Forensic Psychiatry and Psychopathology: An Amendment in Contemporary Period

: As stated by Jaspers, a delusion is a deviant assessment of reality that is irredeemably believed. Therefore, while the delusions are apprehended with the uncommon verdict and are not open to rationality, their irrationality or wrongness is obvious to other persons. While Norman Cameron’s pseudo-community, a supposed community of conspirators, was a historical description of conditions that promote the development of delusional disorders, modern technology and advancement of new communicative tools, like smartphone, hidden camera, satellite, internet, and stealthy or scheming tricks or setups, like double-crossing and masquerading scenarios, stressful circumstances, furtive or hectic arrangements, creating a scene to deceive, hack, or tampering, have brought about the possibility of a conspiracy by prejudiced or inimical people, which may amplify the conceivable diagnostic faults by the perplexity of circumstances. On the other hand, it is the duty of forensic and clinical psychiatrists to guess or discover any kind of deceptive entrapment or simulation. In the present article, the said eccentricities, which may have been accelerated by modern technology, have been discussed briefly, especially with respect to paranoia and paranoid ideation. Moreover, some clarifications for better demarcation of the discussed problem and modification of operational definitions in the realm of psychopathology have been suggested. Certainly, ample watchfulness by a clinical or forensic psychiatrist for neutralizing a thinkable intrigue is an apposite performance for improving civil rights and preventing preventable slips.

Self-Harm Among Forensic Psychiatric Inpatients With Schizophrenia Spectrum Disorders: An Explorative Analysis

The burden of self-injury among offenders undergoing inpatient treatment in forensic psychiatry is substantial. This exploratory study aims to add to the previously sparse literature on the correlates of self-injury in inpatient forensic patients with schizophrenia spectrum disorders (SSD). Employing a sample of 356 inpatients with SSD treated in a Swiss forensic psychiatry hospital, patient data on 512 potential predictor variables were retrospectively collected via file analysis. The dataset was examined using supervised machine learning to distinguish between patients who had engaged in self-injurious behavior during forensic hospitalization and those who had not. Based on a combination of ten variables, including psychiatric history, criminal history, psychopathology, and pharmacotherapy, the final machine learning model was able to discriminate between self-injury and no self-injury with a balanced accuracy of 68% and a predictive power of AUC = 71%. Results suggest that forensic psychiatric patients with SSD who self-injured were younger both at the time of onset and at the time of first entry into the federal criminal record. They exhibited more severe psychopathological symptoms at the time of admission, including higher levels of depression and anxiety and greater difficulty with abstract reasoning. Of all the predictors identified, symptoms of depression and anxiety may be the most promising treatment targets for the prevention of self-injury in inpatient forensic patients with SSD due to their modifiability and should be further substantiated in future studies.