Characteristics of homicide perpetrators among Italian forensic hospital inmates.
OBJECTIVE
To identify distinctive clinical and social features of the psychiatric patients who committed homicide among inmates of Italian forensic hospitals.


METHODS
Clinical and social characteristics of four cohorts of patients were compared: 64 inmates who committed or attempted homicide (Hs), their 64 matched controls from community services caseloads, 54 inmates who committed other crimes and their 54 matched controls from community services caseload.


RESULTS
When compared with other inmates, patients who committed or attempted homicide showed less severe psychopathology (later onset of mental disorders, later contact with mental health services, lower disability scores) except for higher scores at BPRS "hostility" and "suspiciousness" factors; they also showed better premorbid adjustment (socioeconomic status, employment), and surprisingly better behavioural profile (fewer compulsory admissions, fewer previous criminal records, less substance abuse, less frequently in caseloads of community services). When compared with their matched controls, Hs had lower psychopathology, better adjustment, and a similar behavioural profile.


CONCLUSIONS
Italian inmates of forensic hospitals who committed or attempted homicide have clinical features and personal histories which are far from the stereotype of the violent and dangerous psychiatric patients. The risk assessment procedures routinely performed in several countries may detect violent, but not homicidal behaviour.
Servizio Salute Mentale, Assessorato Politiche per la Salute, Regione Emilia-Romagna, Bologna, Italy. afioritti@regione.emilia-romagna.it
Angelo
A
Fioritti
Elisa
E
Ferriani
Paola
P
Rucci
Vittorio
V
Melega
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006708:Homicide; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012111:Residence Characteristics