| 01/11/2004 Psychosis in one
fifth of homicide offenders
Between one in four and one in five homicide offender in Sweden
suffer from a psychotic illness, a study published in today’s
issue of American Journal of Psychiatry suggests. The authors, Drs
Seena Fazel and Martin Grann of CVP, studied all cases of homicide
during 1988-2001 and identified 2,005 homicide offenders. They studied
the results from court-ordered forensic psychiatric evaluations
and also cross-linked their data on homicide offenders with the
National Hospital Register. The results suggest that mental disorder
is very prevalent in homicide offenders; more than 90% received
a psychiatric diagnosis. Dual diagnoses were common, half had a
substance abuse, and half had concomitant personality disorders.
Psychotic illnesses were frequent (20-25%), much more so than in
other violent crimes. The prevalence of psychosis was also much
higher than what has previously been believed on the basis of earlier
studies, which have typically reported prevalence rates of 5-10%.
There could be a number of explanations to this according to the
researchers. This was the largest study on mental disorder and homicide
to date, more than twice the size of any previous study. The register
coverage was better as the study was not limited to only court-ordered
psychiatric examinations as in previous studies. In addition, the
study was conducted in Sweden. Relatively few homicide in Sweden
(approx. 100 annually) and the rate of homicide per capita is low.
In countries with liberal gun laws, more guns, more organised crime
and drug trafficking, the rate of homicide is markedly higher. Examples
include USA, Bolivia, South Africa and the Baltic States. In studies
of the rate of psychotic illnesses from such countries, the rate
of mental illness will be “diluted” and yield lower
prevalence estimates, says Seena Fazel and Martin Grann.
REFERENCE: Fazel S & Grann M. (2004) Psychiatric morbidity
among homicide offenders: a Swedish population study. American Journal
of Psychiatry, 161, 2129-2131.
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