Psychotic Disorders and Sex Offending in a Danish Birth Cohort

Abstract

Context: Psychotic disorders are associated with an increased risk of aggressive behavior and violent crime. Whether there is also an association with sex offending is unknown.Objectives: To estimate the lifetime prevalence of arrests for sexual offenses (with and without physical aggression) among men and women with psychotic disorders, the moderating effects of comorbid personality disorders and substance use disorders, and the prevalence rates for 4 specific psychotic disorders. Design:We examined official records of arrests for sexual offenses with and without physical aggression to compare persons hospitalized with a psychotic disorder with those who had never been hospitalized. Results: Among the men, 2.2% were hospitalized with psychotic disorders. These men committed 8.4% of the physicallyaggressivesexualoffensesand9.0%ofthenon-physically aggressive sexual offenses of the men in the cohort. Compared with men who had never been hospitalized, men with psychotic disorders without a personality disorder or a substance use disorder were not at increased risk of arrest for physically aggressive sexual offenses but were 3 times more likely to have been arrested for non-physically aggressive sexual offenses. Psychotic disorders with comorbid personality disorders or substance use disorders were associated with a 6-fold increased risk of physically aggressive sex offending and a 3-to 5-fold increased risk of non-physically aggressive sex offending.Conclusions: Psychotic disorders comorbid with personality disorders and substance use disorders are associated withanincreasedriskofsexoffendingwithandwithoutphysical aggression. Mental health policy and practice need to take account of these findings to improve functional outcome among persons with psychotic disorders.

Cessation of dangerousness status: an analysis of 224 reports from the Instituto de Perícias Heitor Carrilho, Rio de Janeiro, Brazil

“…The fact that the percentage encountered was lower than expected may reflect a difficulty in establishing or describing such a diagnosis, or it may reveal that most of the experts did not attribute great importance to that diagnosis. Indeed, the numbers are far lower than those found by Alden et al 37 and others. 20,22,30 Fazel & Rongquin, 28 in a meta-analysis of 27 studies, compared the risk of criminal recidivism among a total 3,511 psychotic individuals, 5,446 with mental illness but not psychotic, and 71,552 with no mental illness.…”

“…There is solid evidence in scientific studies, including systematic reviews and meta-analyses, that proves that mental illness is far from being the most important factor in assessing risk of violence, and may not even be an isolated factor. 1,20,21,28,30,33,34,37 Bonta et al 30 conducted a meta-analysis to evaluate the main predictors of criminal recidivism in individuals with and without mental illness. A total of 64 studies with 74 predictors were analyzed.…”

“…Alden et al 37 followed up a cohort of 358,118 live births from 1944 through 1947 and collected data on convictions for sexual offenses, with or without violence, 50 years later, considering the presence of one of the following three: mental illness, substance abuse, or personality disorders. In psychotic individuals, whether schizophrenic or not, an association was found with higher-than-average risk only when there was co-morbidity with personality disorders or substance abuse.…”

Relationship between sexual offences and mental and developmental disorders: a review

“…In this review study we found several factors associated to, as well as motivators of sexual offences, also mentioned as important for recidivism of these offences, according with these instruments cited above: presence of serious mental disorders such as schizophrenia [10][11][12][13][14][15]18,34 , bipolar disorder 10,14,17,18,20,39 , existence of sexual deviants 10,13,15,20,21,33,39 , presence of personality disorders 14,18,24,34 , problems associated with the use of alcohol and/or substances 6,14,15,17,18,20,27 , seriousness of sexual aggression [10][11][12][13][14][15]18,20,21,[26][27][28][37][38][39] , record of abuse in childhood 1...…”

“…A study by Alden et al 14 , examined the data of individuals born in Denmark, between the years of 1944 and 1947, through official records, who were accompanied till the year 1991. The final sample consisted of 173.559 men.…”