Mania and insanity: An analysis of legal standards and recommendations for clinical practice

Significant attention has been allotted to the relationship between psychotic disorders and insanity; however, the study of manic symptoms on criminal responsibility evaluations has been virtually ignored. Given that criminal responsibility evaluations with manic defendants pose unique challenges to forensic examiners, recommendations are needed providing guidelines to insure accurate evaluation. Based on the lack of literature in this area, this article provides a critical analysis of insanity defense standards and their potential application to manic defendants. A clinical case highlights assessment techniques and provides the basis for pragmatic recommendations. A set of guidelines for conducting insanity evaluations with manic defendants is included within the article.