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Sexual Offending and Antisocial Sexual Behavior Among Patients With Schizophrenia

J Clin Psychiatry 1999;60(3):170-175
10.4088/JCP.v60n0304

Background: A number of studies have indicated excessive offending behavior among people with schizophrenia; however, sexual offending has not been widely described.

Method: This study reports on a subgroup of 15 men with schizophrenia, diagnosed according to ICD-10 guidelines, in a secure hospital who had committed sexual offenses or shown antisocial sexual behavior. A comparison group comprised 55 male patients with schizophrenia and a history of violent behavior who were being treated in the same hospitals as the study group.

Results:In 12 of the 15 cases, the sexual offending/behavior postdated illness onset and occurred in the context of psychotic symptoms. Although 12 of the offenders were known to psychiatric services, contact was erratic and only 4 were taking medication. At assessment, those with sexual offenses or antisocial sexual behavior were twice as likely as the larger study sample to report unimpaired sexual interest. This may be of particular relevance in that the group also reported difficulty in forming close personal relationships.

Conclusion: Illness-related factors appear to make an important contribution to sexual offending by this group of patients, highlighting the need for comprehensive and vigorous treatment.