In 182 Spanish court cases involving mania, bipolar disorder fully excused the defendant 3.3% of the time

A review of five years of Spanish criminal sentences involving manic symptoms found most defendants had a prior diagnosis but no current treatment, and that the disorder was a full exonerating factor in six cases out of 182.

Spanish law recognises bipolar disorder as a condition that can modify criminal responsibility, up to and including a finding of non-imputability. How often that actually happens is a separate question. Researchers led by Covadonga Canga-Espina systematically reviewed Spanish criminal court sentences from 2019 to 2024 involving manic symptomatology, identifying 182 and extracting the sociodemographic, clinical and judicial details of each. The defendants were mostly male, 81.9%, and strikingly isolated: 76.9% lacked family support. Most, 69.2%, already had a bipolar diagnosis before the offence. But at the time of the offence, 61.5% were on no medication and 64.3% had no psychiatric follow-up. Nearly two-thirds, 63.7%, had a prior criminal record. The judicial outcomes are the part that surprises people who expect a mental health defence to work often. The most common results were dismissal of the appeal, 37.4%, and a prison sentence, 28.6%. Court-ordered treatment was applied in 6.6% of cases. Bipolar disorder was accepted as a full exonerating factor in 3.3% of the sample, six cases. These are court records, not clinical assessments, so the diagnoses are as the court recorded them and the sample is restricted to cases that reached sentencing with manic symptoms documented. It cannot tell you what proportion of people with bipolar disorder offend, which is a different and much smaller number. What it does show is a population that was mostly diagnosed, mostly untreated, and mostly without support at the point things went wrong.