Psychiatry & Law Radar

Triage urgency criteria for patients on the high security waiting list.

A retrospective cohort of 120 patients admitted to high security forensic psychiatric centres in Flanders compared DUNDRUM-2 Triage Urgency scores for prioritised versus regular admissions. Prioritised patients scored significantly higher, with almost nine in ten rated urgent or very urgent, but roughly one third of regularly admitted patients also had urgent needs, indicating unmet demand in the queue. Psychometric analysis found weak internal consistency and practical scoring difficulties when the scale was applied within the Belgian clinical and judicial framework. The authors nonetheless see value in the instrument for transparency and accountability, and recommend local adaptation and further validation.

Int J Law Psychiatry. 2026;108:102237.

Quality of post-sentence psychiatric expert reports on individuals convicted of islamist terrorist offenses.

In partnership with France's national counter-terrorism prosecutor's office, the authors audited 100 post-sentence psychiatric expert reports (plus 15 second opinions and 10 supplemental reports) on individuals convicted of Islamist terrorism offenses, scoring them against conformity criteria the authors built from French National Authority for Health recommendations and from a literature-derived list of violent-radicalization risk factors. Mean conformity was 86.7%, falling to 82.1% when terrorism-specific criteria were added. Experts frequently did not reference a diagnostic classification, were reluctant to use actuarial instruments or structured professional judgment for recidivism risk, and varied in whether they looked for radicalization-specific risk factors. The authors call for expert training, inter-expert consensus work, and clarification of the respective missions of experts and magistrates.

Int J Law Psychiatry. 2026;108:102252.

"There's more to recovery than just weight gain": Ethical challenges for justice and respect in adjudication of capacity for patients with anorexia nervosa.

A qualitative study line-by-line coded 29 Reasons for Decision issued over ten years by Ontario's Consent and Capacity Board concerning capacity in patients with anorexia nervosa, retrieved from CanLII. Four themes emerged: barriers to procedural fairness, divergent perceptions of people with AN, suspicion/distrust/disbelief, and a disconnect between patient values and medical priorities. The authors conclude, through a procedural justice lens, that these patients face procedural fairness barriers and may experience stigma and epistemic injustice at the tribunal, and they offer recommendations for a more patient-centred, recovery-oriented approach. The study analyses written decisions only; it does not observe hearings, measure assessment reliability, or change the governing legal standard.

Int J Law Psychiatry. 2026;108:102232.

Overburdened and understaffed: A national mixed-methods examination of Canadian forensic mental health and fitness to stand trial.

A mixed-methods national survey — the first in roughly two decades — mapped Canada's forensic mental health infrastructure, identifying 40 forensic sites and 2,031 designated beds, with 29 sites conducting inpatient fitness-to-stand-trial assessments, a 16% increase in the number of such sites since the early 2000s. Site surveys (n = 17) and public data documented substantial provincial variation in capacity, service availability and referral patterns, and thematic analysis of provider interviews (n = 13) yielded four themes centred on care-delivery challenges, growing system burden, stigma and unmet needs. The study is descriptive and exploratory; it reports no controlled comparison and does not establish that Canada is experiencing a U.S.-style competency crisis, only that providers perceive growing pressure.

Int J Law Psychiatry. 2026;108:102230.

Autism as legal insanity - Neurocognitive and contextual arguments in Swedish forensic psychiatric evaluations.

A qualitative content analysis of 20 Swedish forensic psychiatric evaluations (2016-2018) of violent offenders with autism, split evenly between those found to meet the legal standard of severe mental disorder (SMD) and those who did not. Evaluators applied a dimensional rather than categorical approach to autism, with the SMD group characterised by very low psychosocial functioning, fixation on violence, rigid coping strategies, impaired central coherence/metacognition, idiosyncratic worldview, and compulsivity tied to severe anxiety; the no-SMD group was marked by antisocial traits, substance misuse, intact reality monitoring and ability to integrate multiple perspectives. The authors conclude that the threshold for when autism severity becomes 'sufficient' for SMD is vague and inconsistently articulated.

Int J Law Psychiatry. 2026;108:102250.

Assault-on-Law-Enforcement: The Complications of Charges for Individuals on Mental Health Court Dockets.

A sequential mixed-methods study of Virginia's behavioural and therapeutic court dockets (2022-2023), combining open state case data with semi-structured interviews of docket coordinators, found that the single most common alleged offence among mental health court cases was assault on a law enforcement officer, a charge carrying a mandatory minimum custodial term on conviction, and that it was disproportionately laid against Black men. Coordinators reported that these allegations typically arose when defendants were in mental health crisis and perceived police as a threat, and that eligibility for diversion turned on local prosecutorial discretion and on whether a given court would accept violent felony charges. The authors conclude that the mandatory minimum obstructs the disposal most likely to protect officers, the community and the defendant, and recommend dissemination of outcome data with a view to legislative change.

Crim Behav Ment Health. 2026.

Examining the court's perspective: Legal professionals' perceptions and preferences of expert testimony.

A mixed-methods survey of 132 judges and lawyers in the United States and Canada rated 11 elements of mental health testimony and ranked preferences among psychiatrists, psychologists and social workers as expert witnesses. Respondents most valued testimony on clinical diagnosis, psychological testing and descriptive testimony; Americans rated crime statistical data tied to diagnosis as more essential, while Canadians ranked testimony on dangerousness higher. American respondents preferred psychologists as experts, reversing the psychiatrist preference reported in studies from the 1980s to 2010s, whereas Canadian respondents still preferred psychiatrists. Thematic analysis of free-text comments produced four markers of useful testimony: qualified and engaged experts, relevant and useful information, empirical rigor, and clarity and accessibility.

Int J Law Psychiatry. 2026;108:102248.

Criminal liability and Bipolar Disorder in Spain: A systematic analysis of 182 judicial sentences (2019-2024).

A retrospective review of 182 Spanish criminal sentences (2019-2024) involving defendants with bipolar disorder presenting manic symptomatology found the cohort predominantly male (81.87%), socially isolated (76.92% without family support), and largely untreated at the time of the offence (61.54% off pharmacotherapy, 64.29% without psychiatric follow-up), despite 69.23% carrying a prior BD diagnosis. Judicially, the most common outcomes were dismissed appeals (37.36%) and prison sentences (28.57%); bipolar disorder was accepted as a full exonerating factor in only 3.3% of cases, and court-ordered pharmacological treatment was imposed in 6.59%. The authors conclude that social vulnerability and treatment non-adherence cluster with criminal involvement and call for standardised forensic protocols. The design is descriptive and retrospective, with no comparison group and no test of any assessment instrument.

Int J Law Psychiatry. 2026;108:102253.

Descriptive, not categorical: How court questions shape functional expert conclusions in adult capacity cases.

A qualitative analysis of 40 Czech court orders commissioning expert reports in legal-capacity proceedings (202 questions, 188 retained) sorted the questions into eleven clusters and four superordinate categories: illness/medication identification, general cognitive and volitional limitations, specific limitations bearing on rights and obligations, and specific limitations bearing on everyday life. The authors then propose reformulated assignment wording that invites descriptive accounts of condition and functioning instead of categorical 'is/is not capable' conclusions, grounding the proposal in Czech higher-court criticism of judges passively adopting expert categorical findings and in CRPD-style supported decision-making frameworks. The output is a normative set of model phrasings and a recommendation that assignments be structured around the identified semantic clusters; the paper reports no outcome data on whether reformulated questions change judicial decisions.

Int J Law Psychiatry. 2026;108:102249.

Is capacity to consent to healthcare a uniformly defined concept? Insights from a document analysis of laws and national guidelines across six European countries.

A qualitative document analysis of health laws, national guidelines and health-authority recommendations in Norway, England and Wales, Belgium, France, Sweden and Ireland found no uniform description of capacity to consent to healthcare, though a functional approach was a common thread and some countries were more closely aligned than others. The level of operational detail about how capacity should be assessed varied widely, and in several countries the governing documents contained no description of the assessment at all. The authors conclude that several countries lack comprehensive guidance for clinicians on the concept and its assessment.

Int J Law Psychiatry. 2026;108:102235.

Lawyers' perspectives on the increased use of involuntary psychiatric treatment under the mental health act 2016, Queensland, Australia.

Two online focus groups — Mental Health Review Tribunal legal members and independent lawyers representing consumers at hearings — were asked why involuntary treatment rates in Queensland remain high and rising despite the human-rights framing of the Mental Health Act 2016 (Qld). Participants in both groups converged on the view that involuntary treatment is used out of necessity and often in preference to less restrictive options, and attributed this to resource limitations, features of the Act and associated policy, service culture, and systemic barriers to voluntary and less restrictive care. The paper reports the lawyers' proposed remedies: amending the 2016 Act, expanding community mental health resources, strengthening consumer participation and legal representation at tribunal, and leadership to drive cultural change. It presents no data on treatment rates themselves and no measured outcomes.

Int J Law Psychiatry. 2026;108:102233.

Criminal responsibility and mental disorder: Why do heterogeneous constructs not overlap?

A conceptual paper arguing that legal constructs of criminal unaccountability (insanity) and psychiatric constructs (diagnoses, symptoms, functional impairment) categorize complex phenomena for different purposes and therefore cannot be expected to map onto one another. The authors contend that the heterogeneity of psychiatric constructs, and the loose relationships among diagnosis, symptom and impairment, make the legal-psychiatric overlap epistemologically fraught, with consequences for legal certainty and equality before the law. They suggest courts and experts are typically unaware of these issues, creating scope for unrecognized bias. No new empirical data and no change to any legal standard is presented.

Int J Law Psychiatry. 2026;108:102236.

Reforming the insanity defence in Ireland to comply with the Convention on the Rights of Persons with Disabilities.

A scholarly review arguing that the CRPD, as interpreted by UN treaty bodies, does not require abolition of the insanity defence, and proposing a reform model for Ireland instead. The author would replace the cognitive limb with a rule permitting evidence of psychosocial disability to negate mens rea, and replace the evaluative and volitional limbs with a new defence framed around the defendant's capacity to generate alternative choices. It notes that no State Party has moved to abolish the insanity defence, on the view that the UN bodies' interpretations are flawed and unworkable. This is a normative legal proposal; no Irish law has changed and no court or legislature has adopted it.

Int J Law Psychiatry. 2026;108:102258.

A cross-national comparative study on forensic psychiatric evaluation in Switzerland and Italy.

A narrative comparative analysis of forensic psychiatric evaluation in Italy and Switzerland, two Roman-law jurisdictions with divergent psychiatric systems — Italy's community-based model against Switzerland's hospital-centered one. The authors describe differences in how criminal responsibility is assessed, how recidivism risk is approached, how expert reports are constructed, and how forensic psychiatrists are trained in each country, arguing these reflect broader legal and epistemological configurations. It presents no new empirical data and offers no measured comparison of evaluation outcomes or reliability; it concludes by calling for further research toward more standardized international approaches.

Int J Law Psychiatry. 2026;108:102257.

Mental disorder in the courtroom: Challenges for legal practice in low-resource criminal justice system: A qualitative analysis from Indonesia.

Focus groups with nine Indonesian judges, prosecutors and lawyers, analysed by inductive thematic analysis, identified three domains: experience handling cases involving mental disorder, knowledge and regulatory gaps, and future directions. Participants reported difficulty recognising and interpreting mental disorder, communicating with affected defendants, and integrating psychiatric findings into legal reasoning, compounded by limited training, inconsistent use of psychiatric evaluation and restricted access to mental health professionals. The authors conclude that context-specific training, closer legal–clinical collaboration and clearer procedural guidance are needed. This is explicitly the needs-assessment phase of a project to build a forensic psychiatry educational module.

Int J Law Psychiatry. 2026;108:102254.

Field reliability of the Psychopathy Checklist-Revised among life-sentenced prisoners in Sweden: A follow-up study.

Across 217 court-ordered risk assessments of 76 Swedish life-sentenced prisoners seeking commutation (2013-2023), PCL-R interrater reliability was moderate and had not improved since Sturup et al. (2014): ICC = .73 for the total score, with affective and lifestyle facets at .59. Only 27% of score differences between paired assessments fell within one standard error of measurement, far more variability than the manual implies. HCR-20 scores predicted the final structured professional judgment risk classification better than PCL-R scores, indicating limited incremental value for the PCL-R.

Law Hum Behav. 2026;50(4):361-372.

Are feigning screens "competent to stand trial"? A systematic review and meta-analysis of the Miller Forensic Assessment of Symptoms Test, Atypical Presentation Scales, and Structured Inventory of Malingered Symptomatology.

A systematic review and meta-analysis of 14 reports (20 effect sizes, 1,929 participants) pooled the discriminative performance of three overreporting screens used in competency-to-stand-trial evaluations. All three separated overreporters from comparators with very large pooled effect sizes (M-FAST g = 2.75; ATP Scales g = 1.96; SIMS g = 2.99), though SIMS rested on only two effect sizes and could not be analysed further. The M-FAST and ATP Scales showed sensitivity of .87 and .91 respectively, but an elevated false positive rate, leading the authors to conclude the instruments are sound for ruling out the need for further symptom validity testing while a positive screen requires follow-up assessment.

Law Hum Behav. 2026;50(4):335-360.

Deaths in custody: Physical restraint, excited delirium and medico-legal investigation - A systematic review.

A PRISMA-based systematic review of PubMed and Scopus (2010–2025) on deaths in police and prison custody concludes that such deaths are predominantly multifactorial, arising from the interaction of physical restraint, physiological stress, psychoactive intoxication and individual vulnerabilities such as obesity or cardiac disease. It finds that "excited delirium" lacks validated diagnostic criteria or biomarkers and functions in practice as a diagnosis of exclusion, and that prolonged prone restraint with thoracic or cervical compression may precipitate metabolic acidosis and restraint-associated cardiac arrest even without significant hypoxemia. It further concludes that healthy-volunteer experimental studies do not reproduce real custodial conditions and cannot properly be used to rebut restraint risk.

J Forensic Leg Med. 2026;122:103200.

Conservatorship of K.L.

In a published opinion, the California Court of Appeal (Second District) reversed an LPS Act conservatorship order because the trial court never advised K.L. of her right to a jury trial and never took a personal waiver, and the record was silent as to whether counsel had done so. The court held that a written citation merely stating the proposed conservatee has a jury trial right is, standing alone, insufficient to support a knowing and intelligent waiver — at minimum the person must be advised of the right to a unanimous verdict on grave disability. It declined, however, to adopt automatic reversal, holding that a waiver communicated through counsel is permissible and that error is harmless where the record affirmatively shows, on the totality of the circumstances, that the waiver was knowing and intelligent. It distinguished the Sixth District's Conservatorship of C.O. (2021) and a recent First District decision, in each of which counsel had actually explained the right, and remanded without a capacity determination because no evidence of incapacity to waive was offered.

In the Interest of: C.L.

In a published Rule 1612 specialized review, the Pennsylvania Superior Court reversed a juvenile court's order of out-of-home placement for a 13-year-old adjudicated delinquent of a first offense of possession of a firearm by a minor, and remanded for a new dispositional hearing. The excerpt sets out the holding at the outset: placement was not the least restrictive option consistent with the juvenile's individualized needs and public protection under 42 Pa.C.S. §§ 6301(b)(3)(i) and 6352(c). The record showed a court-ordered mental health evaluation recommending Multisystemic Therapy — a family-based treatment unavailable in residential placement — a moderate YLS risk score, no behavioral incidents in detention, ADHD and PTSD diagnoses, a competency finding, and two engaged custodial parents; the juvenile judge nonetheless stated that in over twenty years nothing had convinced him a child with a firearm was safe in the community. The excerpt ends while the court is distinguishing In the Interest of D.W., so its full reasoning and any limiting language were not provided.

2026 Pa. Super. 190

Assessment of Intellectual Disability in Death Penalty Cases.

This is a Psychiatric Services column analyzing the U.S. Supreme Court's decision in Hamm v. Smith, which concerned how courts should evaluate multiple full-scale IQ scores in Atkins v. Virginia claims exempting defendants with intellectual disability from execution. The column reports that the Court declined to establish a framework for weighing conflicting psychometric evidence, and instead uses the case to explain psychometric principles the authors say are routinely misunderstood in litigation. It offers commentary and interpretation rather than new data or new doctrine.

Psychiatr Serv. 2026:appips20260419.

New Kent County Department of Social Services v. Autumn Surran

In a published opinion, the Court of Appeals of Virginia affirmed the circuit court's refusal to terminate the parental rights of a mother and a father under Code § 16.1-283(C)(1) and (C)(2). The father was an insanity acquittee whose conditional release had been revoked and who was recommitted to Eastern State Hospital; the Department had provided him no services, took months even to identify whom to contact for a medical release, and met with him only once, less than a month before the hearing. The court declined to treat involuntary hospitalization as equivalent to incarceration for purposes of relieving the Department of its obligation to offer services, noting the father was engaged in treatment, adherent to medication, earning privileges and on track for visitation. As to the mother, the court held the circuit court acted within its discretion in crediting the substantial progress she made on her own initiative despite receiving no referrals.

Laws Governing the Care of People with Serious Mental Illness in Solitary Confinement.

This is a fifty-state compilation of statutes, administrative codes, and department of corrections policies governing whether, why, and for how long people with serious mental illness may be placed in solitary confinement. It reports wide state-to-state variation in the protections afforded to incarcerated individuals with SMI and argues for uniform legislation restricting the practice for this population. It is a survey and advocacy piece rather than an empirical study; it presents no new data on outcomes and announces no change in doctrine.

J Am Acad Psychiatry Law. 2026.

Patient experiences of coercion in mental healthcare: systematic review and metasummary of qualitative studies from 1991 to 2025.

A preregistered systematic review and metasummary of 291 qualitative studies (1991-2025, 12 databases) mapping patients' reported experiences of coercion in mental healthcare, most commonly involuntary admission, coercive measures and community treatment orders. Negative experiences were reported in 279 of the 291 studies, but mixed experiences appeared in 166 and positive experiences in 167, indicating that the evidence base is not uniformly critical. The authors flag quality problems across the literature: limited author reflexivity and little involvement of experts by experience. Only 18 studies came from low- and middle-income countries, and involuntary medication is comparatively understudied.

BJPsych Open. 2026;12(5):e205.

TANUK S. (A Minor) v. STATE OF ALASKA, DEPARTMENT OF FAMILY & COMMUNITY SERVICES, OFFICE OF CHILDREN'S SERVICES, NATIVE VILLAGE OF HOOPER BAY, and JENNY S

In a child-in-need-of-aid (CINA) case involving a ten-year-old Indian child placed in residential psychiatric care, the Alaska Supreme Court held that where the child is younger than twelve the guardian ad litem holds the psychotherapist-patient privilege under CINA Rule 9(b)(3)(F)(ii), and that an objection lodged through the child's separately appointed attorney under CINA Rule 12.1(b)(1)(C) does not nullify the GAL's waiver. The court reasoned that the GAL's waiver extinguishes both the privilege and the presumption of nondisclosure, so the burden shifts to the objecting child to show that his interest in confidentiality outweighs the need for disclosure under the Rule 9(b)(3)(D) factors. The court reached the merits despite mootness (the records had already been released) under the public interest exception, and affirmed the superior court's order releasing the psychotherapy records to all parties, including the intervening Tribe. The excerpt ends partway through the court's recitation of the Rule 9(b)(3)(D) factors, before its fact-specific application, though the affirmance is stated in the introduction.

2026 WL 2543397

Psychiatric symptoms and criminogenic risk in people with mental illness: Comparing patients across forensic and nonforensic settings.

A cross-sectional comparison of 74 inpatients with mental illness and prior legal involvement, 68 inpatients with mental illness only, and 207 state forensic hospital patients acquitted NGRI found that criminal risk factors, criminal attitudes and social support classified 64.9%-75.2% of participants into their correct group. The legally involved mental illness group scored highest on total criminal risk, criminal friends and perceived social support, exceeding both the mental-illness-only and NGRI groups. The NGRI group had the lowest psychiatric symptom severity, which the authors attribute to sustained treatment in a stable therapeutic milieu rather than to lower baseline illness. The authors conclude that treatment for legally involved patients should target both psychiatric and criminogenic needs.

Law Hum Behav. 2026;50(4):323-334.

Social Determinants and Trends in Involuntary Psychiatric Detentions: A Decade of Population-Based Data.

Using the Ontario Mental Health Reporting System (2013-2023) and 53,088 adult psychiatric detentions, the authors found that immigration status, homelessness, absence of income and lower education were independently associated with higher odds of involuntary admission after adjustment for age, sex, diagnosis and prior admissions (e.g., AOR=1.87 for homelessness, 1.51 for long-term immigrants, 0.84 for postsecondary education). Indigenous identity was associated with markedly higher odds of being brought in for psychiatric assessment (AOR=3.06) but not with involuntary admission, while immigrants had lower odds of assessment despite higher odds of admission. Joinpoint regression showed annual involuntary admission rates rose 3.3% over the decade. The authors conclude that upstream social determinants drive disproportionate exposure to coercion.

Psychiatr Serv. 2026;77(8):709-717.

In Re: Phyllis Moyer Maynor

The Georgia Court of Appeals affirmed a probate court's dismissal, without a hearing, of a ward's petition to terminate her guardianship because the petition was not supported by an affidavit as required by OCGA § 29-4-42 (b). The ward had attached four unsworn, un-notarized letters from medical personnel and a blank, unsigned physician/psychologist/LCSW affidavit form; the court held the letters were not affidavits because they were not sworn statements made under oath. The court further held that the petition's own verification does not substitute for the statutory affidavit, applying expressio unius reasoning drawn from Shuler v. Akpan. Because the petitioner never made the threshold probable-cause showing, no court-ordered evaluation and no hearing were required.

Should I and Can I Use AI for Forensic Psychiatry Report Writing?

A single-author viewpoint arguing that large language models may appropriately support bounded, reversible, independently verifiable tasks around a forensic report — document organization, chronology construction, indexing, transcription, structured summarization — within secure validated environments, but that current evidence does not support AI-assisted generation or material shaping of psycholegal reasoning, credibility assessment, or final opinions. It frames the comparison not as AI versus an idealized evaluator but as two imperfect reasoning systems, human bias and omission against hallucination, hidden omission and limited explainability. It proposes 'AI around the report rather than AI writing the report,' with the psychiatrist retaining full authorship and accountability. It reports no new data and states no new legal rule.

JMIR Ment Health. 2026;13:e99749.

Contextual determinants of the implementation of a mental health diversion policy in California: Lessons learned from local implementation partners.

A qualitative implementation assessment of California's AB 1810 pretrial mental health diversion pathway, based on semistructured interviews with 29 implementation partners across nine counties, coded to the Consolidated Framework for Implementation Research. The authors report that the main early barrier was building infrastructure to oversee mental health evaluations, treatment plans and client progress, and that counties which moved from decentralized to standardized processes — notably assigning a dedicated diversion judge — found this a facilitator. Prosecutor perceptions and public-safety concerns were key barriers, and defense counsel weighed diversion against plea offers carrying short sentences. The authors recommend drawing on drug-court implementation literature.

Psychol Serv. 2026;23(3):411-422.

United States v. Jeremy Burton

The Eighth Circuit affirmed a felon-in-possession conviction and 240-month ACCA sentence, holding the district court did not abuse its discretion in excluding a pharmacologist's proffered testimony about the effect of drug intoxication on the defendant's mental state. Applying settled circuit precedent that § 922(g)(1) is a general intent crime to which voluntary intoxication is no defense, the court found the testimony irrelevant under Rules 402 and 403; it further held that the defendant had not, by an appropriate offer of proof, framed the expert's opinion as bearing on the duration of unconsciousness supporting his 'planted gun' defense, and that the expert's report contained no such opinion. Any error was harmless because the jury heard the intoxication and unconsciousness evidence and was instructed that a planted gun would require acquittal. Judge Kelly dissented, arguing the testimony was relevant to negate the knowing-possession element regardless of the general/specific intent label, citing United States v. Odeh and questioning whether Rehaif's scienter analysis undermines the 'general intent' classification of § 922(g).

Forensic psychiatric evaluation of legal capacity in older adults: Clinical and cognitive correlates.

A retrospective review of 1247 adults aged 60-98 referred to a specialized outpatient service for forensic capacity evaluation between 2020 and 2026 found that 90.9% were judged to possess capacity and 9.1% were judged to lack it and referred for guardianship. Those found to lack capacity were older, less educated, and scored lower on all cognitive screens; in multivariable models only MMSE and verbal fluency scores were independently associated with the capacity determination, with MMSE showing the best ROC discrimination among individual measures. The authors report that screening scores functioned as supportive information within a broader clinical evaluation rather than as standalone determinants.

J Forensic Sci. 2026.

Clinical and Criminal Characteristics of Patients With Schizophrenia Exhibiting Homicidal and Non-Homicidal Behavior: A Comparative Analysis.

Retrospective chart review of 104 patients with schizophrenia admitted to Korea's National Forensic Hospital 2020–2024, comparing 55 who committed homicide with 49 non-homicide violent offenders. Most violence in both groups occurred during treatment discontinuation and was driven by persecutory delusions; the homicide group more often committed premeditated, organized offences with sharp weapons against family members in private, and scored higher on MMPI Psychopathic Deviate and Psychasthenia and PAI suicidal ideation, while the non-homicide group showed higher PANSS positive symptom scores, more grandiose delusions, and more recurrent impulsive violence against strangers in public. The authors conclude that risk assessment should incorporate symptomatology, personality pathology and violence typology.

J Korean Med Sci. 2026;41(33):e212.

Comparison of delusional disorder and schizophrenia in cases lacking criminal responsibility: Sociodemographic, clinical and offense-related characteristics.

A retrospective review of 387 cases adjudicated as completely lacking criminal responsibility under Article 32/1 of the Turkish Penal Code, evaluated by the Council of Forensic Medicine between 2019 and 2023, compared defendants with delusional disorder to those with schizophrenia. Delusional disorder cases were diagnosed later, showed fewer pre-offense psychotic symptoms, were more often married and had more children, and their offenses were more often directed at spouses and more often verbal rather than physical; schizophrenia cases had earlier onset, lower functional capacity and more prominent positive symptoms and physical violence. The spouse-directed offense and verbal violence associations persisted after logistic regression adjusting for age at offense and sex. The study is descriptive comparison within an already-adjudicated sample and does not test any assessment instrument or responsibility standard.

J Forensic Sci. 2026.

An Epistemology for Forensic Psychiatry.

A conceptual article proposing an epistemology — a way of knowing — for forensic psychiatry, arguing that forensic opinion becomes authoritative when its knowledge-based content reaches sufficient quality and credence to qualify as expert testimony. Drawing on traditional and contemporary scholarship, it proposes an alliance of logic and probability, using probabilistic reasoning to accrue evidence toward a conclusion. The piece situates that approach against the uncertainties of science and human behavior, observational and research bias, and a political era characterized by misinformation, skepticism, and distrust. It offers a framework rather than new data or new doctrine.

J Am Acad Psychiatry Law. 2026.

State of Louisiana v. Seth T. Strickland

The Louisiana Second Circuit affirmed a second-degree murder conviction of a defendant who had been found incompetent, restored at Eastern Louisiana Mental Health System after 56 days, and later adjudicated competent, then tried on a dual plea of not guilty and not guilty by reason of insanity entered in chambers on the morning of trial. Applying settled Pate/Drope doctrine, the court held the trial judge adequately protected the competency right: no bona fide doubt arose in the six months between the competency finding and trial, and no reassessment was required before sentencing. It also found 'good cause' for the late plea change under La. C. Cr. P. art. 561 was established because all counsel had assumed the dual plea was already in place, and that the State's failure to call one dissenting sanity-commission member did not bar the other experts' testimony. The court nonetheless vacated the sentence and remanded because the trial court sentenced without ruling on pending post-verdict and new-trial motions and without the Article 873 delay.

Thirty years of forensic psychiatric evaluations: Reflections on diagnostic consistency and expert opinion.

A single-case report tracks one Italian man, first detained at 19 for attempted robbery and homicide, through repeated forensic psychiatric evaluations from 1989 to 2025. Early and mid-course assessments consistently found him not guilty by reason of insanity on the basis of a schizophrenic disorder with mild intellectual disability, but from 2022 the opinions diverged sharply: a collegial panel found partial criminal responsibility, the prosecution's consultant diagnosed a dissociative disorder with exaggerated symptoms and full responsibility, the defense maintained insanity, and a 2023 evaluation found full responsibility with malingering. The authors attribute the divergence to the absence of shared methodological standards, noting that psychometric and neuroscientific tools were introduced only in the most recent phase, and expressly describe their findings as exploratory given the single-case design.

Leg Med (Tokyo). 2026;85:102951.

Aaron Shaw v. State of Florida

Florida's Third DCA dismissed for lack of jurisdiction a certiorari petition challenging an order finding no probable cause that a Jimmy Ryce Act detainee's condition had changed, holding such orders are reviewable by plenary appeal rather than certiorari. On the companion appeal it affirmed, finding the committed person received the statutory notice of his right to petition for release and an opportunity to be heard at the section 394.918(3) probable cause hearing, and that his voluntary decision to log off the Zoom hearing did not vitiate due process. It further held the no-probable-cause finding was supported by competent, substantial evidence in the form of two court-related expert evaluations (one conducted without the respondent's participation, one with an interview), twenty substantiated behavioral management reports, and the respondent's failure to present any contrary evidence.

Ex Parte Randy Louis Dupree v. the State of Texas

A Texas intermediate appellate court held it lacked appellate jurisdiction because the trial court summarily dismissed Dupree's habeas application as frivolous without reaching the merits, then exercised original jurisdiction to treat the brief as a mandamus petition and denied relief. On the merits of the mandamus, the court rejected the claim that GPS ankle monitoring imposed on a civilly committed sexually violent predator residing in the Texas Civil Commitment Center is punitive, holding that Health & Safety Code § 841.082(a)(4)(A)(ii)–(iii) and TCCO Policy 3.36 serve the legitimate nonpunitive purposes of ensuring treatment compliance and protecting the community, per Hendricks and In re Commitment of Fisher. It further held Dupree failed to carry his burden on an as-applied challenge, offering no evidence of his treatment tier, how the monitor restricts his movement inside the facility, or that it was imposed for anything other than his admitted failed polygraph.

The Geography of Guardianship: A Rural Psychiatry Perspective on Decision-Making for Older Adults With Cognitive Decline.

A commentary from a rural New South Wales consultation-liaison psychiatry service arguing that Australian guardianship law, though rights-based in design, is applied inconsistently in rural hospitals because of limited CL psychiatry access, thin administrative support and delayed tribunal hearings. Drawing on three illustrative clinical vignettes rather than collected data, it attributes prolonged hospitalisation and uncertainty about restrictive practice to legislative ambiguity between state guardianship law and Commonwealth aged-care regulation. It concludes that clinician education, streamlined medico-legal and psychiatric support, and alignment of state and Commonwealth frameworks are needed, and notes the Aged Care Royal Commission did not address rural-specific barriers.

Aust J Rural Health. 2026;34(4):e70239.

A case of cannibalistic behaviour in psychosis: Clinical and forensic considerations.

A single-case report describing a 48-year-old ultra-Orthodox Jewish man with schizoaffective disorder and complex developmental trauma who developed post-traumatic and psychotic symptoms after volunteering in disaster victim identification following the October 7, 2023 attack, and who engaged in necrophagic behaviour without homicide. The authors conceptualise the behaviour as opportunistic necrophagic, psychosis-associated cannibalism with paraphilic features, distinguishing it from previously reported psychosis-related cannibalism that typically involves killing and consuming a victim. They argue for formulation-based, trauma-informed assessment rather than treating the act as a discrete diagnostic entity. No legal holding, instrument validation, or systematic data is presented.

J Forensic Leg Med. 2026;122:103197.