The clinical profile of high-risk mentally disordered offenders

Purpose High-risk mentally disordered offenders present a diverse array of clinical characteristics. To contain and effectively treat this heterogeneous population requires a full understanding of the group’s clinical profile. This study aimed to identify and validate clusters of clinically coherent profiles within one high-risk mentally disordered population in the UK. Methods Latent class analysis (a statistical technique to identify clustering of variance from a set of categorical variables) was applied to 174 cases using clinical diagnostic information to identify the most parsimonious model of best fit. Validity analyses were performed. Results Three identified classes were a ‘delinquent’ group ( n = 119) characterised by poor educational history, strong criminal careers and high recidivism risk; a ‘primary psychopathy’ group ( n = 38) characterised by good educational profiles and homicide offences and an ‘expressive psychopathy’ group ( n = 17) presenting the lowest risk and characterised by more special educational needs and sexual offences. Conclusions Individuals classed as high-risk mentally disordered offenders can be loosely segregated into three discrete subtypes: ‘delinquent’, ‘psychopathic’ or ‘expressive psychopathic’, respectively. These groups represent different levels of risk to society and reflect differing treatment needs.