Criminal behavior and violent crimes among patients with affective disorder are associated with more than just overall diagnosis, say German scientists who found a range of factors linked to such behavior.

There has been a great deal of research into criminal and violent behavior in schizophrenia patients. In contrast, there have been few studies of violent and criminal behavior in individuals with affective disorders, and those that have been conducted have, in the main, not differentiated between bipolar disorder, mania, and depression.

To investigate further, Michael Soyka, from Ludwig-Maximilian-University in Munich, and colleagues examined data from the German national crime register of criminal offenses for nonviolent and violent behavior committed by 1561 affective disorder patients, of whom 756 had bipolar disorder, 89 manic disorder, and 702 major depressive disorder (MDD).

The average age of the patients was 53.26 years. In all, 2.1% were single, 47.9% were married or living with a partner, 18.8% were separated or divorced, and 11.2% were widowed. The average hospital stay was 64.39 days. Lack of insight at discharge was observed in just 1.4% of patients. In addition, 21.1% of patients reported a history of substance use problems.

Overall, 95.8% of patients had no conviction after discharge, at 84.3% of manic disorder patients, 97.8% of bipolar disorder patients, and 95.3% of MDD patients, the team notes in the Journal of Affective Disorders. Sixty five patients committed criminal acts, at an average of 4.72 per patient. Defalcation, theft, and fraud were the most common crimes, while physical assault was the most common violent behavior. There was one murder.

Among patients who committed criminal and violent behavior, men were substantially more likely to commit both criminal and violent behavior after discharge than women, at 64.6% versus 35.4% and 85.7% versus 14.3%, respectively. The gender differences were even greater among manic patients (78.6% vs 21.4% and 100.0% vs 0.0%, respectively) and among those with MDD (60.6% vs 39.4% and 90.0% vs 10.0%, respectively).

Separated, divorced, and widowed patients committed offenses more frequently than other individuals. There was no association with age, educational status, length of hospital stay, lack of insight at diagnosis, or history of substance abuse.

The team concludes: “The findings of this study may stimulate further research to identify social and psychopathological predictors for future violent and criminal behavior.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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