Spanish Journal of Legal Medicine最新文献

{"title":"Clinical-forensic profile and mental health engagement in suicide deaths in Lleida (2019–2024)","authors":"Teresa Guilera,&nbsp;Montse Pedrico Serradell,&nbsp;Jordi Blanch Andreu,&nbsp;Eneko Barberia Marcalain","doi":"10.1016/j.remle.2026.500530","DOIUrl":"10.1016/j.remle.2026.500530","url":null,"abstract":"<div><h3>Introduction</h3><div>Suicide is one of the leading causes of preventable mortality and represents a major public health priority.</div></div><div><h3>Objective</h3><div>To analyse the clinical–forensic profile of suicide and their engagement with mental healthcare.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational study was conducted on suicide deaths registered in Lleida between 2019 and 2024. A total of 189 autopsy reports and corresponding medical records from the public healthcare system were reviewed. Sociodemographic, temporal and spatial variables, suicide methods, toxicological results, and mental healthcare-related variables and activation of the Suicide Risk Code (CRS) were analysed. Descriptive and bivariate analysis were performed using Fisher's exact test.</div></div><div><h3>Results</h3><div>Most decedents were male (73.5%), with a mean age of 54.1 years (SD 17.8). The most common method of suicide was hanging (47.1%), followed by jumping from height (22.2%). Most suicides occurred at home (71.9%). Although 67.2% of relatives reported a history of psychiatric disorders, only 36.5% were clinically documented. Only 18% were engaged with mental healthcare, and 10.6% had an activated CRS. Medical risk factors were present in 25.9% of cases. Significant differences were observed by sex in mental health engagement (<em>p</em> = 0.013) and by age in medical comorbidity (<em>p</em> = 0.024).</div></div><div><h3>Conclusions</h3><div>Clinical-forensic profile is characterised by middle-aged and older males with low engagement with mental healthcare, and a high prevalence of medical illness. These findings highlight deficits in early detection and continuity of care and support the need for integrated preventive strategies involving mental health services, primary care, and community-based resources.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 3","pages":"Article 500530"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic and clinical profile of patients judicially referred to a mental health center: A descriptive study of 275 cases in Madrid","authors":"Sara González Vives,&nbsp;Rosa M. Molina Ruiz,&nbsp;Irene Serrano García,&nbsp;Antonio Sánchez Fernández,&nbsp;M. Dolores Morón Nozaleda,&nbsp;José Luis Carrasco Perera","doi":"10.1016/j.remle.2026.500528","DOIUrl":"10.1016/j.remle.2026.500528","url":null,"abstract":"<div><h3>Background</h3><div>Judicially generated demand in mental healthcare remains an underexplored area in Spain despite its clinical and legal relevance. The aim of this study was to analyze the sociodemographic, psychopathological, and judicial profile of patients referred from courts and public prosecutor's offices to a Mental Health Center (MHC) in Madrid.</div></div><div><h3>Methods</h3><div>An epidemiological, descriptive, and retrospective study included 275 patients attended at a MHC in Madrid between 2019 and 2024 following judicial referral. Twenty-one sociodemographic, psychopathological, and judicial variables were analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>The sample was predominantly male (57.8%), with mean age 51.45 years. High labor inactivity was observed (89.5%). The most frequent primary diagnosis was schizophrenia (17.8%), followed by dementia (12.4%) and personality disorders (10.5%). Eighty-two percent of schizophrenia patients had previous psychiatric hospitalizations; 36% had substance use. The most common judicial request was a clinical status report (47.2%). Seventy-three percent did not require judicial support measures for the exercise of legal capacity. All patients with security measures for criminal offenses maintained mandatory outpatient follow-up at the MHC, yet none used psychosocial rehabilitation resources. A decrease in judicial referrals was observed between 2019 and 2022, associated with the COVID-19 pandemic.</div></div><div><h3>Conclusions</h3><div>The typical judicialized patient was predominantly a man with schizophrenia, marked clinical chronicity, and occupational vulnerability. Schizophrenia was the diagnosis most frequently observed among patients subjected to restrictive judicial measures. The principal finding was the association between judicially imposed security measures and absence of psychosocial rehabilitation resource use, suggesting a gap in specialized community mental healthcare.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 3","pages":"Article 500528"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of sex from scapular measurements in a contemporary Mexican sample","authors":"Antinea Menéndez Garmendia,&nbsp;Enrique Ramírez Martínez,&nbsp;Gabriela Sánchez-Mejorada,&nbsp;Guillermo Torres,&nbsp;Jorge A. Gómez-Valdés","doi":"10.1016/j.remle.2026.500529","DOIUrl":"10.1016/j.remle.2026.500529","url":null,"abstract":"<div><h3>Introduction</h3><div>Assessing sex of individuals to create the biological profile is often difficult due to both forensic and bioarchaeological contexts tend to be complex, and incomplete skeletons and/or fragmented human remains are often found. Accordingly, the aim of this research was to analyze the metric differences of the scapula between sexes in the Mexican population, to calculate sectioning points and discriminant functions for sex estimation in those contexts.</div></div><div><h3>Material and methods</h3><div>Five scapular measurements were recorded on a sample of 124 skeletal remains (45 females and 79 males) from the osteological collection housed at the Department of Anatomy, School of Medicine of the Universidad Nacional Autónoma de México. And a Discriminant Function Analysis to obtain multivariate formulas and sectioning points.</div></div><div><h3>Results</h3><div>The results showed differences among sexes in all five measurements. The accuracy of sex estimation ranged from 80.6% to 89.5% with sectioning points and 87.9% al 93.5% based on the eleven discriminant functions.</div></div><div><h3>Conclusions</h3><div>In conclusion, the scapula is a great alternative for biological sex assessment in contexts where is not possible to locate or recover osseous structures like the pelvis; as well as in those in which isolated, fragmented, incomplete and/or commingled human remains are found.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 3","pages":"Article 500529"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The specialty of legal and forensic medicine: Time to complete the transition","authors":"Josep Arimany-Manso,&nbsp;Marta Grijalba-Mazo,&nbsp;Amadeo Pujol-Robinat","doi":"10.1016/j.remle.2026.500532","DOIUrl":"10.1016/j.remle.2026.500532","url":null,"abstract":"","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 3","pages":"Article 500532"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient autonomy and medical liability in suicidal behavior: A legal analysis of the Spanish legal system","authors":"Jordi León Caballero,&nbsp;Lucia Martínez Pariente","doi":"10.1016/j.remle.2026.500519","DOIUrl":"10.1016/j.remle.2026.500519","url":null,"abstract":"<div><div>The management of patients with suicidal behavior raises significant legal challenges in healthcare, where respect for patient autonomy must be balanced against the duty to protect life and the risk of professional liability. In the Spanish legal system, suicide is not classified as a criminal offense; however, healthcare professionals may incur liability when a deviation from the <em>lex artis</em> or a relevant omission in the presence of a reasonably foreseeable risk is established. This article analyzes the legal framework applicable to suicidal behavior, focusing on the limits of informed consent, involuntary hospitalization, the use of coercive measures, and medical liability across different jurisdictions. Based on an analysis of current legislation and relevant case law, areas of legal uncertainty are identified that may encourage defensive medical practices, highlighting the need for clearer and more consistent regulatory and interpretative frameworks.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 3","pages":"Article 500519"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Femicide rates in Honduras (2013–2022)","authors":"Augusto Alfonso Rosales Meléndez","doi":"10.1016/j.remle.2026.500516","DOIUrl":"10.1016/j.remle.2026.500516","url":null,"abstract":"<div><h3>Introduction</h3><div>Honduras reports one of the highest femicide rates. This study analyzed trends in the femicide rate between 2013 and 2022.</div></div><div><h3>Methods</h3><div>A descriptive study using femicide surveillance data from Honduras (2013–2022) was conducted. The age-standardized rate per 100,000 women was calculated, and trends were analyzed using Joinpoint regression.</div></div><div><h3>Results</h3><div>A total of 2,677 femicides were recorded. The age-standardized rate decreased from 10.1 per 100,000 women in 2013 to 3.9 in 2022, with an annual percent change (APC) of −7.6% (95% CI: −12.8 −2.6). Femicide associated with organized crime was the most frequent subtype (49.3%) and accounted for 55% of the overall reduction.</div></div><div><h3>Conclusion</h3><div>The decline in femicide was mainly driven by the reduction in cases related to organized crime, highlighting the need to prevent persistent forms of violence not associated with this context.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 3","pages":"Article 500516"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic experiences at early ages: a comparative study between a group of incarcerated women and a group of women victims of violence in Mexico and Ecuador","authors":"Verónica Molina-Coloma,&nbsp;Rosario Lara-Machado,&nbsp;Beatriz López-Vallejo,&nbsp;Sandra Vargas-Núñez,&nbsp;Doménica Bonilla Pacheco","doi":"10.1016/j.remle.2026.500514","DOIUrl":"10.1016/j.remle.2026.500514","url":null,"abstract":"<div><h3>Introduction</h3><div>Traumatic events ocurring during childhood and adolescence have severe consequences, envolving into a significant social and public health issue. The objective of this study is to compare, by nationality and across groups, incarcerated women and women who are victims of intimate partner violence, regarding the types of traumatic events experienced in childhood and adolescence.</div></div><div><h3>Materials and methods</h3><div>In this study, a cross-sectional descriptive and comparative design was used, and quota and participation sampling of 215 women from Mexico (n = 106) and Ecuador (n = 109) was applied to them, and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) was applied. A 2 x 2 MANOVA was performed to compare groups. Following the global analyses, two tests of inter-subject effects were reported.</div></div><div><h3>Results</h3><div>The results show significant differences in the different types of traumatic events assessed by the CTQ-SF, both by country and by group of women.</div></div><div><h3>Conclusions</h3><div>It is concluded that the group of Ecuadorian women and the group of incarcerated women from both countries have experienced a greater number of traumatic events at younger ages.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 2","pages":"Article 500514"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148528814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide in Argentina. A study based on National Criminal Information System (2017–2023)","authors":"Eleonora Rojas Cabrera,&nbsp;Federico Cruceño,&nbsp;Ambar Pepermans Rojas","doi":"10.1016/j.remle.2026.500505","DOIUrl":"10.1016/j.remle.2026.500505","url":null,"abstract":"<div><h3>Introduction and Objective</h3><div>Suicide is a serious public health problem associated with multiple individual and social-contextual factors. This paper aimed to analyze suicide trends in Argentina during the period 2017–2023, considering sex, age and seasonality.</div></div><div><h3>Material and methods</h3><div>A quantitative and descriptive study from a sociodemographic perspective was carried out, based on data from National Criminal Information System (NCIS). Mortality rates (MR) by sex and age were calculated, and their trends were analyzed by applying joinpoint regression models. Then, the seasonal index (SI) was calculated.</div></div><div><h3>Results</h3><div>During the period of study, the MR due to suicide was higher among men (first semester of 2017: 5.3 and 1.7 per 100,000 men/women, respectively; second semester of 2023: 7.1 and 1.9 per 100,000 men/women, respectively), mostly at younger stages (9.1 and 11.1 per 100,000 men aged 15–24 years in the first semester of 2017 and the second semester of 2023, respectively). Male MR increased significantly till 2018, decreased till 2020 and then increased again; female MR did not vary significantly; and suicides were more common in summer months. However, suicide trends and its seasonality vary according sex and age group.</div></div><div><h3>Conclusions</h3><div>In Argentina, suicide rates behave differently by sex, age and season. Therefore, actions for reducing them must take into account the characteristics of each population group.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 2","pages":"Article 500505"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148528820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal drownings of minors in Catalonia: differences according to the nationality of the victims","authors":"Sofia Bernad,&nbsp;Josep M. Suelves,&nbsp;Josep Maria Casadesús,&nbsp;Eneko Barbería","doi":"10.1016/j.remle.2026.500515","DOIUrl":"10.1016/j.remle.2026.500515","url":null,"abstract":"<div><h3>Introduction</h3><div>Drowning is a preventable cause of infant mortality. In Catalonia, a high proportion of fatal drownings occur among people of non-Spanish nationality. The objective of this study was to describe fatal drownings of children under 18 years of age in Catalonia during the period 2019-2023, analyzing the differences between those who died with Spanish nationality and those of other nationalities.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study based on the autopsy records of the Institute of Legal Medicine and Forensic Sciences of Catalonia, including all cases of drowning deaths in children under 18 years of age between 2019 and 2023. Variables such as age, sex, nationality, location of drowning, and origin of the body were analyzed.</div></div><div><h3>Results</h3><div>Thirty-nine deaths were identified, with a mean age of 6.5 years; 74.4% were male. 56.4% of the deceased had foreign nationality, mainly from African countries. Drownings in swimming pools were more frequent among Spanish children, while drownings in natural waters predominated among foreign children.</div></div><div><h3>Conclusions</h3><div>The high proportion of children of non-Spanish nationality reflects sociocultural and gender inequalities in access to safer aquatic environments and in the acquisition of aquatic skills. Along with other measures, health counseling can promote family supervision of children's swimming and encourage participation in swimming learning programs, especially in populations with less access to safe educational and recreational resources.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 2","pages":"Article 500515"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148528815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert evidence communication: the report and testimony in judicial proceedings","authors":"Maria Luisa Soria","doi":"10.1016/j.remle.2026.500518","DOIUrl":"10.1016/j.remle.2026.500518","url":null,"abstract":"<div><div>In recent years, forensic science has significantly strengthened its commitment to communication that is clearer, more precise, and verifiable, both in expert reports and in courtroom testimony. This article provides an integrated overview of the regulatory framework that governs such communication, encompassing the Ley de Enjuiciamiento Criminal (art. 478), UNE 197001:2019 standard for expert reports, ISO/IEC 17025:2017 of the International Organization for Standardization/International Electrotechnical Commission, the International Laboratory Accreditation Cooperation guideline ILAC G19:06/2022, and ISO 21043, forensic standards series, alongside the major international guidelines that shape best practices, including NIST SP 1500-28, OSAC, AAFS, and ENFSI. It also examines empirical evidence on how judges and juries interpret scientific findings and the factors that may enhance or hinder their understanding.</div><div>Building on this foundation, the article presents practical criteria applicable to disciplines such as toxicology, including cases involving new psychoactive substances (NPS), and forensic genetics, particularly DNA analysis and the use of the Likelihood Ratio (LR). These criteria aim to distinguish clearly between facts, interpretations, and opinions; to document assumptions, uncertainties, and error rates transparently; and to strengthen the expert's communicative effectiveness without sacrificing scientific rigor. Ultimately, the article seeks to contribute to a more robust, comprehensible, and methodologically transparent forensic practice that aligns with current expectations for quality and reliability, as reflected in the work of the National Research Council, NIST, ILAC, OSAC, and the AAFS Standards Board.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 2","pages":"Article 500518"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148528816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}