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Samenvatting Gerechtelijke Geestelijke Gezondheidszorg

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Dit is een samenvatting van de lessen, alsook de reader die de prof zelf heeft geschreven. Elke les werd aangevuld met informatie uit de reader met andere woorden.

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  • December 26, 2021
  • 288
  • 2021/2022
  • Summary
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GGZ
Melissa Amandels




AJ 2021-2022

,Inhoudsopgave
Gerechtelijke geestelijke gezondheidszorg: introductie ................................................................................. 12
Identificatie....................................................................................................................................................... 12
De leerdoelen.................................................................................................................................................... 12
Inhoud en opbouw ............................................................................................................................................ 12
Werkvormen ..................................................................................................................................................... 12
Studiemateriaal ................................................................................................................................................ 12
Evaluatie ........................................................................................................................................................... 12
Schets van het onderzoek van het opleidingsdeel ............................................................................................ 13
Recente actualiteit............................................................................................................................................ 13
Wat is gerechtelijke GGZ? ................................................................................................................................ 13
Verschillende basisparadigma’s ....................................................................................................................... 14
Werkingsgebieden gerechtelijke ggz ................................................................................................................ 14

1 – Psychiatrische stoornissen ........................................................................................................................ 15
Definitie ............................................................................................................................................................ 15
Psychiatrische ziekte.................................................................................................................................... 15
Wat zijn die psychische functies? ................................................................................................................ 15
Psychiatrische stoornis ................................................................................................................................ 16
Stoornissen en klachten .............................................................................................................................. 16
Psychiatrische diagnostiek: doelen en onderdelen ........................................................................................... 16
Doel van diagnostiek ................................................................................................................................... 16
Hoe stelt men een psychiatrische diagnose? .............................................................................................. 16
Psychiatrische diagnostiek ............................................................................................................................... 19
Voorbeeld structuurdiagnose ...................................................................................................................... 20
Ontstaan psychiatrische stoornis ..................................................................................................................... 20
Classificatie/diagnosticeren ......................................................................................................................... 21
DSM-classificatie .......................................................................................................................................... 23
Prevalentie........................................................................................................................................................ 23
Hoe vaak komt een psychiatrische stoornis voor? ...................................................................................... 23
Verschillen in prevalentie? .......................................................................................................................... 24
Behandelingskloof ............................................................................................................................................ 24
Onderbehandeling: redenen? ..................................................................................................................... 25
Psychiatrie en psychiaters…vreemde vogels? ............................................................................................. 25
Stigma .............................................................................................................................................................. 25
Onderzoek en voorbeelden van frames - Van Gorp e.a. (2017) .................................................................. 26
Ontstaan ........................................................................................................................................................... 26
Ontstaan psychiatrische stoornis ................................................................................................................ 26
Stress-Steun-Kracht-Kwetsbaarheid ............................................................................................................ 28
Relatie delict – psychiatrische stoornis ............................................................................................................. 29
Relatie psychiatrische stoornis – delict ....................................................................................................... 29
Heel kort samengevat .................................................................................................................................. 30
Samenvattend .................................................................................................................................................. 30

2 – Psychotische stoornissen .......................................................................................................................... 32



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, Wat is een psychotische stoornis? .................................................................................................................... 32
Wat is psychose? ......................................................................................................................................... 32
Wat is een psychose? .................................................................................................................................. 33
Schizofrenie ...................................................................................................................................................... 36
Wat is schizofrenie niet? ............................................................................................................................. 36
Schizofrenie DSM-5 ..................................................................................................................................... 37
Voorkomen schizofrenie .............................................................................................................................. 37
Verloop schizofrenie .................................................................................................................................... 37
Mortaliteit schizofrenie ............................................................................................................................... 38
Hoe ontstaat schizofrenie? .......................................................................................................................... 38
Gene-environment interaction .................................................................................................................... 39
Dopamine hypothese .................................................................................................................................. 39
Filmfragment (hfst 16) ................................................................................................................................. 39
Behandeling ................................................................................................................................................. 39
Medicatie: antipsychotica of neuroleptica .................................................................................................. 40
Ontwikkelingen in de behandeling .............................................................................................................. 40
Behandeling van schizofrenie: filmfragment ............................................................................................... 41
Bijwerkingen oude AP .................................................................................................................................. 41
Bijwerkingen nieuwe AP .............................................................................................................................. 41
Duration of untreated psychosis “DUR” ...................................................................................................... 41
Herkennen enkele tips ................................................................................................................................. 41
Wat als je zelf last hebt van (rand)psychose? ............................................................................................. 42
Omgangsregels, enkele tips ......................................................................................................................... 42
Samenvattend ............................................................................................................................................. 42
Youtube film ..................................................................................................................................................... 43

3 – Forensische aspecten; psychose ............................................................................................................... 45
Publieke opinie en psychose ............................................................................................................................. 45
Link psychose – geweld?................................................................................................................................... 45
Casus ................................................................................................................................................................ 46
How to beat a murder rap by insanity (T. Vanda) ....................................................................................... 46
Meta-analyse 1 ............................................................................................................................................ 46
Meta-analyse 2 ............................................................................................................................................ 46
Co-morbiditeit .................................................................................................................................................. 47
Voorbeeld schizofrenie en psychopathie .................................................................................................... 47
Vroeg of laat ontstaan van gedragsproblemen ............................................................................................... 47
Ter illustratie................................................................................................................................................ 47
Simulatie? ......................................................................................................................................................... 48
Samenvattend .................................................................................................................................................. 48

4 – Verstandelijke beperking .......................................................................................................................... 49
Inhoud .............................................................................................................................................................. 49
Afkorting ........................................................................................................................................................... 49
Wat is een verstandelijke beperking? ............................................................................................................... 49
Definitie verstandelijke beperking............................................................................................................... 49
Verstandelijke beperking DSM-IV ................................................................................................................ 51
Verstandelijke beperking DSM-5 ................................................................................................................. 51
Verwarring in het werkveld ......................................................................................................................... 51
Verstandelijke beperking ............................................................................................................................. 52
Forensische aspecten; verstandelijke beperking .............................................................................................. 52
Belang van een correcte inschatting van IQ ................................................................................................ 52


2

, Hall v. Florida ............................................................................................................................................... 52
Criminaliteit en verstandelijke beperking? .................................................................................................. 53
Link verstandelijke beperking – delicten ..................................................................................................... 53
Vatbaarheidshypothese............................................................................................................................... 53
PVB oververtegenwoordigd in forensisch circuit?....................................................................................... 54
Relatie PVB – criminaliteit ........................................................................................................................... 54

5 – Middelengebruik en verslaving ................................................................................................................. 55
Wie gebruikt, wat? Epidemiologie ................................................................................................................... 55
Prevalentie op bevolkingsniveau ................................................................................................................. 55
Per Capita Consumptie van Alcoholische dranken in België ....................................................................... 55
Distributie alcoholconsumptie; 80-20 regel ................................................................................................ 56
Leerlingenbevraging VAD ............................................................................................................................ 57
Incidentie Treatment Demand .................................................................................................................... 57
Verloop van een verslaving .............................................................................................................................. 58
Een alcohol- en drugs-politiek heeft zijn belang! ............................................................................................. 58
Maatschappelijke kost ................................................................................................................................. 58
Alcohol Problematiek ....................................................................................................................................... 59
Stigma .......................................................................................................................................................... 59
Maatschappelijk antwoord moet veelzijdig zijn .......................................................................................... 60
Hoe verslaving begrijpen? Geschiedenis van het begrip “verslaving” .............................................................. 60
Wat maakt dat sommigen drank en drugs aantrekkelijk vinden?.................................................................... 61
Verslaving: Beschrijvende Diagnose volgens DSM5 ......................................................................................... 62
Verslavingsgedrag ........................................................................................................................................ 62
Beleving van verslaving ............................................................................................................................... 63
Alcohol, Drugs en Nicotine verhogen intracellulaire Dopamine ................................................................. 64
Gevolg van Dopamine verhoging................................................................................................................. 64
Preventie........................................................................................................................................................... 65
Hulpverlening ................................................................................................................................................... 66
Motiverende Gespreksvoering 1. ................................................................................................................ 66
Aanbod Openbare Verslavingszorg Vlaanderen .......................................................................................... 67
Treatment Gap ............................................................................................................................................ 67
Take Home Message ........................................................................................................................................ 68

6 – Forensische aspecten; middelengebruik en verslaving ............................................................................. 69
Link verslaving – delicten .................................................................................................................................. 69
Middelengebruik en criminaliteit ................................................................................................................ 69
Criminaliteit bij druggebruikers ................................................................................................................... 69
Criminaliteit bij alcoholmisbruik .................................................................................................................. 69
Prevalentie van middelen abusus in detentie: systematische review ......................................................... 70
Druggebruik in de Vlaamse gevangenissen ................................................................................................. 70
Middelen misbruik in forensische settings .................................................................................................. 71
Link middelengebruik – criminaliteit ........................................................................................................... 71
Verslaving als criminogene factor: recidive ...................................................................................................... 72
Effect op omgeving ........................................................................................................................................... 73
Foetaal alcoholsyndroom ............................................................................................................................ 73
Forensische verslavingszorg ............................................................................................................................. 73
Forensische verslavingszorg ........................................................................................................................ 74
Drug Treatment Courts (DTC) ...................................................................................................................... 74
Drug Treatment Courts (DTC) = Drug Behandelings Kamer (DBK)............................................................... 75



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