Different needs in patients with schizophrenia spectrum disorders who behave aggressively towards others depend on gender: a latent class analysis approach

Moritz Philipp Günther,Martina Sonnweber,Sabine Kling,Elmar Habermeyer,Johannes Kirchebner,Steffen Lau

doi:10.1186/s12991-021-00343-5

Moritz Philipp Günther, Martina Sonnweber + Show 4 more

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https://doi.org/10.1186/s12991-021-00343-5

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BackgroundThere is limited research with inconsistent findings on differences between female and male offender patients with a schizophrenia spectrum disorder (SSD), who behave aggressively towards others. This study aimed to analyse inhomogeneities in the dataset and to explore, if gender can account for those.MethodsLatent class analysis was used to analyse a mixed forensic dataset consisting of 31 female and 329 male offender patients with SSD, who were accused or convicted of a criminal offence and were admitted to forensic psychiatric inpatient treatment between 1982 and 2016 in Switzerland.ResultsTwo homogenous subgroups were identified among SSD symptoms and offence characteristics in forensic SSD patients that can be attributed to gender. Despite an overall less severe criminal and medical history, the female-dominated class was more likely to receive longer prison terms, similarly high antipsychotic dosages, and was less likely to benefit from inpatient treatment. Earlier findings were confirmed and extended in terms of socio-demographic variables, diseases and criminal history, comorbidities (including substance use), the types of offences committed in the past and as index offence, accountability assumed in court, punishment adjudicated, antipsychotic treatment received, and the development of symptoms during psychiatric inpatient treatment.ConclusionsFemale offender patients with schizophrenia might need a more tailored approach in prevention, assessment and treatment to diminish tendencies of inequity shown in this study.

Highlights

There is limited research with inconsistent findings on differences between female and male offender patients with a schizophrenia spectrum disorder (SSD), who behave aggressively towards others
The present study aims to explore without preconceptions if gender may explain relevant differences in the histories and treatment needs of patients with schizophrenia spectrum disorder (SSD) who underwent forensic psychiatric inpatient treatment
Some studies have argued that female aggressive behaviour is not as overt as similar behaviour in males and is, less likely to lead to prosecution, which may lead to inaccurate estimates of female violence [12]

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Introduction

There is limited research with inconsistent findings on differences between female and male offender patients with a schizophrenia spectrum disorder (SSD), who behave aggressively towards others. The present study aims to explore without (even statistical) preconceptions if gender may explain relevant differences in the histories and treatment needs of patients with schizophrenia spectrum disorder (SSD) who underwent forensic psychiatric inpatient treatment. Psychiatric research found gender-based differences regarding onset and course of SSD [4,5,6]: Women were. Criminological research has identified a gender gap [7,8,9,10,11,12,13,14,15,16]: women display less violence and aggressive behaviour overall and engage in less serious crimes. Others suggested that the gender gap in violence is largely due to males being more prone to neurocognitive deficits, difficult temperament and hyperactivity paired with poor parenting skills [11], excessive androgen production, thyroid dysfunction, Cushing’s syndrome and congenital adrenal hyperplasia [17]

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