Psychiatrische Erkrankungen und die Prognose krimineller Rückfälligkeit

Abstract

The risk for criminal recidivism of mentally ill offenders is, unlike the general risk of delinquency, not well established. The relationship between psychiatric diagnosis and criminal recidivism was examined in the context of the Munich project on risk assessment. A total of 185 offenders had been examined on the question of culpability between 1992 and 1993. Re-offenses committed before the end of 2001 were recorded according to the Federal Registry of court sentences (Bundeszentralregister); 38.8% of the total group recidivated. High rates of recidivism were observed for individuals with substance abuse (45.5%) and with personality disorders (46.6%). The combination of the two illnesses increased the rate for recidivism to 50%. For individuals with organic, affective and neurotic disorders the rates for recidivism were below the average. Rates of recidivism for schizophrenic offenders were slightly higher, if re-offenses in the state of inculpability were included. The HCR-20 predicted recidivism equally well for offenders with and without a psychiatric diagnosis. In both groups, individuals with HCR-20 scores above the mean recidivated more often and after shorter periods of time.

Rückfallprognosen bei Sexualstraftätern — Vergleich der prädiktiven Validität von Prognoseinstrumenten

“…Die 2. Auflage wurde 1998 ins Deutsche übersetzt [40] und seither in verschiedenen Studien auch von unserer Arbeitsgruppe ausgewertet [50]. Es handelt sich um ein so genanntes strukturiert klinisches Instrument und unterscheidet 3 Untergruppen von Merkmalen.…”

“…Der HCR-20 ist weltweit eines der am besten untersuchten und am häufigsten angewandten Instrumente zur Vorhersage von Gewalttaten (Überblick: [50]). …”

“…Dabei wird die so genannte Fläche unter der Kurve oder "area under the curve" (AUC) ermittelt [50]. Die ROC-Kurven stellen die richtig identifizierten, gewalttätig rückfälligen Sexualstraftäter und die so genannten "falsch-positiven" Sexualstraftäter für jeden einzelnen Skalenwert dar.…”

The relationship between mental disorder and violence

“…As for the further clinical implications, one has to agree with Moscatello conclusions, and even more so as the incidence of aggressive violence in schizophrenia can be reduced by intense mental health care and close supervision 5,8 . Treatment with antipsychotic drugs is indicated but in itself cannot guarantee non-violence.…”

“…There is converging evidence from numerous international studies that (A) the risk of antisocial behaviour and violent offence is increased, and that of homicides even markedly increased, in people with schizophrenia, compared to the general population [4][5][6] . This evidence, based on unselected birth cohorts, representative population studies and retrospective cohorts (schizophrenia patients; prison inmates), is quite robust and does not leave much room for controversial interpretations.…”