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J Am Acad Psychiatry Law 35:1:47-59 (2007)
Copyright © 2007 by the American Academy of Psychiatry and the Law.
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Involuntary Medication Treatment for Competency Restoration of 22 Defendants With Delusional Disorder

Bryon L. Herbel, MD and Hans Stelmach, MD

Dr. Herbel is Staff Psychiatrist, Federal Medical Center (FMC) Butner, Butner, NC. Dr. Stelmach is Staff Psychiatrist, Customized Assistance Services, Human Resources Administration, New York, NY. Address correspondence to: Bryon L. Herbel, MD, Federal Medical Center, Old Oxford Highway 75, Butner, NC 27509. E-mail: bherbel{at}bop.gov

There are no published data on the rates of competency restoration for adjudicated incompetent felony criminal defendants diagnosed with delusional disorder. A retrospective record review was conducted of all incompetent defendants with the principal diagnosis of delusional disorder who had undergone involuntary medication treatment for competency restoration during a 13-year period at a federal psychiatric prison hospital. Of the 181 defendants who were involuntarily medicated for competency restoration during this period, 22 had delusional disorder. Seventeen (77%) of the defendants with delusional disorder improved sufficiently for the forensic evaluators to opine that they had been restored to competency after involuntary treatment with antipsychotic medication. These results are similar to the published data of the relatively high rates of competency restoration for incompetent defendants with diagnosed schizophrenia.




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Copyright © 2007 by the American Academy of Psychiatry and the Law.