Predictors of criminal offending in a clinical sample of patients diagnosed with schizophrenia: A 6-year follow-up study.

Sune Bo, Ahmad Abu-Akel, Mickey Kongerslev, Erik Simonsen

Research output: Contribution to journalArticlepeer-review


Criminal behavior in schizophrenia has been associated with a number of risk factors including symptoms of schizophrenia, co-occurring personality disorders (PDs), substance abuse, intellectual and cognitive dysfunctions, history of violence, and a number of sociodemographic variables. However, the relative importance and predictive power of these factors when considered simultaneously is understudied. In this 6-year follow-up study, we examined the association of these factors with criminal offending in a sample of 108 patients diagnosed with schizophrenia (80.6% men). The proportion of offenders during the follow-up period was 53.7%. A cox proportional hazards model showed that Facet 3 and Facet 4 of the Hare Psychopathy Checklist–Revised, passive–aggressive PD, narcissistic PD, and Global Assessment Functioning were the only significant predictors of offending when all putative risk factors were considered simultaneously. Results also revealed high predictive accuracy of the total score of the Hare Psychopathy Checklist–Revised for offending. Of all potential predictors considered, personality pathology and specifically the antisocial facet of psychopathy emerged as the main predictor of criminal behavior in patients with schizophrenia. These results underscore the importance of including an assessment of personality pathology, including psychopathy, in the evaluation of risk for violence and crime in schizophrenia.

Original languageEnglish
Pages (from-to)216-227
Number of pages12
JournalPersonality Disorders: Theory, Research, and Treatment
Issue number3
StatePublished - 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 American Psychological Association


  • personality disorder
  • predictive validity
  • psychopathy
  • psychosis
  • violence
  • Antisocial Personality Disorder/epidemiology
  • Follow-Up Studies
  • Humans
  • Criminals
  • Male
  • Schizophrenia/epidemiology
  • Crime
  • Female

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


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