Untersuchungen zur Frage des Zusammenhangs zwischen Psychosen und Kriminalität/Gewalttätigkeit

 

 Buy Article Permissions and Reprints

Zusammenfassung

Die vorliegende Übersicht stellt die methodischen Probleme von 23 im letzten Vierteljahrhundert publizierten Arbeiten, die unterschiedliche Aspekte der Frage nach einem möglichen Zusammenhang zwischen Psychosen und dissozialem Verhalten behandeln, systematisch dar: Unterschiedliche diagnostische Formulierungen, unterschiedliche Definitionen von Kriminalität und Gewaltkriminalität, unterschiedlich definierte Beziehungen zwischen Krankheit und Kriminalität, unterschiedliche Informationsquellen und Untersuchungszeiträume, Probleme bei der Fallrekrutierung bzw. bei der Rekrutierung von Kontrollgruppen, interferierende Variablen, statistische Probleme. Anschließend werden die Ergebnisse dieser Arbeiten im Detail diskutiert. Zusammenfassend ist festzustellen, dass auch unter Berücksichtigung von soziodemografischen Merkmalen und komorbidem Substanzmissbrauch zwischen Psychose und Kriminalität ein mäßiger, jedoch meist statistisch signifikanter Zusammenhang besteht, der sich vor allem bei schizophrenen Patienten nachweisen lässt. Deren Kriminalitätsrisiko steigt mit zunehmender Schwere der Gewalttätigkeit, liegt bei Tötungsdelinquenz deutlich über dem der Allgemeinbevölkerung, ist aber in jedem Fall wesentlich geringer als das von Personen mit Substanzmissbrauch und Persönlichkeitsstörungen. Während bei schwersten Formen der Gewaltkriminalität zumindest teilweise ein unmittelbarer Einfluss der Erkrankung nachweisbar ist, dürften bei leichteren Delikten eher indirekte Zusammenhänge (krankheitsbedingte soziale Deprivierung, erhöhte Vulnerabilität für Substanzmissbrauch), begünstigt durch zunehmende Defizite der allgemeinpsychiatrischen Versorgung, vorliegen.

Abstract

This review systematically describes the methodological difficulties arising at the interpretation of studies on the association between psychoses (major mental disorders) and criminality/violence: diagnostic issues, different definitions of illegal behaviour and of the connection between mental illness and crime, different sources of information, differences in the recruitment of cases and control groups and in the time under study, impact of interfering variables and statistical issues, problems of the transferability of results. On this basis the data of 23 papers published between 1981 and 2004 are discussed in detail. Even under consideration of sociodemographic variables and comorbid substance abuse, most studies show a moderate albeit statistically significant association between major mental disorders and crime. This association is especially proven in subjects suffering from schizophrenia. Their risk of committing a crime increases with the severity of the offence and is - compared with the general population - substantially higher for homicide. However, in general much more danger for the public arises from subjects with substance abuse and personality disorders. The severest expressions of violence can be interpreted - at least partly - as a direct consequence of the illness. The association between psychosis and criminality in general seems to be rather an indirect one, mediated through an illness-related increased vulnerability for general criminogenic factors as poverty, social deprivation and substance abuse, intensified by deficits of modern mental health care.

Literatur

• 1 Brennan J J. Mentally ill aggressiveness, popular delusions as reality.  Am J Psychiatry. 1964;  120 1181-1184
  PubMedGoogle Scholar
• 2 Giovannoni J M, Gurel L. Socially disruptive behaviour of ex-mental patients.  Arch Gen Psychiatry. 1967;  7 146-153
  PubMedGoogle Scholar
• 3 Ashley M C. Outcome of 1000 cases paroled from the Middletown State Hospital.  New York State Hospital Quarterly. 1922;  8 64-70
  PubMedGoogle Scholar
• 4 Pollock H M. Is the paroled patient a menace to the community?.  Psychiatric Quarterly. 1938;  12 236-244
  PubMedGoogle Scholar
• 5 Brill H, Malzberg B. Statistical report based on the arrest records of 5354-male ex-patients released from New York state mental hospitals during the period 1946 - 1948. Mental Hospital Service Supplement 153. Washington, DC: American Psychiatric Association 1962
  Google Scholar
• 6 Rappaport J, Lassen G. Dangerousness - arrest rate comparisons of discharged patients and the general population.  Am J Psychiatry. 1965;  121 776-783
  PubMedGoogle Scholar
• 7 Böker W, Häfner H. Gewalttaten Geistesgestörter. Berlin: Springer 1973
  Google Scholar
• 8 Angermeyer M C, Schulze B. Psychisch Kranke - eine Gefahr?.  Psychiat Prax. 1998;  25 211-220
  PubMedGoogle Scholar
• 9 Schanda H. Die Versorgung psychisch Kranker zur Jahrtausendwende - ein Weg in die Zweiklassenpsychiatrie?.  Fortschr Neurol Psychiat. 2001;  69 195-202
  PubMedGoogle Scholar
• 10 Swanson J, Holzer C, Ganju V, Jono R. Violence and psychiatric disorder in the community: Evidence from the Epidemiologic Catchment Area Surveys.  Hosp Community Psychiatry. 1990;  41 761-770
  PubMedGoogle Scholar
• 11 Hodgins S. Mental disorder, intellectual deficiency, and crime.  Arch Gen Psychiatry. 1992;  49 476-483
  PubMedGoogle Scholar
• 12 Hodgins S, Mednick S A, Brennan P A, Schulsinger F, Engberg M. Mental disorder and crime: Evidence from a Danish birth cohort.  Arch Gen Psychiatry. 1996;  53 486-496
  PubMedGoogle Scholar
• 13 Tiihonen J, Isohanni M, Räsänen P, Koiranen M, Moring J. Specific mental disorders and criminality: A 26-year prospective study of the 1966 Northern Finland Birth Cohort.  Am J Psychiatry. 1997;  154 840-845
  PubMedGoogle Scholar
• 14 Räsänen P, Tiihonen J, Isohanni M. et al . Schizophrenia, alcohol abuse and violent behavior: A 26-year follow-up study of an unselected birth cohort.  Schizophr Bull. 1998;  24 437-440
  PubMedGoogle Scholar
• 15 Brennan P A, Mednick S A, Hodgins S. Major mental disorders and criminal violence in a Danish birth cohort.  Arch Gen Psychiatry. 2000;  57 494-500
  PubMedGoogle Scholar
• 16 Petursson H, Gudjonsson G H. Psychiatric aspects of homicide.  Acta Psychiatr Scand. 1981;  64 363-372
  CrossrefPubMedGoogle Scholar
• 17 Wilcox D E. The relationship of mental illness to homicide.  Am J Forensic Psychiatry. 1985;  6 3-15
  PubMedGoogle Scholar
• 18 Gottlieb P, Gabrielsen G, Kramp P. Psychotic homicide in Kopenhagen from 1959 to 1983.  Acta Psychiatr Scand. 1987;  76 285-292
  PubMedGoogle Scholar
• 19 Lindqvist P, Allebeck P. Schizophrenia and crime. A longitudinal follow-up of 644 schizophrenics in Stockholm.  Br J Psychiatry. 1990;  157 345-350
  PubMedGoogle Scholar
• 20 Wessely S C, Castle D, Douglas A J, Taylor P J. The criminal careers of incident cases of schizophrenia.  Psychol Med. 1994;  24 483-502
  CrossrefPubMedGoogle Scholar
• 21 Eronen M. Mental disorders and homicidal behavior in female subjects.  Am J Psychiatry. 1995;  152 1216-1218
  PubMedGoogle Scholar
• 22 Eronen M, Hakola P, Tiihonen J. Mental disorders and homicidal behavior in Finland.  Arch Gen Psychiatry. 1996;  53 497-501
  CrossrefPubMedGoogle Scholar
• 23 Eronen M, Tiihonen J, Hakola P. Schizophrenia and homicidal behavior.  Schizophr Bull. 1996;  22 83-89
  PubMedGoogle Scholar
• 24 Modestin J, Ammann R. Mental disorder and criminality: Male schizophrenia.  Schizophr Bull. 1996;  22 69-82
  PubMedGoogle Scholar
• 25 Modestin J, Hug A, Ammann R. Criminal behavior in males with affective disorders.  J Affect Disord. 1997;  42 29-38
  CrossrefPubMedGoogle Scholar
• 26 Steadman H J, Mulvey E P, Monahan J. et al . Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods.  Arch Gen Psychiatry. 1998;  55 393-401
  CrossrefPubMedGoogle Scholar
• 27 Wallace C, Mullen P, Burgess P, Palmer S, Ruschena D, Browne Ch. Serious criminal offending and mental disorder. Case linkage study.  Br J Psychiatry. 1998;  172 477-484
  PubMedGoogle Scholar
• 28 Mullen P E, Burgess P, Wallace C, Palmer S, Ruschena D. Community care and criminal offending in schizophrenia.  Lancet. 2000;  355 614-617
  CrossrefPubMedGoogle Scholar
• 29 Erb M, Hodgins S, Freese R, Müller-Isberner R, Jöckel D. Homicide and schizophrenia: Maybe treatment does have a preventive effect.  Crim Beh Ment Heal. 2001;  11 6-26
  PubMedGoogle Scholar
• 30 Haller R, Kemmler G, Kocsis E. et al . Schizophrenie und Gewalttätigkeit. Ergebnisse einer Gesamterhebung in einem österreichischen Bundesland.  Nervenarzt. 2001;  72 859-866
  CrossrefPubMedGoogle Scholar
• 31 Schanda H, Knecht G, Schreinzer D, Stompe Th, Ortwein-Swoboda G, Waldhoer Th. Homicide and major mental disorders: A twenty-five year study.  Acta Psychiatr Scand. 2004;  110 98-107
  CrossrefPubMedGoogle Scholar
• 32 Wallace C, Mullen P E, Burgess Ph. Criminal offending in schizophrenia over a twenty-five year period marked by deinstitutionalization and increasing prevalence of comorbid substance use disorders.  Am J Psychiatry. 2004;  161 716-727
  CrossrefPubMedGoogle Scholar
• 33 Schanda H, Taylor P. Aggressives Verhalten psychisch Kranker im stationären Bereich: Häufigkeit, Risikofaktoren, Prävention.  Fortschr Neurol Psychiat. 2001;  69 439-448
  PubMedGoogle Scholar
• 34 Richter D, Berger K. Patientenübergriffe auf Mitarbeiter.  Nervenarzt. 2001;  72 693-699
  CrossrefPubMedGoogle Scholar
• 35 Spießl H, Krischker S, Cording C. Aggressive Handlungen im psychiatrischen Krankenhaus. Eine auf die psychiatrische Basisdokumentation gestützte 6-Jahres-Studie bei 17 943 stationären Aufnahmen.  Psychiat Prax. 1998;  25 227-230
  PubMedGoogle Scholar
• 36 Steinert T. Schizophrenie und Gewalttätigkeit: Epidemiologische, forensische und klinische Aspekte.  Fortschr Neurol Psychiat. 1998;  66 391-401
  PubMedGoogle Scholar
• 37 Steinert T, Wölfle M, Gebhardt R P. Measurement of violence during in-patient treatment and association with psychopathology.  Acta Psychiatr Scand. 2000;  102 107-112
  CrossrefPubMedGoogle Scholar
• 38 Steinert T. Gewalttätiges Verhalten von Patienten in Institutionen. Vorhersagen und ihre Grenzen.  Psychiat Prax. 2002;  29 61-67
  PubMedGoogle Scholar
• 39 Robertson G, Pearson R, Gibb R. The entry of mentally disordered people to the criminal justice system.  Br J Psychiatry. 1996;  169 172-180
  PubMedGoogle Scholar
• 40 Link B, Andrews H, Cullen F T. The violent and illegal behavior of mental patients reconsidered.  Am Sociol Rev. 1992;  57 275-292
  PubMedGoogle Scholar
• 41 Häfner H, An der Heiden W, Behrens St, Gattaz W F, Hambrecht M, Löffler W, Maurer K, Munk-Jörgensen P, Nowotny B, Riecher-Rössler A, Stein A. Causes and consequences of the gender difference in age at onset of schizophrenia.  Schizophr Bull. 1998;  24 99-113
  CrossrefPubMedGoogle Scholar
• 42 Stompe Th, Ortwein-Swoboda G, Strobl R, Friedmann A. The age of onset of schizophrenia and the theory of anticipation.  Psychiatry Res. 2000;  93 125-134
  CrossrefPubMedGoogle Scholar
• 43 Wessely S, Taylor P J. Madness and crime: Criminality versus psychiatry.  Crim Beh Ment Heal. 1991;  1 193-228
  PubMedGoogle Scholar
• 44 Kennedy H G, Iverson R CY, Hill O. Violence, homicide and suicide: Strong correlation and wide variation across districts.  Br J Psychiatry. 1999;  175 462-466
  PubMedGoogle Scholar
• 45 Regier D A, Farmer M E, Rae D S, Locke B Z, Keith S J, Judd L L, Goodwin F K. Comorbidity of mental disorders with alcohol and other drug abuse.  JAMA. 1990;  264 2511-2518
  Google Scholar
• 46 Swartz M S, Swanson J W, Hiday V A, Borum R, Wagner H R, Burns B J. Violence and severe mental illness: The effects of substance abuse and nonadherence to medication.  Am J Psychiatry. 1998;  155 226-231
  PubMedGoogle Scholar
• 47 Drake R, Mueser K. Psychosocial approaches to dual diagnosis.  Schizophr Bull. 2000;  26 105-118
  Google Scholar
• 48 Munkner R, Haastrup S, Jorgensen T, Andreasen A H, Kramp P. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses.  Acta Psychiatr Scand. 2003;  107 111-117
  CrossrefPubMedGoogle Scholar
• 49 Paanila J, Hakola P, Tiihonen J. Mortality among habitually violent offenders.  Forensic Science International. 1999;  100 187-191
  CrossrefPubMedGoogle Scholar
• 50 Brown St. Excess mortality of schizophrenia. A meta-analysis.  Br J Psychiatry. 1997;  171 502-508
  CrossrefPubMedGoogle Scholar
• 51 Harris E C, Barraclough B. Excess mortality of mental disorder.  Br J Psychiatry. 1998;  173 11-53
  CrossrefPubMedGoogle Scholar
• 52 Ösby U, Correia N, Brandt L, Ekblom A, Sparen P. Mortality and causes of death in schizophrenia in Stockholm County, Sweden.  Schizophr Res. 2000;  45 21-28
  CrossrefPubMedGoogle Scholar
• 53 Ösby U, Brandt L, Correia N, Ekblom A, Sparen P. Excess mortality in bipolar and unipolar disorder in Sweden.  Arch Gen Psychiatry. 2001;  58 844-850
  CrossrefPubMedGoogle Scholar
• 54 Cohen D, Llorente M, Eisdorfer C. Homicide-suicide in older persons.  Am J Psychiatry. 1998;  155 390-396
  PubMedGoogle Scholar
• 55 Gottlieb P, Kramp P, Gabrielsen G. The practice of forensic psychiatry in cases of homicide in Kopenhagen, 1959 to 1983.  Acta Psychiatr Scand. 1987;  67 514-522
  PubMedGoogle Scholar
• 56 Coid J. The epidemiology of abnormal homicide and murder followed by suicide.  Psychol Med. 1983;  13 855-860
  PubMedGoogle Scholar
• 57 Felthous A R, Hempel D O. Combined homicides-suicides: A review.  J Forensic Sci. 1995;  40 846-857
  PubMedGoogle Scholar
• 58 Bijl R V, Ravelli A, van Zessen G. Prevalence of psychiatric disorder in the general population. Results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS).  Soc Psychiatry Psychiatr Epidemiol. 1998;  33 587-595
  CrossrefPubMedGoogle Scholar
• 59 Regier D A, Boyd J H, Burke J D, Rae D S, Myers J K, Kramer M, Robins L N, George L K, Karno M, Locke B Z. One-month prevalence of the mental disorders in the United States based on five epidemiologic catchment aera sites.  Arch Gen Psychiatry. 1988;  45 977-986
  PubMedGoogle Scholar
• 60 Kessler R C, McGonagle K A, Zhao S, Nelson Ch B, Huges M, Eshleman S, Wittchen H-U, Kendler K S. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States.  Arch Gen Psychiatry. 1994;  51 8-19
  PubMedGoogle Scholar
• 61 Goldner E M, Hsu L, Waraich P, Somers J M. Prevalence and incidence studies of schizophrenic disorders: A systematic review of the literature.  Can J Psychiatry. 2002;  47 833-843
  PubMedGoogle Scholar
• 62 Bland R C. Epidemiology of affective disorders: A review.  Can J Psychiatry. 1997;  42 367-377
  PubMedGoogle Scholar
• 63 Wittchen H-U, Essau C A, Zerssen D, Krieg J-C, Zaudig M. Lifetime and six-month prevalence of mental disorders in the Munich Follow-Up Study.  Eur Arch Psychiatry Clin Neurosci. 1992;  241 247-258
  CrossrefPubMedGoogle Scholar
• 64 American Psychiatric Association .Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III). Washington, DC: American Psychiatric Association 1980
  Google Scholar
• 65 American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised (DSM-III-R). Washington, DC: American Psychiatric Association 1987
  Google Scholar
• 66 World Health Organisation .Diagnosenschlüssel und Glossar psychiatrischer Erkrankungen, 8. Revision (ICD-8). Berlin, Heidelberg, New York: Springer 1970
  Google Scholar
• 67 Wolfgang M E. Foreword. In: Mednick SA, Christiansen KO: Biosocial Bases of Criminal Behavior. New York: Gardener Press 1977: v-vi
  Google Scholar
• 68 Spitzer R L, Endicott J, Robins E. Research Diagnostic Criteria (RDC). Deutsche Bearbeitung Klein HE. Weinheim, Basel: Beltz 1982
  Google Scholar
• 69 Dixon L, Haas G, Weiden P J, Sweeney J, Frances A. Drug abuse in schizophrenic patients: Clinical correlates and reasons for use.  Am J Psychiatry. 1991;  148 224-230
  PubMedGoogle Scholar
• 70 Jacobi F, Wittchen H-U, Hölting C, Höfler M, Pfister H, Müller N, Lieb R. Prevalence, co-morbidity and correlates of mental disorders in the general population: Results from the German General Health Interview and Examination Survey (GHS).  Psychol Med. 2004;  34 1-15
  CrossrefPubMedGoogle Scholar
• 71 World Health Organisation .Diagnosenschlüssel und Glossar psychiatrischer Krankheiten, 9. Revision (ICD-9). Berlin, Heidelberg, New York: Springer 1980
  Google Scholar
• 72 American Psychiatric Association .Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Washington DC: American Psychiatric Association 1994
  Google Scholar
• 73 Monahan J. Mental disorder and violent behavior. Perceptions and evidence.  American Psychologist. 1992;  47 511-521
  PubMedGoogle Scholar
• 74 Hiday V. Understanding the connection between mental illness and violence.  Int J Law Psychiatry. 1997;  20 399-417
  PubMedGoogle Scholar
• 75 Arseneault l, Moffitt T E, Caspi A, Taylor P A, Silva Ph A. Mental disorders and violence in a total birth cohort.  Arch Gen Psychiatry. 2000;  57 979-986
  PubMedGoogle Scholar
• 76 Schanda H, Schreinzer D, Stompe Th, Ortwein-Swoboda G, Knecht G, Waldhoer Th. The effects of psychiatry reforms on criminality and violence of the mentally ill.  Eur Psychiatry. 2004;  19 105S
  PubMedGoogle Scholar
• 77 Schanda H. Psychiatry reforms and illegal behaviour of the severely mentally ill.  Lancet. 2005;  365 367-369
  PubMedGoogle Scholar

Dr. Hans Schanda

Justizanstalt Göllersdorf

Schlossgasse 17

2013 Göllersdorf

Österreich ·

Email: hans.schanda@meduniwien.ac.at