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The purpose of this paper is to develop a predictive model of criminal risk in civil psychiatric populations, by determining the relative impacts of psychopathy, drug use, impulsivity and intelligence on levels of criminality.

The sample consisted of 871 civil psychiatric patients, selected from the MacArthur Violence Risk Assessment Study, who had been diagnosed with a mental illness or personality disorder, and hospitalised less than 21 days. Each participant was administered the Hare Psychopathy Checklist Screening Version (PCL:SV), Barratt Impulsiveness Scale (BIS-11) and the Wechsler Adult Intelligence Scale (WAIS-R). In addition, information on background demographics, drug use and criminality was obtained via a self-report questionnaire.

Pearson correlations identified significant positive relationships between past arrests, psychopathy, impulsivity and drug use. Intelligence was negatively related to past arrests. Multiple regressions identified a significant main effect for Factor 2 psychopathy on past arrests when controlling for all covariates, but not for Factor 1 psychopathy, intelligence or impulsivity. Drug use and gender had small univariate effects.

It is suggested that future research investigates the influence of specific mental disorders on different types of offending.

By investigating predictors of criminal behaviour in civil psychiatric patients, the present study makes valuable contributions to the research literature, enhancing our theoretical understanding of the relationships between psychopathy and criminality/recidivism. It also has notable implications in applied practice, for example in the development and refinement of risk assessment methods.

We compare the deinstitutionalization of psychiatric patients and the developmentally disabled in the United States and demonstrate that there were two path-dependent processes with significant qualitative and quantitative differences, ultimately leading to better outcomes for developmentally disabled individuals.

Using secondary literature, we construct a sustained comparison of the two processes in terms of outcomes, timing, tempo, extent, funding, demographic composition, and investment in community services. We then reconstruct the strategies of de-stigmatization and framings of moral worth deployed in the two cases, analyzing their effects on deinstitutionalization in terms of conceptions of risk, rights, and care.

Deinstitutionalization began later for developmentally disabled individuals than for psychiatric patients, and was a more gradual, protracted process. It was not driven by fiscal conservatism, discharges, and the trans-institutionalization of the senile aged, as was deinstitutionalization for psychiatric patients, but primarily by the prevention of institutionalization of young children, and increased investment in infrastructure. Consequently, the deinstitutionalization of the developmentally disabled was far more thorough and successful. The process was shaped by the framing of the developmentally disabled as “forever children” by parents’ organizations that demanded a balance between autonomy, protection, and the provision of care. In contrast, the deinstitutionalization of psychiatric patients was shaped by their framing as autonomous citizens temporarily suffering from “mental health problems” that could be prevented, treated, and cured. This frame foregrounded the right to choose (and also refuse) treatment, while undervaluing the provision of care.

The purpose of this paper is to determine: the extent to which an intellectual disability diagnosis meets current diagnostic and statistical manual of mental disorders (DSM) diagnostic criteria; the prevalence of reported autism spectrum disorders (ASD); and the extent to which assessment of developmental issues is central to the diagnosis of psychotic disorder, in patients discharged with a diagnosis of psychotic disorder and intellectual disabilities.

Of all patients discharged with psychotic disorder during a four‐year period (n=3339), chart reviews were completed on those also diagnosed with intellectual disability or borderline IQ.

The findings if this paper are threefold: only 39 percent of the 41 individuals discharged with a diagnosis of psychotic disorder and intellectual disability met documented DSM criteria for intellectual disability; the prevalence of reported ASD was much lower than expected; and the average number of different discharge diagnoses per individual over time was 4.8. Schizophrenia diagnoses were made early in the diagnostic process and tended to persist even when ASD concerns were documented.

The results support the need to systematically assess the developmental issues of patients with intellectual disability as part of the psychiatric diagnostic formulation. Differential diagnoses of psychotic‐like behaviours seen in people with intellectual disability, and alternative frameworks for understanding these behaviours, which in turn should guide more effective interventions and treatment, are discussed.

In Belgium approximately a quarter of forensic psychiatric patients reside within penitentiaries instead of treatment facilities. This situation has yielded the Belgian government several convictions from the Human Rights Court in Strasbourg. In an attempt to facilitate admissions from penitentiary to psychiatric hospital, the Forensic Department of the psychiatric hospital in Rekem (OPZC Rekem), has piloted the InReach project. The paper aims to discuss these issues.

The objective of this project is to engage a psychiatric nurse on the ward in pretherapeutic and motivational activities on a regular basis in the penitentiary for vulnerable groups of forensic psychiatric patients, forming a bridge between penitentiary and hospital. The InReach project even considers patients who have no desire to leave the penitentiary (e.g. due to their psychiatric profile). A motivational approach is used to support these patients in making the transition from penitentiary to hospital.

The current article describes the focus of the InReach project (procedures and InReach candidate profiles) together with the first impressions of the progress that has been made by the InReach project. In addition two case studies of InReach patients are presented. The InReach project is clearly needed in Belgium and because of its success it has been extended to another penitentiary. It is probable the two other medium-security wards will also be included in the project in the near future.

The Belgian government has received several convictions from the Human Rights Court in Strasbourg because a substantial number of forensic psychiatric patients reside within penitentiaries instead of treatment facilities. The InReach project presented in this paper is clearly needed in Belgium and was implemented to initiate and facilitate the transition from penitentiaries to treatment facilities. The need for this type of project is reflected in the number of forensic psychiatric patients that reside within a penitentiary and that are not able or willing to make the transition to a treatment facility because of their psychiatric profile.

The range of prevalence of personality disorder (PD) found in people with intellectual disability (ID) has been reported as vast, and has included data from dissimilar settings. The purpose of this paper is to review the reported prevalence of PD in the general population of people with ID, and to consider how different and changing ideas about PD have affected these rates.

Cross-sectional studies of the prevalence of PD in people with ID were identified. The quality of the studies was considered, along with how cases of PD were identified.

Six studies were included. The reported prevalence of PD in people known to have ID ranged from 0.7 to 35 per cent. Possible reasons for this wide range included different views of PD and methods of assessment.

The wide range of findings suggests that methodological differences are significant. Consideration to how clinicians should respond to the overlap of impairment between ID and PD may improve the conceptual clarity of PD, informing future epidemiological research.

This review was limited to studies of samples likely to be representative of the general ID population. The range of prevalence estimates was narrower than previously reported, and more likely to reflect the true prevalence rate of PD amongst people who have ID. Consideration was also given to how different ideas of PD led to different methods and may have contributed to variance in the results.

There is a paucity of comparative literature on pathway to care among patients with co-occurring disorders and those with only substance use disorders. This paper aims to compare the pathways to care among patients with co-occurring disorder and those with only substance use disorders.

A cross-sectional observational study was carried out on male treatment seekers at a tertiary care substance use disorder treatment center in India. Participants were recruited in two groups, those with co-occurring psychiatric and substance use disorders and those with only substance use disorders. The two groups were matched for age and socio-economic status.

A total of 189 subjects with co-occurring psychiatric and substance use disorders and 197 subjects with substance use disorders only were recruited. Psychiatric services were the most common first point of care. However, a larger proportion of the subjects in the co-occurring disorder group received the first care from faith healers, while a greater proportion received first care from the therapeutic communities in substance use disorder only group. Initial care was sought mostly following suggestion from the family members in both the groups. The time to treatment for substance use disorders did not differ between the two groups, though the treatment seeking for substance use disorder was more delayed than that of psychiatric disorder in the co-occurring disorder group.

The findings shed light on the pathway of care followed in India and is a matter of further research.

Expansion of services and dissemination of information about psychiatric disorders and substance use disorders can provide timely care to patients with substance use disorders and co-occurring disorders.

The findings have a social implication as well. More awareness is needed currently in India for timely treatment of dual disorders.

The paper is an original research by the authors. The data were collected from the participants who reported to the dual diagnosis clinic. The findings are important as they tell us about the current understanding of dual diagnosis by the general public.

The risk of aggression is higher among people with psychiatric disorders. This study aims to determine the association of aggression with schizophrenia, bipolar disorder (BD) and major depressive disorder (MDD) in patients referred to Shahid Beheshti Teaching Hospital in Kerman.

This was a cross-sectional study of 518 patients diagnosed with schizophrenia, BD and MDD who met the inclusion criteria and were compared with a comparison group. All participants completed the Buss–Perry Aggression Questionnaire (BPAQ). Independent samples t-test and Pearson correlation coefficient were used to investigate the relationship between the score of BPAQ and other variables. The Beck Depression Inventory (BDI-13), Young Mania Rating Scale (YMRS) and Positive and Negative Symptom Scale (PANSS) were completed by MDD, BD and schizophrenia patients, respectively.

The mean score of total aggression and its components in the comparison group was significantly (P-value = 0.001) lower than that of the other groups. However, no significant difference was observed between the three schizophrenia, MDD and BD groups. The total aggression score of BPAQ had a significant positive correlation with BDI-13 and YMRS and a significant negative correlation with the PANSS score. Single patients with schizophrenia and people in the comparison group with lower education levels had a higher total aggression score.

Suffering from BD, MDD and schizophrenia, especially in single patients with a lower education level, is associated with physical and verbal aggression, anger and hostility, which emphasizes the need for periodic examination and screening of aggressive behaviors in these patients.

This study aims to describe and analyze the factors associated with dependence and motivation to stop smoking in patients with schizophrenia.

This descriptive, analytical study was conducted between October 2021 and April 2023 at two psychiatric centers in Morocco. The study population consisted of 274 smokers diagnosed with schizophrenia, who were examined just before their discharge. In addition to sociodemographic and economic data, tobacco use status and clinical information, the authors assessed dependence with Fagerström Test for Nicotine Dependence (FTND), motivation to quit and depression.

Around three-quarters (74%) smoked more than 10 cigarettes a day, with a mean FTND score of 5.61 (±1.94). Dependence was reported in 76% of smokers. More than two-thirds (69%) had made at least one attempt to quit, and almost all participants (99%) had done so without medical assistance. Nicotine dependence was associated with income, illness duration, motivation to stop smoking and depression. In addition, lower income, level of education, number of hospitalizations, attempts to stop smoking and nicotine dependence were associated with motivation to quit tobacco use. However, depression was not associated with motivation to stop smoking.

The present study has the following limitations: the cross-sectional nature of the study does not allow for temporal evaluation, the sampling technique does not allow for generalization of the results, participants’ responses may be subjective despite the use of validated psychometric scales.

The results of this research have important public health implications: Duration of schizophrenia progression was associated with nicotine dependence – highlighting the need to offer help as soon as possible after diagnosis, as a preventative measure; Calgary depression score was a factor associated with increased dependence – suggesting that screening and additional help for people with co-existing mental health problems could be important. Similarly, the onset of depression after the development of schizophrenia should be monitored.

The authors have further searched the literature and have not found similar studies. The absence of such studies justifies the significance of this research, and its results will be valuable for publication to guide researchers in the treatment of tobacco dependence and, furthermore, to guide the preventive efforts of health authorities in Morocco. Additionally, to the best of the authors’ knowledge, this study is the first of its kind in Morocco and among the few in North Africa.

The purpose of this paper is to identify studies which have investigated arson or firesetting in individuals with autism spectrum disorder (ASD).

A systematic PRISMA review was conducted.

The present review highlighted the relatively little research that has been conducted to date exploring firesetting or arson in individuals with ASD. In sum, 11 papers were identified in the present review study: 6 were case studies and 5 were empirical studies. The case studies identified in the review highlighted some of the ASD symptomology which may contribute to this type of criminal behaviour. Also, the empirical studies indicate that there is a higher prevalence of individuals with ASD who engage in such criminal behaviours.

There is an urgent need for further empirical research in this area and for there to be an increased awareness and understanding of how ASD can contribute to arson and firesetting in both a legal and clinical context.

This is the first review, to the author’s knowledge, to explore the literature on firesetting or arson in individuals with ASD.

In order to address a notable gap in the research literature, the purpose of this paper is to examine age-related differences in juvenile homicide perpetration.

Data on 150 juvenile homicide offenders and their offences was derived from material available within the public domain, including media reports, case studies, court reports and previously published studies. Comparisons were then made between those aged 14 and under (n=63) and those aged 14-17 (n=87) across a range of offender, victim and offence-related variables.

There were no significant differences between the child (U-14) and adolescent (14-17) offender samples on any of the measured variables. The two groups had similar backgrounds, selected similar types of victims, had comparable breakdowns of different types of victim-offender relationship and had similar patterns of weapon use.

The fact that the two groups did not differ significantly has notable implications in practical and applied domains. By identifying risk factors for juvenile homicide perpetration, findings open up a range of possibilities for identification, investigation and intervention. In addition, findings might inform the development of offender treatment and rehabilitation programmes. Key limitations relate to the quality and quantity of data employed. Ways of remedying these weaknesses in future research are addressed.

This is the first study to directly compare child and adolescent perpetrators of homicide over a broad range of offender, victim and offence attributes.