Psychiatric features of 36 men convicted of sexual offenses

Background: To increase understanding of the relationship between sexual vi olence and mental illness, the authors assessed the legal histories and psy chiatric features of 36 males convicted of sexual offenses. Method: Thirty-six consecutive male sex offenders admitted from prison, jai l, or probation to a residential treatment facility received structured cli nical interviews for DSM-IV Axis I and TI disorders. The participants' lega l histories, histories of sexual and physical abuse, and family histories o f psychiatric disorders were also assessed. Results: The participants' mean rt SD age was 33 +/- 8 years. They had been convicted a mean of 1.8 +/- 1.4 times (range, 1-9 times) for sexual offens es and incarcerated a mean of 8 +/- 6 years (range, 0-22 years). Participan ts displayed high rates of Lifetime DSM-IV Axis I disorders: 30 (83%) had a substance use disorder; 21 (58%), a paraphilia; 22 (61%), a mood disorder( 13 [36%] with a bipolar disorder); 14 (39%), an impulse control disorder; 1 3 (36%), an anxiety disorder; and 6 (17%), an eating disorder. Participants also displayed high rates of Axis II disorders, with 26 (72%) meeting DSM- IV criteria for antisocial personality disorder. In addition, subjects repo rted experiencing high rates of sexual (but not physical) abuse and high ra tes of Axis I disorders, especially substance use and mood disorders, in th eir first-degree relatives. Compared with subjects without paraphilias, sub jects with paraphilias displayed statistically significantly higher rates o f mood, anxiety, and eating disorders, as well as significantly higher rate s of childhood sexual abuse. Conclusion: Recognition and treatment of major psychiatric disorders among sex offenders may increase chances for successful rehabilitation, reduce re cidivism and public victimization, and produce significant public health an d economic benefits. More studies in this area appear warranted to search f or more effective interventions for this severe public health problem.