Legal issues in psychiatry

This paper focuses on legal aspects of suicide prevention, the diagnosis of posttraumatic stress disorder and of testamentary capacity. There are remarkably few data on litigation and suicide despite it being a major concern of most psychiatrists. Limited data suggest that heavy handed defensive use of hospitalization is misguided as inpatient suicides probably dominate suicide litigation. The problem of suicide risk evaluation is discussed emphasising the difference between prediction and risk-assessment, the former being a misguided exercise, the latter being readily achievable, although its limitations need to be understood. Posttraumatic stress disorder is a major focus of personal injury cases. Problems in the DSM-IV criteria and their misuse are reviewed with a particular focus on longitudinal, dimensional and sub-syndromal issues in contrast to cross-sectional and categorical evaluations. Finally, the essentials of assessing testamentary capacity are presented