International Journal of Law and Psychiatry最新文献

{"title":"An International Comparison of Psychiatric Advance Directive Policy: Across eleven jurisdictions and alongside advance directive policy","authors":"Sophie Gloeckler ,&nbsp;Matthé Scholten ,&nbsp;Penelope Weller ,&nbsp;Alexander Ruck Keene ,&nbsp;Soumitra Pathare ,&nbsp;Ramya Pillutla ,&nbsp;Leticia Andorno ,&nbsp;Nikola Biller-Andorno","doi":"10.1016/j.ijlp.2025.102098","DOIUrl":"10.1016/j.ijlp.2025.102098","url":null,"abstract":"<div><div>The present work provides a comparative policy review of psychiatric advance directives, considering 1) variation across eleven international jurisdictions and 2) differentiation from other advance directive policy. The aim is to support well-founded legal and clinical practice when it comes to psychiatric advance directives by 1) clarifying the range of present approaches and 2) highlighting differential treatment of those with mental health conditions. Applicable statutes in England and Wales; Germany; India; the Netherlands; New South Wales (Australia), Northern Ireland, Virginia (USA); Washington (USA); Switzerland; Scotland; and Victoria (Australia) were reviewed by a team with expertise in law, clinical practice, and ethics. Policy variations were identified related to requirements for validity, activation, amendment, revocation, and override of preferences expressed. Psychiatric advance directives tend to be more strictly regulated and have less legal force than medical advance directives, with more restrictive guidelines and more conditions allowing advance preferences to be overridden. Psychiatric advance directives also tend to be less uniform across jurisdictions, sometimes reflecting varied functions of the directive and sometimes suggesting varied framing of the appropriateness of coercion in psychiatric care. More work is needed to evaluate the validity of distinct psychiatric advance directive policy. Stricter regulation and weaker legal force can serve as barriers to use, and coercion carries associated harms; psychiatric advance directive policy, especially choices that differ from other advance directive policy, should be well-justified.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102098"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089754","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":"Unified mental health and capacity law: Creating parity and non-discrimination?","authors":"Jill Stavert,&nbsp;Colin McKay","doi":"10.1016/j.ijlp.2025.102108","DOIUrl":"10.1016/j.ijlp.2025.102108","url":null,"abstract":"<div><div>It has been argued that a fusion of mental health and capacity law creates parity and respects non-discrimination. This approach has been adopted in the Mental Capacity Act (Northern Ireland) 2016, although this legislation is not yet fully in force. Separately the World Health Organisation and the Committee on the Rights of Persons with Disabilities have advocated ending the separate status of mental health law. Across the rest of the UK, the possibility of fusion legislation has recently been considered, although not ultimately recommended in 2018 by the Independent Review of the Mental Health Act for England and Wales and in 2022 by the Scottish Mental Health Law Review. Challenges include potential conflicts with Article 5 of the European Convention on Human Rights, and the Committee on the Rights of Persons with Disabilities' critique of ‘mental capacity’ and whether a capacity threshold is required for unified mental health and capacity law. This article will consider the approach of the Scottish Mental Health Law Review, why it did not recommend immediate fusion and its proposals for greater alignment of mental health and capacity regimes.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102108"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089678","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":"Insanity defense for all? The Arab minority in Israel's psychiatric and legal systems","authors":"Anat Yaron Antar","doi":"10.1016/j.ijlp.2025.102107","DOIUrl":"10.1016/j.ijlp.2025.102107","url":null,"abstract":"<div><h3>Objectives</h3><div>Minorities are often discriminated against by law enforcement. This finding also applies also to the Arab minority in Israel; however, despite extensive research on this topic, only a few studies have examined this bias with regard to psychiatric opinions and judicial decisions on criminal responsibility and the ability to stand trial. This study addresses this bias in its analysis of such opinions and rulings among homicide defendants referred to psychiatric evaluation.</div></div><div><h3>Design</h3><div>The participants were all the 137 homicide defendants (95 Jews and 42 Arabs) hospitalized in Israeli maximum-security units for psychiatric evaluation or treatment between 1997 and 2021.</div></div><div><h3>Results</h3><div>A significant relationship was found between the defendant's ethnicity and the evaluation and ruling: half of the defendants deemed fit to stand trial were Jews, while most of those deemed unfit were Jews at a disproportionate rate. In most cases, the court ruling was consistent with the psychiatric opinions, over 98 % of which were provided by Jewish psychiatrists. The low number of Arab psychiatrists prevented examination of the effect of interaction between their ethnicity and the defendants' ethnicity on their opinions.</div></div><div><h3>Conclusion</h3><div>Three potential explanations for these results are discussed: a true gap between the populations, a lack of cultural competence, and intergroup bias. The implications include the recommendation to train more Arab psychiatrists and enhance the cultural competence of law enforcement officials.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102107"},"PeriodicalIF":1.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941654","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":"Mental health, medical incapacity, and political leadership in the United Kingdom: A multidisciplinary analysis of the intersections between psychiatry and constitutional law","authors":"Alexander J. Smith ,&nbsp;Stefan Theil ,&nbsp;Ashley Weinberg ,&nbsp;Dinesh Bhugra ,&nbsp;Michael Liebrenz","doi":"10.1016/j.ijlp.2025.102109","DOIUrl":"10.1016/j.ijlp.2025.102109","url":null,"abstract":"<div><div>Mental ill-health and medical incapacity in governmental leadership could affect democratic accountability, possibly necessitating complex psychiatric, judicial, and political interactions. Notably, as a prominent democratic jurisdiction, governmental structures in the United Kingdom and the role of its Prime Minister are generally underpinned by constitutional conventions, rather than enforceable legal frameworks. Political continuity and stability thereby rely on the actions and integrity of constitutional agents, which could engender dilemmas if medical incapacity due to mental ill-health becomes evident. Accordingly, based on a critical analysis of relevant legal documents, this paper examines this largely overlooked topic in relation to the office of the United Kingdom's Prime Minister. In doing so, it does not speculate on the mental health of any individual (past or present) and instead explores hypothetical circumstances and constitutional precedents, including the potential for voluntary resignation and involuntary removal, to promote wider knowledge synthesis. Interdisciplinary interpretations are offered for such situations, where constitutional decisions would likely require informal exchanges with mental health specialists and invoke challenges in conducting psychiatric assessments in politically-charged contexts. Finally, to pre-emptively respond to conceivable scenarios and address existing ambiguities, the paper concludes with some interprofessional recommendations aligned with the democratic values of the United Kingdom.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102109"},"PeriodicalIF":1.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941653","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":"Artificial Intelligence (AI) and academic publishing in psychiatry","authors":"Brendan D. Kelly","doi":"10.1016/j.ijlp.2025.102105","DOIUrl":"10.1016/j.ijlp.2025.102105","url":null,"abstract":"<div><div>The current and potential impact of various applications of artificial intelligence (AI) to the field of academic publishing in psychiatry is the subject of increasing attention. At present, AI algorithms assist in data analysis, allowing researchers to process large datasets quickly and uncover complex patterns that would be challenging to detect manually. In psychiatry, this capability can potentially help integrate data from genetics, neuroimaging, and clinical assessments. AI-driven natural language processing (NLP) tools might also facilitate systematic reviews and meta-analyses by automating the extraction and synthesis of information from vast bodies of published literature. In publishing, AI can potentially help to streamline the publication process in certain ways. Automated systems might screen manuscripts for methodological rigor, ethical compliance, and potential conflicts of interest, thereby reducing the burden on editors by prompting them to consider certain matters, and possibly accelerating the publication timeline. AI-powered tools are already used to help with dissemination of research findings by generating summaries and identifying key insights, making information more accessible to a broader audience. In the future, AI has the potential to enhance psychiatric publishing in various other ways. Predictive analytics might identify emerging trends and research gaps in the literature, guiding future studies and funding priorities, although this remains speculative for now. AI could also facilitate more robust collaborations by connecting researchers with complementary expertise and interests. Additionally, the integration of AI in digital platforms could democratise access to cutting-edge research, promote global knowledge sharing, and accelerate advancements in clinical care. As AI continues to evolve, its applications in research and publishing hold the potential to drive significant progress in understanding and treating mental disorders. It is essential that these developments are accompanied by openness about the use of AI in publishing, with clear declarations by authors and publishers about the use of specific applications in published work.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102105"},"PeriodicalIF":1.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898534","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":"Exploring structural stigma towards mental disorders: An analysis of trial verdicts","authors":"Lei Gu ,&nbsp;Hongwei Ding","doi":"10.1016/j.ijlp.2025.102103","DOIUrl":"10.1016/j.ijlp.2025.102103","url":null,"abstract":"<div><div>Mental health issues, particularly depression, often carry a stigma that can infiltrate various societal institutions, including the legal system. This study investigates the structural stigma associated with depression within the context of second-instance criminal trials in China, examining trial verdicts from 2009 to 2023. Through a detailed analysis of 171 cases using Semantic Network Analysis, Critical Discourse Analysis, and logistic regression, this research elucidates the complex ways in which depression is considered in judicial decisions. The findings identify three thematic responses—Neutral Evaluation, Sympathetic Consideration, and Rigorous Standards—that encapsulate diverse judicial attitudes towards the impact of depression on criminal responsibility. Critical Discourse Analysis further reveals three prevailing legal discourses—Stringent Criteria, Inconsistent Approaches, and Individual Negligence—that significantly influence the treatment of defendants with depression. The results also show a declining trend in recognizing depression as a mitigating factor, jointly influenced by crime type, defendant gender, and defendant’s education level, suggesting a shift towards more stringent judicial interpretations over time. These findings underscore the critical need for judicial reforms aimed at reducing stigma and promoting a more equitable treatment of mental health issues in the legal system.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102103"},"PeriodicalIF":1.4,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877059","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":"Insanity defense and social dangerousness: A comparative study between China and Italy","authors":"Huan Wan ,&nbsp;Giovanna Parmigiani ,&nbsp;Stefano Ferracuti ,&nbsp;Ping Yan","doi":"10.1016/j.ijlp.2025.102100","DOIUrl":"10.1016/j.ijlp.2025.102100","url":null,"abstract":"<div><div>The determination of criminal responsibility and the evaluation of social dangerousness in the criminal proceedings of offenders with mental disorders are crucial and complex issues. Forensic psychiatric evaluation practices and regulations vary significantly across jurisdictions, offering comparative analysis opportunities. This paper compares the forensic psychiatric evaluation processes in China and Italy, emphatically examining and analyzing the assessment of criminal responsibility and social dangerousness. The shared language, the potential for harmonizing forensic psychiatry practices, and the pursuit of unified and transparent standards and practices underscore the importance of conducting cross-national comparative research.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102100"},"PeriodicalIF":1.4,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873761","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":"Mental health disorders, adverse childhood experiences and accelerated reoffending among justice-involved youth in Australia: A longitudinal recurrent event analysis","authors":"Emaediong I. Akpanekpo ,&nbsp;Tony Butler ,&nbsp;Preeyaporn Srasuebkul ,&nbsp;Julian N. Trollor ,&nbsp;John Kasinathan ,&nbsp;David Greenberg ,&nbsp;Peter W. Schofield ,&nbsp;Dianna T. Kenny ,&nbsp;Claire Gaskin ,&nbsp;Melanie Simpson ,&nbsp;Jocelyn Jones ,&nbsp;Anyiekere M. Ekanem ,&nbsp;Azar Kariminia","doi":"10.1016/j.ijlp.2025.102099","DOIUrl":"10.1016/j.ijlp.2025.102099","url":null,"abstract":"<div><h3>Background</h3><div>Mental health disorders and adverse childhood experiences (ACEs) are known risk factors for youth offending. However, most studies operationalize these factors as static and fail to distinguish between isolated reoffences and escalating patterns of criminal behaviour. The impact of mental health service engagement on interrupting cyclical, repetitive offending also remains unclear.</div></div><div><h3>Methods</h3><div>We linked offending records (1994–2022) and mental health records (2001−2022) for 1556 justice-involved youth in New South Wales, Australia. The Prentice, Williams, and Peterson Gap Time model with time-varying effects was used to identify factors associated with accelerated reoffending during a five-year follow-up.</div></div><div><h3>Results</h3><div>The median age at first conviction was 15 years for custody-supervised youth and 16 years for community-supervised youth. Among custody-supervised youth aged 14 to 17, the prevalence of ACEs, mental health disorders, and their co-occurrence were 69.6 %, 33.9 %, and 26.5 %, respectively, compared to 42.5 %, 30.8 %, and 14.8 % for community-supervised youth. Recurrent offences occurred in 64.8 % of custody-supervised youth and 52.1 % of community-supervised youth. Age, physical neglect, substance use disorders, and personality disorders demonstrated time-varying effects on reoffending risk. Additional risk factors included physical abuse, parental death, anxiety disorders, mood disorders, and previous incarceration. Mental health service contact was associated with reduced reoffending risk.</div></div><div><h3>Conclusions</h3><div>This study demonstrates the dynamic nature of criminogenic risk factors and the protective effect of mental health service engagement. Youth justice policymakers should prioritize regular mental health assessments and improved access to interventions for justice-involved youth to reduce recurrent offending and enhance public safety.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102099"},"PeriodicalIF":1.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869231","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":"Cognitive biases in forensic psychiatry: A scoping review","authors":"L. Buongiorno ,&nbsp;F. Mele ,&nbsp;G. Petroni ,&nbsp;A. Margari ,&nbsp;F. Carabellese ,&nbsp;R. Catanesi ,&nbsp;G. Mandarelli","doi":"10.1016/j.ijlp.2025.102083","DOIUrl":"10.1016/j.ijlp.2025.102083","url":null,"abstract":"<div><div>Forensic psychiatry plays a critical role in legal contexts but is highly susceptible to cognitive biases that can undermine the accuracy and objectivity of evaluations. This scoping review, guided by the Arksey and O'Malley framework, aims to identify and analyze cognitive biases within forensic psychiatric practice across criminal, civil, and testimonial domains.</div><div>A comprehensive search across five databases yielded 7002 records, with 24 studies meeting the inclusion criteria. From these studies, ten distinct cognitive biases were identified, with the most frequently discussed being gender bias (29.2 %), allegiance bias (20.8 %), and confirmation bias (20.8 %), followed by hindsight, cultural, and emotional biases. Most studies focused on criminal settings, with only two addressing civil contexts.</div><div>Among the mitigation strategies reviewed, structured methodologies and the “considering the opposite” technique were the most positively evaluated and widely discussed approaches. Conversely, the self-awareness strategy was criticized for its limited effectiveness in reducing bias. Emerging tools, such as artificial intelligence, offer potential solutions but require robust ethical safeguards to prevent the perpetuation of systemic biases.</div><div>This scoping review provides a comprehensive overview of the current state of research on biases in forensic psychiatry, underscoring the need for further empirical studies to explore their prevalence, mechanisms, and effective mitigation strategies in greater depth.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102083"},"PeriodicalIF":1.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADHD in adults and criminal behavior: The role of psychiatric comorbidities and clinical and sociodemographic factors in a clinical sample","authors":"Martina Nicole Modesti ,&nbsp;Silvia Gubbini ,&nbsp;Pietro De Rossi ,&nbsp;Agostino Manzi ,&nbsp;Giuseppe Nicolò ,&nbsp;Barbara Adriani ,&nbsp;Simone Pallottino ,&nbsp;Giovanna Parmigiani ,&nbsp;Antonio Del Casale ,&nbsp;Cecilia Guariglia ,&nbsp;Stefano Ferracuti","doi":"10.1016/j.ijlp.2025.102088","DOIUrl":"10.1016/j.ijlp.2025.102088","url":null,"abstract":"<div><h3>Introduction</h3><div>ADHD is a neurodevelopmental disorder associated with functional, behavioral, and relational difficulties. Its onset is in childhood, before the age of 12, and it often persists into adulthood. This study investigates the link between ADHD in adulthood, psychiatric comorbidities, and the risk of criminal behavior, analyzing the impact of clinical and sociodemographic variables.</div></div><div><h3>Methods</h3><div>This cross-sectional study included a sample of 308 patients diagnosed with ADHD, treated at the ADHD Outpatient Clinic of SS Gonfalone Hospital in Monterotondo between 2019 and 2024. Diagnoses and comorbidities were assessed through structured interviews and standardized diagnostic tools (ASRS, DIVA-5). Information on legal status and types of crimes was collected through individual interviews. Statistical analysis was performed using <em>t</em>-tests, chi-square tests, and stepwise logistic regression models.</div></div><div><h3>Results</h3><div>In the sample, 8.1 % of patients with ADHD had committed crimes, with a male prevalence (92 %). Significant predictors of criminal behavior included male gender (OR = 1.899, <em>p</em> = 0.004) and alcohol use disorder (OR = 4.59, <em>p</em> = 0.002). Additionally, oppositional defiant disorder, ADHD diagnosis before the age of 18, and unemployment showed a potential association with risky criminal behavior. Lifetime prescription of antipsychotics (61.4 %) and antiepileptics (48.7 %) was more frequent among participants who committed crimes, while no significant differences were found in the use of atomoxetine and methylphenidate.</div></div><div><h3>Conclusions</h3><div>Adult ADHD, particularly in males, with combined presentation and in the presence of comorbidities such as oppositional defiant disorder and alcohol use disorder, is associated with an increased risk of criminal behavior. The findings highlight the need for personalized and multimodal interventions to mitigate these risks. Future studies should adopt longitudinal designs to explore causal dynamics and evaluate the effectiveness of therapeutic strategies in forensic contexts.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"101 ","pages":"Article 102088"},"PeriodicalIF":1.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}