Crimes and sentences in individuals with intellectual disability in a forensic psychiatric context: a register-based study

Aims To study associations between intellectual disability (ID) and sexual and violent offending among individuals subject to pre-trial forensic psychiatric assessment. To investigate sentences following pre-trial forensic psychiatric assessment in offenders with and without ID. Methods A population-based observational study using data from pre-trial forensic psychiatric assessments in Sweden (1997–2013), the Swedish National Crime Register and several other Swedish national registers. The study population consisted of 7450 offenders (87% men, 13% women) who were subject to forensic psychiatric assessment in 1997–2013, of whom 481 (6.5%) were clinically assessed as having ID. Results ID offenders were more likely than non-ID offenders to have a sexual crime as an index crime [26.2 v. 11.5%, adjusted odds ratio (OR) 2.7, 95% confidence interval (CI) 2.02–3.58] as well as previous convictions regarding sexual offending (10.4 v. 5.6%, adj OR 2.3, 95% CI 1.70–3.12). These associations were restricted to male offenders; sexual offending was uncommon among women. Comorbid attention-deficit hyperactivity disorder reduced the association between ID and sexual offending (adj OR 2.7 v. 3.1, p = 0.017), while comorbid autism spectrum disorder had no significant influence on the association (adj OR 2.7 v. 3.0, p = 0.059). Violent crime was equally common among ID and non-ID offenders. Offenders with ID were more likely than non-ID offenders to be sentenced to forensic psychiatric care or community sanctions and measures (such as probation, conditional sentences or fines) than to prison; however, 15% of individuals who received an ID diagnosis during the forensic psychiatric assessment were sentenced to prison. Previous criminal convictions, concurrent antisocial personality disorders and substance use disorders were associated with a higher probability of a prison sentence among offenders with ID. Conclusions Sexual crime is overrepresented among offenders with ID compared to offenders with other mental disorders than ID in forensic psychiatric contexts. ID offenders become subject to forensic psychiatric care and forensic psychiatric services need evidence-based treatment programmes for offenders with ID. In addition, there is a need for early intervention strategies suitable for disability services and special education schools, in order to address the complex needs of individuals with ID and prevent sexual and violent offending.

Incomplete homicide-suicide in Hunan China from 2010 to 2019: characteristics of surviving perpetrators

Background The mental and psychological conditions of the individuals involved in homicide followed by suicide (H-S) are still unclear, especially in China. Information on these aspects cannot be accurately obtained due to the death of perpetrators. This study aims to demonstrate the characteristics of incomplete H-S with surviving perpetrators, which provide the possibility to obtain detailed mental and psychological information. Methods This study explores incomplete H-S events occurred in Hunan, China from 2010 to 2019, in which the surviving perpetrators received a forensic psychiatric assessment. Three aspects of information, i.e., the subject’s demographic, clinical and criminal information, were recorded and analysed. Results 125 incomplete H-S incidents involved 166 victims were found in the current study. A total of 112 (89.6%) perpetrators were diagnosed with mental disorders, but only 56 of them had a history of consultation due to mental problems, and only one of them adhered to treatment. In most cases, the motivation is related to the psychopathological states, with the most common diagnosis being major depression, followed by schizophrenia. Gender difference was significant among the subjects: females were more likely to have a suicidal history, to be diagnosed as major depression and to be motivated by delirious altruism and family problems. Conclusions This study indicated that psychopathology might be a predisposing factor, which highlighted the importance of mental state assessment for the population involved in incomplete H-S. A clearer understanding of the role of mental disorders might be helpful for the intervention of H-S.

Who are people charged with rape in Croatian: The forensic psychiatric evaluation of people charged with rape

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.

The term of the inpatient forensic psychiatric assessment and its continuation in criminal proceedings

The article discusses the problematic issues of calculating the term for placing a person in a medical institution for the purpose of conducting the inpatient forensic psychiatric assessment (hereinafter referred to as the FPA) in criminal proceedings. Based on the materials of judicial practice: 1) a wide variability of the approaches of judges is demonstrated in the determination of the term for carrying out the FPA in the resolutions (since the legislator, in part 2 of Article 509 of the Criminal Procedure Code of Ukraine (hereinafter – the CPC), indicates only the upper limit of the time period for carrying out the FPA – up to two months); 2) the decisions of judges on the prolongation of the FPA are highlighted and analyzed. The necessity of legislative regulation of prolongation of the FPA term at the level of criminal procedural legislation of Ukraine is proved. In a comparative aspect, the normative regulation of the FPA term and the procedural mechanism of its prolongation in the criminal procedural legislation of the neighboring countries – Kazakhstan, Moldova, Uzbekistan, Estonia, etc. are illustrated. At the same time, the positive experience of foreign countries was recognized as suitable for adoption in the following aspects: (a) determination of the term of the FPA in days; (b) prolongation of the FPA at the reasoned request of the expert (commission of experts); (c) prolongation of the FPA for up to 30 days. In this case, the general term of a person’s stay during one FPA cannot exceed 90 days. However, if an additional or repeated FPA is required, its term must be recalculated. Attention is focused on the fact that the results of the assessments carried out may be different, but the establishment of a reliable mental state of a person acquires particular importance when deciding whether a person is subject to criminal liability. Therefore, it is emphasized that it is inexpedient to propose legislative regulation of the term limit for conducting the FPA in relation to a specific person in one criminal proceeding. It is concluded that since the issue of sending a person to a medical institution for a psychiatric assessment is resolved in the manner prescribed for submission and consideration of applications for precautionary measures (Part 2 of Article 509 of the CPC), it is logical that the prolongation of the inpatient FPA may occur in the order of extension of detention (Article 199 of the CPC).

CLINICAL STRUCTURE OF MENTAL VIOLATIONS OF PERSONS WHO HAVE COMMITTED A CRIME OF SEXUAL NATURE

The article deals with the results of a scientific study carried out as part of a Doctor’s thesis “Forensic psychiatric assessment of persons who have committed a crime of sexual nature”. In order to achieve the goal of the study, the author analyzed 287 cases of forensic psychiatric examinations in relation to subjects who committed sexual offenses and were on forensic psychiatric examinations of an expert institution from the years 2000 up to 2015 (16 years). In order to determine the relationship between the degree of violation of the ability to be aware of their actions and to guide them and resolve expert issues by the author, from the group of “imputability” empirically a group of “limited imputability” was selected that was artificially formed on the basis of the domestic concept of “limited saneness”. It was established that the discovered clinical features in this scientific research can be used to determine the criteria of “limited imputability” in the forensic psychiatric evaluation of persons who committed a criminal crime of sexual nature.

THE MODEL OF FORENSIC PSYCHIATRIC EVALUATION OF ABILITY TO REALIZE THE SIGNIFICANCE OF THEIR ACTIONS AND GOVERNE THEM BY PERSONS WHO HAVE COMMITED SEXUAL OFFENSES

The article gives the results of scientific research conducted within the framework of the doctoral thesis “Forensic psychiatric evaluation of persons who have committed sexual criminal offenses”. For the purposes of the study the author analyzed 287 cases of forensic psychiatric examinations regarding the subject, who committed the sexual offense and were at the forensic psychiatric examination in Kiev city center forensic psychiatric examination in 2000 to 2015 (16 years old). The study revealed the criteria of «limited responsibility» for the perpetrators of sexual crimes, offered a forensic psychiatric assessment model for ability to understand their actions and to govern them in individuals who have committed sexual offenses. Key words: forensic psychiatric examination, responsibility – limited responsibility – irresponsibility, sexual offenses.