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Abstract

Objective

The authors examined the rate of mental disorders in an unselected sample of homicide defendants in a U.S. jurisdiction, seeking to identify psychiatric factors associated with offense characteristics and court outcomes.

Method

Defendants charged with homicide in a U.S. urban county between 2001 and 2005 received a psychiatric evaluation after arrest. Demographic, historical, and psychiatric variables as well as offense characteristics and legal outcomes were described. Bivariate analyses examined differences by age group and by race, and logistic models examined predictors of multiple victims, firearm use, guilty plea, and guilty verdict.

Results

Fifty-eight percent of the sample had at least one axis I or II diagnosis, most often a substance use disorder (47%). Axis I or II diagnoses were more common (78%) among defendants over age 40. Although 37% of the sample had prior psychiatric treatment, only 8% of the defendants with diagnosed axis I disorders had outpatient treatment during the 3 months preceding the homicide; African Americans were less likely than non-African Americans to be in treatment. African American males were more likely to use a firearm and to have a male victim. In exploratory analyses, psychiatric factors did not predict multiple victims, firearm use in the crime, or a guilty verdict.

Conclusions

Rates of axis I disorders were lower than reported in previous studies. Few homicide defendants were in psychiatric treatment at the time of the crime, suggesting limited opportunities for prevention by mental health providers.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 994 - 1002
PubMed: 23896859

History

Received: 29 June 2012
Revision received: 18 March 2013
Accepted: 26 April 2013
Published online: 1 September 2013
Published in print: September 2013

Authors

Details

Christine A. Martone, M.D.
From the Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh; the Behavioral Assessment Unit, Allegheny Court of Common Pleas, Pittsburgh; VISN4 Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh; Hennepin County Medical Center, Minneapolis; and Georgetown University Hospital and Saint Elizabeths Hospital, Washington, D.C.
Edward P. Mulvey, Ph.D.
From the Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh; the Behavioral Assessment Unit, Allegheny Court of Common Pleas, Pittsburgh; VISN4 Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh; Hennepin County Medical Center, Minneapolis; and Georgetown University Hospital and Saint Elizabeths Hospital, Washington, D.C.
Suzanne Yang, M.D.
From the Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh; the Behavioral Assessment Unit, Allegheny Court of Common Pleas, Pittsburgh; VISN4 Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh; Hennepin County Medical Center, Minneapolis; and Georgetown University Hospital and Saint Elizabeths Hospital, Washington, D.C.
Andrei Nemoianu, M.D.
From the Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh; the Behavioral Assessment Unit, Allegheny Court of Common Pleas, Pittsburgh; VISN4 Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh; Hennepin County Medical Center, Minneapolis; and Georgetown University Hospital and Saint Elizabeths Hospital, Washington, D.C.
Ryan Shugarman, M.D.
From the Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh; the Behavioral Assessment Unit, Allegheny Court of Common Pleas, Pittsburgh; VISN4 Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh; Hennepin County Medical Center, Minneapolis; and Georgetown University Hospital and Saint Elizabeths Hospital, Washington, D.C.
Layla Soliman, M.D.
From the Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh; the Behavioral Assessment Unit, Allegheny Court of Common Pleas, Pittsburgh; VISN4 Mental Illness Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh; Hennepin County Medical Center, Minneapolis; and Georgetown University Hospital and Saint Elizabeths Hospital, Washington, D.C.

Notes

Presented in part at the annual meetings of the American Academy of Law and Psychiatry in Baltimore, Oct. 26–28, 2009, and in Boston, Oct. 27–30, 2011; and at the Third World Congress of the World Association of Cultural Psychiatry in London, March 9–11, 2012.
Address correspondence to Dr. Mulvey ([email protected]).

Funding Information

The authors report no financial relationships with commercial interests.Dr. Yang was supported by NIMH grant T32 MH16804 and by the U.S. Department of Veterans Affairs, Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment.

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