The relationship between mental illnesses and crime is a situation that needs to be seriously investigated and preventive initiatives due to the social, economic, and medical problems it causes. It is claimed that with the increase of violent behavior in society, violent behavior increases in psychiatric cases. The risk of violent behavior is not at the same rate in all psychiatric disorders.
Crime, causing legal damage; undermining personal or community safety; It is a behavior that has consequences that can disrupt public order and hinder the development of societies and should be punished (Uygur, Işıklı, Ögel, & Çeliker, 1991). The crime phenomenon should be approached at an individual level as well as a legal event.
The relationship between crime and mental disorders has attracted the attention of researchers and scientists working in this field, and many studies have been conducted on this subject. Based on the idea that people with serious mental illnesses may have violent behavior, it was found that physical violent behavior is also associated with psychiatric disorders.
Violent behavior; In some psychiatric disorders such as substance use disorders, cognitive disorders, schizophrenia, other psychotic disorders, and mood disorders, it is only seen as a part of the manifestation of disorder (Erb, 2001; Öncü et al., 2002; Swanson., 2006). The type, frequency, and nature of violence vary according to the environmental characteristics of the specific event and the characteristics of the disorder (Mulvey, 1994; Öncü, Sercan, Ger, Bilici, & Ural, 2007). Therefore, it can be said that the relationship between violence and criminal behavior is not generalizable.
Considering psychiatric disorders in criminals, it is noteworthy that mental health disorders such as explosive disorder, personality disorder, delusional disorder, and mental retardation are more closely related to violent behavior (Aras, 2014, Belli, Ural, Vardar, & Tezcan, 2011; Bolu et al., 2014; Kılıç & Balcıoğlu, 2012; Maner et al., 1991; Ural, Belli, Öncü, & Sosyal, 2012a).
Five patterns among mentally disordered offenders are distinguished by the relationship between mental disorder, on the one hand, and criminality, on the other.
Pattern 1 offenders are those for whom crime is a response to psychotic symptoms, most often delusions or hallucinations.
Pattern 2 offenders commit crimes motivated by compulsive desires, such as sex offenses by paraphilias and offenses regarded as evidence of disorders of impulse control. Pattern 3 offenders are those with personality disorder for whom the crime is merely one example of a maladaptive pattern of voluntary and knowing behavior.
Pattern 4 offenders have coincidental mental illness that is unrelated to the crime. Pattern 5 offenders are those who become mentally disordered or feign mental disorder as a result of their crimes, such as those who dissociate upon seeing what they have done, those who become depressed in prison, those who become psychotic on death row, and those who malinger mental illness. (Psychiatry Clin North Am.,1992, Sep15).
Investigating the criminal psychopathology relationship is important in terms of determining the risk groups, prevalence, and characteristics, taking measures, and developing preventive mental health policies, while it is also useful in preventing murder in high-risk groups (Tiihonen, Hakola, Eronen, Vartiainen, & Ryynänen, 1996). In addition, examining the crime-psychopathology relationship is also valuable in determining the criminal profile (Cantürk & Cantürk, 2004).
The relationship of crime in schizophrenia and psychotic disorders has been discussed in many studies. It has been reported that patients diagnosed with schizophrenia have a higher risk of violence compared to the general population (Andersen, 2004; Fazel, Gulati, Linsell, Geddes, & Grann, 2009; Ural, Öncü, Belli, & Soysal.2012b; Walsh, Buchanan, & Fahy, 2002 ). Characteristics that distinguish murderers diagnosed with schizophrenia from those diagnosed with other schizophrenia are as follows: male gender, presence of paranoid subtype, low socioeconomic level, early onset of schizophrenia, history of past violence, presence of active delusions during murder, hallucinations, confusion, impulsivity, alcohol-substance abuse/addiction, antisocial personality disorder, aggressive behavior while hospitalized, previous forensic aggression, non-compliance with medical treatment, previous history of both forensic and psychiatric treatment.
Although the risk of homicidal behavior in individuals diagnosed with schizophrenia is higher than in the general population, little is known about the circumstances that trigger violent acts of these criminals. Determining which characteristics distinguish the murderers diagnosed with schizophrenia from those diagnosed with other schizophrenia is important in terms of preventing acts of violence.
It is prominent in publications that the most common comorbidity accompanying the diagnosis of schizophrenia is alcohol and substance use disorder and this is related to violent behavior and murder (Wootton et al., 2008). It is stated that men with comorbid schizophrenia and substance use tend to commit crimes seventeen times more than those without comorbidity (Mullen, Burgess, Wallece, Palmer, & Ruschena, 2000). In a study, it was stated that the crime rate reflected in the courthouse was 32.7% and 10% of them used alcohol-substance during the crime (Ural et al., 2012). The presence of substance use predicts criminal behavior with a higher probability and poses a risk factor in terms of repetitive crime.
When the relationship between personality disorders and crime is examined, Antisocial Personality Disorder (APD) has attracted the attention of researchers. This disorder poses an increased risk for crime and violence in general (Hare & Neumann, 2009; Öncü et al., 2002). It is stated in studies that personality disorders play a role in the violent behavior that causes their current arrest (Brinded et al., 2001; Butler et al., 2006). APD (71%) is the highest in prisoners, followed by other personality disorders.
Self-mutilating behavior is common in antisocial personality disorder. It is stated that among those who have committed rape crimes, they have more AKB and criminal behavior in their past (Algül et al., 2007; Kılıç & Balcıoğlu, 2012). It has been reported that the diagnosis of APD is common in cereals, and their crime scene behavior is different from other criminals. APD is the most common diagnosis in the psychiatric evaluation of criminals. Therefore, in such a diagnosis evaluation, the clinical interviews made by the mental health specialist of the criminal and his development history must be included (Kılıç & Balcıoğlu, 2012).
Studies show that bipolar disorders also pose a risk factor for violence. Psychomotor acceleration and thought disorder lead to violent behaviors in mood disorders. In mood disorders, killing others is seen especially during the onset of the disease or during the short-term depression periods. Bipolar disorder (moderate to severe mania), major depressive episode is higher in prisoners compared to the general population (Brinded et al., 2015; Saatçioğlu et al., 1996). Bipolar patients carry an increased risk of violent behavior. Since socio-demographic and socioeconomic factors may have an effect on committing crime, it is necessary to provide social security and psychiatric services in cases with bipolar disorder. The accessibility, violent behavior, and the risk of committing crime (Camcıoğlu et al., 2014).
As a result, it is an undeniable fact that there is a relationship between mental health and crime. Knowing and understanding this relationship includes studies that may go well both for the benefit of society and for mental health disordered people. So does this mean that every person suffering from mental health disorder will commit a crime? Of course not. It is a huge mistake to label every individual with a mental health disorder as an offender. For example, every individual suffering from schizophrenia does not experience the disease in the same way and to the same level. While a person diagnosed with schizophrenia can murder because of his delusions, another individual diagnosed with schizophrenia can ignore these delusions and continue his life normally. It is not the right approach to isolate individuals from society by labeling and classifying them in this way. On the contrary, while the mental disorder of a person is not the reason for committing a crime, perhaps because of this labeling, the person may commit a crime. We must distinguish between these two situations, and we must not see and stigmatize anyone who has mental health disordered as potential criminals.
Yazan ve derleyen: Psk. Kübra Otu
REFERENCES
Algül, A., Semiz, Ü.B., Ateş, M.A., Başoğlu, C., Doruk, A., Ebrinç, S., Pan, E., & Çetin, M. (2007).
Relationship between substance use and aggression in individuals with antisocial personality disorder. Düşünen Adam, 20, 141-150.
Andersen, H.S. (2004). Mental health in prison populations. A review - with special emphasis on a study of Danish prisoners on remand. Acta Psychiatrica Scandinavica, 110 (s424), 5-59.
Aras, H.İ. (2014). Violence in schizophrenia. Current Approaches in Psychiatry, 6, 45-55 DOI: 10.5455 / cap.20130522110439.
Brinded, P, Simpson, A.I.F., Laidlaw, T.M., Fairley, N., & Malcolm, F. (2001). Prevalence of psychiatric disorders in New Zealand prisons: a national study. Australian and New Zealand Journal of Psychiatry, 35, 166–173. DOI: 10.1046 / j.1440-1614.2001.00885.x
Camcıoğlu, T.H., Öncü, F., Şüküroğlu, S., Ger, M.C., & Uygur, N. (2014). The effect of socio-demographic and socioeconomic factors in the criminal commitment of men with bipolar disorder. Turkish Journal of Psychiatry, 25, 163-170. doi: 10.5080 / u7658.
Cantürk, G. & Cantürk, N. (2004). Criminal profile. Journal of Forensic Medicine, 18, 27-37.
Demirbaş, H. (2020). Crime and Psychopathology. Forensic Psychology, 153-172.
Erb, J.L. (2001). Assessment and management of the violent patient, Jacobson, J.L., & Jacobson, A.M. (edts): Psychiatric Secrets; second edition, Hanley & Belfus Inc, Philadelphia, pp. 440-447.
Hare, R.D., & Neumann, C.S. (2009). Psychopathy: assessment and forensic implications. Canadian Journal of Psychiatry, 54,791-802.
Kılıç, Ö., & Balcıoğlu, İ. (2012). Serial murder and sexual sadism. Journal of Forensic Medicine, 27,54-62. DOI: 10.5505 / adli tıp.2012.96720.
Mullen, P.E., Burgess, P., Wallace, C., Palmer, S., & Ruschena, D. (2000). Communitycare and criminal offending in schizophrenia. The Lancet, 355, 614-617.
Mulvey EP (1994) Assessing the evidence of a link between mental illness and violence. Hospital of Community Psychiatry, 45, 663-668.
Tiihonen, J., Hakola, P., Eronen, M., Vartiainen, H., & Ryynänen, O.P. (1996). Risk of homicidal behavior among discharged forensic psychiatric patients. Forensic Science International, 31, 123-9.
Ural, C., Öncü, F., Belli, H., & Soysal, H. (2012). Violent behavior variables of patients with schizophrenia in forensic psychiatric process: a case-control study. Turkish Psychiatry Journal, 23, 26-32.
Uygur, N., Işıklı, M., Ögel, K., & Çeliker, A.R. (1991). Possible factors that may affect crime commitment in schizophrenics. Dusunen Adam Journal of Psychiatry and Neurological Sciences, 4, 10-14.
Wootton, L., Buchanan, A., Leese, M., Tyrer, P., Burns, T., Creed, F., Fahy, T., & Walsh, E. (2008). Violence in psychosis: Estimating the predictive validity of readily accessible clinical information in a community sample. Schizophrenia Research, 101, 176-184. DOI: 10.1016 / j.schres.2007.12.490.
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