Circumstantial Risks in Psychotic Offenders and their Criminal History: A Review of the Literature

Abstract

The authors present the results of a review of the literature between 1990 and 2006. A search of www.PubMed.com and www.PsychInfo.com yielded 1942 articles using the following search terms: (crime/violence) AND (psychosis/schizophrenia) AND (substance abuse); (crime/violence) AND (psychosis/schizophrenia) AND (personality disorder/psychopathy); or (crime/violence) AND (psychosis/schizophrenia) AND (youth). Ultimately, however, only 29 articles remained after eliminating the articles on irrelevant topics. This review covers the literature on the influence of the circumstantial risks to which violent psychotic patients were exposed since childhood. The temporal relationship between a psychotic disorder and criminality, prior psychiatric care, the victims, psychosocial and circumstantial problems, and behavior problems in childhood and adolescence are discussed, in that order. Studies into the time of the first offense in relation to the onset of psychosis, diagnosis and first admission yielded a variety of results. Most of the forensic patients had had previous contact with general psychiatry before becoming a forensic patient, but the quality of the psychiatric care was not always appropriate. The victims of schizophrenic patients were mostly persons that they knew. Besides substance abuse, social functioning was viewed as an important risk factor. Externalizing behavior in childhood and adolescence was seen most often in future schizophrenics who later committed offenses. In summary, it can be stated that a psychotic disorder should never be seen separately from the circumstantial risk factors.