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Schizophrenia and Criminal Responsibility: A Systematic Review

Tsimploulis, Georgios, MD*; Niveau, Gérard, MD, PhD; Eytan, Ariel, MD, PhD*; Giannakopoulos, Panteleimon, MD, PhD*; Sentissi, Othman, MD, PhD*

The Journal of Nervous and Mental Disease: May 2018 - Volume 206 - Issue 5 - p 370–377
doi: 10.1097/NMD.0000000000000805
Review Article

The significant progress of psychiatry in the 20th century provided a sophisticated theoretical framework to analyze the complex relationships between crime and mental illness. Schizophrenia has been traditionally associated with severe cognitive and affective deficits that heavily influence empathy, judgment capacities, but also control of impulsiveness. Although there is an association between psychotic disorders and absence or decrease of legal responsibility, their relationship is also determined by sociodemographic, developmental, and clinical factors. These disorders are associated not only with abolished criminal responsibility but also with diminished responsibility. We conduct a systematic literature review to examine the relation between schizophrenia and criminal responsibility. We have found that this clinical entity is often associated with diminished or abolished criminal liability. We discuss these findings, focusing on the specific deficits found in patients with schizophrenia and examining how this problem affects their behavior and eventually their accountability for their crimes.

*Mental Health and Psychiatry Department, and †Forensic Medicine Department, University Hospital of Geneva, Geneva, Switzerland.

Send reprint requests to Othman Sentissi, MD, PhD, Mental Health and Psychiatry Department, University Hospital of Geneva, Rue des Bains 35, 1205 Geneva, Switzerland. E-mail:

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