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Homicide and Schizophrenia: Maybe Treatment Does Have a Preventive Effect

NCJ Number
190056
Journal
Criminal Behavior and Mental Health Volume: 11 Issue: 1 Dated: 2001 Pages: 6-26
Author(s)
Martin Erb; Sheilagh Hodgins; Roland Freese; Rudiger Muller-Isberner; Dieter Jockel
Date Published
2001
Length
21 pages
Annotation
This study compared the proportions of homicides committed by persons with schizophrenia in Germany in 1955-64 and 1992-96, compared the proportions of persons with schizophrenia who killed in the two time periods, and compared the characteristics of the homicide offenders with schizophrenia in the two time periods.
Abstract
All persons with schizophrenia in Hessen who had committed or attempted to commit homicide in 1992 to 1996 were identified from the records of the Haina Forensic Psychiatric Hospital. Under German law, this hospital is required to admit all persons suffering from schizophrenia judged to have committed a criminal offense. Only subjects who received a DSM-III-R diagnosis of schizophrenia from both the professionals who conducted the pretrial assessment and those at the forensic hospital were included in the schizophrenic group. During the period under study, 290 persons, aged 18 or older, were judged to have committed or attempted to commit homicide; of these, 29 suffered from schizophrenia. During the period 1955-64, 276 of 3,367 homicides were committed by persons diagnosed with schizophrenia. Findings showed that schizophrenia increased the risk of homicide 16.6 times in the recent cohort and 12.7 times in the older cohort. These odds ratios were not statistically different. The lack of appropriate services for chronic high-risk patients and the failure to use mental health services by the first episode for acutely psychotic patients were associated with homicide. There had been no increase in the risk of homicide among persons with schizophrenia since the implementation of the policy of deinstitutionalization. The examination of the recent period suggested that the provision of specialized long-term care to persons with schizophrenia who were at high risk for violent behavior as well as the use of mental health services by acutely psychotic persons might reduce the risk of homicide. 4 tables, 3 notes, and 42 references