Juvenile sex offending all too often is the reason of public commotion and concern. About 20% of all rapes and 20–50% of cases of child abuse are perpetrated by juveniles. However little is known on the psychiatric characteristics and recidivism rates of these youths. In the present study the prevalence of psychopathology in (subgroups of) juvenile sex offenders and its relation with criminal recidivism two to four years later were investigated.

Semi-structured psychiatric interviews (K-SADS-PL) and a parent-report questionnaire (CSBQ) were carried out with 106 adolescent sex offenders (mean age 15.0 ± 1.5 years, 60 group offenders, 27 solo rapists, and 19 child molesters) referred to the Dutch child protection agency and juvenile justice institutions. Recidivism was ascertained from registration systems.

Three quarters of juvenile sex offenders met criteria for at least one psychiatric disorder and comorbidity was found in more than half of the subjects. Child molesters showed the highest rates of internalizing disorders and showed most pronounced autism spectrum disorder core symptomatology. Forty percent of juvenile sex offenders had committed multiple sexual offenses, but none recidivated sexually within the 2–4 years after the study. Compared to one time sex offenders, multiple sex offenders were higher in DBD and anxiety disorder.

Child and adolescent psychiatric care should be given to juvenile sex offenders, with particular attention to multiple sex offenders and child molesters. However, the predictive value of psychopathology for sexual recidivism remains unclear and warrants further research.