The Pharmaceutical Journal
Vol 276 No 7394 p394
1 April 2006

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Cherry blossom time more
Study shows need to improve diagnosis and treatment of psychiatic problems in prisoners more
In the mind of a killer more
April merriment / Year-round fools more

Cherry blossom time

April is the month, in my corner of the land, when the hedges show fresh life in the shape of flowering cherries — a harbinger of summer days.

There are several species of cherry, wild and cultivated, all sharing the Prunusgenus with a number of species of plum. Britain has two native species of cherry. The commoner species is Prunus avium, often just known as wild cherry, but also called gean or mazzard. Rarer is the smaller European bird cherry, P padus. The words “avium” and “bird” both mark the fact that the fruits are readily eaten by birds.

The bird cherry was once regarded in Scotland as guarded by witches, and therefore never to be used in making walking sticks. The gean was thought in Somerset to be unlucky if it was included in wedding decorations.

The cherry tree was long associated with the cuckoo which appears at much the same time of year as cherry blossom. It was said that the bird must be allowed to enjoy three good meals of ripe cherries before it could cease calling.

In children’s folklore cherry stones were counted in rhymes — “This year, next year, sometime, never”. The special occasion for which the count was made must on no account be revealed to anyone else, so adding to the mystery. To take two bites at the cherry is is an old saying meaning to take advantage of an unexpecetd additional opportunity.

Branches of wild cherry were once sold on the streets of London, the stalks being infused as a cure for an inflamed bladder. It is recorded that London pharmacists sold detached stalks for the same purpose. Cherry stalks are astringent, tonic and sedative, and were given for bronchial complaints, anaemia and diarrhoea in the form of infusions or decoctions. The bark of roots and stems of wild cherry has an odour of almonds, and a bitter and aromatic taste, while its volatile oil contains a small quantity of cyanide.

The exudate of the stem solidifies as a gum, which children have used as a chewing gum. This gum was advocated by Dioscorides as a cure for coughs and was claimed to improve the complexion, appetite and sight.

As A. E. Housman put it in 1896, “Loveliest of trees, the cherry now / Is hung with bloom along the bough.”

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Study shows need to improve diagnosis and treatment of psychiatic problems in prisoners

In the February issue of the British Journal of Psychiatry is a report of an extensive study undertaken of prisoners in Iran suffering from psychiatric disorders, among whom major depression or opioid dependence were the commonest diagnosis. In Iran, the prison population involved overcrowding and poor health care services. The prevalence of mental disorders was assessed in a sample of 351 men by means of an interview and interrogation lasting about 90 minutes.

Of the subjects, 88 per cent met the criteria for significant mental illness at some period of their life and current mental disorder was diagnosed in 57.2 per cent, the prevalent mood disorder being found in 48.7 per cent. The incidence of major depression was 29.1 per cent, of schizophrenia 2 per cent. Some three quarters of those studied had a record of opioid dependence at some time of their lives.

Serious mood disorders and psychopathy were prevalent in prisoners younger than 24 years, whereas disorders attributed to drug misuse were commonest in those aged 25 to 44. Commonly these were associated with a low educational status. Anxiety was more prevalent in married than unmarried prisoners.

The overall assessment has been that a much higher rate of psychiatric disorder occurs in prisons in Iran than in the general population. Compared with Western cultures, Iranians show a similar incidence of psychosis, although depression and disorders due to drug misuse appear to be commoner. There is, however, a pressing need to improve diagnosis and treatment in the Iranian prison population. The mental health of prisoners is an international problem and awaits early attention.

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In the mind of a killer

According to a paper published in the February issue of the British Journal of Psychiatry there is a widespread fear among the public that individuals suffering from a mental disorder constitute a significant threat of violence. On the other hand, some results of research into this specific problem have shown only a minor association between mental disorder and public violence.

A recent study has indicated that roughly one third of individuals who have been convicted of homicidal acts have shown a lifetime history of a disordered mentality, but that only one in 10 was on record as demonstrating such disorder at the time of committing a homicidal offence.

Data were collected from a national sample of homicides, psychiatric reports on convicted persons and clinical data derived from individuals who had been brought into contact with the mental health services.

The sources of information were 1,954 people who had been convicted of homicidal behaviour in England and Wales between 1996 and 1999.

Of the offenders, 90 per cent were male with an average age of 27 years, while of their victims 46 per cent were aged 18 to 35 years. Among a group of 1,432, where some sort of relationship was known between victim and offender, 36 per cent killed a family member or a current or former spouse, 39 per cent killed an acquaintance and 25 per cent killed a stranger.

One third of the offenders were found to be suffering from a mental disorder not classed as a severe psychiatric illness. The diagnosis was most often a personality disorder or drug dependence, including alcoholism. Most of these individuals had not reached the attention of any psychiatrist. Lifelong schizophrenia was diagnosed in 5 per cent, and other mental illness in 10 per cent at the time of the offence. Diminished responsibility was pronounced in those with a lifetime history of affective disorder (depression or delusions). Since most were not acutely ill or undergoing mental health care at the time of the offence, it is unlikely that services available could have averted the offence.

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And I quote …

April merriment
The first of April, some do say
Is set apart for All Fool’s Day;
But why the people call it so
Nor I, nor they themselves, do know,
But on this day are people sent
On purpose for pure merriment
— Poor Robin's Almanac, 1790.

Year-round fools
“April 1. This is the day upon which we are reminded of what we are on the other three hundred and sixty-four.”
— Mark Twain, in ‘Pudd’nhead Wilson’, 1894.

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