[Psychopathy in forensic psychiatry]

Abstract

The review refers to the construct of psychopathy which is of increasing relevance for forensic psychiatry and psychology, especially empiric studies on legal prognosis and predictors of therapeutic efficacy. Psychopathy is related to early-onset delinquency, number and severeness of violent crimes, number of sexual victims in rapists, and unfavorable legal prognosis. Recent research has also indicated that the treatment of psychopaths is complicated by low levels of motivation and high rates of attrition. In psychiatric-diagnostic terms, psychopathy is related to substance abuse and dependency and to cluster A and B personality disorders (PD), especially to antisocial and borderline PD. In juvenile with "psychopathic tendencies", a relationship to impulsivity, emotional and behavioral difficulties, and learning behavior (card sorting test) had been shown and interpreted by reference to an anatomical level. In connection with these findings, the relevance of psychopathic disorder for testimonies on legal responsibility should also be discussed again. Further research on psychopathy, especially psychiatric morbidity and psychosocial functioning in non-forensic groups, is needed.