1
|
Hodgins S, Sivertsson F, Beckley A, Luigi M, Carlsson C. The burden for clinical services of persons with an intellectual disability or mental disorder convicted of criminal offences: A birth cohort study of 14,605 persons followed to age 64. Nord J Psychiatry 2024; 78:411-420. [PMID: 38613517 DOI: 10.1080/08039488.2024.2337192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/19/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Intellectual disability (ID), schizophrenia spectrum disorder (SSD), bipolar disorder (BD), substance use disorder (SUD), and other mental disorders (OMDs) are associated with increased risks of criminality relative to sex-matched individuals without these conditions (NOIDMD). To resource psychiatric, addiction, and social services so as to provide effective treatments, further information is needed about the size of sub-groups convicted of crimes, recidivism, timing of offending, antecedents, and correlates. Stigma of persons with mental disorders could potentially be dramatically reduced if violence was prevented. METHODS A birth cohort of 14,605 persons was followed to age 64 using data from Swedish national health, criminal, and social registers. RESULTS Percentages of group members convicted of violence differed significantly: males NOIDMD, 7.3%, ID 29.2%, SSD 38.6%, BD 30.7%; SUD 44.0%, and OMD 19.3%; females NOIDMD 0.8%, ID 7.7%, SSD 11.2%, BD 2.4%, SD 17.0%, and OMD 2.1%. Violent recidivism was high. Most violent offenders in the diagnostic groups were also convicted of non-violent crimes. Prior to first diagnosis, convictions (violent or non-violent) had been acquired by over 90% of the male offenders and two-thirds of the female offenders. Physical victimization, adult comorbid SUD, childhood conduct problems, and adolescent substance misuse were each associated with increased risks of offending. CONCLUSION Sub-groups of cohort members with ID or mental disorders were convicted of violent and non-violent crimes to age 64 suggesting the need for treatment of primary disorders and for antisocial/aggressive behavior. Many patients engaging in violence could be identified at first contact with clinical services.
Collapse
Affiliation(s)
- Sheilagh Hodgins
- Département de psychiatrie et addictologie, Université de Montréal, and Centre de Recherche Institut national de psychiatrie légale Philippe-Pinel, Centre de Recherche Institut national de psychiatrie légale Philippe-Pinel, Montreal, Canada
| | | | - Amber Beckley
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Sweden
| | - Mimosa Luigi
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Christoffer Carlsson
- Department of Criminology, Stockholm University, Stockholm, Sweden
- Institute for Futures Studies, Stockholm, Sweden
| |
Collapse
|
2
|
Hodgins S. Could Expanding and Investing in First-Episode Psychosis Services Prevent Aggressive Behaviour and Violent Crime? Front Psychiatry 2022; 13:821760. [PMID: 35242064 PMCID: PMC8885584 DOI: 10.3389/fpsyt.2022.821760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/21/2022] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Some persons developing, or presenting, schizophrenia engage in aggressive behaviour (AB) and/or criminal offending. Most of these individuals display AB prior to a first episode of psychosis (FEP). In fact, approximately one-third of FEP patients have a history of AB, some additionally display other antisocial behaviours (A+AB). The large majority of these individuals have presented conduct problems since childhood, benefit from clozapine, have extensive treatment needs, and are unlikely to comply with treatment. A smaller sub-group begin to engage in AB as illness onsets. A+AB persists, often for many years in spite of treatment-as-usual, until a victim is seriously harmed. This article proposes providing multi-component treatment programs at FEP in order to prevent aggressive and antisocial behaviours of persons with schizophrenia. METHOD Non-systematic reviews of epidemiological studies of AB among persons with schizophrenia, of the defining characteristics of sub-types of persons with schizophrenia who engage in AB and their responses to treatment, and of FEP service outcomes. RESULTS Studies have shown that mental health services that simultaneously target schizophrenia and aggressive behaviour are most effective both in reducing psychotic symptoms and aggressive behaviour. Evidence, although not abundant, suggests that a multi-component treatment program that would include the components recommended to treat schizophrenia and cognitive-behavioural interventions to reduce A+AB, and the other factors promoting A+AB such as substance misuse, victimisation, and poor recognition of emotions in the faces of others has the potential to effectively treat schizophrenia and reduce A+AB. Patients with a recent onset of AB would require few components of treatment, while those with prior conduct disorder would require all. Such a program of treatment would be long and intense. CONCLUSIONS Trials are needed to test the effectiveness of multi-component treatment programs targeting schizophrenia and A+AB at FEP. Studies are also necessary to determine whether providing such programs in hospitals and/or prisons, with long-term community after-care, and in some cases with court orders to participate in treatment, would enhance effectiveness. Whether investing at FEP would be cost-effective requires investigation.
Collapse
Affiliation(s)
- Sheilagh Hodgins
- Département de Psychiatrie et Addictologie, Université de Montréal et Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Haina Institute of Forensic Psychiatry, Haina, Germany
| |
Collapse
|
3
|
Lamberti JS, Katsetos V, Jacobowitz DB, Weisman RL. Psychosis, Mania and Criminal Recidivism: Associations and Implications for Prevention. Harv Rev Psychiatry 2021; 28:179-202. [PMID: 32251070 DOI: 10.1097/hrp.0000000000000251] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
People with mental illness are overrepresented throughout the criminal justice system, including jail, prison, probation, and parole populations. Yet much disagreement remains about why this problem exists and how best to address it. This article specifically examines empirical evidence regarding the question of whether psychosis and mania are associated with criminal recidivism, and whether this association is predictive or causal in nature. Review of the current literature suggests that psychotic and manic symptoms are associated with increased likelihood of arrest and incarceration. In addition, current evidence shows that pharmacotherapy can reduce criminal recidivism among justice-involved adults with psychosis or mania. However, the extent to which the association between psychosis, mania, and criminal justice system involvement is causal remains uncertain. Also, the literature suggests that most crimes committed by people with schizophrenia spectrum disorders or bipolar I disorder may be driven by factors other than their psychotic or manic symptoms. These established "criminogenic needs" are more common among people with severe mental disorders than in the general population. For optimal prevention, those who serve justice-involved adults with psychosis or mania in community settings should consider addressing the full range of factors that potentially drive their criminal justice system involvement.
Collapse
Affiliation(s)
- J Steven Lamberti
- From the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY
| | | | | | | |
Collapse
|
4
|
Abstract
Depression and Violence: A Contradiction? Abstract. Depression is one of the leading diseases worldwide. Its symptoms are of great importance for a variety of areas within internal medicine, as patients often pay a visit to their general practitioners first. Although symptoms of depression are observed in both genders, existing peculiarities of the symptoms in men are only insufficiently known or acknowledged. Therefore, we dedicate this article to the concept of male depression, which can be characterized by social withdrawal, irritability or substance abuse. Here, we present practice-related associations between depression and violent behavior, which will be illustrated by two case studies. Of particular relevance is the so-called suicidal-homicidal syndrome, which should make further psychiatric, if not forensic-psychiatric evaluation mandatory.
Collapse
Affiliation(s)
- Sarah Steinau
- Klinik für Forensische Psychiatrie, Psychiatrische Universitätsklinik, Zürich
| | - Nathalie Brackmann
- Klinik für Forensische Psychiatrie, Psychiatrische Universitätsklinik, Zürich
| | - Elmar Habermeyer
- Klinik für Forensische Psychiatrie, Psychiatrische Universitätsklinik, Zürich
| |
Collapse
|
5
|
Beaudoin M, Potvin S, Dellazizzo L, Luigi M, Giguère CE, Dumais A. Trajectories of Dynamic Risk Factors as Predictors of Violence and Criminality in Patients Discharged From Mental Health Services: A Longitudinal Study Using Growth Mixture Modeling. Front Psychiatry 2019; 10:301. [PMID: 31139099 PMCID: PMC6520437 DOI: 10.3389/fpsyt.2019.00301] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/17/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Individuals with severe mental illnesses are at greater risk of offenses and violence, though the relationship remains unclear due to the interplay of static and dynamic risk factors. Static factors have generally been emphasized, leaving little room for temporal changes in risk. Hence, this longitudinal study aims to identify subgroups of psychiatric populations at risk of violence and criminality by taking into account the dynamic changes of symptomatology and substance use. Method: A total of 825 patients from the MacArthur Violence Risk Assessment Study having completed five postdischarge follow-ups were analyzed. Individuals were classified into outcome trajectories (violence and criminality). Trajectories were computed for each substance (cannabis, alcohol, and cocaine, alone or combined) and for symptomatology and inputted as dynamic factors, along with other demographic and psychiatric static factors, into binary logistic regressions for predicting violence and criminality. Best predictors were then identified using backward elimination, and receiver operator characteristic (ROC) curves were calculated for both models. Results: Two trajectories were found for violence (low versus high violence). Best predictors for belonging in the high-violence group were low verbal intelligence (baseline), higher psychopathy (baseline) and anger (mean) scores, persistent cannabis use (alone), and persistent moderate affective symptoms. The model's area under the curve (AUC) was 0.773. Two trajectories were also chosen as being optimal for criminality. The final model to predict high criminality yielded an AUC of 0.788, retaining as predictors male sex, lower educational level, higher score of psychopathy (baseline), persistent polysubstance use (cannabis, cocaine, and alcohol), and persistent cannabis use (alone). Both models were moderately predictive of outcomes. Conclusion: Static factors identified as predictors are consistent with previously published literature. Concerning dynamic factors, unexpectedly, cannabis alone was an independent co-occurring variable, as well as affective symptoms, in the violence model. For criminality, our results are novel, as there are very few studies on criminal behaviors in nonforensic psychiatric populations. In conclusion, these results emphasize the need to further study the predictors of crime, separately from violence and the impact of longitudinal patterns of specific substance use and high affective symptoms.
Collapse
Affiliation(s)
- Mélissa Beaudoin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Laura Dellazizzo
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Mimosa Luigi
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Charles-Edouard Giguère
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Alexandre Dumais
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Institut national de psychiatrie légale Philippe-Pinel, Montreal, QC, Canada
| |
Collapse
|
6
|
Comai S, Bertazzo A, Vachon J, Daigle M, Toupin J, Côté G, Gobbi G. Trace elements among a sample of prisoners with mental and personality disorders and aggression: correlation with impulsivity and ADHD indices. J Trace Elem Med Biol 2019; 51:123-129. [PMID: 30466921 DOI: 10.1016/j.jtemb.2018.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/10/2018] [Accepted: 10/04/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Mental, personality and substance use disorders are over represented among prisoners and aggressive individuals. The psychopathological and biological markers linked to mental functioning remain still unclear. In particular, the role of trace elements in mental illness is still matter of debate. Here, we investigated whether trace elements are correlated to specific psychopathological phenotype groups. METHODS Axis I and II disorders, aggression, impulsivity, adult attention deficit/hyperactivity disorders (ADHD) indices and serum levels of zinc, copper and cadmium were evaluated in 160 male prisoners. RESULTS Using latent class analysis we could subdivide prisoners into three distinct psychopathological classes: Class 1 characterized by low prevalence of aggression, personality disorders and substance abuse/dependence (alcohol, cannabis, cocaine); Class 2 represented by low prevalence of aggression and high prevalence of personality disorders and substance abuse/dependence; Class 3 defined by high prevalence of aggression, personality disorders and substance abuse/dependence. Serum levels of zinc were higher in Class 2 and 3 compared to Class 1. Moreover, Class 3 was associated with higher scores of impulsivity and ADHD indices. CONCLUSION Our results suggest that impulsivity but also adult ADHD indices are related to aggressive behaviour, and higher zinc levels are linked to personality disorders and addictions, but not to aggression.
Collapse
Affiliation(s)
- Stefano Comai
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University Health Center, McGill University, Montreal, QC, Canada; San Raffaele Scientific Institute and Vita Salute University, Milan, Italy.
| | - Antonella Bertazzo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | | | - Marc Daigle
- Institut Philippe-Pinel, Montreal, QC, Canada; Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Jean Toupin
- Institut Philippe-Pinel, Montreal, QC, Canada; Department of Psychoeducation, Sherbrooke University, QC, Canada
| | - Gilles Côté
- Institut Philippe-Pinel, Montreal, QC, Canada; Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University Health Center, McGill University, Montreal, QC, Canada.
| |
Collapse
|
7
|
Krakowski MI, Czobor P. Distinctive profiles of traits predisposing to violence in schizophrenia and in the general population. Schizophr Res 2018; 202:267-273. [PMID: 30021703 DOI: 10.1016/j.schres.2018.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 06/22/2018] [Accepted: 07/01/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We delineated important trait predispositions to violence, including psychopathic and impulsive traits and trait aggression, in patients with schizophrenia and in the general population. METHOD The study included 144 subjects: 40 violent (VS's) and 34 nonviolent (NV's) patients with schizophrenia, 35 healthy controls (HC's) and 35 non-psychotic violent subjects (NPV's). We used the Psychopathy Checklist, Buss-Perry Aggression Questionnaire, and Barratt Impulsiveness Scale (BIS-11). Life History of Aggression, psychiatric symptoms, drug/alcohol abuse and history of conduct problems were also assessed. RESULTS The two violent groups presented with more severe psychopathy, trait aggressiveness and impulsivity than the non-violent subjects; some of these traits being more pronounced in NPV's than in VS's. We further divided the violent patients (VS's) into 2 subgroups, those with a history of conduct problems (VS-CD) and those without (VS-NCD). When we compared these 2 subgroups to each other and to NPV's, we obtained 3 distinct multivariate profiles of traits, consisting of psychopathic traits, anger, motor impulsiveness, and self-control problems. NPV's have the profile with the most severe impairments, followed by VS-CD's and then VS-NCD's. Psychiatric symptoms were more strongly associated with violence in VS-NCD's than in VS-CD's. CONCLUSION Our study provides new insights on trait predispositions to violence. Trait aggressiveness, psychopathic and impulsive traits form a distinctive profile which underlies a core predisposition to violence across populations, including patients with schizophrenia, but particularly in those with a history of early conduct problems. In those without such problems, the symptoms of the illness play a more important role for the violent behavior.
Collapse
Affiliation(s)
- Menahem I Krakowski
- The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, USA; New York University School of Medicine, Department of Psychiatry, 550 First Avenue, New York, NY, USA.
| | - Pal Czobor
- Departments of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| |
Collapse
|
8
|
Dellazizzo L, Dugré JR, Berwald M, Stafford MC, Côté G, Potvin S, Dumais A. Distinct pathological profiles of inmates showcasing cluster B personality traits, mental disorders and substance use regarding violent behaviors. Psychiatry Res 2018; 260:371-378. [PMID: 29247923 DOI: 10.1016/j.psychres.2017.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 12/04/2017] [Accepted: 12/04/2017] [Indexed: 10/18/2022]
Abstract
High rates of violence are found amid offenders with severe mental illnesses (SMI), substance use disorders (SUDs) and Cluster B personality disorders. Elevated rates of comorbidity lead to inconsistencies when it comes to this relationship. Furthermore, overlapping Cluster B personality traits have been associated with violence. Using multiple correspondence analysis and cluster analysis, this study was designed to differentiate profiles of 728 male inmates from penitentiary and psychiatric settings marked by personality traits, SMI and SUDs following different violent patterns. Six significantly differing clusters emerged. Cluster 1, "Sensation seekers", presented recklessness with SUDs and low prevalence's of SMI and auto-aggression. Two clusters committed more sexual offenses. While Cluster 2, "Opportunistic-sexual offenders", had more antisocial lifestyles and SUDs, Cluster 6, "Emotional-sexual offenders", displayed more emotional disturbances with SMI and violence. Clusters 3 and 4, representing "Life-course-persistent offenders", shared early signs of persistent antisocial conduct and severe violence. Cluster 3, "Early-onset violent delinquents", emerged as more severely antisocial with SUDs. Cluster 4, "Early-onset unstable-mentally ill delinquents", were more emotionally driven, with SMI and auto-aggression. Cluster 5, "Late-start offenders", was less severely violent, and emotionally driven with antisocial behavior beginning later. This study suggests the presence of specific psychopathological organizations in violent inmates.
Collapse
Affiliation(s)
- Laura Dellazizzo
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Jules R Dugré
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada; School of Criminology, Faculty of Arts and Science, Université de Montréal, Montreal, Canada
| | - Marieke Berwald
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | | | - Gilles Côté
- Department of Psychology, Université du Québec, Trois-Rivières, Canada; Centre de recherche de l'Institut Philippe-Pinel de Montréal, Montreal, Canada
| | - Stéphane Potvin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Alexandre Dumais
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada; Centre de recherche de l'Institut Philippe-Pinel de Montréal, Montreal, Canada.
| |
Collapse
|
9
|
Abstract
SummaryViolent behaviour in people with a psychiatric disorder causes great public concern and leads to stigma for people with mental illness. There is good evidence for a correlation between schizophrenia and increased rates of violence but any association between mood disorders and violence has been comparatively overlooked. It appears that there may be more evidence relating mood disorders and violence than many clinicians realise. This article highlights the difficulties in assessing this, summarises what is known and discusses what this means for clinical practice.
Collapse
|
10
|
Clark T, Rowe R. Violence, stigma and psychiatric diagnosis: the effects of a history of violence on psychiatric diagnosis. PSYCHIATRIC BULLETIN 2018. [DOI: 10.1192/pb.30.7.254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and MethodThe aim of the study was to investigate whether psychiatrists consider that patients with schizophrenia present a greater risk of violence than patients with other forms of mental illness. Two pairs of clinical vignettes were devised. In each pair, one contained a history of violence and one did not. One vignette was mailed to each of 2000 consultant psychiatrists in the UK. Respondents were asked to give a preferred diagnosis. Rates of diagnosis of bipolar disorder, schizoaffective disorder and schizophrenia were compared within vignette pairs.ResultsFor each pair of vignettes, the rate of diagnosis of schizophrenia was higher (33 v. 21.5%, P=0.008 and 44.4 v. 32.1%, P=0.011), and the rate of diagnosis of bipolar disorder was lower (44.2 v. 62.6%, P<0.0005 and 34.9 v. 49.3%, P=0.004), among those who received the vignette containing a history of violence.Clinical ImplicationsA history of violence may lead to an increased likelihood of receiving a diagnosis of schizophrenia as opposed to bipolar affective disorder. This bias in diagnostic decision-making may affect the treatment received by a patient and may perpetuate and exacerbate the stigma associated with a diagnosis of schizophrenia.
Collapse
|
11
|
Krakowski MI, Czobor P. Proneness to aggression and its inhibition in schizophrenia: Interconnections between personality traits, cognitive function and emotional processing. Schizophr Res 2017; 184:82-87. [PMID: 28007464 DOI: 10.1016/j.schres.2016.11.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/23/2016] [Accepted: 11/24/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Research on aggression in schizophrenia has focused on narrowly defined deficits, while ignoring interconnections among these impairments which provide better explanatory power. Our goal was to investigate interrelations among impairments in important domains related to aggression: personality traits, including psychopathy and impulsivity, cognition and processing of emotions. METHOD 34 healthy controls, 37 high aggression (HAG) and 31 low aggression (LAG) patients with schizophrenia participated. The Barratt Impulsiveness Scale, Psychopathy Checklist, Wisconsin Card Sorting Test (WCST), and Emotion Recognition Test were administered. Psychiatric symptoms were assessed. Canonical Discriminant Analysis (CDA) was performed to determine how these measures distinguish among the groups and to identify underlying symptom profiles. RESULTS CDA revealed two statistically significant profiles of deficits which differentiated the groups. The first comprises impulsivity, psychopathy, and impairments in cognition and fear recognition. It indicates proneness to aggression. The second consists of WCST perseverative errors and facial affect processing impairment; it has an inverse relationship with aggression. These profiles are linked to different psychiatric symptoms in the schizophrenic patients: The first to excitement and poor impulse control; the second to blunted affect and motor retardation. HAG's manifested primarily the first; LAG's had a moderate score on the first and a high score on the second. CONCLUSION Proneness to aggression in schizophrenia is characterized by a multivariate confluence of impulsivity, psychopathy, cognitive difficulties and impairment in fear recognition. There exists, however, a second pattern of psychopathology that may suppress expression of aggression. These opposing patterns have important implications for integrated treatments of aggression.
Collapse
Affiliation(s)
- Menahem I Krakowski
- The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, USA; New York University School of Medicine, Department of Psychiatry, 550 First Avenue, New York, NY, USA.
| | - Pal Czobor
- Departments of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
12
|
Correlates and types of criminal behavior in a sample of hospitalized Egyptian mentally ill patients. MIDDLE EAST CURRENT PSYCHIATRY 2016. [DOI: 10.1097/01.xme.0000481456.17276.60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
13
|
Moberg T, Stenbacka M, Tengström A, Jönsson EG, Nordström P, Jokinen J. Psychiatric and neurological disorders in late adolescence and risk of convictions for violent crime in men. BMC Psychiatry 2015; 15:299. [PMID: 26597299 PMCID: PMC4657257 DOI: 10.1186/s12888-015-0683-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/18/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The relationship between mental illness and violent crime is complex because of the involvement of many other confounding risk factors. In the present study, we analysed psychiatric and neurological disorders in relation to the risk of convictions for violent crime, taking into account early behavioural and socio-economic risk factors. METHODS The study population consisted of 49,398 Swedish men, who were thoroughly assessed at conscription for compulsory military service during the years 1969-1970 and followed in national crime registers up to 2006. Five diagnostic groups were analysed: anxiety-depression/neuroses, personality disorders, substance-related disorders, mental retardation and neurological conditions. In addition, eight confounders measured at conscription and based on the literature on violence risk assessment, were added to the analyses. The relative risks of convictions for violent crime during 35 years after conscription were examined in relation to psychiatric diagnoses and other risk factors at conscription, as measured by odds ratios (ORs) and confidence intervals (CIs) from bivariate and multivariate logistic regression analyses. RESULTS In the bivariate analyses there was a significant association between receiving a psychiatric diagnosis at conscription and a future conviction for violent crime (OR = 3.83, 95 % CI = 3.47-4.22), whereas no significant association between neurological conditions and future violent crime (OR = 1.03, 95 % CI = 0.48-2.21) was found. In the fully adjusted multivariate logistic regression model, mental retardation had the strongest association with future violent crime (OR = 3.60, 95 % CI = 2.73-4.75), followed by substance-related disorders (OR = 2.81, 95 % CI = 2.18-3.62), personality disorders (OR = 2.66, 95 % CI = 2.21-3.19) and anxiety-depression (OR = 1.29, 95 % CI = 1.07-1.55). Among the other risk factors, early behavioural problem had the strongest association with convictions for violent crime. CONCLUSIONS Mental retardation, substance-related disorders, personality disorders and early behavioural problems are important predictors of convictions for violent crime in men.
Collapse
Affiliation(s)
- Tomas Moberg
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden.
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital/Solna, SE-171 76, Stockholm, Sweden.
| | - Marlene Stenbacka
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden.
| | - Anders Tengström
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden.
| | - Erik G Jönsson
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden.
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Peter Nordström
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden.
| | - Jussi Jokinen
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden.
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden.
| |
Collapse
|
14
|
Zhuo Y, Bradizza CM, Maisto SA. The influence of treatment attendance on subsequent aggression among severely mentally ill substance abusers. J Subst Abuse Treat 2014; 47:353-61. [PMID: 25124261 DOI: 10.1016/j.jsat.2014.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 06/18/2014] [Accepted: 06/30/2014] [Indexed: 10/25/2022]
Abstract
The interrelationships between severe mental illness, substance use, and aggression are of longstanding importance with implications for community treatment programs, treatment research and public policy. Through the analysis of longitudinal data collected from 278 patients over a 6-month period following admission to an outpatient dual diagnosis treatment program, this study examined the association between dual diagnosis treatment attendance and subsequent aggression among individuals diagnosed with both a severe mental illness and a substance use disorder. We also tested substance use and psychiatric symptoms as mediators of this treatment-aggression relationship. The results of structural equation modeling analyses indicated that dual diagnosis treatment was associated with lower levels of subsequent aggression. Mediational analyses indicated that greater treatment involvement was associated with reduced substance use, which was associated with lower levels of aggression; thus, substance use was found to mediate the relationship between dual diagnosis treatment and aggression. Surprisingly, severity of psychiatric symptoms did not predict later aggression. These findings suggest that targeting substance use reduction in treatment may have the additional benefit of reducing the risk of later aggression among dual diagnosis patients.
Collapse
Affiliation(s)
- Yue Zhuo
- Sociology and Anthropology Department, St. John's University.
| | - Clara M Bradizza
- Research Institute on Addictions, State University of New York at Buffalo
| | | |
Collapse
|
15
|
Moberg T, Stenbacka M, Jönsson EG, Nordström P, Åsberg M, Jokinen J. Risk factors for adult interpersonal violence in suicide attempters. BMC Psychiatry 2014; 14:195. [PMID: 25001499 PMCID: PMC4227101 DOI: 10.1186/1471-244x-14-195] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 07/01/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicidal and violent behaviours are interlinked and share common biological underpinnings. In the present study we analysed the association between violent behaviour as a child, childhood trauma, adult psychiatric illness, and substance abuse in relation to interpersonal violence as an adult in suicide attempters with mood disorders. METHODS A total of 161 suicide attempters were diagnosed with Structured Clinical Interviews and assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behaviour in childhood (between 6-14 years of age) and during adult life (15 years or older). Ninety five healthy volunteers were used as a comparison group. A logistic regression analysis was conducted with the two KIVS subscales, expressed violent behaviour as a child and exposure to violence in childhood together with substance abuse, personality disorder diagnoses and age as possible predictors of adult interpersonal violence in suicide attempters. RESULTS Violent behaviour as a child, age and substance abuse were significant predictors of adult interpersonal violence. ROC analysis for the prediction model for adult violence with the KIVS subscale expressed violence as a child gave an AUC of 0.79. Using two predictors: violent behaviour as a child and substance abuse diagnosis gave an AUC of 0.84. The optimal cut-off for the KIVS subscale expressed violence as a child was higher for male suicide attempters. CONCLUSIONS Violent behaviour in childhood and substance abuse are important risk factors for adult interpersonal violent behaviour in suicide attempters.
Collapse
Affiliation(s)
- Tomas Moberg
- The Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden.
| | - Marlene Stenbacka
- Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden
| | - Erik G Jönsson
- The Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden,NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Peter Nordström
- The Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden
| | - Marie Åsberg
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Jussi Jokinen
- The Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden
| |
Collapse
|
16
|
Voyer M, Millaud F, Dubreucq JL, Senon JL. Clinique et prédiction de la violence en psychiatrie. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s0246-1072(12)45161-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
17
|
Steinert T, Hamann K. External validity of studies on aggressive behavior in patients with schizophrenia: systematic review. Clin Pract Epidemiol Ment Health 2012; 8:74-80. [PMID: 22934120 PMCID: PMC3428629 DOI: 10.2174/1745017901208010074] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 03/12/2012] [Accepted: 03/12/2012] [Indexed: 12/02/2022]
Abstract
STUDIES ON VIOLENCE IN SCHIZOPHRENIA USE TWO DIFFERENT APPROACHES: use of epidemiological data, and clinical studies recording direct patient data after gaining informed consent. With regard to informed consent requiring agreement and cooperation, the question arises as to what extent participants represent patients with schizophrenia and violent behaviour (external validity). We conducted a systematic literature research. In most of the studies, aggression or violence, respectively, were poorly defined. Only 5 (15.2%) studies used a cut-off score on an aggression scale. Only 6 studies (18.2%) reported the number of patients who refused to participate, and 16 (48.5%) reported the number of drop-outs. Only 3 studies (9.1%) reported a systematic comparison of participants and non-participants. We found that data which allow for the assessment of representativeness of the investigated samples are poorly reported. For most studies, doubts regarding external validity seem justified and generalisability is questionable due to possible selection bias.
Collapse
Affiliation(s)
- Tilman Steinert
- Centre for Psychiatry Suedwuerttemberg, Ulm University, Germany
| | | |
Collapse
|
18
|
Skeem JL, Polaschek DLL, Patrick CJ, Lilienfeld SO. Psychopathic Personality. Psychol Sci Public Interest 2011; 12:95-162. [PMID: 26167886 DOI: 10.1177/1529100611426706] [Citation(s) in RCA: 235] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
19
|
Bo S, Abu-Akel A, Kongerslev M, Haahr UH, Simonsen E. Risk factors for violence among patients with schizophrenia. Clin Psychol Rev 2011; 31:711-26. [PMID: 21497585 DOI: 10.1016/j.cpr.2011.03.002] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 02/24/2011] [Accepted: 03/02/2011] [Indexed: 10/18/2022]
|
20
|
Castillo ED, Alarid LF. Factors associated with recidivism among offenders with mental illness. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2011; 55:98-117. [PMID: 20181775 DOI: 10.1177/0306624x09359502] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This study examined factors that explained or predicted recidivism of offenders who were mentally impaired and were under various correctional interventions. Offenders in a residential treatment program and specialized probation group, specialized probation alone, and mentally ill offenders who had served time in jail were examined. In comparison to the other two groups, the residential treatment offenders had a more extensive criminal history and were thus more likely to fail on supervision as well as to recidivate after supervision ended. Offenders with an alcohol problem were more likely to recidivate earlier and be rearrested for a violent offense than offenders without an alcohol problem.
Collapse
Affiliation(s)
- Eladio D Castillo
- Department of Criminal Justice, University of Texas–San Antonio, 501 W. Durango Blvd., San Antonio, TX 78207, USA
| | | |
Collapse
|
21
|
Abstract
Violence committed by acute psychiatric inpatients represents an important and challenging problem in clinical practice. Sociodemographic, clinical, and treatment information were collected for 1324 patients (677 men and 647 women) admitted to Italian public and private acute psychiatric inpatient facilities during an index period in 2004, and the sample divided into 3 groups: nonhostile patients (no episodes of violent behavior during hospitalization), hostile patients (verbal aggression or violent acts against objects), and violent patients (authors of physical assault). Ten percent (N = 129) of patients showed hostile behavior during hospitalization and 3% (N = 37) physically assaulted other patients or staff members. Variables associated with violent behavior were: male gender, <24 years of age, unmarried status, receiving a disability pension, having a secondary school degree, compulsory admission, hostile attitude at admission, and a diagnosis of schizophrenia, bipolar disorder, personality disorder, mental retardation, organic brain disorder or substance/alcohol abuse. Violent behavior during hospitalization was a predictive factor for higher Brief Psychiatric Rating Scale scores and for lower Personal and Social Performance scale scores at discharge. Despite the low percentage of violent and hostile behavior observed in Italian acute inpatient units, this study shed light on a need for the careful assessment of clinical and treatment variables, and greater effort aimed at improving specific prevention and treatment programs of violent behavior.
Collapse
|
22
|
Vandamme MJ. Schizophrénie et violence : facteurs cliniques, infracliniques et sociaux. ANNALES MEDICO-PSYCHOLOGIQUES 2009. [DOI: 10.1016/j.amp.2009.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
23
|
Voyer M, Senon JL, Paillard C, Jaafari N. Dangerosité psychiatrique et prédictivité. ACTA ACUST UNITED AC 2009. [DOI: 10.3917/inpsy.8508.0745] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
24
|
Swanson JW, Van Dorn RA, Swartz MS, Smith A, Elbogen EB, Monahan J. Alternative pathways to violence in persons with schizophrenia: the role of childhood antisocial behavior problems. LAW AND HUMAN BEHAVIOR 2008; 32:228-40. [PMID: 17602288 DOI: 10.1007/s10979-007-9095-7] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Accepted: 05/04/2007] [Indexed: 05/16/2023]
Abstract
Violence in schizophrenia patients may result from many factors besides the symptoms of schizophrenia. This study examined the relationship between childhood antisocial behavior and adult violence using data from the NIMH CATIE study. The prevalence of violence was higher among patients with a history of childhood conduct problems than among those without this history (28.2% vs. 14.6%; P < 0.001). In the conduct-problems group, violence was associated with current substance use at levels below diagnostic criteria. Positive psychotic symptoms were linked to violence only in the group without conduct problems. Findings suggest that violence among adults with schizophrenia may follow at least two distinct pathways-one associated with premorbid conditions, including antisocial conduct, and another associated with the acute psychopathology of schizophrenia.
Collapse
Affiliation(s)
- Jeffrey W Swanson
- Department of Psychiatry & Behavioral Sciences, Duke University, School of Medicine, 3071, Brightleaf Square, Suite 23-A, 905 West Main Street, Durham, NC 27710, USA.
| | | | | | | | | | | |
Collapse
|
25
|
Tengström A, Hodgins S. Criminal behavior of forensic and general psychiatric patients with schizophrenia: are they different? Acta Psychiatr Scand Suppl 2005:62-6. [PMID: 12072130 DOI: 10.1034/j.1600-0447.106.s412.14.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study was designed to compare the rate of past criminal behavior among male patients being discharged from forensic and general psychiatric hospitals in four countries. METHOD Discharged consecutive patients from eight sites, four general and four forensic psychiatric, were included and asked for participation. Transcripts of past criminal behavior were available for this study. Analyses were limited to men with schizophrenia. RESULTS One in five of the general psychiatric patients had a criminal record. The criminal histories of the offenders in the general and forensic hospitals were similar, except that all patients who had killed were treated in forensic hospitals. CONCLUSION The results point to the need to assess the risk of violent behavior among general psychiatric patients in order to provide them with appropriate treatments designed to prevent criminal recidivism.
Collapse
Affiliation(s)
- A Tengström
- Centre de Recherche, Institut Philippe Pinel de Montréal, Montréal, Canada
| | | |
Collapse
|
26
|
Modestin J, Wuermle O. Criminality in men with major mental disorder with and without comorbid substance abuse. Psychiatry Clin Neurosci 2005; 59:25-9. [PMID: 15679536 DOI: 10.1111/j.1440-1819.2005.01327.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Violent and criminal behavior in the mentally ill remains an issue of major importance and in this context the role of comorbid substance abuse must be addressed. Data on criminal behavior in 282 men with schizophrenia and 261 men with affective disorder were studied. Samples of patients with and without additional substance abuse were compared. Also, non-abusing patients from both diagnostic groups were compared with matched controls from the general population. Substance abuse was found in half of all men in both groups of major mental disorders, and substance abusers had twice as high a probability of having a criminal record. However, compared with the matched sample from the general population, violent criminality was increased in schizophrenic patients without comorbid substance abuse, and patients with affective disorders without substance abuse had a higher probability of committing crimes against property. Men with major mental disorder have an increased probability of becoming criminal even when there is no comorbid substance abuse.
Collapse
Affiliation(s)
- Jiri Modestin
- University of Zurich, Department of Psychiatry, Burghölzli Hospital, Zurich, Switzerland.
| | | |
Collapse
|
27
|
Senon JL. Évolution des attentes et des représentations en clinique dans les rapports entre psychiatrie et justice. EVOLUTION PSYCHIATRIQUE 2005. [DOI: 10.1016/j.evopsy.2004.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
28
|
|
29
|
Hodgins S, Müller-Isberner R. Preventing crime by people with schizophrenic disorders: the role of psychiatric services. Br J Psychiatry 2004; 185:245-50. [PMID: 15339830 DOI: 10.1192/bjp.185.3.245] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Knowledge of when and how to implement treatments to prevent criminal offending among people with schizophrenia is urgently needed. AIMS To identify opportunities for interventions to prevent offending among men with schizophrenic disorders by tracking their histories of offending and admissions to hospital. METHOD We examined 232 men with schizophrenic disorders discharged from forensic and general psychiatric hospitals. Data were collected from participants, family members and official records. RESULTS More than three-quarters (77.8%) of the forensic patients had previously been admitted to general psychiatric services; 24.3% of the general psychiatric patients had a criminal record. Offences had been committed by 39.8% of the forensic patients and 10.8% of the general psychiatric patients before their first admission to general psychiatry, and after their first admission these 59 patients committed 195 non-violent and 59 violent offences. Subsequently, 49 of them committed serious violent offences that led to forensic hospital admission. The offenders were distinguished by a pervasive and stable pattern of antisocial behaviour evident from at least mid-adolescence. CONCLUSIONS General psychiatry requires resources in order to prevent criminal offending among a subgroup of patients with schizophrenic disorders.
Collapse
Affiliation(s)
- S Hodgins
- Department of Forensic Mental Health Science, Institute of Psychiatry, Box PO23, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
| | | |
Collapse
|
30
|
Preti A, Miotto P, De Coppi M, Petretto D, Carmelo M. Psychiatric chrono-epidemiology: its relevance for the study of aggression. Aggress Behav 2002. [DOI: 10.1002/ab.10033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
31
|
Combalbert N, Favard A, Bouchard M. Trouble mental et criminalité : revue critique des recherches épidémiologiques. ANNALES MEDICO-PSYCHOLOGIQUES 2001. [DOI: 10.1016/s0003-4487(01)00089-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
32
|
Hodgins S. The major mental disorders and crime: stop debating and start treating and preventing. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2001; 24:427-446. [PMID: 11521419 DOI: 10.1016/s0160-2527(01)00077-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- S Hodgins
- Department of Psychology, Université de Montréal, C.P. 6128, Succ. Centre-Ville, Montréal, Québec, H3C 3J7, Canada.
| |
Collapse
|