Between expertise and judgment: Discordance between forensic psychiatric reports and judicial decisions in Brazilian...

This study investigates the discordance between forensic psychiatric reports and judicial decisions in Brazilian civil and administrative litigation. Using a retrospective documentary design, we analyzed a random sample of 200 cases (50 per domain) from the Brazilian Electronic Judicial Process (PJe) across four areas: social security (INSS), public service examinations, access to medications, and alleged medical error. Overall concordance was high (87.5%), but 12.5% of cases showed discordance, which clustered significantly in public service examinations (20%) and medical error disputes (20%), with no discordance in social security cases. Qualitative analysis revealed that judicial divergence often stems from the reinterpretation of clinical findings through normative constructs such as "residual capacity" or "duty of diligence," and is facilitated by reports with low structural standardization. Multivariable analysis indicated that longer time lags between the index event and evaluation, along with the absence of structured instruments, were associated with higher odds of discordance. The findings highlight the need for standardized reporting protocols and interdisciplinary training to strengthen the interface between forensic psychiatry and the law in Brazil.