Background People with a major mental disorder are at increased risk of committing crimes, especially violent crimes, compared with the general population. Sub-groups have been identified based on age of onset of anti-social or violent behaviour. Mentally disordered offenders with early onset anti-social behaviour tend to have a lifelong pattern of it, but in a clinical setting, are they easily identifiable as a distinct sub-group?Aims Our main aim was to establish whether distinct groups of early and later onset offenders can be identified from the standard clinical record of men with schizophrenia spectrum disorders selected for hospital treatment after conviction for a serious crime, and to test the hypothesis that even in such a clinically selected group, early onset offending would be associated with subsequent persistent and versatile offending.Methods A retrospective case file review of all 83 men with a schizophrenia spectrum disorder in a complete 2-year discharge cohort from one specialist secure forensic hospital unit (2001-2002).Results A sub-group of patients with early onset anti-social behaviour was confirmed. Prior to this specialist hospitalisation, this group had sustained significantly more criminal convictions and were more criminally versatile than their late onset peers.Conclusions The recognition of clinically meaningful sub-groups among hospitalised offender patients seems straightforward, and may be useful in the development of more specifically focused intervention and in making sense of more longer-term outcomes. Copyright (c) 2010 John Wiley & Sons, Ltd.
Personality disorders (PDs) are prevalent in about one in every 10 adults. Prior to the introduction of the ICD-10 in Denmark, the incidence rate for PD (including schizotypal) among psychiatric patients was approximately 12% and the prevalence rate 14%.
The aim of the present clinical epidemiology study is to investigate the use of ICD-10 PD as primary and secondary diagnoses in years 1995, 2000 and 2006, comorbid disorders and their relation to age and gender.
The study includes all adult patients admitted to any psychiatric hospital (inpatients and outpatients) in Denmark.
Both incidence and prevalence rates of PD diagnoses decrease over the study period. It is evident that all specific diagnoses significantly decrease or remain stable whereas the unspecified and mixed type significantly increases constituting up to 50% of diagnoses. Emotionally unstable PD stands out as the single most prevalent covering around one third of PD diagnoses. A decrease is found in the prevalence of patients receiving a PD diagnosis as a primary diagnosis, but an increase as a secondary diagnosis (most often as comorbid to depression or anxiety disorder). Differences are found in relation to gender and age.
PDs are among the most prevalent disorders; however, rates are decreasing in psychiatric settings. There seem to be a rather huge gap between clinical evaluation and research data on prevalence of PDs. Clinicians need more education and sufficient time for in-depth personality assessment of PDs in all patient groups.