Sociodemographic, Legal, and Clinical Profiles of Female Forensic Inpatients in Karnataka: A Retrospective Study.

BACKGROUND: Forensic patients are often admitted to psychiatric hospitals without any details of illness or treatment. They pose a unique challenge for clinical services in the context of diagnosis, management, and particularly legal issues. MATERIALS AND METHODS: We conducted a retrospective chart review using a structured data-extraction tool. A total of 23 female forensic inpatients were admitted under the Department of Psychiatry from January 2006 to June 2016. Data were analyzed by descriptive statistics. RESULTS: The mean age of the patients was 31.3 ± 7.9 years. In total, 82.6% of them were married, 87% were from a nuclear family, and 78.3% were from an urban background. Totally, 73.9% were referred from prison and 26.1% from the court. However, 73.9% were referred for the purpose of diagnosis and treatment and 21.7% for assessment of fitness to stand trial. Moreover, 47.8% had an alleged charge of murder (of killing close family members). A total of 30.4% had schizophrenia and other psychotic disorders, and 47.8% had a mood disorder. The mean duration of inpatient care was 6.2 ± 7.4 weeks, and 87% had shown considerable clinical improvement at the time of discharge. CONCLUSIONS: The majority of female forensic patients were young adults from nuclear families. They had mood disorders, schizophrenia, and other psychotic disorders. They were referred primarily for treatment purposes. Prospective studies are required for a better characterization of the relationship between crime and psychiatric disorders.

Maternal filicide: A case series from a medico-legal psychiatry unit in India.

Maternal filicide has occurred throughout history and carries along with it, a host of paradoxical and complex clinical, legal and social dimensions. We present findings from a case series of four women inpatients, who were undergoing trials for filicide. All women reported severe marital discord and poor social support. Three had severe depressive episodes before and during the time of the alleged crime. The motive for the alleged act was 'altruistic' in three of them. Early identification of psychiatric illness and risk assessment may help in early intervention and protect the mother and child.

Psychosis Following Carbimazole-induced Acute Alteration of Hyperthyroid Status.

Abrupt normalization of hyperthyroid state with antithyroid drugs is reported to precipitate psychosis. We report the development of acute psychosis in a 20-year-old woman, following 30 days use of tablet carbimazole 10 mg for hyperthyroidism due to the multinodular goiter. At the time of presentation, she was euthyroid with a resolution of hyperthyroid status both clinically and biochemically. After 20 days treatment with tablet olanzapine 10 mg/day and stoppage of carbimazole, psychotic symptoms remitted completely and she has since remained in a euthyroid state and free from psychotic symptoms. This case highlights the development of psychosis in individuals, following rapid restoration to normal serum thyroid hormone levels in hyperthyroid individuals with carbimazole.