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Tijdschrift voor Psychiatrie 54 (2012) 6, 497 - 507

New research

Psychopathology and recidivism among violent offenders with a dual diagnosis. A comparison with other subgroups of violent offenders

J.E. van Horn, M.J. Eisenberg, S. van Kuik, G.M. van Kinderen

background Offenders with a dual diagnose (dd) are more likely than other offenders to repeat delinquent behavior.
aim To investigate whether male violent offenders with substance-related disorders and co-occurring disorders differed from other subgroups of violent offenders in terms of substance disorders, psychopathology, and recidivism. We expected to find that persons with a dual diagnosis would more often be diagnosed with an anxiety or mood disorder and antisocial personality disorder. We also expected that they could have the highest recidivism rates.
method Our sample consisted of 148 (domestic) violent offenders subdivided into offenders with a substance-related disorder and comorbid disorders (dual diagnosis group; n = 50), offenders without an axis I or axis II disorder (n = 28), offenders with a substance-related disorder (n = 23), and offenders with one or several comorbid axis I disorders (excluding substance related disorders) and/or axis II disorders (n = 47).
results Survival analyses showed – with an average follow-up period of 79,6 months – significantly higher general (60%) and violent (44,9%) recidivism rates in the dd-group than in the other subgroups in which the rates were lower than 40% for both general and violent recidivism. Results of Cox regression analyses indicated that merely belonging to the dd-group increased the risk of violent recidivism by a factor of 5.21.
conclusions The dd-delinquents under study did not differ fundamentally from other subgroups of (domestic) violent offenders as far as substance-related disorders and psychopathology were concerned. However, they did engage more often in recidivism, committing general or violent offences.

keywords dual diagnosis, forensic psychiatry, recidivism