European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S567
Introduction Under the Portuguese law, criminal offenders that
are designated as non-criminal responsible – “inimputáveis”, simi-
lar those in the United States of America found “not guilty by reason
of insanity”, are forced to be committed to inpatient forensic units
either in psychiatric hospitals or prison hospitals for mandatory
security measures.
Objectives/aims To evaluate if patients committed in a regional
forensic inpatient unit (RFIU) who had a psychiatric history pre-
ceding the crime, were under long acting injectable antipsychotic
(LAIA) in during the period of the crime.
Methods During September/October 2015, patients committed
to the RFIU in Centro Hospitalar Psiquiátrico de Lisboa were char-
acterized using medical and court records regarding clinical and
demographic variables. The type of crime and previous number of
criminal acts were also accounted for.
Results We included 33 patients in the study. During time of
the crime, 25 patients (75.8%) had history of previous psychiatric
appointments, with an average of 3 commitments to the psychi-
atric inpatient units. The majority (n = 17; 68%) had a diagnose of
“schizophrenia, schizotypal and delusional disorders” (F20–29; ICD
10) and committed “crimes against life” (n = 13; 52%). They had an
average of 0.8 previous criminal acts. During the crime, 7 patients
(28%) were taking LAIA. Those, 16% (n = 4) were doing an unknown
antipsychotic and 12% (n = 3) were doing Haloperidol.
Conclusions Despite several studies showing the clinical and
rehabilitative benefit of using LAIA early in the disease course, most
of the patients in our study, who were already being followed in
outpatient psychiatric units, did not benefit from them.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV680
DSM-5 clinical/legal challenges
regarding the USA’s death penalty
L. French
Webster, USA
Introduction In May 2013, the American Psychiatric Association
(APA) published the Diagnostic and Statistical Manual of Mental Dis-
orders (DSM-5) in order to bring America’s clinical professionals in
concert with the World Health Organization’s (WHO) international
classifications, notably the ICD-10-CM. This effort was met with
considerable resistance and changes were delayed until November
2015. Major social-cultural differences between the United States
and its European and other North American partners (Canada and
Mexico) poses challenges in critical forensic areas such as the clini-
cal/legal assessment of death qualified offenders – a status unique
to the USA.
Objective/aims To articulate the clinical/legal differences
between the previous DSM’s (III; III-R; IV) and the DSM-5 and
how the new language provides greater ambiguity in defining
the mental status requirements for Mens Rea – competence to
understand one’s actions.
Methods Present themajor legal issues surrounding the US death
penalty and brought before the US Supreme Court including: Fur-
man v. Georgia (1972); Greg v. Georgia (1976); Jared v. Texas
(1976); Proffit v. Florida (1976); Adkins v. Virginia (2002); Roper
v. Simmons (2005); Miller v. Alabama (2012): . . . and legislative
actions such as Rosa’s Law (Public Law 111-256; 2010).
Results/conclusions Advocacy groups pushed Rosa’s Law to men-
tal retardation with – intellectual and developmental disability.
This change is reflected in the DSM-5 whereby mental retardation
(MR) was once relegated to axis II, is now classified under intel-
lectual disabilities (ID) given the impression that it is a transitory
(correctable) and not a fix (organ disability) clinical condition.
Disclosure of interest The author has not supplied his declaration
of competing interest.
EV681
When patients with paranoia commit
medicolegal acts: A descriptive study
B. Ghajati∗ hezaiel , R. Chebbi , I. Berrahal , R. Ridha
Razi Hospital, Forensic psychiatry, Tunis, Tunisia
∗ Corresponding author.
Patients with paranoia have always been an attractive and
redoubtable group of mentally ill to mental health professionals. In
fact, beyond complex psychopathology and relatively better func-
tioning, these patients do represent a real threat to themselves and
their presumed persecutors.
Objectives To explore criminological aspects of medicolegal acts
committed by patients with paranoia.
Methods We conducted a retrospective and descriptive study,
based on medical charts consult. Were included, patients
suffering from paranoia (persistent delusional disorder: jeal-
ous/persecutory/erotomania type, DSM-IV), hospitalized in the
forensic psychiatry department of Razi hospital between 1995 and
2015. This psychiatry department provides medical care for male
patients not held by reason of insanity, according to article 38 of the
Tunisian Criminal Code. Patients’ socio-demographic characteris-
tics were collected as well as criminological details of their acts of
violence (victim, weapon type, crime scene, premeditation. . .).
Results We collected 23 patients. Delusional disorder typeswere:
jealousy (17), persecution (4), erotomania (1) and claim (1). The
majority was married (18), undereducated (17), with irregular
work (13). Forensic acts were uxoricide (15), attemptedmurder (5),
violence against people (2) and destruction of public properties (1).
Patients used bladed weapon in most of the cases (13), in the vic-
tim’s residence (19), with premeditation in (17) of the crimes. Nine
patients reported their act of violence to the authorities.
Conclusion Our results do expose further data concerning poten-
tial dangerosity of patients with delusional disorders, and by that
invites mental health professionals to prevent these acts with
screening for violence predictors and risk factors.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV682
Patricide, matricide: A comparative
study among Tunisian patients with
psychotic disorders
B. Ghajati ∗, S. Ghezaiel , R. Chebbi , I. Berrahal , R. Ridha
1 Razi Hospital, Tunis, Tunisia
2 Razi Hospital, Forensic psychiatry, Tunis, Tunisia
∗ Corresponding author.
Parricide is defined as the homicide of a father or mother by a bio-
logical or adopted child. In adults, it is generally associated to a
psychotic condition. Scientific research on the subject, have been
mainly interested in matricide, patricide or double parricide. Stud-
ies comparing authors of patricide to those of matricide are rare.
Objectives To compare socio-demographic and clinical profiles of
patricide and matricide patients.
To compare modus operandi in matricide and patricide patients.
Methods A retrospective, descriptive and comparative study
was conducted, based on medical charts’ consult. Were included
patients suffering from psychotic disorders (DSM-IV), hospitalized
in the forensic psychiatry department of Razi hospital between
1995 and 2015, after not being held for insanity according to