Objective: To review homicides committed during psychotic illness in New South Wales over 10 years from 1993 to 2002. Design and setting: Case series of all known homicides committed during psychotic illness in NSW, taken from reports of psychiatrists submitted in proceedings in the Supreme Court of NSW. Main outcome measures: Demographic and clinical features of perpetrators; estimated frequency of homicide during psychotic illness. Results: In the 10 years from 1993 to 2002, there were at least 88 people charged with 93 homicide offences committed during the acute phase of mental illness. High rates of drug misuse, especially of drugs known to induce psychotic illness and brain injury, were reported. Evolving auditory hallucinations and delusional beliefs that led the person to believe they were in danger were the symptoms strongly associated with lethal assault. The victims were mostly family members or close associates. Only nine of the victims were strangers, including three fellow patients. Most lethal assaults (69%) occurred during the first year of illness, and the first episode of psychotic illness was found to carry the greatest risk of committing homicide. Conclusions: People in their first episodes of mental illness should be considered to be at greater risk of committing serious violence than those in subsequent episodes. Illicit drug use, a history of brain injury, auditory hallucinations and delusional beliefs of immediate danger were particularly associated with lethal assault.

Objective: To examine the circumstances of homicides of children in New South Wales from 1991 to 2005. Design and setting: Retrospective analysis of all identified child homicides in NSW from 1991 to 2005, based on data on offenders and victims obtained from crime statistics, documents located by systematic searches of legal databases and media reports, and medicolegal reports of offenders who committed child homicides during psychotic illness. Main outcome measures: Demographic characteristics of homicides and a history of prior psychiatric treatment among offenders with psychosis. Results: We located documents describing 165 homicides by 157 offenders. Fifty‐nine deaths were a consequence of child abuse, including those of five children who died from methadone overdoses. Both the offenders and the victims in fatal child abuse were significantly younger than in other forms of child homicide. The courts found that 27 child homicides had been committed by 26 offenders during the acute phase of psychotic illness, and 15 of these offenders had never been treated with antipsychotic medication. Conclusions: Earlier identification and treatment of psychotic illness in mothers, and changes in the way methadone is provided to opiate‐dependent parents, might result in a small overall reduction in the number of child deaths. More lives could be saved by measures that reduce the incidence of child abuse, including the prohibition of corporal punishment of children.

The role played by pornography in the generation of thoughts, feelings, impulses and behaviours in its viewers has long been a topic of debate and controversy. The uncertainty about its potential effects on human behaviour, especially its relationship to sexual aggression, has stimulated the recent debate with the possibility of tighter censorship laws being implemented throughout this country. A review of the topic from a number of different perspectives fails to establish that pornography in its purely erotic form has any significant detrimental effect on human behaviour. More difficult to determine are its effects on psychological development. If behavioural disturbances do occur following exposure to such material, they occur in the context of an individual who shows more global disturbances of personality. The current debate regarding pornography provides an opportunity to address in a broader social context issues perhaps more significant for our society: the relationships between men and women, and the roles and recognition provided to each of the sexes.

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A comprehensive literature review on the subject of drug and alcohol treatments in correctional services reveals the size of the drug and alcohol problem within the prison population and reconfirms the positive correlation between drugs, alcohol and criminal activity. Disturbingly few comprehensive ongoing assessment and treatment services are available for the prison population. Special drug and alcohol-related issues such as HIV and hepatitis B infection, and high drug-related post-release prisoner mortality rates demand an urgent review of the policies and procedures concerning the assessment and treatment of drug and alcohol problems in correctional facilities.