Pathways to Violence in Schizophrenia : The role of antisocial personality, substance misuse, delusions, and delusional distress

There is a long held general belief in society that persons with a major mental disorder are dangerous. The media play an important role in the maintenance of this belief by highlighting cases of violent acts by mentally disordered individuals. Though, during the seventies, this belief became more and more criticized. Studies on the relation between severe mental illness and (violent) criminal offending found no relation between the two. In an extensive research on violent crime by ‘mentally abnormal offenders’ in Germany, Häfner and Böker (1973) concluded that “if we define the dangerousness of the mentally abnormal as the probability of their committing a violent crime, then our findings show that this does not exceed the dangerousness of the legally responsible adult population as a whole” (p. 284). From The Baxstrom Studies (Cocozza & Steadman, 1974), we learned that psychiatry failed in the prediction of dangerousness in the mentally ill. Similarly, in the Netherlands, Tuinier (1989) wrote his dissertation on a field study on the relation between psychiatric syndrome and criminality. He also concluded that psychiatric syndromes (except for abuse disorders) have no relation with criminal offending.

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