Forensic Psychiatric Outpatient Consultation Service at the Psychiatric Department of Saint John Hospital, Budapest Between 2007-2014

Abstract

Our forensic psychiatric outpatient consultation service for the Main Detention Centre of Budapest (MDC) started in 2007 May. Before our consultations the clients are examined by the medical doctor of the MDC, and his/her decision to ask for psychiatric examination with specific questions. The clients are transferred by the police to the hospital.

We analysed retrospectively all the cases of 7 years.

Objectives

statistical and qualitative analysis of clients’ reports of 529. The clients were before judicial process and detained in custody in the MDC.

Aims

to analyse the frequent problems and the clinical questions by the referral doctors, the necessity of these problems, and the severity of the clients symptoms.

Methods

We analysed all the files, and the objectives: referral diagnosis, diagnosis after our examination, suicide intentions, intentional aggravation, heteroagression, psychiatric history, drug use and dependency, current medication, presence of psychotic symptoms.

Results

Between 2007-2014 September there were 529 examinations. The most frequent question was to evaluate the suicide risk and to measure the necessity of the admission to an acute psychiatric unit. The number of the referrals remains 80-90 per year since 2012, 33% of the examined clients were diagnosed with personality disorder at our unit.

Conclusion

Specialised service is needed (Forensic Psychiatric Unit) to evaluate more precisely the severity of suicide risk, and to exclude the intentional behaviour. Consultation and training of the MDC medical staff can enhance the more precise psychiatric evaluation especially to differentiate between personality and major psychiatric disorders.