A forensic-psychiatric study of sexual offenders in Rio de Janeiro, Brazil

Paraphilias, Sociodemographic and Forensic Profiles of Men Convicted of Sexual Offenses in Turkey

This study investigated the psychiatric, paraphilic, and forensic profiles of men who were convicted of sexual offenses. It also examined childhood trauma exposure in the group with potential paraphilia. The study was performed in the closed prison located in the Istanbul Silivri Penal Institutions Campus. The interview data of 100 men convicted of sexual offenses were obtained from the psychiatric interview notes based on the DSM-5 criteria, the results of the 28-item Childhood Trauma Questionnaire administered to the participants with paraphilia, and the forensic profiles from examination files. It was found that 39% of individuals were drug users and 36% were alcohol users. Considering the crime scenes, 42% of men convicted of sexual offenses committed the offense in their own house. Pedophilia was the most common among men with paraphilia (59%). The victim age was significantly lower (p < .001), and the male victim ratio was higher (p < .05) in the group with paraphilia than in the group without paraphilia. Sexual offenses against children aged 10 years and below and against males may be suggestive of paraphilia and an increased risk of recidivism.

Understanding the dark side of personality in sex offenders considering the level of sexual violence

This study examined the relationship between the actual level of physical violence in sexual offenses and dark triad, empathic and impulsive personality traits of their perpetrators. Sixty-four male perpetrators of sexual offenses without any serious mental illness were included. A 5-point Likert-type coding system based on Violence Profile for Current Offense was applied to assess the severity of physical violence of each sexual offense. Personality traits of dark triad (psychopathy, Machiavellianism, narcissism), trait empathy and impulsiveness were also evaluated. Multivariate analyses indicated that non-stranger victim, secondary psychopathy, narcissism and empathy could significantly predict greater involvement of physical violence in a sexual offense. In addition, empathy was negatively correlated with all dark triad traits. Sexual violence should be conceptualized in the form of a continuum, and, considering such an approach, offenders with high secondary psychopathy and narcissism may show preference for sexual assaults that are more violent in nature.

Psychiatric and Forensic Characteristics of Sex Offenders With Child and With Adult Victims

This study presents psychiatric and forensic characteristics of people accused of a sexual crime and sent for evaluation. Data were drawn from the only institutional psychiatric forensic assessment center in Croatia, during a 9-year period, from January 1, 2010 to December 31, 2018. There were 72 cases of sex offenses: 37 with child victims and 35 with adult victims. People accused of sex offenses with child victims were more often sexually abused during childhood and treated psychiatrically as inpatients. They used alcohol less often. Sex offenders with child victims were diagnosed with narcissistic and antisocial personality disorder, dementia, and pedophilic disorder. Those with adult victims were diagnosed with antisocial personality disorder, alcohol related disorders and dementia. Due to these differences, the management of these two groups of offenders in both mental health and penal systems should be different.

Factors Associated with Prolonged Institutionalization in Mentally Ill People with and Without a History of Violence and Legal Involvement: A Cross-Sectional Study

This is a cross-sectional study carried out on 34 individuals hospitalized for a long period in the Federal District, in Brazil. To evaluate factors related to prolonged institutionalization in mental patients with history of violence and criminal records. Individuals found were assorted into two groups: with and without criminal records. We analyzed 56 items by reviewing medical records and health records. Demographic and social data, history of violence, criminal involvement, medical history, substance use, and other aspects related to long hospitalizations, by reviewing medical and health records. We found a profile of male individuals: single, male, with an average age of 47.6 years, low education, and little professional qualification from correctional facilities or long-term psychiatric clinics and hospitals. Most men had a history of aggressive behavior, a leading psychiatric diagnosis of psychosis, and an issue with polypharmacy. Two factors showed statistical significance and were highly related to longer institutionalizations: polypharmacy and records of hospitalization for violent behavior. Further studies with these populations are needed to increase knowledge on the subject. They can help health care systems to improve and provide broad, humanized and quality assistance with multi-professional teams, aiming to reduce prolonged hospitalizations.

The profile of offenders accused of rape referred to the Observation Ward of the Free State Psychiatric Complex, Bloemfontein, South Africa, 2011–2015

Background: Sexual assault in South Africa has reached alarming proportions. Mental illness amongst offenders accused of rape is one of the complicating factors.Aim: To describe the sociodemographic, clinical and forensic profile of alleged offenders accused of rape referred to a South African tertiary public psychiatric hospital for forensic evaluation, as well as describe the profile of the reported victims.Setting: Free State Psychiatric Complex (FSPC) Observation Ward, Bloemfontein, South Africa.Methods: This cross-sectional retrospective study compiled a sociodemographic, clinical and forensic profile of offenders accused of rape referred to the FSPC for forensic assessment between 2011 and 2015. The study population comprised 159 alleged offenders. Sociodemographic data, mental status, clinical diagnoses, comorbid substance use and forensic outcomes were collected from clinical files.Results: All accused offenders were male with a median age of 30 years. About half obtained primary school level education. Unemployment was common (37.3%) with 40% receiving government grants. Most accused offenders were single (78.0%). Clinically, schizophrenia spectrum and other psychotic disorders were the most common diagnoses (30.8%), followed by intellectual disability (16.3%). Almost a third of the accused offenders did not suffer from any mental illness. Alcohol (20.1%) and cannabis use disorders (12.6%) were dominant comorbidities. After a 30-day evaluation period, 53.2% of alleged offenders were found competent to stand trial. The verdict of criminal responsibility was made for 43.7% of this sample.Conclusion: This study contributes data on sociodemographics, psychiatric morbidities and comorbidities and forensic findings amongst alleged offenders of rape referred for forensic assessment.

Forensic psychiatric evaluations of people charged with rape in Croatia

Introduction: Sexual violence is a substantial public health problem that is associated with a major impact on victims, and in Croatia, more than half of reported cases of sexual violence involve rape. To help understand their general profiles and consider any implications arising, the aim of this research was to describe the forensic psychiatric characteristics of people charged with rape. Methods: All evaluations of people charged with rape and sent for evaluation at the largest assessment centre in Croatia during the period 2010-2018 were analysed (n  =  56). Results: Alleged offences most often took place in a perpetrator or victim's home (71%), while the next most frequent location was the street (15%). Over 80% of alleged victims were known to the accused. Alcohol use and abuse were present in 73% of the accused, and 29% were drinking at the time of the alleged offence. Alcohol-related disorders were presented in 38% of the accused, while 38% had a personal history of drug use, and antisocial and narcissistic personality disorders were present in 48% and 29%, respectively. Psychotic disorders were rare (1.8%). Most of the accused were found to be criminally responsible; however, forensic psychiatric assessment procedures were inadequate when considering psychosexual assessments. Conclusions: Interventions based around public health and education should be considered in this field, and forensic psychiatric assessments should be prioritized for improvement.

Institucionalização prolongada, transtornos mentais e violência: uma revisão científica sobre o tema

Resumo Trata-se de uma revisão de literatura sobre institucionalização prolongada, transtornos mentais e violência. Uma busca sistematizada foi realizada nos principais bancos de dados e foram analisados trabalhos dos últimos 22 anos. Os resultados foram divididos em dois grupos: “Estudos relacionando fatores ligados à predição/risco de violência e institucionalização” e “Estudos relacionando risco de violência e desassistência/desinstitucionalização”. Verificou-se que a doença mental isoladamente não é fator diretamente associado ao maior risco de violência, que fatores relacionados à própria institucionalização e à assistência com privação de liberdade influenciam a predição de violência. Conclui-se que abordagens humanizadas, multiprofissionais e com equipe treinada, aliadas ao gerenciamento dos reais fatores de risco de violência, contribuirão para uma melhor assistência e menor necessidade de institucionalização.

Crime sexual e retardo mental

Apresentamos o caso de um homem que cometeu estupro de menino de cinco anos de idade. A perícia psiquiátrica concluiu que o mesmo apresentava retardo mental moderado, sendo inimputável. Atualmente ele cumpre medida de segurança em Hospital de Custódia e Tratamento Psiquiátrico do Rio de Janeiro. São discutidos fatores motivadores desse comportamento sexual, bem como as questões subjetivas do paciente que contribuíram para esse comportamento.

Cessation of dangerousness status: an analysis of 224 reports from the Instituto de Perícias Heitor Carrilho, Rio de Janeiro, Brazil

Objectives:

To evaluate factors related to dangerousness cessation at the end of involuntary commitment based on an analysis of expert reports. In light of the current legal requirement of dangerousness cessation as a pre-requisite for prison or internment release of individuals subjected to the safety measure, we sought elements to reflect on the practice of expert examiners in charge of making this decision.

Methods:

The authors revised 224 expert psychiatric dangerousness cessation reports released 2011 through 2014 and collected data for a statistical analysis.

Results:

The following variables were associated with positive risk cessation assessments: no inadequate behavior (according to the assistant professionals), no productive psychotic symptoms, no negative symptoms, presence of insight, presence of a support network, and no psychoactive substance abuse. The following variables were associated with negative dangerousness cessation decisions: early onset of malfunction, lack of insight, negative attitudes, active signs of major mental illness, presence of impulsiveness, poor response to treatment, presence of plans lacking feasibility, exposure to destabilizing factors, lack of personal support, and presence of stress.

Conclusions:

In this study we were able to identify factors associated with dangerousness in a sample of expert reports. The knowledge of factors linked to a higher risk of recidivism in illegal activities or violent behavior is crucial for decision-making regarding the release of offenders after their legally established period of involuntary commitment.

Characteristics of paraphilics in Turkey: A retrospective study-20years

OBJECTIVE

This study is carried out to research the frequency of occurrence and the characteristics of paraphilic cases in Turkey and forensic aspects of them and to explain forensic psychiatric studies of people show paraphilic actions and assess them from legal aspects.

METHOD

This research is done by studying a total of 101,208 cases who were sent to Istanbul Forensic Medicine Institute (FMI) by the judicial organs of 4th Specialization Board between 1984 and 2004 to decide whether they show paraphilic actions or not. When choosing the cases of pedophilic actions, incest incidents were excluded and 307 incidents were taken into assessment.

RESULTS

The male subjects are 97.4%, 39.7% of them are 19-29years old, 10% of them are over age 60, 59% of the subjects are single, 36.5% of them are unemployed, 71.7% of the incidents have no physical disorder. The subjects who were imprisoned before were 20.2% and 22.1% of them had undergone psychiatric treatment before the incident. Twenty separate diagnosis are determined by the FMI for the subjects. There were mental retardation, schizophrenia and various personality disorders on the top the diagnosis list. The paraphilia type of the incidents are pedophilia (60.3%), exhibitionism (8.1%), pedophilia and exhibitionism (7.5%) and fetishism (5.9%). It was determined that there were more than one paraphilia type in 40 incidents (13%). FMI decided that 54.7% of them have criminal responsibility, 25.1% of them have no criminal responsibility, and 20.2% of them have reduced criminal responsibility.

CONCLUSION

There were 20 separate type of diagnosis for the incidents. It is understood that paraphilic incidents do not seek for help although they have the symptoms of disorder and they are exposed to psychiatric assessment only when they face a criminal inquiry. This suggests that there are more paraphilic incidents in the society than what we encounter.

O exame de Verificação de Cessação de Periculosidade: a importância da avaliação ampliada em um caso com conclusão contrária ao parecer da equipe assistente

Trata-se de uma discussão a respeito de um caso em que um indivíduo sob medida de segurança, devido a tentativa de homicídio, foi submetido à avaliação de sua periculosidade por peritos psiquiatras. A conclusão foi de que sua periculosidade não havia cessado, divergindo da opinião de sua equipe assistente. Foram identificados relevantes fatores que implicam um maior risco de violência e reincidência criminal, demonstrados no laudo. O resultado mostra que uma avaliação criteriosa e independente é fundamental para a elaboração de um bom laudo psiquiátrico.