DOCTORS MISS TREATABLE PROBLEMS IN VIOLENT OFFENDERS

Doctors frequently overlook epilepsy, serious head injuries, and other neurological abnormalities in violent offenders, a new report notes-even though these problems are strongly linked to aggression and criminal behavior, and sometimes can be successfully treated.

The authors say the link between brain disorders and violence is clear, citing research including:

--a study reporting an unusually high number of severe head injuries in death-row felons;

--research showing that almost a fifth of patients with a history of recurrent attacks of unprovoked and uncontrollable rage had a history of head injury;

--a study revealing that around 70% of patients suffering traumatic brain injuries develop aggressive behavior or extreme irritability; and,

--a large-scale study showing a strong association between minor head injuries and delinquent behavior.

Pavlos Hatzitaskos et al. say that "there is an ever-increasing body of data suggesting that in certain contexts individuals with brain dysfunction are more likely to respond aggressively than individuals who are more intact neuropsychiatrically." They note that many brain dysfunctions can be treated, and that "when brain function is restored to relative normality, violent individuals are often much more able to function appropriately."

Hatzitaskos and colleagues found that neurologists, psychiatrists, and pediatricians overlooked numerous cases of epilepsy, serious head injury, blackouts, perinatal problems, major accidents, and physical abuse. They note that "contrary to the prevailing wisdom among forensic psychiatrists that violent offenders tend to malinger, we have found that the most violent offenders consider themselves normal and. prefer the label `bad' to `mad.' Therefore they conceal or minimize medical and psychiatric problems," making informal, open-ended questioning a poor method of eliciting medical data.

Hatzitaskos and his co-workers have developed a detailed medical questionnaire which they recommend for doctors evaluating violent offenders. Information is available from Dorothy Otnow Lewis, Professor of Psychiatry, New York University School of Medicine, 550 1st Avenue, New Bellevue 21 South 25, New York, NY 10016.