Background. The study was aimed at an analysis of forensic psychiatric opinions issued on the grounds of observation or outpatient examination of substance abusing or substance dependent perpetrators, or those acting under the influence of psychoactive substances. Opinions submitted by expert psychiatrists from six psychiatric facilities were compared with the practice of forensic experts from the Institute of Psychiatry and Neurology.
Methods. Using a questionnaire developedfor the purposes of this study 50 forensic psychiatric opinions based on observation (21 cases) and outpatient examination (29 cases) were analysed. The opinions had been issued in the years 1992-2002 by expert psychiatrists from six randomly selected psychiatric hospitals (in Bolesławiec, Cibórz, Choroszcz, Międzyrzecz, Toruń, Świecie). A number of variables were analysed: the perpetrator 's age, sex, psychiatric diagnosis, type and number of crimes committed, type and number of psychoactive substances ingested, as well as the perpetrator's accountability at the time of committing crime.
Results. Only two opinions concerned women. Drug dependence was diagnosed in 38 perpetrators, drug abuse in 12, and concomitant alcohol dependence in 8 cases. Most of the perpetrators were using more than one psychoactive substance. Stimulants and opiates were the substances used most frequently, followed by cannabinoles and sedatives, while hallucinogens and inhalants were definitely rare. Personality disorders, mostly dissocial personality, were found in 31 cases, while in 2 cases - personality disorders of organic origin. A majority of perpetrators had been under the influence of psychoactive substances tempore criminis, but in 34 cases the experts found no grounds for recognising either inaccountability or highly diminished accountability. In 3 cases the perpetrator 's inaccountability at the time of committing the criminal act was recognised (Article 31 par. 1 of the Penal Code), but a motion was filed for Article 31, par. 3 of the Penal Code. In 3 perpetrators highly diminished accountability was recognised by the experts. The majority of criminal acts were against property (55%), against the Act on Counteracting Drug Dependence (17%), against the family (15%), while only 13% of offences were against life and health.
Conclusions. Irrespective of the psychiatric facility, there was a consensus between the experts that if criminal acts had been committed under the influence ofpsychoactive substances or in the state ofsubstance dependence, there were no grounds for recognising inaccountability, except for psychotic disorders - unless the perpetrator could have foreseen their occurrence. A motion for diminished accountability is justified if the perpetrator suffered from severe symptoms of the withdrawal syndrome or if organic changes were found in his/her central nervous system. When issuing an opinion on a substance dependent person, experts should articulate the necessity for the perpetrator's treatment in an alcohol/drug treatment ward of a penal institution, even if this question has not been asked by the court.