A Retrospective Evaluation of Psychiatric Comorbidity and Substance Use in Forensic Cases Admitted to Emergency Service

Abstract

Objectives: Forensic cases are commonly encountered cases with high legal responsibility. In addition to low socio-economic status and level of income, psychiatric diagnoses such as substance and alcohol abuse, personality disorders, some axis 1 disorders have been reported to increase violent behavior. In this retrospective study, we evaluated substance abuse, psychiatric comorbidity, and relationship between type of forensic report and psychiatric diagnoses in forensic cases. Methods: Data regarding sociodemographic characteristics, forensic circumstances and psychiatric history of forensic cases admitted to Van Military Hospital Department of Emergency between January 2012-April 2014 recruited from hospital database. Results: One hundred and four(23.6%) of the 441 patients had a psychiatric history. There was no significant difference in terms of injury severity score between the group with psychiatric diagnose history and the group with no psychiatric history(p=0.06). Adjustment disorder and B cluster personality disorder were the most prevalent psychiatric diagnoses in study population. Assault(52.9%), intoxication(26%) and firearm/sharp object injuy (17.3%) were the most encountered forensic circumstances in those with psychiatric history as assault and intoxication were found to be significantly higher than other events in this population(p<0.05). Assessment of relationship between type of forensic event and psychiatric diagnoses showed assault, firearm/sharp object injuy, and intoxication were statistically significant in B cluster disorder patients while intoxication was found to be significant in anxiety diagnosed patients(p<0.05). Substance use was determined in fourty-six patients(44.2%) of those with psychiatric history while a significant relationship was found between substance use and firearm/sharp object injuy in this population(p=0.03). Conclusion: Detailed evaluation of psychiatric comorbidity and substance use with appropriate psychiatric therapeutic interventions could have a positive impact on management of forensic cases.