Magic and forensic psychiatry:A case study and review of the literature

Forensic psychiatrists routinely appear in courts for crimes that have been perpetrated by mentally ill patients or when the defendant is suffering from a major psychiatric disorder.However,committing crimes under the presumed effects of magic and witchcraft is uncommon.A variety of delusional thoughts and personality disorders have been imputed in aggressive behaviour that might culminate in homicide.The patterns of a premeditated homicide,as well as the aberrations of the interpersonal relations,as a rule require long-term and close contact.As such,the family is a setting where such occurrences have been reported.We describe a case of first-degree murder by a woman who killed her mother-in-law after accusing her repeatedly of sorcery and witchcraft.Such complicated cases cannot be resolved without the help of forensic experts,whose role remains multifaceted and of particular importance.

Post‑traumatic Stress Disorder:Relationship to Traumatic Brain Injury and Approach to Forensic Psychiatry Evaluation

Posttraumatic stress disorder(PTSD)has an important and complex relationship with traumatic brain injury(TBI).The prevalence of comorbid PTSD and TBI is increasing in both military and civilian populations.Moreover,TBI has emerged as an important risk factor for the development and manifestation of PTSD.Meanwhile,PTSD is also a significant mediator of the negative sequelae of TBI.PTSD and TBI,especially mild TBI(mTBI),have overlapping neural substrates and neuroanatomical functional features.Given that comorbid PTSD and TBI remain a challenge for forensic psychiatry evaluation,we review the relationship between the two disorders and discuss special considerations during evaluation of the condition.

Chinese Forensic Psychiatry: History, Development and Challenges

China has a long history of forensic psychiatry,which can be traced even back to Zhou dynasty(11th century B.C.).However,modern forensic psychiatry has not been set up in China until the 1970s.After the interruption of Cultural Revolution of 1966‑1976,there was a period of rapid development.In the past five years,a series of judicial identification system reforms have been taking place.In 2010,China had 225 forensic psychiatry agencies,2,090 forensic psychiatry experts and 40,822 cases.The experts are organized within the separate agencies of psychiatric hospitals,universities,the Institute of Forensic Sciences of the Ministry of Justice and other forensic agencies.Apart from criminal forensic psychiatry,the experts are often asked to evaluate civil competency for the clients involved in civil litigation.Chinese forensic psychiatry has developed rapidly during the past 30 years,and formed the characteristics of its own under the special legal system.However,there is still much work for Chinese forensic psychiatrists to do for the future.

Profile of Forensic State Patients Admitted to ZébéPsychiatric Hospital (Togo)

Introduction: Zébé Psychiatric Hospital is the only psychiatric hospital able to receive forensic mentally ill patients in Togo. The aim of this study was to describe the socio-demographic, clinical and forensic aspects of forensic mentally ill patients. Method: This was a descriptive cross-sectional study conducted from August 16th to September 16th, 2021 among forensic patients admitted to the Zébé Psychiatric Hospital. Results: During the study period, we recorded 28 forensic mentally ill patients. Fifty-seven point one percent (57.1%) of the forensic patients came from rural areas. The mean age of these patients was 37.3 years, and ranged from 13 to 82 years. Males predominated in 96.4% of cases. Primary education represented 39.3% of cases. Single people predominated in 92.9% of cases. They were unemployed in 64.3% of cases. Forty-six point four percent (46.4%) of these patients were using at least one psychoactive substance. Forensic offenses were dominated by murder in 53.6% of cases. The victim was a family member in 53.6% of cases and male in 60.7% of cases. They had schizophrenia spectrum disorders in 78.6% of the cases. Forty-six point four percent (46.4%) of these patients were not responsible for their offences and 82.1% were abandoned by their families. Conclusion: The information gathered in this study will help to better organize strategies for mental health promotion and prevention of mental illness and crime in the general population.

Factors Associated with Homicides in Psychiatric Expertise in Togo

Background: In most societies, homicide or murder is a crime that often leads to imprisonment. Studies around the world have sometimes found cases of mental illness (schizophrenia spectrum disorders) as an explanation for some homicides. The aim of this study was to determine the factors associated with homicide in the Togolese context. Methods: This was a descriptive and analytical cross-sectional study of pre-trial psychiatric expertise reports from January 31st, 2019 to January 30th, 2022. Results: Out of 704 defendants appraised, 206 (29.3%) had committed homicide. Males accounted for 91.7% of Homicide defendants (HD). Their average age was 31.6 ± 12.2 years, with extremes of 16 and 74 years. Factors associated with homicide were female gender, age between 30 and 45 years, married or cohabiting status and occupation as a farmer/fisherman/breeder. Psychoactive substance use (PAS), mental illness and psychiatric history were not associated with homicide. Conclusion: Preventing delinquency and interpersonal conflict, and promoting social cohesion, could significantly reduce homicides in Togo.

Diagnostic procedures and classification of antisocial behavior in Norwegian inmates in preventive detention

In official Norwegian government reports’ prison statistics, it is claimed that the prevalence of Dissocial Personality Disorder (DPD) or Antisocial Personality Disorder (APD) among inmates in preventive detention is approximately 50%. Furthermore, previous findings have described a practice in which forensic examiners use the DSM SCID axis II for APD to confirm an ICD 10 diagnosis of DPD. Clinical investigation supported by the use of SCID Axis II for quality assurance was performed on almost half the population of inmates (46.4%) in preventive detention at a high security prison. The inmates had all committed severe violent acts including murder. All the information obtained by applying the DSM IV-TR criteria was tested against the ICD-10 Research Criteria (ICD-10-RC) for Dissocial Personality Disorder (ICD-10, DPD). It was found that all inmates met the ICD-10-RC for (DPD) and the DSM-IV-TR definition for Adult Antisocial Behavior (AAB). On the other hand, none met the DSM-IV-TR criteria for (APD). The SCID Axis II failed to identify inmates with APD because the DSM-IV-TR C-criteria, referring to symptoms of childhood Conduct Disorder (CD), were not met. These findings raise important questions since the choice of diagnostic system may influence whether a person’s clinically described antisocial behaviour should be classified as a personality disorder or not. For the inmates, a diagnosis of APD or DPD may compromise their legal rights and affect decisions on prolongation of the preventive detention. Studies have shown that combining the DSM and the ICD diagnostic systems may have consequences for the reliability of the diagnosis.

Violent offences of methamphetamine users and dilemmas of forensic psychiatric assessment

Methamphetamine(MA),an extremely addictive synthetic stimulant,has quickly spread to become the most frequently used illicit drug in China.People with a history of chronic and heavy MA use have a high possibility of exhibiting schizophrenia-like psychotic symptoms,mainly delusions of reference,auditory hallucinations and cognitive deficits.These emerging findings suggest MA use increases aggression and violence and that there is a correlation between MA use and violence.However,it is unclear how to assess the capacity of criminal responsibility in“MA-induced”psychosis and how to set clear boundaries between schizophrenia and MA-induced psychosis when only limited and inconsistent evidence is available.Furthermore,a final persuasive differential diagnostic method based on improved understanding of schizophrenia and MA-induced psychotic disorders has yet to be developed.This paper will evaluate the epidemiology,social harm,and forensic psychiatric assessment of MA users,propose a future direction for the differential diagnosis between MA-induced psychotic disorders and schizophrenia,and put forward some practical solutions to assess the capacity of criminal responsibility of defendants with drug-induced psychotic disorder.

Need for education of psychiatric evaluation of offenders with mental disorders:A questionnaire survey for Japanese designated psychiatrists

BACKGROUND The management of offenders with mental disorders has been a significant concern in forensic psychiatry.In Japan,the introduction of the Medical Treatment and Supervision Act in 2005 addressed the issue.However,numerous psychiatric patients at risk of violence still find themselves subject to the administrative involuntary hospitalization(AIH)scheme,which lacks clarity and updated standards.AIM To explore current as well as optimized learning strategies for risk assessment in AIH decision making.METHODS We conducted a questionnaire survey among designated psychiatrists to explore their experiences and expectations regarding training methods for psychiatric assessments of offenders with mental disorders.RESULTS The findings of this study’s survey suggest a prevalent reliance on traditional learning approaches such as oral education and on-the-job training.CONCLUSION This underscores the pressing need for structured training protocols in AIH consultations.Moreover,feedback derived from inpatient treatment experiences is identified as a crucial element for enhancing risk assessment skills.

Clinicosocial Profile of People Who Inject Drugs Receiving Opioid Substitution Therapy at New Delhi

Introduction:Injecting drug use is a public health concern due to its clinical,social,economic,and legal consequences.Objective:(1)To evaluate the prevalence of infections associated with injecting drug use;and(2)To assess the social profile of substance users and high-risk behaviors among people who inject drugs(PWID)receiving opioid substitution therapy(OST).Materials and Methods:A cross-sectional study was conducted among 100 PWID who were deemed eligible using inclusion and exclusion criteria.Data were collected through an interviewer-administered structured questionnaire after obtaining informed written consent.Results:The results revealed that 14%of PWID had human immunodeficiency virus(HIV),7%had tuberculosis,and 2%had hepatitis B virus(HBV).None of the PWID self-reported hepatitis C virus(HCV)infection.Importantly,71%of PWID were living on the streets(i.e.homeless),and 41%of PWID had a history of sharing needles with other users in the preceding 3 months.Unmarried or single PWID had significantly increased risk of homelessness(χ^(2)=4.570;P=0.032)and reported high-risk sexual practices with commercial sexual partners in the preceding 3 months(χ^(2)=4.163;P=0.041).Homeless PWID had significantly increased frequency of injecting practices(P=0.020).Conclusion:Despite the higher global prevalence of HCV compared with HBV and HIV among PWID,HCV testing is not currently conducted at most OST centers in India.Access to free needles and syringes should be enhanced to reduce the morbidity associated with injecting drug use.

Attempted altruistic infanticide in a context of psychotic decompensation induced by stress linked to the COVID-19 pandemic:a case report

the mediatization of the CoVID-19 pandemic has created a lot of stress leading sometimes to mental health issues.We present a case of a thirty-year-old woman with no history of psychotic disease but some vulnerabilities and no criminal record,who attempted to kill her seven-year-old son during a brief delusional episode in the context of fear of the coronavirus.she was successfully treated by pharmacotherapy and psychotherapy.she was examined by forensic psychiatrists leading to the conclusion that her responsibility was highly diminished,and her reoffending risk was low.We add to the literature that the CoVID-19 pandemic has been such a stressor for mentally vulnerable people that it could lead to severe psychiatric decompensation and even criminal acts.

Sensory information in children’s statements of sexual abuse

The credibility of children’s statements of sexual abuse is a controversial issue in forensic psychiatry and psychology.Neurobiological and clinical laboratory studies show that real memories contain more information regarding sensory details than false memories.The goal of the present field study was to evaluate whether sensory information was present in child-ren’s statements of sexual abuse,and whether this information was more often present in credible statements compared with non-credible statements.Sensory details were extracted from a sample of 96 statements of sexual abuse from children;62 statements were consi-dered credible and 34 statements were considered non-credible.This study showed that sensory information was present in 79% of children’s reports of child sexual abuse.Sensory information was significantly more often present in statements considered credible com-pared with non-credible statements(85.5%,P<0.001),but there were large variations in the sense involved.Logistic regression analysis showed that the presence of at least one sensory detail may be a good predictor of credibility(odds ratio,OR=23.484,P<0.05).It seems appropriate to include sensory details when assessing the credibility of children’s statements of child sexual abuse,but it has not yet been demonstrated that use of such details signifi-cantly improves the validity of credibility assessments.

Eye tracking and child sexual offenders:a systematic review

Eye tracking is used in sexology to identify attractiveness and sexual desire indirectly.This systematic review summarizes results of works that have used eye tracking to analyse paedophilic interest in order to investigate its potential as a useful forensic tool.Six studies met the inclusion criteria.Five of them concerned a large study project and used approximatively the same sample of paedophiles(inpatients),forensic patients(without a sexual interest in children)and healthy controls to make comparisons between the three groups.One study added 11 self-declared paedophiles(outpatients)for a comparison between inpatient paedophiles,outpatient paedophiles and controls(healthy and forensic inpatients).One study compared a group of child sexual offenders with non-offenders.All studies used static pictures of male and female subjects at different pubertal stages.Some studies divided every picture into a different area of interest.Dependent variables used are fixation latency(early attention)and relative fixation time,(later attention).Each study identified significant differences between the paedophile group versus other groups:shorter fixation latency on child pictures,longer fixation time on child pictures and number of fixation most important on child pictures.Two scores(age preference index and attentional control index)showed hight and/or moderate sensitivity and specificity.Although the results suggest the eye tracking can discriminate between paedophile interest and non-paedophile interest,there are too few studies on this specific topic and further research is needed with larger and different sample,carried out by different research teams.If these findings were confirmed,it remains unclear as to their impact in a forensic context when presented openly in Court.

The Doppelgänger phenomenon and death:a peculiar case of homicide by a subject with first-episode psychosis

The Doppelgänger phenomenon refers to the experience of a direct encounter with one’s self,characteriswed by:(i)the perception of a figure with one’s own identical physical features;or(ii)the apprehension that the perceived figure shares the same personality and identity.The Doppelgänger does not only look like the same person,it is his/her double.The perceptual element is usually a hallucination,although occasionally a false perception of an actual figure may be involved.This phenomenon has been described in individuals suffering from overwhelming fear,severe anxiety or intoxication,epilepsy,as well as in the sleep-wakefulness transition.It has also been reported in major psychoses.The fear of imminent death often precedes the Doppelgänger experience.This report presents the case of a 30-year-old man,Mr.Y,who was stabbed to death by Mr.X,his“double”.The aggressor and his victim,although not related,were truly doubles;remarkably,they shared the same name and surname,age,professional activity and place of work.Moreover,they attended the same sports center but barely knew each other.The forensic psychiatric evaluations in Mr.X,subsequent to the crime committed,were suggestive of a psychotic condition.This case is unique in the scientific literature.In the most serious psychotic forms,the issue of the“double”calls into question not only the dissociative processes involved in the etiopathogenesis of the disorder,but also bio-psycho-social elements,as well as personal data in this case,which made the victim and the aggressor“identical”.In the context of psychopathological functioning,the delusional mood(Wahnstimmung)that precedes the development of delirium is a sort of gateway to an impending psychotic illness,involving delusional awareness or mood(atmosphere).In psychosis,splitting is the main issue and this influence is seen as an evil,foreign,apocalyptic and unknown side no longer recognised as belonging to the self even in a physical sense.In such a situation,it is felt that the only way to survive is by suppressing one’s double as a defense against disorganisation of the self.