SummaryThe importance of considering antisocial behaviour among people with autism-spectrum disorders is apparent from the significant number of case reports and case series describing criminal behaviour of people with a diagnosis of Asperger syndrome. The evidence so far does not support a specific association between the syndrome and criminal offending. However, a small yet significant number of offenders with autism who engage in illegal behaviour find themselves socially excluded or detained in secure provisions for prolonged periods. This article gives an overview of the scant empirical evidence relating to criminality within the context of Asperger syndrome, and offers suggestions for managing the syndrome in mentally disordered offenders.

Very little is known about the sexual activities of psychiatric patients during their stay in hospital and beyond. In this article, we have explored how mental health professionals working within a forensic psychiatric unit construct the issue of patient sexuality in order to ascertain the range of sexual possibilities open to patients. Drawing on interviews with twenty four participants--psychiatrists and clinical psychologists (clinical staff), we examined how participants made sense of patient sexuality and their clinical judgments in relation to them. Using a thematic analysis, we were able to identify a number of relevant themes emerging, including a) what the limits of acceptable sexual behaviour were judged to be, b) discrimination against transgender and same sex relationships, c) vulnerability among female patients and therapeutic efficacy, and d) an abject fear of patient pregnancy. Furthermore, a general concern throughout was the putative professional conflict between the clinical and ward staff. Further discussion regarding the potential for clearer policy on patient sexuality and further training for professionals is developed in the final section.

Since the 1960s, Western society has adopted a more liberal attitude to sexuality. Choice of sexual partners, sexual preferences, attitudes and practices are increasingly a matter of individual choice and freedom. These changes, however, have had little impact on the lives of psychiatric in-patients (Eiguer et al, 1974; Akhtar et al, 1977; Taylor & Swan, 1999). ‘Mental illness,’ it has been suggested, ‘is one of the few disabilities where people run the risk of losing their freedom in order to receive in-patient treatment’ (Cook, 2000). This loss of liberty and rights becomes more pronounced in secure settings where mentally disordered offenders can spend a substantial part of their adult (sexual/reproductive) lives. Prisoners in some US state prisons (of medium and low security) are afforded conjugal visits from their married partners, in view of the rights of the latter. Paradoxically, detention in secure units, which we consider a therapeutic and not a punitive measure, places constraints on the formation of new relationships and the maintenance of previously existing ones. New relationships are, in our experience, viewed with more concern than previously existing ones.

There exists now a body of research that describes case studies of individuals with autism spectrum disorder (ASD) who have engaged, or are alleged to have engaged, in a range of illegal behaviours, and that attempts to estimate the prevalence of ASD at different stages of the criminal justice process. Taken together, this research does suggest that some individuals with ASD will come into contact with the criminal justice system, but many questions regarding this apparent association remain unanswered. The purpose of this review is to propose a direction for research to address some of these unanswered questions and potentially inform the development of treatments and service provision.

Aims and MethodTo find out why consultant psychiatrists chose psychiatry as a career. A questionnaire was developed and posted to 87 consultant psychiatrists in substantive posts within a London psychiatric training scheme.ResultsThe survey had a response rate of 83% (72 out of 87). The majority of consultants (n=40) chose psychiatry as a career after leaving medical school. The most important reasons cited were empathy with the patient group (36.1%), the interface of psychiatry with the neurosciences (25%), the better working conditions expected in psychiatry (20.8%) and medical school teaching of the subject (19.4%).ConclusionsThe study highlights the need for recruitment efforts after medical school. The findings also reflect the lasting influence of medical school exposure to psychiatry. Interventions for improving recruitment in psychiatry are suggested. The under-recruitment of British medical graduates is masked by overseas recruitment into the specialty.