عنوان انگلیسی مقاله:
The role of substance use disorder in the commission of criminal offenses by subjects suffering from schizophrenia
ترجمه فارسی عنوان مقاله:
نقش اختلال در مصرف مواد در ارتکاب جرایم جنایی توسط افراد مبتلا به اسکیزوفرنی
Sciencedirect - Elsevier - LEvolution psychiatrique, 85 (2020) 217-228. doi:10.1016/j.evopsy.2020.02.002
Caroline Bègue (Interne en Psychiatrie), Martin Bouthier (Psychiatre, Assistant des Hôpitaux), Vincent Mahé (Psychiatre des Hôpitaux, Expert auprès de la Cour d’Appel de Paris)
Introduction. – Although the association between schizophreniaand violence has been established, the mediating role of associa-ted substance use disorder is still debated. Addictive comorbidities,identified in almost half of people with schizophrenia, are conside-red to be a main explanation for delinquency in this population,regardless of the mental disorder. However, some authors describethe existence of sub-groups of subjects with schizophrenia whomay be violent and for whom substance-related disorders wouldnot always be necessary for the emergence of violent behaviors.Objective. – The purpose of this study was to assess the fre-quency of substance use disorders in subjects with schizophreniawho had committed criminal offenses and to compare the socio-demographic, historical, clinical, and criminal characteristics ofthese subjects with and without an associated substance use disor-der.Method. – We conducted a descriptive study based on forensicreports realized between 2001 and 2018 from a single expert in criminal cases. All reports involving patients suffering from schizo-phrenia were retrospectively included in our study.Results. – Our sample consisted of 104 subjects suffering from schi-zophrenia and having committed criminal offenses. A psychoactivesubstance use disorder (USPA) was found in 52 subjects (50%).There were no significant differences between the two groups inthe pattern of infractions committed. However, there were clinicalspecificities in each group. Thus, offenders with schizophrenia whowere non-users of psychoactive substances (NUSPA) had signifi-cantly more criminal history of violence against others (73.9% vs.42.3%; p = 0.026) and more acute psychotic symptoms at the time ofthe offense (67.3% vs. 30.8%, p < 0.001). The expert more often retai-ned an abolition of discernment in the NUSPA group (68.6 VS 32.7;p < 0.01) and a diminished discernment in schizophrenic subjectsusing psychoactive substances (USPA) (31.4% VS 67.3%; p < 0.01).Conclusions. – Half of the schizophrenic offenders did not have acomorbid substance use disorder. The increased risk of delinquencyin subjects with schizophrenia cannot only be attributed to theeffects of associated substance use. There is delinquency associatedwith schizophrenic illness, apart from substance use, that has somespecific characteristics that warrant the pursuit of further studies.
Keywords:Addiction | Comorbidity | Crime | Violence| Schizophrenia | Forensic psychiatry | Retrospective study