A second homicide by a released mentally ill person is a potentially avoidable tragedy that can reduce the prospects of conditional release for other mentally ill offenders.
The aim of this study was to compare the clinical and criminological features of single and recidivist homicide offenders with schizophrenia from the Chuvash Republic of the Russian Federation.
Data were extracted from the criminal and clinical records of all people with schizophrenia who had been convicted of a homicide in the Chuvash Republic at any time between 1 January 1981 and 31 December 2010. Those convicted of a second homicide offence during the 30 years of the study were compared with those convicted of a single homicide.
Sixteen (10.7%) of 149 homicide offenders with schizophrenia had committed a previous homicide. The 16 recidivists included nine offenders who were diagnosed with schizophrenia at the time of their first homicide (after January 1981), three who were diagnosed with schizophrenia only after the first homicide and four who had already been diagnosed with schizophrenia at the time of a pre-1981 homicide. Time at risk for recidivists and non-recidivists differed, but the average time back in the community for the non-recidivists just exceeded the average time to second homicide for the recidivists. All the recidivists were men. Living in a rural area and dissocial personality traits were associated with homicide recidivism.
In the Chuvash republic, most of the repeat homicide offences by people with schizophrenia were committed by people residing in rural areas with less access to psychiatric services, which provides indirect evidence for the efficacy of ongoing treatment and supervision in preventing repeat homicides. This area of study is, however, limited by the small numbers of cases and the long follow-up required. International collaborative studies are indicated to provide a more accurate estimate of the rate of recidivist homicide in schizophrenia.
It has been suggested that the characteristics of homicides committed by people with schizophrenia from regions with a high total homicide rate differ from the characteristics of homicides by people with schizophrenia from regions with low rates of homicide.
Homicide offenders in the Chuvash Republic of the Russian Federation have been systematically examined for over 30 years. This study reports on a review of the documents from pre-trial psychiatric assessments and legal proceedings of all people charged with homicide offenses between 1981 and 2010 who were found to have schizophrenia.
There were 133 people (120 men, 13 women) with an ICD-10 diagnosis of schizophrenia who committed a homicide offense in the 30 years of the study, including 15 repeat homicide offenders and 9 homicides with multiple victims. The odds ratio (OR) for homicide associated with schizophrenia was 13.5, 95% confidence interval (CI) (11.4-16.0). The mean age of the offenders was 34.8 (SD 9.6) and most had the paranoid subtype of schizophrenia (78%). The majority of victims were family members (51%) or acquaintances (43%). Delusions of persecution, auditory hallucinations and other positive symptoms were present in 58% of offenders at the time of the homicide. The remaining 42% exhibited negative symptoms such as emotional deficits, had antisocial attitudes or were regarded as having impaired self-control. Alcohol intoxication was reported at the time of 45% of homicides. Stabbing was the most common method and few of the homicides involved firearms.
The characteristics of homicide offenders with schizophrenia from Chuvashia do not appear to differ greatly from those of homicide offenders with schizophrenia from regions with far lower rates of homicide.
There are few studies of the relationship between mental disorder and homicide offences from regions with high rates of homicide. We examined the characteristics and psychiatric diagnoses of homicide offenders from the Chuvash Republic of the Russian Federation, a region of Russia with a high total homicide rate. In the 30 years between 1981 and 2010, 3414 homicide offenders were the subjected to pre-trial evaluations by experienced psychiatrists, almost half of whom (1596, 46.7%) met the international classification of diseases (ICD) 10 criteria for at least one mental disorder. The six most common individual diagnoses were alcohol dependence (15.9%), acquired organic mental disorder (7.3%), personality disorder (7.1%), schizophrenia (4.4%) and intellectual disability (3.6%). More than one disorder was found in 7.4% of offenders and alcohol dependence was the most frequently diagnosed co-morbid disorder. One in ten offenders were found to be not criminally responsible for their actions. Few homicides involved the use of substances other than alcohol, and firearms were used in 1.6% of homicides. The finding that people with mental disorders other than psychosis committed a high proportion of homicides in a region with a high rate of homicide, suggests that people with mental disorders are vulnerable to similar sociological factors to those that contribute to homicide offences by people who do not have mental disorder.