This study describes the prevalence of adverse events and length of stay in forensic psychiatric patients with and without a restriction order. Detailed clinical and administrative information from medical records and written court decisions was gathered retrospectively from admission until discharge for a Swedish population-based, consecutive cohort of forensic psychiatric patients (n=125). The median length of stay for the whole cohort was 951 days, but patients with a restriction order stayed in hospital almost five times as long as patients without. Restriction orders were related to convictions for violent crime, but not for any other differences in demographic or clinical variables. The majority of the patients (60%) were involved in adverse events (violence, threats, substance abuse, or absconding) at some time during their treatment. Patients with restriction orders were overrepresented in violent and threat events. Previous contact with child and adolescence psychiatric services, current violent index crime, psychotic disorders, a history of substance, and absconding during treatment predicted longer length of stay. Being a parent, high current Global Assessment of Functioning scores, and mood disorders were all significantly related to earlier discharge. In a stepwise Cox regression analysis current violent index crime and absconding remained risk factors for a longer hospital stay, while a diagnosis of mood disorder was significantly related to a shorter length of stay.

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Thirty-eight women undergoing augmentation mammaplasty, consecutively operated on at the Department of Plastic and Reconstructive Surgery, Malmö, Sweden, were studied preoperatively regarding medical history, personality, psychosocial and psychiatric characteristics. Thirty-six of these patients were interviewed one year postoperatively. Thirty-three age-matched women operated on with minor surgical out-patient procedures were used as a contrast group. The mammaplasty patients generally came from insecure homes with conflicts between parents and unsatisfactory emotional relations to both parents. Their educational as well as income level was significantly lower than the contrast group and they were socially isolated. Their sexual adaptation seemed to have been hampered by their sensitivity reactions towards their breasts but nonetheless most of them lived in stable heterosexual relations. Generally the augmentation mammaplasty patients were not psychiatrically abnormal apart from the negative evaluation of their physical attractiveness. The great majority of the women, 86%, were satisfied with the results of surgery. Postoperatively the patients changed their style of dressing, extended their leisure time activities and social contacts, improved their sexual life and relations to their spouse. Postoperative increase of nervous symptoms was reported by 39% of the patients, but about as many patients, 36%, reported decreased nervous symptoms. Difficulties in accepting the surgical result, sexual dysfunctions and negative mental reactions proved to be associated with specific personality characteristics. Various factors have previously been proposed as being usable in the prediction of adverse reactions after augmentation mammaplasty. None of these factors, however, proved in this study to correlate with postoperative maladaptation. A need for increased methodological stringency in predictor studies is indicated.

Diademan (5) und 1,6-Homodiademan (6), die ersten Kohlenwasserstoffe mit cis-Tris-o-homobenzol-Geriist, wurden durch Photoisomerisierung der monoolefinischen Vorstufen 8 (,,Snouten") bzw. 15 (,,4, gewonnen. Analog entstand aus 17 (,,endo,exo-Bishomobarrelen") das iiberbriickte trans-Tris-o-homobenzol7, das sich bequemer auch durch Rhodium(1)-katalysierte Isomerisierung von 17 oder thermische Umlagerung von exo,exo-Bishomobarrelen 18 erhalten lien. Das nicht iiberbriickte 4 wurde nach einer neuen Synthesesequenz aus 1,3-Cyclohexadien dargestellt. Thermisch lagern sich 5 und 6 sehr leicht in Triquinacen (9) bzw. Diademane and Structurally Related Compounds, I Preparation and Characteristic Reactions of Some Tris-whomobenzene HydrocarbonsDiademane (5) and 1,6-Homodiademane (6) are the first hydrocarbons with cis-tris-o-homobenzene skeletons. They were prepared by photoisomerization of the olefinic precursors 8 (,,snoutene") and 15 (,,4,5-homosnoutene"), respectively. In an analogous reaction the bridged trans-tris-o-homobenzene 7 was formed from 17 (,,endo,exo-bishomobarrelene"). 7 is more easily obtained from 17 by rhodium(1)-catalyzed isomerization or from exo,exo-bishomobarrelene 18 by thermal rearrangement. The unbridged 4 was prepared using a newly developed synthetic sequence starting from 1.3-cyclohexadiene. The thermal rearrangement of 5 and 6 to triquinacene (9) and 1,lO-homotriquinacene (16) is very facile; the gas phase kinetic parameters (Ink (5) = 33.7 -31600lRTand Ink (6) = 32.2 -28300/RT, both first order) strongly corroborate, that these rearrangements are concerted [,2, + .2, + ,2,] cycloreversions. [3,6-12C2]-labelled 4 upon thermolysis yields a truns-bicyclo[4.3.O]nona-3,7-diene (31 P 22) with a 12C-labelling pattern, which proves its formation via a 3-step mechanism. The first step in this sequence most probably