The criminal and personality profile of patients with schizophrenia and comorbid psychopathic traits

Sixty-one male forensic patients who met the DSM-IV criteria for schizophrenia were categorised into high and low psychopathic trait groups using the Psychopathy Checklist: Screening Version. The groups were compared on their criminal history, symptom profile, personality style, risk scores and subsequent institutional violence. Patients with high scores on the PCL:SV had a greater number of previous convictions and were more likely to have a family history of criminality. The high psychopathy-scoring group had higher levels of Positive and Negative Syndrome Scale grandiose and hostile symptomatology, and higher scores on trait impulsivity and aggression. They also had a more coercive, less compliant interpersonal style than the low-psychopathy scoring group. The high-psychopathy scoring group were more likely to be involved in institutional aggression and had higher levels of risk for violence. Patients with schizophrenia and high levels of comorbid psychopathy have a distinctive interpersonal style that may contribute to their greater risk of disruptive institutional behaviour.