Reconstructing the Unseen: Psychosis

When criminal responsibility turns on a past psychotic state, the expert is asked to infer what can no longer be directly observed. Unlike competence assessments, criminal responsibility evaluations are inherently retrospective and vulnerable to many issues such as missing records, witness unreliability, and cognitive bias.
Contemporary forensic guidance increasingly favors transparent, multi-source assessment over unstructured narrative judgment. Prioritize records proximal to the offence, including collateral accounts. Examine behavior before, during, and after the act. Use structured tools cautiously to support auditability. No tool
removes uncertainty or replaces expert judgment. Neurobiological findings and AI-assisted record review may support evidence organization, but neither can directly determine responsibility. The most defensible opinion explicitly defines the material-time window, tests competing explanations, links psychopathology to legally relevant capacities, and clearly states evidentiary limits. Retrospective reconstruction should be presented as a disciplined inferential process, not retrospective certainty.

Keywords: Forensic Psychiatry, Psychosis, Criminal, Review.