Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.725
Filtrar
1.
BMC Psychiatry ; 23(1): 48, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36653792

RESUMO

BACKGROUND: There is still a lack of comprehensive research on the profile of patients in forensic mental health hospitals in China. This study aims to investigate the socio-demographic, clinical, and offense-related characteristics of mentally ill offenders in the Hunan Provincial Forensic Psychiatric Hospital in China. METHODS: This study was conducted from November 1, 2018, to January 30, 2019. The data of socio-demographic, clinical, and offense-related characteristics of the patients were collected. The Brief Psychiatric Rating Scale (BPRS), the Modified Overt Aggression Scale (MOAS), and the Clinical Global Impression-Severity (CGI-S) scale were used to measure their psychiatric conditions. RESULTS: A total of 461 participants were enrolled in this study. Among them, 86.3% were males and 56.8% were unmarried; the average age of them was 44.7 ± 10.1 years, and the mean years of education were 7.51 ± 3.3 years. Before their current offense, a total of 345 patients (74.8%) had sought medical help for their mental illnesses. While 303 (87.8%) of these patients were prescribed antipsychotics, 254 (73.6%) failed to take them regularly. Of all the inpatients, 90.5% were diagnosed with schizophrenia; 385 (83.5%) engaged in homicidal offenses, with 54.0% of the victims being their family members. In homicide cases, the relatives were more likely to be victims of female patients. The mean length of stay in the forensic hospital was 8.02 ± 4.74 years, and over 80.0% of the patients had been hospitalized for over 5 years. CONCLUSIONS: To our knowledge, this is the first study investigating the profile of forensic patients receiving compulsory treatments in a forensic psychiatric hospital in China. These results add to the world literature on the characteristics of forensic patients and can help identify common treatment and risk-related needs of this population.


Assuntos
Pacientes Internados , Transtornos Mentais , Masculino , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Psiquiatria Legal , Hospitais Psiquiátricos , China/epidemiologia , Demografia
2.
Int J Law Psychiatry ; 86: 101854, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36528930

RESUMO

BACKGROUND: In China, police departments usually initiate assessment of criminal responsibility after patients with mental disorders commit crimes. However, the specific conditions demanding assessment are not clearly stipulated by law. Few studies have been conducted on the epidemiological characteristics and assessment of criminal responsibility in patients with mental disorders. This study aimed to analyze the features and identify influencing factors for assessment of criminal responsibility for patients with mental disorders in a single-center cohort. METHODS: Cases undergoing criminal responsibility assessment at the Center of Forensic Science, East China University of Political Science and Law in Shanghai (CFS, ECUPL) between 2010 and 2020 were retrospectively reviewed. Criminal responsibility was categorized as criminal irresponsibility, diminished criminal responsibility, and full criminal responsibility. Differences among the groups were then statistically analyzed. RESULTS: In the study period, 437 patients including 361 males (82.61%) were referred for criminal responsibility assessment. Their ages ranged from 15 years to 91 years. After assessment, the number of cases with criminal irresponsibility, diminished criminal responsibility, and full criminal responsibility were 196 (44.85%), 181 (41.42%), and 60 (13.73%), respectively. The Chi-square test and nominal regression analysis showed that influencing factors for assessment of criminal responsibility comprised crime in public places (OR = 14.734; 95% CI: 1.463-148.424), crime in victim's residence (OR = 10.852; 95% CI: 1.068-110.214), crime in suspect's residence (OR = 9.542; 95% CI: 1.046-87.092), forensic psychiatric diagnosis of F1X (OR = 0.014,0.011; 95%CI:0.001-0.261,0-0.5), F2X (OR = 5.75; 95%CI:1.315-23.145), F4X (OR = 0.077; 95%CI:0.016-0.38,) and F6X (OR = 0.112,0.075; 95% CI: 0.022-0.558,0.006-0.959), criminal object of property (OR = 9.989; 95% CI: 1.305-76.455), cases of theft (OR = 0.09, 0.087; 95% CI: 0.013-0.648,0.012-0.654), and cases of endangering public security (OR = 0.152, 0.205; 95% CI: 0.034-0.678, 0.045-0.931). CONCLUSION: Crime in public places, suspect's residence and victim's residence, forensic psychiatric diagnosis of F1X, F2X, F4X and F6X, criminal object of property, case types of theft and endangering public security were influencing factors in assessment of criminal responsibility. Therefore, special attention should be paid to patients with mental disorders under such circumstances in order to avoid bias on assessment of criminal responsibility.


Assuntos
Criminosos , Transtornos Mentais , Masculino , Humanos , Adolescente , Psiquiatria Legal , Estudos Retrospectivos , China/epidemiologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia
4.
Sante Ment Que ; 47(1): 129-149, 2022.
Artigo em Francês | MEDLINE | ID: mdl-36548796

RESUMO

Objectives This article aims at a critical study of the evolution of therapeutic measures in Swiss criminal law and of the ambiguous role that criminal justice let play to legal psychiatry in its decisions. Swiss law defines as criminal sanctions both sentences (punishment) and measures. Among the latter, a distinction must be drawn between therapeutic measures, aiming in principle at the treatment of the convicted person, and security measures, designed essentially to protect public security. Method To this end, after a brief presentation of the history of penal treatment measures in Switzerland, the status of measures in the criminal sanctions system is examined, presenting the range of different criminal measures and their evolution in time. Then, the relationship between mental health and justice, in particular the question of institutional treatment of mental disordered delinquents is analyzed, including the criticisms that it raises. Results The development of criminal measures over the last twenty years is characterized by two general trends: a strong decrease in the total number of criminal measures which have been ordered, and a sharp increase in the number of institutional therapeutic measures (Art. 59 CPS) to which offenders with serious mental disorders have been convicted. This latter increase is in line with a Swiss criminal security policy that is becoming more and more oriented towards risk management and marked by an obsession with the control of "high-risk offenders." In this logic, the primary aim of treatment for these offenders is supplanted by the aim of the protection of public security. This assumption is particularly tangible since therapeutic measures are not subject to a specific time limit and can be - and in practice are - regularly extended. This obsession with security is also crystallized in the difficult interaction between the judicial and the psychiatric worlds, since expertise is required for the pronouncement and the extension of a criminal measure. The system is criticized as well under a psychiatric as under a juridical point of view, and certain aspects have been recently condemned by the European Court of Human Rights. Conclusion We can observe that the use of the institutional therapeutic measure has increased, yet departing from its initial purpose, and obeying the movement towards more public security, even though the pronouncement of this measure is open to criticism. It rarely achieves its therapeutic objective, it is regularly submitted to prolongation, and it can lead to a measure of internment or a custodial sentence pronounced jointly, which run counter to the concrete needs of a person with mental health problems.


Assuntos
Criminosos , Psiquiatria Legal , Humanos , Direito Penal , Suíça , Saúde Mental , Criminosos/psicologia
5.
Sante Ment Que ; 47(1): 111-128, 2022.
Artigo em Francês | MEDLINE | ID: mdl-36548795

RESUMO

Objectives The right to refuse care for accused persons found criminally not responsible on account of mental disorder or unfit to stand trial is recognized and strictly regulated by the legal mechanisms of Quebec civil law, and Canadian criminal law does not allow them to be treated against their will. Review Boards, which are responsible for ruling on and periodically re-evaluating their situation, cannot prescribe treatment, but have the authority, with the consent of the accused, to impose a condition relating to treatment. The purpose of this ethnographic study is to document the discourse and practices of the Quebec Review Board in this area. Method The research material consists of observations from the hearings of the Quebec Review Board (n = 70), file observation grids completed by defense lawyers (n = 191), interviews with psychiatrists (n = 7) and defense lawyers (n = 7) and the study of one hundred court decisions from 2018, randomly selected. Results Our study shows that the practices of the Quebec Review Board make it possible, directly or indirectly, through the ambiguity of conditions or the pressure exerted by certain treatment teams, to override the accused's refusal of care and to impose treatment. The implications of these findings for the evolution of knowledge and practices in forensic psychiatry are discussed. Conclusion While the Review Boards are supposed to manage the risk to public safety, they are in fact, in the context of the State's disengagement in social matters, exercising surveillance and control, in particular via the conditions relating to treatment.


Assuntos
Transtornos Mentais , Transtornos Psicóticos , Humanos , Quebeque/epidemiologia , Canadá , Psiquiatria Legal , Consentimento Livre e Esclarecido
6.
Psychiatr Danub ; 34(4): 635-643, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36548875

RESUMO

BACKGROUND: Forensic-correctional psychiatric services are an important component of the public mental health services that provide care to offenders with mental illness in the criminal justice system and conduct psycho-legal assessments. Although forensic-correctional psychiatric services have evolved in Abu Dhabi, more work is needed in providing adequate mental health care for offenders. METHODS: This study provides a situational analysis of forensic-correctional psychiatric services in Abu Dhabi. We included a descriptive analysis of the data collected on service users admitted for psycho-legal assessments and treatment in the forensic-correctional units and those reviewed in the medical board units for issuing court reports. The study spanned the period between January 2019 to October 2020. RESULTS: A total of 398 males were included in the study. The participants' mean age was 35.3 (SD 9.27) years and were predominantly single, unemployed and high school graduates. The most prevalent diagnosis was schizophrenia spectrum disorder, (n=129, 31.6%). The mean length of stay in the forensic-correctional unit was 11.07 days. As many as 82.4% of the participants were referred for evaluation. The most common type of crime was categorized as "abnormal behaviour" under the code of practice number 511 of the list of crimes as per the general prosecutor of the United Arab Emirates followed by violence. CONCLUSION: Considering the level of demand for services and the limited number of forensic-correctional health professionals, there is a need for more resources to develop expertise, clinical services and infrastructures to expand the practice of forensic-correctional psychiatry. The creation of a universal database for all forensic-correctional psychiatric services is needed to better understand the unmet mental health needs. An additional investment of resources for research to inform mental health policy, laws and practice is indicated. Optimally, the lessons highlighted in this study can guide action plans for improving forensic-correctional mental health services in comparable settings.


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Masculino , Humanos , Adulto , Emirados Árabes Unidos/epidemiologia , Psiquiatria Legal , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Transtornos Mentais/diagnóstico , Saúde Mental , Crime
7.
Hist Psychiatry ; 33(4): 412-428, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36408551

RESUMO

This study examines criminal cases related to blasphemy under the absolute monarchy of Denmark-Norway, and presents the evaluation of mental states within a forensic context between 1713 and 1733. First, the article explains how the legal framework and normative guidelines for pastoral care envisaged the interplay between judges, priests and doctors in evaluating mental states. Then, an examination of selected cases is provided, showing the dynamics and the role assignment in the evaluation of mental states in practice. Covering a period characterized by a gradual differentiation of theology, law and medicine, this case study enhances understanding of what preceded the development of psychiatry as a medical speciality during the nineteenth century.


Assuntos
Criminosos , Psiquiatria , Humanos , Psiquiatria Legal/história , Noruega , Dinamarca
8.
Psychiatr Pol ; 56(3): 591-602, 2022 Jun 30.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-36342987

RESUMO

In foreign literature, the term ?dyadic death' is used to describe a situation of a murder followed by the perpetrator's suicide. It differs from the term ?extended suicide' used in Poland. While it is recognized that the occurrence of ?dyadic death' can be caused, apart from mental disorders, by unfavorable environmental factors, ?extended suicide' is equated with the occurrence of severe depressive disorders in the perpetrator. The above-mentioned constructs describing a homicide-suicide were analyzed from the psychiatric and criminological point of view. The study shall discuss a case of a young woman who drowned her young son in a public place, and then declared her suicide intentions. An analysis of the course of mental disorders in the perpetrator, her biological burdens, situational and family conditions was carried out, and the personality factors that led to her mental decompensation were taken into account. Pathological motivational background of the perpetrator of her son's murder was clearly modified by her personality dysfunctions exacerbated by life difficulties. It differed from the motivation of a ?typical' perpetrator of ?dyadic death' or ?extended suicide' presented in the literature. Settlements in cases involving murder and subsequent suicide attempts require a thorough forensic-psychiatric and criminological analysis. In some cases, the terms describing such situations do not refer to the clinical condition of the offender but to the nature and image of the crime. Abuse of these terms may contribute to judicial errors.


Assuntos
Criminosos , Homicídio , Feminino , Humanos , Homicídio/psicologia , Psiquiatria Legal , Tentativa de Suicídio , Medicina Legal
9.
Child Abuse Negl ; 134: 105913, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36302287

RESUMO

BACKGROUND: Forensic interviews for children who have undergone online sexual solicitation (OSS) constitute a unique setting compared to other forms of child sexual abuse (CSA). In these cases, the interviewer holds concrete evidence of the abuse in the form of pictures or texts. During the interview, interviewers use these materials to advance the data collection regarding the abuse, a practice that may significantly influence the child's wellbeing. OBJECTIVE: The current study aims to explore children's experiences during forensic interviews concerning OSS. PARTICIPANTS AND SETTING: The sample included 20 Jewish children in Israel who were referred to and participated in a forensic investigation. METHODS: A thematic qualitative methodology was used to analyze the children's narratives. RESULTS: The findings demonstrate the children's difficulties when confronted with materials related to the abuse. The children detailed the different ways the interview challenged their wellbeing, including visualizing and verbalizing the abuse, new insights, and being videotaped. CONCLUSIONS: The findings in the current study emphasized the intrinsic challenges that children face in OSS forensic interviews resulting from the tension between the interviewer's need to collect details about the abuse and the child's desire to forget it. Practical ramifications pertaining to these threats to the child's wellbeing, future recommendations, and limitations of the study will be discussed.


Assuntos
Abuso Sexual na Infância , Maus-Tratos Infantis , Criança , Humanos , Entrevista Psicológica/métodos , Rememoração Mental , Psiquiatria Legal
13.
J Appl Res Intellect Disabil ; 35(6): 1267-1280, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35995572

RESUMO

BACKGROUND: People with an intellectual disability who commit a criminal offence can be detained, by a court, in a forensic inpatient facility. There is limited understanding of how inpatients with an intellectual disability and their nurses navigate risk in U.K. forensic services. METHODS: A traditional literature review design was followed to map evidence (2000-2021) around the forensic and health and wellbeing risks faced by inpatients with an intellectual disability, nurses' perceptions of managing risk, and patient experiences of informing risk assessment and management. Papers were analysed thematically. RESULTS: Findings suggest that restrictive measures to mitigate forensic risks (e.g., violence) can exacerbate the risk of poor health and wellbeing outcomes. There was some limited evidence of direct patient involvement in risk assessment and management. CONCLUSION: Further research is required to explore how forensic inpatients with an intellectual disability can have input in care planning, risk assessment and management.


Assuntos
Pacientes Internados , Deficiência Intelectual , Psiquiatria Legal , Humanos , Reino Unido , Violência
15.
Int J Law Psychiatry ; 83: 101812, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35777104

RESUMO

Forensic research and practice have historically focused on risk assessment and prevention. This risk-oriented paradigm is shifting towards a more recovery-oriented perspective. The aim of this scoping review is to provide an overview of research on the factors influencing rehabilitation and recovery and discuss the recovery paradigm in a forensic setting. We performed a systematic search of the literature from the past 10 years, in Pubmed, Cinahl and PsycInfo, on recovery and rehabilitation. All types of study designs were included. Data was analysed and charted using an Excel template with various data items of interest. Clinical, personal, social, functional and forensic factors were found to be of influence on recovery and rehabilitation. A number of these overlapped with factors of influence on recidivism and desistance, others did not. Most studies on recovery and rehabilitation focused on a clinical forensic setting. This study provides an overview of the current body of knowledge on the factors influencing recovery and rehabilitation in forensic clients, and encourages researchers and practitioners in their focus on the recovery paradigm in forensic care. The body of evidence on rehabilitation and recovery is not yet as profound as that on recidivism and desistance. More knowledge on recovery trajectories for offenders in prison or ambulatory care, for example, is required.


Assuntos
Criminosos , Reincidência , Medicina Legal , Psiquiatria Legal , Humanos , Medição de Risco
16.
Rev Med Suisse ; 18(789): 1345-1348, 2022 Jul 06.
Artigo em Francês | MEDLINE | ID: mdl-35792586

RESUMO

The practice of psychiatry and psychology in prisons is essential because of the high prevalence of mental disorders that is observed. Psychiatrists and psychologists, such as other health care professionals, should be affiliated to the health department and intervene in the therapeutic role, which must be distinguished from the role of the psychiatric expert mandated by the court. Therapy in prison is challenging because of the sometimes contradictory issues, at the interface of clinical, societal, security, legal and political fields. Health care professionals can thus be subject to important pressures or to ethical and deontological issues.


La pratique de la psychiatrie et de la psychologie en milieu pénitentiaire est essentielle du fait de la forte prévalence des troubles mentaux qui y est observée. Comme l'ensemble du personnel médicosoignant, les psychiatres et psychologues devraient être rattachés au département de la santé et interviennent dans un rôle de thérapeute qui doit être bien distinct du rôle de l'expert psychiatre mandaté par la justice. Les prises en charge thérapeutiques sont complexes en raison des enjeux parfois contradictoires, à l'interface des champs cliniques, sociétaux, sécuritaires, juridiques et politiques. Les thérapeutes peuvent ainsi être soumis à d'importantes pressions ou à des questionnements éthiques et déontologiques.


Assuntos
Transtornos Mentais , Psiquiatria , Psiquiatria Legal , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Prisões
17.
Vertex ; 33(156): 25-34, 2022 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-35856780

RESUMO

OBJECTIVES: The "Guide to understand and assess the quality of the case formulation in forensic mental health - TECF" is tested in order to contribute to the development of the forensic reports. METHOD: Twelve mental health professionals of different Latin American traditions assessed with the TECF the quality of ten international forensic reports, both psychological and psychiatric. The guide includes the manual that describes the dimensions, criteria and guidelines to assess the quality of the forensic case formulation. RESULTS: Internal consistency indicators were in a rank of 0.34- 0.81 for the dimensions and 0.85 for the total TECF. The absolute agreement intraclass correlation coefficient among evaluators with similar tradition reached values of 0.72; 0.52; 0.76 and 0.77 for the dimensions and 0.84 for the total. The agreement among evaluators with different traditions was less. CONCLUSIONS: The TECF is a promising instrument to guide the assessment of quality and to stimulate improvement of the forensic reports. Caution is recommended in light of the traditional rating scale method due to the effect that can be produced by the different practices.


Assuntos
Psiquiatria Legal , Transtornos Mentais , Humanos , Saúde Mental
18.
Int J Risk Saf Med ; 33(S1): S79-S83, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35871373

RESUMO

BACKGROUND: In 2011 Mrs A assaulted two people, one who died. In the hours prior to the attack she made multiple attempts to gain help including attending accident and emergency, contact with an inpatient service and the police. Subsequent investigation highlighted that her risk was not well documented or understood. OBJECTIVE: This quality improvement project aimed to improve knowledge and awareness of HCR-20 risk assessments amongst mental health professionals. METHOD: The Quality Improvement approach was taken and various initiatives were introduced to improve knowledge of the location and purpose of the HCR-20 and to ensure that these risk assessments were regularly updated. RESULTS: The results indicated that knowledge relating to the HCR-20 significantly improved amongst staff and breaches of deadlines for updating these risk assessments dramatically declined after the induction of the interventions. CONCLUSION: Including the 'risk formulation' and 'scenarios' from the HCR-20 in clients' crisis plans, introducing training relating to the HCR-20, and including discussions relating to the HCR-20 at the beginning of CPA meetings resulted in improved MDT awareness and knowledge of the HCR-20. A broader understanding and awareness of risk factors enabled the service to move towards a culture of risk being everyone's business.


Assuntos
Psiquiatria Legal , Violência , Humanos , Feminino , Psiquiatria Legal/métodos , Violência/psicologia , Medição de Risco/métodos , Pacientes Internados/psicologia , Fatores de Risco
19.
BMJ Open ; 12(7): e058581, 2022 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-35868830

RESUMO

INTRODUCTION: Secure forensic mental health services are low volume, high cost services. They offer care and treatment to mentally disordered offenders who pose a high risk of serious violence to others. It is therefore incumbent on these services to systematically evaluate the outcomes of the care and treatment they deliver to ensure patient benefit in multiple domains. These should include physical and mental health outcomes, as well as offending related outcomes. The aim of Dundrum Forensic Redevelopment Evaluation Study (D-FOREST) is to complete a structured evaluation study of a complete national forensic mental health service, at the time of redevelopment of the National Forensic Mental Health Service for the Ireland. METHODS AND ANALYSIS: D-FOREST is a multisite, prospective observational cohort study. The study uses a combination of baseline and repeated measures, to evaluate patient benefit from admissions to forensic settings. Patients will be rated for physical health, mental health, offending behaviours and other recovery measures relevant to the forensic hospital setting at admission to the hospital and 6 monthly thereafter.Lagged causal model analysis will be used to assess the existence and significance of potential directed relationships between the baseline measures of symptomatology of schizophrenia and violence risk and final outcome namely length of stay. Time intervals including length of stay will be measured by median and 95% CI using Kaplan-Meier and Cox regression analyses and survival analyses. Patient related measures will be rated as changes from baseline using general estimating equations for repeated measures, analysis of variance, analysis of covariance or logistic regression. ETHICS AND DISSEMINATION: The study has received approval from the Research Ethics and Effectiveness Committee of the National Forensic Mental Health Service, Ireland. Results will be made available to the funder and to forensic psychiatry researchers via international conferences and peer-reviewed publications. TRIAL REGISTRATION NUMBER: NCT05074732.


Assuntos
Criminosos , Transtornos Mentais , Serviços de Saúde Mental , Criminosos/psicologia , Psiquiatria Legal/métodos , Humanos , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Estudos Multicêntricos como Assunto , Estudos Observacionais como Assunto , Estudos Prospectivos , Violência/psicologia
20.
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...