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Amnesia and Crime: A Neuropsychiatric Response

Dr. Wortzel is Instructor-Fellow, Veterans Integrated Service Network 19 Mental Illness Research, Education, and Clinical Center (VISN 19 MIRECC), Denver Veteran's Affairs Medical Center, and the Neurobehavioral Disorders Program, Department of Psychiatry, University of Colorado School of Medicine, Denver, CO. Dr. Arciniegas is Director of the Neurobehavioral Disorders Program and Associate Professor of Psychiatry and Neurology, University of Colorado School of Medicine, Denver, CO. Address correspondence to: Hal S. Wortzel, MD, Department of Psychiatry, CPH Room 2508, 4200 East 9th Avenue, C268-25, Denver, CO 80262. E-mail: hal.wortzel{at}uchsc.edu

Bourget and Whitehurst's "Amnesia and Crime," published in a prior issue of the Journal, addresses a conceptually complex and clinically challenging subject. Their treatment emphasizes psychiatric conditions in which memory disturbances may arise that are relevant to criminal proceedings. However, their consideration of the neurobiology of memory, memory disturbances, and the neurobiological bases of interactions between psychiatric symptoms and memory merit further elaboration. The relevance of memory impairment to criminal matters requires forensic psychiatric experts to possess a basic understanding of the phenomenology and neurobiology of memory. The present authors describe briefly the phenomenology and neuroanatomy of memory, emphasizing first that memory is not a unitary cognitive domain, clinically or neurobiologically. The assertion that psychotic delusions produce memory impairment is challenged, and the description of "organic" amnesia, both semantically and in terms of its clinical features, is reframed. Resources on which to build a neuropsychiatric foundation for forensic psychiatric opinions on memory impairment surrounding criminal behavior are offered.

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				D. Bourget and L. Whitehurst Commentary: A Response to Wortzel and Arciniegas About Amnesia and Crime J Am Acad Psychiatry Law, June 1, 2008; 36(2): 224 - 226. [Abstract] [Full Text] [PDF]