Publications by authors named "Gabriele Mandarelli"

After the approval of the law 81/2014, a new care-framework has been outlined for the psychiatric offenders in Italy and alternative facilities have been gradually activated. This pilot national survey was conducted in order to explore the attitudes of a panel composed by Italian psychiatrists, engaged in forensic not-engaged in forensic activities, on the changes related to the application of the law. We employed an ad-hoc questionnaire named SOPF: (in english: The Psychiatric Forensic Assessment after the Closing of the Forensic Psychiatric Hospitals) to explore the opinions regarding ten relevant issues in the field of forensic psychiatry and forensic assessment.

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Inmates' food refusal is a large-scale phenomenon raising clinical, ethical, and professional responsibility issues. Obtaining a clinical balance of the right to refuse food with the right to protect the inmate's health can be a challenging process. Several reasons may support inmates' choice of refusing food, including political or protest reasons, as well as psychiatric disorders.

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Article Synopsis
  • Since 2015, Residencies for Execution of Security Measures (REMS) in Italy have treated dangerous offenders acquitted for mental disorders, primarily those with schizophrenia spectrum disorders (SSD) and personality disorders (PD).
  • The study analyzed data from 528 REMS patients, revealing that the PD group had more females and substance abuse issues, while the SSD group often involved serious offenses like homicide.
  • Findings suggest that patients with PD show more violent behavior in REMS, while SSD patients are treated with higher doses and combinations of antipsychotics, highlighting the need for tailored treatment approaches.
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Article Synopsis
  • Eating disorders are severe conditions that require weight restoration and psychotherapy, but many patients often refuse treatment, raising concerns about their ability to make decisions regarding their care.
  • A study involving 45 women at a psychiatric unit in Rome assessed various psychiatric symptoms and decision-making capacity, revealing that 67% of participants exhibited low decision-making capacity, with even higher rates among those with Anorexia Nervosa and Bulimia Nervosa.
  • Specific psychological symptoms can either impair or enhance a patient's ability to make informed decisions, indicating that clinicians should carefully evaluate their patients' decision-making capacity to provide appropriate support.
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Objective: The primary aim of this study was to conduct a comparative analysis of homicide cases and their perpetrators with psychotic illnesses in Italy and Turkiye, identifying the extent to which country-specific factors influence offender profiles and crime-scene characteristics.

Method: This cross-national chart review study recruited individuals with psychotic illnesses from forensic psychiatric centers in Italy and Turkiye who were referred for criminal responsibility assessments. Data were collected on the offenders' background characteristics, psychiatric history, victim profiles, and crime-scene details.

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The relationship between autism spectrum disorder (ASD) and sexual offending (SO) is an overlooked issue, both in clinical practice and in research. Based on a pre-specified protocol (PROSPERO: CRD42024501598), we systematically searched Pubmed and Scopus, between January 1st, 1994 and January 12th, 2024, for articles related to SO in ASD. Study quality was assessed with study design-specific tools (Study Quality Assessment Tools, NHLBI, NIH).

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Unlabelled: The possible tendency of subjects to decrease, hide, or omit symptomatic aspects of their mental functioning is one of the main problems in forensic psychological and psychiatric evaluations. We aimed at verifying the possible existence of significant differences in the Millon Clinical Multiaxial Inventory-III (MCMI-III) scales scores between a sample of dissimulators ( = 40) and their non-dissimulator counterpart matched by age, sex, and diagnosis. Cases and comparisons were retrieved from the archive of a single university forensic psychiatric centre between 2013 and 2022.

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Background: In the age of digitalization and big data, personal health information is a key resource for health care and clinical research. This study aimed to analyze the determinants and describe the measurement of the willingness to disclose personal health information.

Methods: The study conducted a systematic review of articles assessing willingness to share personal health information as a primary or secondary outcome.

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The Italian mafia organizations represent a subculture with values, beliefs and goals that are antithetical to and undermining of the predominant society. The conduct of individual members includes such extreme violence for material gain, it may at least superficially suggest a severe personality disorder. Since the first edition of the DSM and into the 21st century, various terms have been used, sometimes interchangeably, but over time inconsistently, to designate the mentality and practices of mafia members.

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Insanity evaluations are often criticized for their-alleged-lack of objectivity, reliability and transparency. Structured tools to guide and support forensic evaluators during these evaluations have been developed-but they are rarely employed in forensic practice. In the present article, we consider the value of these tools for forensic practice in terms of opportunities and limitations.

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Introduction: Interest in identifying the clinical implications of the neuropathophysiological background of schizophrenia is rising, including changes in cortical gyrification that may be due to neurodevelopmental abnormalities. Inpatients with schizophrenia can show abnormal gyrification of cortical regions correlated with the symptom severity.

Methods: Our study included 36 patients that suffered an acute episode of schizophrenia and have undergone structural magnetic resonance imaging (MRI) to calculate the local gyrification index (LGI).

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While denial of pregnancy and neonaticide are rare, they are potentially associated and share some risk factors. Neonaticide has been proposed as the extreme outcome of a denial of pregnancy. However, the process leading to such a possible outcome is not yet fully understood.

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Background: The need for highly effective therapies in rheumatologic diseases has led to the widespread and growing use of a heterogeneous class of molecules called biological agents. The increasing experience with biological agents has raised concerns about safety and efficacy issues that need to be discussed in the informed consent acquisition process.

Methods: The authors performed a review of the literature on biological agents focusing on their most important characteristics concerning the informed consent procedures.

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To evaluate the characteristics of the reported workplace violence in a psychiatric intensive care unit (PICU) by analyzing an electronic hospital incident reporting system (IRS). One hundred thirty reports were retrieved from January 2017 to June 2020, referring to assaults committed by patients (71% males) with an average age of 29.8 years (SD, 14.

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The insanity defense represents one of the most controversial and debated evaluations performed by forensic psychiatrists and psychologists. Despite the variation among different jurisdictions, in Western countries, the legal standards for insanity often rely on the presence of cognitive and/or volitional impairment of the defendant at the time of the crime. We developed the defendant's insanity assessment support scale (DIASS) based on a wide view of competent decision-making, which reflects core issues relevant to legal insanity in many jurisdictions.

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In the forensic field, most studies employing virtual reality (VR) interventions have focused on offenders. The validity and safety of VR applications for victims of crime are still unclear. Following PRISMA guidelines, a systematic review on VR interventions for crime victims was performed to assess the efficacy, acceptability by patients, and cost-effectiveness of these interventions compared to in-person care.

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Few data exist regarding treatment with antipsychotics in forensic psychiatric patient populations with high social dangerousness. We performed a secondary analysis of 681 patients treated with at least one antipsychotic, extracted from a 1-year observational retrospective study, conducted on 730 patients treated in the Italian Residencies for Execution of Security Measures (REMS) (96.4% of the REMS population).

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Unlabelled: The SARS-CoV-2 spread is a threatening and challenging issue for correctional systems worldwide because of many factors, particularly overcrowding and of the intrinsic characteristics of the population. The prevention measures adopted by the Italian Government were aimed to protect and preserve both inmates' and prison workers' health. The present study aimed to evaluate the efficacy of the adopted strategies.

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Sex-offenders are at risk of criminal recidivism. For the treatment to be truly effective, it must be individualized. For this purpose, an accurate assessment should focus on criminological, psychological, and psychopathological features.

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Unlabelled: Initial evidence exists on a subtype of matricide committed by subjects suffering from severe mental disorders. Matricide perpetrators often undergo a forensic psychiatric evaluation during the subsequent criminal trial because of supposed legal insanity. The few studies on matricide by mentally disordered perpetrators suggested a possible association between such extreme form of violence and schizophrenia spectrum disorders, especially in case of active delusions or hallucinations.

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Intentional homicide, a declining phenomenon in Italy, represents one of the most extreme forms of violence. A specific subgroup of homicidal assailants is represented by those affected by mental disorders, where the relationship between psychopathology and characteristics of the homicidal attack is not yet fully understood. We analyzed the case files of 187 homicides or attempted homicides, in which the defendant had undergone a forensic psychiatric evaluation within the previous 10 years from a single forensic psychiatric center.

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