[Schizophrenic diseases, psychosis and homicide: the importance of community psychiatry for the prevention of offences].
OBJECTIVE
Even though homicides of psychotic patients are relatively rare, they have a great impact on the public opinion about the mentally ill. Current literature indicates that psychotic patients are at an increased risk to commit violent offences. The risk of this group to commit a homicide is even more increased. The question of our study was to find out whether past homicides of schizophrenic patients could have been avoided if treatment had been administered properly.


METHODS
Review of 39 homicide cases, committed by patients who had been psychotic during the offence.


RESULTS
10.2 % of the homicides could have been prevented in the absence of mistakes of therapists or legal authorities. Another 15.4 % of the homicides could have probably been avoided in case of communication between the treating therapists and family of the patient previously to the offence.


CONCLUSIONS
The whole family of the patient should be involved in the therapy. Possibilities are home visits on the basis of community care. Furthermore, threats of psychotic patients should be taken seriously.
Nitschke
Joachim
J
Bezirksklinikum Ansbach, Klinik für Forensische Psychiatrie, Ansbach. dr.joachim.nitschke@bezirkskliniken-mfr.de
Osterheider
Michael
M
Mokros
Andreas
A
D000293:Adolescent; D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017007:Duty to Warn; D042241:Early Diagnosis; D005260:Female; D005858:Germany; D006708:Homicide / Q000517:prevention & control* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011368:Professional-Family Relations; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*; D012563:Schizophrenia, Paranoid / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012565:Schizophrenic Psychology; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data; D055815:Young Adult