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The clinical profile of high-risk mentally disordered offenders

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

High-risk mentally disordered offenders present a diverse array of clinical characteristics. To contain and effectively treat this heterogeneous population requires a full understanding of the group’s clinical profile. This study aimed to identify and validate clusters of clinically coherent profiles within one high-risk mentally disordered population in the UK.

Methods

Latent class analysis (a statistical technique to identify clustering of variance from a set of categorical variables) was applied to 174 cases using clinical diagnostic information to identify the most parsimonious model of best fit. Validity analyses were performed.

Results

Three identified classes were a ‘delinquent’ group (n = 119) characterised by poor educational history, strong criminal careers and high recidivism risk; a ‘primary psychopathy’ group (n = 38) characterised by good educational profiles and homicide offences and an ‘expressive psychopathy’ group (n = 17) presenting the lowest risk and characterised by more special educational needs and sexual offences.

Conclusions

Individuals classed as high-risk mentally disordered offenders can be loosely segregated into three discrete subtypes: ‘delinquent’, ‘psychopathic’ or ‘expressive psychopathic’, respectively. These groups represent different levels of risk to society and reflect differing treatment needs.

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Acknowledgments

This investigation was funded by the Ministry of Justice and Department of Health through the DSPD programme. We would also like to thank all the clinical staff who made our visits to these high security destinations run so smoothly; teams were run by Professor Tony Maden, Ms Julie Luther, Mr Lawrence Jones, Dr Gopi Krishnan and Dr. Jacqui Saradjian.

Conflict of interest

We declare that we have no conflicts of interest. All procedures involved in the conduct of this research were approved by a UK ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Author information

Authors and Affiliations

  1. Institute of Psychiatry, King’s College London, PO63 De Crespigny Park, London, SE5 8AF, UK

    Jenny Yiend

  2. East London NHS Foundation Trust, London, UK

    Mark Freestone

  3. Department of Primary Care Health Sciences, University of Oxford, Oxford, UK

    Maria Vazquez-Montes

  4. Experimental Psychology, University of Oxford, Oxford, UK

    Josephine Holland

  5. Department of Psychiatry, University of Oxford, Oxford, UK

    Tom Burns

  6. Wolfson Institute for Preventive Medicine, Queen Mary University of London, London, UK

    Mark Freestone

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  1. Jenny Yiend
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  4. Josephine Holland
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  5. Tom Burns
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IDEA group

Corresponding author

Correspondence to Jenny Yiend.

Additional information

The members of the IDEA group are listed in Appendix.

Appendix

Appendix

The IDEA group comprises (in alphabetical order): Tom Burns, Martin Clarke, Helen Doll, Wendy Dyer, Zoe Elkington, Tom Fahy, Seena Fazel, Ray Fitzpatrick, Alison Foster, Lindsey Johnston, Cara Jones, Louise Linsell, Helen McKinnon, Jacinta Prendergast, Robert Rogers, Julia Sinclair, Lucy Willmott and Jenny Yiend.

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Yiend, J., Freestone, M., Vazquez-Montes, M. et al. The clinical profile of high-risk mentally disordered offenders. Soc Psychiatry Psychiatr Epidemiol 48, 1169–1176 (2013). https://doi.org/10.1007/s00127-013-0696-9

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  • DOI: https://doi.org/10.1007/s00127-013-0696-9

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