Neuropsychological Assessment and Verification of Cognitive Impairments in Forensic Psychiatry Patients

In modern clinical psychiatry, there is a tendency to introduce the principle of quasi-dimensional assessment, which can be facilitated by the use of specialized diagnostic methods such as neuropsychological examination. The purpose of the study is to clarify the possibilities of neuropsychological examination during forensic psychiatric examination for persons held criminally responsible. As part of the forensic psychiatric examination of persons brought to criminal responsibility on the basis of the Serbsky State Scientific Center for Social and Forensic Psychiatry Ministry of Health of the Russian Federation, 113 men (age 42±13) were examined with established groups of diagnoses, including organic, personality disorders, as well as schizophrenic spectrum disorders, disorders associated with the use of psychoactive substances. Of these, 50 people were declared “insane” and 63 were “sane”. A neuropsychological examination was performed using qualitative syndrome and quantitative analysis. In individuals with organic mental disorders (OMD), there were more pronounced disorders of neurocognitive functioning compared to those surveyed with other mental disorders. In addition, persons with OMD who were recognized as “insane”, compared with persons recognized as “sane”, had more pronounced disorders in such parameters as: programming, regulation and control, neurodynamic characteristics, auditory—speech memory, with primary interest - frontal (p=0.004), temporal (p=0.004), and subcortical structures (p=0.005). The results of a neuropsychological examination can be used to verify an expert decision at the level of both medical and psychological criteria, primarily in the examination of persons suffering from an organic mental disorder.

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