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Scandinavian forensic psychiatric practices - an overview and evaluation

Nordic Journal of Psychiatry. Vol 59, s. 92 - 102 | 2005


The Scandinavian countries share a social-democratic and humanistic view in that mentally
disturbed offenders should not be punished or sentenced to prison if they are considered
unaccountable for their actions. The countries differ, however, for example regarding referrals
for medico-legal examinations. This article gives: 1) an overview of the Scandinavian forensic
psychiatric practices regarding organization, legislation, resources and use of methods, and
2) a study of forensic psychiatric assessments as they are done in the Scandinavian countries.
From each country 20 forensic psychiatric court reports concerning male murderers were
examined. Each report was scored in five sections: characteristics of the defendant, setting of the
observation, acting professions, methods used and premises for the experts’ conclusions. Data
were summarized with descriptive measures. Danish and Swedish experts had a more frequent
use of tests and instruments than Norwegian experts. Swedish experts used the Global
Assessment of Functioning Scale (GAF), and they diagnosed the observant according to
DSM-IV. The Scandinavian experts rarely referred to the tests they had applied nor did they
refer to any kind of theory or literature as a basis for their conclusion. Only a few reports
expressed doubt concerning the validity of the conclusion. Stating all the premises of the forensic
psychiatric examination might improve the quality of the reports by doing them more explicit
and verifiable. More use of standardized actuarial-based methods and more attention to
knowledge about clinical judgemental processes is recommended.