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Tijdschrift voor Psychiatrie 42 (2000) 11, 793 - 802

New research

Violence and psychotic disease

P.J.A. van Panhuis, P.M.A.J. Dingemans

background Persons with psychiatric disturbances who commit violent crimes are in the Netherlands often sentenced to an indefinite stay in a special hospital by the criminal judge (tbs-order). Clinical observation of these groups of patients learned that a growing number of psychotic patients is among them. Abuse of alcohol and drugs seems to be an important interfering force and was hence included in the research.
aims Study of interaction between violent crimes and psychiatric, more special psychotic morbidity in year cohorts of tbs-patients.
methods Three cohorts (n = 407) of patients starting their tbs in different periods were compared on demographic variables, kind of delicts and psychiatric morbidity. A structured standard list was used as an instrument. results Psychotic patients frequently commit violent crimes or attempt to do so. In most of these cases the psychotic condition is acute. Violent crimes committed by psychotic persons appeared to be less serious than those committed by patients with 'only' a personality disorder or without a psychiatric diagnosis. Abuse of alcohol and drugs has increased in this group in time.
conclusions Treatment of acute psychotic conditions and limitation of alcohol and drug abuse can contribute in prevention of the process of criminalisation of psychotic patients.

keywords acute psychosis, cohort study, forensic psychiatry, psychopathology, violence