“Legally insane or not“ – systematic recording and assessment of psychotic symptoms in forensic psychiatric reports

The academic competence in the field of forensic psychiatry in Norway is very limited. In the last years basis for defining a defendant as mentally retarded or unconscious has slightly been studied, but there are no update studies on the bases for defining a defendant as psychotic in Norway. Also, there are no systematic reviews on the quality of forensic reports. There is an assumption that the quality varies and is unsatisfactory, but this needs to be studied and the academic competence needs to be improved.  The increased academic competence in the field of forensic psychiatry and psychoses is mandatory to aid the law system and politicians to make the right decisions. Also, this competence is mandatory to improve the guidelines for the forensic work of the court appointed psychiatrists / psychologists.  Forensic experts in Norway has no systematic assessment of mental health, and it is not required that the experts should use reliable and valid instruments in the assessment of psychotic symptoms in the forensic reports. As the conclusions in court regarding legal insanity or not have vast consequences for the defendant as well as for health care system and society it is important to improve the academic quality in the field.

This project has a descriptive design. The group of three expert evaluators will identify to what extent Norwegian experts are using structured diagnostic and symptom assessment interviews, and in case, which instruments they are using.  The quality and reliability of the psychotic symptom descriptions in the forensic reports will be examined by letting the three raters use the PANSS to rate the symptoms described in the reports. The agreements between the three raters will be assessed, to find to what extent their conclusions correspond to the conclusion of the forensic experts in their report.  The third objective is to determine whether there has been a significant change in the description and registration of psychotic symptoms in the reports finished before and after the trial of July 22 terrorist in April-June 2012.