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Schizophrenia is a devastating mental illness, and one of a larger class of psychotic disorders defined by the presence of delusions (false beliefs) and/or hallucinations (sensory perceptions without external sensory input). Schizophrenia may also be characterized by disorganized speech and behavior and by negative symptoms such as social, cognitive, and emotional withdrawal. Sensationalized accounts of dangerous, violent, and criminal behavior committed by schizophrenic persons have proliferated through the popular media; and the assumption of schizophrenia-associated crime and violence has contributed to public fear, stigma, social rejection, and even the denial of services and programmatic funding to schizophrenic individuals (Raine, 2006). In reality, most schizophrenic persons are not criminal or violent. Given this common misperception, a review of the empirical schizophrenia-crime/violence literature—along with proposed explanations for the relationship based in psychological, neurobiological, and social theory—appears timely.

Two converging lines of evidence continue to support a relationship between schizophrenia and crime: First, higher rates of psychosis and schizophrenia are found in criminal or delinquent populations; and second, schizophrenia patients are much more criminal and violent than the general population. In most cases, family or close network members are the victims of severe violent crimes, and most offending is found among young males in early illness stages. Examination of the schizophrenia-crime link began over a century ago with early psychoanalytic proposals and published case histories. This inquiry has progressed through research in different areas, including studies of violence within psychiatric hospital settings, of criminal behavioral histories of mentally ill individuals, and of national registry case linkages.

Schizophrenia and Specific Crime Types

Violent Crimes

Violent schizophrenic crime research has examined a broad range of violence indicators, from assaults in psychiatric hospitals to criminal record violent convictions. Much of what is currently known about schizophrenic violence is based upon studies of newly admitted schizophrenia inpatients, who often experience emotional turmoil along with intense psychotic symptoms (Krakowski, 2005). Forensic inpatient samples indicate that, violent psychotic offenders are often first-time offenders who committed severe physical assaults against intimates. Non-hospitalized schizophrenic persons may engage in the spectrum of violent behaviors observed in the general population, from minor assaults to brutal murders. And limited evidence suggests some schizophrenic and mentally ill murderers may be characterized by specific motivational, behavioral, and emotional characteristics (Häkkänen & Laajasalo, 2006; Nijman et al., 2003).

Property and Drug Crimes

To date, nonviolent or property offending among schizophrenic persons has not been systematically studied, though incidental data indicate that schizophrenic offenders may commit vagrancy crimes and minor thefts for motives other than material gain. Substance use rates among schizophrenic persons are high, possibly representing efforts to use legal and illegal substances to ameliorate psychotic symptoms. Individuals with schizophrenia are more likely than others to abuse substances and be criminal and violent (Douglas & Skeem, 2005).

Sexual Crimes

Sexual crimes appear comparatively rare among schizophrenic persons. Individuals with schizophrenia and other psychotic disorders comprise only small percentages (i.e., 2 to 5 percent) of sexual offender populations (Alish et al., 2007), and they demonstrate reduced proportional rates of sexual offense convictions in comparison to non-mentally ill individuals in case linkage studies. Rare descriptive reports suggest a complex relationship between schizophrenia and sexual offending.

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