title: [Does the duration of confinement of criminally responsible mentally disordered offenders (§ 21/2 StGB) play a role in the development of a functional psychosyndrome? - A pupillometric investigation].
abstract: BACKGROUND
  Pupillometry is a non-invasive investigation based on the concept that pupillary reagibility depends on a number of specific sensory, mental and emotional variables. By means of the receptor test based on the topical application of the cholinergic antagonist tropicamide cognitive deficits can be evaluated. The present study focuses on the question whether the receptor test is able to differentiate criminally responsible mentally disordered offenders (§ 21/2 StGB) with different durations of confinement concerning the presence of a functional psychosyndrome, as defined by Grünberger.
  
  
  METHODS
  Four groups of offenders with different durations of confinement (group A: confinement 0-2 years, n = 26, X = 33; group B: 2-5 years, n = 29, X = 34; group C: 5-10 years, n = 6, X = 36; group D: >10 years, n = 10, X = 43) were investigated by means of a computer-assisted TV pupillometer. After a baseline measurement 0.01% tropicamide was instilled into the eye. The second measurement was conducted 20 min after the first, the 3rd and 4th measurements in intervals of 20 min.
  
  
  RESULTS
  The groups with a longer duration of confinement showed a reduced activation and vigilance and increased fatigability as compared with the groups of shorter confinement. In the receptor test the group that had been imprisoned for 0-2 years showed more cognitive deficits than those imprisoned for ≥5 years.
  
  
  CONCLUSIONS
  Evaluation of activation, fatigability and vigilance indicates that the duration of confinement plays a role in the development of a functional psychosyndrome. The results of the receptor test, in which the group with a longer duration of confinement showed less pronounced cognitive deficits and no significant changes of the tropicamide effect over time, suggest that in this group a dose change might be required to make the cognitive deficits evident.
authors.affiliation: Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Wien, Austria. bernd.saletu@meduniwien.ac.at
authors.forename: Josef
authors.initials: J
authors.lastname: Grünberger
authors.forename: Thomas
authors.initials: T
authors.lastname: Wisnecky
authors.forename: Katinka
authors.initials: K
authors.lastname: Keckeis
authors.forename: Sonja
authors.initials: S
authors.lastname: Kaplan
authors.forename: Jutta
authors.initials: J
authors.lastname: Heilmann
authors.forename: Patricia
authors.initials: P
authors.lastname: Twardowsky
authors.forename: Hans
authors.initials: H
authors.lastname: Stöhr
authors.forename: Anna
authors.initials: A
authors.lastname: Bösch
mesh_terms: D000328:Adult; D001143:Arousal; D003072:Cognition Disorders / Q000175:diagnosis*; D003134:Commitment of Persons with Psychiatric Disorders; D003936:Diagnosis, Computer-Assisted; D004568:Electrodiagnosis; D005221:Fatigue / Q000175:diagnosis; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists; D019965:Neurocognitive Disorders / Q000175:diagnosis*; D009483:Neuropsychological Tests; D012025:Reflex, Pupillary / Q000187:drug effects; D013577:Syndrome; D014331:Tropicamide
chemical_list: D018727:Muscarinic Antagonists; D014331:Tropicamide