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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1664

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1665

EV681

When patients with paranoia commit

medicolegal acts: A descriptive study

B. Ghajati

, S. G

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1666

EV682

Patricide, matricide: A comparative

study among Tunisian patients with

psychotic disorders

B. Ghajati

1 ,

, S. Ghezaiel

2

, R. Chebbi

2

, I. Berrahal

2

, R. Ridha

2

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