Gender Differences in Diagnoses of Mentally Disordered Offenders

Abstract

We investigated differences in psychiatric diagnoses and medicolegal insanity decisions between female and male forensic psychiatric patients. Data on all offenders (N = 4396) subjected to a court-ordered forensic psychiatric inpatient evaluation were obtained for the years 1992–2000. A significantly higher proportion of female mentally disordered offenders were given a diagnosis of personality disorder while mentally disordered male offenders more often had a diagnosis of alcohol and/or drug dependence or sexual disorders. There was an increased likelihood that violent women would be declared legally insane even after controlling for a number of potential confounders. This may reflect an underlying difference in the severity of psychiatric morbidity not accounted for diagnostically or that a gender bias exists in the forensic psychiatric evaluation process.