The main objective of this study was to assess behavioural changes in forensic patients (those assessed as not guilty by reason of insanity and sent for an involuntary forensic treatment) during the COVID-19 pandemic restrictions. There were 82 patients treated at the Department for Forensic Psychiatry of the University Psychiatric Hospital Vrapče in 2020, 45 of which stayed in the department for the whole year. Data were extracted from their charts and from the nurses’ reports about their body masses, additional therapy prescribed and incidents at the ward. During the lock-down due to the COVID-19 pandemic, the body masses of the forensic patients decreased signifi cantly in the first weeks of the lock-down and stayed low during the rest of 2020. Patients used fewer additional antipsychotics, benzodiazepines, hypnotics and pain killers in April 2020 as compared to February 2020. In June 2020, the use of these drugs returned to pre-pandemic levels, with the exception of antipsychotics. In August 2020, painkiller use increased to higher than pre-pandemic levels. The number of incidents during lock-down was lower compared to pre-pandemic levels.
There are cases in forensic psychiatric evaluations with inconclusive information or with important information missing. In such situations, when new information becomes available the judge may ask an expert to supplement his/her report in the light of new information. For the purpose of this study, we collected 42 supplemental evaluations written in the University Psychiatric Hospital Vrapče to determine possible factors which were associated with changes in supplemental evaluations. The following data were gathered: demographic data, types of criminal offenses, reasons for the supplement evaluation, court questions, and diagnoses. Changes in supplemental evaluations occured more often when the defendants were diagnosed with a personality disorder (PD) only, compared to those who had a PD with a comorbidity, especially substance use disorders. Defendants with the diagnosis of a substance use disorder were 63.7% less likely to have changed experts’ evaluations. The evaluations remained the same when the reason for supplemental evaluations were new witnesses’ testimonies. Considering the principle of economy of actions in a judiciary system, a more critical approach should be taken when the judge requests a supplemental report.
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