Examination of the forensic psychiatric and sociodemographic characteristics of adults WHO are applied to the Akdeniz University department of forensic medicine for the evaluation of criminal license

The concept of criminal responsibility has been one of the most controversial topics in terms of public conscience, legal and medical aspects since ancient times. Today, there is a strong social agreement on this concept compared to the past, and this situation is also taken into the legal framework in Turkish laws under Turkish Penal Code 31st, 32nd, 33rd and 34th articles, which comprises crimes committed by underage, mental health disorders, deafness and temporary reasons, such as being under the influence of alcohol or drug, respectively. In our study, it was aimed to evaluate the relationship between criminal responsibility decisions, types of crimes alleged to have been committed, sociodemographic and forensic psychiatric characteristics of the adult cases that were applied to Forensic Medicine Department for the evaluation of criminal responsibility, thus, to contribute to the medicolegal literature. The data of the cases, which were applied to Akdeniz University Faculty of Medicine, Department of Forensic Medicine for the evaluation of criminal responsibility between 01.01.2016 and 31.12.2020, were obtained retrospectively through the electronic and physical archive of Forensic Medicine Department, and the Mia-Med information processing system of the Hospital. The data obtained from 1011 cases were uploaded to IBM SPSS version 26.0 (IBM Corporation, Armonk, NY, USA) and the statistical significance level was accepted as p<0.05 by performing the necessary statistical analyzes. While the average age of 1011 people evaluated in our study was 37.04, 84% (n:849) were male and 16% (n:162) were female and the average education period was 8 years. Additionally, 53.5% (n:541) of the cases were primary school graduates, 49.8% (n:503) were single, 55.1% (n:557) had no children, 48.7% (n:492) was unemployed at the time of the incident. Only 26.7% (n:270) of the cases were using alcohol, and 29.8% (n:301) had a history of substance use. 116 Alleged crimes committed was assault in 26.3% (n:266) of the cases, theft, fraud or forgery in 23.2% (n:235), insult or threat in 11.6% (n:117) and sexual assault in 7.8% (n:79). Primary school graduates were comprised of 66.7% (n:8) of the cases claimed to have committed murder, 55.6% (n:148) of the cases alleged to have committed the crime of assault, 53.2% of the cases alleged to have committed the crime of sexual assault (n:42), 51.9% (n:122) of the cases alleged to have committed theft, fraud or forgery. On the contrary, 62.5% (n:5) of the cases alleged to have committed terrorist crimes were university graduates. According to reports, cases alleged to have committed assault, sexual assault, and theft, forgery or fraud were most frequently unemployed at the date of the incident and this group's rates in these crimes were 52.3% (n:139), 46.8% (n:37) and 47.2% (n:111), respectively. It was determined that 66.7% (n:8) of the cases who were applied with alleged murder and 75% (n:6) of the cases that were alleged with terrorist crime were working in a job on the date of the incident. While only 37.8% (n:382) of the cases had a previous criminal history, it was found that the cases applied for alleged murder, assault, sexual assault and theft, fraud or forgery mostly do not have a known previous criminal history, with rates of 75% (n:9), 65% (n:173), 78.5% (n: 62) and 51.5% (n:121), respectively. It was observed that 55.9% (n:33) of the cases who escaped from the military or prison or who were deserters had previous criminal histories. As a result of psychiatric and neurological examinations; It was determined that 22.6% (n:228) of the cases had been diagnosed with schizophrenia or a psychotic disorder, 11.1% (n:112) with bipolar disorder, and 10.2% (n:103) with mental retardation. No criminal responsibility had been detected, in accordance with TPC article 32/1, in 41% (n:414) of the cases, criminal responsibility had determined to be unaffected in 37.3% (n:378), reduced criminal responsibility was determined, in accordance with TPC article 32/2, in 8.8% (n:89). There had been reduced criminal responsibility, in accordance with TPC article 34/1, in 0.2% (n:2) of 117 cases, and 12.7% (n:128) of them had been referred to a closed inpatient psychiatric clinic to be evaluated under close observation. The cases that were decided to be within the scope of TPC articles 32/1 or 32/2 were most commonly primary school graduates (44.6% (n:185) and 57.3% (n:51), respectively), and the second most common was high school graduates (23.6% (n:98) and 14.6% (n:13), respectively). Moreover, 61.9% (n:234) of the cases with full criminal responsibility were primary school graduates, 17.7% (n:67) were high school graduates. The cases, within the scope of TPC articles 32/1, and 32/2, were mostly unemployed at the date of the incident (56.3% (n:232) and 48.3% (n:43) respectively), while 46.9% (n: 177) of the cases with full criminal responsibility were found to be actively working in a job, and 40.5% (n: 153) were unemployed. In all 414 cases determined to be in the scope of TPC article 32/1, 30.2% (n:125) of them allegedly committed assault, 17.2% (n:71) allegedly committed theft, fraud or forgery. On the other hand, in all 89 cases determined to be in the scope of TPC article 32/2, 32.6% (n:29) allegedly committed theft, fraud or forgery, 28.1% (n:25) allegedly committed assault. Among the 378 cases with full criminal capacity, 28.9% (n:109) of them allegedly committed theft, fraud or forgery, 21.6% (n:82) of them allegedly committed assault. In 84.7% (n:193) of 228 cases diagnosed with schizophrenia or psychotic disorder, 82.2% (n:92) of 112 cases diagnosed with bipolar disorder, and 73.8% (n:76) of 103 cases diagnosed with mental retardation were determined to have no criminal capacity in scope of TPC article 32/1. Of the 15 people with borderline mental capacity, 73.4% (n:11) were considered under TPC Article 32/2, 13.3% (n:2) were considered under TPC Article 32/1, and 13.3% (n: 2) of them were determined to have full criminal capacity. Moreover, 75.4% (n:43) of 57 cases with mild mental retardation were within the scope of TPC Article 32/1, 24.6% (n:14) were within the scope of TPC Article 32/2. It was determined that all of the cases with moderate mental retardation (n:28) and severe mental retardation (n:3) were considered within the scope of TPC Article 32/1. 118 Considering the distribution of 505 cases, which were determined to be within the scope of TPC Articles 32/1, 32/2 or 34/1 as a result of the criminal responsibility assessment, it was observed that the main disorder that affected their criminal responsibility was schizophrenia or psychotic disorder in 41.3% (n:209), bipolar disorder in 20.7% (n:105), and mental retardation in 20% (n:101). Among alleged assault suspects (n:150), whose criminal responsibility was determined to be affected, 46.7% (n:70) had schizophrenia or psychotic disorder, 22.7% (n:34) had bipolar disorder, 15.3% (n:150) had mental retardation. Among alleged sexual assault suspects (n:41), whose criminal responsibility was determined to be affected, 51.2% (n:21) had mental retardation, 26.8% (n:11) had schizophrenia or psychotic disorder, 9.8% (n:4) had bipolar disorder. Moreover, among alleged theft, fraud or forgery suspects (n:102), whose criminal responsibility was determined to be affected, 29.4% (n:30) had mental retardation, 29.4% (n:30) had schizophrenia or psychotic disorder, 18.6% (n:19) had bipolar disorder, 2.9% (n:3) had kleptomania. It was observed that the 1011 cases evaluated within this study were predominantly comprised of cases that is 30-44 years old, male, primary school graduate, single, without children, unemployed, without a history of substance or alcohol abuse. As a result of the psychiatric and neurological examinations, it was observed that the most common diagnoses were schizophrenia or psychotic disorder, bipolar disorder and mental retardation. On the other hand, in 34.8% of the cases, the results of the examination were normal, or the diagnosis could not be made. The distribution of mental retardation degree of 103 cases diagnosed with mental retardation was as mild mental retardation (n=57, %55,3), moderate mental retardation (n=28, %27,2), borderline mental capacity (n=15, %14,6) and severe mental retardation (n=3, %2,9) respectively. It was determined that criminal responsibility of 50% of the cases were affected (i.e., they were in accordance with TPC Articles 32/1, 32/2 or 34/1), 37.3% of the cases were considered to have full criminal responsibility, 12.7% 119 were referred to a closed inpatient psychiatric clinic to be evaluated under close observation. It was seen that most of the cases diagnosed with schizophrenia or psychotic disorder, bipolar disorder and mental retardation (n=361, %81,5), were considered to have no criminal responsibility, in accordance with TPC Article 32/1. Similarly, all the cases diagnosed with organic brain syndrome and Asperger's syndrome (n=10, %100) were determined to have no criminal responsibility, while all the cases diagnosed with kleptomania were (n=3, %100) considered to have reduced criminal responsibility within the scope of TPC Article 32/2. It has been seen that most of the people diagnosed with borderline mental capacity (n=11,%73,4) were evaluated according to TPC Article 32/2, most of the cases with mild mental retardation (n=43, %75,4) were evaluated according to TPC Article 32/1, and all of the cases with moderate and severe mental retardation (n=31, %100) were evaluated within the scope of TPC Article 32/1. Considering the distribution of psychiatric or neurological diseases that caused this situation, it was determined that criminal responsibility was affected mostly due to schizophrenia or psychotic disorders (n=209, %41,3), bipolar disorder (n=105, %20,7) and mental retardation (n=101, %20), respectively. While the alleged assault crimes, that was committed by the cases whose criminal responsibility was affected, were mostly committed by the ones diagnosed with schizophrenia or psychotic disorder (n=70, %46,7), bipolar disorder (n=34, %22,7) and mental retardation (n=23, %15,3), respectively, it was determined that sexual assault and theft, fraud or forgery were mostly committed by cases with mental retardation (n=21, %51,2) (n=30, %29,4), schizophrenia or psychotic disorder (n=11, %26,8) (n=30, %29,4) and bipolar disorder (n=19, %18,4), respectively. Both in our study and in other studies conducted on criminal capacity in Forensic Medicine and Psychiatry outpatient clinics, it was found that for a significant portion of the cases no decision could be made about the criminal responsibility and they were referred to closed psychiatry clinics (n=128, %12,7). 120 However, it was understood that in these clinics, very few of the cases were determined to have no criminal responsibility, and the majority of the people who were determined to have no criminal responsibility also had psychotic disorders. Therefore, it has been concluded that it is of great importance to receive the previous medical and forensic documents together from the authorities to give more accurate medical and legal answers to the authorities, to prevent legal delays and unnecessary reexamination of the patient due to incomplete medical history, to diagnose diseases such as psychotic disorders more easily, to reduce the number of patients that needs to be referred to closed inpatient psychiatry clinics and alleviate the heavy burden in these clinics.