A population-based study of juvenile perpetrators of homicide in England and Wales

This study aimed to describe the social, behavioural and offence characteristics of all convicted perpetrators of homicide aged 17 and under; to examine their previous contact with mental health services, and to discuss strategies for homicide prevention. An eight-year (1996-2004) sample of 363 juvenile homicide perpetrators in England and Wales was examined. The majority of perpetrators were male, used a sharp instrument, and most victims were acquaintances or strangers. Over half had previously offended. A history of alcohol and/or drug misuse was common, as was the prevalence of family dysfunction, abuse, educational difficulties or discipline problems. Previous contact with mental health services was rare. Earlier intervention targeting social and psychological adversity and substance misuse could help to reduce the level of risk for future violence, and may reduce homicide rates among juveniles. Strengthening engagement with young offenders and increasing resources to prevent recidivism may also be beneficial.     

Homicide in the Canadian Prairies: elderly and nonelderly killings.

OBJECTIVE: To examine the psychosocial and clinical characteristics of male perpetrators of elderly and nonelderly homicides in the Canadian Prairies. METHOD: We examined data drawn from a study of 901 adult homicide offenders who were incarcerated or on parole between 1988 and 1992 in Alberta, Saskatchewan, and Manitoba. RESULTS: Of those studied, 67 men were convicted of homicide involving 79 elderly victims, and 671 were convicted of homicide involving 675 nonelderly victims. Most perpetrators were single and engaged in irregular patterns of employment at the time of their index offence. Fourteen (20.8%) offenders with elderly victims had a history of psychiatric treatment, compared with 98 (14.6%) offenders with nonelderly victims; however, this difference was not statistically significant. Approximately 30% of both groups were diagnosed with personality disorders. A comparison of the index- offence characteristics showed no significant differences between the 2 groups. CONCLUSION: Our findings suggest that elderly individuals are more likely to be killed in their own homes by strangers. Social isolation appears to be a significant risk factor in cases of elderly homicide.     

Mentally abnormal homicide in New Zealand as defined by legal and clinical criteria: a national study

BACKGROUND: Homicides by people with mental illness have been studied using either clinical or legal categorization of the homicide as abnormal. No previous study has employed both definitions in the same population. METHOD: A retrospective study of all homicides in New Zealand between 1988 and 2000 considered mentally abnormal homicide using a legal definition (when the courts deemed a contribution of mental illness was present) and a clinical definition (defined as the presence of a discharge diagnosis from inpatient mental health treatment) of 'mentally abnormal'. Rates, characteristics and time trends were investigated. RESULTS: Of the 844 cases, 7.1% met legal criteria for being mentally abnormal, while 7.7% had ever received a diagnosis for a psychotic illness, and a further 14.5% had been admitted to a psychiatric hospital for any other reason. The majority (60%) of perpetrators with a psychotic diagnosis received a mental health disposition from the court. Of these, 60% were first diagnosed with their psychotic illness prior to the homicide, while 28% were first diagnosed at the time of the offence and a further 12% after imprisonment. Of all those who received a psychotic diagnosis, 89% had post-conviction admissions or a mental health disposition. CONCLUSION: Legal and clinical definitions of mentally abnormal homicide detect similar rates of mentally abnormal homicide, but illustrate somewhat different dimensions of the relationship between mental illness and homicide.     

Perpetrators of homicide with schizophrenia: a national clinical survey in England and Wales

OBJECTIVE: Few studies have described rates of schizophrenia in a national sample of homicide perpetrators. This study aimed to describe this group's social and clinical characteristics, mental state features, offense details, and outcome in court. METHOD: Analyses used a national clinical survey that collected data on people convicted of homicide in England and Wales (1996-1999). Data were collected for those with schizophrenia or other delusional disorders from psychiatric reports and questionnaires. RESULTS: Of the 1,594 people convicted of homicide, 85 (5 percent) had schizophrenia. Of the 57 people with schizophrenia for whom data were available, 32 (56 percent) had been ill for less than 12 months, and in the month before the offense, 32 (56 percent) had shown a change in the quality, intensity, or conviction of or emotional response to their delusional beliefs. Twenty-four (28 percent) had no previous contact with psychiatric services. CONCLUSIONS: Regular assessment of delusions may help to detect an increased risk of violence, including homicide. More intensive care should be available for patients with a history of schizophrenia and previous violence.     

Gender differences in homicide offenders' criminal career,substance abuse and mental health care. A nationwide register‐based study of Finnish homicide offenders 1995–2004

Background It is generally considered that women who kill are more likely to have a psychiatric disorder than their male counterparts, but as a relatively small group, women are much less often studied than men in this context. Aim To explore gender differences in the psychosocial history of homicide offenders. Method In this nationwide register‐based study, data were extracted from the forensic psychiatric examination and crime reports of all 91 women prosecuted for homicide in Finland between 1995 and 2004 and from those of the next adjacent man convicted of a separate homicide (n = 91). Results Both female and male homicide offenders had a troubled childhood, but more women had witnessed or experienced family violence; more women had failed to complete their primary education. Men, however, were more likely to have had an offending history. Although there were no differences between the men and women in the frequencies of psychiatric diagnoses or of substance abuse, the women had more often received prior mental health treatment. The women were also more likely to have had a history of suicidal behaviour. Conclusions Both female and male homicide offenders are a troubled group of people, with slightly different criminal careers. Many use mental health services and therefore prevention could be improved. The suggestion of a special sub‐group of women characterised by early educational and behavioural difficulties needs replication, as it may have implications for service development. Copyright © 2010 John Wiley & Sons, Ltd.     

Current and lifetime psychiatric illness among inmates not identified as acutely mentally ill at intake in Connecticut's jails

This study presents estimates of current and lifetime psychiatric illness among inmates not identified as acutely mentally ill at intake into all five of Connecticut's adult jails (four male facilities and one female facility). Diagnoses were assessed with the Structured Clinical Interview for DSM-IV (SCID), Clinician-Administered PTSD Scale, and the Global Assessment of Functioning (GAF) and are reported by gender and race/ethnicity. The results showed that more than two of three inmates met the criteria for at least one lifetime psychiatric disorder, almost half for an anxiety disorder, and more than one-third for an affective disorder. Overall, estimates of psychiatric morbidity in the women were higher than those in the men, with the exception of antisocial personality disorder (ASPD). Of particular note, borderline personality disorder was diagnosed in 23.2 percent of women and 12.9 percent of men. An allegation of a violent offense was not associated with the presence of mental illness or with a specific diagnosis. Lifetime history of any mental illness was associated with significantly reduced scores (range, 12-15 points reduction) on the Global Assessment of Functioning. The study showed that current and lifetime psychiatric morbidity are elevated among newly incarcerated adults who do not exhibit obvious signs of severe mental illness and are associated with functional impairment. While such disorders do not necessarily require treatment, unrecognized mental illness may place offenders at greater risk while incarcerated than offenders without mental illness. This study reinforces the need for appropriate screening and referral for treatment at intake into jail.     

Paternal filicide in Québec

In this retrospective study, relevant demographic, social, and clinical variables were examined in 77 cases of paternal filicide. Between 1991 and 2001, all consecutive coroners' files on domestic homicide in Québec, Canada, were reviewed, and 77 child victims of 60 male parent perpetrators were identified. The results support data indicating that more fathers commit filicide than do mothers. A history of family abuse was characteristic of a substantial number of cases, and most of the cases involved violent means of homicide. Filicide was frequently (60%) followed by the suicide of the perpetrator and more so (86%) in cases involving multiple sibling victims. The abuse of drugs and alcohol was rare. At the time of the offense, most of the perpetrators were suffering from a psychiatric illness, usually depressive disorder. Nearly one-third were in a psychotic state. The proportion of fatal abuse cases was comparatively low. Many of the perpetrators had had contact with health professionals prior to the offense, although none had received treatment for a psychiatric illness.     

Factors associated with self-report of sexual violence against men and women with mental disorders in Brazil

Objectives

Patients with mental illness (PMI) are more vulnerable to sexual violence (SV). This study aimed at assessing factors associated with SV against PMI, stratified by gender in Brazil.

Methods

Cross-sectional multicenter study with a national sample of 2,475 PMI randomly selected from 26 psychiatric services. Odds ratios were estimated with 95% confidence interval using logistic regression.

Results

A high prevalence of lifetime SV against PMI was observed (19.8%) and it was higher among women (26.6%) than men (12.5%). Among women, episodes of SV were more often caused by intimate partners and in the domestic environment, and among men, by strangers and in the streets. Among women, the following variables were independently associated (p?Conclusions The prevalence of SV in the studied population was high, especially among women. Women have more behavior factors associated with SV and they need protection, especially those in isolation and socially deprived. However, men also suffer SV, usually more often during childhood than adulthood and special attention should be given to lifetime illegal drug use and earlier psychiatric hospitalization. Preventive actions beyond mental health are important, such as social and economic actions to improve the living conditions of PMI.     

Risque d’homicide et troubles mentaux graves : revue critique de la littérature

Introduction

Tragic and high profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed. It is also generally thought that schizophrenia predisposes subjects to homicidal behaviour.

Objective

The aim of the present paper was to estimate the rate of mental disorder in people convicted of homicide and to examine the relationship between definitions. We investigated the links between homicide and major mental disorders.

Methods

This paper reviews studies on the epidemiology of homicide committed by mentally disordered people, taken from recent international academic literature. The studies included were identified as part of a wider systematic review of the epidemiology of offending combined with mental disorder. The main databases searched were Medline. A comprehensive search was made for studies published since 1990.

Results

There is an association of homicide with mental disorder, most particularly with certain manifestations of schizophrenia, antisocial personality disorder and drug or alcohol abuse. However, it is not clear why some patients behave violently and others do not. Studies of people convicted of homicide have used different definitions of mental disorder. According to the definition of Hodgins, only 15% of murderers have a major mental disorder (schizophrenia, paranoia, melancholia). Mental disorder increases the risk of homicidal violence by two-fold in men and six-fold in women. Schizophrenia increases the risk of violence by six to 10-fold in men and eight to 10-fold in women. Schizophrenia without alcoholism increased the odds ratio more than seven-fold; schizophrenia with coexisting alcoholism more than 17-fold in men. We wish to emphasize that all patients with schizophrenia should not be considered to be violent, although there are minor subgroups of schizophrenic patients in whom the risk of violence may be remarkably high. According to studies, we estimated that this increase in risk could be associated with a paranoid form of schizophrenia and coexisting substance abuse. The prevalence of schizophrenia in the homicide offenders is around 6%. Despite this, the prevalence of personality disorder or of alcohol abuse/dependence is higher: 10% to 38% respectively. The disorders with the most substantially higher odds ratios were alcohol abuse/dependence and antisocial personality disorder. Antisocial personality disorder increases the risk over 10-fold in men and over 50-fold in women. Affective disorders, anxiety disorders, dysthymia and mental retardation do not elevate the risk. Hence, according to the DMS-IV, 30 to 70% of murderers have a mental disorder of grade I or a personality disorder of grade II. However, many studies have suffered from methodological weaknesses notably since obtaining comprehensive study groups of homicide offenders has been difficult.

Conclusions

There is an association of homicide with mental disorder, particularly with certain manifestations of schizophrenia, antisocial personality disorder and drug or alcohol abuse. Most perpetrators with a history of mental disorder were not acutely ill or under mental healthcare at the time of the offence. Homicidal behaviour in a country with a relatively low crime rate appears to be statistically associated with some specific mental disorders, classified according to the DSM-IV-TR classifications.     

Caractérisation sociodémographique, clinique et criminologique d’une population de 210 meurtriers

Introduction

After a saturated media coverage of some murders, questions were raised about the mentally ill and their dangerous and violent nature which may sometimes culminate in homicide. The popular idea that someone who kills an unknown person in the street is mentally ill is firmly rooted in the collective consciousness. Yet, epidemiological data are reassuring: only 15% of such murders are committed by the seriously mentally ill (schizophrenia, paranoia, melancholia).

Aim

To describe the sociodemographic, clinical and forensic characteristics of a convicted population of 210 murderers.

Method

Consecutive series of cases of people convicted of murder in Angers between 1975 and 2005. Information on sociodemographic and clinical characteristics of perpetrators of homicide was collected from psychiatric reports prepared for the courts. This retrospective study identifies several types of pathological murders (schizophrenia, paranoiac delirious disorder, affective disorder: melancholia and hypomania, drugs abuses, personality disorders).

Results

The murderers were men whose mean age was 33. Most were single, living alone and jobless. Two thirds of them had psychiatric records and one third a record of violence against persons. There were 14 cases of schizophrenia (6.7%), eight cases of persistent delusional disorder, 15 cases of affective disorder, 11 cases of mental disorder, five cases of neurological symptomatology, 44 cases of personality disorder and 35 cases of alcohol abuse or alcohol dependency disorder. A third of the murderers did not have any kind of mental disorder (n = 73). Fifty-two (24%) were mentally ill. Two thirds had a history of mental illness and one third had a record of previous convictions of violence. Crimes were mostly committed at nighttime and in the house of the victim. The most common method of killing was stabbing. Fourteen percent had symptoms of mental illness at the time of the offence. The 217 victims were, in decreasing order, a family member, a current or former spouse/partner (53%), an acquaintance (30%) or a stranger (17%). The forensic and juridical consequences (via the application of former article 64 or the present article 122-1 of the French Criminal Code) were envisaged in less than 10% of the cases.

Conclusions

These data allowed the authors to determine the general risk factors of homicidal violence (male gender, youth and alcohol abuse) as well as some more specific factors (mental illness, comorbidities…). The dynamic characteristics of the meeting of the crime protagonists should be added to these factors.     

Prevention of homicidal behaviour in men with psychiatric disorders

Objectives. Homicide is overwhelmingly committed by men compared to women. Conservative estimates suggest that more than a third of these individuals have a treatable psychiatric disorder. These data present an opportunity to mental health clinicians to assist in the prevention of homicide by improving men's mental health. Methods. We review the current literature on men's mental health with a focus on assessing and reducing homicide risk in men with psychiatric conditions. Results. Bipolar disorder and schizophrenia appear to share a neural endophenotype that is a risk factor for homicide. Dual disorders, or the presence of a substance use disorder with other major mental illness, are a major risk factor for homicide in males. Dual diagnosis disorders, personality disorders and pathological traits and male depression share emotion dysregulation, irritability, and reactive aggression. Promoting physician education, addressing firearm safety, reducing the reluctance of men relative to women to engage in help-seeking behaviour, and using targeted risk interviews which integrate these data are all currently recommended. Conclusions. The main focus in prevention of homicidal behaviour in males with psychiatric disorders should be to identify high risk groups, to provide adequate treatment, and to facilitate compliance with long-term treatment while considering male specific problems and needs.     

Gender differences in bipolar disorder: retrospective data from the first 500 STEP-BD participants

OBJECTIVE: To examine gender differences in a large sample of patients with bipolar illness. METHODS: Exploratory analysis of baseline data from the first 500 patients in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a multi-center NIMH project. Participants are allowed to have medical and psychiatric comorbidities, and to enter in any mood state, thus making the population more generalizable than many research cohorts. Diagnoses and history were assessed using structured clinical instruments administered by certified investigators. Given the exploratory nature of these analyses, there is no correction of for multiple comparisons. However, we emphasize findings that are statistically significant at the more stringent p < 0.01 level. RESULTS: Compared with men, women had higher rates of BPII (15.3% M versus 29.0% F, p < 0.01), comorbid thyroid disease (5.7% M versus 26.9% F, p < 0.01), bulimia (1.5% M versus 11.6% F, p < .0.01) and post-traumatic stress disorder (10.6% M versus 20.9% F, p < 0.01). Women and men had equal rates of history of lifetime rapid cycling and depressive episodes. Men were more likely to have a history of legal problems (36% M versus 17.5% F, p < 0.01). CONCLUSIONS: Potentially important gender differences in certain illness characteristics were found in our study; however, in contrast to other reports, we did not find higher rates of lifetime depressive episodes or rapid cycling in women. Although our study is limited by its retrospective study design, its results are strengthened by our large sample size and use of structured interviews.     

Homicide due to mental disorder in England and Wales over 50 years

BACKGROUND: It has been stated that rates of homicide due to mental disorder are constant over time. AIMS: To examine whether there were changes in the rates of homicide due to mental disorder over time, and whether changes in these rates were associated with changes in the rates of other homicides in England and Wales. METHOD: Examination of four sets of official homicide statistics from England and Wales from 1946 to 2004. RESULTS: The rate of total homicide and the rate of homicide due to mental disorder rose steadily until the mid-1970s. From then there was a reversal in the rate of homicides attributed to mental disorder, which declined to historically low levels, while other homicides continued to rise. CONCLUSIONS: The reasons for the rise and fall in homicides attributed to mental disorder are not clear. The earlier increase in such homicides may have been due to the same sociological factors that caused the increase in other homicides over that time. The subsequent decline may have been due to improvements in psychiatric treatments and service organisation. Another possibility is that there has been an informal change to the legal tests for the finding of homicide due to mental disorder.     

Familicide: a comparison with spousal and child homicide by mentally disordered perpetrators

Background Familicides, the killings of multiple family members, are believed to constitute an overlap between child homicide (filicide) and intimate partner homicide (uxoricide). Aim The aim of this paper was to examine and compare the socio‐demographic, contextual and psychopathological factors of familicide perpetrators with factors of filicide and uxoricide perpetrators. Methods Data were extracted from files in a forensic psychiatric observation hospital in Utrecht, The Netherlands, for the years 1953–2006. The sample of 536 persons was identified in one of the three categories of interest; 23 were accused of familicide, 133 of filicide and 380 of uxoricide. Results Familicide perpetrators are more likely than filicide perpetrators to be male, to be older, to be more educated and to commit the offence with physical violence. They are more likely than uxoricide perpetrators to be married, less likely to have committed a previous violent offence but more likely to suffer from a personality disorder and more likely to attempt suicide following the homicide. Conclusion Although similarities exist between the three groups under study, those accused of familicide cannot be equated with those accused of filicide or uxoricide. The finding that a large majority of the perpetrators were mentally ill at the time and that many killed when faced with divorce and/or custody over the child(ren) may suggest that increased monitoring of this group might have preventative value. Copyright © 2008 John Wiley & Sons, Ltd.     

The National Trajectory Project of Individuals Found Not Criminally Responsible on Account of Mental Disorder. Part 5: How Essential Are Gender-Specific Forensic Psychiatric Services?

Objective:

To state the sociodemographic characteristics, mental health histories, index offence characteristics, and criminal histories of male and female forensic psychiatric patients. Clinicians and researchers advocate that mental health and criminal justice organizations implement gender-specific services; however, few studies have sampled forensic patients to evaluate the extent to which men’s and women’s treatment and management needs are different.

Method:

Data were collected from Review Board files from May 2000 to April 2005 in the 3 largest Canadian provinces. Using official criminal records, participants were followed for 3 to 8 years, until December 2008. The final sample comprised 1800 individuals: 15.6% were women and 84.4% were men.

Results:

There were few demographic differences, but women had higher psychosocial functioning than men. Both men and women had extensive mental health histories; women were more likely diagnosed with mood disorders and PDs and men were more likely diagnosed with schizophrenia spectrum disorders and SUDs. The nature of the index offence did not differ by gender, except women were more likely to have perpetrated murders and attempted murders. For offences against a person, women were more likely to offend against offspring and partners and less likely to offend against strangers, compared with men. Women had significantly less extensive criminal histories than men.

Conclusions:

Not criminally responsible on account of mental disorder–accused women have a distinct psychosocial, clinical, and criminological profile from their male counterparts, which may suggest gender-specific assessment, risk management, and treatment in forensic services could benefit patients. The findings are also consistent with traditional models (Risk-Need-Responsivity) and ultimately demonstrate the importance of individual assessment and client-centred services.     

Paternal filicide: a study of 10 men.

OBJECTIVE: To describe the psychiatric and sociodemographic profiles of 10 men who killed 1 or more of their children. METHOD: Data were gathered from psychiatric, psychological, and criminological assessments found in the files of 10 filicidal men hospitalized at the Institut Philippe Pinel de Montréal between 1982 and 1994. RESULTS: Many situational factors were present during the period preceding the offence (such as the possibility of a separation or financial problems). Most of these homicides have been classified as pathological filicides. At the time of the offence, the most frequent diagnoses were mood disorders. Eight subjects had personality disorders, one-half of which were borderline personality disorders. Four men had psychotic symptoms at the time of the offence. Six of the 10 men also killed or attempted to kill their spouses. CONCLUSION: Many factors are involved in the dynamics of a filicidal situation. It is therefore difficult to identify specific warning signals for the prevention of this type of homicide. However, mental health professionals and the general population must be made aware of the importance of early assessment of possible filicidal tendencies when a man verbalizes delusional ideas about his child and/or if he manifests disorganized and bizarre behaviour.     

Gender differences in firesetting: results from the national epidemiologic survey on alcohol and related conditions (NESARC)

This study presents gender differences in sociodemographics and in psychiatric correlates of firesetting in the United States. Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a representative sample of U.S. adults. Face-to-face interviews of more than 43,000 adults were conducted in the 2001-2002 period. This study focused on the 407 subjects with a lifetime history of firesetting. The prevalence of lifetime firesetting in the U.S. was 1.7% in men and 0.4% in women. Firesetting was significantly associated with a wide range of antisocial behaviors that differed by gender. Multivariate logistic regression analyses indicated associations in both genders with psychiatric and addictive disorders. Men with a lifetime history of firesetting were significantly more likely than men without such history to have lifetime generalized anxiety disorder as well as a diagnosis of conduct disorder, antisocial personality disorder, alcohol or cannabis use disorder, and obsessive-compulsive personality disorder. Women with a lifetime history of firesetting were significantly more likely than women without such history to have lifetime alcohol or cannabis use disorder, conduct disorder, and antisocial or obsessive compulsive personality disorder, as well as psychotic disorder, bipolar disorder or schizoid personality disorder. Women with a lifetime history of firesetting were significantly more likely than men with such history to have a lifetime diagnosis of alcohol abuse and antisocial personality disorder as well as a diagnosis of schizoid personality disorder. Our findings indicate that firesetting in women could represent a behavioral manifestation of a broader spectrum than firesetting in men.     

Tobacco smoking among people living with a psychotic illness: The second Australian survey of psychosis

Objective: The aims of this study were to (a) describe patterns of tobacco smoking among Australians living with a psychotic illness and (b) explore the association between smoking and measures of psychopathology, psychiatric history, psychosocial functioning, physical health, substance use and demographic characteristics. Methods: Data were from 1812 participants in the 2010 Australian Survey of High Impact Psychosis. Participants were aged 18-64 years and resided in seven mental health catchment sites across five states of Australia. Bivariate statistics were used to compare smokers with non-smokers on the measures of interest, and to compare ICD-10 diagnostic categories on measures of smoking prevalence, nicotine addiction and quitting history. Multivariate logistic regression was used to test whether (a) demographics and psychiatric history were associated with having ever smoked and (b) whether symptoms and psychosocial functioning were independently associated with current smoking, after controlling for demographics, psychiatric history and substance use. Results: The prevalence of current tobacco smoking was 66.6% (72% of men and 59% of women); lifetime prevalence was 81%. In univariate analyses, individuals with a diagnosis of schizophrenia or schizoaffective disorder were most likely to be smoking tobacco (70%) and were more nicotine dependent. Smokers reported worse perceived physical health, lower body mass index and waist circumference, and more lifetime medical conditions. A younger age of illness onset, male gender and low education were associated with having ever smoked. Associations with current smoking included low education, male gender, no formal employment, worse negative symptoms, higher daily caffeine consumption, and alcohol dependence and substance abuse/dependence. Conclusions: The prevalence of tobacco smoking is high amongst people with a psychotic disorder, and is associated with adverse mental health symptoms as well as high rates of other substance use, poorer subjective physical health, and a higher risk of the many known health consequences of smoking.     

Gender differences in prevalence,risk, and clinical correlates of alcoholism comorbidity in bipolar disorder

OBJECTIVE: The prevalence of lifetime alcohol abuse and/or dependence (alcoholism) in patients with bipolar disorder has been reported to be higher than in all other axis I psychiatric diagnoses. This study examined gender-specific relationships between alcoholism and bipolar illness, which have previously received little systematic study. METHOD: The prevalence of lifetime alcoholism in 267 outpatients enrolled in the Stanley Foundation Bipolar Network was evaluated by using the Structured Clinical Interview for DSM-IV. Alcoholism and its relationship to retrospectively assessed measures of the course of bipolar illness were evaluated by patient-rated and clinician-administered questionnaires. RESULTS: As in the general population, more men (49%, 57 of 116) than women with bipolar disorder (29%, 44 of 151) met the criteria for lifetime alcoholism. However, the risk of having alcoholism was greater for women with bipolar disorder (odds ratio=7.35) than for men with bipolar disorder (odds ratio=2.77), compared with the general population. Alcoholism was associated with a history of polysubstance use in women with bipolar disorder and with a family history of alcoholism in men with bipolar disorder. CONCLUSIONS: This study suggests that there are gender differences in the prevalence, risk, and clinical correlates of alcoholism in bipolar illness. Although this study is limited by the retrospective assessment of illness variables, the magnitude of these gender-specific differences is substantial and warrants further prospective study.     

Gender- and violence-related prevalence of mental disorders in prisoners

Objectives To clarify the prevalence of mental diseases including personality disorders in a sample of German prisoners regarding delinquency and gender specificity. Method Crime history, present state and lifetime mental disorders, as well as personality disorders, were assessed amongst 415 inmates and compared regarding gender and type of delinquency. Results Female offenders more often committed homicide while male offenders more frequently committed assault and robbery. Men had a higher prevalence of alcohol abuse and dissocial PD while women more often showed depression, anxiety disorders and Borderline PD. Violent offences were related to a higher prevalence of alcohol abuse and dissocial PD, as well as higher comorbidities of mental disorders. Conclusion Results emphasize the complexity of the needs and requirements of imprisoned offenders. Our findings reveal an urgent need for psychiatric–psychotherapeutic services to provide suitable care to inmates in order to contribute to a more favorable legal prognosis.