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In-patient management of men with schizophrenia who commit serious sexual offences

Department of Forensic Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF

Aims and method A survey of the management of all 84 restricted hospital order in-patients with schizophrenia, resident in any hospital in England and Wales, during May 1997, with an index conviction for a contact sex offence against a woman, was carried out.

Results Treatment concentrated upon pharmacological therapy for psychiatric symptoms. Only a small minority of patients received specific psychological therapy to address sexual offending issues, despite responsible medical officers reporting that over four-fifths of patients continued to have marked social or sexual difficulties relating to women, and that nonpsychotic factors appeared to make a significant contribution to index sexual offending in about three-quarters of cases.

Clinical implications Many in-patients with schizophrenia who have committed sexual offences may not be receiving optimal management and more research is required to elucidate their treatment needs.