مجله پزشکی قانونی
سال سی‌ام شماره 3 (پیاپی 111، پاییز 1403)

Considering the importance of issuing correct and valid legal medical expert opinions about the financial incapability due to dementia, This study aims to examine the level of agreement between the expert opinions issued by the provincial legal medicine commission offices and the central legal medicine commission office and the effect of the use of diagnostic criteria such as the psychological test (MMSE), the existence of the results of neuroimaging, external consultations and the presence of a neurologist in expert meetings has been done on the level of this agreement.

The present study was conducted on 122 cases of people claiming financial incapability due to dementia referred to the central medical commission from September 2022 to September 2023. To examine the level of agreement (reliability) of expert opinions issued by Cohen's kappa coefficient, to analyze data from descriptive statistics methods and to investigate the relationship between some diagnostic criteria on the level of agreement, logistic regression was used using SPSS 19 software.

There is a good agreement with the Kappa coefficient of 0.626 between the expert opinions issued regarding the financial incapability or the financial capability in the last commission held in the provinces and the Central Commission, and there is a good agreement with the Kappa coefficient of 0.681 between the expert opinions issued regarding the time of onset of financial incapability. In 76.2% of cases, there was no test MMSE, 77.8% of external consultations, 24.6% of neuroimaging or related results. The three variables have a significant and positive effect on the level of agreements made.

Although the level of agreement in the expert opinions issued between the last commission held in the province and the central commission is good, the agreement between the interrater should be relied on as a reliable source when the interrater is made according to specific and standard diagnostic criteria. Therefore, the use of standard and same instruction, the use of new psychometric tools for more accurate diagnosis of the mental capacity of patients, and the continuous training of psychiatrists and psychologists are necessary.

Intellectual development is essential for assessing criminal responsibility and can impact judicial decisions. This study aimed to evaluate the intellectual development of offenders under 18 years old referred to the General Department of Forensic Medicine in Fars.

Individuals under 18 who were referred to the General Department of Forensic Medicine in Fars for assessment of intellectual development were examined.

An analysis of cases from 2013 to 2015 identified 103 individuals under 18, including 100 males (97%), 2 females (2%), and 1 bisexual (1%). Most were single (98%). Educationally, 72 (69.6%) had less than a diploma, 21 (20.6%) had a diploma, and 10 (9.8%) were illiterate. In terms of occupation, 42 were students (40.2%), 35 were self-employed (34.3%), and 26 were unemployed (25.5%). The most frequent crime was murder, committed by 31 individuals (30.4%). Regarding mental maturity, 80.4% exhibited no intellectual growth at the time of their offenses, while only 18.6% demonstrated development. Additionally, 38.2% had a history of mental health issues.

The findings indicate that assessments of intellectual development should incorporate psychological factors such as IQ, emotional intelligence, rational intelligence, social intelligence, and personality.

The use of psychiatric medications is on the rise. Medical students, due to academic pressures and unique life circumstances, especially during clinical training, are more prone to taking these medications. This study aims to investigate the prevalence of psychiatric medication use among medical students at Tehran University of Medical Sciences and to identify the factors associated with it.

This cross-sectional study used an online survey that gathered demographic details along with data regarding the consumption of psychiatric drugs. Information such as the types and amounts of medications taken, reasons for usage and prescription methods was gathered. Subsequently, the data was analyzed using SPSS software.

The results indicated that 39.16% of the students had used psychiatric drugs in their lifetime, with 22.73% currently using them. Anxiety (26.57%) and depression (23.43%) were the most commonly reported reasons for use.Students in clinical stages were more likely to use psychiatric medications.

This study demonstrates an ongoing increase in psychiatric drug use as students’ progress in their medical education. The findings also highlight the need for preventive and supportive interventions to enhance the mental health of medical students

Injuries and deaths caused by road traffic accidents are increasing daily. One of the important causes of disability and death in Iran is traffic accidents related to motorcyclists. This study aimed to investigate the epidemiology of traffic accidents leading to the death of motorcyclists in 2011 to 2021.

In this study, using the available data of the Forensic Medical Organizationof the country, it was conducted among Iranian motorcyclists who died in traffic accidents between in 2011 to 2021. Data were collected using a checklist and analyzed in SPSS 23.

During the years 2011 to 2021, 42685 people died due to motorcycle accidents, of which 95.6% were men and 4.4% were women. Also under 30 years old 53.6% died. Most victims died in hospital (51.2%) due to head injuries (54.6%). The mortality rate was higher in people with the less than diploma (78.4%) and self-employed (39.2%). Among the victims 47.3% died on suburban roads and 39% died on inner city roads. Among the dead, 78% were drivers, and 20.6% were passengers. Also, most accidents (48%) occurred on suburban roads.

In order to reduce accidents, preventive strategies such as respect for laws, access to essentials and knowledge of the correct use of safety devices are recommended, especially among young men.

Aggression is the second most common complaint in the psychiatric emergency department. The aim of this study was to determine the frequency of various psychiatric disorders among aggressive patients, which could be useful in their treatment process.

The present study is a descriptive and cross-sectional study conducted in 2023. The sample was selected through census. 1027 patients with various psychiatric diagnoses were identified, and finally 294 were eligible for inclusion in the study. After identifying the patients, their medical records were reviewed and based on that information, the checklist was completed.

66 (22.4%) of the patients with bipolar I disorder presented in the mania phase as manic. The most common mental illnesses identified in men and women were: 41 (32.3%), 25 (15%) with bipolar I disorder, manic phase, and 32 (25.1%), 25 (15%) with bipolar I disorder, manic phase. 38 (25%) of patients under 38 years of age had bipolar I disorder, manic phase. There was also a significant relationship between age (P=0.008) and gender (P=0.049) with psychiatric disorders (P<0.05).

Aggression, as a worrying behavior for the general health of the community, can often be accompanied by psychiatric disorders. Bipolar disorder, especially in the manic phase (manic or non-manic), has the highest frequency among aggressive patients, which can be related to gender and age.

In contemporary societies, compensating for bodily injuries resulting from accidents and negligence through the payment of damages is a legal action and a moral necessity, significantly impacting the lives of victims and social justice. Accordingly, the present study aims to investigate medical malpractice cases referred to legal medicine in Isfahan in terms of payment of compensation by medical liability insurance companies in cases of medical staff convictions.

This descriptive, cross-sectional, retrospective study analyzed cases of healthcare staff negligence that led to their condemnation. Relevant information was collected through telephone interviews to determine the method and extent of compensation payments to the victims. Data were statistically analyzed using SPSS.

The majority of negligence leading to condemnation was attributed to physicians (89.1%), midwives (8.1%), and other healthcare staff (2.18%). A definitive ruling had been issued in 37.83% of all cases, among which 57.84% received full compensation, 21.42% received partial damages, and 14.28% had no compensation awarded at all. The reasons for the non-payment or delayed payment of compensation by insurance companies included non-compliance with regulations, repeated condemnations, the passage of more than 4 to 6 years since the insurance policy's expiration, and deficiencies in documentation.

The time gap between the occurrence of the error and the issuance of the ruling significantly influences the compensation payment process, and the presence of multiple liable parties adds to the ambiguity and delays in payments. Furthermore, the lack of inadequacy of information regarding healthcare liability insurance and the failure to review insurance policies are serious issues, as most insured individuals are unaware of the terms. Consequently, insurance companies need to take steps to introduce specialized representatives to the healthcare staff.