Forensic psychiatry assessment during parental alienation claims: two cases with different outcomes

Abstract

pineal melatonin in optimizing mitochondrial function being mediated by the circadian gene, Bmal1. 2 The interactions of melatonin and Bmal1 in the regulation of cocaine-driven changes in mitochondrial function will be important to determine.Cocaine also significantly alters immune system responses, generally increasing the activity of most immune cell subsets. 3 Immune cell activation is powerfully regulated by the shift in mitochondrial metabolism from oxidative phosphorylation to glycolysis, with the shift back to an anti-inflammatory phenotype being driven by the autocrine effects of melatonin, as first shown by Regina Markus and colleagues in Brazil. 4 The effects of melatonin -including via Bmal1 -in the mitochondria of immune cells on the regulation of cocaine's effects is an important avenue for future investigation.Cocaine has significant effects on the gut microbiome, with the locomotor-inducing effects of cocaine being significantly modulated by the gut microbiome. This research suggests that increasing the levels of gut microbiome-derived short-chain fatty acids, especially butyrate, could have clinical utility. Butyrate effects include the induction of melatonin and the optimization of mitochondrial function, which may underpin its dampening effects on immune cell activity. 5 Whether optimizing the gut microbiome with probiotics or with the nutraceutical sodium butyrate would afford additional clinical efficacy to melatonin in the management of cocaine addiction has yet to be clarified.Such lines of research should considerably help to clarify the biological underpinnings to melatonin's interaction with cocaine, as well as help optimize treatment.

Medical–Legal and Psychosocial Considerations on Parental Alienation as a Form of Child Abuse: A Brief Review

“…The national legal framework imposes legal medicine expertise in such cases to avoid detecting false-positive cases of parental alienation [ 7 , 37 ] and to acknowledge the risk of maladaptation and the mental development of the child. Elements that can raise the degree of difficulty in the examination are the child being of a very young age, a long period of time having elapsed since the accusations were first made, and the presence of psychiatric pathologies in the parents/children [ 38 ].…”