Background:Forensic patients are often admitted to psychiatric hospitals without any details of illness or treatment. They pose a unique challenge for clinical services in the context of diagnosis, management, and particularly legal issues.Materials and Methods:We conducted a retrospective chart review using a structured data-extraction tool. A total of 23 female forensic inpatients were admitted under the Department of Psychiatry from January 2006 to June 2016. Data were analyzed by descriptive statistics.Results:The mean age of the patients was 31.3 ± 7.9 years. In total, 82.6% of them were married, 87% were from a nuclear family, and 78.3% were from an urban background. Totally, 73.9% were referred from prison and 26.1% from the court. However, 73.9% were referred for the purpose of diagnosis and treatment and 21.7% for assessment of fitness to stand trial. Moreover, 47.8% had an alleged charge of murder (of killing close family members). A total of 30.4% had schizophrenia and other psychotic disorders, and 47.8% had a mood disorder. The mean duration of inpatient care was 6.2 ± 7.4 weeks, and 87% had shown considerable clinical improvement at the time of discharge.Conclusions:The majority of female forensic patients were young adults from nuclear families. They had mood disorders, schizophrenia, and other psychotic disorders. They were referred primarily for treatment purposes. Prospective studies are required for a better characterization of the relationship between crime and psychiatric disorders.

Objectives: Transcranial magnetic stimulation (TMS)-derived cortical reactivity studies provide a unique opportunity to non-invasively study gamma amino butyric acid (GABA)-mediated inhibitory neurotransmission in bipolar disorder (BD). Earlier studies were conducted in smaller samples and on patients who were on medications that can potentially confound the results. We aimed to study short-interval (SICI) and longinterval intracortical inhibition (LICI) in medication-naïve/free symptomatic (manic) BD patients (n=39), first episode mania (FEM) patients who had recently (≤6 months) remitted with treatment (remitted FEM; n = 28) and healthy subjects (HSs; n = 45). Methods:Resting motor threshold (RMT), stimulation intensity to elicit a 1-mV motor evoked potential (MEP) (SI 1 mV ), SICI and LICI were measured in three groups using single-and paired-pulse TMS.Results: Motor thresholds were higher in the manic BD and HS groups compared to the remitted FEM group (P < .001). SICI was lower (P = .026) but LICI was higher (P = .044) in the manic BD and remitted FEM groups compared to the HS group.Conclusions: Lower motor thresholds in remitted FEM perhaps reflect the effect of treatment, and could be studied as potential prognostic neuromarkers. Inverse findings for SICI (reduced) and LICI (increased) in BD indicate a possible differential involvement of the GABA A and GABA B subreceptor systems. These could be trait markers as they are impaired in both mania and euthymia.

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