REPETITIVE AND NONREPETITIVE VIOLENT OFFENDING BEHAVIOR IN MALE-PATIENTS IN A MAXIMUM SECURITY MENTAL-HOSPITAL - CLINICAL AND NEUROIMAGING FINDINGS

Objective: To examine if different violent offending behaviours are as sociated with different clinical and neuroimaging profiles. Method: Th irty-nine schizophrenic and schizoaffective offenders from a maximum s ecurity mental hospital - 20 repetitive violent offenders (RVOs) and 1 9 non-repetitive violent offenders (NRVOs) - were selected for clinica l and neuroimaging assessments. Results: Both groups had positive fami ly history of mental illness and violence. Age, diagnosis, duration of illness, victim profiles and use of weapons at the time of the index offence were similar. RVOs had a higher prevalence of early parental s eparation, juvenile conduct problem, previous convictions of crimes no t involving violence, impulsive suicide attempts, delusion of their li ves being threatened at the time of the index offence and electroencep halographic (EEG) abnormalities localized to temporal lobes. NRVOs had a higher prevalence of sexual inexperience and command hallucinations to kill at the time of the index offence. Asymmetric gyral patterns a t the temporo-parietal region were particularly common in RVOs and abs ent in NRVOs. Non-specific white matter changes in magnetic resonance imaging (MRI) and generalized cortical hypometabolism in positron emis sion tomography (PET) were present in both groups. Conclusions: Differ ent structural and metabolic changes in the brain were associated with different violent offending behaviours. The complex interaction betwe en violent behaviour, clinical features and neuroimaging findings in s chizophrenia requires further studies.