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Violent offenders with schizophrenia: quantitative and qualitative studies focusing on the family of origin
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The focus of the thesis is on violent offenders with schizophrenia and their relatives. The aims were to explore incidence of violent crimes, the extent to which family members were victims, to investigate individual background factors among violent offenders, and to identify psychotic symptoms and triggering factors associated with fatal violence. In addition, parents were interviewed to build an understanding of their experiences and emotional reactions.

One study examined all 369 male individuals who had committed a violent crime (assault, homicide or attempt to any of these crimes), who in a pre-trial forensic psychiatric evaluation (FPE) during 1992-2000 were diagnosed with schizophrenia, and who were referred to forensic psychiatric treatment. Although the majority of the 615 victims was unacquainted to the offenders, family members or male acquainted were most at risk of being severely injured or killed as victims.

Background factors were studied for the 207 Swedish offenders who for their first time were subjects of a FPE during the study period. There were indications that those offenders who targeted family members had an earlier onset and more severe course of their mental illness.

During the study period, 48 offenders committed homicides. Of the 52 victims, 83% were family members or acquainted to the offender. Those who killed a family member had more often delusions and/or hallucinations, were less often intoxicated, had to a lesser extent committed a previous violent crime and they were younger at the time of the homicide.

Parents, who were interviewed, were very emotionally involved in their adult sons, although they were not living together. Ignorance regarding the diagnosis of their son and his criminality negatively influenced the contacts, both between parent and son and between parent and professionals in psychiatry. However, the referral to forensic psychiatric treatment gave the parents hope for a positive development.

Place, publisher, year, edition, pages
Umeå: Klinisk vetenskap , 2004. , 58 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 904
Keyword [en]
Psychiatry, schizophrenia, offenders, homicide, criminality, victim relations, family members, forensic psychiatry
Keyword [sv]
Psykiatri
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
URN: urn:nbn:se:umu:diva-298ISBN: 91-7305-692-8 (print)OAI: oai:DiVA.org:umu-298DiVA: diva2:142992
Public defence
2004-09-17, Sal B, Tandläkarhögskolan, NUS, Umeå, 09:30 (English)
Opponent
Supervisors
Available from: 2004-08-25 Created: 2004-08-25 Last updated: 2010-08-10Bibliographically approved
List of papers
1. Victim relations and victim gender in violent crimes committed by offenders with schizophrenia
Open this publication in new window or tab >>Victim relations and victim gender in violent crimes committed by offenders with schizophrenia
2003 (English)In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 38, no 6, 326-330 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Family members and friends appear to be most at risk of becoming victims of violence committed by offenders with major mental disorders. The aim of the present study is to examine, in a national sample, victim relation in violent crimes committed by male offenders with schizophrenia, with special reference to victim gender and the severity of violence. METHOD: We identified all violent offenders who were diagnosed with schizophrenia in forensic psychiatric evaluations during the years 1992-2000 and examined their court convictions. In total 588 victims were included, 327 men and 261 women, and distributed into three groups based on their relation to the offender: Family of origin (n = 77), Network (n = 183) and Unacquainted (n = 328). RESULTS: The majority of the victims were unacquainted with the offender, but the violence was less severe in this group. Among family members, e. g. parents, siblings and grandparents, there were more female than male victims (60 % vs 40 %), and victims in families, as well as males within the offender's network, were those most likely to be seriously or fatally injured. Female family victims, in particular mothers, were those most likely to die as victims of severe violence. CONCLUSIONS: The study highlights the risk for family members and the immediate network of becoming a target of violence. Mental health services together with community-based services have an important task in identifying risk situations and taking preventive measures.

Keyword
schizophrenia, violence, victim, family, gender, Sweden
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-4038 (URN)10.1007/s00127-003-0640-5 (DOI)12799783 (PubMedID)
Available from: 2004-08-25 Created: 2004-08-25 Last updated: 2017-12-14Bibliographically approved
2. Do violent offenders with schizophrenia who attack family members differ from those with other victims?
Open this publication in new window or tab >>Do violent offenders with schizophrenia who attack family members differ from those with other victims?
2003 (English)In: International Journal of Forensic Mental Health, ISSN 1499-9013, E-ISSN 1932-9903, Vol. 2, no 2, 195-200 p.Article in journal (Refereed) Published
Abstract [en]

Do violent offenders with schizophrenia who attack family members differ from those with other victims?Data on individual background factors were collected on all male offenders of violent crimes who for theirfirst time were subject to forensic psychiatric evaluation in Sweden between 1992 and 2000 and were diagnosedwith schizophrenia. In addition to descriptive data for the whole sample, analyses were made in order toidentify possible characteristic factors for offenders who targeted family members. In comparison to offenderswith other victims, the findings indicate an earlier onset of mental illness, in terms of that they were morelikely to have interrupted their schooling at an earlier stage, were more likely to have had psychiatriccontacts in childhood, to be younger when first compulsorily admitted to psychiatric inpatient treatment,and they were also younger when they committed the index crime. The findings suggest the need to addressthe possibility of violent behavior within the family when managing patients with major mental disorders.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-4039 (URN)
Available from: 2004-08-25 Created: 2004-08-25 Last updated: 2017-12-14Bibliographically approved
3. Victim relations and factors triggering homicides committed by offenders with schizophrenia
Open this publication in new window or tab >>Victim relations and factors triggering homicides committed by offenders with schizophrenia
2006 (English)In: Journal of Forensic Psychiatry & Psychology, ISSN 1478-9949, E-ISSN 1478-9957, Vol. 17, no 2, 192-203 p.Article in journal (Refereed) Published
Abstract [en]

In Western countries about 10 - 15% of those convicted of homicide suffer from a psychotic disorder. Victims are most often from the offender's immediate network, such as family members and friends. Delusions and/or hallucinations have an important role in violent behaviour, as does coexistent alcohol or drug abuse. In this study, all 48 homicides from 1992 - 2000 committed by offenders in Sweden diagnosed with schizophrenia were studied in order to identify possibly triggering factors related to victim relations. Nine of the 52 victims were strangers to the offender. In 54% of cases, the homicides were associated with obvious delusions and/or hallucinations. Among offenders with family victims 72% suffered from obvious delusions and/or hallucinations, as compared to 43% of offenders with non-family victims. Of the offenders, 79% were known to psychiatric services, but at the time of the crime only 33% had any ongoing contact. Despite 48% having been prescribed antipsychotic drugs, no more than two individuals were actually taking their medication. The offenders who had killed members of their biological families were seldom intoxicated and few had earlier convictions for violent crime. The mental health care services have a major responsibility to prevent homicides and violent crimes being committed by those with schizophrenia.

Keyword
Schizophrenia, homicide, victim relations, psychotic symptoms, intoxication, psychiatric treatment
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-4040 (URN)10.1080/14789940600631522 (DOI)
Available from: 2004-08-25 Created: 2004-08-25 Last updated: 2017-12-14Bibliographically approved
4. Schizophrenia and violent crime: The experience of parents
Open this publication in new window or tab >>Schizophrenia and violent crime: The experience of parents
2006 (English)In: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 29, no 1, 57-67 p.Article in journal (Refereed) Published
Abstract [en]

Individuals with schizophrenia have an increased risk of committing a violent crime, although their contribution to the overall criminality in society is small. In this qualitative study we have interviewed parents of adult sons, diagnosed with schizophrenia and who recently had been referred to forensic psychiatric treatment due to a violent crime, with an aim to explore the parents' experiences and emotional reactions. Four events, or status passages, emerged as crucial and common for all parents. These were the onset of the mental disorder, the diagnosis of schizophrenia, the violent behaviour/criminality and the recent referral to forensic psychiatric treatment. Every passage evoked strong emotional reactions such as guilt, fear, disappointment, anger and relief, which in return led to different actions taken. Unawareness of the character and severity of their sons' mental illness and the type of violent criminality they had committed were common and complicated contacts both between the parents and their sons, and also between family members and official authorities. The findings emphasize that psychiatric healthcare professionals must take the initiative and responsibility for information, education and support of family members.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-13688 (URN)10.1016/j.ijlp.2004.07.002 (DOI)16278016 (PubMedID)
Available from: 2008-12-03 Created: 2008-12-03 Last updated: 2017-12-14Bibliographically approved

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