The Impact of COVID-19 Pandemic on Forensic Psychiatric Cases in a University Hospital in Turkey

Yıl 2024, Cilt: 38 Sayı: 3, 195 - 204, 31.12.2024

Doğancan Sönmez , Meltem Puşuroğlu , Mehmet Baltacıoğlu , Cicek Hocaoglu , Bulent Bahceci

Öz

Introduction: The coronavirus (COVID-19) pandemic has caused various negative effects on human life in terms of health, economics, and social aspects. Just as the pandemic has had an impact on many areas of life and medicine, it may also have had an impact on forensic psychiatry, which is the intersection of law and psychiatry. In this study, we aimed to investigate the impact of the COVID-19 pandemic on adult forensic psychiatric cases and contribute to the literature.

Method: This study is a retrospective, single-center study conducted at xx University Hospital. The files of 978 forensic psychiatric cases admitted within four years were scanned from the hospital data recording system. In the study, all cases applied for forensic psychiatric evaluation between 11.03.2020-03.03.2022 (pandemic period) and 03.03.2018-11.03.2020 (pre-pandemic period) were included. These two groups, including cases from the pandemic and pre-pandemic periods, were compared in terms of sociodemographic, criminal and forensic psychiatric characteristics.

Results: A total of 978 cases were included in our study, 451 in the pre-pandemic period and 527 in the COVID-19 pandemic period. An increase in the number of forensic psychiatric cases has been detected during the pandemic. It has been determined that there is a significant increase in forensic psychiatric cases sent especially due to Article 432 of the Turkish Civil Code (TCC 432) and Article 32 of the Turkish Penal Code (TPC 32). While 115 (25.5%) of the pre-pandemic period applications were TPC 32 and 69 (15.3%) were TPC 432, 209 (39.7%) of the pandemic period applications were TPC 32 and 158 (30%) were TCC 432 (p < 0,001).

Conclusion: Little information is available on how a pandemic may affect forensic psychiatric referrals. The most important result of our study is the detection of an increase in cases referred under TMK 432 and TCK 32. The most important feature of our study is that it is one of the limited number of studies in the literature investigating the effect of the pandemic process on forensic psychiatric cases and is also the first study in our country. In conclusion, this study provides an important basis for understanding the impact of the pandemic on forensic psychiatry and developing appropriate intervention strategies.

Anahtar Kelimeler

Forensic psychiatry, Forensic medicine, COVID-19, Pandemic, Turkish Penal Code, Turkish Civil Code

COVID-19 Pandemisinin Türkiye’de Bir Üniversite Hastanesi Psikiyatri Kliniğine Başvuran Adli Psikiyatrik Vakalar Üzerine Etkisi

Öz

Giriş: Coronavirus (COVID-19) pandemisi sağlık, ekonomik ve sosyal açıdan insan yaşamında çeşitli olumsuz etkilere yol açmıştır. Pandeminin hayatın ve tıbbın birçok alanda etkisi olduğu gibi hukuk ile psikiyatrinin kesişim alanı olan adli psikiyatri üzerinde de etkisi olmuş olabilir. Bu çalışmada, COVID-19 pandemisinin erişkin adli psikiyatrik vakalar üzerindeki etkisini araştırıp literatüre katkı sağlamayı amaçladık.

Yöntem: Bu çalışma xx Üniversite Hastanesinde yapılan retrospektif, tek merkezli bir çalışmadır. Dört yıllık süre içinde başvuran 978 adli psikiyatrik vakanın dosyaları üç aylık süre içinde hastane veri kayıt sisteminden taranmıştır. Çalışmada 11.03.2020-03.03.2022 (pandemi dönemi) ve 03.03.2018-11.03.2020 (pandemi öncesi dönem) arasında adli psikiyatrik değerlendirme için başvuran tüm vakalar çalışmaya dahil edilmiştir. Pandemi ve pandemi öncesi dönemdeki vakaları içeren bu iki grup sosyodemografik, kriminal, adli psikiyatrik özellikleri açısından karşılaştırılmıştır.

Bulgular: Çalışmamıza pandemi öncesi dönemde 451, COVID-19 pandemisi döneminde ise 527 olmak üzere toplam 978 vaka dahil edilmiştir. Pandemi sırasında kurumumuza başvuran adli psikiyatrik vakaların sayısında artış saptanmıştır. Özellikle Türk Medeni Kanunu’nun 432. maddesi (TMK 432) ve Türk Ceza Kanunu’nun 32. maddesi (TCK 32) nedeniyle gönderilen adli psikiyatrik vakalarda ciddi artış olduğu saptanmıştır. Pandemi öncesi dönem başvurularının 115’i (%25,5) TCK 32 ve 69’u (%15,3) TMK 432 iken pandemi dönemi başvuranların 209’u (%39,7) TCK 32 ve 158’i (%30) TMK 432’dir (p < 0,001).

Sonuç: Bir pandeminin adli psikiyatrik başvuruları nasıl etkileyebileceğine ilişkin çok az bilgi mevcuttur. Çalışmamızın en önemli sonucu TMK 432 ve TCK 32 kapsamında gönderilen vakalarda artış saptanmasıdır. Çalışmamızın en önemli özelliği pandemi sürecinin adli psikiyatrik vakalar üzerindeki etkisini araştıran literatürdeki sınırlı sayıda çalışmadan biri ayrıca ülkemizdeki ilk çalışma olmasıdır. Sonuç olarak, bu çalışma, pandeminin adli psikiyatri üzerindeki etkisini anlamak ve uygun müdahale stratejileri geliştirmek için önemli bir temel sağlamaktadır.

Anahtar Kelimeler

Adli psikiyatri, Adli tıp, COVID-19, Pandemi, Türk Ceza Kanunu, Türk Medeni Kanunu

Kaynakça

• Aydın S, Batmaz S, Aslan ÜEA, Çelikbaş ÜZ, Çetin ÜS. Multidisciplinary approach to evaluation of forensic psychiatry reports. Bulletin of Legal Medicine. 2021;26(1).
• Özcanli T, Ortaköylü L. Forensic medicine application on forensic psychiatry report arrangement. Turkiye Klinikleri J Psychiatry-Special Topics. 2011;4(1):22-6.
• Öncü F, Sercan M. Forensic psychiatry determination of criminal responsibility in criminal law. Forensic Psychiatry Practice Guide. 2014.
• Moreno C, Wykes T, Galderisi S, Nordentoft M, Crossley N, Jones N, et al. How mental health care should change as a consequence of the COVID-19 pandemic. The Lancet Psychiatry. 2020;7(9):813-24.
• Kozloff N, Mulsant BH, Stergiopoulos V, Voineskos AN. The COVID-19 global pandemic: implications for people with schizophrenia and related disorders. Schizophrenia Bulletin. 2020;46(4):752-7.
• Telles LEB, Valença AM, Barros AJS, da Silva AG. Domestic violence in the COVID-19 pandemic: a forensic psychiatric perspective. Revista Brasileira de Psiquiatria. 2021;43(3):233-4.
• Polat S, Hocaoglu C. Clinical features, cases of psychiatric diagnosis and socio-demographic characteristics of patients with polyclinics of forensic psychiatry in education research hospital. Ortadogu Medical Journal. 2020;12(2):290-4.
• Örüm MH. Evaluation of forensic cases admitted to Kahta State Hospital. J Phoenix Medical Journal. 2021;3(1).
• Kalenderoğlu A, Yumru M, Selek S, Savaş HA. Evaluation of cases, referred to forensic psychiatry unit in Gaziantep University. Neuropsychiatry Archive. 2007.
• Kocakaya H, Özturan DD. Retrospective analysis of cases admitted to an university hospital psychiatry outpatient clinic. Kırıkkale University Faculty of Medicine Journal. 2023;25(2):285-92.
• Koç A, Parlak E. Diagnostic and sociodemographic characteristics of cases evaluated for criminal liability in the forensic psychiatry outpatient clinic: 6.5-year retrospective study. Turkiye Klinikleri Journal of Forensic Medicine & Forensic Sciences. 2023;20(2).
• Bolu A, Toygar M, Pan E, Erdem M, Ünlü G, Balıkçı A. Evaluation of forensic cases in a training hospital psychiatric clinic; five-year review. Gülhane Medical Journal. 2014;56:1-4.
• Yumru M, Haluk A, Tutkun H, Herken H, Karasu M, Dülger HE. Evaluation of cases examined from a forensic psychiatric perspective at Gaziantep University: high rates of alcohol-substance use. Anatolian Journal of Psychiatry. 2005;6:30-5.
• Civil Arslan F, Özkorumak Karagüzel E, Sağlam Aykut D, Kocagöz K, Kutlu G, Baz A, et al. Examination of forensic cases admitted to the psychiatry outpatient clinic of a university hospital. Journal of Forensic Medicine. 2016;30(3):205-12.
• Pilan BŞ, Kaleli İİ, Erermiş S, Kaya A, Köse S, Özbaran B, et al. Child and adolescent forensic psychiatry experiences during the COVID-19 pandemic. Journal of Dr Behcet Uz Children’s Hospital. 2022;12(1).
• Isık GÇ, Cinpolat R, Kiris E, Cevik Y. Evaluation of forensic medical cases during COVID-19 pandemic. Clinical and Experimental Health Sciences. 2022;12(1):205-8.
• Sarı Doğan F, Öztürk TC. The effect of the COVID-19 pandemic on forensic cases admitted to an emergency department. Forensic Science, Medicine and Pathology. 2023;19(2):169-74.
• Sevgi A, Şahsenem Ö, Ayşenur K, Beyza K, Melike P, Özge Y, et al. Effects of COVID-19 pandemic on forensic cases in a paediatric emergency department in Türkiye. Eastern Mediterranean Health Journal. 2023;29(4):271-5.
• Cengisiz C, Tamam L, Dizdar G, Paşaoğlu E, Yilmaz E. Comparison of suicidal tendencies before and during the COVID-19 pandemic in a city in the western region of Turkey. Cukurova Medical Journal. 2022;47(3):1095-104.
• Ataman K, Bozkurt V, Göka E, İlhan M, Yildirim N, Çiftçi E, et al. Social effects of the COVID-19 pandemic. Turkish Journal of Hygiene and Experimental Biology. 2021;78(3).
• Roesch E, Amin A, Gupta J, García-Moreno C. Violence against women during covid-19 pandemic restrictions. British Medical Journal Publishing Group; 2020.
• Mohler G, Bertozzi AL, Carter J, Short MB, Sledge D, Tita GE, et al. Impact of social distancing during COVID-19 pandemic on crime in Los Angeles and Indianapolis. Journal of criminal justice. 2020;68:101692.
• Gradoń K. Crime in the time of the plague: Fake news pandemic and the challenges to law-enforcement and intelligence community. Society Register. 2020;4(2):133-48.
• Ahmad T. Corona virus (COVID-19) pandemic and work from home: challenges of cybercrimes and cybersecurity. Available at SSRN 3568830. 2020.
• Ayas Ö., Analysis of a year with pandemic in the context of theft crime: example of the Turkey and England. Journal of Criminology and Social Sciences. 2021.
• McDonald JF, Balkin S. The COVID-19 virus and the decline in crime. Social Science Electronic Publishing. 2020.
• Layman HM, Thorisdottir IE, Halldorsdottir T, Sigfusdottir ID, Allegrante JP, Kristjansson AL. Substance use among youth during the COVID-19 pandemic: a systematic review. Curr Psychiatry Rep. 2022;24(6):307-24.
• Ayas Ö., Comparative crime research drug offence in Turkey and England by legal and social aspects. Crime and Penal Journal. 2020:829-48.
• Carlyle M, Leung J, Walter ZC, Juckel J, Salom C, Quinn CA, et al. Changes in substance use among people seeking alcohol and other drug treatment during the COVID-19 pandemic: evaluating mental health outcomes and resilience. 2021;15:11782218211061746.
• Roberts A, Rogers J, Mason R, Siriwardena AN, Hogue T, Whitley GA, et al. Alcohol and other substance use during the COVID-19 pandemic: a systematic review. Drug and Alcohol Dependence. 2021;229:109150.
• Smith CL, Waters SF, Spellacy D, Burduli E, Brooks O, Carty CL, et al. Substance use and mental health in pregnant women during the COVID-19 pandemic. Journal of Reproductive and Infant Psychology. 2022;40(5):465-78.
• Moreno C, Wykes T, Galderisi S, Nordentoft M, Crossley N, Jones N, et al. How mental health care should change as a consequence of the COVID-19 pandemic. The Lancet Psychiatry. 2020;7(9):813-24.