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Mental disorder and violence

A special (high security) hospital study

Published online by Cambridge University Press:  02 January 2018

Pamela J. Taylor ,
Morven Leese ,
Deborah Williams ,
Martin Butwell ,
Rachel Daly  and
Emmet Larkin
Pamela J. Taylor*
Affiliation:
Institute of Psychiatry, London
Morven Leese
Affiliation:
Institute of Psychiatry, London
Martin Butwell
Affiliation:
Broadmoor Hospital
Rachel Daly
Affiliation:
United Dental and Medical School of Guy's and St Thomas' Hospital, London
Emmet Larkin
Affiliation:
The Towers Hospital, Leicester
*
P. J. Taylor, Professor of Special Hospital Psychiatry, Institute of Psychiatry, London SE5 8AF
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Abstract

Background

From a first clinical description of a complete resident sample of special (high security) hospital patients, we examined the association between mental disorder and violence.

Method

A record survey of all 1740 patients resident at any time between 1 January and 30 June 1993. inclusive, and, for most, the official criminal record.

Results

1015 patients (58%) had functional psychosis, one-quarter of whom also had an independent personality disorder: 461 (26%)had personality disorders uncomplicated by psychosis, and 264 (16%) had learning disabilities. Pre-admission substance misuse, which was probably under-recorded, had been most common among those with psychosis and an independent personality disorder. Less than 10% had never been convicted of a criminal offence, although 25% had been admitted directly from other hospitals. Direct personal violence was more common among men, and fire-setting among women. Schizophrenia was most strongly associated with personal violence. More than 75% of those with a psychosis were recorded as being driven to offend by their delusions. In the absence of delusions, hallucinations had no such effect.

Conclusions

For people with personality disorder better clinical descriptions seem essential. For people with a pure psychosis, as symptoms were usually a factor driving the index offence, treatment appears as important for public safety as for personal health.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 3 , March 1998 , pp. 218 - 226
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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