Comorbidity in forensic psychiatry describes the co-occurrence of two or more conditions or psychiatric disorders, known in the literature as dual diagnosis. There is a close relationship between violent offenders and comorbid substance abuse confirmed by numerous studies in the field of forensic psychiatry. Comorbidity also strongly contributes in the process of establishing psychiatric diagnosis of diminished mental capacity or insanity at the time of the offense, in the course of clinical assessment and evaluation of violent offenders.

The aim of this study was to perform a descriptive analysis of a sample of patients admitted in a long-stay unit, in compliance with a court ordered criminal sentence. We analyzed the comorbidity and demographic patterns among inpatients admitted during a period spanning from 2007 to 2012. We also contemplated the typology of offenders and reviewed risk assessment scales, based on illness onset pre-dating the first offense.

In conclusion, our results are congruent with other similar published studies. Due to the high prevalence of dual diagnosis in violent offenders their management requires a multilevel approach to the patient. In civilian psychiatric units, which also admit court ordered inpatients, the implementation of risk assessment scales in clinical practice is strongly recommended.