Criminal responsibility assessment is undertaken by psychologists or psychiatrists to assess offenders' legal capacities, which vary among countries or regional legislations. There are two psychometric tools (i.e., checklists) validated for criminal responsibility assessment: the Roger Criminal Responsibility Scale, and the rating scale of criminal responsibility for mentally disordered offenders. Despite the existence of psychometric tools structured in clinical vignettes for evaluating legal capacities, none serve the purpose of assessing criminal responsibility. This study aims to validate a novel psychometric tool structured in vignettes for the assessment of criminal responsibility called the “Criminal Responsibility Scale.” We applied the tool to 88 defendants referred for criminal responsibility assessment in a forensic medical institute in the city of Rio de Janeiro, Brazil, from December 2017 to December 2018. The validity of the Criminal Responsibility Scale and subscales were evaluated using confirmatory factor analysis. The two-factor solution proved satisfactory and met the needs for practical application of the tool (Kaiser–Meyer–Oklin = 0.82; p < 0.001). Moreover, the inter-rater reliability was evaluated by comparing the tool's final score with that of the expert's conclusion in each case and was found to be satisfactory (k = 0.667–1.0), with a resulting cutoff point of 30.50 (±2) and a Youden index of 0.509. Hence, the Criminal Responsibility Scale is an effective psychometric tool for assessments of criminal responsibility that may encourage future research in assessments of legal capacity with clinical vignette-based psychometric instruments.

BackgroundDementia is a clinical syndrome which is more common in elderly people. Dementia with Lewy bodies (LBD) is not so rare in elderly people, with cognitive impairment in about 30% over age 65. The clinical picture is characterized by fluctuation in cognitive functions, recurrent, well-formed, detailed visual hallucinations, and Parkinsonism, with rigidity, tremor, bradykinesia, and slurred speech.Case presentationWe present a case report of LBD in a 73-year-old retired teacher, which a initial wrong diagnosis of refractory depression for at least 3 years. We also conduct a review of recent works on theme.ConclusionLBD diagnosis can be neglected for years, with a legal and clinical issues to patients and their families. Detailed medical research, including differential diagnosis, are very necessary on those cases, specially when they are called refractory. We encourage new research and adequate clinical training to prevent damage.

The current article describes the case of a man who claimed amnesia in relation to a sexual crime he had allegedly committed. Psychiatric examination concluded that the individual was feigning amnesia. Claimed amnesia of a criminal offense is one of the most commonly feigned symptoms in the forensic medical setting. It is thus necessary to rule out organic or psychogenic causes of amnesia and always consider feigned amnesia in the presence of psychopathological alterations that do not reflect classically known syndromes.

Dementia is a clinical syndrome characterized by multiple, acquired and persistent cognitive deficits, capable of substantially interfering in the patient’s activities of daily living. The diagnosis of Dementia with Lewy Bodies (LBD) is characterized by fluctuation in cognitive functions, recurrent, well-formed, and detailed visual hallucinations, and parkinsonism, with stiffness, tremor, bradykinesia, and slurred speech. Our goal is to describe a case report of LBD that for several years was diagnosed and treated as depression. It is extremely important to have detailed medical research in these cases, including performing differential diagnosis with depression, in order to enable adequate treatment, family guidance and receipt of financial benefits provided by government authorities.