Epilepsy in the context of forensic psychiatry: The relationship between epilepsy, violence and criminal responsibility

Purpose

This study aimed to describe the sociodemographic, clinical, and criminal characteristics of forensic psychiatry patients with epilepsy and to examine the relationship between epilepsy and seizures, criminal responsibility, and violence.

Materials and Methods

The study included 1235 patients who had completed inpatient treatment in a high-security forensic psychiatry unit. Within the total sample, 48 individuals diagnosed with epilepsy were assessed in terms of sociodemographic, clinical, and criminal variables, and their characteristics were compared to those of the overall sample.

Results

The prevalence of epilepsy was 3.79% (n=48). No significant difference was found between the groups of forensic psychiatry patients with a diagnosis of epilepsy and forensic psychiatry patients without a diagnosis of epilepsy in terms of self-destructive behaviour, suicide attempt, history of imprisonment, non-documented offense, and index offense severity (respectively p=0.598, p=0.840, p=0.907, p=0.479, p=0.343). The epilepsy group had a higher rate of non-violent offences, and no patients had committed severe violent offences. There were two patients (4.1%) in whom the index offence was associated with epilepsy and seizures.

Conclusion

The prevalence of epilepsy in the forensic psychiatry patient group was higher than in the general population. The predominance of non-violent offenses among the epilepsy group, the absence of any serious violent offense in this group, and the minority in other violence-related indicators provides important evidence against stigmatisation based on exaggerated associations between epilepsy and violence. The high comorbidity rates of epilepsy and intellectual disability underscore the need for developing special treatment programmes and approaches.