The medical terms insanity and psychosis are used synonymously to describe a condition with substantial changes in the "total" personality and loss of realism. In the 10th revision of the diagnostic classification system ICD-10 (1994) the intention was to replace the term "psychosis" with "psychotic" to indicate the presence of hallucinations and delusions. However, in Danish legislation - most importantly in the penal code and the Mental Health Act - the term "insanity" is still in use. This difference has lead to diagnostic uncertainty, especially in clinical and forensic psychiatric practice.