A Catathymic Infanticide

Abstract: A case of infanticide committed by a 37‐year‐old married man, the father of three sons, is reported. Clinically depressed since adolescence, and also diagnosed with obsessive‐compulsive disorder and a dependent personality, the subject began to worry about killing someone a decade before the homicide. Increasingly disabled by his major depression, unable to work, and confined in his home, the idea that his only recourse was to kill one of his sons became fixed and frequent. Following his fourth psychiatric hospitalization, he took his 13‐month‐old son home from day care and drowned him in the bathtub. He then called the police and reported his crime. This sudden act of intentional killing was followed by a period of emotional relief and calmness, clearly illustrating the three stages of chronic catathymic homicide.     

Suicide behind bars: trends, inconsistencies, and practical implications

The results of two comprehensive approaches are compared: the nationwide surveys of suicides in U.S. jails by Hayes and the international meta-analyses of suicides in jails and prisons by Fazel et al. Factors are classified as demographic, situational, clinical, and methodical. More than 50% of U.S. jail suicide victims were men, white, unmarried, under 28 years of age, charged with minor or drug-related offenses, and intoxicated with drugs or alcohol. Suicides significantly occurred in isolation. Suicide victims in the international study were significantly (p < 0.001) men, white, married, pretrial, and charged with or convicted of violent offenses. Psychiatric diagnosis, alcohol abuse, taking psychotropic medication, and suicidal ideation were also positively correlated in the international study, but suicide victims were distributed more evenly over age-groups. Results of other studies illustrate the near universality of some findings. Three theories of suicide are briefly discussed.     

对邱兴华杀人案的司法鉴定学反思

关于邱兴华杀人案（下称邱案）的各种学术讨论和争论似乎已经不少，但查阅文献发现，有关邱案的文章，分别是从刑事诉讼法学、刑事证据学、刑事心理学、精神医学角度，法制新闻学以及从人权保护，法治进步等角度对该案进行解读。然而既然这是一个涉及司法鉴定的个案（虽然实际上并没有进行任何实质性鉴定活动），那么从司法鉴定学的角度对与该案有关的几个最基本的问题进行理论阐述，或许能有些许不同的作用。这几个问题包括：精神病概念的辨析，是否患病与是否需要接受刑事处罚之间是什么关系，何时需要启动司法精神医学鉴定？应如何配置我国刑事诉讼中的司法精神医学鉴定启动模式？     

Not just welfare over justice: Ethics in forensic consultation

The ethics of forensic professionalism is often couched in terms of competing individual and societal values. Indeed, the welfare of individuals is often secondary to the requirements of society, especially given the public nature of courts of law, forensic hospitals, jails, and prisons. We explore the weaknesses of this dichotomous approach to forensic ethics, offering an analysis of Psychology's historical narrative especially relevant to the national security and correctional settings. We contend that a richer, more robust ethical analysis is available if practitioners consider the multiple perspectives in the forensic encounter, and acknowledge the multiple influences of personal, professional, and social values. The setting, context, or role is not sufficient to determine the ethics of forensic practice.     

The Effects of Substance Use on Offender Crime Scene Behavior

Abstract:  Substance use has an effect on an individual's propensity to commit acquisitive crime with recent studies showing substance users more likely to leave forensic material at a crime scene. An examination of acquisitive crime solved in Northamptonshire, U.K., during 2006 enabled 70 crime scene behavior characteristics to be analyzed for substance and nonsubstance use offenders. Logistical regression analyses have identified statistically significant crime scene behavior predictors that were found to be either present at or absent from the crime scene when the offender was a substance user. Most significant predictors present were indicative of a lack of preparation by the offender, irrational behavior, and a desire to steal high value, easily disposed of, property. Most significant predictors absent from the crime scene were indicative of more planning, preparation, and execution by the offender. Consideration is given to how this crime scene behavior might be used by police investigators to identify offenders.     

Disrobing associated with epileptic seizures and forensic implications

Little is known about the clinical aspects and medico-legal consequences of disrobing in the context of epileptic seizures. Seizure-related disrobing may occur either as an ictal automatism or during the postictal period. Some patients may experience a seizure while already in the unclothed state, engage in ictal wandering, and thereby appear in public in the nude. Two cases involving disrobing associated with seizures captured via video-monitored electroencephalography are offered. An additional case reveals the legal consequences endured by one patient who experienced a nocturnal seizure and began wandering in an unclothed state. Collectively, these cases illustrate the medical reality of seizure-related disrobing and the related adverse effects on patients' quality of life. Disrobing associated with epileptic seizures carries the potential for serious legal consequences if not properly identified as an ictal phenomenon.     

A Clinical Study of Competency to Consent to Hospitalization and Treatment in Geriatric Inpatients*

Abstract: This study used a Competency Questionnaire modified for medical surgical patients (CQ‐Med). Twenty‐nine patients (ages 65–94 years) admitted to a geriatric medicine unit were studied. Along with the CQ‐Med, patients were administered several WAIS‐R subtests, the Blessed Dementia Scale (BDS), and Mini Mental State Exam (MMSE). Additionally, a blind forensic evaluation for competency to consent to hospitalization and treatment was performed for the purpose of validation of the CQ‐Med. Results of the study found that, as expected, increased age was correlated with decreasing performance on the CQ‐Med and decreased findings of competence by clinical exam. However, there was great variability within each age group, demonstrating individual differences in the progress of declining competency. CQ‐Med scores also correlated well with the WAIS‐R subtest raw and scaled scores. Scores on the MMSE and BDS were less well correlated. The CQ‐Med may be a useful adjunct in assessing declining competency in geriatric patients.     

Mental health weapons prohibition: demographic and psychiatric factors in petitions for relief

Federal law and most states prohibit possession of firearms by individuals with a history of certain psychiatric diagnoses and/or treatment. In California, an involuntary 72-h hold can trigger a 5-year ban on firearm possession. Individuals so prohibited may petition for early termination of the ban. We report on the demographic and psychiatric characteristics of a sample of individuals petitioning for early relief in Los Angeles County, and on the results of their petitions. The majority of petitioners were Caucasian men over age 40. Sixteen percent of petitioners were employed in law enforcement or armed security, and all of their petitions were granted. Individuals for whom there was greater evidence of mental disorder were significantly less likely to petition successfully. The results are discussed in terms of the benefits of involving a forensic expert in the petition process, which is not presently required under California law.     

Prevalence of delusional jealousy in psychiatric disorders

Delusional jealousy is a known risk factor for violence and homicide, but little is known about its prevalence in psychiatric disorders. We therefore reviewed retrospectively the psychopathological symptoms at admission and discharge, assessed with the AMDP system, of all patients admitted to the Psychiatric Hospital, University of Munich, Germany, from January 2000 through December 2008 (n=14,309). We identified 72 cases of delusional jealousy (0.5% of the whole sample). The prevalence was highest in schizophrenia and other psychoses (1.3%), and more of the patients with delusional jealousy were men (43 of 72, 59.7%). One-fifth (15 of 72, 20.8%) of the patients with delusional jealousy were aggressive at admission (vs. 6.2% of the total sample). We conclude that delusional jealousy is a comparatively rare phenomenon that is most frequent in schizophrenia and related psychoses. Quite a number of affected patients are aggressive, which may indicate a risk of future violence.     

The presence of low IQ and mental retardation among murder defendants referred for pretrial evaluation

After an overview of definitions of mental retardation and recent case law regarding mental retardation and the death penalty, this paper presents a study of factors associated with a mental retardation (MR) diagnosis among murder defendants. Subjects with a full-scale IQ< or =70 (n=42) were compared with other pretrial murder defendants (n=228) referred for forensic evaluation over a 5-year period. Subjects with an IQ< or =70 who were diagnosed with MR were compared with subjects with an IQ< or =70 who did not receive this diagnosis. Female murder defendants were more likely to receive a diagnosis of MR (p=0.03). MR was also more commonly diagnosed in subjects with an Axis I cognitive disorder (p=0.018). Having an IQ< or =70 was more common in subjects with a psychotic and substance use disorder (p=0.03) and did not necessarily lead to a diagnosis of MR in this subgroup. Implications for diagnosing MR among murder defendants are discussed.