Detection of deception is important for the practice of psychiatry, especially for forensic psychiatry. Previous neuroimaging studies have identified that activity of the prefrontal and parietal cortices was associated with deceptive behaviors. However, the temporal sequence of neural activation in these regions remained unknown.

In this fMRI study, we used a face recognition deception paradigm involving three mental processes in the following temporal order of a deceptive response:

1. (1) Perception

2. (2) Formulation

3. (3) Response, to examine the activation of the brain regions during the process of deception.

Fourteen healthy males were scanned by a 3T Philips scanner while performing the deception task. A 2-way ANOVA model was employed to understand the activation pattern of neural correlates of deception during the three processes studied.

Activations of the prefrontal, the fusiform, the supramarginal, the postcentral, the angular, the precuneus, and the rolandic areas were found to peak at different processes. Specifically, the fusiform, the prefrontal, and the precuneus regions were activated first, with their activation peaked at the perceptual process. On the other hand, the activity of the supramarginal, the angular, and the postcentral regions peaked at the formulation process. Activity of the rolandic region was peaked at the response process.

This study showed that there are different temporal gradients of neural activations with respect to the cognitive processes that evolve in deception. By understanding the specific role played by each of the neural correlates during deception, the accuracy and reliability of lie detection could be enhanced.

To review how children's memory, communicative skills, social knowledge, and social tendencies can influence the quality of forensic interviews with children, in the special setting of child sexual abuse.

A review of the studies designed to evaluate children's capacities as witnesses.

The research demonstrates both

1. 1) how much researchers and interviewers have collectively learned about children's communicative and memory retrieval capacities and

2. 2) that this information can be used by interviewers to maximize the value of their investigative interviews with alleged victims of abuse.

Controlled studies have repeatedly shown that the quality of interviewing, reliably and dramatically improves, when interviewers employ a structured interview protocol.

Professional (and popular) interest in child sexual abuse was prompted in part by dramatic increases in the numbers of reported cases, and by awareness that many cases of abuse might go unrecognized because the victims were the only possible sources of information and were seldom given the appropriate opportunities to describe their experiences to those who might have been able to help them.

The use of a structured protocol improves the quality of information obtained by investigators from alleged victims, thereby increasing the likelihood that interventions will be appropriate.

To asses competence to consent to treatment in involuntary committed patients (ICP) for a mental disorder, as compared to matched acute voluntary hospitalized patients (VHP). To evaluate the effect of psychopathology severity and cognitive dysfunction on decisional capacity.

Cases were recruited among ICP at the Umberto I Hospital, ‘Sapienza’ University of Rome; controls were age- and sex-matched VHP, in the same ward and time period. Subjects were diagnosed according to DSM-IV-TR criteria and further evaluated through a) MacArthur Competence Assessment Tool for Treatment (MacCAT-T) b) Brief Psychiatric Rating Scale-24 (BPRS) c) Raven's Colored Progressive Matrices (CPM) d) Mini Mental State Examination (MMSE).

Eighteen cases were enrolled (67% women), mean age was 25.1 ± 2.8 years. There were no differences between groups in: diagnostic distribution (40% schizophrenic spectrum disorders, 40% mood disorders, 20% other diagnosis), disease duration, MMSE. ICP had higher BPRS total scores (mean difference ± S.D.= 10.3 ± 19.4; [95% C.I.= 0.6 ÷ -20.0]), and performed worse than VHP in MacCAT-T comprehension (-1.0 ± 1.3; [95% C.I.= -1.6 ÷ -0.3]), appreciation (-1,7 ± 2.0; [95% C.I.= -3.0 ÷ -0.7]), reasoning (-2.1 ± 2.9; [95% C.I.= -3.6 ÷ -0.7]) and expression of a choice (-0.8 ± 1.0 [95% C.I.= -1.3 ÷ -0.3]). Competence to give informed consent was associated with psychopathological dimensions but not with MMSE and CPM scores, in the sample overall.

Competence to consent to treatment was reduced in ICP compared to VHP. Involuntary commitment was not necessarily associated with incapability of making treatment decisions.

To develop a clinician-oriented semi-structured interview for the assessment of sexual consent: the Sexual Consent Competency Assessment Scale (SCAS). To assess sexual consent competence in a sample of hospitalized patients, affected by bipolar disorder (BD) and schizophrenic spectrum disorders (SSD, schizophrenia or schizoaffective disorder).

Patients were recruited at the Psychiatric ward of S. Spirito Hospital, Rome and diagnosed according to DSM-IV-TR criteria. The SCAS items were derived and adapted from Kennedy et al. (Am J Ment Retard 2001;106:503-510). The scale items were directly rated by 2 independent clinicians, on a 3-point Likert Scale corresponding to 3 possible outcomes: capable, marginally capable or incapable. Internal consistency, test-retest and inter rater-reliability were good. Principal component factor analysis (PCA) with varimax rotation was applied.

Fifty-four BD patients (51.9% females) and 31 SSD patients (71.0% females) were recruited (mean age, years: 38.1±13.4; 38.4±9.7 respectively; p=0.91). BD patients had better sexual consent competence compared to SSD, there were no gender differences. Cognitive functioning as measured by the Raven Progressive Matrices appeared to moderate the relationship between diagnostic group and sexual consent decisional capacity, with better scores corresponding to higher competence. PCA revealed two interpretable factors 1) cognitive-emotional and 2) consequences-prevention. There were no significant group differences between BP and SSD in the second factor.

The SCAS proved good psychometric validity and reliability. Patients with bipolar disorder showed better sexual consent competence compared to schizophrenic spectrum disorders.

To compare stress and mental health in criminals serving a sentence in prison and serving an alternative punishment.

120 offenders were randomly selected (60 in prison (imprisoned group=IG), 60 undergoing an alternative punishment (Not Imprisoned Group=NIG)), and were assessed using SCL90-R and Coudron's Stress Scale.

All of 9 Symptom Scales of SCL90-R and levels of stress in the Stress Inventory were significantly higher in IG than NIG.

These findings suggest that other alternatives for prison (fines, punishment suspension, deprivation of social rights, restricted liberty…) have the advantage of better mental health and less stress experience by convicts; factors crucial for the criminals’ rehabilitation and social adjustment.

Psychiatric patients have a rather infamous, albeit widely publicised distinction of causing harm to themselves: at times leading to suicide and equally worryingly for society: harm to others occasionally leading to homicide.

There is a collateral knock-on distress, aside of incremental cost effects to various members of society, inclusive of both parties. These acts resulting in harm are termed “irrational”, “mad”, “and dangerous” and were deemed predictable. No doubt, improved psychotropic medications, evolving teams with greater responsibilities and incorporating ever improving psychological therapies have improved delivery of high quality care to our patients.However, the quest for a standardised, valid, generalisable, user friendly risk tool remains elusive, albeit increasingly improving, or is it?

Psychiatrists now more than ever are tasked with the challenge of assessing, managing and preventing if not predicting such harm and to aid seamless recovery and rehabilitation into society and thereof.

Risk assessment has gone through four generations of tools/ methods. All have their merits and areas that can be improved upon. Significantly, all emphasise a time limited and context driven assessment rather than one off documents. Each method has its place and time and contribute not only to effective risk management but also to recovery oriented treatments and facilitating, monitoring and supervising optimal rehabilitation needs of psychiatric patients.

In this poster we follow the journey of risk assessment tools ranging from the “unstructured/clinician based” to START (Short Term Assessment of Risk and Treatability), pondering if we have now come full circle?

The risk factors of criminal behavior in patients with schizophrenia are not well explored. This study is to explore the risk factors for criminal behavior in patients with schizophrenia in rural China.

We used data from a 14-year prospective follow-up study (1994-2008) of criminal behavior among a cohort (n=510) of patients with schizophrenia in Xinjin County, Chengdu, China.

There were 489 patients (95.9%) who were followed up from 1994 to 2008. The rate of criminal behavior was 13.5% among these patients with schizophrenia during the follow-up period. Compared with female subjects (6 cases, 20.0%), male patients had significantly higher rate of violent criminal behavior (e.g., arson, sexual assault, physical assault, and murder) (24 cases, 80.0%) (p< 0.001). Bivariate analyses showed that the risk of criminal behavior was significantly associated with being unmarried, of younger age, previous violent behavior, homelessness, lower family economic status, no family caregivers, and higher scores on measures (PANSS) of positive, negative, and total symptoms of illness. In multiple logistic regression analyses being unmarried and previous violent behavior were identified as independent predictors of increased criminal behavior in persons with schizophrenia.

The risk factors for criminal behavior among patients with schizophrenia should be understood within a particular social context. Criminal behavior may be predicted by specific characteristics of patients with schizophrenia in rural community. The findings of risk factors for criminal behavior should be considered in planning community mental health care and interventions for high-risk patients and their families.

The issues of my research study concern psychosocial and personality conditioning of criminal thinking styles of juveniles.

The objective of my research study is to distinguish and characterize profiles of criminal thinking styles of juvenile boys and girls who committed a criminal offence and to define psychosocial (restricting to the family environment - a guardian system) and personality factors conditioning a criminal thinking style of juveniles.

For the purpose of the research following methods have been used: PICTS by G. Walters - has been adapted into polish circumstances, Values Scale (Rokeach), Davis Empathy Scale, The Tennessee Self-Concept Scale (TSCS) by Fitts, Skala Postaw by Plpoa, KBPK by Kurzyp-Wojnarska.

In the analysed problem the following research tasks are involved:

1. · Singling out of juvenile criminal thinking styles

2. · determining the criminal predicators in criminal thinking styles

3. · establishing predicators of criminal thinking styles, defining factors determining criminal thinking style of juveniles (a group of explanatory variables include: thinking styles of parents (guardians), parents’ attitude towards a child, a value system of parents, personality variables of a juvenile, i.e. self-esteem, empathy level (level of emphatic understanding), a sense of control and a social competence level).showing (presenting) constitutive differences and similarities In terms of criminal thinking styles between the group of minors and their parents (guardian)

4. · establishing the differences and similarities in terms of cognitive functioning (thinking styles) of the juveniles due to the criminal act.

Community forensic mental health teams are a new service within the widening range of specialized community services, providing an interface between Generic and Forensic Services. Few teams have been set up in the UK, and many have been developed without a pilot scheme. The service in Hertfordshire was established in 2004, with no previous audits or reports done to evaluate the working of this team.

This work aims to ascertain and evaluate the role of this service, comparing with standards formulated in accordance to guidelines set by Clinical Governance bodies such as NICE, DoH, FR&D, Sainsbury Centre, following principles outlined in the Reed Report. It also identifies gaps in the service and recommends implementing changes to improve clinical effectiveness.

A literature review was conducted to outline the characteristics of a community forensic service. Referrals over 12 months from July 2007 until July 2008 were analysed to look into the number, source, appropriateness, acceptance, response time and response methods. Data collection involved review of notes including meeting minutes, computerised notes and patient file. Information was recorded against a question template. Analyses are represented with use of graphs.

indicated the number of referrals and the quality of response from the team.

Service gaps were identified, and recommendations were made to implement proposed changes. The completion of the Audit cycle which is due in December this year will add to the evidence base which can then guide development of newer teams or improvement in functioning of existing teams.

The research aims to investigate the steroid hormones level alterations among subjects with personality disorders in conditions of social isolation.

Serum levels of cortisol, testosterone, dehydroepiandrosterone and dehydroepiandrosterone sulfate were measured in 58 males with personality disorders (convicted of murder) and in 49 physically and mentally healthy males (convicted of property crimes) being in conditions of social isolation. The control group consisted of 30 physically and mentally healthy males. The hormone serum levels were measured by ELISA method.

In comparison with the control group the increase of cortisol, testosterone and dehydroepiandrosterone concentration in patients in conditions of social isolation have been observed. Concentration of dehydroepiandrosterone sulfate in the investigated groups did not differ from the control group.

Patients with personality disorders have shown a trend toward cortisol, testosterone and dehydroepiandrosterone level increase as compared with physically and mentally healthy males convicted of property crimes. Concentration of dehydroepiandrosterone sulfate in the investigated groups did not differ from the control group.

No correlations between steroid hormones levels and time spent in conditions of social isolation have been observed

Increase of cortisol, testosterone and dehydroepiandrosterone level is associated with criminal behavior, but also it might be a consequence of influence of the factor of social isolation.

Evaluation the patients with various psychiatric diagnoses with criminal behavior with EEG registration. Aims of investigation are as follows:

1. 1. To define the importance for the difference between the EEG changes at the patients with criminal behavior and the patients from the control group;

2. 2. To examine the relationship between the EEG findings of the patients with criminal behavior and the diagnostic entities according to ICD - 10.

In this paper we shall present a simple prospective analysis of 158 EEG investigations made on patients examined at the Psychiatric Hospital in Demir Hisar for a period of 24 months, which are with aggressive and criminal behavior.

In men normal EEG found (69.44%) prevails in relation with abnormal EEG found (30.56%). There was the significant difference between normal and abnormal EEG found and the diagnoses in hospital patients.There was the significant difference between EEG found in hospital patients and its criminal factor. The difference between the means age (37.73 god.) of patients in control group with abnormal EEG found and the mean age of patients with normal EEG found is significant. In patients (32.28%) in examiner group was registered abnormal EEG found more significant than in patients in control group(9.49%).

There was significant difference between EEG found in patients in control and examiner group. Suggested measures: More easily diagnosis providing of psychiatric disorders with aggressive and criminal behavior, with help of EEG method, and hereby would be facilitated the psychiatric expertise.

To study influence of forensic psychiatric diagnosis in case of criminal responsibility, treatment necessary and violence to court orders.

Samples were 301 inpatients of Galya Rajanagaridra Institute who were criminal offenders during year 2000-2007. Data were collected from medical records and reports of the judgments and prosecution. The data were analyzed by descriptive statistic.

The study found that most of samples were single, males who aged between 21-40 years old. They were unemployed and graduated primary school. Most of them were sent by courts. Murderers were found the most. Regarding to psychiatric diagnosis, most of them were psychosis and their motivation to crime were delusion and hallucination. Moreover, psychiatrists diagnosed that 125 samples (41.5 %) were not criminally responsible, 143 samples (47.5 %) needed treatment and 42 samples (14.0 %) were stated as violence. In those cases, 5 and 22 cases (1.7 and 7.3 %) were dropped the charge by police and district attorneys, respectively. Regarding to criminal responsibility according to the section 65 of Criminal Code, courts agreed with psychiatrist's diagnosis for 49.3 %. In case of treatment order according to the section 48 and 56 of Criminal Code, courts disagreed with psychiatrist's diagnosis for 64.1 % totally.

The study showed that forensic psychiatric diagnosis, in cases of criminal responsibility, treatment necessary and violence, moderately influenced to court orders. Thus, this leads to question to develop forensic psychiatric work in the future.

We assessed 29 young persons (14-21 years old), who committed crimes according to article 156 of Criminal Code of Ukraine «Depravity of Minors».

Assessment tools: surveillance, clinical and diagnostic interview, objective psychometric scales and test methods to identify the studied trait.

Established 11 youth with developmental delay [5 with mild developmental delay - F70 (17.2%), 3 with moderate (10.3%), and 3 with severe (10.3%)], 12 with behavioral disturbances [2 - F91.0 (6.9%), 4 - F91.1 (13.8%), 5 - F91.2 (17.2%), 1 - F91.3 (3.4%)], 6 - were found to be mentally healthy (20.7%). Sexual benefit of committed crime (importance of satisfaction of sexual desire or relief of sexual arousal) confirmed only in 7 youth (24.1%). Most of them were mentally intact (5; 17.2%) and belonged to an older adolescent group (19-21 years). Remaining participants, who were developmentally delayed, called curiosity and desire of knowledge of sexual differences of another sex, as their most important motives for crime. Another group, juveniles with behavioral disturbances, cited physical humiliation or ritualistic punishment (particularly these were seen in oral-genital encounters) of their victims as rationale. In this group there were frequent cases of group rape, as opposed to first group where sexual encounters have been mostly individual. In the meantime the most deprived character of sexual relation was noted among mentally healthy minors.

None of the assessed has shown signs of diagnosis G1-G3. Diagnosis of F65.4 has been completely excluded despite the potential of some negative prognosis in future.

Study focuses on the way patients are followed-up after discharge. This aims in determining continuity of follow up and possibly gaining insight in the need of patients for readmission; also, approaching the possible influence of follow-up on patients’ admission-free time interval.

Sample consists of patients admitted in our department from August 2007 until January 2008. Telephone structured interview was used to gather information. Questions focused on patients’ present follow up state and any re-admissions in a psychiatric ward. Answers were either given directly by patients or by a member of patients’ family. For information to be representative, three calls were made to each patient on different occasions; only then was the answer considered as valid for inclusion in the study.

Of 198 patients admitted, 105 (53%) could be reached.

Of those admitted, mean value of hospitalization time was 21.38 days. Specifically, among re-admitted patients, mean time of first hospitalization was 20.52 days. Among non re-admitted ones respective value was 21.73 days; upon comparison, no statistically significant difference was found (t-test).

Out of 105 reached: 73.3% are still being followed-up, 26.6% are not; 41.55% are followed-up in our outpatient ward whilst 36.3% visit private practices. 3.8% are followed-up at community primary mental health care services. 73.3% have not been readmitted ever since discharge

The majority of patients are followed up at our department's outpatient ward. Patients followed-up at private practices are less whereas much less are followed up at primary psychiatric community care services.

The emergence of Acute Care Team has changed the delivery of services in the United Kingdom. The Acute Care Team led by a senior psychiatrist, is composed of in-patient and home treatment teams, which work in close liaison. As this is a relatively new model, the effectiveness is yet to be proven.

The study was performed to evaluate the influence of the Acute Care Team on service delivery.

The aim of the study was to determine the difference in the number of admissions and duration of hospital stay, following the inception of the model at Clatterbridge Hospital, in the Northwest region of England.

Retrospective data was obtained for a 14 month time period before and after introduction of acute care team in June 2007. All consecutive admissions to a general adult psychiatric ward were included in the study. The outcome measures were the number of admissions, average duration of hospital stay and average bed occupancy. Data was obtained from the hospital register.

There was no difference in the total number of admissions. However, the length of stay reduced significantly from 58.9 days to 14.4 days (reduction by 75%). The average bed occupancy was also reduced by 38%.

Our study suggests that the Acute Care Team is an effective system of health care delivery and can have financial implications on the organization of mental health services in the future.

The increase of immigrants in Canada has set an example for Western countries on how cultural diversity affects health, mental health, and needs. The mental health of elderly immigrants, however, is often forgotten in service delivery system.

This paper examines the socio-cultural determinants of mental health of elderly immigrants in Canada through synthesizing research findings from various studies. The presentation aims to highlight a few key intervention focuses for addressing mental health of this vulnerable immigrant subgroup.

Secondary data analysis was used, using three national surveys and a local community survey, including the Ethnic Diversity Survey, the General Social Survey, the Health and Well Being of Older Chinese in Canada, and the Health and Well Being of Older South Asian in Calgary. Mental health was presented by life satisfaction, self-reported stress, self-reported happiness, self-reported level of trust, sense of belonging, feeling out of place, worrying about hate crime, depressive symptoms, and general mental health measured by SF-36.

Socio-cultural determinants related to a higher level of social support, a higher level of trust, and better financial resources were found to be correlates of more positive mental health. Racial discrimination, culture related beliefs, and barriers often led to negative mental health outcomes.

Promoting a better mental health should expand beyond the use of individual interventions and treatments. Socio-cultural determinants have to be addressed through creating a more positive social and structural environment for the elderly immigrants.