FORENSIC PSYCHIATRY

Psychiatry – deals with etiology, diagnosis

and treatment of Mental disorders.

F. Psychiatry – application of psychiatry

in the administration of justice.

Insanity / Unsoundness of Mind.

“ Is the disease of mind, or the personality
in which there is derangement of mental
and emotion process”
 Mental Health Act 1987
 Earlier LUNACY Act 1912 was
repealed and mental Health Bill
– passed in 1987.

 “Unsoundness of mind” word is used in

I.P.C.s and used as synonym with
Insanity, Lunacy, madness, mental
derangement, mentally ill.
 Causes of Insanity
Intrinsic Factors
a) Genetic
1) Specific gene.
2) Chromosomal abnormalities.
3) Biochemical abnormalities.

b) Constitutional
1) Physical or physique
2) Personality
3) Temperament
Extrinsic Factors

a) Physical – organic causes / drug

Intoxication / Injury /
Infection / Malnutrition / others

b) Psycho-social
1) early up bringing.
2) Adversities.
3) Mental conflicts.
4) Personal / Family loss.
5) Psycho-social stress.
6) Financial loss.
7) Failures in Exams, love.
Classification of Mental Disease

a) Mental retardation.
b) Psychoses – 1) Organic
2) Functional
* Schizophrenia
* M.D.P
c) Neurosis – Anxiety / Hysteria / phobia
obsession / Depression.
d) Personality disorders.
e) Sexual Deviations.
d) Drug Dependence.
 AFFECT – means the out word
manifestations of person’s
feeling / mood / or emotions.

 AFFECTIVE DISORDERS
Disorders in which chief feature is
the grossly affected persons mood
/ feelings.
e.g - Depression
- Mania
 APHASIA
(MOTOR APHASIA)
Loss of ability to express the
meaning by use of speech or writing

(SENSORY APHASIA)

and to understand spoken or written

languages
 CONFABULATION

“Pathological loss of memory”

e.g. - In Head injuries.

- Dementia.
- Korschkoff’s psychosis.

Patient fills the goop with imaginary

events.
 DELIRIUM
“Is a syndrome produced by a transient
disturbance of brain function”

Is a disturbance in the state of consciousness

in which orientation is impaired.

- Blunted mental faculty

- Irrelevant and incoherrent
thought process.
- Orientation to time / place disturbed.

i.e. - Patient fail to recognise the place /

persons / and time, around him.
 Delirium is seen in……………
 Insane person.
 Trauma.
 Anoxia.
 Mental stress.
 High fevers.
 Acute poisoning – Datura.
 Addicts / Alcoholics.
M.L.I – Not liable for their offences.
 DELUSION
“ False belief in
something which is
not a fact and persist
even after its falsity
has been clearly
demonstrated or
proved”.
 Types of delusion..
1. Delusion of Grandeur (Exhaltation)
(Megalomania)
2. Delusion of persecution. (paranoid)
3. Delusion of Influence.
4. Delusion of Reference.
5. Delusion of Infidelity.
6. Delusion of Self Reproach.
7. Nihilistic Delusion.
8. Hypochondria cal Delusion.
 HALLUCINATION
“False perception
without any
external object /
or stimulus, to
produce it”

“Seeing , hearing,
tasting, smelling
/feeling
something which
is not actually
present”.
 Types of Hallucination

1. Visual.

2. Auditory.

3. Olfactory.

4. Gustatory.

5. Tactile.

6. Psychomotor
(kinesthetic)
 ILLUSION


False / erroneous
“

interpretation of an

external objects by his

senses”
e.g.
Rope with snake.

Dog with Lion.

Stem with Ghost.

 OBSESSION
“A single idea, thought or emotion is
constantly entertained by a person
inspite of all efforts of the sufferer, to
drive it away from his mind”

- Highly Rigid type personality.

- compulsive obsessive neurosis.
e.g. 1. Closing the door.
2. Counting money.
3. Washing hands / taking bath.
 IMPUSE
“Sudden and irresistible force, compelling
a person to the conscious performance of
some action without motive or forethought”
Types
1. Kleptomania.
2. Pyromania
3. Mutinomania,.
4. Dipsomania.
5. Sexual.
6. Suicidal.
7. Homicidal.
Kleptomania
Pyromania
 LUCID INTERNAL

“ Period occurring during insanity,

when all symptoms, completely
disappears and person becomes
normal”

e.g. - In M.D.P.
- In Head Injury.
 PHOBIA
“Excessive or irrational fear for some
object or stimulus” – specific fear.

Types
1. Achro-phobia – High places.
2. Agaro-phobia – Open places.
3. Claustro-phobia – Closed.
4. Necro-phobia – Of dead bodies.
5. Patho-phobia – Of diseases.
 PSYCHOPATH (Sociopath)

“Personality disorder where the person

neither, mentally ill, nor mentally defective,
but fails to conform the normal standards
of behaviour in the society”
 Not a certifiable insane.

 Does not observe ethical behaviors.

 Immoral / antisocial / Mistrustful and
criminal / selfish.
 Impulsive / temper outburst known as
short circuit reaction.
 SOMNAMBULISM

“Is a condition where

the person walks
during sleep”

 He is not asleep, but in a

state
 Dissociated state of
Consciousness
 Is a kind of Automatism.
-
 SOMNALENTIA

“State of mind where a person is in a

condition in between sleep and wake”

.
Sleep drunkenness
 Mental Retardation
(oligophrenia) (Amentia)

“ Incomplete mental maturation due to

arrested mental development”.

Immaturity in Attention.
Perception.
Cognition.
Social adoptability.
 Mental age
IQ = X 100
Chronological age

- Normal IQ – 90-110 for the adult

- age of 16 years.
Grades
1. Moron (Slightly retarded) IQ – 50 -75
6-11 Yrs
2. Imbecile (moderately retarded ) IQ – 20-50
3-7 Yrs
3. Idiots (Severely retarded) IQ – 0-20
3 Yrs
 Psychosis
- Major mental disorders of organic or
emotional origin, characterised by
derangement of personality
- Accompanied by many symptoms.
- Withdrawal from reality & living in a world
e.g. --
 Dementia (organic).
 Schizophrenia (split personality).
 Manic depressive psychosis (Bipolar
insanity ).
Psychotic Killer
- Incapable of knowing the nature of the
acts
- Judgement is at Fault
Psychopathic Killer
- Killing is unintentional due to loss of
control
- No control over his aggression
SCHIZOPHRENIA
- Hereditary tendency.
- Split personality
where the patient loses
contact of his
surroundings
- Primarily disorder of
cognition (thinking)
- Withdrawal from
reality.
 Splitting of different Psychic function
Behavior
Thought
Affect
Delusion
Hallucination
Personality deterioration
 M.D.P. Manic Depression Psychosis
MANIA –
Condition of exaltation
Euphoria / irritable
/excited.
Loss of control.

DEPRESSION
(MELANCHOLIA)
Intense feeling of misery
Sadness of mood in
Posture/Movement/expr
ession
- Wide swing of moods from euphoric elation to

deep depression

- Extremes of mood hyperactive & depressive

stupor

- Isolated attacks of mania & depression seen

Neurosis:
A group of personality disturbances resulting from
reactions to life
1 Anxiety
2 Hysterical
3 Phobic
4 obsessive compulsive Neurosis
5 Depressive Neurosis
Diagnosis of Insanity:
1. Preliminary examination
2. Family history
3. Personal history
4. Physical Examination
- Patients manner
- Deformities and malformations
- Temperature
- Complete and detailed examination
5. Mental condition
- Gen appearance
- Talk
- Speech
- Writing
- Behaviour
- Mood
- Memory
- Sleep
- Walking and gait
- Attitude and posture
- Sex behavior
- Attention
- Thought process
- Thought content
6 other investigations
7 observation

Certification
 True insanity Feigned insanity
1) Onset Very gradual Sudden

2) Motive Absent Present

3) Causes- Always present Absent

Predisposing –
precipitating Always present Absent

4) Facial expression Peculiar Normal

5) Signs & of particular type Not uniform, usually a

symptoms mixture of insanity
6) Physical -Wrinkled & moist Absent
manifestations skin constipation,
furred tongue, loss
of appetite &
insomnia etc.
7) Habits -Dirty,
filthy, Not so.
nonsence

8) Effects of No effect in Change present.

observation behaviour

9) Repeated No concern Resents frequent

examination examination for
fear of detection.

No effect, not Soon exhausted,

10) Exertion exhausted. perspiring, and
feels sleepy.
 Mental Health Act -1987
1. Defines the criteria for admission and restraint
of Insane.
2. Guidelines for establishment of psychiatric
Hospitals.
3. Discharge of mentally ill person.
4. Describes the custody and care of property of
mentally ill person.
5. Protection human Rights of Insane.
6. Penalties and punishments for violation of Act.
 Restraint of an Insane
A) Immediate.
B) Admission to psychiatric hospital.
1. Voluntary patient.
2. On application by relatives or friends.
3. Reception order on petition.
4. Wandering dangerous or cruelly treated
mentally ill.
5. Mentally ill prisoner.
6. Escaped mentally ill.
 Discharge of the Insane
1. Admitted as Voluntary Patient.
2. Admitted on Application / Patient.
3. The officer I/C of the mental hospital can
discharge any patient on the
recommendations of 2 doctors of the
hospital.
4. Admitted as wandering / dangerous
mentally ill.
5. Mentally ill Prisoner.
 Responsibilities of an Insane
A) Civil Responsibilities.
Management of property.
Contracts.
Marriage.
Competency as a witness.
Validity of consent.
Civil rights.
Guardianship.
Testamentary capacity
Testamentary capacity
(capacity to make valid will)
 Testator should be major.
 Testator should be compos mentis.
 Testator should understand the nature and consequences of
the act.
 Testator should know his property, to whom he is giving and
that he has good reason for his action.
 That he is doing it voluntarily and without undue influence,
force or misrepresentation by any other person.
 Must sign it in presence of two witnesses, out of which one
should be a medical man. Both the witness should also sign.
 None of the witnesses must be a beneficiary from the will.
Holograph will is one which is
written by the testator in his own
handwriting.
Valid during lucid interval.
A will can be made even by blind, deaf,
dumb, suffering from aphasia,
A will is valid, even if the testator committed
suicide shortly after making the will.
A will is invalid if made during delirium.
A will cannot be made during drunk nesses.
A will cannot be made during insanity.
B) Criminal Responsibility

Criminal responsibility means

liability to punishment for the
crimes committed.

The law presumes that every

person is sane and accountable
for his actions, unless contrary
is proved.
 Insanity & Murder
Insanity is plea commonly raised in the case of
murder.

a) To avoid conviction if insane at the time of crime.

b) To void conviction if insane at the time of trial of the case.

c) To avoid capital punishment if insane at the time of

execution.
Characteristics of the murder committed by an insane are

a) It is purposeless or motiveless.
b) There is no target to hit.
c) Its perpetration is without any preparedness, accomplices
or secrecy. There is no selection of proper time and place.
d) Usually multiple murders are done.
e) There is no attempt to destroy evidence.
f) There is no attempt to run away. He may rather, himself
notify to police.
 The legal test
 There should be some evidence of
mental disease or defect.

 This must exist at the time of

commission of crime.

 Itshould be of such a degree that the

person is unable to understand that
the act is wrong / or contrary to law.
1) Mc Naughten rule
“ the accused person is not legally responsible,

- If it is clearly proved that at the time of

committing the crime,

- He was suffering from such a defect of

abnormality of mind,

- That he did not know the nature and quality

of the act he was doing,

- Or that what he was doing was wrong.

 Section 84 I.P.C
“ Nothing is an offence which is done
by a person”
- Who at the time of doing it,
- By reason of unsoundness of mind,
- Is incapable of knowing the nature of
the act,
- Or that he is doing what is either wrong
or contrary to law.
2) Doctrine of partial responsibility.
3) Durham rule.
4) Currens rule.
5) American Law Institute test.
6) Norwegian system.