Forensic psychiatric and criminal dimensions of juvenile homicide/attempted homicide cases in Turkey.

OBJECTIVE: This study aimed to analyze a sample (n = 65) of juvenile homicide/attempted homicide cases in terms of psychiatric, demographic, criminal characteristics, IQ scores, and Rorschach test (where available) characteristics and decisions on criminal responsibility. METHOD: Data were collected through a retrospective chart review of cases between the ages of 12 and 18 at the time of the offense, who were referred to the Observation Department of the Council of Forensic Medicine (Adli Tip Kurumu Baskanligi, Gözlem Ihtisas Dairesi) for determination of criminal responsibility between 2014 and 2019 and who were assessed under inpatient status by law. RESULTS: There were 65 juvenile homicide/attempted homicide offenders (7 female, 58 male). Reduced or no criminal liability was found in seven cases (10.7 %). Recent and past trauma was found in 21.5 % and 16.9 % of our cases respectively. The percentage of alcohol or illicit drug use disorder was 35.4 %. Non-suicidal self-injury was found in 38.5 % of our cases, and 6.4 % of these had a concurrent suicide attempt. Most of our cases (55.4 %) were neither in employment nor in education at the time of the offense. CONCLUSION: The juvenile homicide/attempted homicide offenders were a heterogeneous group. Rates of serious mental illness were low. School and working functionality were low. Antisocial personality traits, alcohol/substance use disorders, past and recent trauma, emotional regulation problems, and poor school and work functioning appear to be important in the development of this serious offending.

Severe liver enzyme elevations after three years of olanzapine treatment: a case report and review of olanzapine associated hepatotoxicity.

Atypical antipsychotics commonly cause isolated asymptomatic increase in the aminotransferase levels. Among these atypical antipsychotics, mostly transient, asymptomatic increase in hepatic enzymes has been reported with olanzapine, however olanzapine rarely may induce a clinical and/or biological hepatic toxicity. The pathogenesis of olanzapine-associated hepatotoxicity is not well known and is mostly a transient phenomenon. However, substantial and lasting changes may occur and result in symptomatic hepatitis. In the following case report, we report on a 44-year-old female patient diagnosed as Bipolar Disorder Type I, whose liver enzyme levels increased ten fold of normal ranges during the third year of the olanzapine treatment and returned to the normal levels within three weeks after olanzapine discontinuation. Although significant liver enzyme elevations are uncommon during olanzapine treatment, based on reports of serious hepatotoxicity, controlled and longitudinal research are needed to learn side effects of this drug on liver. Clinicians should be aware of possible hepatotoxic effects of atypical antipsychotics and should monitor the liver enzyme levels whenever they feel necessary.