Psychotic Symptoms and Prior Use of Psychiatric Services in Psychotic Offenders Detained Under the Dutch Entrustment Act (TBS): An Exploratory Study

Abstract

According to the literature, most forensic psychotic patients have been in contact with general psychiatry before the index offense. However, the services received are not always in agreement with their needs. Comorbidity with a conduct disorder or antisocial personality disorder can influence the first admission to psychiatry. Four groups of patients with a history of severe violent offenses, but not sex offenses, were recruited from forensic psychiatric hospitals (TBS-hospitals) and one general hospital (N= 137). The design was retrospective, all information was extracted from existing files, and a list of sociodemographic, psychiatric, and criminological variables was used. A SPSS statistical package was used to analyze the data. It was hypothesized that psychotic offenders had more positive and negative psychotic symptoms and that they made less use of psychiatric services and psychotropic drugs, compared to psychotic patients in general psychiatry. Psychotic offenders had received less treatment, both in childhood and as adult, compared to psychotic patients in general psychiatry. General psychiatry could prevent psychotic patients tfrom becoming offenders, while forensic psychiatry can be of significant assistance to general psychiatry in learning how to perform risk assessment and how to deal with the antisocial characteristics in psychotic patients.

Keywords:

• forensic psychotic patients
• service use
• comorbidity with personality disorder
• positive symptoms
• negative symptoms