Several studies suggest the existence of a relationship between major mental disorders and crime. However, it is important to emphasize that violent behaviors do not affect all patients and that issues of criminality among mentally ill persons only represents a small proportion.

The objective of this study is to establish the general and clinical profile of perpetrators of sexual and physical assaults.

This is a retrospective study of the records of forensic psychiatric expertise, conducted in the psychiatry department of the University Hospital of Mahdia during the period from May 1st 2000 to May 31st 2013.

The general profile of the population the study was characterized by a mean age of 39 years, a sex ratio of 8.25, unemployment in 73% of cases and by the presence of a psychiatric personal history 54% of cases. Sexual and physical assaults accounted for 54.5% of cases. It was essentially in descending order: assault and battery (65%), rape (16.2%) and incest (5.4%). As for the clinical profile, schizophrenia and epilepsy were recorded each in 13.5% of cases, major depressive disorder in 8.1% of cases, bipolar disorder in 5.4% and substance abuse in 5.4% of cases. A personality disorder was observed in 48.6% cases, essentially antisocial personality (55%). Comorbidity with addictive behavior was observed in 56.7% of cases.

It is necessary to characterize a subgroup of patients with mental disorders, likely to commit violent crimes, in order to prevent acting out behaviors and adapt their management.

The authors have not supplied their declaration of competing interest.

The aim of this study was to identify the socio-demographic status and clinical features of patients with acute psychotic disorder and who committed a medicolegal act, seek acute psychosis implicated and raise the characteristics of this medicolegal acts.

We performed a retrospective study of 25 male patients with acute psychotic disorder. They were involuntary hospitalized in the medicolegal department of Razi, according to Article 29 of Law after committing a medicolegal act because of dementia within the meaning of article 38 of the Tunisian Penal Code.

It was about a young person, average age of 27.32 years, family cohesion was often present (80%), with forensic history (20%), violence history (20%) and substance abuse (40%), having a personality disorder (25%), having a precipitating factor (32%), having an acute psychotic episode (72%), repetitive acute psychotic episode (16%), a first manic episode (8%) and drug-related psychotic disorder (4%). They had committed by order of frequency serious physical assault (43.5%), attempted murder, assault and injury followed by attacks against property (40%). The victim was mostly a family member (40%), without determination, under the influence of toxic substances (16%) and motivated by delusions of persecution (51%). The acting out was recognized (68%). The majority was indifferent (92%) and does nothing (68%).

The first-episode psychosis have a high-risk of acting out, early treatment may prevent some medicolegal acts. Preventing of acting out in the psychotic involves the identification of risk factors and an early treatment of mental disease.

The authors have not supplied their declaration of competing interest.

Stalking, a dangerous persecution, gained attention because of persecution of celebrities by fans suffering by mental disorders. In psychiatry, there is no consensus about the exact definition of stalking, because it can result from many different motivations and constellations of psychopathological symptoms.

The authors provide an overview of the current state of stalking, i.e. dangerous persecution as a new crime in Slovakia. They describe the characteristics of stalkers (persecutors), victims and their interaction in their forensic psychiatric practice.

Search in author's expert reports were conducted on stalking. Analysis of motivations, mechanisms of persecutions and analysis of psychopathological symptoms and mental disorders in stalkers and their victims were made.

Stalkers and their victims are a heterogeneous group with different psychopathology and mental disorders including personality disorders and psychosis. The authors document general principles of forensic psychiatric assessment of stalkers as crime offenders.

Stalking is problem also in forensic psychiatric practice also in Slovakia. Stalkers who suffer from mental disorders require adequate diagnostic and psychiatric treatment also in forced setting.

The authors have not supplied their declaration of competing interest.

Prof. Jane Ireland found that 65% of assessment reports sampled from UK family courts were ‘poor’ or ‘very poor’.

The presentation raises international awareness of the problem and explains the contextual factors that contribute to malpractice.

The paper highlights typical deficiencies in family court assessments and forensic processes in order to reduce the risk of unsafe custody rulings.

Due to the paucity of published academic literature ‘ad hoc’ Internet searches were utilised to collect source material and identify advocates. A range of conferences, seminars and continued professional development (CPD) events revealed the background for some of the persistent problems.

The suppression of the trauma-centric approach to mental health issues and its re-emergence are central to understanding the trajectory and how to improve professional practice.

Organised Ritualised Crime Abuse Networks (ORCANs) seem to be at work infiltrating institutions that are supposed to uphold law and order.

Inadequate psychometric instruments appear to beguile some mental health professionals into wrong diagnosis and testimony.

The standard of UK family court assessments must improve. Scrapping ‘forced adoption’ legislation that drives the ‘child snatching’ culture in UK social services department would benefit society including citizens from abroad whose governments vocally criticise the removal of their children through clandestine UK ‘child protection’ procedures.

The author has not supplied his declaration of competing interest.

Prevalence studies show that nearly 80% of young offenders present psychiatric comorbidity. Juvenile offenders are at 3 times higher risk of being diagnosed with a psychiatric disorder. Recent systematic reviews have mainly focused on youth in detention neglecting youth in the community. Females and ethnic minorities have been overlooked in the literature in spite of the increasing rates of psychiatric disorders striking these groups.

To perform a meta-analysis on the prevalence rates of various mental disorders including depression, psychosis, PTSD, conduct disorder, ADHD, learning disabilities and personality disorders among young offenders. Self-harm and suicidal behaviour are examined too.

To compare the prevalence of psychiatric disorders among young offenders across custody and community and to emphasise on gender, age, and ethnic variations.

Relevant studies have been identified with computer-assisted searching and scanning of reference lists. Prevalence of mental disorders based on gender, age and ethnicity along with potential moderating factors are extracted from the included studies. Meta-regression is performed to test covariates that might have contributed to differences in prevalence rates across studies.

After searching the relevant literature, 99 studies were determined to be eligible for data extraction.

Young offenders with ongoing mental health problems comprise a vulnerable group within forensic psychiatric services that needs special attention. More prevalence studies should be conducted to improve mental health provision. Ethnic, gender, and age variations across young offenders should be addressed and turn interventions into a tailored process that responds to the young person's particular treatment needs.

The authors have not supplied their declaration of competing interest.

Forensic adaptations of assertive community treatment (ACT) remain understudied in Europe, whereas promising results emerge from the United States. There is a need for research into the effectiveness of ForACT outside the United States, as Europe differs greatly in terms of organisation of mental health and judicial system.

Investigating effectiveness of forensic adaptations of ACT in the area of Flanders, Belgium. Outcome measures are divided into forensic, like arrests or incarcerations, and non-forensic, like admissions and length of stay.

Investigating effectiveness of ForACT on forensic and non-forensic outcome measures as well as factors related to outcome. A third outcome is community tenure, which is the actual number of days divided by the potential number of days spent in the community.

A controlled cohort study was designed over with first results at 33 months. The experimental group consists of a new ForACT team in the area of Flanders, Belgium (n = 70). Patients are admitted from prison, psychiatric hospitals or other community-based care. The control group consists of mentally ill offenders in community-based treatment after release from prison (n = 56).

Results on forensic measures and community tenure are promising in favour of the ForACT team. In contrast, clients are often, though shortly, readmitted into psychiatric residential care. Substance use emerges as the main reason for admissions.

A local forensic adaptation of ACT reveals promising results on forensic outcome measures, yet suffers a large number of admissions.

The authors have not supplied their declaration of competing interest.

Substance-related mechanism may be capable of promoting brain changes in high-risk individuals [1,2]. Cannabis use reported to be associated in long-term cognitive effects.

To evaluate mental status and criminal behavior in individuals under cannabinoid consumption in forensic psychiatric assessment.

A retrospective analysis was conducted of forensic psychiatry examination reports in psychoactive substance consumption cases (n = 170) in National Service of Forensic Psychiatry 2010–2014. Offenders, which were reported with cannabinoid consumption (n = 57) were assessed by socio-demographic characteristics, mental state, court order and outcome.

Eighty-six percent offenders with cannabinoid consumption in observed period were men. The age of offenders prevailed from 18 to 35 years with basic education; 57.9% of offenders consuming cannabinoids were single (Fig. 1).

A total of 36.8% of all crimes in research group were committed against property, 31.6% – an unlawful possession of psychotropic substances, 22.8% – committed against human health, 8.8% – against public order (Fig. 2).

Impulse control deficiency and emotion disorders were prevalent among offenders under cannabinoid consumption; 17.5% were committed irresponsible, all of them due to comorbid psychiatric disorder. More likely to offend were men, aged 18–35 years, single, who had basic or lower education.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

High-security hospital patients are often complex in presentation characterised by treatment resistance, medication non-concordance and history of violence. Paliperidone is licensed as both an oral and depot antipsychotic for the treatment of schizophrenia. Whilst there is data for the effectiveness of paliperidone palmitate (PP), there are no studies involving patients in forensic settings or those with comorbid personality disorder.

To determine the effects of PP on violence, aggression and personality pathology.

To evaluate the clinical effectiveness of PP.

This was a retrospective service evaluation involving 11 patients. Medical records and interviews with the treating psychiatrist were used to formulate clinical global impression (CGI) and to identify incidents of violence. The effect on personality symptom domains; cognitive-perceptual, impulsive-behavioural dyscontrol and affective dysregulation was ascertained, as well as engagement with occupational and psychological therapies.

Six patients were being prescribed PP. All 6 showed improvement in the CGI score with benefits in the symptom domains. Two patients demonstrated a reduction in violence risk and 2 remained incident-free. There was improvement in engagement with therapies. Benefits were also seen in aspects of personality for those who had discontinued PP.

This pragmatic study of a small but complex patient group demonstrated that PP was effective in reducing symptoms of schizophrenia. Additionally and for the first time, it was shown that PP was also effective in reducing violence as well as improving personality pathology dimensions in a comorbid patient. This could have significant implications for management of high-security patients.

The authors have not supplied their declaration of competing interest.

The systematized and proper sized research of alcohol pharmacokinetics in Korean has not reported ever.

Aim of this study is to measure the β value and alcohol pharmacokinetic factors in Korean adult female and the relationship between the β value and some variables including age, smoking, total body water, drinking capacity, BMI, blood cholesterol, body fat and body fat ratio.

Ninety-one subjects were randomly divided into two groups. One group was provided as much as 0.35 mg/mL/kg of alcohol and the other as much as 0.70 mg/mL/kg, and blood alcohol concentration was measured 15, 30, 45, 60, 90, 120, 180, and 240 min after the women finished drinking.

The subjects’ mean alcohol elimination rate (β) was −0.002379 mg/100 mL·h, and there was no statistically significant difference in elimination rate between the two groups. The mean time to reach maximum blood alcohol concentration was 45 minutes, alcohol absorption rate was 0.1123 ± 0.1799 g/L/min, and the area under the concentration curve was 109.15 ± 62.95. Among the factors that correlated with alcohol metabolism, alcohol absorption rate and follicle-stimulating hormone were statistically significant, but age, body mass index, and body fat percentage were not significantly correlated with alcohol metabolism.

These results suggest that the β values for healthy Korean females can differ from the cut-offs that are currently used in Korea, which suggests that the legal limit for driving under intoxication should be adjusted.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Parricide (referring as parental homicide) is a rare event among homicides, yet challenging and intriguing from psychiatric point of view. Still, literature concerning parricide is sparse and most studies concern small or heterogenous samples or anecdotal cases.

To analyze differences in parricide offenders among forensic psychiatric inpatients at the university psychiatric hospital Vrapče's centre for forensic psychiatry.

To test some differences between parricide offenders with regard to specific type of parricide.

Available retrograde data of 50 years forensic inpatients (n = 430). We identified parricide cases of matricide and patricide included.

The analysis included a total of 22 parricide offenders. All parricide offenders were male adults. Matricide was more prevalent then patricide (13 vs. 9). Matricide offenders were in average younger when committed crime, had more prevalence of psychotic disorders and earlier onset of symptoms in comparison with patricide group.

We identified differences and similarities between these two parricide offenders groups. It is important to expand research further including different types of motives and family dynamics regarding the type of parricide victim.

The authors have not supplied their declaration of competing interest.

The need for medical treatment in organic pathology is justified even against the will of the patient in the context of represen

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

Erotomania, or De Clerambault's Syndrome, was first described in 1921. However, cases of Insane Love were long known before. Presently, this condition is classified as a delusional disorder typically affecting women. However, in forensic samples, most of these reports relate to men with violent behaviour, associated to harassing or stalking of a woman.

To present the case of a man, diagnosed with Erotomania and literature review of similar cases.

To bring awareness to the infrequent diagnosis of this condition in males and the legal implications this condition may have.

Consultation of the patient's clinical process and published articles focusing on Erotomania in men.

A 50-year-old man was referred from Court for persistently stalking a woman on the past few years. He revealed erotomanic and persecutory delusions, believing these accusations were all part of a scheme to restrain his alleged relationship.

There was a clinical improvement during hospitalization and treatment with antipsychotics. Due to the legal process in court, a forensic examination was also performed.

On the follow-up, the patient remained stabilized. He would not verbalize any delusional content, and calmly deny any inadequate behaviour. However, some of his stalking attitude remains. As many of these patients, we believe his delusion is still present, although his behaviour is more controlled with treatment. Recognizing the characteristics and course of this disorder in our patients, grants a better chance of intervention and attentiveness towards the legal implications that may arise.

The authors have not supplied their declaration of competing interest.

The relationship between clinical factors and both psychosocial and criminal history characteristics among forensic psychiatric patients entering treatment in Lithuania has not been well explored.

The aims and objectives of this presentation are:

– to overview the clinical, socio-demographic and criminal factors in a Lithuanian sample of forensic psychiatric patients;

– to demonstrate which factors were significant to violent criminal behaviour;

– to address some main concerns and issues of risk assessment processes.

Data were collected from 325 forensic psychiatric patients’ files in one forensic psychiatric hospital in Lithuania. A sample consisted of 36 (11%) females and 289 (89%) males. The average age of patients was 41.7 years (SD = 14.0).

Psychosis was the most common psychiatric diagnosis. The substance abuse problem was common in this population as well. The results of the logistic regression show that increase in patients’ substance abuse and their age was significantly associated with violent offending.

The study stressed an urgent need for further research of forensic patients in Lithuania.

The authors have not supplied their declaration of competing interest.

The relationship between psychotic motivation and the genesis of medico-legal acts is well documented in the literature. Delirium and hallucinations, in particular, have been widely reported in this context.

The aim was to identify socio-demographic, clinical, and criminological profile of patients hospitalized for forensic acts committed in psychotic context.

We conducted a descriptive retrospective study, including 7 patients committing a forensic act in psychotic context, selected among all patients hospitalized after a judgement of dismissal (Tunisian law), in psychiatry department, Hedi Chaker university hospital, Sfax, Tunisia. Socio-demographic and clinical data were collected through patients’ observations.

The mean age was 37.7 years. Sex-ratio (M/F) was 6. The criminological act was an attack in 57.1% and homicide in 42.9% of cases. It was committed on the outside in 42.9% of cases. The tool was a bladed weapon in all cases. The victim was a family member in 71.4% of cases. The context was a delirium in 71.4% (theme: 80% persecution, 20% jealousy; mechanism: 40% hallucinatory, 60% interpretative) and hallucinations in 42.9% of cases. Among our patients, 57.1% were indifferent and 28.6% regretted the act. Psychiatric diagnosis was: schizophrenia 57.1%; delusional disorder 28.5% and brief psychotic disorder 14.2%. Personality disorder was reported in 28.6% of patients.

The acting out in a psychotic moment in patients with mental illness remains the most formidable event, causing sometimes the problem of criminal liability. Control of attendance at psychotherapy and psychotropic treatment are preventive and curative necessary measures to avoid crossing the dangerous acts.

The authors have not supplied their declaration of competing interest.

A heated and longstanding debate exists as to whether psychopathy and narcissism represent two distinct, albeit overlapping, constructs, or two different labels for the same concept. However, relatively scant attention has been dedicated to this issue in offender populations, which are likely to present elevated levels of both psychopathy and narcissism. Furthermore, the picture is complicated by the multidimensional nature of both constructs.

We sought to explore the associations among psychopathy facets and pathological narcissism dimensions, comparing an offender sample with community participants.

To highlight similarities and differences in clinically relevant and sub-clinical levels of psychopathy and narcissism dimensions, as well as in pattern of associations between them.

A sample of male offenders incarcerated in Italian jails, and a sample of community-dwelling men, were administered the Self-Report Psychopathy Scale (SRP-4; Paulhus et al., 2015) and the Pathological Narcissism Inventory (PNI; Pincus et al., 2009).

As expected, levels of both narcissism and psychopathy were significantly higher in the offender sample. Narcissism and psychopathy were only partly related, with correlations ranging from low to moderate in size, and differential pattern of associations between selected dimensions emerged consistently with theoretical models and in line with prior studies.

Psychopathy and narcissism are two separate syndromes, which share similar aspects but also present distinct features and this is likely to explain their partial overlap. Future studies should take a closer look at how facets of psychopathy and narcissism relate across different samples (e.g., also examining female offender samples).

The authors have not supplied their declaration of competing interest.

To investigate whether maladaptive strategies to cope with shame feelings were associated with psychopathic traits.

To examine the association between four maladaptive shame coping were positively related with psychopathic traits.

A sample of male offenders incarcerated in Italian jails completed the Self-Report Psychopathy Scale (Paulhus et al., 2015) and the Compass of Shame Scale (Elison et al., 2006).

As hypothesized, maladaptive shame regulation strategies did predict psychopathic traits in the offender sample examined. Specifically, significant and meaningful associations occurred between avoidance and attack other coping styles and psychopathic traits.

The present study is among the first in providing evidence of a possible relationship between maladaptive strategies to cope with shame feelings and psychopathic traits, and such link can be informative to tailor treatment programs for these hard-to-treat patients.

The authors have not supplied their declaration of competing interest.

We have previously reported a human-specific nucleotide in the promoter sequence of the calreticulin (CALR) gene at position –220C, which is the site of action of valproic acid.

Reversion of this nucleotide to the ancestral type, –220A, co-occurs with severe deficit in higher brain cognitive functions.

In the current study, we compare the pattern of protein binding between –220C and –220A.

Antibodies reactive against transcription factors CREB, USF, and c-Myc were used to identify the specific proteins involved in complexes with DNA using electrophoretic mobility shift assay (EMSA).

Significant increase was observed in the overall protein complexes binding to the –220 C allele vs. –220A. The transcription factors, CREB, USF, and c-Myc, were differentially bound to –220C, represented by supershifts.

We propose that differential binding of CREB, USF, and c-Myc to CALR nucleotide –220C may be linked with the evolution of higher brain functions in human.

The author has not supplied his/her declaration of competing interest.