BACKGROUND: The extent to which rates of homicide by people with or without schizophrenia vary over time has theoretical and practical implications in understanding homicide by people with mental illness.
OBJECTIVE: The aim was to report on the rates of homicide by people diagnosed with schizophrenia over time in a region in which there were dramatic changes in the overall rates of homicide.
METHODS: An examination of homicide by people diagnosed with schizophrenia in the course of judicial psychiatric examination, and the rate of other homicide in the Chuvash Republic of the Russian Federation between 1981 and 2020 was undertaken.
RESULTS: During the 40 years of the study a total of 5741 people faced legal proceedings for a homicide offence, of whom 179 (3.1%) were diagnosed with schizophrenia. During the study period the average annual total homicide rate rose from about 9 per 100 000 in the 1980s, peaked at 17 per 100 000 in the 1990s before falling to 13 per 100 000 in the 2000s and 6 per 100 000 in the 2010s. Rates of homicide by people with schizophrenia also rose and fell over this period and were significantly associated with the rates of other homicide (r = 0.503, d.f. = 38, P = 0.001).
CONCLUSIONS: The rise and fall in rates of homicide by people diagnosed with schizophrenia in parallel to total homicide suggests that homicidal behaviour might not be intrinsic to the clinical manifestations of the illness, and might instead reflect a heightened vulnerability to social factors that are associated with homicide by people without schizophrenia.

The criminal responsibility of offenders with mental disorders is a key issue in forensic psychiatry. Japan\'s implementation of the Medical Treatment and Supervision Act and Lay Judge Act in the early 2000s raised public awareness of this issue. To determine how criminal court judges in Japan assess the criminal responsibility of offenders, we examined 453 district court verdicts that mention psychiatric evidence. We extracted elements from each verdict that may be associated with courts\' decision-making regarding criminal responsibility and analyzed the relationship between each element and the adjudication of criminal responsibility. We investigated the changes in each element\'s prevalence over time. A logistic regression analysis revealed that the following were independently associated with the court decisions that offenders\' criminal responsibility was intact: understandable motivation for committing the offense, homogeneity of the offense from the defendant\'s usual behavioral pattern, a coherent process used to commit the offense, alertness while offending, and absence of psychotic symptoms. We observed that recent verdicts are more focused on the offender\'s perception of illegality and the coherence of the offending process while disregarding the defendant\'s consciousness and memory while offending. Thus, the courts focus on some specific elements for evaluating the criminal responsibility of each offender.

Mentally ill offenders have a right to a fair trial and adequate treatment in terms of the law. The diversion of mentally ill offenders between the criminal justice and the mental health care systems is linked to the forensic psychiatric assessment and based on two psycho-legal constructs, fitness to stand trial (FTST) and criminal responsibility (CR). Forensic psychiatric assessment is therefore an important element in criminal law and plays a major role in the court\'s decisions regarding the sentence, detention, placement, or treatment of mentally ill offenders. The legislation aims to ensure balancing the rights of mentally ill offenders to psychiatric care and society\'s safety. A narrative overview of the literature summarizing the findings on legislation regulating FTST and CR assessment and their practice in different areas of the world was conducted. It offers insight into the advantages and disadvantages of the various approaches and examines the way court proceedings function in these different geographical and psychosocial-legal contexts. This may have policy implications for individual systems and allow countries to consider feasible mechanisms to refine the relevant legislation to improve their practices in forensic psychiatric assessments. Worldwide, relevant legislation is considered as essential in protecting mentally ill offender\'s right; it has been established for many years regarding specifying the procedures and responsibilities for the mental health care and criminal justice systems. Despite similarities in the principles of the psycho-legal constructs in different countries, there are differences in the way legislations are implemented, often depending on the available resources.

The prevention of sexual violence is a major goal of sexual health. In cases of accused sexual offenders, the assessment of diminished criminal responsibility of the accused is one of the most important procedures undertaken by experts in the German legal system. This assessment follows a two-stage method assessing first the severity of a paraphilic disorder and then second criteria for or against diminished capacity. The present study examines the predictive validity of two different sets of criteria for the assessment of criminal responsibility in the context of paraphilic disorders combined with sexual offending. Two exemplary case vignettes of two suspected sexual offenders were developed to assess the criteria. For each participant, one of the two exemplary case vignettes was randomly presented. The presentation of the two different sets of criteria was also randomized, so that each participant was assigned only one of the two criteria sets to rate one of the presented cases. N = 349 participants from different professional backgrounds (mental health and legal professionals) completed their assessments and were included in the data analysis. The data were evaluated using logistic regression. Results show that the more recently published criteria set (Briken and Müller, 2014) predicts both the severity of the disorder as well as the diminished capacity twice as good as the older criteria set of Boetticher et al. (2005) currently used regularly for forensic court reports. In preliminary conclusion, the new criteria of Briken and Müller (2014) form an empirically based assessment of criminal responsibility. However, the proposed criteria cannot replace an extensive exploration of the accused person and a careful file analysis. Validity and reliability of the results are also limited due to the methodical choice of a vignette study.

computed tomography and the Bender Gestalt Test are some of the tests used routinely for the assessment of alleged offenders referred under Sections 77 and 78 of the Criminal Procedure Act 51 of 1977. An exploratory retrospective study was conducted at the Free State Psychiatric Complex. The aim of this study was to identify the extent to which the Bender Gestalt Test results and the computed tomography scans are associated with outcomes in the assessment of competency to stand trial and criminal responsibility in individuals referred to the Free State Psychiatric Complex (FSPC) observation unit. This was a cross-sectional study and the entire population of patients admitted in 2013 was included in the study. The clinical and demographic data were obtained from patient files. The majority of participants were black, males, single and unemployed. The most common diagnosis was schizophrenia. The current study showed no statistically significant association between the Bender Gestalt Test Hain\'s scores and the outcome of criminal responsibility and competency to stand trial. Similarly, the study also showed no statistically significant association between the presence of a brain lesion and the outcome of criminal responsibility and competency to stand trial. It was also concluded that as CT scans are expensive, patients should be referred for that service only when there is a clear clinical indication to do so.

The aim of this study was to examine and compare similarities and differences among types of parricide committed by adult offenders. The forensic psychiatric evaluation reports of the 4th Specialization Board of the Council of Forensic Medicine from 2009 to 2011 in Turkey were screened retrospectively. One hundred thirty-five adult perpetrators of parricide (125 male, 10 female) were detected, 51.9% of whom committed patricide, 40% of whom matricide and 8.1% of the perpetrators committed double parricide. Most of the perpetrators used sharp instruments as the killing method. No mental disorders were detected in 58.5% of the perpetrators, while psychotic disorders were identified in 30.4% of the cases. This study supported the predominance of sharp instruments as the killing method and a preponderance of matricide among the offenders with psychotic disorders. Although psychotic disorders were the most commonly detected mental disorders in the parricide offenders, most of them did not suffer from mental disorders.