Evaluation of forensic psychiatric cases: a four-year review

Objective: This study aims to identify the psychiatric conditions of cases required to be examined psychiatrically, by analyzing retrospectively the forensic reports prepared by the Department of Forensic Medicine of Gulhane Military Medical Academy.

Methods: Forensic reports prepared by the Department of Forensic Medicine of Gulhane Military Medical Academy between January 1, 2011 and November 30, 2014 were examined retrospectively.

Results: During a four-year period, 2408 cases were assessed by the Department of Forensic Medicine. Of these cases, 158 (6.5%) were needed to be examined psychiatrically. Of the 158 cases, 98.7% (n=156) were male and 1.3% (n=2) were female. The vast majority of cases (51.3%, n=81) consisted of private soldier rank while a few cases were related to civilians (1.9%, n=3). As a consequence of psychiatric examination, the relevant cases were most commonly diagnosed with anxiety disorder (44.9%, n=71). Post-traumatic stress disorder (18.3%, n=29) was the second most common of the cases with which they were diagnosed. Psychopathology was not detected in several (n= 6, 3.8%) of these cases. The cases to be psychiatrically evaluated were referred to the Psychiatry Polyclinic etiologically because of firearm injuries (39.2%, n=62), explosives injuries (25.3%, n=40), accidentally blunt traumatic injuries (13.3%, n=21) and battery (11.4%, n=18). 43% (n=68) of the cases referred to Psychiatry Polyclinic to be evaluated were to undergo an outpatient treatment while 57% (n=90) of them were referred to inpatient treatment. Workforce loss ratio was calculated in 90 of 158 cases and in 53.3% (n=48) of these cases it was determined as >1%, while there were no malfunctions needed to be calculated for workforce loss ratio in psychiatric terms in 46.6% (n=42) of 90 cases.

Conclusion: There are many notable aspects of the study. The most important ones are that a psychiatric assessment was needed due to the exposure to life events which had caused bodily injuries in a large majority of the cases, and that the ratio of anxiety disorders was higher and the ratio of post-traumatic stress disorder was relatively higher as compared to other psychiatric diagnoses. A very limited number of studies have been carried out for the cases in the field of forensic psychiatry in our country. These studies were also associated with whether the mania level of substance uses was being psychiatrically evaluated by the relevant courts, and with the assessment of criminal responsibility.