Parental separation at birth and criminal behaviour in adulthood

Background: Parental absence has been connected with later criminality. We studied the association between very early separation and criminality in a unique data set. Methods: The index cohort consisted of 2,906 subjects born between 1945 and 1965 in Finland who were temporarily isolated from their family immediately after birth and sent to adequate nursing homes due to tuberculosis in the family. The average separation time was 7 months. For every index subject, two reference subjects (matched for sex, year of birth and place of birth) were gathered. Data on criminal offences were obtained from Statistics Finland arising from adolescence to middle age, between January 1, 1977 and December 31, 1998. The association between parental separation and subcategories of non-violent and violent criminality and violent recidivism, respectively, in male and female offspring was analysed. Subjects who had committed at least two violent crimes were defined as violent recidivists. Results: Of the male index subjects, 12.1% as compared with 7.1% of the reference cohort (estimated relative risk RR 1.73; 95% CI 1.42–2.11) had committed violent offences. Of the male index subjects 5.2% and of the male reference subjects 3.6% were violent recidivists (RR 1.47; 1.10–1.98). Of the male index subjects 26.3% and of the reference cohort 23.4% had committed nonviolent crimes (RR 1.14; 1.01–1.29). Among females, non-violent crimes were committed by 7.9% of the index subjects and by 5.0% of the reference subjects, respectively (RR 1.54; 1.18–2.00). Violent crimes were rare among female subjects. Conclusion: Criminal behaviour was more prevalent among both male and female subjects separated at birth from their families because of tuberculosis in the family than in the reference cohort. Especially violent crimes were prevalent in the male index cohort. Even so, the differences between the index and reference cohorts were rather modest. Very early separation may have some, although limited, influence on later criminality in the offspring. Accepted: 10 January 2003 Correspondence to P. M?ki, MD     

Incipient offending among schizophrenia patients after first contact to the psychiatric hospital system.

The study examines how age, sex and substance use disorder are associated with the risk of committing a criminal offence. The study explicitly examines the risk after the first contact to the psychiatric hospital system and after the diagnosis of schizophrenia for those with no previous criminal record; the association between previous non-violent criminality and later violent criminality is also analysed. The study sample comprised 4619 individuals ever diagnosed with schizophrenia. All solved offences were accessible. Data were analysed using Cox's regression. Schizophrenic men had twice the risk of schizophrenic women of committing both violent and non-violent offences. A registered substance use disorder increased the risk 1.9- to 3.7-fold, depending on the starting point for the analyses, while increasing age on first contact or when diagnosed with schizophrenia diminished the risk. Previous non-violent criminality increased the risk for later violent criminality 2.5- to 2.7-fold, depending on the starting point for the analyses. The results suggest that the psychiatric treatment system can play an active role in preventing criminality among individuals with schizophrenia. The preventive measures should be based on a thorough assessment including criminal history at intake and alertness toward young psychotic men with substance use disorders and especially if they also have a criminal history.     

DSM-IV Conduct Disorder symptoms in adolescents as markers of registered criminality

A nationwide sample of 1,079 Norwegian adolescent psychiatric in-patients, 581 males and 498 females, were followed up after 11–33 (mean 23.2) years. On the basis of detailed records from index hospitalisation they were re-diagnosed and retrospectively scored on 14 of the 15 behaviour items listed as diagnostic criteria for conduct disorder in DSM-IV. The patient list was linked to the national criminal registry, and 48 % were found to have a criminal record. The ability of the 14 behaviour items to identify overall and specific kinds of registered criminality was investigated. In males, “stealing” was the strongest marker for overall and violent crime. “Having forced someone into sexual activity” was a strong marker for later sex offences. In females, “running away from home” was strongly associated with overall and violent registered criminality. ROC curves were constructed to test the sensitivity and specificity of the sum of conduct disorder behaviour items fulfilled in the identification of individuals with registered criminality. The area under the curve was 0.81 (95 % c. i. = 0.78–0.85) in males and 0.75 (95 % c. i. = 0.71–0.80) in females. A cut-off at 3 criteria fulfilled seemed optimal in males and somewhat high in females. Accepted: 17 May 2001     

Low verbal ability predicts later violence in adolescent boys with serious conduct problems

Abstract

Background: Delinquent adolescents are a known high-risk group for later criminality. Cognitive deficits correlate with adult criminality, and specific cognitive deficits might predict later criminality in the high-risk adolescents. Aims: This study aimed to explore the neuropsychological performance and predictors of adult criminal offending in adolescents with severe behavioural problems. Methods: Fifty-three adolescents (33 boys and 20 girls), aged 15–18 years, residing in a reform school due to serious conduct problems, were examined for neuropsychological profile and psychiatric symptoms. Results were compared with a same-age general population control sample, and used for predicting criminality 5 years after the baseline testing. Results: The reform school adolescents’ neuropsychological performance was weak on many tasks, and especially on the verbal domain. Five years after the baseline testing, half of the reform school adolescents had obtained a criminal record. Males were overrepresented in both any criminality (75% vs. 10%) and in violent crime (50% vs. 5%). When cognitive variables, psychiatric symptoms and background factors were used as predictors for later offending, low verbal intellectual ability turned out to be the most significant predictor of a criminal record and especially a record of violent crime. Conclusions: Neurocognitive deficits, especially in the verbal and attention domains, are common among delinquent adolescents. Among males, verbal deficits are the best predictors for later criminal offending and violence. Clinical implications: Assessing verbal abilities among adolescent population with conduct problems might prove useful as a screening method for inclusion in specific therapies for aggression management.     

Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses

OBJECTIVE: To analyse how committed crimes and substance-related diagnoses are associated with the age on the first contact with the psychiatric hospital system and the age at diagnosing of schizophrenia among schizophrenics. METHOD: In a register-based study including all Danes diagnosed with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. RESULTS: Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when the diagnosis of schizophrenia was first given. In contrast, having a substance-related diagnosis was associated with a younger age on first contact but did not influence the age at which the diagnosis of schizophrenia was given. CONCLUSION: It is important that both psychiatrists and the judicial system are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment.     

Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort

Background: The diagnosis of schizophrenia by clinicians is not always accurate in terms of operational diagnostic criteria despite the fact that these diagnoses form the basis of case registers and routine statistics. This poses a challenge to psychiatric research. We studied the reasons for diagnostic discordance between clinicians and researchers. Methods: The Northern Finland 1966 Birth Cohort (n = 11,017) was followed from mid-gestation to the end of the 31st year. Psychiatric outcome was ascertained through linkage to the national hospital discharge register containing clinical diagnoses made by the attending physician. The hospital notes of all subjects admitted to hospital during the period 1982–1997 due to psychiatric disorder were reviewed and 475 research, operational DSM-III-R diagnoses were formulated. Results: Ninety-six cases met operational criteria for schizophrenia. Fifty-five (57 %) had concordant diagnoses: both the clinical and research diagnoses were schizophrenia. Forty-one (43 %) had discordant diagnoses: the clinical diagnosis was other than schizophrenia (mainly schizophreniform or other psychosis). Discordant cases were more likely to be older at onset, experience a shorter treatment duration, fewer treatment episodes, and to have a comorbid diagnosis mental retardation. Conclusions: Clinicians do not make the diagnosis of schizophrenia as often as the application of operational criteria would suggest they should. The discordance between clinical diagnosis and the research, operational diagnosis is especially likely in cases having late onset and few contacts to psychiatric hospital. Accepted: 12 December 2002 Correspondence to Kristiina Moilanen, MD     

Registered criminality and sanctioning of schizophrenia patients

Background: Patients with schizophrenia have been shown to have an increased risk of criminality, especially violent crimes. Aims: The aim of the current study was to describe the pattern of crimes committed by Danish patients with schizophrenia and examine the sanctions given for crimes in relation to the different periods in the patients’ lives: not yet known to the psychiatric hospital system, known to the system but not yet diagnosed with schizophrenia, and after being diagnosed with schizophrenia. Methods: Information from the Danish Psychiatric Central Research Register was correlated with data from the Danish National Crime Register. Results: One of the more prominent findings was that 16% of patients diagnosed with schizophrenia receive a prison sentence or a suspended prison sentence, despite the fact that Denmark is a co-signatory of the European Prison Rules and should treat, rather than imprison, individuals with schizophrenia. Conclusion: The findings suggest that greater alertness is needed in the judicial system for individuals diagnosed with schizophrenia.     

Psychiatric admissions at different levels of the national health care services and male criminality: the Northern Finland 1966 Birth Cohort study

  Background: It has earlier been suggested that one-third of violent offenders are recorded in psychiatric case registers. Our aim was to study whether violent and non-violent offenders differ with respect to admissions to any health care inpatient service due to psychiatric disorders. Methods: We used a genetically homogeneous, general population database from the Northern Finland 1966 Birth Cohort, together with the Finnish Hospital Discharge Register and national crime registers. Results: We found that one-third of violent and one-fourth of non-violent male offenders had at least one hospital admission due to a psychiatric disorder before the age of 32. Sixty-five violent criminals – 1.2% of all cohort males (n=5636) – accounted for 14.4% of all psychiatric treatment days. The admission rates among both violent and non-violent male offenders were significantly higher when compared with males with no criminal history. Among violent males, only half (55.5%) of the inpatient hospital days due to psychiatric disorders occurred in psychiatric hospitals. The corresponding percentages for non-violent criminals and non-criminals were 64.9% and 74.1%, respectively. Among the violent offenders, one-third of hospital inpatient days occurred in university hospitals or central hospitals, and only 1.9% of them occurred in a comprehensive community care system. Conclusions: Violent offenders' admission rates due to a psychiatric diagnosis are high, and they are frequently treated at an inappropriate health care level. Accepted: 23 February 2000     

Adolescence-limited versus life-course-persistent criminal behaviour in adolescent psychiatric inpatients

 A nation-wide sample of 1072 Norwegian adolescent psychiatric inpatients were followed up 15–33 (mean 23.8) years after hospitalisation, by record linkage to the National Register of Criminality. Defining criminal behaviour as entry into the criminal registry, 481 patients (45%) had an adolescent criminal debut, entering the registry before the age of 21. Of these, 130 (27%) had no criminal record after the age of 21 and were consequently considered as adolescence-limited criminal offenders, as opposed to the remaining 351 (73%) individuals who continued their criminal behaviour beyond the age of 21 and were considered as life-course-persistent criminal offenders. On the basis of hospital records, all patients were rediagnosed according to DSM-IV and scored on factors hypothesised to have predictive power as to persistence of criminal behaviour. We found that 79.6% of the male, and 58.8% of the female adolescent delinquents went on to life-course-persistent criminality. In females, intravenous use of illegal drugs, and being discharged from the hospital elsewhere than to the family home, were strong and independent predictors of life-course-persistent criminal behaviour. In males, the following were significant and independent predictors of life-course-persistent criminality: a high number of conduct disorder criteria fulfilled, comorbidity of psychoactive substance use disorder, and having attended correctional school. Accepted: 8 March 1999     

Mentally disordered offenders in Sweden: differentiating recidivists from non-recidivists in a 10-year follow-up study

Background: Forensic psychiatric patients present a challenge as they manifest severe mental disorders together with criminal behaviour. There are well-known risk factors for criminal behaviour in the general population, yet knowledge of what predicts reconviction in the Swedish forensic population in the long-term perspective is still insufficient.

Aims: The study aims to (1) describe background and clinical characteristics of forensic psychiatric patients in a 10-year follow-up, (2) analyse risk factors associated with recidivism, and (3) test the predictive validity of risk factors for general and violent criminality.

Methods: Detailed information on all offenders from the Malmö University Hospital catchment area sentenced to forensic psychiatric in-patient treatment from 1999–2005 (n?=?125) was collected. Court decisions were collected up until the end of 2008 (median follow-up time?=?6.2 years, range?=?0.6–9.7 years).

Results: Relapse in general crime (n?=?30) was predicted by low educational attainment, mental disorder in a first degree relative, and low age at first sentenced crime. Relapse in violent crime (n?=?16) was predicted by low educational attainment and low GAF scores. Patients with a restriction order were less likely to relapse in both crime categories.

Conclusions: Signs of childhood adversities together with early debut in criminality appeared as important risk factors for general and violent recidivism. Forensic psychiatric treatment combined with a restriction order was demonstrated as a protective factor against recidivism, suggesting that the risk of recidivism is strongly related to the level of supervision. Although the low number of recidivism cases is highly desirable, it unfortunately reduces the power of the analyses in this paper.     

The association between psychopathology of first-episode psychosis patients within the schizophrenia spectrum and previous offending

Patients with schizophrenia have been shown to have an increased risk of criminality. The aim was to describe possible psychopathological differences between schizophrenia spectrum patients with and without a criminal career before first-episode psychosis. In a multi-centre study, 16 psychiatric treatment centres included and rated 477 patients with first-episode psychosis over a 2-year period on socio-demography, the Positive and Negative Syndrome Scale, OPerational CRITeria checklist, Global Assessment of Functioning, Premorbid Adjustment Scale and Self-report Insight Scale for psychosis. Data were linked with data concerning criminal and psychiatric history. No key characteristics were found to assist the early detection of criminal persons before first psychiatric hospital contact for a psychotic incident. However, when adjusted for sex, age, abuse, living conditions, marital status, employment status and education, a primarily positive symptomatology was associated with a prior criminal career. The premorbid level of functioning and several function parameters were also significantly associated with criminal history. There are significant differences in psychopathology between schizophrenia spectrum patients with and without a criminal career before first-episode psychosis, and a better screening procedure in the judicial system could detect these individuals earlier and make adequate treatment possible.     

Mental disorder, intellectual deficiency, and crime. Evidence from a birth cohort.

Studies of criminality among patients in psychiatric hospitals and of mental disorder among incarcerated offenders have suggested an association between the major mental disorders (schizophrenia and major affective disorders) and crime. However, these investigations are characterized by notable methodological weaknesses, and, consequently, this conclusion has remained tentative. Little is known about the criminality of intellectually handicapped people. The present study examined the relationship between crime and mental disorder and crime and intellectual deficiency in an unselected Swedish birth cohort followed up to age 30 years. It was found that men with major mental disorders were 2 1/2 times more likely than men with no disorder or handicap to be registered for a criminal offense and four times more likely to be registered for a violent offense. Women with major disorders were five times more likely than women with no disorder or handicap to be registered for an offense and 27 times more likely to be registered for a violent offense. These subjects committed many serious offenses throughout their lives. The criminal behavior in over half these cases appeared before the age of 18 years. Intellectually handicapped men were three times more likely to offend than men with no disorder or handicap and five times more likely to commit a violent offense. Intellectually handicapped women were almost four times more likely to offend than women with no disorder or handicap and 25 times more likely to commit a violent offense.(ABSTRACT TRUNCATED AT 250 WORDS)     

Substance abuse in schizophrenia. A Singapore perspective

Background Most of the information on the prevalence and patterns of substance abuse in patients with schizophrenia has been from studies conducted in North America and Europe and data from Asian countries are conspicuously lacking. This study was undertaken with the aim to identify the prevalence and patterns of substance abuse among patients with first-episode schizophrenia in the city-state of Singapore. Methods All new patients with a diagnosis of first-episode schizophrenia or schizophreniform disorder who were seen in one calendar year in the only state mental institute in Singapore and its affiliated outpatient clinics were evaluated for a lifetime history of substance use. Results In a sample of 272 patients, 201 (73.6 %) were abstainers, 43 (15.8 %) had “mild” substance use and 28 (10.3 %) had “heavy” use patterns. Alcohol was the most frequently abused substance. The substance users were more likely to be males and were more likely to have a criminal record than abstainers. Conclusions To our knowledge, this is the first study that examines the co-morbidity of substance abuse in schizophrenia in an Asian population. Our findings once again highlight the fact that patients with schizophrenia are at a high risk for substance abuse. Accepted: 20 February 2002     

Schizophrenia: illness impact on family members in a traditional society – rural Ethiopia

Background: Studies have consistently shown that both the subjective and objective dimensions of burden among family members of schizophrenia patients and other psychiatric disorders are prevalent. However, as most of these reports were from western societies, we lack information on the subject in developing countries. Method: The study was conducted within the framework of the ongoing epidemiological study of course and outcome of schizophrenia and bipolar disorders in a rural population of 15–49 years of age. Three hundred and one cases of schizophrenia and their close relatives participated in the study. Results: Family burden is a common problem of relatives of cases with schizophrenia. Financial difficulty is the most frequently endorsed problem among the family burden domains (74.4 %). Relatives of female cases suffered significantly higher social burden (Z = 2.103; p = 0.036). Work (Z = 2.180; p = 0.029) and financial (Z = 2.088; p = 0.037) burdens affected female relatives more often than males. Disorganised symptoms were the most important factors affecting the family members in all family burden domains. Prayer was found to be the most frequently used coping strategy in work burden (adj. OR = 1.99; 95 % CI = 1.08–3.67; p = 0.026). Conclusion: Negative impact of schizophrenia on family members is substantial even in traditional societies such as those in Ethiopia where family network is strong and important. The scarce existing services in the developing countries should include family interventions and support at least in the form of educating the family members about the nature of schizophrenia illness and dealing with its stigma and family burden. Received: 15 January 2002 / Accepted: 29 July 2002 Correspondence to Gunnar Kullgren, MD, PhD     

Temporal sequencing of lifetime mood disorders in relation to comorbid anxiety and substance use disorders

Background: Little is known about the temporal sequencing of psychiatric disorders. The aim of this study was to obtain insight into patterns of co-occurrence of DSM-III-R mood disorders in relation to anxiety and substance use disorders, their temporal sequencing and the sociodemographic and long-term vulnerability predictors of this temporal sequencing. Methods: Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a psychiatric epidemiological study in a representative sample of 7,076 adults aged 18–64. Results: Of those who had ever experienced a mood disorder, 46 % of males and 57 % of females had a history of anxiety disorders, and 43 % and 15 % of substance use disorders. Mood disorders were associated with all anxiety and substance use disorders, except with alcohol abuse among males. In the majority of anxiety-comorbid cases, the mood disorder arose after the anxiety disorder; the pattern for substance use-comorbid disorders was more variable. Deviation from the usual sequence of major depression and anxiety disorders was more often seen among females, subjects with a higher educational level, subjects who experienced childhood parental divorce, and subjects who experienced childhood emotional neglect. Conclusions: When comorbid with anxiety disorders, mood disorders clearly tend to be secondary. Few of the studied demographic factors, familial vulnerability factors and childhood life events predict the sequencing of mood disorders in relation to other disorders. Received: 20 September 2001 / Accepted: 29 July 2002 Correspondence to R. de Graaf     

Patients' and their relatives' causal explanations of schizophrenia

Background: Previous studies with schizophrenia patients and their relatives which have been carried out in the western part of Germany and in Austria have demonstrated a strong tendency towards assuming psychosocial stress as a cause of schizophrenia. The question arises as to whether patients with schizophrenia and their relatives in the eastern part of Germany (former German Democratic Republic) share these beliefs. Methods: Problem-centered interviews were conducted with 100 schizophrenia patients living in the catchment area of the university hospital who were in psychiatric outpatient treatment. Thirty-six relatives were also interviewed at the same time. Results: Both patients and relatives most frequently reported psychosocial stress as a cause of the illness. Sixty-two per cent of the patients and 86 % of the relatives reported more than one cause. However, the majority of them did not explicitly link these causes to one another. Discussion: Similarities between the results of this study and those of previous studies prevail. However, there are some differences with regard to the role attributed to socialisation and society. Whereas there is a stronger tendency to hold the family responsible for the illness in the West, in the East the social conditions are more frequently considered to be of etiological relevance. Inconsistencies between patients' and relatives' beliefs and the results of psychiatric research on the causes of schizophrenia suggest a need to provide specific psychoeducation for both. Received: 28 October 2002 / Accepted: 4 November 2002 Correspondence to Dr. Anita Holzinger     

Conduct disordered adolescents hospitalised 1963–1990

Abstract Secular trends in the criminal activity of conduct disordered adolescents admitted as psychiatric in-patients in Norway were examined. A nationwide sample of 650 adolescents hospitalised with DSM-IV Conduct Disorder during the years 1963–1990 was followed up 12–33 years after index hospitalisation by register linkage to the National Crime Register. In all, 469 patients, 82% of the males and 57% of the females, had a criminal record at follow-up. The study population was divided into four consecutive cohorts and gender-specific cohort differences in registered criminality were investigated, using survival analysis. There was a marked increase and subsequent levelling off in overall registered criminality from the first to the most recent cohort of conduct disordered females, in contrast to unchanged crime rates in conduct disordered males. Monitoring specific types of crime, males’ violent crime rates initially increased but levelled off in more recent cohorts, whereas female violent crime rates increased steadily, with the highest level seen in the most recent cohort. A marked increase in drug offences was observed in both genders. Cox regression demonstrated numerous strong cohort effects, even when controlling for other important factors, including substance use comorbidity. Research into causal mechanisms is warranted.     

The 1 % of the population accountable for 63 % of all violent crime convictions

Purpose

Population-based studies on violent crime and background factors may provide an understanding of the relationships between susceptibility factors and crime. We aimed to determine the distribution of violent crime convictions in the Swedish population 1973–2004 and to identify criminal, academic, parental, and psychiatric risk factors for persistence in violent crime.

Method

The nationwide multi-generation register was used with many other linked nationwide registers to select participants. All individuals born in 1958–1980 (2,393,765 individuals) were included. Persistent violent offenders (those with a lifetime history of three or more violent crime convictions) were compared with individuals having one or two such convictions, and to matched non-offenders. Independent variables were gender, age of first conviction for a violent crime, nonviolent crime convictions, and diagnoses for major mental disorders, personality disorders, and substance use disorders.

Results

A total of 93,642 individuals (3.9 %) had at least one violent conviction. The distribution of convictions was highly skewed; 24,342 persistent violent offenders (1.0 % of the total population) accounted for 63.2 % of all convictions. Persistence in violence was associated with male sex (OR 2.5), personality disorder (OR 2.3), violent crime conviction before age 19 (OR 2.0), drug-related offenses (OR 1.9), nonviolent criminality (OR 1.9), substance use disorder (OR 1.9), and major mental disorder (OR 1.3).

Conclusions

The majority of violent crimes are perpetrated by a small number of persistent violent offenders, typically males, characterized by early onset of violent criminality, substance abuse, personality disorders, and nonviolent criminality.     

Criminal and violent behavior in schizophrenic patients: An overview

Abstract  An overview of the most important older and newer results regarding the relationship between violent and criminal behavior on the one hand and schizophrenic illness on the other hand is presented. Four different methods are available to study this relationship: (i) study of the prevalence of mental illness in criminal/violent populations; (ii) study of criminality/violence rate in samples of psychiatric patients; (iii) study of criminality/violence in community samples comparing mental patients with non-patient community residents; and (iv) study of criminality/violence in birth cohorts prospectively. All these methods have been used; but samples composed of schizophrenic patients exclusively were only exceptionally studied. The results indicate that there is a modest but significant relationship between schizophrenia and violence and crime which persists even after controlling for demographic and socio-economic variables. The probability of schizophrenic patients to be criminal or violent depends on the acuity of their illness and is increased by their use of psychoactive substances. Generally, however, violent and criminal acts directly attributable to mental illness account only for a very small proportion of such acts in the society.     

Clinical correlates of later violence and criminal offences in schizophrenia

BACKGROUND: Violence and criminality in patients with schizophrenia has been described in several studies but prediction of later criminal behavior is difficult. METHODS: We reviewed the national crime register for records of criminal offences committed by 1662 patients with schizophrenia treated between 1990 and 1995 in the Psychiatric Hospital of the University of Munich. Analyses were performed to determine predictors of later criminal behavior, and the psychopathological syndrome scales in the Association for Methodology and Documentation in Psychiatry (AMDP) system were used to establish possible psychopathological characteristics for such behavior. RESULTS: One hundred and sixty nine (10.2%) of the 1662 patients had been convicted in the 7-12 years after discharge, whereby male patients (117 of 685, 17.1%) outnumbered female patients ( 52 of 977, 5.3%) by more than 3 to 1. The rate of violent crimes was especially high: 62 (3.7%) patients were convicted for physical injury offences. Five cases of manslaughter or murder were recorded. AMDP syndrome scales were found to be predictive for later criminal offences. Significantly higher rates of criminal conviction and recidivism were found for patients with lack of insight at discharge. Analyses also showed a significantly higher risk of non-violent and violent crimes in patients with a hostility syndrome at admission and discharge. There was a significantly lower incidence of criminal behavior in subjects with a depressive syndrome. CONCLUSION: Data indicate a significant rate of minor and serious physical injury offences in former inpatients with schizophrenia. Moreover, results identify risk factors for future non-violent and violent criminal behavior in patients with schizophrenia.