International Journal of Law and Psychiatry最新文献

{"title":"Recidivism among forensic psychiatric patients undergoing outpatient treatment for mental health disorders - A meta-analysis.","authors":"Panagiota Bali, Fotios Chatzinikolaou, Evangelia Karachaliou, Jakub Lickiewicz, Tella Lantta, Konstantinos Tasios, Vasiliki Efstathiou, Athanasios Douzenis","doi":"10.1016/j.ijlp.2025.102155","DOIUrl":"https://doi.org/10.1016/j.ijlp.2025.102155","url":null,"abstract":"<p><strong>Introduction: </strong>The risk for general or criminal recidivism in forensic psychiatric patients has not been extensively investigated in the literature. The aim of this review is to evaluate criminal recidivism among forensic patients with mental disorders undergoing some type of outpatient treatment.</p><p><strong>Methods: </strong>In this review, we utilized PubMed, Embase, Scopus, and the Cochrane Library to search for studies published from January 1990 up to July 2024. Eligible studies should i) evaluate forensic patients with mental health conditions, ii) evaluate patients undergoing outpatient treatment, and iii) evaluate criminal recidivism (general, sexual, or violent) as a primary outcome. Recidivism was also compared between groups when reported.</p><p><strong>Results: </strong>Overall, 12 clinical studies including 3271 patients were evaluated. Of these, 3048 patients undergoing outpatient treatment were analyzed. The mean age of all patients was 23.4 years (SD = 6.3), and 79.7 %. were male. The mean follow-up was 33.82 months. Overall, the pooled proportion for general recidivism was 39.1 % (95 % CI: 25 %-54.3 %), and for violent recidivism was 21.7 % (95 % CI: 2.6 %-52.3 %; data from four studies). In group comparisons (data from five studies), there was no difference between patients under treatment and the control groups as far as general recidivism (OR = 0.489; 95 % CI [0.202-1.183]; P = 0.112), and violent recidivism (OR = 0.283; 95 % CI [0.056-1.416]; P = 0.124) were concerned.</p><p><strong>Conclusion: </strong>The general and violent recidivism rates are high among forensic patients undergoing outpatient treatment for mental health disorders. There was no difference between outpatient treatment and control groups regarding their effect on recidivism. However, most of the studies reviewed did not provide information about drug treatment; more comparative studies focusing on pharmacotherapy are needed to verify any benefits of outpatient treatment.</p>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"102155"},"PeriodicalIF":1.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric evaluations for adolescent offenders with delinquency in Taiwan","authors":"Yu-Ning Her ,&nbsp;Ya-Hsuan Wang ,&nbsp;Da-Yuan Ma ,&nbsp;Chieh Chang ,&nbsp;Fan-Jung Wan ,&nbsp;Nian-Sheng Tzeng","doi":"10.1016/j.ijlp.2025.102156","DOIUrl":"10.1016/j.ijlp.2025.102156","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study is to investigate the psychiatric evaluations for juvenile offenders.</div></div><div><h3>Methods</h3><div>A total of 166 juvenile offenders were enrolled in this study. After diagnostic psychiatric interviews for 166 juvenile offenders, three groups of academic achievement (normal, academically challenged, and those suspended/dropouts from school). Different offenses, including those were against people, property, related to illicit drugs, or related to sex and delinquency and mental illness were also recorded. The relationship among the mental illness, types of offenses, and academic achievement was analyzed.</div></div><div><h3>Results</h3><div>In this study, 89.76 % of juvenile offenders reported educational achievement problems and 89.76 % of them had psychiatric disorders. The educational achievement with regard to the types of offenses (<em>p</em> &lt; 0.001) or specific mental illness (<em>p</em> &lt; 0.001). Juvenile offenders who <del>were</del> lagged behind in school performance showed more offenses against property (56.48 %), and more ADHD and conduct disorder (ADHD only: 36.11 %. ADHD with conduct: 12.04 %. ADHD with mood disorder: 11.11 %. Conduct disorder: 14.81 %). Those who dropped out of school showed more offenses against people and more mood disorder (mood disorder only: 24.39 %. Mood disorder with ADHD: 24.39 %). For those without academic challenges, the most common offenses were related to sex.</div></div><div><h3>Conclusions</h3><div>These findings revealed that often times juvenile offenses are related to psychiatric disorders and school problems.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102156"},"PeriodicalIF":1.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental factors in forensic assessments of children over the minimum age of criminal responsibility: A study of forensic reports in Norway 2013–2024","authors":"Kari Eriksen Øverland ,&nbsp;Kevin S. Douglas ,&nbsp;Elisabeth Norman ,&nbsp;A. Linda Gröning","doi":"10.1016/j.ijlp.2025.102154","DOIUrl":"10.1016/j.ijlp.2025.102154","url":null,"abstract":"<div><div>Despite the international recognition of children's evolving capacities and the importance of incorporating these factors into forensic assessments, there is limited research on forensic practices specific to children above the minimum age of criminal responsibility (MACR). The current study is part of a larger project examining legal and forensic assessments related to children's criminal unaccountability (criminal insanity) in Norway. The aim of the current study was to examine how forensic assessments of children above the MACR are conducted in Norway, and to what extent developmental factors are considered in these assessments. Drawing on existing literature, we first propose a set of principles for developmentally informed forensic assessments of children. The principles address direct expert-child interaction; structured assessment procedures; collateral/contextual information; cultural responsiveness; and the qualifications of forensic experts. We then evaluated 122 forensic assessments of children aged 15 to 18 years according to the proposed principles. Our findings revealed significant gaps, including minimal direct engagement with the child, low usage of structured assessment tools, limited collateral information from caregivers and schools, lack of cultural considerations and a concerning lack of child-specific expertise among forensic experts. These shortcomings underscore the need for more rigorous and developmentally sensitive practices. Recommendations include enhanced training, incorporating developmental principles into curricula, and establishing standardized protocols integrating structured assessment tools and comprehensive contextual information. While conducted in a Norwegian context, our study calls for further research in other jurisdictions to develop international guidelines that accommodate the unique developmental needs of children in forensic settings.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102154"},"PeriodicalIF":1.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and reliability of Mexican version of MacArthur competence assessment tool for treatment decision (MacCAT-T) in patients with schizophrenia","authors":"Ana Fresán ,&nbsp;Ricardo-Arturo Saracco-Alvarez ,&nbsp;J. Mónica Arienti-González ,&nbsp;Rebeca Robles-García ,&nbsp;Carlos-Alfonso Tovila-Zárate ,&nbsp;J. Nicolás I. Martínez-López","doi":"10.1016/j.ijlp.2025.102153","DOIUrl":"10.1016/j.ijlp.2025.102153","url":null,"abstract":"<div><h3>Background</h3><div>The MacArthur Competence Assessment Tool for Treatment (MacCAT-T), a semi-structured interview, is designed to evaluate patient decision-making capacity, a crucial aspect of patient-physician interaction.</div></div><div><h3>Methods</h3><div>A process study was undertaken of a sample of Mexicans diagnosed with schizophrenia aged between 18 and 50 years to determine the validity and reliability of the MacCAT-T in this population. A ROC curve was plotted to obtain discriminant validity, convergent validity was tested with the VAGUS scale and internal consistency was obtained as a measure of reliability.</div></div><div><h3>Results</h3><div>Adequate sensitivity (0.95) and specificity (0.75) were obtained with a cut-off point of seven. Significant correlations were observed between the MacCAT-T and the VAGUS scales (<em>r</em> = 0.54 and <em>r</em> = 0.76, <em>p</em> &lt; 0.05), indicative of adequate convergent validity. Internal consistency values were 0.93 for the total score and over 0.80 for all its dimensions.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that the MacCAT-T is a valid, reliable tool that can be used to assess decision-making capacity in Mexican patients with schizophrenia, which could have a heuristic value for promoting ethical clinical and research practices designed to achieve the crucial balance between patient autonomy and safeguarding.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102153"},"PeriodicalIF":1.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatrists’ engagement with advance statement in Victoria, Australia","authors":"Paige Lerman ,&nbsp;Penelope Weller ,&nbsp;Frances Shawyer ,&nbsp;Lisa Brophy ,&nbsp;Bridget Hamilton ,&nbsp;Chris Maylea ,&nbsp;Elisabeth Wilson-Evered ,&nbsp;Graham Meadows ,&nbsp;Ellie Fossey","doi":"10.1016/j.ijlp.2025.102144","DOIUrl":"10.1016/j.ijlp.2025.102144","url":null,"abstract":"<div><div>Psychiatric advance directives have been a prominent theme in mental health system reform. This study aimed to investigate psychiatrists' attitudes towards advance statements following their introduction in the <span><span>Mental Health Act 2014</span></span> in Victoria, Australia (<em>Mental Health Act 2014 (Vic)</em> ss 19–22). Advance statements are non-binding legal documents that permit mental health consumers to outline their treatment preferences, should they become subject to compulsory treatment. The mixed methods design involved psychiatrists completing an online survey based on a clinical vignette (<em>n</em> = 18) followed by in-depth interviews (<em>n</em> = 4). Results showed that psychiatrists viewed insufficient support from their institutions and peers as primary barriers to the effective use of advance statements, suggesting the need for deliberate implementation strategies to ensure psychiatrists make reasonable efforts to give effect to advance statements.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102144"},"PeriodicalIF":1.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptoms of mental health difficulties in police cell detainees in Iceland: Is it an appropriate place of safety for patients? A mixed methods study","authors":"Rannveig Íva Aspardóttir,&nbsp;Hannah Jones,&nbsp;Alan Underwood,&nbsp;Jennifer Hopton,&nbsp;Georgina Mathlin","doi":"10.1016/j.ijlp.2025.102143","DOIUrl":"10.1016/j.ijlp.2025.102143","url":null,"abstract":"<div><div>Individuals with mental health difficulties in Iceland can be detained in police cells as a last resource place of safety when psychiatrists consider patients unsuitable for admission to a ward, for example, due to being under the influence of substances or being too violent. We aimed to investigate if detainment in a police cell affected symptoms of mental illnesses, and subsequently if police cells are an appropriate place of safety for patients in Iceland. We used a mixed methods approach utilising administrative records of detainees' visible symptoms of mental illnesses and ten semi-structured interviews with mental health professionals and police sergeants. Unpublished secondary data from the Reykjavik Metropolitan Police of detainees (<em>n</em> = 6874) and exceptional incidents in police cells from the 1st of January 2018 to the 18th of August 2022 was analysed. 72.1 % of all suicide attempts and 77.3 % of all self-harming behaviour took place in the initial four hours of detainment. Three themes generated from the interviews with professionals: 1) violent behaviour as a determining factor in using police cells as a place of safety, 2) the detrimental impact of detainment in police cells on mental health, and 3) the lack of support and resources for professionals to appropriately care for individuals with mental health difficulties. The study highlights police cells are not currently suitable places of safety in Iceland. New laws and regulations in Iceland should be developed to support police and mental health professionals to adequately provide safety for individuals with mental health difficulties.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision-making capacity law developments in Aotearoa New Zealand","authors":"Kate Diesfeld ,&nbsp;Greg Young","doi":"10.1016/j.ijlp.2025.102140","DOIUrl":"10.1016/j.ijlp.2025.102140","url":null,"abstract":"<div><div>New Zealand, as well as other jurisdictions, are revisiting their decision-making capacity law regimes. Currently several strands of New Zealand capacity law are under review. Reforms could impact many people across many domains of decision-making. Focussing on adult decision-making, we describe features of New Zealand's approach to decision-making capacity law that resemble other jurisdictions. We then summarise unique features of New Zealand law and explain the urgency of reform, in light of our obligations under the United Nations Convention on the Rights of Persons with Disabilities, research funded by the Human Rights Commission and the findings of New Zealand's Royal Commission of Inquiry Abuse in Care. Analysis of New Zealand's capacity law is timely, given the current review of the two key statutes governing adult decision-making and mental health legislation.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102140"},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blurred boundaries: Community treatment orders as instruments of racial surveillance","authors":"Chioma Dibia,&nbsp;Agomoni Ganguli-Mitra","doi":"10.1016/j.ijlp.2025.102141","DOIUrl":"10.1016/j.ijlp.2025.102141","url":null,"abstract":"<div><div>The Mental Health Act 1983 (MHA) authorizes the compulsory detention and treatment of people with mental disorders who are perceived to pose a risk to themselves or to others. Since its enactment, there have been concerns that the coercive powers of the Act have been disproportionately used for Black people with mental disorders. This disproportionate impact of the MHA on Black people is most clearly seen in the excessive use of Community Treatment Orders (CTOs). Although there is limited evidence on the effectiveness of CTOs, they continue to be used increasingly in the care of Black people, with latest data showing that Black people are over seven times more likely to be issued CTOs than White people (National Health Service Digital, 2024). This is particularly concerning as CTOs are commonly perceived as intrusive and have been described as a form of racial surveillance. In this paper, we explore the idea of CTOs as instruments of racial surveillance and argue that their continued use in the care of Black people with mental disorders is an extension of the intrusive powers of the State and might constitute a form of racial injustice.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes and ethical beliefs of Russian psychiatrists towards the use of coercive treatment practices","authors":"Andrew Stickley ,&nbsp;Roman Koposov ,&nbsp;Johan Isaksson ,&nbsp;Tomiki Sumiyoshi ,&nbsp;Oleg A. Ponomarev ,&nbsp;Vladislav Ruchkin","doi":"10.1016/j.ijlp.2025.102142","DOIUrl":"10.1016/j.ijlp.2025.102142","url":null,"abstract":"<div><div>In many countries little is known about the attitudes and ethical beliefs of practicing psychiatrists towards the use of coercive practices. This is true as regards Russia where coercion was used for political purposes during the Soviet period. However, substantial changes have occurred in the psychiatric system in recent decades with a focus on patients' rights and the idea of consent. This study aimed to investigate the beliefs and attitudes of Russian psychiatrists towards coercive treatment practices in situations of clinical decision making. Data were obtained from 93 (81 % of all practicing) psychiatrists in the Arkhangelsk region in northwestern Russia. The psychiatrists completed three case vignettes to obtain information regarding the use of coercive treatment practices in different clinical situations, and responded to an ethical attitudes inventory. The psychiatrists' decisions regarding coercive treatment, and the extent of information provided to the patients and their relatives were impacted by the severity and risks (violence, suicidality) associated with the patient's disorder. In most instances psychiatrists were not responsive to pressure from the patient's family or other hospital personnel. Very few gender differences in attitudes and practices were found. Psychiatrists generally reported that they encountered different situations with abusive practices primarily in the past. This study suggests that the factors associated with the use of coercive treatment practices by Russian psychiatrists may mirror those in other countries. Further research should elucidate the actual extent to which coercive practices are used in Russian psychiatry and delineate the factors associated with their actual use.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"Article 102142"},"PeriodicalIF":1.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychopathy, neuroscience, and critical issues: A legal primer","authors":"Luke Danagher","doi":"10.1016/j.ijlp.2025.102139","DOIUrl":"10.1016/j.ijlp.2025.102139","url":null,"abstract":"<div><div>Psychopathy occupies a pivotal yet unsettled position at the intersection of neuroscience, business ethics, and criminal jurisprudence. Despite rapid scientific advances, core uncertainties remain. This article examines five issues of immediate legal relevance: (1) the contested neurobiological basis of psychopathy; (2) reproducibility concerns linked to the broader replication crisis in psychological and neuroscientific research; (3) limitations of leading assessment instruments (e.g., PCL-R), and the risks of reifying cut-off scores; (4) accumulating evidence favouring a dimensional understanding of psychopathy- an approach which sits uneasily alongside law's often binary demands; and (5) the construct's extension into non-forensic domains, illustrated by workplace psychopathy, which raises questions about conceptual expansion beyond its clinical and correctional roots. In synthesising these literatures, the article offers guidance for courts and legal practitioners in applying current science cautiously, transparently, and accurately.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"103 ","pages":"Article 102139"},"PeriodicalIF":1.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}