The Presence of Minor Physical Anomalies of a Hand in Patients with Mental Disorders.

INTRODUCTION: Minor physical anomalies (MPA) are subtle morphological deviations with little to none clinical significance that are developed prenatally and therefore could be an indicator of structural changes in the brain developing at the same time. Aim of this study was to determine whether the MPA of the hand can distinguish psychotic patients from patients with non-psychotic diagnoses as well as from the healthy individuals. SUBJECTS AND METHODS: 100 consecutive patients from the University Hospital Center Zagreb, Department of psychiatry, were included in this case-control study along with 100 healthy control subjects. Investigators examined the dorsal and palmar side of the hand and were blind to the patient's diagnoses previous to the examination. Examined MPA included thenar crease, proximal transverse crease, proximal interphalangeal joint, eponychium of the middle digit, fingernail size and digital flexibility. RESULTS: Results showed significant differences in the quantity of MPA between the patients and the control group, as well as differences between patients with psychosis and the healthy subjects. CONCLUSIONS: Despite the fact that previous studies demonstrated characteristic distribution of specific MPA in schizophrenia, this study did not prove such results. Moreover, this study showed that all the MPA are equally common in both schizophrenia and other psychoses.

Sex Offenders in Croatia: Fifteen Years Later.

BACKGROUND: The aim of the study was to compare the characteristics of sex offenders today, and those who committed a sex crime fifteen years ago, in regard to their psychiatric-forensic aspects. SUBJECTS AND METHODS: Data from the University psychiatric hospital Vrapce, Center for forensic psychiatry on court people sent for psychiatric and forensic evaluation, who were accused of sex offense in two time frames (1998-2001 and 2010-2016) were analysed. In total there were 50 and 57 male subjects sent for an evaluation. RESULTS: In both groups rape was the most prevalent offence, and both groups had the same prevalence of abuse, earlier psychiatric treatment and the majority of offenders were diagnosed with dissocial personality disorder and other personality disorders. Paedophilia was diagnosed in only a minority (14% and 7% respectively) of cases. The latter group (2010-2016) committed more sex offences against children, more often were with no mental disorder and less often had alcohol dependence and mental retardation. Up to one third of the later group were not giving their defence, compared to 4% of the former group. CONCLUSIONS: Changes in court case law and psychiatrists' usage of diagnostic criteria have influenced the prevalent diagnoses in sex offenders. Paraphilias are not often diagnosed in sex offenders because they do not confirm the act, and in recent years more often use not to give their defence (which makes reaching the diagnosis more challenging).

Psychiatric and Forensic Characteristics of Sex Offenders With Child and With Adult Victims.

This study presents psychiatric and forensic characteristics of people accused of a sexual crime and sent for evaluation. Data were drawn from the only institutional psychiatric forensic assessment center in Croatia, during a 9-year period, from January 1, 2010 to December 31, 2018. There were 72 cases of sex offenses: 37 with child victims and 35 with adult victims. People accused of sex offenses with child victims were more often sexually abused during childhood and treated psychiatrically as inpatients. They used alcohol less often. Sex offenders with child victims were diagnosed with narcissistic and antisocial personality disorder, dementia, and pedophilic disorder. Those with adult victims were diagnosed with antisocial personality disorder, alcohol related disorders and dementia. Due to these differences, the management of these two groups of offenders in both mental health and penal systems should be different.

Forensic psychiatric evaluations of people charged with rape in Croatia.

Introduction: Sexual violence is a substantial public health problem that is associated with a major impact on victims, and in Croatia, more than half of reported cases of sexual violence involve rape. To help understand their general profiles and consider any implications arising, the aim of this research was to describe the forensic psychiatric characteristics of people charged with rape. Methods: All evaluations of people charged with rape and sent for evaluation at the largest assessment centre in Croatia during the period 2010-2018 were analysed (n = 56). Results: Alleged offences most often took place in a perpetrator or victim's home (71%), while the next most frequent location was the street (15%). Over 80% of alleged victims were known to the accused. Alcohol use and abuse were present in 73% of the accused, and 29% were drinking at the time of the alleged offence. Alcohol-related disorders were presented in 38% of the accused, while 38% had a personal history of drug use, and antisocial and narcissistic personality disorders were present in 48% and 29%, respectively. Psychotic disorders were rare (1.8%). Most of the accused were found to be criminally responsible; however, forensic psychiatric assessment procedures were inadequate when considering psychosexual assessments. Conclusions: Interventions based around public health and education should be considered in this field, and forensic psychiatric assessments should be prioritized for improvement.

Psychiatric and Forensic Differences Between Men Charged with Sex Offences and Men Charged with Other Offences.

Studies on differences between individuals convicted of sexual offences and nonsexual offences are sparse and there is an on-going debate as to whether sexual offenders differ from other offenders. The primary aim of this study was to determine demographic characteristics, prevalence of mental disorders, alcohol and drug use at the time of the crime and the criminal responsibility of individuals charged with sexual offences, compared to nonsexual crimes, with the aim of bringing awareness to the similarities and differences between men charged with sex offences and those charged with other crimes. This is a single-institution retrospective study of subjects charged with sexual offences and sent for institutional psychiatric evaluation to a Forensic Psychiatric Centre in an urban, academic, tertiary-care center. The control group consisted of individuals charged with nonsexual offences referred to the same center. Results showed significant differences between individuals charged with sexual offences and nonsexual offences. Men charged with sex offences more frequently committed their crimes alone and victimized children equally as often as adults. They also less frequently pleaded guilty in court. They were more likely to be abused in childhood and more often had antisocial personality disorder and paraphilias and less often substance-related disorders. The majority were considered criminally responsible. Our results show that sex offenders are different from nonsex offenders in many characteristics of their personal history, offence characteristics and forensic evaluations and these particular differences warrant different approaches to the prevention of future re-offending, compared to nonsex offenders.