Objective: To explore the relationship between conclusions of forensic psychiatric evaluation on ”mental status at the time of offense (MSO)” and their acceptance by the courts. Methods: Forensic psychiatric evaluation reports and corresponding court decisions of all criminal cases referred to Taipei City Psychiatric Center for MSO evaluation after April 23, 1981 for which the investigation or trial had been completed prior to September 1, 2003 were included. Concordance between each category of MSO conclusion and the court decision was analyzed. Results: The sample consisted of 428 MSO conclusions from 419 evaluees/evaluations. Overall concordance was 93.9% (402/428). Conclusions of ”diminished responsibility” reached the highest concordance (99.3%) and were followed by those of ”full responsibility” (95.9%). Conclusions of ”insanity” were least frequently accepted (83.6%). Differences between the concordance rate for each conclusion were significant (p<0.001). Excluding cases referred from the District Attorneys' Office, concordance for conclusions of ”diminished responsibility” remained the highest (99.3%), followed by those for ”full responsibility” (95.8%) and ”insanity” conclusions (82.1/). Differences between the concordance rate for each conclusion remained significant (p<0.001). Conclusion: Overall, the concordance between MSO conclusions and court decisions is high in Taiwan. Concordance for each category of conclusion, however, was significantly different. Mutual untranslatability between psychiatric-psychological and legal concepts, and the courts' tendency to preserve full adjudicative power over unlawful behaviors may account for these differences. The finding that standards applied by the courts on the issue of insanity varied and that qualified evaluators could draw different MSO conclusions from the same case, both illustrated by case studies, warrant re-examination. Since the Criminal Code has recently been revised, evaluators must familiarize themselves with, and reach consensus among themselves on the key concepts of the new insanity defense standards.
Objective: To explore the relationship between conclusions of forensic psychiatric evaluation on ”mental status at the time of offense (MSO)” and their acceptance by the courts. Methods: Forensic psychiatric evaluation reports and corresponding court decisions of all criminal cases referred to Taipei City Psychiatric Center for MSO evaluation after April 23, 1981 for which the investigation or trial had been completed prior to September 1, 2003 were included. Concordance between each category of MSO conclusion and the court decision was analyzed. Results: The sample consisted of 428 MSO conclusions from 419 evaluees/evaluations. Overall concordance was 93.9% (402/428). Conclusions of ”diminished responsibility” reached the highest concordance (99.3%) and were followed by those of ”full responsibility” (95.9%). Conclusions of ”insanity” were least frequently accepted (83.6%). Differences between the concordance rate for each conclusion were significant (p<0.001). Excluding cases referred from the District Attorneys' Office, concordance for conclusions of ”diminished responsibility” remained the highest (99.3%), followed by those for ”full responsibility” (95.8%) and ”insanity” conclusions (82.1/). Differences between the concordance rate for each conclusion remained significant (p<0.001). Conclusion: Overall, the concordance between MSO conclusions and court decisions is high in Taiwan. Concordance for each category of conclusion, however, was significantly different. Mutual untranslatability between psychiatric-psychological and legal concepts, and the courts' tendency to preserve full adjudicative power over unlawful behaviors may account for these differences. The finding that standards applied by the courts on the issue of insanity varied and that qualified evaluators could draw different MSO conclusions from the same case, both illustrated by case studies, warrant re-examination. Since the Criminal Code has recently been revised, evaluators must familiarize themselves with, and reach consensus among themselves on the key concepts of the new insanity defense standards.