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BackgroundIndividuals who were charged with a serious offence may be referred by courts for forensic psychiatric assessment. The court may declare them as state patients if they are found unfit to stand trial or not criminally responsible because of mental illness or defect.In forensic psychiatry practice, there may be challenges in the forensic psychiatric observation process, and discrepancies may occur between the clinician report and the court’s decision.ObjectivesTo describe elements of the forensic psychiatric observation and discuss the legal correlates associated with the admission of state patients.MethodA retrospective study of the forensic psychiatric observation records of 91 newly admitted state patients at a forensic unit in KwaZulu-Natal over a 3-year period.ResultsA total of 71 state patients (78.02%) were found not fit to stand trial and 10 patients (10.99%) were not criminally responsible. Nine patients (9.89%) were fit to stand trial and criminally responsible but still declared state patients and 13 state patients (14.29%) did not commit a serious offence. There was correlation for diagnosis between the assessing and the treating psychiatrists.ConclusionThe findings of the forensic observation were not always considered by the courts. Individuals found fit to stand trial, those found criminally responsible and those who did not commit serious crimes were declared state patients.A better understanding of legal dispositions for mentally ill offenders and an active collaboration between judicial and mental health systems may contribute in developing national guidelines for observation and admission of state patients.

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Introduction:Sexual function is one aspect of physical functioning. Sexual dysfunction, no matter the etiology, could cause distress. in people with chronic renal failure, sexual problems have often been neglected in clinical practice and research. The aim of this study was to assess the sexual functioning of patients with chronic renal failure.Methods:A total of 50 patients with chronic renal failure on hemodialysis were included in this study. The questionnaire included thirty items: sociodemographic data, clinical factors and history, sexual functioning before and after hemodialysis. Data were analyzed using SPSS 17.Results:Twenty seven per cent (27%) of the patients stated having no sexual activity at all. Eighty-three per cent (83%) of sexually active patients had sexual dysfunction. Sexual dysfunction in men was due to erectile failure, to loss of sexual interest, and to fatigue. Women reported essentially asthenia, loss of sexual interest and finally dyspareunia. These disorders appeared on average three years after being on hemodialysis.Conclusions:The prevalence of sexual dysfunction was high among patients with chronic renal failure. This disorder needs special attention and management from doctors.

Introduction:Several studies suggest mental disorders and substance misuse to be associated with a higher rate of violence and crime.The aim of this study was to determinate the correlation between addictive behaviours and criminal offences in patients suffering from bipolar disorder.Methods:Twenty-eight subjects with bipolar disorder were recruited from the forensic psychiatry service in Razi hospital and each one was compared with two patients suffering from bipolar disorder, correlated in gender and age and without history of criminal behavior. Data were analyzed using SPSS 11.5Results:The most frequent crimes committed by patients (about two thirds) were nonviolent (theft, pyromania, fraud, falsification of documents, damage to a property…).The rate of criminal behavior was highest during manic episodes: 51, 7%.Substance use was present in 66,7% of patients with history of criminal behavior against 30% in the comparative group.This association was significant (p = 0,002). The odds ratio was about 5.Conclusions:Our study suggests that comorbid bipolar disorder and addictive behavior may significantly increase the risk of criminality.