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The purpose of this paper is to examine the awareness of intellectual disabilities (ID) amongst professionals in the criminal justice system (CJS) and their knowledge of those persons, either as victims, witnesses, suspects, accused or defendants.

A survey of the professionals in the CJS (n=388), combined with a series of focus group interviews with experienced professionals (n=20), was conducted.

One out of three respondents (police, district attorneys and judges) reported that they have regular contact with suspects who have an ID. Differences in knowledge of ID amongst professionals in the CJS can explain awareness and detection of persons with ID.

Non-responders may represent professionals with no knowledge or less interest in these issues.

Reflections on ID have not previously been studied in the Norwegian CJS. The findings serve as a basis and status quo for further research.

Some patients with severe mental disorders are refractory to psychotherapeutic or psychopharmacological interventions. We describe a patient with severe symptoms from the age of 16 to 44. Her illness is best described as a schizo-affective disorder. Several series of electroconvulsive therapy (ECT) followed by maintenance once a week for more than six years has kept her out of hospital beds for three years. The patient demonstrates the feasibility of long term ECT and the absence of disturbing cognitive reductions.

Some patients with severe mental disorders are refractory to psychotherapeutic or psychopharmacological interventions. We present a patient who at the age of 19 developed several schizophrenia - suspect symptoms. Soon inexplicable general seizures where observed. He was treated with antipsychotics, but had two bouts of malignant neuroleptic syndrome. Electroconvulsive therapy (ECT) gave some symptom relief and he continued on maintenance ECT for years with weekly intervals. Interruption of this treatment pattern rapidly increased symptom load. After seven years a lorazepam provocation test was performed as he had a new relapse after 3 weeks without ECT. In the ensuing hours his aggressiveness and nonsense speaking rapidly diminished. Kahlbaums observation of seizures as part of a catatonia was not understood in this case. The publication of the new DSM-V diagnosis of catatonia may hopefully reduce the probability of treating a patient for schizophrenia for years without access to a more targeted medication and ECT plan.