Sex Offenders in Croatia: Fifteen Years Later.

BACKGROUND: The aim of the study was to compare the characteristics of sex offenders today, and those who committed a sex crime fifteen years ago, in regard to their psychiatric-forensic aspects. SUBJECTS AND METHODS: Data from the University psychiatric hospital Vrapce, Center for forensic psychiatry on court people sent for psychiatric and forensic evaluation, who were accused of sex offense in two time frames (1998-2001 and 2010-2016) were analysed. In total there were 50 and 57 male subjects sent for an evaluation. RESULTS: In both groups rape was the most prevalent offence, and both groups had the same prevalence of abuse, earlier psychiatric treatment and the majority of offenders were diagnosed with dissocial personality disorder and other personality disorders. Paedophilia was diagnosed in only a minority (14% and 7% respectively) of cases. The latter group (2010-2016) committed more sex offences against children, more often were with no mental disorder and less often had alcohol dependence and mental retardation. Up to one third of the later group were not giving their defence, compared to 4% of the former group. CONCLUSIONS: Changes in court case law and psychiatrists' usage of diagnostic criteria have influenced the prevalent diagnoses in sex offenders. Paraphilias are not often diagnosed in sex offenders because they do not confirm the act, and in recent years more often use not to give their defence (which makes reaching the diagnosis more challenging).

Indications for psychiatric safety measures: a retrospective study.

The aim of this article has been designed to investigate the influence of particular diagnostic categories on recommendations for safety measures, and to investigate the impact of constellatory factors, as the states of acute alcoholism, acute intoxication by psychoactive drugs and intense affect, on the recommendations for safety measures. The sample consisted of 120 examinees forensically expertised at the Center for Forensic Psychiatry of the Psychiatric Hospital Vrapce in the period from January 1, 1998 to December 31, 1999, and evaluated as less responsible according to the new Penal Code. All the examinees had the same legal presumptions for safety measures (decreased responsibility). The sample was divided into two groups: a group of examinees for whom a safety measure had been recommended and a group without such recommendations. The basic methodological instrument was a specially designed questionnaire with 137 items. Regarding socio-demographic characteristics, no statistically significant differences existed between the two groups taking into account age, gender, level of education and marital status. The diagnosis of personality disorder as the first one, did not influence recommendations for safety measures. Alcohol and drug abuse were statistically significantly present in the group with recommended measures as second diagnoses, and besides influencing responsibility, had an impact on the recommendation of safety measures. An intense affect influenced the reduction of responsibility, but not the suggestion of safety measure, while alcohol and drug intoxications, besides affecting responsibility, had an impact on the suggestion of safety measure. The decisive impact of dependence influenced the recommendation for safety measures.

Implementation of first Croatian Law on Protection of Persons with Mental Disorders.

The aim of this article was to examine Croatian psychiatric practice regarding involuntary hospitalization, after the Law on Protection of Persons with Mental Disorders became effective, on January 1, 1998. Data on the practice of involuntary hospitalizations of patients with mental disorders in Vrapce Psychiatric Hospital were collected from the medical records, for the years 1998 and 1999. Data regarding involuntary hospitalizations from other Croatian hospitals and departments were obtained from heads of psychiatric hospitals and departments for the first five months of 1998. The rate of involuntarily hospitalized patients in Vrapce Psychiatric Hospital rose significantly from 1998 to 1999 (p < 0.01). The rate of patients involuntarily hospitalized under section 21, subsection 3 rose significantly from 1998 to 1999 (p < 0.01), while rate of patients involuntarily hospitalized under section 22, subsection 1 decreased significantly in the same period (p < 0.01) in Vrapce Psychiatric Hospital. The implementation of the Law on protection of persons with mental disorders was not applied uniformly in all Croatian psychiatric institutions during first five months of 1998. Further analyses on this subject are necessary in order to investigate the influence of changes and supplements to the Law on the protection of persons with mental disorders on the practice of involuntary hospitalizations.

Involuntary hospitalizations of patients with mental disorders in Vrapce Psychiatric Hospital: five years of implementation of the first Croatian law on protection of persons with mental disorders.

AIM: To analyze data on the practice of involuntary hospitalizations of patients with mental disorders in Vrapce Psychiatric Hospital from January 1, 1998, when the Law on Protection of Persons with Mental Disorders came into power, to December 31, 2002; with particular reference to the changes and supplements to the Law on December 1999. METHOD: The data on patient's sex, age, and diagnosis were collected from the medical records. Patients were diagnosed according to ICD-10 criteria. When a patient had two or more diagnoses, he or she was placed in category of the primary diagnosis. Results were statistically analyzed by descriptive statistics and chi-square test. Statistical significance was set to p<0.01. RESULTS: The rate of involuntarily hospitalized patients increased by significantly from 1998 to 1999 (from 30.8% to 39.6%; p<0.01, chi square test). This rate decreased to 5.6% in 2000 (p<0.01), and continued to decrease in 2002 (3.5%). There was no difference between involuntarily hospitalized patients regarding sex in 1998 (p=0.302) and 1999 (p=0.136). Men were significantly more often involuntarily hospitalized than women in 2000, 2001, and 2002 (p<0.01). Schizophrenia and other psychotic disorders were the most common diagnoses among involuntarily hospitalized patients in each of the observed years. CONCLUSION: Changes and supplements to the Law on Protection of Persons with Mental Disorders from December 1999, which abolished the necessity for a written consent for hospitalization and the necessity for prescribed procedure of hospitalized persons who were mentally incompetent to consent for hospitalization, led to significant decrease in the number of involuntary hospitalizations.

Forensic importance of jealousy.

The aim of the investigation is to define as clearly as possible specific forensic psychiatric characteristics of persons who committed homicide and or attempted due to jealousy (the nature and severity of psychopathology, the level of responsibility, danger for the community, intensity and nature of aggression, the victimologic dimension, the relation of alcohol and jealousy). A retrospective method based on forensic psychiatric expertises in the period 1975-1999 was used. They encompassed 200 examinees that committed murder or attempted it. The results show the connection of psychotic jealousy with the highest degree of danger in diagnostic categories of paranoid psychosis and paranoid schizophrenia. The time span from the first manifestations of jealousy until the actual commitment of a crime is the longest in personality disorders and the shortest in schizophrenia. Exogenous provoking situations were dominant for committing homicide due to jealousy in personality disorders. Acute alcohol intoxication has a specific significance in crime due to jealousy in the same diagnostic category. Clear criteria were designed for forensic psychiatric evaluation of murder and attempts of homicide caused by jealousy, which will be of help in everyday practice in the field forensic work and treatment.