Juliana Nunes

The profile of sexual abusers of minors: A forensic-psychiatric study

The World Health Organization (WHO, 2006) defines sexual abuse as the involvement of a child in sexual activity that he or she does not fully comprehend, being unable to give informed consent to, or for which the child is not developmentally prepared, or else that violates the laws or social taboos of society. In Portugal, the law that regulates the sexual abuse of underage people (minors) is enclosed in crimes of sexual auto-determination, which are described as child sexual abuse (article 171°) and sexual acts with a teenager (article 172°), and those are applied to the person that has copulation, anal intercourse and oral intercourse with underage abusing from their inexperience. Our objective is to investigate the profile of sexual abusers of minors, namely, the socio-demographic features, clinical correlations, and the level of penal responsibility of sexual offenders who were referred by court to forensic psychiatric assessment in the Institute of Legal Medicine of the City of Coimbra. Moreover, verify if these individuals present mental disorders at the time of the offence. The present study is of descriptive nature, being based on the observation and consultation of 30 clinical processes of sexual abusers. All written reports were obtained from 2005 to 2015 by court-appointed psychiatric experts on individuals that have been charged of committing sexual crimes against minors and referred to the main forensic institute in the city of Coimbra. This study will contribute to the increase of more information on these offenders, promoting the development of more adequate contingency plans for this population.

Perfusion SPECT in the differential diagnosis of dementia

Dementia is a syndrome–usually of a chronic or progressive nature–in which there is deterioration in cognitive function beyond what might be expected from normal ageing (WHO). As the world population ages, the number of people afflicted with dementing illnesses will increase. This neurodegenerative disease is one of the major causes of disability and dependency among older people worldwide. Brain single-photon emission computed tomography (SPECT) allows the study of regional cerebral blood flow, providing functional information. Each of the different types of dementia has a distinct blood flow pattern that is revealed with SPECT imaging and which can be used for differential diagnoses. This imaging technique can also be used to differentiate dementia from pseudodementia. The use of SPECT has been recommended in various guidelines to help in differential diagnosis of dementia. The National Institute for Health and Clinical Excellence in the UK recommend the use of SPECT or positron emission tomography (PET) to help differentiate Alzheimers disease (AD) from frontotemporal dementia and vascular dementia when there is diagnostic doubt (NICE, 2006). The European Federation of the Neurological Societies guidelines for diagnosis also supports the use of FDG-PET (18F fluorodeoxyglucose positron emission tomography) or perfusion SPECT when clarifying a diagnosis of AD. This review describes the utility of perfusion SPECT in differential diagnosis of neurodegenerative dementias.