

Kaleidoscope

  • Derek K. Tracy, Dan W. Joyce and Sukhwinder S. Shergill
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *