Forensic Psychiatric Examination Research Articles

Особенности криминального поведения обвиняемых в совершении особо тяжких преступлений с различными нарушениями функций программирования, регуляции и контроля психической деятельности (Часть 2)

<p style="text-align: justify;">The purpose of our study was the features of criminal behavior of the accused in the commission of particularly serious crimes in the context of the formation functions of programming and control. The sample consisted of 59 men aged 18—60 years, of those accused of committing particularly serious crimes aimed at a forensic psychiatric examination, the average age was 33.7 years. The methods of neuropsychological examination and psychological analysis of criminal cases were used. Syndrome of defeat of the basal divisions of the frontal lobes, prefrontal syndrome, syndrome of defeat of the medial divisions of the frontal lobes, Postfrontal (premotor) syndrome is most often seen among persons accused of particularly serious crimes. The criminal behavior of the accused in the Commission of particularly serious crimes was characterized by uncritical damage to the basal parts of the frontal lobes. The impulsivity is the main characteristic of the criminal behavior of the accused in especially serious crimes with the defeat of the prefrontal frontal lobe (prefrontal syndrome). Subjects with the defeat of the kinetic (dynamic) factor differed greater rigidity of criminal behavior. The behavior of those accused of committing particularly serious crimes was passive (energy-saving) in violation of the energy factor in the case of damage to the medial parts of the frontal lobes. The obtained results can be used to solve the issues of drawing a portrait of an unknown criminal, as well as in the course of correctional work with persons prone to repeat illegal behavior.</p>

«Проблемные ситуации»: апробация в качестве судебно-психиатрического метода исследования при изменении гражданско-правового статуса

<p style="text-align: justify;">As part of solving the task of developing methods to improve the quality and evidence of forensic psychiatric decisions, in a comparative non-randomized study the “Problem Situations” methodology was tested as a method of forensic psychiatric assessment in civil cases on applications for change civil legal status. The sample consisted of 67 subjects who underwent inpatient forensic psychiatric examination in connection with the decision on the issue of changing their civil status in 2021—2022. A conclusion corresponding to legal capacity was given in relation to 12 people; diminished legal capacity - 24 people; incapacity — 31 people. Pairwise group comparisons using Pearson’s goodness-of-fit test (Chi-square) and biclustering procedures confirmed the predictive validity of the method.</p>

A casuistic case of ignoring an expert opinion by the court conclusions about the absence of drug use disorder diagnosis

The article cites the case of Dmitry A., who was detained by the police on the street on suspicion of using cannabinoids and sent for a medical examination for intoxication, which he refused. The judge found Dmitry guilty and ordered him to be examined at a drug treatment clinic. Based on the results of an inpatient examination, despite the absence of mental disorders, somatic consequences of episodic cannabinoid use and the absence of pathological changes according to laboratory tests, he was diagnosed with "harmful use of cannabinoids". Dmitry was placed under preventive observation. During the court-ordered forensic psychiatric examination at the Serbsky Center (Moscow), the drug diagnosis was not confirmed. However, the expert opinion was ignored at the court hearing. The author analyzes the frequency and validity of the diagnosis of "harmful use of psychoactive substances" and concludes that the case of Dmitry A. may become a precedent.

Forensic psychiatric examination of terrorist-related criminal cases: clinical and social characteristics of the sub-experts, analysis of the expert case

In recent years, due to changes in the socio-political situation, including at the international level, the number of terrorism-related criminal cases has increased, and, therefore, the number of forensic psychiatric examinations conducted in this category of cases has risen. To date, there is a lack of any scientific studies or analytical reviews devoted to the problem of forensic examination of suspects and the accused involved in such criminal cases. The article presents the results of a review of cases of outpatient complex forensic psychological and psychiatric examinations in terrorism-related criminal cases conducted on the basis of the Department of Forensic Psychiatric Examination, Psychiatric Clinical Hospital in Moscow, from 2020 to 2023. In total, 25 cases were described and analyzed, clinical and social characteristics were studied, and an overview of expert solutions was given. An analysis of one expert case was carried out. During the examinations, 56 % of the examinees did not show symptoms of mental illness when committing the incriminated criminal act, while 36 % of the examinees in the sample were diagnosed with a mental disorder. The diagnoses included mild cognitive disorder, various types of personality disorders (emotionally unstable, schizoid, with mixed features), alcohol abuse, as well as paranoid and undifferentiated forms of schizophrenia. Based on the conducted research, it is concluded that no confessional model of religious or other consciousness in itself is a source of terrorism, including its political form. Predisposition to terrorist manifestations is a multi-level phenomenon and enters an active phase due to certain «triggers» that operate at the individual, group or mass level, which depends, among other things, on psychopathological factors.

Forensic Psychiatric Examination: General Theoretical Issues

The article outlines the issue of appointing and conducting a forensic examination in Ukraine, specifically focusing on forensic psychiatric examination. It presents the key concepts and terms related to forensic psychiatric examination, along with its tasks, types, procedures, and significance for the judicial process. The conclusion drawn is that expert conclusions constitute a vital form of evidence in court proceedings, enabling the determination of case circumstances that may not be established through any other means.
 The current state of appointment and conduct of forensic psychiatric examinations in Ukraine has been analyzed, existing problems have been identified and ways of solving them have been considered.
 It has been established that the main problem in appointing and conducting a forensic psychiatric examination is that it is a complex and multifaceted type of forensic examination, which requires highly qualified and experienced forensic experts, but currently, there is a shortage of qualified psychiatric experts. This might result in a forensic examination being conducted improperly or with infringements.
 The paper specifies the need for advanced training and acquisition of experience by forensic experts conducting forensic psychiatric examinations to ensure conclusions’ objectivity. The author concludes that forensic psychiatric examination requires the forensic expert to possess high professionalism, objectivity, independence, honesty, responsibility, competence, and tactfulness.
 The article highlights the main concepts and terms associated with the appointment and conduct of a forensic psychiatric examination; describes the procedure for conducting a forensic psychiatric examination; reveals the importance of a forensic psychiatric examination for the judicial process; analyzes the current state of appointment and conduct of a forensic psychiatric examination in Ukraine; identifies the main problems associated with the appointment of a forensic psychiatric examination; considers possible recommendations for solving these problems. The author also draws attention to the importance of observing the rights and freedoms of persons who are the subject of forensic psychiatric examination.

Use Of Special Knowledge During The Investigation Of Knowingly False Testimony Of The Witness And The Victim

Fair and objective justice requires compliance by all its participants with legally established principles. At the same time, in law enforcement practice there are cases of falsification of evidence, which is caused by various circumstances, and motivational factors that are guided by the participants in the process, in particular, the witness and the victim. That is why similar acts are criminalized, and the scientific community has an updated task to develop substantiated recommendations for improving the quality of investigations of similar facts. Taking into account the significant importance of special knowledge in similar criminal proceedings, which is evidenced by the analysis of court practice, the purpose of the article is defined as the clarification of typical forms of special knowledge used during the pre-trial investigation of knowingly false statements by witnesses and victims, the specifics of their implementation. Based on the results of the research, it was determined that the appointment of a forensic handwriting examination, a forensic psychiatric examination, a forensic psychological examination, in particular with the use of a polygraph, a forensic telecommunications examination, and less often a technical examination of a document is typical. Each of the outlined forensic examinations has its specifics that need to be considered. Prospects for further scientific research are outlined.

Особенности криминального поведения обвиняемых в совершении особо тяжких преступлений с различными нарушениями функций программирования, регуляции и контроля психической деятельности (Часть 1)

<p style="text-align: justify;">The purpose of our study was the features of criminal behavior of the accused in the commission of particularly serious crimes in the context of the formation functions of programming and control. The sample consisted of 59 men aged 18—60 years, of those accused of committing particularly serious crimes aimed at a forensic psychiatric examination, the average age was 33.7 years. The methods of neuropsychological examination and psychological analysis of criminal cases were used. Syndrome of defeat of the basal divisions of the frontal lobes, prefrontal syndrome, syndrome of defeat of the medial divisions of the frontal lobes, Postfrontal (premotor) syndrome is most often seen among persons accused of particularly serious crimes. The criminal behavior of the accused in the Commission of particularly serious crimes was characterized by uncritical damage to the basal parts of the frontal lobes. The impulsivity is the main characteristic of the criminal behavior of the accused in especially serious crimes with the defeat of the prefrontal frontal lobe (prefrontal syndrome). Subjects with the defeat of the kinetic (dynamic) factor differed greater rigidity of criminal behavior. The behavior of those accused of committing particularly serious crimes was passive (energy-saving) in violation of the energy factor in the case of damage to the medial parts of the frontal lobes. The obtained results can be used to solve the issues of drawing a portrait of an unknown criminal, as well as in the course of correctional work with persons prone to repeat illegal behavior.</p>

Terms of pre-court investigation in the form of inquiry

The aim of the work is to establish the specifics of terms of pre-trial investigation in the form of inquiry and to identify problems that arise in practice and need to be resolved in order to increase an effectiveness of investigation of criminal misdemeanors. The methodological basis of the work made up provisions of the modern theory of scientific knowledge of legal and social phenomena. While writing the article, both general philosophical and general scientific, as well as special legal methods of scientific knowledge were used. Results. The introduction of a simplified pre-trial investigation in the form of inquiry has accelerated the average terms of pre-trial investigation and trial of minor criminal offences, however, in practice, a number of problems arise, including those related to the terms, which find their ambiguous interpretation and the solution of which is of important practical importance. Thus, the Criminal Procedure Code of Ukraine does not provide for inquiry periods from the moment of entering information about a criminal offense into the Unified Register of Pretrial Investigations until the day of notifying a person of suspicion, which, according to most jurists, is a violation of the general principles of criminal proceedings. In addition, there are gaps regarding the order and terms of the prosecutor’s extension of the inquiry period. There are also questions regarding the reasonableness of the inquiry period: а maximum is one month, in particular with regard to proceedings that require the appointment of a forensic psychiatric examination of a suspect; and a minimum of 72 hours, as this period may fall on weekends, etc. It is obvious that the identified complications can be eliminated first of all by introducing reasonable changes and additions to the Code of Criminal Procedure of Ukraine, taking into account the needs of practice and the results of thorough scientific research.

Classification of forensic psychiatric examinations

The article considers the classification of forensic psychiatric examinations according to various criteria. The most common is the division into types depending on the subject matter of research. According to this criterion, the following types of forensic psychiatric examinations are distinguished:
 
 forensic psychiatric examination of the suspect or accused. The purpose of this examination is to establish the presence or absence of any mental disorder in the person charged with the offence that could affect his or her ability to understand and control his or her actions;
 forensic psychiatric examination of the witness, the purpose of which is to establish the presence or absence of any mental disorder that could affect his or her ability to perceive, remember and reproduce information during the period of time when the events about which he or she testifies took place;
 forensic psychiatric examination of the victim, the purpose of which is to establish the presence or absence of any mental disorder in the victim during the period of time when the events occurred that could affect his or her ability to understand the situation, assess the danger and respond adequately to it;
 forensic psychiatric examination of the convicted person, the purpose of which is to establish the presence or absence of a mental disorder in the convicted person, which may be the basis for applying compulsory medical measures to him/her.
 
 In addition, the types of forensic psychiatric examinations are considered:
 
 forensic psychiatric examination in cases of limitation of civil capacity of an individual, recognition of an individual as incapacitated. The purpose of this examination is to establish the presence or absence of a mental disorder in an individual that prevents him or her from fully understanding the significance of his or her actions and controlling them;
 forensic psychiatric examination in cases of invalidation of a transaction. The purpose of this examination is to determine whether a person had a mental disorder at the time of the transaction that could have affected his or her ability to understand the meaning of the transaction and control his or her actions.

Scientific support for the use of psychiatric knowledge in the investigation of crimes against human life and health

The category of criminal offences against life and health is quite significant. A large number of crimes included in this category are characterised by a high level of social danger, as they encroach on the greatest social value which is life and health of a person. In the investigation of such crimes, it is typical to use specialised knowledge in the fields of forensic psychiatry and psychology in procedural and non-procedural forms. Given that the process of cognition and assimilation of scientific knowledge begins with clarification of the peculiarities of its historical development, the purpose of the article is to clarify the state of scientific development of the issues related to the use of special psychiatric and psychological knowledge in the investigation of crimes against life and health of a person.
 It has been determined that the current state of scientific significance of the use of special psychiatric and psychological knowledge in the investigation of crimes against human life and health is influenced by the peculiarities of development of criminal procedure legislation. In addition, based on the analysis of legal literature, the assessment of the developments made by Ukrainian scholars has been provided. It is established that careful attention has been paid to the study of certain aspects of the appointment of forensic psychiatric and forensic psychological examinations in the investigation of various types of murders, bodily injuries, and domestic violence. At the same time, based on the results of the generalisation of scientific works authored by Ukrainian scholars, it has been determined that the national legal literature does not address the peculiarities of involving specialists in investigative (search) actions in the course of investigation of crimes against life and health of a person, as well as the prospects for implementing non-procedural forms of using specialised knowledge. The article emphasizes that this issue, as well as the prospects for using specialised knowledge of psychology and psychiatry in non-procedural forms, require a thorough analysis and coverage in the legal literature in order to improve the practical activities of the prosecution in criminal proceedings.

Theoretical and legal principles of forensic psychiatric examination in criminal proceedings

The category of forensic examinations includes examinations conducted in civil or criminal proceedings by court order. Forensic examinations are carried out in specialised forensic institutions or outside these institutions in accordance with the procedure established by law. A significant number of forensic examinations are conducted in forensic departments of state psychiatric institutions. According to Ukrainian legislation, state forensic institutions are those institutions that are specifically designated to conduct forensic examinations and are subordinate to the Healthcare Department. A forensic psychiatric or comprehensive forensic psychological and psychiatric examination must be conducted by experts in accordance with the procedure set out in the Civil Procedure and Criminal Procedure Codes of Ukraine. Depending on the nature of the expert research, forensic psychiatric examination departments are divided into outpatient and inpatient.
 The knowledge that a psychiatric expert must have is specific, taking into account knowledge of the patterns and characteristics of mental activity of the individual. This specialised knowledge is acquired during special professional psychological and psychiatric training, and is subsequently implemented in the practice of forensic psychiatric examination, and therefore has legal significance. The knowledge used in the pre-trial investigation of criminal offences and in court proceedings is used to establish the mental state of the person who committed the criminal offence.
 The theoretical and legal aspects of the appointment and conduct of forensic psychiatric examination have been determined on the basis of the analysis of the provisions of legal acts in this area. The issues related to the professional component of training of experts conducting forensic psychiatric examination have been highlighted, and it has been found that, as a rule, they have their own individual style of professional activity and constantly improve their level of competence.
 It has been found out that the subject of psychiatrist's research is mental diseases and disorders, brain diseases manifested by disorders of mental activity of a person. The issues of ethical standards in the activities of an expert in conducting a forensic psychiatric examination have been considered.

PSYCHIATRIC ASPECTS OF MURDERS IN CHUVASHIA (2011–2020)

Murders are one of the most important causes of mortality in Russia, and most aggressors suffer from mental disorders. The purpose of the research is to study the structure of mental disorders of murderers and its features in Chuvashia in 2011–2020. Materials and methods. The forensic psychiatric examination examined 507 murderers (409 men and 98 women) aged 15 to 83 years (average age – 40.65±13.82 years). Mental disorders, medical, social and criminal indicators of murderers, as well as 507 victims were taken into account. Results. 474 murders were committed single-handedly, 14 – in a group of 2-4 people; ordinary murders accounted for 96.5%, those with two or more victims – 3.5%. Post-homicidal suicides in aggressors were observed in 2.5%. Mental disorders were qualified in forensic psychiatric examinations in 72.6% of the subjects, most often they were alcohol dependence (20.1%), especially among women (27.6%). Among other mental disorders, personality disorders (13.8%), organic mental disorders (12.8%), schizophrenia (6.3%), mental retardation (2.8%) and comorbid mental disorders (16.8%) were noted. 10.5%, most often patients with schizophrenia and organic mental disorders, are recognized as insane during forensic psychiatric examinations. The instruments (method) of murder in 94% of cases were piercing and cutting objects, "blunt weapons" and strangulation. Women were significantly more likely to use "bladed weapons", and men – to "blunt weapons". More than 40% of the victims were family members, more than 50% were acquaintances, friends, and only 6.3% were strangers. Women were significantly more likely to kill their spouses (unmarried cohabitants etc.) and children, and men – acquaintances. 84.0% of criminals were intoxicated at the time of the murder. Both the aggressor and the victim drank together in 59% of cases. Insane murderers (with pronounced mental disorders) were significantly older, had a lower level of education, family status, hereditary burden of mental disorders, various organic harms, they killed two or more victims more often and committed post-homicidal suicides (7.5%). Conclusions. Almost three–quarters of all murderers had mental disorders, and one in five had mental disorders due to alcohol abuse. The leading cause of the murders was conflicts arising between familiar people and/or family members against the background of alcohol intoxication. A certain role was played by the criminal experience of the participants in the incident, long-term hostile relations, readiness to inflict bodily harm to the victim and murder another person.

Postmortem forensic psychiatric examination in criminal proceedings

The article reflects the specifics of postmortem forensic psychiatric examination in criminal proceedings. It is carried out a scientific search for the features of this examination in expert-oriented studies and interviews of expert psychiatrists. It is found that the expert assesses the mental state of the deceased person in their absence on the basis of the person’s medical documentation and the materials of the criminal proceedings. It is determined that expertly significant information is not always reliable and sufficient for the expert to fulfill the duties assigned to them. In this case, the expert must use the rules of Part 4 of Art. 69 of the Criminal Procedure Code of Ukraine and refuse to give an opinion. In its turn, the court should perceive the conclusion of the postmortem forensic psychiatric examination as a source of evidence that needs to be carefully checked and evaluated in order to make a legal judgment in criminal proceedings.
 Based on the analysis of judicial practice materials, it has been proven that the conclusions of the postmortem forensic psychiatric examination are used in criminal proceedings for the purpose of evaluating: versions regarding the possibility of a person to commit suicide; the mental state of the suspect, the accused, the person against whom coercive medical measures were supposed to be applied, after their death; reliability of testimony or explanations of the victim who died; reliability of testimonies or explanations of a witness who died; the presence in the expert’s actions of the composition of the criminal offense provided for in Art. 384 of the Criminal Code of Ukraine.
 It is proposed to standardize the grounds for closing criminal proceedings upon the death of a person for whom coercive medical measures were supposed to be applied and to supplement Paragraph 5, Part 1 of Art. 284 of the CPC of Ukraine by a new subject – a person in relation to whom the application of coercive medical measures was intended. It is established that criminal proceedings regarding the use of coercive medical measures cannot be closed on the basis of Paragraph 2, Part 1 of Art. 284 of the CPC of Ukraine in the absence of the subject and the subjective party of the criminal offense.

Identifying deficits in Ukrainian law: Forensic psychiatry misuse in proceedings of administrative offenses

Ukraine is actively denouncing and abandoning its Soviet legacy, with the legal process of decommunization being at the forefront of this process.11Two bills from 2015 regulate the process of decommunization: ‘On denouncing the Communist and the National-Socialist (Nazi) totalitarian regimes in Ukraine and banning the propaganda of their symbols’ and ‘On access to archives of repressive bodies of the Communist totalitarian regime of 1917–1991’ However, despite Ukraine's ongoing judiciary reformation process amplified by the signing of the Association Agreement between Ukraine and the European Union, Ukraine's legal system still contains inherited Soviet legal deficiencies that allow for human rights violations. Some of the most glaring deficiencies relate to the rules and regulations for assigning and conducting forensic psychiatric examinations in cases of administrative offenses.With an aim to aid Ukraine in eliminating present legal deficiencies that allow for violations of human rights, here we discuss current definitions, rules, and regulations concerning appointment and execution of forensic psychiatric examinations in cases of administrative law violations. We place particular emphasis in our discussion on the European Court for Human Rights case “Zaichenko v Ukraine, No 2”, and the reform bill that followed this case. This case is an ‘in vivo’ illustration of how Ukraine's legal deficiencies have created grounds for the violation of individual human rights.Our assessment of the current rules and regulations for assigning and conducting forensic psychiatric examinations in proceedings of administrative offenses reveals that the legal deficiencies persist. The proposed reform bill is thus a highly warranted initiative, which however has several issues in its formulations and fails to address a few of the worst existing deficiencies. Ukraine's legislators must do further work to put through reforms that will safeguard individuals from unjustified forensic psychiatric examinations.

Effects of Substance Use and Antisocial Personality on Neuroimaging-Based Machine Learning Prediction of Schizophrenia.

Neuroimaging-based machine learning (ML) algorithms have the potential to aid the clinical diagnosis of schizophrenia. However, literature on the effect of prevalent comorbidities such as substance use disorder (SUD) and antisocial personality (ASPD) on these models' performance has remained unexplored. We investigated whether the presence of SUD or ASPD affects the performance of neuroimaging-based ML models trained to discern patients with schizophrenia (SCH) from controls. We trained an ML model on structural MRI data from public datasets to distinguish between SCH and controls (SCH = 347, controls = 341). We then investigated the model's performance in two independent samples of individuals undergoing forensic psychiatric examination: sample 1 was used for sensitivity analysis to discern ASPD (N = 52) from SCH (N = 66), and sample 2 was used for specificity analysis to discern ASPD (N = 26) from controls (N = 25). Both samples included individuals with SUD. In sample 1, 94.4% of SCH with comorbid ASPD and SUD were classified as SCH, followed by patients with SCH + SUD (78.8% classified as SCH) and patients with SCH (60.0% classified as SCH). The model failed to discern SCH without comorbidities from ASPD + SUD (AUC = 0.562, 95%CI = 0.400-0.723). In sample 2, the model's specificity to predict controls was 84.0%. In both samples, about half of the ASPD + SUD were misclassified as SCH. Data-driven functional characterization revealed associations between the classification as SCH and cognition-related brain regions. Altogether, ASPD and SUD appear to have effects on ML prediction performance, which potentially results from converging cognition-related brain abnormalities between SCH, ASPD, and SUD.

General and violent recidivism of former forensic psychiatric patients in Finland.

Forensic psychiatric care in Finland is provided to individuals who have committed a crime due to a serious mental disorder and are in need of psychiatric care. The reconviction (recidivism) rates for this patient group vary in time and between countries, likely due to different treatment practices and requirements for forensic care. We set out to study criminal recidivism in a national cohort of all patients released from forensic psychiatric care in Finland between 1999 and 2018. National registries were used to identify the patients and gain information on their criminal sentences. Forensic psychiatric examinations were used to record demographic information for the cohort. The cohort was followed up from hospital discharge to the end of 2019. We identified a total of 501 patients who were released from forensic psychiatric care (mean age: 46.6 years [SD 13.4), 434 (86.6%) were male). The mean and median times spent in treatment for the cohort was 10.0 years [SD 6.5] and 8.7 years, respectively. 91% of the patients had schizophrenia spectrum disorder (F2*), and 63.5% had a substance use disorder. A total of 83 patients (16.6%) committed any crime after being released from care, and the mean time to recidivism was 3.8 years. The recidivism rate was 2015 per 100,000 person years. A total of 48 patients (9.6%) committed a violent crime. The mean time to violent recidivism was 4.2 years. The violent recidivism rate was 1,083 per 100,000 person years. A longer duration of treatment was associated with a decreased risk of general recidivism (HR 0.95, 95% CI 0.90 to 1.00, p = 0.05). Factors associated with higher recidivism were male sex, having a comorbid substance use disorder and younger age at discharge. The recidivism rate in Finland was markedly lower than has been previously reported for other Western countries, and the mean duration of treatment was also longer. A longer treatment time may reduce the risk of criminal recidivism in forensic psychiatric patients. The results suggest, as previous studies have found, that more effort is indicated on the treatment of substance abuse.

«Проблемные ситуации» как методика судебно-психиатрического исследования: параметры оценки и проверка внутренней согласованности

<p style="text-align: justify;">In order to standardize “The Problem situations” as a forensic instrument, a study was conducted with the aim to identify the parameters of the assessment and to check the internal consistency of the instrument. The sample consisted of 47 subjects who underwent inpatient forensic psychiatric examination in connection with the decision on the issue of changing their civil status, with schizophrenia, intellectual disabilities and organic mental disorders. Primary and secondary evaluation parameters were identified by the content analysis. Correlation analysis was used to check the internal consistency of the instrument. On the example of the first problematic situation, the procedure for identifying secondary parameters is shown. It has been established that the correlation analysis between the secondary parameters belonging to three categories: causes — consequences — solutions, confirms the results of a qualitative analysis and biclustering. Significant correlations between semantic similar secondary parameters that are related to different problem situations were revealed. A conclusion was made about the internal consistency of the instrument and about its assumed construct validity.</p>

Phénoménologie, expertise, méthode : comment les pratiquer avec douceur

ObjectivesThis article aims to show how the forensic psychiatric examination reconstructs, by progressing gently from the facts and the intimate history of a life, a clinical practice which is specific to it. MethodWe set aside the theories that prevail in the medical and judicial domains in order to make the clinical phenomena appear as they occur in the subject's natural experience of the world. We practice this form of reduction beginning with the encounter with the patient, and relate it in this article by choosing a literary style (37 numbered paragraphs made up of a number of equal words), that is faithful to its subjective progression, made of gentleness, formalizations, and cuts showing the objective points of attachment to the solidity of the clinical. ResultsThe clinical facts occur in the patient's lived world and in the common world, each one thought of as a reality of daily life and a reality of work, and which are co-constructed by institutions and culture. Our results are presented as clinical variations on the theme of the forensic psychiatric examination, highlighting the importance of the subject's inner history as well as the importance of his or her culture. DiscussionThis work shows how, by passing from the oral to the written form and then returning to the oral form at the time of the hearing, the expert witness does not so much describe the facts as he produces them, by placing them in direct relation with subjective experience: that of the perpetrator, that of the victim, and that of the expert himself. As a collection of stories, no fact, clinical or judicial, has any meaning in isolation. It only becomes worthwhile through the relationship that it makes present from various angles and points of view, characteristic of the plural realities that make up the co-construction of the expertise. The phenomenological method, by progressing gently, allows the facts to appear as they can make sense to each of the protagonists. A common horizon of values can then emerge from the discussion and the successive passages from oral to written form, which sheds light on the possibilities of discernment, choice, and responsibility that structure the missions entrusted to the expert witness. ConclusionPhenomenology brings to forensic psychiatry a rigorous method of progression on the philosophical level as well as on the clinical level. It can thus contributes to the progression of the judicial truth without draping the reality of the clinical facts with any cerebral mythology or any preconceived theory applied from the outside to the facts, to the subject's own experience, and to what links them.

Interdepartmental cooperation in prevention auto- and heteroaggressive behavior of minors

The growing trend in the number of shootings cases in schools determines the need to take preventive measures to identify minors at risk of committing socially dangerous acts. The purpose is to determine approaches for interdepartmental interaction between specialized medical organizations and educational organizations in the aspect of minors auto- and heteroaggressive behavior preventing. Materials and methods. Behavioral indicators and psychological characteristics of adolescents who planned or committed attacks on educational institutions, minors with autoaggressive behavior who underwent complex forensic psychological and psychiatric examinations at the FSBI “NMIC PN named after V.P. Serbsky” of the Ministry of Health of Russia are analyzed. Results. In 2022, a new version of the «Methodological materials on the signs of deviations, the actions of education system specialists in situations of social risks and prevention of deviant behavior of students» was introduced into the educational process (methodological development “Prevention Navigator”). One of the new aspects is a block dedicated to identifying the risk of an attack on an educational organization (signs of the risk of committing a particularly dangerous act and a special algorithm of actions). The article describes aspects of the interaction of educational organizations with specialized medical institutions in the context of identifying such students and preventing socially dangerous behavior of minors. Conclusion. The current system of interaction between educational institutions and medical organizations specializing in the field of mental health of children and adolescents requires improvement and legal support

Medical psychologist: organizational and legal regulation of activity and personnel training system

The qualification requirements for the position of a medical psychologist are analyzed. The demand for the professional activity of a medical psychologist in the provision of psychiatric, narcological, neurological and general somatic care is shown. The knowledge, skills and abilities of medical psychologists are widely used in the providing medical care for diseases and behavioral disorders, in the consideration of forensic psychiatric examination. There is a tendency to further strengthening the interaction of medical psychologists with psychiatrists and psychotherapists. The features of undergraduate and postgraduate training in the specialty “Clinical Psychology” are highlighted. A comparative analysis of the staffing of medical organizations of the Russian Federation by medical psychologists was carried out, the unevenness of this indicator across the regions of the country was shown. The conclusion is made about the relevance of the adoption of the professional standard “Medical Psychologist” for optimizing the qualification characteristics of professional activity and creating an objective basis for building professional higher and postgraduate education programs in clinical psychology, taking into account the requirements of the employer. Prospects for increasing the role of medical psychologists in the organizations of the Russian Ministry of Health are associated with the inclusion of their functional duties in the Procedures for providing of medical care in general somatic practice and with the expansion of the number of universities providing training in the specialty “Clinical Psychology”.