Comorbidity of Psychopathy with Major Mental Disorders

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A considerable number of patients with major mental disorders seen by the forensic psychiatrist, or being treated in forensic hospitals, have a comorbidity with other disorders. This comorbidity has a significant influence on clinical outcome, criminal relapse, on detention rate and length of detention (Lindquist & Allebeck. 1989; Soyka et al., 1994). In addition, comorbidity has an influence on the assessment of criminal responsibility: In a recent study, patients suffering from schizophrenia and antisocial personality disorder (APD) were more often held to be responsible or to have diminished responsibility while patients who received the diagnosis of schizophrenia alone were considered to be irresponsible for their criminal acts (Nedopil, 1996b). The group of patients suffering from that comorbidity was, however, relatively small. Only 5 out of the 41 schizophrenics assessed as a consequence of violent crimes had a comorbid antisocial personality disorder.