Analysis of concordance between conclusions of forensic psychiatric evaluation and court decisions after 2005 Criminal Code Amendment in a Taiwan psychiatric hospital.

The aim of the study is to explore the relationships between results of forensic psychiatric evaluation on "mental status at the time of the offense (MSO)" and the final decision of the courts after the amendment of the Criminal Code in 2005. All criminal cases referred to Taipei City Psychiatric Center for MSO evaluation from July 1, 2006, to December 31, 2015, were reviewed, and only the completed trials were included. Concordance rates in each category of MSO conclusion and the court decision were analyzed and compared. The sample consisted of 366 MSO evaluations. Overall concordance was 95.6% (350/366). The concordance rate in conclusions of "full responsibility", "diminished responsibility", and "insanity" were 98.3% (177/180), 97.7% (126/129) and 91.9% (34/37) separately, and these three groups showed no statistical significance after compared with the other. Conclusions of "intentionally or negligently induced insanity or diminished responsibility" reached the lowest concordance at 65.0% (13/20) and compared with the other three groups all showed statistical significance. We found, after the amendment of Criminal Code, the lowest concordance rate in those conclusions of "insanity" before change seemed diminished. But the conclusions of "intentionally or negligently induced insanity or diminished responsibility" became the major origin leading to discordance. Comparing to the previous finding in the same hospital which revealed separate conclusions resulted in statistically significant concordance rates, the effect of the amendment seems likely to improve the consensus among psychiatric experts and trial judges except substance and alcohol related mental condition.