Psychosis and Homicide
Unlike other Western countries, the Netherlands applies a 5-point scale of accountability (3). Of the 61 reports that we investigated, 36 psychotic defendants (59 %) were considered unaccountable, 14 (23%) had strongly diminished accountability, four (7 %) had diminished accountability, and one (2%) was considered fully accountable. (The fifth category is slightly diminished accountability, and no defendants were judged to have this level of accountability.) Most of the suspects did not have a violent criminal past and were not under psychiatric treatment at the time of the offense, in line with the findings of Dr. Nielssen and colleagues.
In conclusion, the rate of violent offenses among persons with psychosis is even higher than the number of persons found NGMI. For example, some psychotic defendants commit a homicide because they need money to support a comorbid addiction. Although not all violent offenses by persons with psychosis are caused by the underlying psychosis, we fully agree with the authors that the early recognition and treatment of psychosis may prevent violent offences.
1 : Comparison of first-episode and previously treated persons with psychosis found NGMI for a violent offense. Psychiatric Services 62:759–764, 2011 Link, Google Scholar
2 : Pre-trial psychiatric evaluations and ethnicity in the Netherlands. International Journal of Law and Psychiatry 33:192–196, 2010 Crossref, Medline, Google Scholar
3 : The relationship between mental disorders and different types of crime. Criminal Behaviour and Mental Disease, July 2011. DOI