Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
Federal Evaluation Centre for Violent and Sexual Offenders (FECVSO), Austrian Ministry of Justice, Vienna, Austria.
Acta Psychiatr Scand. 2023 Jul;148(1):6-18. doi: 10.1111/acps.13547. Epub 2023 Mar 25.
In offending populations, prevalence rates of mental disorders are much higher than in the general population. Nevertheless, it is unclear whether mental disorders can improve the prediction of recidivism beyond actuarial risk assessment tools.
The present prospective-longitudinal study was conducted between 2001 and 2021 and included 1066 men convicted of sexual offenses in Austria. All participants were evaluated with actuarial risk assessment tools for the prediction of sexual and violent recidivism and the Structured Clinical Interview for Axis I and Axis II disorders. Sexual and violent reconvictions were assessed.
Exhibitionism and an exclusive pedophilia showed the strongest correlations with sexual recidivism in the total sample. In the child related offense subsample additionally a narcissistic personality disorder was correlated with sexual recidivism. The strongest correlation with violent recidivism was found for an antisocial and borderline personality disorder. None of the mental disorders could improve the prediction of recidivism beyond actuarial risk assessment tools.
Common current actuarial risk assessment tools revealed good predictive accuracy in men convicted of sexual offenses. With few exceptions mental disorders were only weakly associated with recidivism, suggesting that there is no direct link between mental disorders and violent and sexual reoffending. Mental disorders should nevertheless be considered in treatment issues.
在犯罪人群中，精神障碍的患病率远高于普通人群。然而，精神障碍是否能提高累犯预测的准确性，超过了行为风险评估工具，目前还不清楚。
本前瞻性纵向研究于 2001 年至 2021 年进行，包括 1066 名在奥地利被判犯有性犯罪的男性。所有参与者均接受了行为风险评估工具的评估，以预测性和暴力累犯，以及轴 I 和轴 II 障碍的结构化临床访谈。评估了性和暴力再定罪。
在总样本中，露阴癖和单纯性恋童癖与性累犯的相关性最强。在与儿童有关的犯罪亚组中，自恋型人格障碍与性累犯也相关。与暴力累犯相关性最强的是反社会型和边缘型人格障碍。没有一种精神障碍能提高累犯预测的准确性，超过了行为风险评估工具。
目前常用的行为风险评估工具在被判犯有性犯罪的男性中显示出了良好的预测准确性。除了少数例外，精神障碍与累犯的相关性较弱，这表明精神障碍与暴力和性再犯罪之间没有直接联系。然而，精神障碍在治疗问题上仍应被考虑。
