In psychiatric clinical practice compulsory admission to hospital is the last option of the overall care provided to mentally ill patients, justified in terms of civil and human rights because of issues of protection for patients’ and society members’ life and health. Usually treating psychiatrists believe that issues of compulsory admission are without doubt associated with the permission, or even obligation, to apply compulsory treatment in a routine daily base.

In this review, we are exploring issues around the implementation of compulsory treatment.

Thorough research of the main databases and web search engines for relevant studies, agencies and organizations, interested in compulsory treatment issues.

Research shows ambiguous views. Conservatives argue that delay of any substantial, even enforced, and well documented treatment, would result in delay of treatment and excess use of other potentially more enforced methods. Using laws and legislation patients’ rights are guarded but we also have the obligation to treat patients. On the other hand, liberals express totally opposite views. Capacity (or incapacity) is not ‘all or nothing’ but specific to decision and should be respected, with the exception to emergency treatment need.

The capacity of decision-making of the mentally ill patient, whether or not being compulsory admitted, should be assessed in a more holistic and systematic approach and become part of the standard practice, followed by dissemination of these decisions to all relevant parties. Restore decisional autonomy should be one of the main goals of any therapeutic intervention.

The author has not supplied his declaration of competing interest.

For an inmate incarcerated for life we could acknowledge factors contributing to the desire to commit suicide, as social isolation, insensitive discipline, lack of privacy, constant threat of violence, fear, guilt, hopelessness, and depression are prominent in the life imprisonment.

To discuss the ethical issues of prevention suicide in inmates incarcerated for life.

We performed thorough research of the main medical databases, and web search engines for relevant studies, articles and opinions and reviewed them independently.

Prevalence of mental illness is high among inmates and several common stressors typically herald an inmate's suicide. Suicide is often the single most common cause of death in correctional settings. Even though some suicide victims have consulted a mental health service-provider before their suicide, the majority of suicide victims were not mentally ill. The paradox, particularly for life sentence inmates is that we are trying to persuade an inmate to live within a disciplinary environment, which has as side effect the increase of suicidality of the inmates.

Prisons’ inability to protect the health and safety of inmates could raise ethical issues. We have obligation to adequate suicide prevention for all inmates, and we should be more broad minded as the will to die in mentally healthy individuals is beside an free will expression, a sign of serious lack of support and humane living conditions. We should be vigilant not to use the prevention of suicide programs as another way to increase punishment of life long imprisonment.

The author has not supplied his declaration of competing interest.

Almost 50 years after the mental health reform in Europe and the deinstitutionalization of the mentally ill, there seems to be a slow change in the social concept of mental disorder. However, in the case of mental retardation, little progress has been made, since the social approach to these patients does not seem to involve the promotion of their autonomy. This is a reality with implications in medical, social and forensic psychiatry settings.

We will present a statistical analysis on interdiction/inhabilitation processes in two districts of Portugal followed by a comparative analysis between Portuguese and other European countries’ civil law concerning the regulation of legal capacity.

Critical analysis of the means by which the concept of legal incapacity has been applied in the Portuguese social setting.

Descriptive and retrospective analyses of 500 expert reports in the districts of Coimbra and Viseu regarding interdiction/disqualification processes. Research on Pubmed and legal databases; keywords used: mental disability, mental retardation, civil law, mental incapacity, legal incapacity, legal capacity, interdiction, curator.

The number of forensic psychiatric examinations has suffered a significant increase in the last years. The majority of these expertise concern interdiction/inhabilitation processes. Mental retardation is the more prevalent diagnosis, and the great majority of the cases were interdicted.

In Portugal, the law has been applied in order to safeguard the economic assets of mentally retarded individuals, but not in order to promote their social integration and autonomy.

The authors have not supplied their declaration of competing interest.

Under the Portuguese law, criminal offenders that are designated as non-criminal responsible – “inimputáveis”, similar those in the United States of America found “not guilty by reason of insanity”, are forced to be committed to inpatient forensic units either in psychiatric hospitals or prison hospitals for mandatory security measures.

To evaluate if patients committed in a regional forensic inpatient unit (RFIU) who had a psychiatric history preceding the crime, were under long acting injectable antipsychotic (LAIA) in during the period of the crime.

During September/October 2015, patients committed to the RFIU in Centro Hospitalar Psiquiátrico de Lisboa were characterized using medical and court records regarding clinical and demographic variables. The type of crime and previous number of criminal acts were also accounted for.

We included 33 patients in the study. During time of the crime, 25 patients (75.8%) had history of previous psychiatric appointments, with an average of 3 commitments to the psychiatric inpatient units. The majority (n = 17; 68%) had a diagnose of “schizophrenia, schizotypal and delusional disorders” (F20–29; ICD 10) and committed “crimes against life” (n = 13; 52%). They had an average of 0.8 previous criminal acts. During the crime, 7 patients (28%) were taking LAIA. Those, 16% (n = 4) were doing an unknown antipsychotic and 12% (n = 3) were doing Haloperidol.

Despite several studies showing the clinical and rehabilitative benefit of using LAIA early in the disease course, most of the patients in our study, who were already being followed in outpatient psychiatric units, did not benefit from them.

The authors have not supplied their declaration of competing interest.

In May 2013, the American Psychiatric Association (APA) published the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in order to bring America's clinical professionals in concert with the World Health Organization's (WHO) international classifications, notably the ICD-10-CM. This effort was met with considerable resistance and changes were delayed until November 2015. Major social-cultural differences between the United States and its European and other North American partners (Canada and Mexico) poses challenges in critical forensic areas such as the clinical/legal assessment of death qualified offenders – a status unique to the USA.

To articulate the clinical/legal differences between the previous DSM's (III; III-R; IV) and the DSM-5 and how the new language provides greater ambiguity in defining the mental status requirements for Mens Rea – competence to understand one's actions.

Present the major legal issues surrounding the US death penalty and brought before the US Supreme Court including: Furman v. Georgia (1972); Greg v. Georgia (1976); Jared v. Texas (1976); Proffit v. Florida (1976); Adkins v. Virginia (2002); Roper v. Simmons (2005); Miller v. Alabama (2012): … and legislative actions such as Rosa's Law (Public Law 111-256; 2010).

Advocacy groups pushed Rosa's Law to mental retardation with – intellectual and developmental disability. This change is reflected in the DSM-5 whereby mental retardation (MR) was once relegated to axis II, is now classified under intellectual disabilities (ID) given the impression that it is a transitory (correctable) and not a fix (organ disability) clinical condition.

The author has not supplied his declaration of competing interest.

To explore criminological aspects of medicolegal acts committed by patients with paranoia.

We conducted a retrospective and descriptive study, based on medical charts consult. Were included, patients suffering from paranoia (persistent delusional disorder: jealous/persecutory/erotomania type, DSM-IV), hospitalized in the forensic psychiatry department of Razi hospital between 1995 and 2015. This psychiatry department provides medical care for male patients not held by reason of insanity, according to article 38 of the Tunisian Criminal Code. Patients’ socio-demographic characteristics were collected as well as criminological details of their acts of violence (victim, weapon type, crime scene, premeditation…).

We collected 23 patients. Delusional disorder types were: jealousy (17), persecution (4), erotomania (1) and claim (1). The majority was married (18), undereducated (17), with irregular work (13). Forensic acts were uxoricide (15), attempted murder (5), violence against people (2) and destruction of public properties (1). Patients used bladed weapon in most of the cases (13), in the victim's residence (19), with premeditation in (17) of the crimes. Nine patients reported their act of violence to the authorities.

Our results do expose further data concerning potential dangerosity of patients with delusional disorders, and by that invites mental health professionals to prevent these acts with screening for violence predictors and risk factors.

The authors have not supplied their declaration of competing interest.

To compare socio-demographic and clinical profiles of patricide and matricide patients.

To compare modus operandi in matricide and patricide patients.

A retrospective, descriptive and comparative study was conducted, based on medical charts’ consult. Were included patients suffering from psychotic disorders (DSM-IV), hospitalized in the forensic psychiatry department of Razi hospital between 1995 and 2015, after not being held for insanity according to article 38 of Tunisian Criminal Code. Only patients who committed patricide or matricide were included.

Our sample included 26 patients (13 patricides; 13 matricides). There was non-significant differences between two groups concerning: instructional level (P = 0.277), professional status (P = 0.387) and marital status (P = 0.790). Committers of patricide and matricide did not differ in terms of psychiatric diagnosis (P = 0.242) and substance abuse (P = 0.550). A significant difference was found between the two groups in terms of schizophrenia subtypes, patricide patients suffered from a disorganized schizophrenia whereas matricide patients suffered from paranoid subtype (P = 0.05). Patricide was more frequently associated to a conflictual relationship between son and father (P = 0.05). We did not record a significant difference in the crime weapon or its motivations.

Our results helps draw a profile for parricide patients in order to help identify the ones at risk.

The authors have not supplied their declaration of competing interest.

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.